Northeast Italy Research Articles

Psychological impact of COVID-19 pandemic on healthcare workers in a highly burdened area of north-east Italy.

Healthcare workers exposed to coronavirus 2019 (COVID-19) patients could be psychologically distressed. This study aims to assess the magnitude of psychological distress and associated factors among hospital staff during the COVID-19 pandemic in a large tertiary hospital located in north-east Italy. All healthcare and administrative staff working in the Verona University Hospital (Veneto, Italy) during the COVID-19 pandemic were asked to complete a web-based survey from 21 April to 6 May 2020. Symptoms of post-traumatic distress, anxiety and depression were assessed, respectively, using the Impact of Event Scale (IES-R), the Self-rating Anxiety Scale (SAS) and the Patient Health Questionnaire (PHQ-9). Personal socio-demographic information and job characteristics were also collected, including gender, age, living condition, having pre-existing psychological problems, occupation, length of working experience, hospital unit (ICUs and sub-intensive COVID-19 units vs. non-COVID-19 units). A multivariable logistic regression analysis was performed to identify factors associated with each of the three mental health outcomes. A total of 2195 healthcare workers (36.9% of the overall hospital staff) participated in the study. Of the participants, 35.7% were nurses, 24.3% other healthcare staff, 16.4% residents, 13.9% physicians and 9.7% administrative staff. Nine per cent of healthcare staff worked in ICUs, 8% in sub-intensive COVID-19 units and 7.6% in other front-line services, while the remaining staff worked in hospital units not directly engaged with COVID-19 patients. Overall, 63.2% of participants reported COVID-related traumatic experiences at work and 53.8% (95% CI 51.0%-56.6%) showed symptoms of post-traumatic distress; moreover, 50.1% (95% CI 47.9%-52.3%) showed symptoms of clinically relevant anxiety and 26.6% (95% CI 24.7%-28.5%) symptoms of at least moderate depression. Multivariable logistic regressions showed that women, nurses, healthcare workers directly engaged with COVID-19 patients and those with pre-existing psychological problems were at increased risk of psychopathological consequences of the pandemic. The psychological impact of the COVID-19 pandemic on healthcare staff working in a highly burdened geographical of north-east Italy is relevant and to some extent greater than that reported in China. The study provides solid grounds to elaborate and implement interventions pertaining to psychology and occupational health.

Postoperative complications after minimally invasive esophagectomy in the prone position: any anesthesia-related factor?

To evaluate the incidence of postoperative complications arising within 30 days of minimally invasive esophagectomy in the prone position with total lung ventilation and their relationship with 30-day and 1-year mortality. Secondary outcomes included possible anesthesia-related factors linked to the development of complications. The study is a retrospective single-center observational study at the Anesthesia and Surgical Department of a tertiary care center in the northeast of Italy. Patients underwent cancer resection through esophagectomy in the prone position without one-lung ventilation. We included 110 patients from January 2010 to December 2017. A total of 54% of patients developed postoperative complications that increased mortality risk at 1 year of follow-up. Complications postponed first oral intake and delayed patient discharge to home. Positive intraoperative fluid balance was related to increased mortality and the risk to develop postoperative complications. C-reactive protein at third postoperative day may help detect complication onset. Complication onset has a great impact on mortality after esophagectomy. Some anesthesia-related factors, mainly fluid balance, may be associated with postoperative mortality and morbidity. These factors should be carefully taken into account to obtain better outcomes after esophagectomy in the prone position without one-lung ventilation.

Managing moderate water deficit increased anthocyanin concentration and proanthocyanidin galloylation in “Refošk” grapes in Northeast Italy

Grapevines in Karst between Italy and Slovenia are grown on a shallow "Terrarossa” red karst loam laying on carbonate rocks. In Karst, water stress conditions occur during the summer season both because of the rain scarcity and the poor available water content of the soils. Moreover, irrigation can be used to only partially supply grapevine requirements, where possible. An irrigation trial was carried out in a vineyard of “Refošk” during the seasons 2018–2019 to understand the effects of two deficit irrigation regimes (20% and 50% ETC) on yield parameters and basic maturation, but mainly on polyphenol content, composition and extractability. During the summer season Ψstem was regularly checked in order to follow the plant water status, and at harvest time berry samples were collected to determine the total concentration of anthocyanins and proanthocyanidins and their extractability in a wine-like solution. Moreover, the structural characteristics of seed and skin proanthocyanidins were analyzed. In both seasons, differences in plant water status were ascertained, but values of Ψstem never highlighted situations of severe water stress for both deficit irrigation regimes. 20% ETC resulted in a significant increase in the concentration of both total and extractable anthocyanins; on the other hand, proanthocyanidin concentration was not significantly affected by the irrigation regime. As regards the structure of proanthocyanidins, 20% ETC accounted for a higher degree of galloylation in both total and extractable seed and skin proanthocyanidins. A more limited irrigation regime resulted in both higher anthocyanin concentration and degree of galloylation of seed and skin proanthocyanidins - attributes that might account for a better wine quality potential.

Paleo-Seismicity in the Euganean Hills Province (Northeast Italy): Constraints From Geomechanical and Geophysical Tests in the Schio-Vicenza Fault Area

Gouges and cataclasites within exhumed fault zones are valuable indicators of past seismic events. Gouge layers, 40- to 100-cm-thick and decameters long, have been found within uplifted Cretaceous limestones in the Euganean Hills (SW of Padova, NE Italy), Cenozoic subvolcanic chambers intruded within a Meso-Cenozoic sequence. The main tectonic lineament in the area is the Schio-Vicenza Fault that bounds the Euganean Hills to the East. Micropaleontological analyses reveal that the gouges derive from the fragmentation and pulverization of the adjacent pristine carbonatic rocks. Stress tests on specimens from bedrock associated with gouges yielded a minimum dissipated strain energy of 0.3–0.5 MJ/m3to shatter them. Henceforth, additional strain energy was necessary to pulverize these rocks within the gouge zones. Global navigation satellite system observations show that the present deformation pattern in this region of Italy is a few tens of nanostrain (10–30 1/y), not enough to generate such gouge layers. Therefore, the seismicity of the Euganean Hills (currently M ≤5) must be reconsidered in the light of the Schio-Vicenza Fault past activity. The gouges may imply that the Schio-Vicenza Fault had a more intense activity in the past, or this area was affected by remote events or tectonic structures. This article provides new clues on the evolution of the tectonic and morphological setting of the area, with relevant consequences on seismic risk assessment of the nearby urbanized area, including the cities of Padova and Vicenza.

A Complete Morphodynamic Study to Face a River Engineering Issue

The last reach of the Tagliamento River, in North East Italy, is progressively changing its planimetric geometry, causing sediment deposition close to a port and preventing the regular navigation in that area. In the present paper, this river engineering issue has been addressed in a complete way, first investigating the cause which brought to the present situation, and then proposing a number of design solution to mitigate the problem. Some of them have been analyzed by means of a morphodynamic numerical model, reproducing the effects on the bottom height of an average year in terms of flow and tides. The results of each simulation are compared to those of the present situation, in order to underline any advantages of the proposed design solution.

The effects of everyday-life exposure to polycyclic aromatic hydrocarbons on biological age indicators

BackgroundFurther knowledge on modifiable aging risk factors is required to mitigate the increasing burden of age-related diseases in a rapidly growing global demographic of elderly individuals. We explored the effect of everyday exposure to polycyclic aromatic hydrocarbons (PAHs), which are fundamental constituents of air pollution, on cellular biological aging. This was determined via the analysis of leukocyte telomere length (LTL), mitochondrial DNA copy number (LmtDNAcn), and by the formation of anti-benzo[a]pyrene diolepoxide (B[a]PDE–DNA) adducts.MethodsThe study population consisted of 585 individuals living in North-East Italy. PAH exposure (diet, indoor activities, outdoor activities, traffic, and residential exposure) and smoking behavior were assessed by questionnaire and anti-B[a]PDE–DNA by high-performance-liquid-chromatography. LTL, LmtDNAcn and genetic polymorphisms [glutathione S-transferase M1 and T1 (GSTM1; GSTT1)] were measured by polymerase chain reaction. Structural equation modelling analysis evaluated these complex relationships.ResultsAnti-B[a]PDE–DNA enhanced with PAH exposure (p = 0.005) and active smoking (p = 0.0001), whereas decreased with detoxifying GSTM1 (p = 0.021) and in females (p = 0.0001). Subsequently, LTL and LmtDNAcn reduced with anti-B[a]PDE–DNA (p = 0.028 and p = 0.018), particularly in males (p = 0.006 and p = 0.0001). Only LTL shortened with age (p = 0.001) while elongated with active smoking (p = 0.0001). Besides this, the most significant determinants of PAH exposure that raised anti-B[a]PDE–DNA were indoor and diet (p = 0.0001), the least was outdoor (p = 0.003).ConclusionNew findings stemming from our study suggest that certain preventable everyday life exposures to PAHs reduce LTL and LmtDNAcn. In particular, the clear association with indoor activities, diet, and gender opens new perspectives for tailored preventive measures in age-related diseases.CapsuleEveryday life exposure to polycyclic aromatic hydrocarbons reduces leukocyte telomere length and mitochondrial DNA copy number through anti-B[a]PDE-DNA adduct formation.

Sources of variation of antimicrobial use in Charolaise and Limousine beef breeds in Veneto region (Italy)

Sources of variation of antimicrobial use in Charolaise and Limousine beef breeds in Veneto region (Italy)

A Multilevel Procedure at Urban Scale to Assess the Vulnerability and the Exposure of Residential Masonry Buildings: The Case Study of Pordenone, Northeast Italy

More than the 60% of the Italian residential building stock had already been built by 1974, when seismic codes were enforced on a minimal part of the country. Unreinforced masonry buildings represent most of that share, but they are typical for each region, in terms of both materials and structural configurations. The definition of ‘regional’, i.e., more specific, vulnerability and exposure models are required to improve existing forecast models. The research presents a new geographic information system (GIS)-based multilevel procedure for earthquake disaster prevention planning at urban scale; it includes multicriteria analysis, such as architectural types, structural vulnerability analysis, microzonation studies, and socio-economic aspects. The procedure has been applied to the municipality of Pordenone (PN), a district town of the Friuli–Venezia–Giulia region, in Northeast Italy. To assess the urban seismic risk, more than 5000 masonry residential buildings were investigated and common types within sub-municipal areas and exposure data were collected. Simplified mechanical analysis provided a ‘regional’ vulnerability model through typological fragility curves. The integration of results into GIS tool permitted the definition of cross-mapping among vulnerability, damage scenarios (conditional and unconditional) and exposure (seismic losses, casualties, impact), with respect to various earthquake intensities expected in the town. These results are presented at different scales: from the single building, to submunicipal area and to the entire town.

Choice of the Optimal Design and Operation of Multi-Energy Conversion Systems in a Prosecco Wine Cellar

Despite the high energy consumption of wine making processes, little efforts have been spent so far, both at the industrial and scientific level, to search for alternative energy systems in wine cellars. In fact, almost all the existing cellars take electricity from the grid and burn natural gas or other fossil fuels to fulfil their energy demands. This paper analyses the energy demands of a real Prosecco wine cellar in the North East of Italy, which can be considered as a “reference” cellar for dimensions and wine production. The goal is to find the best energy conversion system in terms of maximum profits, efficiency and share of renewable energy utilization. Four alternative design configurations are proposed, and each one optimized considering the three objectives. Results show that a 35% gain in the maximum profits is obtained by including a natural gas fueled CHP internal combustion engine and an absorption chiller. This configuration is also the best one to achieve the maximum efficiency (61%), resulting in 18% reduction of primary energy consumption. Conversely, the utilization of a biomass boiler and an absorption chiller allows maximizing the share of renewable energy consumption, which is about 35% considering the existing availability of biomass from pruning harvesting and the relative limited surface available for photovoltaic generation. This option may become economically interesting when the price of natural gas increases of at least 50%.

<strong>A morphological and phylogenetic characterisation of <em>Inocybe similis</em> (Agaricales, Inocybaceae), a rare species described by Bresadola in 1905</strong>

Inocybe similis, a very rare smooth-spored species originally described from Italy by Bresadola, is illustrated. Based on sequence generated from the type specimen, freshly collected specimens from five sites, Grado in north-east Italy, Tolmin in Slovenia, Forchach and Rieden in Austria and Füssen in Gemany could be asigned to I. similis and a more detailed description is provided here. The macro- and micromorphological features of I. similis suggest this species should be placed in Inocybe sect. Splendentes according to Singer´s classification. In contrast, our phylogenetic analyses support instead that I. similis belongs to Inocybe sect. Marginatae. From a morphological point of view, I. similis is close to I. vulpinella, but it is phylogenetically close to I. flavobrunnescens in sect. Marginatae.

First insights into plastic and microplastic occurrence in biotic and abiotic compartments, and snow from a high-mountain lake (Carnic Alps)

Plastic pollution has become a pervasive environmental problem on a global scale, from the ocean depths to the aquatic ecosystems of the Tibetan Plateau. To date, data on plastic and microplastic occurrence in pristine ecosystems like high-mountain lakes are lacking. In this study, plastic (>5000 μm) and microplastic (10–5000 μm) levels were measured in snow at the end of the winter season (April 2020), and in water, sediment, and biological samples collected monthly (June–October 2019) during the ice-free season from the Dimon Lake, a high-mountain lake in the Carnic Alps, northeast Italy. Biological samples consisted of chironomids (Diptera, Chironomidae; n = 150) and stomach contents of Cottus gobio (n = 40). Analysis of the water, sediment, and biological samples revealed the absence of plastic and microplastics larger than 10 μm, whereas the snow samples contained microplastics of polyethylene terephthalate (PET) albeit at very low levels (0.11 ± 0.19 L-1). These results show that while the lake ecosystem could be considered unpolluted by microplastics, abundant snow precipitation in winter can trap microplastic particles that deposit on the ground. The very low levels of PET microparticles recorded in the snow samples suggest the need for further research to better understand the source of microplastic pollution in this environmental matrix.

Early and midterm outcomes of endovascular aneurysm repair with an ultra-low-profile endograft from the Triveneto Incraft Registry

ObjectiveWe evaluated the early and midterm outcomes of the Incraft (Cordis Corp, Bridgewater, NJ) ultra-low-profile endograft by analyzing data from the Triveneto Incraft Registry (TIR). MethodsTIR is an independent multicenter cohort registry of 10 vascular surgery units in the Triveneto area (Northeast Italy). A prospective analysis of patients electively treated with Incraft from September 2014 to June 2019 was performed. The main outcomes were technical success, major 30-day complications, 30-day aneurysm-related death, freedom from reintervention, and mortality rate during follow-up and were analyzed using Kaplan-Meier curves. Univariable Cox regression was used to evaluate the associations between anatomic complexity factors and reintervention. ResultsDuring the study period, 209 patients were included in the registry. Their mean age was 76.9 ± 7.7 years and the Society for Vascular Surgery comorbidity score was 0.97 ± 0.52. Most patients (n = 181; 86.6%) had presented with at least one complex anatomic factor: aortic neck angle α <135° in 31 patients (14.8%), conic neck in 17 patients (8.2%), iliac tortuosity index τ >1.5 in 102 (48.8%), iliac artery calcification >50% in 106 (50.7%), and external iliac artery <6 mm in 45 (21.5%). The concurrent presence of two or more complex iliac anatomic factors was present in 67 patients (32.1%). The technical success rate was 99.5%, and the early major complication rate was 1.5% (one limb occlusion, one iliac branch stenosis, one type III endoleak [EL]). No 30-day mortality was recorded. The mean follow-up period was 18.5 ± 13.2 months. The overall mortality was 9.5% (n = 18), none related to the aneurysm. The freedom from reintervention rate was 92.1%. Of these patients, six (3.2%) had been treated for type II EL embolization, one (0.5%) for type IA EL, four (2.1%) for iliac branch occlusion, and one (0.5%) for flow-limiting external iliac artery dissection. None of the single anatomic factors analyzed were predictive of reintervention. However, the association of two or more complex iliac anatomic factors was predictive of related reintervention (hazard ratio, 7.25; P = .014). The crude reintervention rate in this complex subgroup of patients was low (4 of 67; 6%). ConclusionsData from the TIR have demonstrated excellent early and midterm outcomes of endovascular aneurysm repair using the Incraft stent graft in patients with complex anatomy. The concurrent presence of two or more complex iliac anatomic factors still represent an issue for endovascular aneurysm repair success. However, the technical characteristics of this device resulted in low intervention rates, even for patients with these challenging issues.

Cardiovascular effectiveness of human-based vs. exendin-based glucagon like peptide-1 receptor agonists: a retrospective study in patients with type 2 diabetes.

Glucagon like peptide-1 (GLP-1) receptor agonists (GLP-1RA) are effective to control type 2 diabetes (T2Ds) and can protect from adverse cardiovascular outcomes. GLP-1RA are based on the human GLP-1 or the exendin-4 sequence. We compared cardiovascular outcomes of patients with T2D who received human-based or exendin-based GLP-1RA in routine clinical practice. We performed a retrospective study on the administrative database of T2D patients from the Veneto Region (North-East Italy). We identified patients who initiated a human-based or exendin-based GLP-1RA from 2011 to 2018. The primary outcome was occurrence of major adverse cardiovascular events (MACE). Secondary outcomes were individual MACE components, revascularization, hospitalization for heart failure, or for cardiovascular causes. From 330193 patients with diabetes, 6620 were new users of GLP-1RA. After propensity score matching, we analysed 1098 patients in each group, who were on average 61 years old, 59.5% males, 13% with established cardiovascular disease, had an estimated diabetes duration of 8.4 years, and a baseline HbA1c of 7.9%. During a median follow-up of 18 months, patients treated with human-based GLP-1RA as compared to those treated with exendin-based GLP-1RA, showed lower rates of MACE [hazard ratio 0.61; 95% confidence interval (CI) 0.39-0.95], myocardial infarction (0.51; 95% CI 0.28-0.94), and hospitalization for cardiovascular causes (0.66; 95% CI 0.47-0.92). We observed better cardiovascular outcomes among patients treated with human-based vs. exendin-based GLP-1RA under routine care. In the absence of comparative trials and in view of the limitations of retrospective studies, this finding provides a moderate level of evidence to guide clinical decision.

Dientamoeba fragilis in the North-East of Italy: Prevalence study and treatment.

Dientamoeba fragilis is an intestinal protozoan, an inhabitant of the human gastrointestinal tract, with a worldwide distribution. The reported prevalence of D. fragilis varies worldwide in different populations between 0.3% and 82.9%, and its role as a pathogen is still unclear. The parasite has been identified in the faeces of asymptomatic patients and with different acute and chronic symptoms, like abdominal pain, diarrhoea, flatulence, nausea and vomiting. The aims of this study were to evaluate the prevalence of D. fragilis in the North-East of Italy, and the clinical improvement of symptoms after recommended treatment with paromomycin or metronidazole. Furthermore, a literature review of D. fragilis prevalence studies in Italy was carried out to show the Italian situation. Of 575 enrolled people, 85 (14.8%) were positive for D. fragilis. The most prevalent symptoms were abdominal pain 28.2%, anal itching 27.1%, watery diarrhoea 18.8%, meteorism 16.5% and nausea/lack of appetite 14.1%. The high rate of anal itching was unexpected, because it wasn't a common symptom. 32 patients were co-infected with B. hominis (37.7%) and three with G. lamblia (3.5%). Our study showed paromomycin had a high efficacy for treatment of D. fragilis infections 100.0% (45/45), while caution must be used when using metronidazole 53.3% (24/40). We recommend paromomycin for empirical treatment, given its great effectiveness in our population.

Critical incidents rates and types in Italian Intensive Care Units: A five-year analysis

ObjectiveTo describe rates and types of critical incidents in Intensive Care Units. Research methodologyA retrospective study in four intensive care units of an Academic Hospital located in the North-East of Italy. All critical incidents recorded in an incident reporting system database from 2013 to 2017 were collected. Results160 critical incidents emerged. The rate was 1.7/100 intensive care-patient admissions, and 2.86/1000 in intensive care-patient days. Nurses reported most of the critical incidents (n = 113, 70.6%). In 2013 there were 19 (11.9%) critical incidents which significantly increased by 2017 (n = 38, 23.7%; p = 0.034). The most frequent critical incidents were medication/intravenous fluids issues (n = 35, 21.9%) and resources and organisational management (n = 35, 21.9%). Less frequently occurring incidents concerned medical devices/equipment (n = 29, 18.1%), clinical processes/procedures (n = 18, 11.3%), documentation (n = 14, 8.8%) and patient accidents (n = 13, 8.1%). Rare incidents included behaviour, clinical administration, nutrition, blood products and healthcare associated infection. ConclusionOver a five-year period, documented incidents were steadily increasing in four Italian intensive care units. A voluntary incident reporting system might provide precious information on safety issues occurring in units. at both policy and professional levels.

Assessment of the direct quantitation of SARS-CoV-2 by droplet digital PCR

Droplet digital PCR (ddPCR) is a sensitive and reproducible technology widely used for quantitation of several viruses. The aim of this study was to evaluate the 2019-nCoV CDC ddPCR Triplex Probe Assay (BioRad) performance, comparing the direct quantitation of SARS-CoV-2 on nasopharyngeal swab with the procedure applied to the extracted RNA. Moreover, two widely used swab types were compared (UTM 3 mL and ESwab 1 mL, COPAN). A total of 50 nasopharyngeal swabs (n = 25 UTM 3 mL and n = 25 ESwab 1 mL) from SARS-CoV-2 patients, collected during the pandemic at IRCCS Sacro Cuore Don Calabria Hospital (Veneto Region, North-East Italy), were used for our purpose. After heat inactivation, an aliquot of swab medium was used for the direct quantitation. Then, we compared the direct method with the quantitation performed on the RNA purified from nasopharyngeal swab by automated extraction. We observed that the direct approach achieved generally equal RNA copies compared to the extracted RNA. The results with the direct quantitation were more accurate on ESwab with a sensitivity of 93.33% [95% CI, 68.05 to 99.83] and specificity of 100.00% for both N1 and N2. On the other hand, on UTM we observed a higher rate of discordant results for N1 and N2. The human internal amplification control (RPP30) showed 100% of both sensitivity and specificity independent of swabs and approaches. In conclusion, we described a direct quantitation of SARS-CoV-2 in nasopharyngeal swab. Our approach resulted in an efficient quantitation, without automated RNA extraction and purification. However, special care needs to be taken on the potential bias due to the conservation of samples and to the heating treatment, as we used thawed and heat inactivated material. Further studies on a larger cohort of samples are warranted to evaluate the clinical value of this direct approach.

Evaluation of runoff and soil erosion under conventional tillage and no-till management: A case study in northeast Italy

Conservation agriculture, and in particular no-till systems, generally yield improvements in both soil characteristics (e.g. structure, and water holding capacity) and soil processes (such as runoff and hence erosion). Nevertheless, during the first years of no-till, the soil is prone to compaction due to the poor structure, missing ploughing activities, and passage of tractors and machinery, thus favouring surface runoff and soil erosion. Little information exists about the effect of no-till when applied during the transition period from conventional to conservation agriculture. This study aimed at analysing runoff and soil erosion in a non-tilled field in comparison with a tilled field during the transition period. The study was conducted at the Padova University Experimental Farm, in northeast Italy. Six sub-plots (2.5 m × 5 m) were established, three in a tilled field (CT plot) and three in a non-tilled field (NT plot). Each sub-plot was equipped with a runoff water collection system. Runoff was monitored during two sampling seasons: from May to October 2017 and May to September 2018. Runoff water volume was measured at each rainfall event, and the amount of sediment was quantified by drying the runoff samples. This technique is simple and inexpensive and suitable to be applied also in rural areas with inadequate infrastructures and economic resources. Two indices, runoff reduction benefits (RRB) and sediment reduction benefits (SRB), were computed. During the monitoring period, 24 runoff events occurred. NT practices coincided with reductions of over 50% in runoff volumes and 50% to 95% in sediment losses. Only the runoff event just after the CT soil harrowing produced a significantly lower runoff and sediment loss in CT than in NT field, due to the effect of soil tillage on surface roughness and rainfall infiltration. The average sediment concentration in NT was only 47% of CT. The RRB and SRB values confirmed a reduction in runoff and sediment loss in the NT compared with the CT plot, but SRB was greater than the RRB, indicating that the no-till regime showed a better control of sediment loss than it did the runoff amount. The reduced runoff and sediment yield in the NT plot could have important on-site benefits in terms of both sustainable soil management and surface water quality.

Exposure to perfluoroalkyl substances and thyrotropin levels in an exposed young adult population in the Veneto Region

Background: Perfluoroalkyl substances (PFASs) are persistent and widespread environmental pollutants. People living in the North-East of Italy have been exposed from the late 1970s to 2013 to high concentrations of PFASs through drinking water. The role PFASs could play on thyroid function is still controversial and studies that focused on thyrotropin (TSH) showed inconsistent results. The aim of this study was to evaluate the association between serum PFASs and TSH levels and its dose-response shape in a large exposed population. Methods: A cross-sectional study was conducted in 14,993 individuals aged 20-39 living in the contaminated area. In the main analysis, patients with thyroid pathologies and pregnant women were excluded. Serum levels of perfluorooctanoic acid (PFOA), perfluorooctanesulfonic acid (PFOS), perfluorohexanesulfonic acid (PFHxS) and perfluorononanoic acid (PFNA) were measured by HPLC-MS/MS. Generalized Additive Models were used to evaluate the association between TSH levels and serum PFASs, using thin plate spline smooth terms to model the potential non-linear relationship. Models were stratified by gender and adjusted for potential confounders. A secondary analysis was conducted to evaluate the association between PFASs and the prevalence of self-reported thyroid disorders. Results: In both males and females, a statistically significant non-linear association was found with PFOS. The shape of the slopes shows a decrease in TSH concentration at low levels of PFOS but an increase at higher serum PFOS. PFOA in females was instead found to have a modest linear positive association with TSH. No association was found between TSH and PFNA or PFHxs. We also found higher odds of reporting thyroid disease with increased measured PFNA concentrations in women. Conclusions: Serum PFASs concentrations were modestly associated with thyroid function in this highly exposed young adults population suggesting this substance to be a possible endocrine disruptor. There is evidence of a non-linear association with TSH for PFOS.

Cannabis potency in North-East Italy: A ten-year study (2010–2019)

This paper presents data about potency of herbal and resin cannabis products seized during 2010–2019 in north-east Italy. More than 12,000 cannabis samples were analyzed and concentrations of THC, CBD and CBN were collected. The results of our study provided clear evidence for an increase in the potency of cannabis products across the study period, which is consistent with other studies. Globally, the median THC concentrations increased from about 6%–11%, but differences were found between herbal and resin materials. THC potency in resin materials increased more consistently across the study period with a dramatic raise during 2018–2019, with median THC contents around 17%.CBD concentrations were found to decrease constantly over the study period, especially in herbal materials, which had a mean CBD concentration of 0.3%. In particular, about 75% of the analyzed herbal samples had a CBD concentration which was less than 3% of the corresponding THC concentration. In contrast, more than 50% of the analyzed resin materials had a CBD concentration which was about 30% of the corresponding THC concentration. This is consistent with the increase in prevalence of high-potency seedless female herbal products observed in the same period and indicates that herbal and resin materials were produced from different varieties of cannabis plants. However, resin materials derived from high THC/low CBD cannabis plants were recently found. Different routes (e.g. northern Europe) or different modalities of distribution were assumed for these products.CBN concentrations were also considered and found to be very low and consistent across the study period indicating reliability of THC values used in statistical analysis.In conclusion, this study provided an accurate picture of cannabis products seized over a decade over a definite geographical area which can be extremely helpful for comparative purposes and for national and international statistical analyses on cannabis products.

Study of polyphenols, antioxidant capacity and minerals for the valorisation of ancient apple cultivars from Northeast Italy

Nutritional properties and quality of apple fruits can be related to presence of secondary metabolite contents such as phytochemicals and mineral elements. In this paper, eight polyphenols, four major minerals (Na, K, Mg, Ca), total phenolic content and antioxidant capacity were determined in fourteen ancient apple cultivars grown in Friuli Venezia Giulia (Northeast Italy) to highlight their nutraceutical properties. Both apple peel and pulp were examined separately and results were compared to those of six widespread commercial cultivars using principal component analysis. Ancient apples had much higher content in healthful compounds with respect to commercial varieties, particularly in the peel. Ancient cultivars showed a superior antioxidant capacity in peel (3- to 9- fold) and in pulp (2- to 5-fold) compared to commercial cultivars, with a good correlation with total phenolic content (R = 0.83 in peel and 0.69 in pulp). The polyphenols that mostly characterized the ancient apples pulp were catechins and flavonols. Regarding macro elements, K and Mg content were higher in ancient cultivars, while Na and Ca showed no significant differences. In the perspective of a sustainable economic and social development of local agricultural realities, these results contribute to the valorisation of ancient local apple cultivars as invaluable reservoir of genetic biodiversity to be promoted as functional food or exploited in breeding novel apple hybrids with high nutraceutical properties and better resistance to parasites.