Varese Province Research Articles

Dwarfism-related skeletal dysplasia in Italy. Multi-analytic study of 8th century CE human remains from Azzio (Varese) and biocultural implications of a pathology

Skeletal dysplasias are a broad family of genetic disorders, often challenging to diagnose even in clinical literature without molecular analysis. Some cases of possible skeletal dysplasia have also been identified in osteoarchaeological samples, although achieving a definitive diagnosis is fraught with difficulties. This paper presents the analysis of the osteological remains of AZ-III-3, discovered in the archaeological context of the Church of Sant’Antonio and Eusebio in Azzio (Varese province, Italy). The study aims to demonstrate that even with limited skeletal elements, a diagnosis can be hypothesised using macroscopic morphometric and radio diagnostic techniques. These methods, compared with clinical and paleopathological literature, have allowed for the identification of a rare Italian case of dwarfism-related skeletal dysplasia. This contribution seeks to address the biocultural presence of individuals affected by these skeletal dysplasias, listing and discussing all published Italian cases, including that of AZ-III-3, whose chronological framework was established through both archaeological context analysis and 14C dating.

Interactive effects of long-term exposure to air pollutants on SARS-CoV-2 infection and severity: a northern Italian population-based cohort study.

We examined interactions, to our knowledge not yet explored, between long-term exposures to particulate matter (PM 10 ) with nitrogen dioxide (NO 2 ) and ozone (O 3 ) on SARS-CoV-2 infectivity and severity. We followed 709,864 adult residents of Varese Province from 1 February 2020 until the first positive test, COVID-19 hospitalization, or death, up to 31 December 2020. We estimated residential annual means of PM 10 , NO 2 and O 3 in 2019 from chemical-transport and random-forest models. We estimated interactive effects of pollutants with urbanicity on SARS-CoV-2 infectivity, hospitalization, and mortality endpoints using Cox regression models adjusted for socio-demographic factors and comorbidities, and additional cases due to interactions using Poisson models. 41,065 individuals were infected, 5,203 were hospitalized and 1,543 died from COVID-19 during follow-up. Mean PM 10 was 1.6 times higher and NO 2 2.6 times higher than WHO limits, with wide gradients between urban and non-urban areas. PM 10 and NO 2 were positively associated with SARS-CoV-2 infectivity and mortality, and PM 10 with hospitalizations in urban areas. Interaction analyses estimated that the effect of PM 10 (per 3.5 µg/m 3 ) on infectivity was strongest in urban areas (HR=1.12, 95%CI:1.09-1.16), corresponding to 854 additional cases per 100,000 person-years, and in areas at high NO 2 co-exposure (HR=1.15, 1.08-1.22). At higher levels of PM 10 co-exposure the protective association of ozone reversed (HR=1.32, 1.17-1.49), yielding to 278 additional cases per µg/m 3 increase in O 3 . We estimated similar interactive effects for severity endpoints. We estimate that interactive effects between pollutants exacerbated the burden of SARS-CoV-2 pandemic in urban areas.

The Church of San Giovanni Evangelista in Castelseprio – multi-disciplinary strategies for the characterization of the masonry structures

The remains of the archaeological site of Castelseprio (Varese province, Italy) are listed under the UNESCO World Heritage as proof of one of the seven settlements of the Lombards in Italy. Freestanding elements belonging to the apse and the lateral walls of the church of San Giovanni Evangelista are still preserved nowadays, reaching heights around 5 and 10 m, respectively. The condition of these walls, both in terms of slenderness and incompleteness, constitutes a possible vulnerability under horizontal actions that would need to be assessed for conservation. In particular, the presence of multi-leaf and/or low-compact sections could limit the structural capacity of the walls and contribute to brittle collapses, even under low forces. According to the analyses of mortars carried out in the excavation site, the specific characteristics of the local geo-resources (clay-rich sediments traditionally called “Ferretto” deposits) directly influenced the incidence of pozzolanic binding processes, allowing the formation of two different aluminosilicate-based reaction products based on a standard calcic system (C-A-S-H) and on a magnesian one (M-A-S-H). This peculiar reuse of local lateritic soils, with a high concentration in the bedding mortars of the foundational structures, increased not only the general durability of the masonry but also the mechanical properties of the first architectural complex of San Giovanni. Based on the types of mortar identified, various configurations of wall sections were assumed (monolithic and multi-layered) and their mechanical behaviour through kinematic analyses was compared, to evaluate the relevant limits of the seismic capacity of the walls.

What Else Is Needed to Improve Survival from Out-of-Hospital Cardiac Arrest to Hospital Admission? Data from a Prospective Registry for the Years 2020–2023 in the Italian Province of Varese

What Else Is Needed to Improve Survival from Out-of-Hospital Cardiac Arrest to Hospital Admission? Data from a Prospective Registry for the Years 2020–2023 in the Italian Province of Varese

Impact of home-school commuting mode choice on carbon footprint and sustainable transport policy scenarios

Car use for commuting to school is responsible of a significant amount of CO2 emissions, negatively impacting on climate change and calling for action. We collected 8,343 responses through an online survey before the Covid-19 pandemic (November/December 2019) from a sample of schools located in the province of Varese (Northwest of Italy). First, the study estimates the home-school commuting CO2 emissions from students and school staff of the selected schools, both in the starting scenario and in policy scenarios, inducing different potential shifts from car towards more sustainable transport means. Second, it determines the most relevant factors of transport mode selection for school commuting. The findings show that students at high school, even if their trips are generally longer, have lower CO2 emissions than teachers/staff and students of primary and middle schools, because of a higher intensive use of public transport. The optimistic scenario of a 75% shift from car use to walking, for home-school distances up to 2 km, and to public transport, for distances between 2 and 10 km, would save a big amount of CO2 emissions, included in the range 60–67%. Travel distance and time are the two most relevant factors, when students and teachers/staff select the transport means for school commuting. The identification of appropriate sustainable transport policies should consider the geographical, urban, and infrastructural characteristics of the place in which each school is located and of the travel routes.

A normative study of the Italian version of the CERAD neuropsychological battery in young‐old and old‐old participating in population‐based studies

AbstractBackgroundPrevalence of dementia increases with increasing age. Although cognitive assessment is central to the diagnosis of dementia, normative data on neuropsychological tests in non‐selected elderly populations are limited and those available in the oldest‐old rare. Objectives: To report the distribution of scores and normative data on CERAD neuropsychological test battery in a large elderly population including a sizeable number of very old individuals participating in population‐based studies.MethodSubjects included in the analyses were non‐demented participants in three Italian population‐based studies (Monzino‐80 plus, Varese Province, Lombardy; Heath and Anemia, Biella municipality, Piedmont; and Moltrasio, Como province, Lombardy) and in the first normative study on CERAD battery (Lugli 2002). Participants fulfilling DSM‐IV criteria for dementia were excluded. Tests were administered and scored by specifically trained psychologists following standardized criteria, the same in all four studies. The Italian version of CERAD showed high test‐retest reliability (r = 0.89). Multivariable linear regression models were fitted to investigate the association of age (in years), sex, and education (years of schooling) with performance on CERAD tests.ResultThe total population consisted of 2,501 individuals (mean age: 83 years; women: 64%; average education: 6.8 years; institutionalized: 69 [3%]), 802 of whom were young‐old (65‐79 years of age) and 1,699 old‐old (80+ years: 1,155 octogenarians, 470 nonagenarians, and 74 centenarians). The Table shows the distribution of scores (means, SDs, and 5th percentiles) on each test by the whole population as well as by each age class. Better performance on all tests was significantly associated with lower age and higher education; women scored significantly better than men on Word List Learning and Recall, and men better than women on short‐Boston Naming Test and Constructional Praxis Copy and Recall. Refusal to continue and fatigue were the main reasons put forward by elderly participants for not completing the test battery.ConclusionThe present study provides normative data on a neuropsychological test battery commonly utilized in the diagnosis of dementia in a large, non‐selected population of young‐old and old‐old. Performance on CERAD test battery declines with increasing age and lower years of education; performance on some tests were also influenced by sex.

New records of <em>Austropotamobius pallipes</em> (Decapoda: Astacidae) relict populations from the Ticino River

Based on available literature, the white-clawed crayfish Austropotamobius pallipes complex, a species of Community interest according to the EU Habitats Directive, has not been reported in the Lombard Park of the Ticino Valley (Northern Italy) since almost two decades, with the last findings dating back to 2005. In 2021, we found two small populations in the northernmost area of the park (Sesto Calende, province of Varese). These observations support the urge for implementing actions focused on the monitoring and conservation of this endangered species in the Lombard Park of the Ticino Valley in order to avoid its local extinction.

Where was my cup of honey made? PDO honey and sub-regional ethnocentric consumer segments

PurposeThe goal of this study is to understand if ethnocentrism exists at the sub-regional level among honey consumers living in the same production area as a protected designation of origin (PDO). Moreover, this analysis explores if ethnocentrism is influenced by individual economic conditions, among other socio-demographic characteristics.Design/methodology/approachA sample of 725 consumers was collected through the use of a questionnaire that was circulated in the province of Varese, one of the few honey PDO areas in Italy. The authors performed a principal component analysis and a two-step cluster analysis to identify different PDO honey consumer segments, focusing on their interest for PDO attributes.FindingsThe authors identified four consumer segments, depending on socio-demographic, consumption habits, frequencies, preferred attributes and preferences for the PDO product. One cluster exhibited strong preferences for the PDO honey, in the spirit of ethnocentrism, and was characterised by low-income levels; ethnocentric preferences were also observed in another cluster that had a different socio-economic profile.Research limitations/implicationsHoney is a niche product and not universally diffused among consumers: further analyses should investigate sub-national ethnocentrism for more universal food products. Yet, through the inspection of the different profiles found, it was possible to devise marketing strategies to boost PDO honey purchasing and to bring consumers closer to PDO products.Originality/valueThis analysis considers ethnocentrism as a segmentation criterion for PDO honey consumers that live in the very same PDO honey production area and enriches the existing literature on the relationship between ethnocentrism and individual economic status.

Steady turnover in a bird community in a periurban landscape in Northern Italy: a look at the change in species richness over time

From November 2017 until February 2022, with a partial interruption during 2020 linked to the COVID 19 pandemic, the bird community was monitored in a 30 hectares periurban plot in north-western Lombardy, in the province of Varese. The study area consists of a mosaic of farmland/ urban habitat (Luino and Germignaga municipalities) with scattered strips of woodland on the east side of Lake Maggiore. The farmland is mainly cultivated ryegrass or maize and permanent grassland. The turnover and phenology of the avifauna was regularly monitored. The year was divided up 4 seasons: winter, spring migration, breeding season and autumn migration. Each season was further divided into 10-day periods, giving a total of 37 ten-day periods over the whole year. For each ten-day period, there was a minimum of 4 surveys, alternating a 500m transect over 30 minutes with a single point count for 30 minutes. A total of 134 species were observed. The trend in species richness follows a sinusoidal curve relating to the migration periods. The area of farmland, while not having any regularly breeding species, supported 65 foraging species, with permanent grassland being more species rich than either maize or ryegrass. The Sorensen Similarity Index, based on incidence matrices, ranged from the lowest value of 0.6480 (during the winter of 2018/19 to spring migration in 2019) to the highest value of 0.8572 (from spring migration 2019 to the breeding period in 2019). Most of the nesting species are synanthropic, occupying the urban areas of this plot, including a colony of northern house martins.

Mild anemia and 11- to 15-year mortality risk in young-old and old-old: Results from two population-based cohort studies.

Mild anemia is a frequent although often overlooked finding in old age. Nevertheless, in recent years anemia has been linked to several adverse outcomes in the elderly population. Objective of the study was to investigate the association of mild anemia (hemoglobin concentrations: 10.0-11.9/12.9 g/dL in women/men) with all-cause mortality over 11-15 years and the effect of change in anemia status on mortality in young-old (65-84 years) and old-old (80+ years). The Health and Anemia and Monzino 80-plus are two door-to-door, prospective population-based studies that included residents aged 65-plus years in Biella municipality and 80-plus years in Varese province, Italy. No exclusion criteria were used. Among 4,494 young-old and 1,842 old-old, mortality risk over 15/11 years was significantly higher in individuals with mild anemia compared with those without (young-old: fully-adjusted HR: 1.35, 95%CI, 1.15-1.58; old-old: fully-adjusted HR: 1.28, 95%CI, 1.14-1.44). Results were similar in the disease-free subpopulation (age, sex, education, smoking history, and alcohol consumption adjusted HR: 1.54, 95%CI, 1.02-2.34). Both age groups showed a dose-response relationship between anemia severity and mortality (P for trend <0.0001). Mortality risk was significantly associated with chronic disease and chronic kidney disease mild anemia in both age groups, and with vitamin B12/folate deficiency and unexplained mild anemia in young-old. In participants with two hemoglobin determinations, seven-year mortality risk was significantly higher in incident and persistent anemic cases compared to constant non-anemic individuals in both age groups. In participants without anemia at baseline also hemoglobin decline was significantly associated with an increased mortality risk over seven years in both young-old and old-old. Limited to the Monzino 80-plus study, the association remained significant also when the risk was further adjusted also for time-varying covariates and time-varying anemia status over time. Findings from these two large prospective population-based studies consistently suggest an independent, long-term impact of mild anemia on survival at older ages.

Alcohol consumption and the risk of dementia in the oldest old: The Monzino 80‐plus study

AbstractBackgroundWine, beer, spirits or liqueurs are widely popular beverages worldwide. Several studies have investigated the association between alcohol consumption and dementia with inconsistent results, however very few data are available on this relationship in the oldest‐old. Objectives: To investigate the association of alcohol consumption with the development of dementia in advanced age in a prospective population‐based study of 80‐years or older residents in Varese province, Italy (Monzino 80‐plus Study).MethodInformation on alcohol consumption (wine, beer, spirits or liqueurs) was obtained from the subject and/or a primary informant, mostly a family member, using a standardized questionnaire. Diagnosis of dementia fulfilled DSM‐IV criteria. Covariates entered in the fully adjusted logistic and Cox regression models: age, sex, education, diabetes, hypertension, heart failure, myocardial infarction, COPD, ictus, TIA, parkinsonism. Since former drinkers stopped drinking on average 12.4±13.7 (cross‐sectional study) and 16.0±17.0 (longitudinal study) years before interview, they were categorized, together with the never drinkers, in the group of non‐drinkers.ResultAmong the 2,195 participants (mean age: 90.2 years; women: 72.7%) interviewed at first visit, 1,107 (50.4%) were current drinkers (wine, only or together with other alcoholic beverages: 99.8% in cross‐sectional and 100% in longitudinal studies), 318 (14.5%) former drinkers, and 770 (35.1%) never drinkers. Consumers on average currently drank 18.2±15.5 g/day of ethanol, started drinking at 21.4±16.2 years of age, and have been drinking for 68.1±11.2 years. Prevalence of dementia was lower among current drinkers (27.8%) compared to non‐drinkers (47.2%; fully adjusted p&lt;0.0001). There were 1,139 individuals without dementia at first visit with at least one follow‐up available (mean age: 88.4 years; women: 69.3%). In the following 15.5 years, current drinkers (n=675) had a lower occurrence of dementia (43.3%) than non‐drinkers (53.0%; fully adjusted HR: 0.8372, 95% CI: 0.7008‐1.0002, p=0.0503). When current drinkers were divided according to daily intake into two groups (&gt;0‐24 and &gt;24 g/day of ethanol), results of both cross‐sectional and longitudinal analyses gave analogous results.ConclusionAlcohol consumption, mostly of moderate amounts, is common among oldest‐old and is associated with a marginally non‐significant lower risk of incident dementia.

Smoking and the risk of dementia in the oldest‐old: The Monzino 80‐plus study

AbstractBackgroundNicotine is a cholinergic agonist that can enhance short‐term cognitive performance. After initial findings suggesting a possible protective effect of smoking against dementia, subsequent research has pointed out smoking as a risk factor for dementia and Alzheimer’s disease. However, very few data are available on this relationship in the oldest‐old. Objectives: To explore the association of smoking with the development of dementia in advanced age in a prospective population‐based study of 80‐years or older residents in Varese province, Italy (Monzino 80‐plus Study).MethodInformation on smoking habit was obtained from the subject and/or a primary informant, mostly a family member, using a standardized questionnaire. Diagnosis of dementia fulfilled DSM‐IV criteria. Logistic regression and Cox proportional hazard models were used to investigate cross sectional and longitudinal associations between smoking and dementia risk.ResultThe initial population consisted of 2,193 individuals (mean age: 90.2 years; women: 72.7%). At first visit oldest‐old who had never smoked represented the large majority of the population (1778, 81.1%), while current smokers were very few (n=49, 2.2%). On average, they currently smoked 9.7±7.9 cigarettes daily, started smoking at 22.8±11.7 years of age, and had been smoking for 67.1±10.3 years. Former smokers (n=366; 16.7%) had quit smoking on average 29.6±18.0 years before initial interview. Prevalence of dementia was lower among current smokers (18.4%) compared to never smokers (40.0%; p=0.0036), but this difference was no longer significant after adjustment for age, sex, and education (adjusted p=0.2435). There were 1,138 individuals without dementia at first visit with at least one follow‐up available (mean age: 88.4 years; women: 69.2%). In the following 15.5 years, current smokers (n=28) had a higher occurrence of dementia (60.7%) than never smokers (50.1%; age, sex, and education adjusted HR: 1.30, 95% CI: 0.80‐2.12, p=0.2913) or non‐smokers (never and former) (46.9%; age, sex, and education adjusted HR: 1.34, 95% CI: 0.83‐2.18, p=0.2349). The low proportion of current smokers limited the possibility to investigate the effect of smoking on dementia incidence.ConclusionSmoking habit is very uncommon among oldest‐old and it was not significantly associated with the risk of dementia either in cross sectional or longitudinal analysis.

&lt;em&gt;Somatochlora arctica&lt;/em&gt; (Odonata: Corduliidae) oviposing at “lower than usual” altitude for Italy and the Mediterranean Region and first observation for the Varese Province (Northern Italy)

Somatochlora arctica is an endangered dragonfly with populations characterized by low density and scattered distribution. The presence of the species in the Varese Province, recorded during the specific monitoring operations for Nehalennia speciosa, is reported for the first time. The observation of an oviposing female was carried out in a peat bog placed at 550 m a.s.l., the lowest altitude for the species in Italy and one of the most unusual for the Mediterranean Region. The peculiarities of this record are shown.

Proposal and Implementation of a Heliport Pavement Management System: Technical and Economic Comparison of Maintenance Strategies

Maintenance and rehabilitation (M&amp;R) scheduling for airport pavement is supported by the scientific literature, while a specific tool for heliport pavements lacks. A heliport pavement management system (HPMS) allows the infrastructure manager to obtain benefits in technical and economic terms, as well as safety and efficiency, during the analyzed period. Structure and rationale of the APSM could be replicated and simplified to implement a HPMS because movements of rotary-wing aircrafts have less complexity than fixed-wing ones and have lower mechanical effects on the pavement. In this study, an innovative pavement condition index-based HPMS has been proposed and implemented to rigid and flexible surfaces of the airport of Vergiate (province of Varese, Italy), and two twenty-year M&amp;R plans have been developed, where the results from reactive and proactive approaches have been compared to identify the best strategy in terms of costs and pavement level of service. The result obtained shows that although the loads and traffic of rotary-wing aircrafts are limited, the adoption of PMS is also necessary in the heliport environment.

The role of diet on the risk of dementia in the oldest old: The Monzino 80-plus population-based study

Longevity also carries its dark side of age-related chronic diseases, dementia being one of the worst and the most prevalent. Since dementia lacks effective treatments, preventing or delaying it is highly desirable. Dietary habits and nutrition have been found to be important modifiable risk factors for many chronic diseases, but evidence on the role of diet on the risk of dementia is still limited, particularly among the very old. Aim of the present work is to study the association of the Mediterranean diet and its components with prevalent and incident dementia in the oldest-old. We analyzed data from the Monzino 80-plus study, a population-based study in subjects 80 years or older in the Varese province, Italy. A validated food frequency questionnaire was used to collect information on 23 different foods consumed in the previous year. A Mediterranean diet score was calculated and its components were classified into tertiles. Multivariable models for dementia prevalence and incidence were adjusted for demographic and clinical characteristics. Information on nutrition was available for 1390 subjects in the cross-sectional study and 512 subjects in the longitudinal study, mean respective ages 93 and 92. Greater adherence to Mediterranean diet, greater consumption of eggs, fruits and vegetables, carbohydrates, and greater food intake were associated with a lower prevalence of dementia. Increasing number of portions per week and consumption of legumes significantly decreased the incidence of dementia during the 3.6 year mean follow-up: corresponding hazard ratios of highest vs. lowest tertiles (95% confidence intervals) were 0.66 (0.46-0.95) and 0.68 (0.47-0.97), respectively. Oldest-old eating less and having diets with less variety and nutrient density were more frequent among subjects with dementia. The longitudinal analysis confirmed oldest-old subjects who eat more portions, as well as those who have a higher intake of legumes, are at decreased risk of developing dementia even though reverse causality cannot be completely ruled out.

Adopting a cross-scale approach for the deployment of a green infrastructure

The implementation of a Green Infrastructure (GI) involves several actors and governance scales that need adequate knowledge support. The multifunctionality of GI entails the implementation of a cross-scale approach, which combines assessments conducted at different levels and active stakeholder engagement. This paper provides a methodology to implement a cross-scale approach to support the deployment of a Regional GI. The methodology was tested in Lombardy Region (north-west of Italy), considering three relevant territorial scales and relative strategic and planning policies. The continental level representing the overall policy-context; the regional level, with its key role for guaranteeing landscape coherence and connectivity and the local level where planning actions are effectively designed and implemented. The EU Biodiversity Strategy for 2030 and the EU GI strategy were used as references for the continental level; at the regional level, a proposal of Regional GI was evaluated focusing on two Provinces (Varese and Lecco), three regional parks (Ticino, Adda Nord and Campo dei Fiori). At the local scale, the new development plan of the Municipality of Cassano d'Adda (Milan metropolitan area) was evaluated considering different possible scenarios. The regional GI was evaluated with respect to the capacity to provide Cultural Ecosystem Services (CES). CES were mapped using the ESTIMAP-recreation model. The model was adapted to the regional and local level with the active engagement of local stakeholders. Additionally, census data were analysed to obtain an overview of the equitable distribution of the CES amongst inhabitants. Results show that, in 78% of the census blocks of the study area, inhabitants have a high-value recreation resource within 4 km (31% within 4 km and 47% within 300 m). Unmet demand characterises 22% of the census blocks in the study area, clustered in zones with a high population density. The regional GI covers almost completely the two Provinces and the regional parks. In Varese Province: 68% of the territory is included in the regional GI, 82% of the census blocks local demand for recreation opportunities is met, but the population density is higher where the demand is unmet. The Province is characterised by a relatively old population (share of people older than 65 years 23.4%). In Lecco Province, 80% of the territory is included in the regional GI, in 96% of the blocks the local demand is met and the local population is relatively old (share of elderly population 22.12%). The three regional parks present significant differences, strongly influenced by the territorial context. The Campo dei Fiori Park is almost completely included in the regional GI. The entire local population has nature-based recreation opportunities in their close vicinity. Nevertheless, the population density is very low and citizens are relatively old. The majority of the Parco Adda Nord is included in the regional GI providing recreation opportunities to 90% of the census blocks within the Park boundaries. A total of 70% of Ticino Park is included in the regional GI, where local residents are relatively old (share of elderly population 23.78%) and 90% of local census blocks are close to nature-based opportunities. At local scale, we explored how the approach can be used to estimate changes in the CES potential provision and how this can be integrated into a site management plan. This paper demonstrated that the combination of studies in a cross-scale perspective enhances the understanding of GI multifunctionality. It provides a framework to adapt CES mapping models to the local setting with active stakeholders engagement. Moreover, it demonstrates that also highly urbanised areas, such as the Lombardy Region in Italy, can play a role in the deployment of a continental GI and can support biodiversity and nature protection.

Relation between anticholinergic burden and cognitive impairment: Results from the Monzino 80-plus population-based study.

We examined data collected in the Monzino 80-plus study to assess the relations between cognitive performance and ACB scores according to the hypothesis that a higher anticholinergic burden is associated with reduced cognitive performance. The Monzino 80-plus is an ongoing, prospective, door-to-door population-based study started in 2002 among all residents 80 years or older in eight municipalities of Varese province, Italy. To establish the relation between cognitive impairment and the anticholinergic drug burden we recorded the ACB score for each patient at baseline. The relations between ACB score and dementia or MMSE scores were also examined after exclusion of patients taking any antipsychotic. A sample of 2140 elderly people was eligible for analysis. A significant dose-effect relationship was observed between total ACB score and diagnosis of dementia in univariate and multivariate models. Patients in ACB class ≥4 had about 4.5 times the risk of diagnosis of dementia. A relation was also found between higher ACB scores and lower MMSE scores; patients who scored 4 or more had a mean of 6.4 points lower than those not taking anticholinergic drugs. The dose-effect relationship between ACB score and diagnosis of dementia was not maintained after exclusion of patients using antipsychotics, while the association between higher ACB scores and lower MMSE scores was still present, with patients in ACB class ≥4 having a mean score about 4.4 lower. There are clear relations between anticholinergic load and reduced cognitive performance, while the association with dementia remains uncertain. For primary care and geriatric clinicians, an ACB score ≥ 4 can be considered the cut-off to identify high-risk populations who may benefit from the evaluation of anticholinergic burden with the ACB scale.

Incidence of dementia in the oldest-old and its relationship with age: The Monzino 80-plus population-based study

IntroductionRelationship between age and dementia at extreme old ages is still an open question, yet population-based studies in this high-risk age segment are rare. MethodsThe Monzino 80-plus is a population-based study among residents 80 years and older in the Varese province, Italy. Of 1371 eligible individuals, 1294 (94.4%), of whom 64 are centenarians, were included in the incidence study. ResultsSince 2002, 584 new cases of all-cause dementia were identified over 15 years. The overall incidence rate was 7.9 per 100 person-years. Dementia risk rose with age (IRR: 1.06), with the cubic model providing the best fit (R2 = 0.91–0.96). Cumulative incidences of dementia unadjusted and adjusted for competing mortality risk progressively diverged with age. ConclusionDementia incidence also keeps rising in nonagenarians and centenarians. Slowing down in growing risk of developing dementia with age is mainly attributable to increasing competing risk of death and resulting selective survival of individuals at lower risk of dementia.

Vascular flora of Milan Malpensa airport (Lombardy, Italy). Part I: checklist

Airport areas have, among flight infrastructures, large green spaces which, not having production purposes, are managed through interventions of minimal disturbance on habitats, with potentially positive effects on the conservation of biodiversity. The checklist of the vascular flora of the airport of Milan Malpensa is here presented. This airport extends for 12.44 km2 in the southwestern portion of the province of Varese (Lombardy, Italy) in the administrative districts of Cardano al Campo, Casorate Sempione, Ferno, Lonate Pozzolo, Samarate, Somma Lombardo and Vizzola Ticino. The collection campaigns were carried out between August 2010 and September 2018. The specimens collected are now kept in the herbarium facility of the Natural History Museum of Milan (MSNM). The floristic list was organized following the arrangement and the nomenclature of the recently published Italian flora checklists. It includes 395 taxa of specific and subspecific rank (9.35% of the entire flora of Lombardy) belonging to 247 genera and 72 families. The native taxa are 318, while the alien ones are 77. The native/aliens ratio is comparable to the one calculated at the regional level (4.10 vs. 4.42). The endemic contingent includes two taxa: Centaurea nigrescens subsp. pinnatifida, Italian endemic, and Euphrasia cisalpina, endemic to the Alps. The Malpensa airport is still the only site confirmed at the national level for Lepidium heterophyllum and, at the regional level, for Festuca muralis and Euphrasia cisalpina. The ecological characteristics and the data analysis will be discussed in a second contribution.

Range expansion and redefinition of a crop-raiding rodent associated with global warming and temperature increase

Since the 1970s, the crested porcupine Hystrix cristata has shown a marked range expansion in Italy. A web page has been created to collect occurrences of this species to monitor its distribution redefinition. Thus, aims of this work were (i) to identify the main predictors promoting the distribution of this large rodent in Italy and (ii) to predict its potential expansion under future climate change scenarios. A total of 1674 locations were used for this analysis, i.e., all those collected through the web page, with the exception of recently introduced populations (Sardinia, Western Liguria and Province of Varese). The current distribution of the crested porcupine covers a total of 135,177 km2, as estimated through ensemble predictions. Future climate change scenarios for 2050 and 2070 show that a further range expansion by this species would occur up to 225,576 km2, mainly towards areas where the species was historically absent. The increase of isothermality (i.e., the ratio between the mean diurnal and the annual temperature range) and the mean temperature of the driest months would help crested porcupines to reach high altitudes, e.g., in the Alps. In mountain habitats, the ongoing global warming is shifting the distribution of European forests to high elevations, thus potentially providing porcupines with suitable habitats. A reduction in snow cover and the snow period at ground level would remove an important barrier to the range expansion of the crested porcupine in Italy, and thus facilitate digging and food search by this large rodent. Despite being protected at national and international levels, the crested porcupine is reported to be an introduced species to Italy and, therefore, monitoring its range expansion is required. Furthermore, there are complaints about crop damage in agriculture ecosystems, and the species is still widely poached, thus additional management practices are required. Thus, given the conservation interest of this large rodent, an integrated and constantly updated monitoring system that sustains an addressed set of decision-making tools is recommended.