Search Results (1,788)

Background/Objectives: This qualitative study investigated the perspectives and lived experiences of individuals with obesity, with a specific focus on psychological needs, beliefs, attitudes, and experiences related to psychological support. The study aimed to identify perceived barriers and facilitators to adherence in weight management and to examine participants’ views on digital psychological interventions designed to promote mental health and well-being. These findings represent the preliminary phase of a broader research project aimed at developing and implementing personalized digital psychological interventions to enhance engagement, treatment effectiveness, and equity of care in obesity management. Methods: Five focus groups were conducted with a purposive sample of 35 patients (48.6% female) diagnosed with obesity and enrolled in a four-week multidisciplinary weight-reduction program at the IRCCS Istituto Auxologico Italiano, San Giuseppe Hospital, Piancavallo (VB), Italy. Sessions were audio-recorded, supplemented with field notes, transcribed verbatim, and analyzed using reflexive thematic analysis to identify recurrent patterns of meaning across participants’ narratives. Results: Six overarching themes were identified: (1) obesity as an embodied and pervasive experience; (2) the interplay between emotions, weight stigma, and identity construction; (3) family and social relationships as both supportive and ambivalent; (4) personal agency and self-regulation processes in weight management; (5) access to healthcare services and experiences with healthcare professionals; and (6) the perceived role of psychological support within multidisciplinary care. Participants described obesity as a complex, multidimensional condition encompassing physical, emotional, relational, and contextual challenges that directly influence treatment engagement and adherence. Conclusions: Psychological support emerged as a central component of comprehensive obesity care. Findings underscore the need for personalized, flexible, and digitally supported psychological interventions to enhance long-term adherence, acceptability, and overall well-being. Full article

Mercury (Hg) decontamination in active and decommissioned mining areas is a difficult task since Hg may affect environmental matrices and man-made materials. Despite its toxicity as an inorganic form being rather limited with respect to organic compounds (e.g., methyl-Hg), severe effects to human health and ecosystems are recognized. In this work, we review the geochemical activities carried out in the last 13 years at the Abbadia San Salvatore (AbSS) mining and production area. This site belongs to Mt. Amiata (Tuscany, central Italy), which is considered the third-largest Hg-district in the world. Air, water, soil and man-made materials within the AbSS area were investigated to verify to what extent such matrices were affected by Hg contamination. The geochemical investigations are used as important tools to proceed with specific remediation operations of edifices, mining structures and machineries as well as the local groundwater system. To the best of our knowledge, restoration of decommissioned areas affected by Hg contamination at a large scale, such as the AbSS exploitation and production site, is rather uncommon. Currently, the remediation activities in the AbSS area are going on and they are expected to be concluded at the end of 2026 or the beginning of 2027, when the former mining area will turn into a public archeometallurgical museum. Full article

Objectives: To report the performance of a screening program for undiagnosed HCV infections in the general population of one Italian region. Methods: The Marche region, central Italy, provided organized free HCV screening for the resident population born between 1969 and 1989, from July 2023 to December 2025. People with known liver disease or HCV treatment were excluded, and those eligible were invited by letter to access the blood draw. After a positive anti-HCV test, a reflex HCV-RNA test was performed on the same sample. The investigated outcomes were extension, uptake, HCV-RNA detection rate, and positive predictive value (PPV) of the anti-HCV test. Potential predictors of an infection diagnosis were investigated through multivariable analyses. Results: Over 30 months, 412,897 individuals were invited (93.6% extension), and 48,596 participated (11.8% uptake). Positive tests were 308 for anti-HCV (0.63%) and 42 for HCV-RNA (0.09% detection rate), with a relatively low PPV of the anti-HCV test (13.6%), which increased in males (15.2%) and individuals born in specific foreign countries (>20%). Multivariate analyses confirmed a higher risk of a positive HCV-RNA test for males (adjusted odds ratio—OR: 2.21; 95%CI 1.45–3.38) and those born in Moldova, Ukraine, and Pakistan (adjusted ORs between 10 and 15; p ≤ 0.001). Conclusions: The low detection rate was consistent with other Italian studies, suggesting that a combination of opportunistic recruitment and tailored pathways is required for high-risk groups in order to achieve the WHO HCV elimination targets. Future analyses should assess linkage-to-care and therapy compliance to evaluate the long-term cost–benefit ratio. Full article

Introduction: Childhood and adolescent obesity is a growing global health challenge associated with early metabolic and cardiovascular complications. This study aims to compare questionnaire-assessed physical activity patterns and lifestyle characteristics among children and adolescents with obesity and normal-weight peers and to explore their associations with clinical measurements and cardiometabolic risk. Assessing resting metabolic rate (RMR) by indirect calorimetry may provide additional insight into metabolic status beyond conventional anthropometric indicators. Methods: This prospective cross-sectional study included 58 children and adolescents aged 5–18 years with obesity and 30 normal-weight controls evaluated in Sfânta Maria Emergency Children’s Hospital Iași, Romania. Clinical data included anthropometric measurements and available biochemical parameters. RMR was assessed through indirect calorimetry (Fitmate Pro, Cosmed, Rome, Italy). Parents completed a structured lifestyle questionnaire adapted from validated international instruments, collecting information on physical activity, sedentary behavior, and wearable device use. Data analysis was conducted using SPSS 22.0, applying descriptive statistics and Pearson correlation analysis. Results: Children with obesity reported higher body mass index (BMI) (30.48 ± 5.31 kg/m²), higher RMR values, lower physical activity levels and greater sedentary time than controls. RMR correlated positively with BMI, central adiposity, blood pressure, waist-to-height, hepatic steatosis and exercise tolerance. Although electronic devices for monitoring physical activity were more frequently used in the obesity group, this was not associated with higher activity levels. Conclusions: Children and adolescents with obesity exhibited a clustered cardiometabolic risk profile and reduced physical activity. RMR measured by indirect calorimetry may contribute to a more comprehensive metabolic assessment in pediatric obesity. Full article

This study evaluated contamination by polychlorinated dibenzodioxins and dibenzofurans (PCDDs/Fs) and polychlorinated biphenyls (PCBs) in 390 feeds and 1756 food samples collected in Latium and Tuscany (Italy, 2016–2025) using HRGC-HRMS. PCDDs/Fs and dioxin-like PCBs (dl-PCBs) are expressed as WHO 2005 toxic equivalents (WHO₀₅-TEQ). Non-dioxin-like PCBs (ndl-PCBs) lack dioxin-like toxicity mechanisms due to their non-coplanar structure and are not assigned a toxic equivalence factor. Feed results were normalised to 12% moisture content. Median levels of WHO₀₅-PCDDs/Fs+dl-PCBs TEQ at the upper limit in feed were 10–100 times lower than those reported in European monitoring data (EFSA, 2002–2010) for comparable categories, including additives, premixtures, raw materials and compound feed, with plant and animal feed materials below 0.03 ng/kg and aquaculture feed at 0.24 ng/kg. Food contamination was generally low, with the median WHO₀₅-PCDDs/Fs+dl-PCBs TEQ 2–4 times lower than Italian national data (2013–2016), considering comparable categories such as meat, fish, milk, eggs, oils, baby foods, marine oils, animal fats and liver. Higher levels were observed in game meat, sheep products and fermented milk than in pork and poultry. The contamination remained stable over time. These results indicate an improvement in food safety thanks to national and EU regulations, although continued surveillance of high-risk and undersampled categories remains essential. Full article

Groundwater quantification is essential for sustainable water resources management, yet it is often hampered by limited data availability and difficulties in measuring spring discharges. This study investigates three carbonate aquifers in Central Italy’s Abruzzo region: the Genzana–Greco, Morrone, and Marsicano mountains. The aim is to resolve uncertainties in spring attribution, and groundwater flow patterns using isotopic analyses combined with field surveys. The Genzana–Greco aquifer was examined to clarify the sources of the Acquachiara spring and the previously unreported Germina spring, assessing whether recharge occurs locally or from the carbonate massif. In this case, the results indicate that the Germina, together with a similar known spring of Capolaia, share a common recharge sector, while the Acquachiara spring is mainly fed by higher-elevation carbonate areas, excluding significant contributions from local alluvial deposits. In the Morrone mountain aquifer, discharge gains along the Pescara River through the Gole di Popoli were quantified, and spring isotopic compositions were compared to the main basal spring Giardino to better define groundwater contributions. In this case study, the stable isotopes and tritium data confirm recharge from the central–southern massif and support the identification of basal springs and Pescara River gains as primary discharge points, with minimal influence from surface water. For the Marsicano mountain aquifer, the role of Lake Scanno in feeding the Villalago springs was investigated through isotopic analysis of inflows, downstream springs, and basal aquifer discharge points to constrain the hydrogeological water budget. The results highlight Lake Scanno’s role in the recharge of Villalago springs and delineate the Cavuto group as a major discharge system receiving inputs from central and northern sectors of the massif. Overall, the integration of isotopic tracers with hydrological measurements allowed a more precise characterization of aquifer recharge areas, Mean Residence Times, and groundwater flow paths, improving the understanding of regional water resources in a complex carbonate setting. Full article

Dirofilaria repens is the leading cause of subcutaneous (dogs) and subcutaneous/ocular dirofilariosis (humans) in the Old World. Despite its rapid geographical spread, driven by climate change, the emergence of new invasive vectors (Aedes albopictus) and growing interest in its study due to the emergence of new cases in areas previously free of the parasite, amongst other factors, scientific research into this pathogen remains limited. This study provides the first longitudinal bibliometric analysis of global research on D. repens (1955–2025). Data from Web of Science and Scopus were processed using PRISMA and RAMIBS protocols, resulting in a normalized corpus of 624 documents analyzed via science mapping techniques. The field exhibits a sustained annual growth rate of 3.79%, transitioning into an exponential expansion phase in 2011. While Italy retains historical leadership, spatial analysis confirms a research displacement towards Central and Eastern Europe (Germany, Poland). Thematic evolution reveals a structural shift from isolated clinical case reports to a multidisciplinary ecosystem dominated by molecular epidemiology, vector competence, and surveillance. Dirofilaria repens has gone from being a minor and neglected issue to having a significant number of reports and studies subject to interest in addressing the disease that results from its infection in different hosts. However, the intellectual structure exposes an operational fragmentation between clinical medicine and medical entomology. Future research must overcome national silos and integrate reservoir management with vector control, transforming the current reactive approach into a predictive preventive system aligned with the One Health framework. Full article

Within the hospital sector, digitalization brings smarter, more resilient and more sustainable systems. Advancements in remote sensing technologies and building information modeling (BIM) are revolutionizing infrastructure design and construction. The aim of the study is to investigate the impact of digitalization on the spatial configuration of hospitals and its effects on operational efficiency and environmental sustainability, combining theoretical insights with an empirical survey of fourteen hospitals in Italy. The methodology adopted consisted of the following steps: (i) the conduct of a literature review; (ii) the analysis of international best practice; (iii) the definition of criteria to support the design of digital hospitals; (iv) the investigation on the Italian context through a survey; (v) data collection and analysis to support the formulation of strategies for smart hospital development. The findings highlight how the adoption of innovative solutions related to clinical and management sector can optimize hospital workflow, enhance management efficiency, and create safer and more functional and sustainable environments. However, the persistence of outdated infrastructures and the need for significant adaptation still represent major barriers: only 28.7% of hospitals have a fully centralized logistics hub, and just 7.1% have implemented a Digital Twin. In conclusion, this research provides a reference framework for designers, healthcare administrators, and policymakers, outlining strategies for the development of smart and sustainable hospitals. Full article

The aim of the study was to investigate the relationship between air pollution exposure and gut microbiota-related biomarkers among a cohort of healthy school-age children. A cross-sectional biomonitoring study was conducted among 11-year-old healthy children living in central Italy. Selected urinary (u) volatile organic compounds (VOCs) (benzene, toluene, ethylbenzene, xylenes, methyl tertbutyl ether, ethyl tert-butyl ether, 2-methyl-2-butyl methyl ether, and diisopropyl ether) were measured as exposure biomarkers while u-indican and faecal (f) zonulin were assessed as indicators of gut dysbiosis and intestinal permeability, respectively. Socio-demographic and lifestyle data were collected through questionnaires. u-VOCs showed higher geometric means among children exposed to environmental tobacco smoke, living in urban areas, and those spending a longer time in motor vehicles. u-Ethylbenzene and u-toluene were the most abundant compounds (mean ± SD: 307 ± 118 ng/L and 188 ± 94 ng/L, respectively). Mean f-zonulin and mean u-indican were, respectively, 49.09 ± 18.41 ng/mL and 5.97 ± 3.50 mg/dL. A statistically significant positive correlation was observed between u-ethylbenzene and u-indican (p = 0.02) and between u-toluene and f-zonulin (p = 0.05). These findings provide preliminary evidence that air pollution may influence gut microbial metabolic activity and intestinal barrier regulation in children, supporting the need for larger longitudinal studies. Full article

The large-scale penetration of Distributed Energy Resources (DERs), the proliferation of Energy Communities, and the increasing provision of flexibility services are fundamentally transforming distribution network operation, rendering traditional Distribution Management Systems (DMSs) structurally inadequate. This paper addresses this structural gap by proposing and experimentally validating A-ISolE, a novel hybrid Artificial Intelligence (AI) architecture that natively integrates centralized and distributed intelligence within a unified DMS framework. The core scientific contribution of this work lies in the formulation and deployment of a coordinated, hierarchical AI paradigm in which cloud-level predictive and optimization modules dynamically interact with edge-level autonomous control agents. Specifically, the paper introduces: (1) an integrated forecasting state estimation pipeline with AI-enhanced grid observability; (2) intelligent fault location and optimal feeder reconfiguration algorithms embedded into operational control loops; and (3) distributed edge control strategies enabling autonomous yet coordinated microgrid stabilization. The architecture is validated on a real pilot microgrid in Sanremo (Italy). Experimental results demonstrate quantifiable gains in many parameters, substantiating the feasibility of hybrid centralized/distributed AI as a foundational paradigm for future resilient and decarbonized distribution networks. Full article

Wildlife can serve as a potential reservoir and spreader of resistant and pathogenic bacteria. Raptors, occupying the ecological position of apex or mesopredators, integrate exposure across different habitats and therefore serve as bioindicators of environmental dissemination of pathogens. In this study, we isolated 54 Escherichia coli (E. coli) strains from feces sampled from 64 raptors admitted to a wildlife rescue center in Central Italy. Phenotypic antimicrobial susceptibility testing was conducted, followed by molecular screening for resistance genes. Additionally, the presence of intestinal E. coli pathotypes, including STEC, EHEC, EPEC, ETEC, EAEC, EIEC, and NTEC, was evaluated through virulence gene analysis. Results indicated notable resistance to commonly used antimicrobials, with the highest percentages observed for ampicillin (40.74%), fluoroquinolones (31.48%), and tetracycline (25.93%). Molecular analysis of phenotypically resistant isolates identified the presence of several resistance genes, including bla_TEM (13 isolates), bla_CTX-M (4 isolates), bla_CMY-2 (3 isolates), bla_SHV (1 isolate), tet(A) (9 isolates), tet(B) (4 isolates), cat1 (1 isolate), and cmlA (2 isolates). Furthermore, 29.63% of isolates were classified as multidrug-resistant (MDR) and 7.41% as extensively drug-resistant (XDR). Regarding virulence profiles, one isolate harboring eaeA, escV, and astA genes was classified as atypical EPEC, while 27.78% isolates had only the astA gene, preventing precise pathotype assignment. These findings highlight the circulation of antimicrobial-resistant and potentially pathogenic E. coli strains within raptor populations in Central Italy, emphasizing the zoonotic potential and reaffirming the role of raptors as bioindicators within a One Health approach. Full article

Public administrations increasingly seek to adopt digital tools for evidence-based policymaking, yet systematic frameworks guiding this adoption remain scarce. This paper aims to develop and apply a co-creation framework for technology adoption roadmaps in public sector policymaking. The objectives are threefold: (1) to systematically identify impacts, facilitators, and barriers through structured stakeholder engagement; (2) to structure these elements into Impact Pathways and Transition Scenarios; and (3) to derive actionable policy recommendations. Using a participatory action research design, a seven-step co-creation methodology was applied across all four cases addressing crisis management challenges: forest fires in Finland, floods and refugee reception in Italy, power outages in Greece, and wildfires in Spain. Through structured stakeholder engagement combining surveys, workshops, and online consultations, the study identified seven categories of policy support results; twelve impacts spanning technology adoption, policy process enhancement, public administration capacity, and citizen empowerment; nine facilitators across financial, organisational, legal, and technical dimensions; and eight frustrators assessed through a risk matrix. These elements were structured into Impact Pathways, visualising causal relationships among policy support tools, enabling factors, and transformation outcomes. Four Transition Scenarios were derived, aligned with the policy lifecycle stages of inception, negotiation, set-up, and operation, accompanied by fifteen actionable policy recommendations classified by thematic area, timeframe, and stakeholder responsibility. The findings reveal that evidence-based policies represent a central transformation target across all result categories, while effective stakeholder engagement and leadership commitment emerge as cross-cutting enablers. The integrated framework contributes to digital governance research by operationalising co-creation for strategic roadmap development and offers practitioners a decision-support tool for planning digital technology-assisted policymaking transformations. Full article

The increasing frequency of disasters caused by landslides, mainly due to climate change leading to more intense extreme events, requires reliable predictive models for risk mitigation. Italy, in particular, is a country at high risk of landslides, but the lack of an updated catalogue of landslide activation dates poses a significant challenge for defining reliable activation thresholds. This study develops a methodology for mapping landslide susceptibility based on events in a pilot area of central Italy, integrating a database of landslides with known activation dates with predisposing and triggering parameters. Two statistical techniques were compared to assess their predictive performance in discriminating landslide from non-landslide conditions during extreme precipitation events. A comparison between binary logistic regression (BLR) and decision trees (QUEST) revealed the clear superiority of the BLR model, which achieved excellent predictive accuracy (AUC = 0.913). The model identified clay-rich lithology, gentle slopes (0–16°) and maximum daily precipitation as the most significant controlling factors. This result led to the generation of three derivative products: a susceptibility map, a hazard map for an extreme precipitation scenario with a 100-year return period, and a spatially distributed map of activation thresholds. This threshold map quantifies the intensity of precipitation required to exceed a critical probability of landslide initiation (p > 0.7) at any point in the territory. The susceptibility map highlights critical areas within the study area, while the hazard map also includes the return period of the event. The threshold map is a direct and operational tool for early warning systems, transforming a statistical model into a guide for real-time risk management. The study area serves as a pilot area that could allow this methodology to be replicated. With the integration of real-time meteorological data, it could function as a real-time warning system. The proposed framework therefore provides a directly actionable tool for civil protection agencies, land-use planning authorities, and emergency managers, enabling location-specific rainfall alert thresholds to be issued rather than a single regional value, with the potential to reduce both false alarms and missed warnings. Full article

Agriculture must shift to sustainable practices that support mitigation and adaptation, with crop diversification highlighted as a key adaptive practice. A field experiment was conducted in central Italy to study forage and grain production of wheat (Triticum aestivum L.) and pea (Pisum sativum L.) intercropping (IC) comparing three nitrogen fertilizations (NF) (i.e., 0, 70, and 140 kg ha⁻¹) and two cropping systems (CS) (i.e., arable (AR) and silvo-arable (SIAR)) for two consecutive cropping seasons (2023–2024 and 2024–2025). Forage and grain production were determined at flowering and at maturity to identify temporal trends in resource use. Overall, the results demonstrated that poplar presence did not significantly impact IC productivity, as forage biomass at flowering was 5.00 t ha⁻¹ in AR and 4.77 t ha⁻¹ in SIAR in 2024, and 3.20 t ha⁻¹ in both cropping systems in 2025. Moreover, NF was the main driver of both forage and grain production, without significant interaction with the CS, and a moderate N rate (i.e., 70 kg ha⁻¹) was the most efficient, ensuring both wheat and pea productivity. The absence of a yield penalty in the IC in the SIAR supports the agroecological value of integrating annual intercrops with tree components. Full article

Reliable individual identification and minimally invasive tracking are essential for monitoring threatened snake populations. A relict high-altitude population of Vipera ursinii ursinii was studied in the Maiella National Park (Central Apennines, Italy) during two field seasons (2024–2025) to (i) validate dorsal head photo-identification against unequivocal PIT-tag identities and (ii) test a novel, non-invasive telemetry method based on externally attached harmonic diodes detected with a RECCO^® harmonic direction finder (HDF). All analysed snakes were PIT-tagged and photographed under standardised conditions. Manual photo-identification based on dorsal cephalic scale counts was performed independently by four blinded operators. In parallel, software-assisted photo-identification was conducted with two independent programmes (Wild-ID and Hotspotter). Both methods were evaluated exclusively against PIT-tag-confirmed identities. Manual identification achieved moderate-to-high overall accuracy (0.77–0.91) but showed marked inter-operator variability. Software-assisted matching appeared more consistent: Hotspotter identified 75% of true recaptures at first suggestion (85% within the top six suggestions), while Wild-ID identified 56% at first suggestion (88% within the top six). Correct matches were primarily supported by the distinctive pholidosis of the dorsal head region, especially apical, intercanthal and parafrontal scales—which were highly diverse but independent of sex and age class in the studied population. Externally attached HDF diodes enabled repeated short-term relocations with detachments occurring within hours to several days and mostly associated with ecdysis. The method was minimally invasive, supporting its applicability for monitoring small-bodied animals with low-density populations and restricted ranges. Full article