The climate affects how a city\'s outdoor spaces are utilized. It is more likely that people will use and appreciate public areas designed for pedestrian use, such as parks, squares, streets, and foot-cycle pathways, when they provide a comfortable and healthy environment. A predicted increase in global temperature has made the climate uncomfortable, especially during the summer when heat stress is strengthened and anticipated. This phenomenon is more severe in urban areas, often affected by the Urban Heat Island (UHI) effect. Since the spatial characteristics of a city influence its climate, urban design can be deployed to mitigate the combined effects of climate change and UHI. This research is conducted to study the UHI effect on thermal comfort in an urban open space in Rome (Italy) and aims at identifying and implementing a methodology that urban designers can follow to reduce the impact of urban heat islands and increase thermal comfort in urban outdoor space. This study is based on an urban design concept adopting the Sustainable Development Goals as guidelines; it investigates how UHI\'s effect affects the use of public space and examines the influence of urban microclimatic conditions on the thermal perception of users through PET, PMV and PPD values, that were assessed through simulations with ENVI-MET software. The study thus proposes a redesign for the site in Rome, with a masterplan based on sustainable design principles, aimed at improving the microclimatic conditions in the site. The design solution was then validated through ex post simulations.

UNASSIGNED: The COVID-19 pandemic has posed significant challenges to the education system, leading to changes in student academic performance and mental health. The aim of this study was to evaluate variables relating to changes in academic performance and mental health during the pandemic.
UNASSIGNED: We carried out a cross-sectional study from 28 February 2022 to 13 April 2022, during the free SARS-CoV-2 screening campaign offered by Sapienza University of Rome. A structured questionnaire was constructed to explore the decline in academic performance during the COVID-19 pandemic. The Coronavirus Anxiety Scale (CAS), a validated self-reporting mental health screener of dysfunctional anxiety associated with the coronavirus crisis, was used.
UNASSIGNED: A sample of 1,134 students was enrolled. A total of 25.4% of the participants reported a decline in academic performance. In addition, Coronavirus Anxiety Scale scores revealed that 133 (11.5%) students had a dysfunctional anxiety problem due to COVID-19. A multivariable logistic regression model showed that being a senior student (aOR: 0.70 95% CI: 0.52-0.96) and having good financial status (aOR: 0.64, 95% CI: 0.47-0.88) decrease the likelihood of a decline in academic performance, while not being Italian (aOR: 2.12, 95% CI: 1.29-3.48), having felt the need for psychological support (aOR: 2.58, 95% CI: 1.87-3.55) and being enrolled in a science/technology faculty (aOR: 1.81, 95% CI: 1.27-2.57) were more likely to result in a decline in academic performance.
UNASSIGNED: Our results show that the pandemic has affected academic performance. The COVID-19 emergency highlighted the importance of considering mental health and economic status in policymaking to effectively support students.

BACKGROUND: The study aims to evaluate the association of proximal flow-inversion cerebral protection and MicroNet-covered CGuard stents in reducing early and late embolic events in carotid artery stenting procedures.
METHODS: From 2018 to 2023, we performed 204 procedures in 180 patients with flow inversion cerebral protection and CGuard stents at the Vascular Surgery Unit of Sant\'Eugenio Hospital in Rome. Cerebral protection was achieved with a Flow-Gate2 catheter connected to a peripheral vein. The tip balloon is inflated in the CCA to obtain an effective endoclamping, the pressure difference between the carotid bifurcation and the venous compartment ensures a constant back flow with wash-out in the venous compartment. Inclusion criteria were: life expectancy of >12 months, target lesions indicating treatment according to ESVS Guidelines, increased surgical risk due to comorbidities or anatomic issues. ECD follow-up was performed immediately postoperatively, at 30 days, 6 and 12 months, and subsequently annually.
RESULTS: The treatment protocol was successfully implemented in 99% of cases. No major strokes occurred, while one minor stroke (0.5%) occurred within 8 hours of the procedure, regressing in the following months. One perioperative death (0.5%) due to cerebral hemorrhage occurred three hours after the procedure. All patients remained asymptomatic, with no short or medium-term neurological score deterioration. One hemodynamically significant restenosis (0.5%) was detected at the 6-month follow-up. All patients completed the 6 months follow-up, though 6 (3%) were lost at the 12-month appointment.
CONCLUSIONS: Our prospective monocentric study has demonstrated the effectiveness and safety of the FlowGate2 flow inversion cerebral protection system in association with MicroNet covered CGuard stent.

Magnetic and chemical biomonitoring methodologies were applied to the southern slopes of the Palatine Hill archaeological area in Rome, Italy. Plant leaves and lichen transplants were respectively sampled and exposed between July 2022 and June 2023 to assess the impact of vehicular particulate matter from Via dei Cerchi, a trafficked road coasting Circus Maximus, towards the archaeological area upon the Palatine Hill. The magnetic properties of leaves and lichens, inferred from magnetic susceptibility, hysteresis loops and first order reversal curves, were combined with the concentration of trace elements. It was demonstrated that the bioaccumulation of magnetite-like particles, associated with tracers of vehicular emissions, such as Ba and Sb, decreased with longitudinal distance from the road, without any important influence of elevation from the ground. Lichens demonstrated to be more efficient biomonitors of airborne PM than leaves, irrespective of the plant species. Conversely, leaves intercepted and accumulated all PM fractions, including road dusts and resuspended soil particles. Thus, plant leaves are suitable for providing preventive conservation services that limit the impact of particulate pollution on cultural heritage sites within busy metropolitan contexts.

Secondary shrublands and transitional woodland/shrub formations are recognised to be particularly susceptible to plant invasions, one of the main global threats to biodiversity, especially in dynamic peri-urban landscapes. Urban fringes are in fact often the place for the sprawl of artificial surfaces, fragmentation of habitats, and complex land transitions (including both agriculture intensification and abandonment), which in turn increase propagule pressure of exotic species over residual semi-natural ecosystems. Within this framework, the present study was aimed at analysing i) how landscape composition and configuration affect the richness of woody exotic species in shrubland and transitional woodland/shrub patches, and ii) how this threat can be addressed by means of green infrastructure design in a peri-urban case study (Metropolitan City of Rome, Italy). Accordingly, the occurrence of exotic plants was recorded with field surveys and then integrated with landscape analyses, both at patch level and over a 250 m buffer area around each patch. Thus, the effect of landscape features on exotic plant richness was investigated with Generalised Linear Models, and the best model identified (pseudo R-square = 0.62) for inferring invasibility of shrublands throughout the study area. Finally, a Green Infrastructure (GI) to contain biological invasion was planned, based on inferred priority sites for intervention and respective, site-tailored, actions. The latter included not only the removal of invasive woody alien plants, but also reforestation and planting of native trees for containment of dispersal and subsequent establishment. Even though specifically developed for the study site, and consistent with local government needs, the proposed approach represents a pilot planning process that might be applied to other peri-urban regions for the combined containment of biological invasions and sustainable development of peripheral complex landscapes.

BACKGROUND: Physical fatigue is one of the most disabling symptoms in people with Multiple Sclerosis (PwMS). Several factors might influence the development of fatigue, such as gender, education, body mass index (BMI), Expanded Disability Status Scale (EDSS), disease duration, working status (Ws), physiotherapy (Ph), and disease-modifying therapies (DMTs). Fatigue Symptoms and Impacts Questionnaire-Relapsing Multiple Sclerosis (FSIQ-RMS) is a patient-reported outcome (PRO) that allows one to define the impact of fatigue in PwMS clearly. This study aimed to assess fatigue impact on PwMS by using FSIQ-RMS.
METHODS: The participants were enrolled from May to July 2021 in MS Centers of Sant\'Andrea Hospital and Policlinico Umberto I Hospital in Rome. Fatigue was evaluated using the FSIQ-RMS, validated, and culturally adapted in Italian. Clinical and demographic data were collected at the same time.
RESULTS: We enrolled 178 PwMS [Female 74.16%; RMS 82.58%, SPMS 17.52%]. FSIQ-RMS scores were significantly correlated with EDSS (p-value < 0.01). Analysis of variance between means showed a statistically significant difference between the BMI groups at the 24hours_FSIQ-RMS score and the 7days_FSIQ-RMS score (p < 0.01), with the lower BMI group having the highest scores. Furthermore, perceived fatigue significantly improved both in subjects performing Ph (p < 0.05) and in those who actively work (p < 0.01).
CONCLUSIONS: The use of FSIQ-RMS in a real-world setting confirmed that underweight and high levels of disability are closely related to fatigue. In addition, Ph and active Ws are strongly correlated with fatigue in PwMS.

OBJECTIVE: to assess the association between the occupational sector and respiratory mortality in the metropolitan longitudinal studies of Rome and Turin.
METHODS: retrospective cohort study.
METHODS: the 2011 census cohorts of residents of Rome and Turin aged 30 years and older who had worked for at least one year in the private sector between 1970s and 2011 was analysed. The individuals included in the study were followed from 9 October 2011 to 31 December 2018. Occupational history was obtained from archives of private sector contributions at the National Social Insurance Agency (INPS) and then was linked to data from the longitudinal studies.
METHODS: the study outcome was non-malignant respiratory mortality. The exposure of interest was whether or not individuals had worked in one of the 25 occupational sectors considered (agriculture and fishing, steel industry, paper and printing, pharmaceuticals, manufacturing, textile, energy and water, food and tobacco industry, non-metal mining, glass & cement industry, metal processing, electrical construction, footwear and wood industry, construction, trade, hotel and restaurants, transportation, insurance, healthcare, services, laundries, waste management, hairdressing, cleaning services, and gas stations). The association between the occupational sector and respiratory mortality, adjusted for potential confounders (age, marital status, place of birth, educational level), was estimated using Cox models. All analyses were stratified by sex and city.
RESULTS: a total of 910,559 people were analysed in Rome and 391,541 in Turin. During the eight years of follow-up, 4,133 people in Rome and 2,772 people in Turin died from respiratory causes. The sectors associated with high respiratory mortality in both cities among men were footwear and wood industry (adjusted HR for age: 1.37 (95%CI 1.07-1.76) and 1.48 (95%CI 1.08-2.03) in Rome and Turin, respectively), construction (HR: 1.31 (95%CI 1.20-1.44) in Rome and 1.51 (95%CI 1.31-1.74) in Turin), hotel and restaurant sector (HR: 1.25 (95%CI 1.07-1.46) in Rome and 1.68 (95%CI 1.20-2.33) in Turin), and cleaning services (HR: 1.57 (95%CI 1.19-2.06) in Rome and 1.97 (95%CI 1.51-2.58) in Turin). Some sectors had high respiratory mortality only in one of the two cities: in Rome, the food& tobacco industry, and gas stations, while in Turin, the metal processing industry. Among female workers, the cleaning services sector was associated with higher respiratory mortality in both Rome and Turin (HR: 1.52, 95%CI 1.27-1.82, e 1.58, 95%CI 1.17-2.12, respectively).
CONCLUSIONS: the data confirm the previously known associations between occupational sectors and respiratory mortality for exposures characteristic of specific sectors, such as construction, hotel and restaurant sector, and cleaning services. The differences reported between the two cities reflect the different composition of the workforce and the size of the two study populations. Administrative social insurance data can provide helpful information for epidemiological studies of occupational exposure.

Created and published in a printed volume in 1611, the emblem chosen by the literary Academy of the Umoristi is intriguing at multiple levels. At a time when the water cycle was still unknown, the image engaged the thorny question of how the evaporation of salty seawater, condensed into clouds, could subsequently pour down as sweet rain. Additionally, the Lucretian motto \"Redit agmine dulci\" audaciously evoked the philosophy of atoms. The combination of the image and the motto suggested looking at the meteorological phenomenon on display as a sort of natural distillation process, not different from the circulations taking place in the alembic. This enquiry will document how the Academy of the Umoristi was influenced in the choice of its emblem by the scientific Academy of the Lincei and how, towards the end of the seventeenth century, under the patronage of Christina of Sweden, the interconnection of alchemy and atomism alluded to in the academic emblem was reclaimed as a distinctive philosophical banner.

Over the last 50 years the significance of Galen\'s contributions to the arts of medicine and surgery have been increasingly recognized. Despite his errors, his contributions to medical and surgical practice have been profound. In the present context, his teachings on cranial surgical instruments and technique would continue to be influential throughout one and a half millenia. His technical advice was sound. His error about the anatomy of blood vessels supplying CNS were not of much consequence since the CNS would remain surgically inaccessible until the end of the 19th century. He reclassified fractures as extending to the diploe or through the internal table. Moreover, they could be simple, comminuted, depressed, or elevated. He did not mention indications or clinical changes, on the other hand he had many sensible remarks to make on the instrumentation required for cranial surgery. As will be seen in what follows, he was much quoted in justification of the decisions of his successors. The major errors of significance related to his description of the anatomy of the cranium and its sutures. His concern about the cranial attachment, vascular components and excretory functions of the sutures added to Hippocrates\' concerns about their inherent weakness resulted in the teaching that trepanation should avoid these structures. This was to have a limiting effect on the placement of trepanation openings which was of no benefit to the patients. Moreover, his enthusiasm for bloodletting would also serve to potentiate Hippocrates teaching on this matter, to the advantage of nobody.

Celsus gave an adequate description of the bones and sutures of the calvarium. His classification of injuries was simple including fissures and depressions. He is the first to relate specific symptoms to specific tissue injury. In addition, he was aware that fractures could be present in the absence of typical findings. He was also the first to note the meningeal vessels could rupture producing severe localized pain. His treatment was more conservative than that of Hippocrates. Plasters were to be used and if there was no deterioration trepanation was avoided. He described the use of the crown trepan (modiolus) and the instrument with a smaller tip which expands rapidly to prevent penetration. He also described the technique of rotating the trepan between the palms. His description of operations for depressed fractures were unusually clear and relevant even by modern standards. His wound care is strikingly different from that of Hippocrates as he advocates various dressings soaked in vinegar and as time passes plasters should be softened with rose oil. Regrettably, Celsus influence would not be felt until the time of the Renaissance, because his texts were lost. However, his \"De Medicina\" was rediscovered and became the first medical text to be published using the new moveable type printing press, in the year 1478. Thus, his influence was minimal in the Arabic world and the early Renaissance. Thereafter it was profound.