Italian Region Of Emilia-Romagna Research Articles

Effects of COVID-19-targeted non-pharmaceutical interventions on pediatric emergency department use: a quasi-experimental study interrupted time-series analysis in North Italian hospitals, 2017 to 2022.

The use of Non-Pharmaceutical Interventions (NPIs) during the COVID-19 pandemic is debated. Understanding the consequences these measures may have on vulnerable populations including children and adolescents is important. This is a multicenter, quasi-experimental before-after study involving 12 hospitals of the North Italian Emilia-Romagna Region, with NPI implementation as the intervention event. The 3 years preceding NPI implementation (in March 2020) constituted the pre-pandemic phase. The subsequent 2 years were further subdivided into a school closure phase (SC) and a subsequent mitigation measures phase (MM) with milder restrictions. Interrupted Time Series (ITS) regression analysis was used to calculate PED Standardized Incidence Rate Ratios (SIRR) on the diagnostic categories exhibiting the greatest frequency and/or variation. In the 60 months of the study there were 765,215 PED visits. Compared to the pre-pandemic rate, overall PED presentations dropped by 58 and 39% during SC and MM, respectively. "Symptoms, signs and Ill-defined conditions," "Injury and poisoning" and "Diseases of the Respiratory System" accounted for 74% of the reduction. A different pattern was instead seen for "Mental Disorders," which exhibited the smallest decrease during SC, and is the only category which rose already at the end of SC. ITS analysis confirmed the strong decrease during SC (level change, IRR 0.17, 95%CI 0.12-0.27) and a significant increase in MM (slope change, IRR 1.23, 95%CI 1.13-1.33), with the sharpest decline (-94%) and rise (+36%) observed in the "Diseases of the Respiratory System" category. Mental Disorders showed a significant increasing trend of 1% monthly over the whole study period exceeding pre-pandemic levels at the end of MM. Females and adolescents showed higher increasing rates both in SC and MM. NPIs appear to have influenced PED attendance in different ways according to diagnostic categories, mirroring different mechanisms of action. These effects are beneficial in some cases and harmful in others, and establishing a clear balance between pros and cons is a difficult task for public health decision makers. The role of NPIs on PED use appropriateness deserves investigation. The rise in pediatric mental disorders independent of the pandemic makes interventions addressing these issues urgent.

A Priori Estimation of Radar Satellite Interferometry’s Sensitivity for Landslide Monitoring in the Italian Emilia-Romagna Region

The InSAR technique is known to be a powerful tool for precise monitoring of wide areas in terms of displacements. It is conceivable to also use this technique to monitor landslide areas, but geometrical distortions due to ground morphology and land cover could make InSAR processing ineffective for such applications. Because of the computational burden of InSAR processing, it is important to have preliminary knowledge about the possible suitability of the technique for the inspected area before acquiring and processing the data. This paper aims to perform a preliminary analysis of the InSAR sensitivity for the specific case of landslide monitoring. A new approach is proposed considering aspects specific to landslide displacements, which are basically tangent to the slope direction. Pre-processed coherence maps were used to account for the impact of land cover. The whole analysis can be carried out without acquiring cumbersome SAR datasets and can be used as a preliminary step. The Italian Emilia-Romagna region has been considered as the study area, with landslide areas accounting for more than 12% of its territory. The outcomes show that the inspected area has favourable morphological conditions, mainly thanks to its mild slopes and the limited number of landslides facing north, but the land cover has a strong negative impact on the InSAR sensitivity. Nevertheless, 7.5% of the landslide areas have promising conditions for monitoring using radar interferometry.

Primary membranous nephropathy in the Italian region of Emilia Romagna: results of a multicenter study with extended follow-up.

Since primary membranous nephropathy is a heterogeneous disease with variable outcomes and multiple possible therapeutic approaches, all 13 Nephrology Units of the Italian region Emilia Romagna decided to analyze their experience in the management of this challenging glomerular disease. We retrospectively studied 205 consecutive adult patients affected by biopsy-proven primary membranous nephropathy, recruited from January 2010 through December 2017. The primary outcome was patient and renal survival. The secondary outcome was the rate of complete remission and partial remission of proteinuria. Relapse incidence, treatment patterns and adverse events were also assessed. Median (IQR) follow-up was 36 (24-60) months. Overall patient and renal survival were 87.4% after 5 years. At the end of follow-up, 83 patients (40%) had complete remission and 72 patients (35%) had partial remission. Among responders, less than a quarter (23%) relapsed. Most patients (83%) underwent immunosuppressive therapy within 6 months of biopsy. A cyclic regimen of corticosteroid and cytotoxic agents was the most commonly used treatment schedule (63%), followed by rituximab (28%). Multivariable analysis showed that the cyclic regimen significantly correlates with complete remission (odds ratio 0.26; 95% CI 0.08-0.79) when compared to rituximab (p < 0.05). In our large study, both short- and long-term outcomes were positive and consistent with those published in the literature. Our data suggest that the use of immunosuppressive therapy within the first 6 months after biopsy appears to be a winning strategy, and that the cyclic regimen also warrants a prominent role in primary membranous nephropathy treatment, since definitive proof of rituximab superiority is lacking.

A population-based study of BRCA breast cancer incidence and prognosis in the Italian Emilia Romagna region: The MUTina study.

10616 Background: In Italy, about 3% of all breast cancer (BC) are related to BRCA1 and BRCA2 gene mutations. In the Emilia Romagna Region, a unique hub and spoke model was adopted for select and follow people at risk, starting from the Regional Screening Programs, General Practioners and specialists, covering all the area. This study was designed to uniformly identify and treat BRCA1/2 related BC. Characteristics and outcome of tumors detected by this protocol will be presented. Methods: In this multicenter-retrospective study, seven out of nine provinces collected data about BRCA-related BC identified in the Emilia-Romagna region. Patients and tumors characteristics, surgical information, treatment modalities for early (neoadjuvant or adjuvant therapies) and advanced disease, type of relapse (local/distant), second primary tumors occurrence, surgical preventive strategies (bilateral mastectomy, oophorectomy), gene testing data, disease free survival (DFS) and overall survival (OS) were registered. Comparisons between BRCA1 and BRCA2 tumors were performed. Results: Since 2000 to 2011, 284 BC were registered (171 BRCA1, 110 BRCA2 and 3 BRCA1 and BRCA2 mutated) with a median age at onset of 42 years. BRCA1-related tumors were mostly triple negative BC (TNBC) compared to BRCA2 ones. The diagnosis was at stage I in 52.3% of cases, being 59.7% BRCA1 and 39% BRCA2 (P = 0.0015). BRCA2 patients, compared to BRCA1, received more frequent up-front surgery (85% vs. 74.9%, P = 0.049) and less chemotherapy (34.1% vs 65.9%, P = 0.004). After a median 12-years follow-up period, 136 patients (47,9%) developed an ipsilateral/local or systemic recurrence or contralateral second BC. BRCA1 developed more local recurrences, compared to BRCA2 that had more distant relapses (P = 0.013). Median OS was not reached in the whole population, with 80.3% of patients alive at the analysis cut-off. Among the two populations, there was a benefit trend for BRCA1 patients (P = 0.071), mostly for those who received chemotherapy (P = 0.0036), contralateral mastectomy (P = 0.0001) and oophorectomy (P &lt; 0.0001). Finally, 25.7% of patients developed a second tumor, excluding BC, mostly ovarian cancer. Conclusions: Although BRCA1-related BCs show more aggressive characteristics than BRCA2 BC, the early diagnosis due to our regional surveillance program, leads to a trend for better outcome, even if not statistically significant. The BRCA1 highest rate of recurrence reflects the tendency to local rather than distant relapse. Furthermore, the BRCA deficiency appears to be a predictor of chemosensitivity. Finally bilateral mastectomy and oophorectomy seem to be associated to better outcome. In conclusions, our data support the using of an intensive screening associated to maximal surgery and chemotherapy when BC arises in BRCA carriers, to overcome the unfavorable tumors characteristics of these patients.

К ВОПРОСУ О ФИГУРАТИВНЫХ МОТИВАХ В ФАСАДНОМ ДЕКОРЕ ПАЛАЦЦО ПОДЕСТА В БОЛОНЬЕ

The article focuses on the structure and semantic analysis of figurative reliefs in the façade decoration of the Bologna palazzo del Podestà (13th – 15th c.), which was rebuilt in Renaissance style in the epoch of Giovanni II Bentivoglio (ruled in 1463–1506) and presents an important example of Quattrocento palace architecture in the northern Italian region of Emilia Romagna. The problem of the palace reconstructions makes it necessary to look at its decoration in the broader context of 15th century secular buildings in Bologna and Emilia Romagna. Consequently, firstly, three groups of reliefs are discerned (prevailing floral reliefs, zoomorphic and anthropomorphic reliefs, reliefs on historical subject). Secondly, the “retrospective” character of many elements concerned seems obvious and may be explained as inspired by local as well as tramontane Romanesque decorative tradition. Thirdly, semantic interpretation in the historical context of Bologna is accepted as applicable not only to the reliefs on historical subject here, but also to other carvings.

Over 30-year retrospective analyses of moped-motorcycle fatal road accidents in the northern area of the Italian region of Emilia Romagna and review of the literature: Aiming for further preventive measures in the future

Road traffic injuries are a major cause of morbidity and mortality worldwide, with pedestrians and riders of two-wheeled motor vehicles being the most vulnerable. The present study aims to determine the epidemiological characteristics of fatal motorcycle crashes in a portion of the Italian region of Emilia Romagna, and to compare them with the data available in literature.Data were retrieved from autopsy reports on 350 subjects who died following road accidents involving moped or motorcycle in the cities of Parma, Piacenza, and Reggio Emilia. Two types of data were extrapolated: circumstantial and traumatological. The population was divided into subgroups according to gender, crash time, alcohol positivity, presence or absence of the helmet, and the period elapsed between the accident and death.Most of the considered road accidents occurred during the day and on weekends. 25.5 % of the victims tested positive for alcohol. As far as traumas are concerned, the limbs resulted to be the most affected body segment, followed by the head (87.4 %), the thorax (85.7 %), the abdomen (65.7 %), and lastly the neck (50.3 %).According to similar studies, the sample victim of a moped/ motorcycle accident is a young male subject. The results obtained allow us to demonstrate that the mandatory use of the helmet has reduced skull and brain injury over the years. At present, no law regulates the use of protections for other body parts. Regulatory interventions in this sense would be desirable given the ever more rapid technical evolutions in the field of motorcycles.

Assessing the externalities of a waste management system via life cycle costing: The case study of the Emilia-Romagna Region (Italy).

Effective and efficient urban waste management systems (WMSs) are a cornerstone for a sustainable society. Life cycle costing (LCC) provides a useful framework for the joint analysis of economic and environmental impacts of a WMS, by considering both financial and external costs. The present study applies the methodology of societal LCC to the WMS of the Italian region of Emilia-Romagna to provide a case study on how the available information on waste flows and budget costs of a real WMS can be used to obtain an estimate of the total cost of waste management, including externalities. The results evidence that the main source of negative externality in the analyzed WMS is the transportation of waste, with only a minor role of external burdens due to incinerators and landfills. However, the positive externality resulting from recycling more than compensates those impacts, leading to a net external benefit associated to the WMS. The contribution of both uncertain unit external costs and environmental benefits imputable to recycled materials to the overall uncertainty of the result is systematically investigated by parametric uncertainty analysis. The most critical parameters in determining the sensitivity of the result are the monetary values attributed to primary energy consumption and CO2 emissions, together with assumptions on energy savings related to recycling. Eventually, it is shown how the developed LCC model can be used as decision-support tool to preliminarily investigate the implications of alternative management options on the financial and external costs of the WMS.

EVOLUTION OF THE URBAN WASTE MANAGEMENT SYSTEM IN THE EMILIA-ROMAGNA REGION

This multidisciplinary study aims to analyse how the urban waste management system has changed in the Italian region of Emilia-Romagna, during the decade in which a single regional regulatory unit, the Emilia-Romagna Territorial Agency for Water and Waste Services (ATERSIR), was established and became operational, and the waste management planning was centralized at regional level. Particularly, the following changes have been analysed: i) the methods of municipal waste management (WM), considering waste generation, separate waste collection and waste treatment; ii) the costs of WM service, with a focus on cost of treatment and disposal of unsorted waste; and iii) the urban solid WM policies, in terms of levels of governance, territorial planning and implementation of policies on the regional territory. The period within which the analysis was carried out covers the years from 2008 to 2018, comparing two time frames, before and after ATERSIR establishment. Data at municipal level were gathered and analysed. The results of the technical, economical and institutional assessment show that relevant benefits occurred, such as a constant improvement of environmental performances, the optimisation of the waste flows to plants, a higher level of uniformity of WM cost among Municipalities and a better quality of data collected from waste providers for the technical and economic regulation of the sector. Potential improvements are identified, whilst the institutional reform is positively evaluated in all the analysed aspects.

A Statistical Model for Earthquake And/Or Rainfall Triggered Landslides

Natural hazards can be initiated by different types of triggering events. For landslides, the triggering events are predominantly earthquakes and rainfall. However, risk analysis commonly focuses on a single mechanism, without considering possible interactions between the primary triggering events. Spatial modeling of landslide susceptibility (suppressing temporal dependence), or tailoring models to specific areas and events are not sufficient to understand the risk produced by interacting causes. More elaborate models with interactions, capable of capturing direct or indirect triggering of secondary hazards, are required. By discretising space, we create a daily-spatio-temporal hazard model to evaluate the relative and combined effects on landslide triggering due to earthquakes and rainfall. A case study on the Italian region of Emilia-Romagna is presented, which suggests these triggering effects are best modeled as additive. This paper demonstrates how point processes can be used to model the triggering influence of multiple factors in a large real dataset collected from various sources.

Impact of the COVID-19 pandemic on dental hygiene students in the Italian region of Emilia-Romagna.

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a new coronavirus detected in China at the end of 2019. Because SARS-CoV-2 is highly infectious due to contamination in the air, there is a high risk of infection in the dental environment which is represents a serious problem for professionals and students (dentistry and dental hygiene). In Italy, since February 23, 2020, the government has suspended all teaching activities of schools and universities. An anonymous questionnaire was administered to the students of the degree courses in Dental Hygiene of the Emilia Romagna Region, one of the most affected regions in Italy. The survey was intended to highlight the practical and emotional consequences of the emergency of COVID-19 on educational activities and in the training of students. The survey was sent to the 150 students enrolled in the universities of Bologna, Ferrara and Modena and Reggio Emilia; 141 of them completed it (94%). Since the start of the COVID-19 pandemic, several surveys have been proposed to measure the impact of this emergency situation on dental professionals; at present, however, there are still no assessments for dental hygiene degree courses, in particular aimed at assessing the psychological impact on students. Students consider the dental hygienist as a risky profession, while the risk taken by patients is considered as low. Given the concern reported the students, it would be useful to address the issue of proper assessment of risk during the university training of dental hygienists.

Impact of the COVID-19 pandemic on dental hygiene students in the Italian region of Emilia-Romagna

Objectives The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a new coronavirus detected in China at the end of 2019. Because SARS-CoV-2 is highly infectious due to contamination in the air, there is a high risk of infection in the dental environment which is represents a serious problem for professionals and students (dentistry and dental hygiene). In Italy, since February 23, 2020, the government has suspended all teaching activities of schools and universities. Methods An anonymous questionnaire was administered to the students of the degree courses in Dental Hygiene of the Emilia Romagna Region, one of the most affected regions in Italy. The survey was intended to highlight the practical and emotional consequences of the emergency of COVID-19 on educational activities and in the training of students. Results The survey was sent to the 150 students enrolled in the universities of Bologna, Ferrara and Modena and Reggio Emilia; 141 of them completed it (94%). Since the start of the COVID-19 pandemic, several surveys have been proposed to measure the impact of this emergency situation on dental professionals; at present, however, there are still no assessments for dental hygiene degree courses, in particular aimed at assessing the psychological impact on students. Conclusions Students consider the dental hygienist as a risky profession, while the risk taken by patients is considered as low. Given the concern reported the students, it would be useful to address the issue of proper assessment of risk during the university training of dental hygienists.

Genetic Diversity of Castanea sativa Mill. Accessions from the Tuscan-Emilian Apennines and Emilia Romagna Region (Italy)

This work investigated the genetic diversity of 134 Castanea sativa Mill. accessions present in the Italian region of Emilia-Romagna. Samples were taken from three collection fields (Granaglione, Zocca and Paloneta) in the Tuscan-Emilian Apennines. The accessions were analyzed by using 16 microsatellite markers (SSR). Genetic distances among accessions, calculated through the DICE coefficient, were used to construct an UPGMA cluster analysis. One major genotype (named “Marroni”) was identified across the three investigated collection fields; this variety corresponds to a sweet chestnut cultivar that has been propagated and widely diffused in the Emilia-Romagna region. Other genotypes were represented by different varieties of Italian chestnuts. The results of this study will be used to define and share guidelines for the characterization and varietal certification of the chestnut varieties in the Emilia-Romagna region.

Reorganizing territorial healthcare to avoid inappropriate ED visits: does the spread of Community Health Centres make Walk-in-Clinics redundant?

BackgroundCommunity care has recently been restructured with the development of Community Health Centres (CHCs), forcing a general rethink on the survival of previous organizational solutions adopted to reduce inappropriate ED access, for example Walk-in-Clinics (WiCs).MethodsWe focus on the Italian Emilia-Romagna Region that has made huge investments in CHC development, whilst failing to proceed at a uniform rate from area to area. Estimating panel count data models for the period 2015–2018, we pursue two goals. First we test the existence of a “CHC effect”, choosing five urban cities with different degree of development of the CHC model and assessing whether, all else being equal, patients treated by GPs who have their premises inside the CHC show a lower need to seek inappropriate care (Aim 1). Second, we focus our attention on Walk-in-Clinics, investigating the long-established WiC in the city of Parma that currently coexists with three CHCs recently established in the same catchment area. In this case we try to assess whether, and to what extent, the progressive development of the CHCs in the city of Parma has been affecting the dynamics of WiC access (Aim 2).ResultsAs regards Aim 1, we show that CHCs reduce the probability of inappropriate patient access to emergency care. As regards Aim 2, in the city of Parma patients whose GP belongs to the CHC are less likely to visit the WiC on a workday, with no significant change during the weekend when CHCs are closed, questioning the need to maintain them both in the same area when the CHC model is fully implemented.ConclusionsOur results confirm the hypothesis that expanding access to primary care settings diminishes inappropriate ED use. In addition, our findings suggest that where CHCs and WiCs coexist in the same area, it may be advisable to implement strategies that bring WiC activities into step with CHC-based general primary care reforms to avoid duplication.

Is a COVID-19 Second Wave Possible in Emilia-Romagna (Italy)? Forecasting a Future Outbreak with Particulate Pollution and Machine Learning

The Nobel laureate Niels Bohr once said that: “Predictions are very difficult, especially if they are about the future”. Nonetheless, models that can forecast future COVID-19 outbreaks are receiving special attention by policymakers and health authorities, with the aim of putting in place control measures before the infections begin to increase. Nonetheless, two main problems emerge. First, there is no a general agreement on which kind of data should be registered for judging on the resurgence of the virus (e.g., infections, deaths, percentage of hospitalizations, reports from clinicians, signals from social media). Not only this, but all these data also suffer from common defects, linked to their reporting delays and to the uncertainties in the collection process. Second, the complex nature of COVID-19 outbreaks makes it difficult to understand if traditional epidemiological models, such as susceptible, infectious, or recovered (SIR), are more effective for a timely prediction of an outbreak than alternative computational models. Well aware of the complexity of this forecasting problem, we propose here an innovative metric for predicting COVID-19 diffusion based on the hypothesis that a relation exists between the spread of the virus and the presence in the air of particulate pollutants, such as PM2.5, PM10, and NO2. Drawing on the recent assumption of 239 experts who claimed that this virus can be airborne, and further considering that particulate matter may favor this airborne route, we developed a machine learning (ML) model that has been instructed with: (i) all the COVID-19 infections that occurred in the Italian region of Emilia-Romagna, one of the most polluted areas in Europe, in the period of February–July 2020, (ii) the daily values of all the particulates taken in the same period and in the same region, and finally (iii) the chronology according to which restrictions were imposed by the Italian Government to human activities. Our ML model was then subjected to a classic ten-fold cross-validation procedure that returned a promising 90% accuracy value. Finally, the model was used to predict a possible resurgence of the virus in all the nine provinces of Emilia-Romagna, in the period of September–December 2020. To make those predictions, input to our ML model were the daily measurements of the aforementioned pollutants registered in the periods of September–December 2017/2018/2019, along with the hypothesis that the mild containment measures taken in Italy in the so-called Phase 3 are obeyed. At the time we write this article, we cannot have a confirmation of the precision of our predictions. Nevertheless, we are projecting a scenario based on an original hypothesis that makes our COVID-19 prediction model unique in the world. Its accuracy will be soon judged by history—and this, too, is science at the service of society.

A meteorological analysis interpolation scheme for high spatial-temporal resolution in complex terrain

An adaptive high-temporal resolution interpolation scheme for meteorological observations is presented. It stems from a combination of linear regression, anomaly correction and clustering. A number of approaches to tackle this problem for monthly and daily data have been proposed in the past, but interpolation studies at sub-daily temporal scales are much more limited. Hourly and sub-hourly observational datasets use to present high variability that may be related to different weather conditions. In the proposed methodology, rather than considering the whole data set to perform the interpolation, data are divided in different clusters of variable size, separating regions with potential dissimilar behaviour. A linear regression model is calculated for each cluster and compared against a global model obtained considering all the observations. Only those clusters whose regression model yields a reduction of errors compared to the global model are selected. The adaptive condition lays on that several numbers of clusters are tested and the one that performs the best, in terms of Root Mean Square Error, is selected every time an interpolation is conducted. The methodology presented provides gridded analysis fields of hourly and sub-hourly intervals at 250 m of horizontal resolution. It was originally developed for a complex terrain region (Catalonia, NE Spain), and it was also demonstrated in the German Land of Baden-Württemberg and in the Italian region of Emilia-Romagna. Results show a reduction of cross-validation errors using the leave-one-out method for air temperature and dew point temperature fields and a proper representation of complex orography features. The scheme presented is implemented in Python as pyMICA and it is available as open-source software.

Fighting cancer in coronavirus disease era: organization of work in medical oncology departments in Emilia Romagna region of Italy.

Aim: To assess which and when measures were applied to reduce coronavirus disease (COVID-19) spreads have been applied in medical oncology departments. Materials & methods: We surveyed all medical oncology departments from the Italian Emilia Romagna region via a multidomain questionnaire. The questions covered items on patients, healthcare workers, risk reduction measure and clinical trials. Results: A total of 12 centers involving 861 healthcare members joined the survey. The measures applied to patients and health workers partially converged in all the departments while major divergences were found in the clinical trials domain. High rate of COVID-19 infection occurred among medical doctors (21/208, 10.1%) and social care workers (13/110, 11.8%). Rate of infection among nurses was 5.7% (24/418). Conclusion: All measures able to reduce risk of COVID-19 infection must be applied in medical oncology departments. Early introduction of risk reduction measures may be a critical issue.

Early Identification of Locally Emerging Trends in Psychoactive Substance Use – Experience and Best Practice in Four European Localities

Background: Timely information about trends in psychoactive substance use could yield tailored interventions and reduce potential harms. However, conventional epidemiological tools might have limited capacity to detect trends emerging on a local level. Objectives: The aim of this study was to explore best practice in the identification of new drug trends at the local level. Methods: A total of 33 key informants from seven European municipalities/regions were interviewed to describe trends in substance use in their locality and to provide expert insights on how these were identified. Semi-structured interviews were analyzed with open coding method. Results: Four case studies that described local trends and responses were compiled: onset of problematic GHB use in the Dutch municipality of Breda (1); emerging retail shops selling new psychoactive substances (NPS) across the regions of Czech Republic (2) and in the Portuguese Agueda and Coimbra (3); and use of drugs with unknown content in the Italian region of Emilia Romagna, and its city Bologna (4). “Early identifiers” in the four case studies were organizations that work directly with people who use drugs (PWUD), emergency departments, and local police. Efficient methods of horizontal and vertical information sharing, sometimes facilitated by communication platforms, were in place, such that included early warning systems on local, national, and supra-local level. Local-level identification systems appeared as best suited to provide locally relevant information. Conclusions: Best practice in identifying emerging trends should involve all relevant “early identifiers”, should consist of supra-local exchange platforms, integrate the qualities of local-level identification, and be facilitated by local-level coordinators.

The occurrence of Brassica montana Pourr. (Brassicaceae) in the Italian regions of Emilia-Romagna and Marche, and in the Republic of San Marino

Brassicamontana Pourr., a wild relative of the Brassicaoleracea L. cole crops (broccoli, cabbage, cauliflower, etc.), deserves special attention for its potential to easily transfer agronomically useful traits to related crops. Monitoring existing B.montana populations is the first step to enabling long-term conservation and management of wild genetic resources. The main distribution area of B.montana extends along the coasts of the northern Mediterranean Sea from north-east Spain to north-west Italy (coast of Liguria and Apuan Alps in Tuscany). Further east and south, the distribution of B.montana is fragmentary, with isolated populations, in some cases, only observed in the 19th or early 20th century and never re-confirmed later. In this paper, we focus on all the B.montana reports for the Italian regions of Emilia-Romagna and Marche, and additionally for the neighbouring Republic of San Marino. Literature records were verified through field visits where possible. According to our analysis, the presence of B.montana is confirmed in the Marche and the Republic of San Marino, but not in Emilia-Romagna. We recommend further studies on the distribution of B.montana in Italy, also applying molecular means, beyond morphology, to distinguish B.montana from naturalized B.oleracea and other related taxa.

Detection of Extended- Spectrum Beta-Lactamase producing Escherichia coli from mesenteric lymph nodes of wild boars (Sus scrofa)

Wild boars (Sus scrofa) are increasing in several European countries, including Italy. In areas with intensive animal farming, like the Italian Emilia-Romagna region, they are likely to be exposed to antimicrobialresistant (AMR) bacteria of livestock origin. In 2017-2018, 108 mesenteric lymph nodes samples were collected from 108 wild boars hunted in Parma province, Emilia-Romagna region, to be tested for ESBL- and carbapenemase-producing Escherichia coli. One isolate (WB-21L) out of 108 (0.9%) was phenotypically confirmed as ESBLproducing E. coli. The strain WB-21L was tested by PCR for the genes blaSHV, blaCTX-M, blaTEM, blaAmpC, blaKPC, blaNDM, blaVIM, blaIMP, blaOXA-48, blaSPM, blaBIC, blaSIM, blaDIM, blaGIM, blaAIM, resulting positive for TEM β- lactamase. Resistance to ampicillin, amoxicillin/clavulanic acid, streptomycin, sulfasomidine, tetracycline and trimethoprim confirmed the multi-resistance nature of the strain WB-21L. Nine E.coli isolates showed resistance to meropenem by the Kirby Bauer test but none of them showed Meropenem MIC values indicative of resistance. In conclusion, the present study shows the presence of ESBL E. coli in wild boars and the possible risk of transfer to game meat handlers and consumers. Future studies are needed to better evaluate the sources of AMR bacteria in wildlife.

Impact of hospital admissions subsequent to renal transplantation on Italian regional resources: a retrospective study in the Italian region of Emilia-Romagna.

Aim of this retrospective study was to investigate costs and resource consuming, expressed by diagnosis related groups (DRG), related only to hospitalizations of renal transplant recipients (RTRs) for all causes in the Region Emilia Romagna (RER) in Italy. We included all hospital admissions of RTRs (International Classification of Diseases 9th Revision, Clinical Modification [ICD-9-CM] code V420) between 2001 and 2015. We calculated number of admissions, RTRs and inhabitants of RER for each year, mean age, length of stay (LOS) in the hospital as total number of days, mean and median days, mean value of DRG and costs of admissions during the 15-year period of the study. RTRs admitted in the 15 years study period were 9,197 and mean age 56.6±1.6 years. Admissions were 14,558, and mean rate of admitted RTRs (*100,000) was 14.21. Total, mean and median LOS were 122,966, 8.7 and 6 days, respectively. Total costs of admissions during the study period were €72,717,232 with mean DRG values of €3,409. Number of admissions and total number of days required for RTRs as well as mean age of admitted patients increased from 2001 to 2015, however mean and median LOS remained stable. Costs due to admissions of RTRs appeared to gradually increase in the long term probably due to the increasing number of admissions and increasing mean age of admitted RTRs.