Search Results (3,531)

Early detection of clinical deterioration in emergency department (ED) patients is critical for timely interventions. This study evaluated the predictive performance of the National Early Warning Score (NEWS) parameters using machine learning. We conducted a single-center retrospective observational study including 27,238 adult ED patients admitted to Merano Hospital (Italy) between June 2022 and June 2023. NEWS vital signs were collected at triage, and mortality at 48 h, 7 days, and 30 days was obtained from ED database. Decision tree analysis (CHAID algorithm) was used to identify predictors of mortality; 10-fold cross-validation was applied to avoid overfitting. Mortality was 0.4% at 48 h, 1% at 7 days, and 2.45% at 30 days. For 48-h mortality, oxygen supplementation (FiO₂ >21%) and AVPU = “U” were the strongest predictors, with a maximum risk of 31.6%. For 7-day mortality, SpO₂ was the key predictor, with mortality up to 48.1%. At 30 days, patients with AVPU ≠ A, FiO₂ > 21%, and SpO₂ ≤ 94% had a mortality risk of 66.7%. Decision trees revealed different cut-offs compared to the standard NEWS. This study demonstrated that for ED patients, the NEWS may require some adjustments in both the cut-offs for vital parameters and the methods of collecting these parameters. Full article

Objectives: The aim of this study was to analyse no-show patterns in healthcare appointments, identify associated factors, and explore key determinants influencing non-attendance. Study Design: This was a retrospective observational study. Methods: We analysed 120,405 healthcare appointments from 2022–2023 in Turin, Northern Italy. Data included demographics, appointment characteristics, and attendance records. Logistic regression identified significant predictors of no-shows, adjusting for confounders. Results: A 5.1% (n = 6198) no-show percentage was observed. Younger patients (<18 years) and adults (18–65 years) had significantly higher odds of missing appointments than elderly patients (>65 years) (OR = 2.32, 95% CI: 2.17–2.47; OR = 2.46, 95% CI: 2.20–2.74; p < 0.001). First-time visits had a higher no-show risk compared to follow-up visits and diagnostics (OR = 1.11, 95% CI: 1.04–1.18; p < 0.001). Each additional day of waiting increased the likelihood of no-show by 1% (OR = 1.01, 95% CI: 1.01–1.01; p < 0.001). Conclusions: No-show percentages are influenced by demographic and service-related factors. Strategies targeting younger patients, longer waiting times, and non-urgent appointments could reduce no-show percentages. Full article

On-farm emergency slaughter (OFES) is employed when cattle are unfit for transport but still suitable for human consumption, thereby ensuring animal welfare and reducing food waste. This study analysed OFES patterns in Northern Italy, where a large cattle population is housed but information on the practice is rarely analysed. A total of 12,052 OFES cases from 2021 to 2023 were analysed. Most involved female cattle (94%) from dairy farms (79%). Locomotor disorders were the leading reason (70%), particularly trauma and fractures, followed by recumbency (13%) and calving-related issues (10%). Post-mortem findings showed limbs and joints as the most frequent condemnation sites (36%), often linked to trauma. A significant reduction in OFES cases occurred over time, mainly due to fewer recumbency and calving issues, likely reflecting stricter eligibility criteria introduced in 2022. Weekly variations, with peaks on Mondays and lows on Saturdays, suggest that logistical constraints may sometimes influence OFES promptness. These findings suggest that on-farm management and animal handling could be improved further to reduce welfare risks and carcass waste. Due to the lack of standardised data collection and regulatory harmonisation, a multi-country investigation could improve our understanding of this topic and inform best practice. Full article

This study investigates ground deformations in the southeastern Po Plain (northern Italy), focusing on the Bologna area—a densely populated region affected by natural and anthropogenic subsidence. Ground deformations in the area result from geological processes (e.g., sediment compaction and tectonic activity) and human activities (e.g., ground water production and underground gas storage—UGS). We apply a multidisciplinary approach integrating subsurface geology, ground water production, advanced differential interferometry synthetic aperture radar—DInSAR, gas storage data, and land use information to characterize and analyze the spatial and temporal variations in vertical ground deformations. Seasonal and trend decomposition using loess (STL) and cluster analysis techniques are applied to historical DInSAR vertical time series, targeting three representatives areas close to the city of Bologna. The main contribution of the study is the attempt to correlate the lateral extension of ground water bodies with seasonal ground deformations and water production data; the results are validated via knowledge of the geological characteristics of the uppermost part of the Po Plain area. Distinct seasonal patterns are identified and correlated with ground water production withdrawal and UGS operations. The results highlight the influence of superficial aquifer characteristics—particularly the geometry, lateral extent, and hydraulic properties of sedimentary bodies—on the ground movements behavior. This case study outlines an effective multidisciplinary approach for subsidence characterization providing critical insights for risk assessment and mitigation strategies, relevant for the future development of CO₂ and hydrogen storage in depleted reservoirs and saline aquifers. Full article

For effective groundwater resource management, it is essential to model the dynamic behaviour of aquifers in response to rainfall. Here, a methodological approach using a recurrent neural network, specifically a Long Short-Term Memory (LSTM) network, is used to model groundwater levels of the shallow porous aquifer in Southern Italy. This aquifer is recharged by local rainfall, which exhibits minimal variation across the catchment in terms of volume and temporal distribution. To gain a deeper understanding of the complex interactions between precipitation and groundwater levels within the aquifer, we used water level data from six wells. Although these wells were not directly correlated in terms of individual measurements, they were geographically located within the same shallow aquifer and exhibited a similar hydrogeological response. The trained model uses two variables, rainfall and groundwater levels, which are usually easily available. This approach allowed the model, during the training phase, to capture the general relationships and common dynamics present across the different time series of wells. This methodology was employed despite the geographical distinctions between the wells within the aquifer and the variable duration of their observed time series (ranging from 27 to 45 years). The results obtained were significant: the global model, trained with the simultaneous integration of data from all six wells, not only led to superior performance metrics but also highlighted its remarkable generalization capability in representing the hydrogeological system. Full article

Background: Art therapy is increasingly recognized as a valuable complementary intervention for individuals with eating disorders (EDs), who frequently experience comorbid anxiety and difficulties with emotional regulation. However, few studies have examined its short-term effects on state and trait anxiety within structured clinical settings. Methods: This pilot study involved 19 adolescent females (mean age 17.7 ± 2.1 years) diagnosed with anorexia nervosa (AN) or bulimia nervosa (BN) and admitted to the Mariconda Regional Residence for Eating Disorders (ASL Salerno, Italy) in residential or semi-residential treatment. Participants completed a structured six-week cycle of weekly textile-based art therapy sessions, designed to promote emotional expression and body reconnection. State and trait anxiety levels were assessed pre- and post-session using the State-Trait Anxiety Inventory (STAI). Repeated-measures ANOVA was used to analyze state anxiety changes; a linear mixed-effects model was applied to trait anxiety. Results: State anxiety significantly decreased immediately after sessions (p = 0.002). A significant main effect of session (p = 0.01) and a time × session interaction (p = 0.025) indicated variability across sessions. Trait anxiety showed a non-significant trend toward reduction (p = 0.11); however, reductions were significant at sessions 4 (p = 0.015), 5 (p < 0.001), and 6 (p = 0.005). Conclusions: Art therapy may offer immediate reductions in state anxiety and may contribute to a longer-term reduction in trait anxiety with 4–6 sessions. These findings support integrating creative interventions within multidisciplinary ED treatment programs. Future research with larger samples and control groups is needed to confirm and expand upon these preliminary results. Full article

In this paper, an in-depth characterization of the composition of extra-virgin olive oil (EVOO) from different cultivars was performed, with the aim of obtaining the fingerprint profile of bioactive constituents and studying the oxidative stability of the samples, both by an accelerated stability test and after four months of storage at room temperature. Among the investigated cultivars, some were typical of Umbria (Central Italy), namely Moraiolo, Frantoio, and Dolce Agogia, others of Apulia (Southern Italy), Coratina, Peranzana, and Bella di Cerignola, and others were typical Spanish cultivars cultivated in Umbria (Arbequina and Arbosana). The comparison of the chemical parameters among oils from the different cultivars allowed for their discrimination by multivariate statistical analysis. Some phenolic compounds were mainly responsible for the sample group’s differentiation, with the oils from the Spanish cultivars clearly distinguished from the Umbrian and Apulian sample groups. The processing of the results by chemometric analysis during oil storage and stability tests again allowed the discrimination of the samples analyzed at different storage times. This study contributes to increasing knowledge on olive oils—chemical and nutraceutical properties from specific cultivars, particularly some less studied so far, such as the Bella di Cerignola cultivar, and their changes in their nutraceutical properties during storage. Full article

COVID-19 vaccines have revolutionized prevention and clinical management by reducing disease severity and mortality. However, their long-term impact on hospitalization is unclear. This retrospective study assessed whether vaccination status, timing, and number of vaccine doses influence the risk of hospitalization and COVID-19 pneumonia in a large cohort in Italy, several years after initial vaccine rollout. From 1 October 2023, to 2 February 2024, at Humanitas Research Hospital (Milan) and two affiliates, we recorded age, sex, comorbidities, vaccination status (number of doses and time since last dose), admission type (urgent vs. elective), and pneumonia diagnosis. Baseline health was quantified by the Charlson Comorbidity Index. Among 16,034 admissions (14,874 patients), vaccination data were available for 5743 cases: 40.8% were in the emergency setting and 59.2% were elective. Patients presented with pneumonia in 6.8% of cases. Laboratory results confirmed COVID-19 pneumonia occurred in 43.7% of pneumonia cases, with a 16.9% mortality. Patients with no vaccine dose had a higher proportion of COVID-19 pneumonia, while COVID-19 pneumonia rates were lower in individuals who had received more vaccine doses. There were no significant differences in COVID-19 pneumonia risk by timing of last vaccination. Moreover, hospitalized unvaccinated patients had overall more frequent emergency admissions (57.3%), while patients with three or more doses had about a ~40% emergency admission rate. COVID-19 positivity during hospitalization was highest in unvaccinated patients (90.7%) and declined with vaccination status. Vaccinated patients, especially those with multiple doses, had significantly lower COVID-19 pneumonia rates and emergency admissions. These findings suggest a possible protective effect of vaccination in modifying the clinical presentation and severity of illness among those who are hospitalized and support continued vaccination efforts for high-risk groups to reduce severe adverse outcomes. Full article

Bacterial meningitis remains a critical public health issue globally due to its high morbidity and mortality. Understanding regional epidemiological trends is essential to inform vaccination strategies and public health interventions. This observational, retrospective study analyzed cerebrospinal fluid (CSF) isolates collected from 731 confirmed cases of bacterial meningitis between 2014 and 2024 in Lombardy, Italy. Pathogen identification and serotyping of Streptococcus pneumoniae (SP), Neisseria meningitidis (NM), and Haemophilus influenzae (HI) were conducted using culture-based and molecular techniques. Trends were assessed across age groups and time using Kruskal–Wallis and chi-square tests. Results: SP was the predominant pathogen (78.4%), followed by NM (13.0%) and HI (8.6%). Significant temporal variation was observed for SP and NM, while HI trends remained stable. The impact of COVID-19-related restrictions was evident in a reduction in cases during 2020–2021. SP serotypes 3 and 8, HI non-typeable strains, and NM serogroup B were most frequent. No major shifts in serotype distribution were observed. Long-term surveillance data from Lombardy underscore the dominance of vaccine-targeted serotypes, ongoing circulation of resilient clones, and post-pandemic epidemiological shifts. These findings support continuous surveillance and inform vaccine strategy adjustments at the regional and national levels. Full article

Background: Behavioural heterogeneity in obesity is increasingly recognised, but how specific dietary patterns, food preferences and physical activity vary between obesity classes remains poorly characterised. Methods: We analysed behavioural, dietary, and lifestyle data from 1366 adults attending a tertiary obesity clinic in Italy. Participants were stratified into five obesity classes defined by BMI. Age-adjusted regression models and chi-square tests with Bonferroni correction were used to examine associations between obesity severity and key behavioural outcomes, including food preferences, eating behaviours, physical activity, and self-reported sleep quality. Results: The prevalence of uncontrolled eating, skipping meals, and fast eating significantly increased with obesity severity after adjusting for age (all p < 0.05). Preference for yoghurt and legumes declined with increasing BMI, whereas preferences for meat and dairy remained stable. Age-adjusted sport participation decreased progressively, with significantly lower odds in Obesity I, II, and IIIA compared to the Overweight group. Sleep quality was highest among overweight participants and declined with obesity severity; night-time awakenings were most frequent in Obesity IIIB. Conclusions: Distinct behavioural and lifestyle traits, including lower sport participation, reduced preference for fibre-rich foods, and greater frequency of uncontrolled, fast, and irregular eating, showed overall trends across obesity classes. While these findings suggest the presence of behavioural phenotypes, their interpretation is limited by the cross-sectional design and the use of self-reported, non-validated measures. Future studies should incorporate objective assessments to inform targeted obesity interventions. Full article

In the past hundred years, three pontiffs have written apostolic letters to commemorate anniversaries relating to Dante: in 1921, Benedict XV marked the sixth centenary of the death of the great poet; in 1965, Paul VI judged it opportune to write on the occasion of the seventh centenary of his birth; and in 2021, Pope Francis added his voice to the numerous others wishing to honour the memory of the supreme Florentine poet on the seventh centenary of his death. Each letter is a product of its time: one hundred years ago, the Pope—still confined within the Vatican and refusing to recognise the Kingdom of Italy due to the Roman Question—addressed his text “to the beloved sons, professors and pupils of literary institutes and centres of higher learning within the Catholic world”; Paul VI, in full accord with the spirit of the Second Vatican Council and its vision of a Church seeking collaboration with the world, addressed his writing to Dante scholars more broadly, and within the same letter, together with other academic authorities, established the Chair of Dante Studies at the Catholic University of the Sacred Heart in Milan; Pope Francis today, in his outward-facing style of evangelisation, challenges everyone to (re)read Dante, whose teaching remains relevant seven hundred years after his death. Despite the differing political contexts and ecclesial agendas, Benedict XV, Paul VI, and Pope Francis are united on one point: Dante is a Christian poet—critical of the Church, certainly, but loyal to his faith and desirous of a religious institution that is more serious and less corrupt. This brief study presents the homage which the Church, today, seven centuries later, renders to this Poet—now widely recognised as a passionate witness of an arduous and active faith, in pursuit of justice and freedom. Full article

The non-traditional companion animal (NTCA) sector, particularly involving avian species, has significantly expanded in Italy, raising concerns over the spread of infectious diseases. These animals can harbor various pathogens and act as reservoirs, posing risks to native wildlife through legal or illegal trade, escapes, or intentional releases. However, the epidemiology of avian pathogens in NTCAs remains poorly understood and is typically investigated only in symptomatic individuals. In the present study, cloacal and choanal cleft swabs were collected from 319 ornamental and raptor birds across 19 families, pooled and tested for beak and feather disease virus (BFDV), avian polyomavirus (APV-1), psittacid herpesvirus 1 (PsHV-1), and avian metapneumovirus (aMPV). BFDV and APV-1 were detected in 13.79% and 2.19% of birds, respectively, with five co-infections. No cases of PsHV-1 or aMPV were found. Both viruses showed a higher prevalence than in previous Italian and most of international studies, with several non-psittacine species, including birds of prey, testing positive—some for the first time. Mixed-species settings and participation in public exhibitions were proven as significant infection risk factors. The study highlights the growing relevance of BFDV and APV-1 in non-commercial birds and recommends improved biosecurity and preventive screening to reduce disease spread and safeguard animal health. Full article

Accurate estimation of erupted lava volumes is essential for understanding volcanic processes, interpreting eruptive cycles, and assessing volcanic hazards. Traditional methods based on Mid-Infrared (MIR) satellite imagery require clear-sky conditions during eruptions and are prone to sensor saturation, limiting data availability. Here, we present an alternative approach based on the post-eruptive Thermal InfraRed (TIR) signal, using the recently proposed VRP_TIR method to quantify radiative energy loss during lava flow cooling. We identify thermally anomalous pixels in VIIRS I5 scenes (11.45 µm, 375 m resolution) using the TIRVolcH algorithm, this allowing the detection of subtle thermal anomalies throughout the cooling phase, and retrieve lava flow area by fitting theoretical cooling curves to observed VRP_TIR time series. Collating a dataset of 191 mafic eruptions that occurred between 2010 and 2025 at (i) Etna and Stromboli (Italy); (ii) Piton de la Fournaise (France); (iii) Bárðarbunga, Fagradalsfjall, and Sundhnúkagígar (Iceland); (iv) Kīlauea and Mauna Loa (United States); (v) Wolf, Fernandina, and Sierra Negra (Ecuador); (vi) Nyamuragira and Nyiragongo (DRC); (vii) Fogo (Cape Verde); and (viii) La Palma (Spain), we derive a new power-law equation describing mafic lava flow thickening as a function of time across five orders of magnitude (from 0.02 Mm³ to 5.5 km³). Finally, from knowledge of areas and episode durations, we estimate erupted volumes. The method is validated against 68 eruptions with known volumes, yielding high agreement (R² = 0.947; ρ = 0.96; MAPE = 28.60%), a negligible bias (MPE = −0.85%), and uncertainties within ±50%. Application to the February-March 2025 Etna eruption further corroborates the robustness of our workflow, from which we estimate a bulk erupted volume of 4.23 ± 2.12 × 10⁶ m³, in close agreement with preliminary estimates from independent data. Beyond volume estimation, we show that VRP_TIR cooling curves follow a consistent decay pattern that aligns with established theoretical thermal models, indicating a stable conductive regime during the cooling stage. This scale-invariant pattern suggests that crustal insulation and heat transfer across a solidifying boundary govern the thermal evolution of cooling basaltic flows. Full article

(1) Background: Occupational exposure to asbestos remains a significant public health concern due to its association with pleural cancer and other cancers. This cohort study examines the incidence of asbestos-related diseases among railway carriage maintenance workers exposed to asbestos between 1960 and 1979 in Bologna, Italy. (2) Methods: A cohort of 2197 male workers was followed from 1960 onwards, with data collected on asbestos exposure, smoking habits, and mortality outcomes. The association of asbestos exposure and smoking with the risk of pleural cancer and lung cancer was assessed using Cox proportional hazards regression models. (3) Results: This study identified a substantial burden of asbestos-related pleural cancer, with an exponential increase in risk over time since the beginning of exposure. Our results suggest the lack of a multiplicative effect of asbestos exposure and smoking on lung cancer risk. The Cox models showed a significant association between smoking and lung cancer risk, with a hazard ratio of 3.26 (95% CI: 1.10–9.64, p = 0.03), less significant for asbestos exposure, with a hazard ratio of 1.42 (95% CI: 0.66–3.06). (4) Conclusions: This study provides valuable insights into the long-term health effects of occupational asbestos exposure and underscores the complex interaction between asbestos exposure and smoking in the development of lung cancer. Full article

Cellulite is a widespread aesthetical dermatological condition affecting a significant proportion of postpubertal women, characterized by dimpled skin, primarily on the thighs, buttocks, and hips, which has an important psychological impact. Cellulite, also called lipodystrophy or oedematosclerotic panniculitis, causes an aesthetic change in the skin that affects the epidermis, dermis, hypodermis and subcutaneous fat in different ways. The aim of the present prospective study research was to evaluate the efficacy of electromagnetic field and negative pressure in the treatment of cellulite. Methods: A total of 35 women with an average age of 40, ranging from 18 to 50 (mean 32.2 ± 7.48), with a body mass index between 18.5 and 26.9 (mean 22 ± 3.01), were enrolled in this study. The degree of cellulite of the patients was assessed clinically using the Cellulite Severity Scale (CSS) and Nürnberger–Müller classification. All patients received one session per week for a total 12 treatment sessions with Bi-one^® LifeTouchTherapy medical device (Expo Italia Srl—Florence—Italy), which generates a combination of vacuum and electromagnetic fields (V-EMF). Total treatment time was approximately 20–30 min per patient. The GAIS score, Cellulite Severity Scale (CSS) and Nürnberger–Müller classification for cellulite was evaluated 1 month after the 12 treatments with LifeTouchTherapy. Results: A statistical difference was recorded in cellulite improvement by visual analog scale (VAS) and global aesthetic improvement scale (GAIS). Conclusions: The results of the present prospective clinical study show the efficacy and safety of Bi-one^® LifeTouchTherapy in the treatment of cellulite. Electromagnetic fields combined with negative pressure therapy promote tissue regeneration and reduce fibrosis, which results in visible cosmetic improvements of cellulite. Full article