Sustainability-oriented management in the SMEs. A multilevel analysis in the European Union.

This research focuses on SMEs in the EU and their acceptance of circular economy practices, with a special attention to the structural characteristics that might be significant drivers. Eight indicators of environmentally friendly practices are studied: water saving, energy saving, renewable energy, material saving, waste reduction, sale of waste materials, waste recycling, and eco-designed products. A sample of European SMEs from EU-28 data (countries at the time of the survey) is used to test hypotheses through eight multilevel probit regression models. Company- and country-level covariates are added to the multilevel models. The results showed that the number of employees, the business sector and the type of products/services sold have an impact on environmentally friendly practices. On the other hand, at the national level, per capita GDP and greenhouse gas emissions are the most relevant factors in the eight models. These findings are relevant for the implementation of the European Green Deal, which aims to increase resource efficiency through the transition to a cleaner EU and circular economy.

Behavioral guidance for improving dental care in autistic spectrum disorders.

Introduction: Autism spectrum disorders (ASDs) impair many aspects of everyday life and may prevent access to dental care, often limiting it to emergencies. Impaired oral health has long-lasting negative consequences on health status and on the acquisition of oral habits (e.g., oral respiration and grinding) or competencies (e.g., proper speech production). Children with ASD may be scared in the dental setting, which is rich in sensory stimuli and requires physical contact. Due to their behavioral manifestations, they represent a challenge for dentists and hygienists. We created a dedicated pathway with behavioral support for children with ASD to allow dental care and possibly limit the use of general anesthesia. Methods: We evaluated the effects of behavioral support in a quasi-experimental design by comparing two groups of children with ASD. The first group (n = 84) was visited every 2 months for 3 years and received additional support (visual aids, caregiver training, and longer visit duration). A control group, matched for age and sex, was visited at least twice a year or more, if needed, according to standard healthcare guidelines. Results: Compliance with the schedule was high throughout the 3 years. The degree of collaboration significantly improved after 1 year in the supported group, while the control group did not change. At the end of the study, collaboration remained significantly higher than at the beginning in the supported group. Half of dental treatments were possible without general anesthesia in supported children. No adverse effect was apparent on collaboration due to COVID-19 restrictions. Discussion: Behavioral techniques improved the compliance of ASD children to regular dentistry visits and treatment. Furthermore, oral hygiene at home was similarly improved, addressing oral health from a lifelong perspective.

Diffusion of COVID-19 among children and adolescents during the second and third waves of the pandemic in Italy.

This paper explores COVID-19 diffusion among children and adolescents (up to 19 years old) in Italy using the publicly available data that were collected and released by the Italian National Institute of Health (ISS). We consider in more detail the so-called second and third waves of the pandemic in Italy and explore the relationship between schools opening and the diffusion of COVID-19, which is a highly debated topic in the recent reference literature. We analyse the dynamics of COVID-19 incidence in the country as a whole and in its individual regions. Moreover, we compare the regions in which different levels of restrictions were imposed during the pandemic as well as different school closure calendars. We found there to be a significant correlation between the dynamics of the COVID-19 infections among young people in Italy and school closures during both the second and the third waves of the pandemic. CONCLUSION: Specifically, we found school closures to have mitigated the spread of the infection, especially among patients between the ages of 14 and 19. WHAT IS KNOWN: • The relationship between the opening of schools and the diffusion of COVID-19 is a debated topic. • SARS-CoV-2 diffusion among school-aged adolescents is almost twice as that among children. • SARS-CoV-2 is a mild disease for infants and children. WHAT IS NEW: • We analysed original data on the diffusion of COVID-19 among children and adolescents in Italy. • We calculated incidence of COVID-19 with reference to school-age classes and compared over time in the whole country and in the regions of Italy. • We analysed incidence dynamics considering school closures and other restrictions imposed by the local and national authorities to limit virus diffusion.

Neuropsychological assessment of Boucher-Neuhäuser syndrome: A case report.

OBJECTIVE: Boucher-Neuhäuser Syndrome (BNS) is a rare autosomal recessive disorder characterized by hypogonadotropic hypogonadism, spinocerebellar ataxia, and chorioretinal syndrome, and associated with a variant in the PNPLA6 gene. Although many reports have mentioned the presence of cognitive impairment, a neuropsychological assessment of a BNS case has never been published. Here, we provide a detailed description of a young adult patient with BNS who has a homozygous pathogenic variant in the PNPLA6 gene. METHOD: A 21-year-old man with progressive ataxia and a history of hypogonadotropic hypogonadism and chorioretinal dystrophy was diagnosed with BNS. A comprehensive cognitive evaluation was performed, requiring the ad hoc selection and adaption of neuropsychological tests to overcome visual and motor impairments that characterize this syndrome. RESULTS: The patient presented an intact global cognitive profile with selective executive dysfunction and mild verbal reasoning dysfunction. In particular, attentional-inhibitory control, working memory, and set switching were impaired, and inadequate development of conceptual knowledge and abstract reasoning was observed. CONCLUSIONS: This is the first report of an explicitly documented comprehensive neuropsychological assessment in a patient with BNS. The battery we composed is an example of a methodology that can be used to conduct a detailed cognitive examination without being penalized for physical impairment.Further studies are needed to define the typical cognitive features that characterize BNS and possibly identify its cognitive phenotype(s).

Assessing heterogeneity in menstrual cycles by means of a multilevel latent class approach.

In this paper, we study the problem of heterogeneity in cervical mucus hydration at different times relative to the mucus peak both between cycles and women, specifying and estimating appropriate multilevel latent class models for longitudinal data. We estimate multilevel and growth latent class models which classify women on the basis of the evolution of cervical mucus characteristics observed over the fertile period of each menstrual cycle taking into account that we observe a different number of cycles per woman and correlation over time between consecutive observations. The effect of potential covariates on mucus evolution patterns is as well evaluated. Results confirm the existence of heterogeneity in mucus evolution between cycles and women. Moreover, an important significant effect of a woman's age is found.

Molecular analysis of carnivore Protoparvovirus detected in white blood cells of naturally infected cats.

BACKGROUND: Cats are susceptible to feline panleukopenia virus (FPV) and canine parvovirus (CPV) variants 2a, 2b and 2c. Detection of FPV and CPV variants in apparently healthy cats and their persistence in white blood cells (WBC) and other tissues when neutralising antibodies are simultaneously present, suggest that parvovirus may persist long-term in the tissues of cats post-infection without causing clinical signs. The aim of this study was to screen a population of 54 cats from Sardinia (Italy) for the presence of both FPV and CPV DNA within buffy coat samples using polymerase chain reaction (PCR). The DNA viral load, genetic diversity, phylogeny and antibody titres against parvoviruses were investigated in the positive cats. RESULTS: Carnivore protoparvovirus 1 DNA was detected in nine cats (16.7%). Viral DNA was reassembled to FPV in four cats and to CPV (CPV-2b and 2c) in four cats; one subject showed an unusually high genetic complexity with mixed infection involving FPV and CPV-2c. Antibodies against parvovirus were detected in all subjects which tested positive to DNA parvoviruses. CONCLUSIONS: The identification of FPV and CPV DNA in the WBC of asymptomatic cats, despite the presence of specific antibodies against parvoviruses, and the high genetic heterogeneity detected in one sample, confirmed the relevant epidemiological role of cats in parvovirus infection.