The Incidence of Myasthenia Gravis in the Province of Ferrara, Italy, in the Period of 2008-2022: An Update on a 40-Year Observation and the Influence of the COVID-19 Pandemic

Myasthenia gravis (MG) is the most common neuromuscular junction disorder. We evaluated the MG incidence rate in the province of Ferrara, Northern Italy, over two time frames (2008-2018 and 2019-2022, i.e., the COVID-19 pandemic) and considered early-onset (EOMG), late-onset (LOMG), and thymoma- and non-thymoma-associated MG. Moreover, in the second period, we assessed its possible relationship with SARS-CoV-2 infection or COVID-19 vaccination. We used a complete enumeration approach to estimate the MG incidence and its temporal trend. For the period of 2008-18, 106 new cases were identified (mean incidence rate 2.7/100,000 people). The highest rates were observed for the over-70 age group and in rural areas, with 17% of thymoma-associated MG. During the COVID-19 period, 29 new cases were identified (average incidence rate 2.1/100,000 people), showing a marked (though not statistically significant) decrease in the mean annual incidence compared to the previous period. Again, the highest rate was observed for the over-70 age group. The first period was in line with our previous observations for the period between 1985 and 2007, highlighting a rising incidence of LOMG and a marked decrease in EOMG. During the COVID-19 period, incidence rates were lower in the first years whereas, when the pandemic ended, the previous trend was confirmed.

Considerations about the multidimensional evaluation of a stab wound tibial neuropathy: a case report

We present a rare case of a traumatic lesion of the tibial fibers of the sciatic nerve with spared peroneal fibers. A 33-year-old victim of a three month earlier stabbing attack came to our attention with gait impairment and weakened left foot plantar flexion and left foot internal rotation and supination. Based upon clinical signs and neurophysiological investigations we suspected that a traumatic injury of the left tibial nerve had occurred. Ultrasound examination detected a lesion of part of the left sciatic nerve, in a different site than expected. The patient was immediately enlisted for a tailored surgical reconstruction.

The Value of Craft Beer Styles: Evidence from the Italian Market

This study aims to estimate the market value, or implicit prices, associated with the main craft beer attributes (e.g., beer style, organic, gluten-free, and package-related features) and support producers in detecting the more profitable marketing strategies. For this purpose, we conducted an empirical analysis employing sales data of craft beers from the Italian online market, and we estimated a hedonic price model via ordinary least squares. Results show that the type of package and cup only has moderate effects on price. Furthermore, a moderate premium price is found for gluten-free craft beers, while craft beers with organic labels and Italian origin do not benefit from the higher price. Instead, the beer style adopted strongly affected the product price: the highest premium prices were detected for Barleywine (+49.9%) and Italian Grape Ale (+39.6%) beer styles. Furthermore, relevant premium prices, higher than +25%, were estimated for other beer styles such as Sour, Fruit Beer, and Stout. Results suggest that artisanal breweries can effectively differentiate their product according to the beer style. To the best of our knowledge, the current study offers the first empirical evidence on how beer styles as well as other product characteristics affect the market price of craft beer by using secondary data.

Improving meat tenderness using exogenous process: The consumer response

The aim of this paper is to investigate purchase intention (PI) for meat obtained through a tenderization process based on a treatment with exogenous proteolytic enzymes. Particularly, perceived risks and perceived benefits on the consumer acceptance of tender meat produced through this emerging technology have been evaluated. In order to achieve the stated objective, a survey was conducted on a national representative sample of Italian consumers (N = 1006), who received information about the traditional and the emerging tenderization processes. Principal Component Analysis and Structural Equation Model were applied to the collected data. Results show that consumer purchase intention for meat treated with exogenous proteolytic enzymes was strongly influenced by perceived benefits and weakly influenced by perceived risks. Another important result is that perceived benefits are mainly affected by trust in science. Finally, a Cluster Analysis was performed to distinguish consumer segments with different response patterns.

Toward the circular economy into the olive oil supply chain: A case study analysis of a vertically integrated firm

While the paradigm of circular economy (CE) and the processes of socio-technical transition have been broadly investigated at the theoretical level, understanding how the transition toward circular models can be implemented in practice is still limited. This contribution aims to provide in-depth and evidence-based insights on an emerging pathway for the operability of CE into the olive oil supply chain. A case study from the Apulia region (the leading olive oil producing area in Italy) is presented to show how an existing business model can be transformed into a circular one, and to what extent it can be replicated. The study focuses on a vertically integrated firm, in which a new industrial process has been introduced to manage olive pomace, which is one of the most important by-products obtained from olive oil extraction. The empirical analysis is built on the Circular Business Model Canvas (CBMC), which is conceived as a suitable theoretical and methodological tool to speed up the transition process toward CE at a micro-economic level. This analytical framework allows us to identify the interplaying elements that the firm combines to capture, create, and deliver value, as well as the relationships with the broader economic system. Particular attention is paid to two distinctive components of CBMC: material loops and adoption factors. Also, internal and external factors affecting the adoption of the new circular business model have been discussed by separating drivers and barriers of the transition process.

Do consumers understand health claims on extra-virgin olive oil?

Health claims have been introduced in food labelling to support consumers' awareness of healthy food choices and to enhance a healthy diet. Even though many countries around the world have developed legislation and guidelines to regulate the introduction of health claims on food labels, there is the evidence that many consumers do not understand the meaning of these claims. This study analyses whether Italian consumers really understand authorized health claims on extra-virgin olive oil and what are the drivers of such understanding. An Olive Oil Health Claims Understanding index was constructed and embedded in a structured questionnaire, which was then administered to a representative sample of Italian household members who are responsible for food shopping (N = 1,030). Results from the survey showed that only 36% of the respondents understood the meaning of the authorized health claims on extra-virgin olive oil. Moreover, the findings confirmed that the understanding of health claims is related to socio-demographic, personal and psychographic characteristics of consumers, as well as to their attitudes toward using food as medicine. Outcomes also proved the central role of nutrition knowledge in affecting understanding of health claims.

Consumers' Trade-Off between Nutrition and Health Claims under Regulation 1924/2006: Insights from a Choice Experiment Analysis

The aim of this paper is to investigate consumers’ preferences and willingness to pay (WTP) for functional mozzarella cheese whose health benefits (reduced fat and enrichment in omega-3) are communicated by using nutrition claims (article 8) and health claims (articles 13 and 14) of the EU Regulation 1924/2006. In order to achieve the stated objective a choice survey was developed and administered to a sample of Italian respondents. The product attributes and attribute levels included in the choice experiment were obtained from in-depth interviews conducted with stakeholders working on the development of this new product in the Italian region of Puglia. Results show that many participants were not aware of functional food. Marketing segmentation performed via latent class analysis indicates that the development of this hypothetical product should be based on the addition of naturally enriched omega-3. In terms of health communication under Regulation 1924/2006, heterogeneity of preferences of the nine identified segments reveals that respondents have a clear preference for products from the Puglia region, for the combined nutrition claim over single nutrition claims and for the reduction of disease health claim (article 14) over the health claim (article 13). In monetary terms, willingness to pay for health claims is higher than nutrition claims.

Consumers' willingness to buy innovative traditional food products: The case of extra-virgin olive oil extracted by ultrasound

Innovation is fundamental for all agri-food companies to increase competitiveness, however the industrial process of extra virgin olive oil (EVOO) has changed very little over the last few decades. As it is a traditional food product (TFP), the main obstacle to innovation is precisely its traditional nature. According to the literature, any innovation regarding TFPs should be considered in terms of the specific product, and market success mainly depends upon the perceptions and traits of consumers. The present study evaluated the willingness of consumers to buy an innovative EVOO obtained by ultrasound extraction (ultrasonic EVOO) through an ordered logit model. The sample was composed by 961 EVOO consumers. The average age of respondents was 39 and the majority were female (55.4%). At first, the respondents reacted almost equally to the idea of buying ultrasonic EVOO, with 49% of the sample stating they were not willing to buy the product and 51% stating that they were willing to. The major insight from our study is that consumers who are the most willing to buy the product are those who formed a positive quality perception after being introduced to the key characteristics of the new product. In addition, the willingness to buy seems to be higher for consumers who prefer EVOO with a fruity flavour and without a sweet taste, for consumers who attach great importance to the taste of food and with a higher than average educational level. This predominant role of consumers' perception in the case of innovative TFPs should, thus, be researched further.

Successful breastfeeding: a global intervention for a physiological process

In our perinatal unit we applied the ten steps of WHO/UNICEF for Baby Friendly Hospital Initiative and evaluated the percentage of exclusive (EBF) or complementary breastfeeding (CBF), and of formula fed (FF) healthy full-term infants (HFI) at hospital discharge (HD). HFI performing EBF at HD were 85.3%, a quite high value. At the age of 3 mths EBF percentage ranged between 59-62.4%, and at 6 mths it decreased to 51.7-37.7%. Customer satisfaction questionnaire at HD ranked "good" to "very good" in 92.8%. Causes of breastfeeding reduction with time and comparison with previous and actual situation in Italy and civilized countries are discussed.

[Trends of colorectal cancer incidence, mortality and survival in the Umbria, region of Italy. 1978-82 and 1994-99]

The aim of the study is to show the colorectal cancer trend in Umbria, a central Italian region, from 1978 to 1999. Data concerning regional incidence, mortality and survival derived from an ad hoc survey carried out in Umbria in the period 1978-1982 and from Umbria Population-based Registry (RTUP) for the years 1994-1999. The incidence of colorectal cancer increases in both sexes, expecially for the age class > 75 years. Mortality rises slightly, without no difference between sexes. Survival of patients with colorectal cancer has improved in the two sexes from 45 to 74 years-age, while the lower survival has registered for age between 75 and 84 years. We concluded that the situation in Umbria is quiet good, but it is affected by aging of Umbrian population. Delaying in diagnosis or inefficacy in therapy can explain shorter survival in older patients.