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At least 19 recordsLinked to original sources

PubMed1998

Hyperlipidaemia: differences in management practices and attitudes in two regions in Europe--Sicily and the Stockholm area.

In order to compare attitudes and management concerning hyperlipidaemia and risk factors for coronary heart disease among doctors in northern and in southern Europe, a questionnaire study was undertaken among doctors in primary health care and departments of internal medicine in Sicily and Stockholm. The regions differed in culture and health-care structure. Guidelines were similar, but screening of healthy individuals was recommended in Sicily, and not in Sweden. One hundred and fifty-three general practitioners in Sicily and 120 in Stockholm, 211 internists in Sicily and 83 in Stockholm participated. Main outcome measures were management policies for investigation and treatment and also attitudes. Routine lipid checks at first visits were done by few doctors in Stockholm but by a majority in Sicily (p < 0.001); in the presence of general cardiovascular risk factors (other than heredity, diabetes, cardiovascular disease and hypertension), routine checks were carried out more often by both general practitioners (p < 0.001) and internists (p < 0.005) in Stockholm. Drug treatment was initiated at lower cholesterol levels for secondary and primary intervention, cardiovascular disease, cardiovascular risk factors and hereditary hyperlipidaemia by both groups in Sicily (p < 0.001), as was dietary treatment. Secondary prevention was considered important by all groups, but primary prevention only by Sicilian doctors. We concluded that there were differences in views and management practice between doctors in Sicily and in Stockholm on the investigation and treatment of patients with hyperlipidaemia. Doctors tested lipids at first visits in Sicily but not in Stockholm. Treatment was initiated at lower levels of cholesterol in Sicily.

Drug Utilization↗

PubMed2006

Molecular characterization of Anaplasma platys strains from dogs in Sicily, Italy.

BACKGROUND: The genetic diversity of Anaplasma platys (Rickettsiales: Anaplasmataceae) strains is currently poorly defined. The present study was designed to characterize A. patys strains in dogs from Palermo, Sicily, Italy, using a combination of PCR and sequence analysis of the 16S rDNA, heat shock operon groESL and citrate synthase (gltA) genes. RESULTS: Blood was collected from 344 dogs (111 pet dogs, 122 pound dogs and 111 hunting dogs) during 2003-2005 in the Province of Palermo, Sicily, Italy. The prevalence of A. platys in dogs in Sicily, as demonstrated by PCR and sequence analysis of the 16S rDNA, groESL and gltA genes, was 4%. None of the samples were positive for A. marginale, A. centrale, A. ovis and A. phagocytophilum DNA. Three different gltA genotypes of A. platys were identified in dogs from Sicily. Two of the gltA sequences of Sicilian A. platys strains were different from sequences reported previously. However, one of the gltA, 16S rDNA and groESL sequences were identical to the sequence of A. platys strains from other regions of the world characterized previously. CONCLUSION: At least three different strains of A. platys were identified in dogs from Sicily by PCR and sequence analyses of the 16S rDNA, groESL and gltA genes. The results reported herein suggested that genetic diversity of A. platys strains may be similar to A. ovis, but lower than the diversity reported for A. marginale and A. phagocytophilum. This lower genetic diversity may have resulted from restricted movement of infected hosts compared to A. marginale-infected cattle and/or the limited host range of A. ovis and A. platys as compared with A. phagocytophilum. These results expand our knowledge about A. platys and encourage further research for analysis of the genetic variation of A. platys strains worldwide.

Anaplasma↗

PubMed1995

Molecular characterization of trimethoprim resistance in salmonellas isolated in Sicily, 1985-1988.

The occurrence of trimethoprim (Tp) resistance in salmonellas isolated from humans and water samples in Sicily between 1985 and 1988 has been investigated and the Tp resistance mechanisms have been further characterized on the basis of hybridization with probes for the dihydrofolate reductase (DHFR) genes types I, II, IV and V. Of 765 strains examined, high level (> 1000 mg/l) resistance to Tp was identified in 23 strains (3%). In 22 of these strains, such resistance was associated with resistance to sulphonamides. Six serovars with Tp-resistant strains were identified, Salmonella typhimurium (14 strains), S. enteridis (2), S. agona (2), S. mbandaka (2), S. virchow (2), S. indiana (1). In all strains with high level Tp resistance, resistance to this antimicrobial was plasmid-encoded, in most strains by plasmids with MWs ranging from 70-100 MDa. On the basis of restriction endonuclease analysis, four different categories of Tp resistance plasmids were identified in Tp-resistant strains of S. typhimurium. Hybridization with the DHFR I probe was observed in three strains of Tp-resistant S. typhimurium and two strains of Tp-resistant S. enteritidis; in contrast, in none of the strains tested was there any detectable hybridization with the probes for DHFR types II, IV and V. It is concluded that the DHFR type I resistance mechanism, common in Tp-resistant enterobacteria in many European countries, is relatively uncommon in Tp-resistant salmonellas isolated in Sicily. Furthermore, the DHFR V resistance mechanism, previously identified in strains of Shigella sonnei isolated in Sicily and associated with travellers from Sri Lanka, has not yet appeared in salmonellas in Sicily.

Acute Disease↗

PubMedDate not supplied

Acute hepatitis E in Catania (eastern Sicily) 1980-1994. The role of hepatitis E virus.

Between 1980 and 1994, 540 patients with acute viral hepatitis were admitted to hospital at the Department of Infectious Diseases of Catania (eastern Sicily). Twenty-five patients out of 540 were assessed as having non-A, non-B, non-C hepatitis. These subjects were studied for anti-HEV IgM and IgG seroprevalence by testing serial serum samples collected 1, 4, 12 and 24 weeks after the onset of acute disease. Fourteen of 25 samples (56%) seroconverted to anti-HEV IgG antibodies. No sample was positive for anti-HEV IgG at week 1, ten samples were positive at week 4 and the remainder at week 12. Anti-HEV reactivity was maintained until week 24 in all cases. In 11 of the 14 patients seroconverting to anti-HEV, the presence of IgM anti-HEV was found, which appeared in the sample from week 1 and gradually disappeared thereafter. Identified risk factors for HEV transmission included travel in the tropics and shellfish ingestion (anti-HEV positive versus anti-HEV negative: p < 0.05). HEV-related hepatitis is not yet a major public health problem in Sicily but, from our data, the trend of its incidence is clearly upwards. The high incidence of faecally-orally transmitted diseases in Sicily, the crucial position of Sicily in the middle of the Mediterranean Sea (where HEV largely circulates) and the increase of migration from developing countries are all factors which should increase awareness for a more active surveillance of the spread of HEV in our area.

Acute Disease↗

PubMedDate not supplied

Epidemiology and clinical characteristics of endemic cretinism in Sicily.

In this study we report the prevalence of endemic cretinism in the general population of two iodine deficient areas in Northeastern Sicily that were described more than 10 yr ago. In addition, the individual characteristics of endemic cretins are considered in order to define the typical expressions of this major iodine deficiency disorder in Sicily. Forty-three mental defectives were identified: 22 were living in an area with three bordering and closely connected municipalities within the province of Messina and with a population of 17,485 inhabitants (prevalence = 0.13%). Three out of the 22 were school-age children. The other community, in the province of Catania, was constituted by a unique and mostly agricultural hamlet, and showed a prevalence of cretinism that was 0.68% (21/3,100). Among the 43 mental defectives, 16 (37%) presented prominent neuromotor and neurosensorial disorders, including deafmutism and were euthyroid, thus conforming to the neurological type of cretinism; 13 (30%) were hypothyroid and exhibited stunted growth without significant neuromotor and neurosensorial impairment (myxedematous cretins). In the remaining 14 individuals (33%) neurological disorders were associated with stunted growth and clinical or biochemical hypothyroidism. These data indicate that also in Sicily endemic cretinism is a continuum of a variety of forms: among these the pure neurological and pure myxedematous forms represent the two extremes. Our observations also indicate that endemic cretinism still represents a major public health problem in Sicily. The finding of 3 endemic cretins younger than 13 yr suggests the persistence of this disorder even in the presence of improved economic, social and nutritional conditions.

Adolescent↗

PubMed1979

Multiple sclerosis in southern Europe. I: Prevalence in Sicily in 1975.

Previous reports on large population groups have suggested that the prevalence of multiple sclerosis (MS) in Sicily and southern Italy is low, of the order of 4-8 per 100 000. In contrast, immigrants from Italy resident in Greater London, many of whom are from southern Italy and Sicily, had a hospitalised MS prevalence similar to that found among people born in the United Kingdom (1960-72). The present study shows that in Enna city (population 29 000) in central Sicily, the prevalence of probable MS was 53 per 100 000, which is of the same order of magnitude as has been reported from the United Kingdom and northern Europe. The high prevalence of MS found in Enna city may be due, at least in part, to the fact that the population studies was small. Because Enna is on high ground, similar studies are being undertaken in two small coastal towns of Sicily.

Adult↗

PubMed2006

High prevalence and fast rising incidence of multiple sclerosis in Caltanissetta, Sicily, southern Italy.

BACKGROUND: Epidemiological studies conducted in Sicily and Sardinia, the two major Mediterranean islands, showed elevated incidence and prevalence of multiple sclerosis (MS)and a recent increase in disease frequency. OBJECTIVE: To confirm the central highlands of Sicily as areas of increasing MS prevalence and elevated incidence, we performed a follow-up study based on the town of Caltanissetta (Sicily), southern Italy. METHODS: We made a formal diagnostic reappraisal of all living patients found in the previous study performed in 1981. All possible information sources were used to search for patients affected by MS diagnosed according to the Poser criteria. We calculated prevalence ratios, for patients affected by MS who were living and resident in the study area on December 31, 2002. Crude and age- and sex-specific incidence ratios were computed for the period from January 1, 1993, to December 31, 2002. RESULTS: The prevalence of definite MS rose in 20 years from 69.2 (retrospective prevalence rate) to 165.8/100,000 population. We calculated the incidence of definite MS for the period 1970-2000. These rates calculated for 5-year periods increased from 2.3 to 9.2/100,000/year. CONCLUSION: This survey shows the highest prevalence and incidence figures of MS in the Mediterranean area and confirms central Sicily as a very-high-risk area for MS.

Adolescent↗

PubMed1991

Genetic and cultural transmission in Sicily as revealed by names and surnames.

The study of names as cultural characters and of surnames, which behave like genetic markers, is useful for comparing cultural and genetic transmission. Genetic transmission has a unique vertical component, which also can be present in the transmission of cultural traits associated with a horizontal (or epidemic) component resulting from local customs or fashion. Our aims in this study are to infer genetic patterns in Sicily from surnames and names and to evaluate and compare the consequences of vertical versus horizontal transmission of cultural markers. Names and surnames of 88,383 consanguineous spouses collected in 16 dioceses of Sicily were analyzed by multivariate analysis to reveal and compare the geographic clusters obtained from both sets of data. As a result, both data sets indicate a major separation between the eastern and the western region of Sicily. Also, distance matrices obtained from names are highly correlated with those from surnames. But names seem to form fewer and larger geographic clusters, whereas surnames are more greatly subdivided into smaller clusters. The most common male names present a different pattern from surnames. Vertical transmission is the cause of the similarity of the main geographic patterns of names and surnames and their correspondence with findings from geography of genes, and horizontal cultural transmission explains the major differences. Furthermore, the genetic and cultural affinities can be correlated with the historical background of Sicily.

Cluster Analysis↗

PubMed1999

Livestock production and animal health in Sicily, Italy.

In Sicily, as in other Mediterranean areas, livestock represents one of the most important resources for the island economy. This sector involves more than 16,000 farms of cattle and 10,000 farms of sheep and goats (respectively 6% and 15% of national production) which are actually increasing their number. Most livestock in Sicily is owned by small holders and pastoralists. Regional production of milk feeds some industries, which involve a large and increasing occupational area. Due to its peculiar geographic aspect Sicily is constituted by hill areas with sporadic grasses, therefore extensive grazing methods represent an ancient, traditional practice for using poor lands. For the control of infectious diseases Veterinary Services (VS) are based on the public regional network that is coordinated by the Ministry of Health in Rome. Even if Sicilian VS had to solve many constraints related to traditional "pastoral management system", to the lack of any sanitary background of this sector, to unknown data on the numbers of the whole livestock, the effort done in the last years has allowed to monitor for brucellosis, bovine leukemia virus (BLV), bovine TBC, swine vescicular disease (MVS) and other diseases for the majority of the farms. Tick-borne diseases (TBDs) still represent a serious impediment to the improvement of meat and milk production in the region. Every year, several outbreaks related to Theileria, Babesia or Anaplasma infections in cattle are recorded. Imported breeds pay the most expensive tribute often with a mortality rate of 100%. In the last five years more than 170 outbreaks of TBDs have been notified by our Institute although the pathogen prevalence and economical impact in the Sicilian livestock is still unknown. The outdoor grazing of the animals, far away from observation, a subclinical course of the disease, can in fact create difficulties in discovering infection and therefore the therapy is often too late. New diagnostic and control methods (PCR, vaccination) are being developed at the Istituto Zooprofilattico Sperimentale of Sicily in cooperation with other national and international laboratories (such as the University of Utrecht).

Animal Husbandry↗

PubMed2003

Brief communication: coexistence of two distinct patterns in the surname structure of Sicily.

The extent of variation in the migratory movements that occurred in Sicily was evaluated using surname data taken from the telephone directories of the 390 communes of the island. The surname distribution of each commune was linearized by a log-log transformation, and a significant fit to a linear regression model was found in almost all cases. Interestingly, the slope of the regression line appeared to be a sensitive indicator of the different level of isolation associated with each Sicilian commune. By this approach, two distinct groups of communes, showing a higher or lower degree of isolation, were obtained, and two independent analyses of the surname structure of Sicily were carried out. A first multidimensional scaling analysis, based on the more isolated communes, yielded evidence for a more ancient pattern, characterized by a geographical gradient along the east-west axis. The same analysis, addressed to the less isolated communes, instead highlighted a wide network of interactions between geographically distant zones of the island. The fitting of the surname distribution to the log-log model allowed for the detection of a narrow subset of 35 Sicilian communes, whose significantly higher degree of isolation was statistically proved by the parallelism test. We believe that a genetic analysis focused on such specific zones of the island could reveal ancient patterns of differentiation, thus helping to answer the controversial question of the genetic history of Sicily.

Emigration and Immigration↗

PubMed1992

Genetic structure of the population of Sicily.

Genetic heterogeneity within Sicily was investigated on the basis of ACP1, ADA, ESD, GLO1, PGD, PGM1, PGM2, SODA, ABO, and MN gene frequencies, and compared to those of other regions of Italy for which these same loci have been examined. Correspondence analysis revealed no differences within the island, at least at the provincial level, but showed genetic differentiation among Italian regions, distinctly clustering northern, central, and southern populations, respectively. These data indicate a close relationship between Sicily and southern Italy. In addition, the contribution of Middle Eastern populations to the gene pool of Sicily was evident.

ABO Blood-Group System↗

PubMed1987

Delta infection in eastern Sicily.

Sera from 619 HBsAg+ subjects living in eastern Sicily, consecutively collected from 1975-1985, were tested for markers of delta virus (HDV) infection: delta antigen (HDAg), antibodies to delta (anti-HDIg), and also for antibodies to HBcore of IgM type (anti-HBcIgM) and for the system HBe-anti-HBe. The subjects included 210 asymptomatic carriers, 238 patients with acute hepatitis and 171 patients with chronic liver disease. HDAg was not found in any of the samples. Anti-HD was found in 28/171 (16.3%) patients with chronic liver disease, in 13/210 (6%) asymptomatic HBsAg carriers and in 13/238 (5.4%) patients with acute hepatitis. None of our patients were drug addicts. One had a history of blood transfusion, and nine came from the same family unit. The prevalence of HDV infection in eastern Sicily is lower than in other areas of Sicily possibly because of the lower percentage of HBsAg carriers in the local population. Parenteral transmission of HDV does not seem to play a major role in our area, while the familial clustering suggests close body contact as an important way of spread.

Adolescent↗

PubMedDate not supplied

Endemic cretinism in Sicily.

This work reports the presence of endemic cretinism in a small district located inside an endemic goiter area in north-eastern Sicily, personally described. The study covers 19 mental defectives (11 females and 8 males, mean age 35.8 +/- 15.5 yr) selected on the basis of severe mental retardation recognized by the local doctors. No systematic survey for cretinism was carried out in the total population. Marked mental retardation was evident in all subjects. Nine of them exhibited clinical and biochemical signs of hypothyroidism (myxedematous cretins). The 10 others were clinically euthyroid and had deaf-mutism and/or pyramidal tract dysfunction (neurological cretinism). Familial aggregation of cretinism was also observed. In both myxedematous and neurological cretins and urinary iodine excretion was very low, but not significantly different from that recorded in the euthyroid controls of the same area. The data available do not clarify the pathogenesis of endemic cretinism in Sicily. However, the marked height retardation, the observation of delayed bone maturation and the severity of mental deficiency suggest that thyroid failure was present in early life. The presence of endemic cretinism today in Sicily constitutes a strong argument in favour of the immediate introduction of adequate iodine prophylaxis.

Adolescent↗

PubMed2001

Epidemiology of multiple sclerosis in Sicily.

From epidemiological data obtained over more than 20 years by surveys conducted in different parts of Sicily, it is evident that Sicily is a high-risk area for multiple sclerosis (MS). This is in sharp contrast with the gradient hypothesis. High frequencies have been found in different parts of the island having different geoclimatic features, but at least two cities (Monreale and Enna) had had a prolonged Norman domination. This is in agreement with the hypothesis that MS originated in Northern Europe and spread around the world throughout the raids of the northern peoples. The increase in frequency estimated by follow-up and incidence studies is well established and is only in part linked to the improvement in diagnostic techniques. Finally, it is noteworthy that in the islands of Malta, a few sea miles away from Sicily, the MS prevalence rates are in the range of 4-8 cases per 100000 persons. This occurrence represents a natural model to investigate MS etiology through analytic studies and genetic analyses.

Age Factors↗

PubMed2006

Incidence of Crohn's disease and CARD15 mutation in a small township in Sicily.

BACKGROUND: The incidence of Crohn's disease (CD) has been shown to be lower in Southern than in Northern Europe. Data on the frequency of the NOD2/CARD15 mutations for Mediterranean area are very scant. AIM: To determine the incidence of CD from 1979 to 2002 in a township in Sicily together with the allele frequency of NOD2/CARD15 mutations in patients, family members and controls, and to determine the allele frequency of these mutations in sporadic CD from other areas of Sicily in comparison with a control population. METHODS: Casteltermini is a small town close to Agrigento (Sicily) with a population of 9,130 inhabitants. All the diagnoses of inflammatory bowel disease (IBD) made from 1979 to 2002 were obtained through the local health authority. NOD2/CARD15 mutations were studied in 23 out of the 29 patients with CD in Casteltermini, in 60 family members and in 64 controls. NOD2/CARD15 was also studied in 80 sporadic cases of CD disease among Sicilians outside Casteltermini and 118 healthy controls. RESULTS: From 1979 to 2002, 29 patients with CD and 13 patients with ulcerative colitis (UC) were registered. The 6-year mean incidence of CD ranged from 8.0 to 17 new cases for every 100,000 inhabitants, whereas the mean incidence of UC ranged from five new cases to 7.8 for every 100,000 inhabitants. The allele frequencies of NOD2/CARD15 mutations (L1007finsC, G908R, R702W) were 8.7, 4.3 and 8.7%, respectively, in CD cases; 5.0, 4.2 and 3.1% in family members; 1.6, 2.3 and 3.1% in controls. In sporadic Sicilian CD patients outside Casteltermini the allele frequency was 7.5, 8.1, 6.2% whereas in control population it was 3.3, 1.6, 1.6%. CONCLUSIONS: A high incidence of CD compared with UC was observed in this small town in Southern Italy. The frequency of NOD2/CARD15 mutations in CD is similar to other Caucasian population studied so far.

Adolescent↗

PubMed2005

Mycobacterium tuberculosis molecular evolution in western Mediterranean Islands of Sicily and Sardinia.

In this study, a total of 204 Mycobacterium tuberculosis DNAs from Sicily (n = 144) and Sardinia (n = 60) were studied by three genotyping methods. Results were analyzed both within and across islands, to define the phylogeographical specificities of the genotypes, look for their diversity and infer a molecular evolutionary scenario. A strong link between geography and tuberculosis genotypes was observed in Sardinia. The results were also matched against a world-wide genetic diversity database to compare the population structure of the tubercle bacilli in the islands. Eight common genotypes between Sicily, Sardinia and continental Italy were found which underlines the influences of the Italian mainland on the population structure on the islands and vice versa. A unified evolutionary scenario of M. tuberculosis evolution was built using numerical taxonomy and maximum parsimony (MP) methods. The finding of multiple families of M. tuberculosis strains (S, T, LAM, Haarlem), their presumed links with the major genetic groups (MGG) of M. tuberculosis complex, supports the view of independent introduction of several ancestral genotypes in Sicily and in Sardinia. We conclude that the two PCR-based genotyping combination (spoligotyping-VNTR) is an excellent tool to reconstruct M. tuberculosis phylogeny, that may be used to construct global and local evolutionary scenarios of the M. tuberculosis complex. The results obtained are paradigmatic of the complex interplay that exists between epidemic dynamics and evolutionary genetics of M. tuberculosis.

DNA, Bacterial↗

PubMed2005

Serologic and molecular characterization of Anaplasma species infection in farm animals and ticks from Sicily.

Although Anaplasma marginale was known to be endemic in Italy, the diversity of Anaplasma spp. from this area have not been characterized. In this study, the prevalence of Anaplasma spp. antibodies in randomly selected farm animals collected on the island of Sicily was determined by use of a MSP5 cELISA for Anaplasma spp. and an immunofluorescence test specific for Anaplasma phagocytophilum. Genetic variation among strains of Anaplasma spp. from animals and ticks was characterized using the A. marginale msp1alpha and the Anaplasma spp. msp4 genes. Eight species of ticks were collected and tested by PCR. Seropositivity for Anaplasma spp. and A. phagocytophilum was detected in bovine and ovine samples. All the donkeys were seropositive for A. phagocytophilum but not for Anaplasma spp. Four A. marginale genotypes were identified by msp4 sequences from bovine and tick samples. Two new genotypes of Anaplasma ovis were characterized in sheep. The sequences of A. phagocytophilum from three donkeys proved to be identical to the sequence of the MRK equine isolate from California. Six A. marginale genotypes were found in cattle and one tick using the A. marginale msp1alpha sequences. All genotypes had four repeated sequences in the N-terminal portion of the MSP1a, except for one that had five repeats. The Italian strains of A. marginale contained three repeat sequences that were not reported previously. Definition of the diversity of Anaplasma spp. in Sicily reported, herein is fundamental to development of control strategies for A. marginale, A. ovis and A. phagocytophilum in Sicily.

Amino Acid Sequence↗

PubMed2006

Analysis of mosses and soils for quantifying heavy metal concentrations in Sicily: a multivariate and spatial analytical approach.

BACKGROUND: The use of vegetal organisms as indicators of contamination of the environment is partially replacing traditional monitoring techniques. Amongst the vegetal organisms available, mosses appear to be good bioindicators and are used for monitoring anthropogenic and natural fall-out on soils. This study has two objectives: the evaluation of the concentrations of heavy metals in soils and mosses of the Sicily Region, in Italy and the identification of the origin of fall-out of heavy metals. METHODS: Mosses and the surface soil were sampled at 28 sites, only the youngest segments of Hylocomium splendens and Hypnum cupressiforme, corresponding to the plant tissues produced during the last 3 years, were taken. The elements Cd, Cu, Ni, Pb and Zn were analysed by ICP-MS and Hg by AAS. Statistical analysis was by PCA and spatial representation by GIS. RESULTS AND DISCUSSION: In the mosses sampled in Sicily, the highest concentrations of Cd were found around the cities of Palermo and Messina. The highest concentrations of Hg were recorded in the northern part of the island between Trapani and Messina, similar to the distribution of Cu. Different areas with the highest concentrations of Ni were found near the south coast, in the vicinity of Palermo and around the Volcano Etna. The highest concentrations of Pb were found in the south-west coast near Agrigento, where important chemical plants and petroleum refineries are located. Except for a few locations, Zn fall-out was found to be evenly distributed throughout Sicily. CONCLUSION: The sites where the concentrations of heavy metals cause greatest concern have been revealed by the PCA analysis and portrayed using GIS. Also of some concern is the diffuse and anthropogenic origin of Hg and Cd. The combined approach of using soil and mosses, together with pedological interpretation and application of multivariate statistical techniques has provided valuable insight into the environmental aspects of heavy metal deposition in a region of southern Europe. RECOMMENDATIONS AND OUTLOOK: Further insight into the deposition of heavy metals will require more detailed sampling of soils and mosses in both new and previous study areas. This needs to be complemented by detailed pedological investigations in the study areas. Future research programmes will address these issues.

Air Pollution↗