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Several studies have focused on the behaviour of consumers towards organic wine, finding varying and sometimes conflicting results. Some scholars have noted that consumers may perceive wine labelled as organic to be of a lower quality, whereas others have found that consumers are willing to pay a premium price for it. Starting from these discrepancies found in the literature, this study seeks to investigate how the organic certification influences consumers when purchasing a bottle of red wine, evaluating the possible presence of attribute non-attendance (ANA) behaviour. A choice experiment was carried out on a sample of Italian wine consumers. Findings highlight that although, on average, consumers do not prefer organic wine, there is a relevant niche in the market consisting of consumers who benefit from purchasing it. Moreover, we have found that the majority of the sample ignores the organic attribute when choosing a bottle of wine, which reveals ANA behaviour.

This study aims to quantify the economic value of environmental externalities by proposing an approach tailored to areas designated for “civic uses”. These areas fall within the broader category of “collective goods” on which the legislator places particular emphasis, especially in regard to their protection and enhancement. The technique applied in this study is the total economic value (TEV), quantified through a spatialization and modeling of socioeconomic and environmental variables on Geographic Information Systems. The methodology was used for a specific case study area, the forests of Land Association “Bosco dei Bardi” in the Tuscany region of central Italy. This area exhibits the same characteristics and fulfills the same functions as those designated for civic uses. The results demonstrate the importance of providing public decision-makers with appropriate tools to protect and enhance these areas. The results also underscore the economic significance of forest ecosystem services compared to average regional values. The study finally confirms that Land Associations present a promising avenue for revitalizing abandoned territories, consistent with civic use objectives.

Purpose The commitment of multidisciplinary teams in antimicrobial stewardship programs (ASPs) is often inadequately considered, especially in surgical wards. We wanted to evaluate clinical, microbiological, and pharmacological outcomes before and after the implementation of an ASP in the Vascular Surgery ward of Fondazione IRCCS Policlinico San Matteo, a tertiary care hospital in Pavia, Italy. Methods This was a quasi-experimental quality-improvement study. The antimicrobial stewardship activity was conducted twice a week for 12 months and consisted of both prospective audit and feedback of all the ongoing antimicrobial prescriptions by the infectious diseases’ consultants and educational meetings for the healthcare workers of the Vascular Surgery ward. For comparison between the study periods, Student t test (Mann–Whitney test for skewed distributions) was used for quantitative variables (ANOVA or Kruskall-Wallis for > 2 groups respectively), and Pearson’s chi-squared test (Fisher exact test where appropriate) for categorical variables. 2-tailed tests were used. P-value significance cut-off was 0.05. Results During the 12-month intervention period, among a total number of 698 patients, 186 prescriptions were revised, mostly leading to de-escalating an ongoing antimicrobial therapy (39, 20.97%). A statistically significant reduction in isolates of carbapenem-resistant Pseudomonas aeruginosa (p-value 0.003) and the absence of Clostridioides difficile infections were reported. No statistically significant changes were observed in terms of length of stay and all-cause in-hospital mortality. A significant decrease in the administration of carbapenems (p-value 0.01), daptomycin (p-value < 0.01) and linezolid (p-value 0.43) was registered. A significant reduction in antimicrobial costs was also observed. Conclusions The implementation of a 12-month ASP brought significant clinical and economic results, highlighting the benefits of a multidisciplinary teamwork.

The aim of this study is to evaluate the role of contrast transesophageal echocardiography (cTEE) in the diagnostic characterization of acute aortic syndromes (AAS) [aortic dissection, intramural hematoma, penetrating ulcer]. We enrolled 66 non-consecutive patients with clinical suspicion of AAS. Standard transesophageal echocardiography and cTEE were performed prior to gated-CT angiography, which has been assumed as reference standard. cTEE was obtained with a single bolus of contrast agent injection. The definitive diagnosis of AAS was made in 48 patients by gated-CT angiography: 22 aortic dissections, 15 intramural hematomas and 11 penetrating aortic ulcers. Standard TEE and cTEE correctly diagnosed AAS in 87 and 100 % ( P  = 0.03) cases respectively. Standard TEE correctly diagnosed aortic dissection in 20/22 (91 %) and cTEE in 22/22 (100 %) ( P  = 0.5) cases. cTEE was superior than standard TEE in the visualization of false lumen entry tear (22/22 vs. 16/22, P  = 0.03). Standard TEE correctly diagnosed intramural hematoma in 11/15 and cTEE 15/15 ( P  = 0.12) cases. Microtears were identified in 3 patients by cTEE an in 1 patient by standard TEE ( P  = 0.4). The presence of focal contrast enhancement was identified in 4 and 0 patients by cTEE and standard TEE respectively ( P  = 0.06). Both standard and cTEE correctly diagnosed penetrating aortic ulcer in 11/11 (100 %) ( P  = 1.0) cases. cTEE provides additional value over standard TEE in the diagnosis and in the anatomic and functional characterization of AAS.

Purpose The purpose of this paper is to investigate preferences for wine made from hand-harvested grapes, and the interactive effect between this attribute and organic certification. Design/methodology/approach Data were collected via an online choice experiment involving a sample of 408 Italian wine consumers. A random parameter logit was performed to estimate consumer preferences for wine attributes: harvest type, organic and the interaction between these. The experiment also includes geographical indications and price. Furthermore, a latent class model (LCM) is performed to investigate taste heterogeneity for the included wine attributes. Findings On average, consumers prefer the wine produced with hand-harvested grapes. The hypothesis of an interaction between organic and hand-harvested attributes is rejected. Using the LCM, the authors identify three segments with significant taste heterogeneity in terms of the magnitude and the sign of the parameters. Moreover, consumer attitudes towards food naturalness differ according to their belonging to the segments. Originality/value The novelty of this article is twofold. First, this study investigates, for the first time, the impact of the hand-harvested method on consumer wine preferences. Second, hand-harvesting and organic have independent values.

BackgroundThree-dimensional (3D) printing is a disruptive technology that is quickly spreading to many fields, including healthcare. In this context, it allows the creation of graspable, patient-specific, anatomical models generated from medical images. The ability to hold and show a physical object speeds up and facilitates the understanding of anatomical details, eases patient counseling and contributes to the education and training of students and residents. Several medical specialties are currently exploring the potential of this technology, including general surgery.MethodsIn this review, we provide an overview on the available 3D printing technologies, together with a systematic analysis of the medical literature dedicated to its application for abdominal surgery. Our experience with the first clinical laboratory for 3D printing in Italy is also reported.ResultsThere was a tenfold increase in the number of publications per year over the last decade. About 70% of these papers focused on kidney and liver models, produced primarily for pre-interventional planning, as well as for educational and training purposes. The most used printing technologies are material jetting and material extrusion. Seventy-three percent of publications reported on fewer than ten clinical cases.ConclusionThe increasing application of 3D printing in abdominal surgery reflects the dawn of a new technology, although it is still in its infancy. The potential benefit of this technology is clear, however, and it may soon lead to the development of new hospital facilities to improve surgical training, research, and patient care.

Background and aims In order to systematically review the latest evidence on anesthesia, intraoperative neurologic monitoring, postoperative heparin reversal, and postoperative blood pressure management for carotid endarterectomy. The present review is based on a single chapter of the Italian Health Institute Guidelines for diagnosis and treatment of extracranial carotid stenosis and stroke prevention. Methods and results A systematic article review focused on the previously cited topics published between January 2016 and October 2020 has been performed; we looked for both primary and secondary studies in the extensive archive of Medline/PubMed and Cochrane library databases. We selected 14 systematic reviews and meta-analyses, 13 randomized controlled trials, 8 observational studies, and 1 narrative review. Based on this analysis, syntheses of the available evidence were shared and recommendations were indicated complying with the GRADE-SIGN version methodology. Conclusions From this up-to-date analysis, it has emerged that any type of anesthesia and neurological monitoring method is related to a better outcome after carotid endarterectomy. In addition, insufficient evidence was found to justify reversal or no-reversal of heparin at the end of surgery. Furthermore, despite a low evidence level, a suggestion for blood pressure monitoring in the postoperative period was formulated.

On one hand, the main difficulties in establishing a wide, evidence-based consensus about the best approach to visceral artery aneurysms (VAAs) and pseudoaneurysms (VAPAs) are the paucity of data, due to their rarity in the general population, and the extreme heterogeneity of this group of diseases, which encompasses different aneurysm types, with different degrees of rupture risks according to their anatomical locations [...]

In some Anglo-Saxon countries, such as Australia and the United States, initiatives have already emerged to promote standardized evaluation practices. However, in Italy, this process is still evolving. Since 1994, the International Valuation Standards Committee (IVSC) has been working on various documents to establish uniform evaluation practices globally. These International Valuation Standards (IVS) are gradually gaining recognition in Italy. Through the efforts of organizations like ABI, Tecnoborsa, the Revenue Agency, and professional associations, IVS are being integrated into evaluation practices for credit approval and public administration requirements.

In some Anglo-Saxon countries, such as Australia and the United States, initiatives have already emerged to promote standardized evaluation practices. However, in Italy, this process is still evolving. Since 1994, the International Valuation Standards Committee (IVSC) has been working on various documents to establish uniform evaluation practices globally. These International Valuation Standards (IVS) are gradually gaining recognition in Italy. Through the efforts of organizations like ABI, Tecnoborsa, the Revenue Agency, and professional associations, IVS are being integrated into evaluation practices for credit approval and public administration requirements.