UNASSIGNED: In the hospital environment, any liability for organizational inadequacy and/or inefficiency, or again for defects in the facilities, or inadequacy of health equipment may be found in the work of the apex professional figures: Medical Director, the General Manager, and/or others. The responsibility for the internal organization of the department falls on the figure of the Director of the Complex Structure where the deficiencies have not been promptly and adequately reported to the top figures.
UNASSIGNED: A woman 61-year-old, was admitted on a voluntary basis to the Department of Psychiatry. On the third day, in the early morning hours, the patient was found on the ground floor, lying on the floor near the entrance door of the ward with a lacerated contusion wound to the head. The woman underwent total body CT examination with findings of fractured polytrauma as well as subarachnoid hemorrhage and complete fracture of the spleen, which was surgically removed. Three days later, despite the care given, death occurred. The injuries ascertained were consistent with voluntary precipitation from the second-floor stairwell window. The investigations conducted by the police and the checks carried out by the head of the Internal Prevention and Protection Service and the company\'s Risk Manager, highlighted multiple critical issues.
UNASSIGNED: The case allows for numerous considerations relating to liability profiles in the determinism of the patient\'s death, the hospital\'s company failure to implement measures to prevent the patient\'s suicide in the hospital was influential.

July 2023 has been confirmed as Earth\'s hottest month on record, and it was characterized by extraordinary heatwaves across southern Europe. Field data collected under real heatwave periods could add important evidence to understand human adaptability to extreme heat. However, field studies on human physiological responses to heatwave periods remain limited. We performed field thermo-physiological measurements in a healthy 37-years male undergoing resting and physical activity in an outdoor environment in the capital of Sicily, Palermo, during (July 21; highest level of local heat-health alert) and following (August 10; lowest level of local heat-health alert) the peak of Sicily\'s July 2023 heatwave. Results indicated that ~40 min of outdoor walking and light running in 33.8°C Wet Bulb Globe Temperature (WBGT) conditions (July 21) resulted in significant physiological stress (i.e., peak heart rate: 209 bpm; core temperature: 39.13°C; mean skin temperature: 37.2°C; whole-body sweat losses: 1.7 kg). Importantly, significant physiological stress was also observed during less severe heat conditions (August 10; WBGT: 29.1°C; peak heart rate: 190 bpm; core temperature: 38.48°C; whole-body sweat losses: 2 kg). These observations highlight the physiological strain that current heatwave conditions pose on healthy young individuals. This ecologically-valid empirical evidence could inform more accurate heat-health planning.

Brucellosis is one of the world\'s major zoonotic pathogens and is responsible for enormous economic losses as well as considerable human morbidity in endemic areas. Definitive control of human brucellosis requires control of brucellosis in livestock through practical solutions that can be easily applied to the field. In Italy, brucellosis remains endemic in several southern provinces, particularly in Sicily Region. The purpose of this paper is to describe the developed brucellosis model and its applications, trying to reproduce as faithfully as possible the complex transmission process of brucellosis accounting for the mixing of grazing animals. The model focuses on the contaminated environment rather than on the infected animal, uses real data from the main grazing areas of the Sicily Region, and aims to identify the best control options for minimizing the spread (and the prevalence) and to reach the eradication within the concerned areas. Simulation results confirmed the efficacy of an earlier application of the controls, showed the control should take place 30 days after going to pasture, and the culling time being negligible. Moreover, results highlighted the importance of the timing of both births and grazing pastures (and their interaction) more than other factors. As these factors are region‑specific, the study encourages the adoption of different and new eradication tools, tuned on the grazing and commercial behavior of each region. This study will be further extended to improve the model\'s adaptability to the real world, with the purpose of making the model an operational tool able to help decision makers in accelerating brucellosis eradication in Italy.

Seasonal cycles in plants and animals drive key timings of human practices in an agrosystem like the best time for harvest, planting, or pruning. Within the framework of historical phenological studies, we attempt a reconstruction of the olive (Olea europaea L.) phenology along millennia. Thanks to its extraordinary longevity, the olive tree is a living proxy from the past and embodies a still uncollected long-term memory of ecological behaviors. A cultural keystone species, olive cultivation has more and more played a crucial role for biodiversity conservation, livelihood of rural communities and their enrooted cultural identity in the whole Mediterranean. By compiling traditional phenological knowledge from historical written sources and oral traditions, and using it as historical bio-indicator of the linkage between human ecological practices and seasonal changes of plant behavior, we compiled a monthly ecological calendar of the olive tree covering the last ∼2800 years. As a case study, we chose a special place: Sicily, unique for its position in the Mediterranean, geomorphology and legacies in the form of cross-temporal accumulated eco-cultures. Such a sui generis ecological calendar provides an additional case study to explore the intertwining of plant behavior and human adaptation strategies and the interplay between cultural diversity, ecological disturbance and phenological stability. All of this, in turn, can inform action for the present and future sustainable management of these millennial trees.

Microseism is the continuous background seismic signal caused by the interaction between the atmosphere, the hydrosphere and the solid Earth. Several studies have dealt with the relationship between microseisms and the tropical cyclones, but none focused on the small-scale tropical cyclones that occur in the Mediterranean Sea, called Medicanes. In this work, we analysed the Medicane Apollo which impacted the eastern part of Sicily during the period 25 October-5 November 2021 causing heavy rainfall, strong wind gusts and violent sea waves. We investigated the microseism accompanying this extreme Mediterranean weather event, and its relationship with the sea state retrieved from hindcast maps and wave buoys. The spectral and amplitude analyses showed the space-time variation of the microseism amplitude. In addition, we tracked the position of Apollo during the time using two different methods: (i) a grid search method; (ii) an array analysis. We obtained a good match between the real position of Apollo and the location constraint by both methods. This work shows that it is possible to extract information on Medicanes from microseisms for both research and monitoring purposes.

BACKGROUND: Mushroom poisoning is an important cause of intoxication worldwide. The toxic mechanism remains frequently unknown and the diffusion of non-endemic species may cause the emergence of new syndromes. An example is the widespread of Chlorophyllum molybdites in Sicily.
METHODS: Pavia Poison Centre was recently involved in the management of 10 intoxications caused by the ingestion of Chlorophyllum molybdites, which was not considered part of the Italian mycological species. The clinical syndrome was characterized by severe gastrointestinal symptoms. In paediatric or vulnerable patients, it may bring to hypovolemic shock that necessitate intensive support. The possibly confusion with amatoxins-containing mushrooms may complicate the management.
CONCLUSIONS: Chlorophyllum molybdites is widespread on the oriental coast of Sicily and it could be confused with \"parasol mushrooms\". Cooperation between emergency physicians, clinical toxicologist and mycologist, supported by improving of laboratory tests, is essential for the appropriate clinical management. Climate changes and migration flows can interfere with the diffusion of new species and the development of novel syndromes.

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This review article focuses on the technological aspects and microbiological critical points of pressed-cooked cheeses processed from raw ewe\'s milk without the inoculation of starter cultures, in particular \"Pecorino\" cheese typology produced in Italy. After showing the composition of the biofilms adhering to the surface of the traditional dairy equipment (mainly wooden vat used to collect milk) and the microbiological characteristics of PDO Pecorino Siciliano cheese manufactured throughout Sicily, this cheese is taken as a case study to develop a strategy to improve its hygienic and safety characteristics. Basically, the natural lactic acid bacterial populations of fresh and ripened cheeses were characterized to select an autochthonous starter and non-starter cultures to stabilize the microbial community of PDO Pecorino Siciliano cheese. These bacteria were applied at a small scale level to prove their in situ efficacy, and finally introduced within the consortium for protection and promotion of this cheese to disseminate their performances to all dairy factories. The innovation in PDO Pecorino Siciliano cheese production was proven to be respectful of the traditional protocol, the final cheeses preserved their typicality, and the general cheese safety was improved. An overview of the future research prospects is also reported.

Compared to other types of social networks, criminal networks present particularly hard challenges, due to their strong resilience to disruption, which poses severe hurdles to Law-Enforcement Agencies (LEAs). Herein, we borrow methods and tools from Social Network Analysis (SNA) to (i) unveil the structure and organization of Sicilian Mafia gangs, based on two real-world datasets, and (ii) gain insights as to how to efficiently reduce the Largest Connected Component (LCC) of two networks derived from them. Mafia networks have peculiar features in terms of the links distribution and strength, which makes them very different from other social networks, and extremely robust to exogenous perturbations. Analysts also face difficulties in collecting reliable datasets that accurately describe the gangs\' internal structure and their relationships with the external world, which is why earlier studies are largely qualitative, elusive and incomplete. An added value of our work is the generation of two real-world datasets, based on raw data extracted from juridical acts, relating to a Mafia organization that operated in Sicily during the first decade of 2000s. We created two different networks, capturing phone calls and physical meetings, respectively. Our analysis simulated different intervention procedures: (i) arresting one criminal at a time (sequential node removal); and (ii) police raids (node block removal). In both the sequential, and the node block removal intervention procedures, the Betweenness centrality was the most effective strategy in prioritizing the nodes to be removed. For instance, when targeting the top 5% nodes with the largest Betweenness centrality, our simulations suggest a reduction of up to 70% in the size of the LCC. We also identified that, due the peculiar type of interactions in criminal networks (namely, the distribution of the interactions\' frequency), no significant differences exist between weighted and unweighted network analysis. Our work has significant practical applications for perturbing the operations of criminal and terrorist networks.

Despite some researchers reporting clinical signs in cattle associated with Trypanosoma theileri, its role as a pathogen is still unclear. We describe here the isolation of Trypanosoma theileri during a routine laboratory investigation. Mature and immature vital parasitic forms were observed within hematopoietic cell cultures from the bone marrow of one cow for monocyte isolation. The animal was submitted to clinical examination and blood sample counting (CBC). Postmortem analysis included gross and histological examination and PCR in the liver, spleen, brain, lymph nodes, and lungs. PCR and Giemsa staining were used for parasite identification. A second cow belonging to the same farm was positive for Trypanosoma theileri by PCR performed on blood sample. In this case, the postmortem analysis included also testis. Clinical examination showed only a reduction in body weight in both cases. The CBC revealed an increase of lymphocytes and neutrophils while red blood cells were within the normal range. Spleen was slightly increased in volume and the histology revealed a proliferative activity of the white and red pulp. The biomolecular analysis identified the parasite as Trypanosoma theileri and its DNA was detected in the bone marrow, testis, and brain. The unusual finding of parasite in the brain, testis, and bone marrow raises new clinical implication on disease course and also possible sexual transmission.