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Preserving the soundscape and geographic extension of quiet areas is a great challenge against the wide-spreading of environmental noise. The E.U. Environmental Noise Directive underlines the need to preserve quiet areas as a new aim for the management of noise in European countries. At the same time, due to their low population density, rural areas characterized by suitable wind are considered appropriate locations for installing wind farms. However, despite the fact that wind farms are represented as environmentally friendly projects, these plants are often viewed as visual and audible intruders, that spoil the landscape and generate noise. Even though the correlations are still unclear, it is obvious that visual impacts of wind farms could increase due to their size and coherence with respect to the rural/quiet environment. In this paper, by using the Immersive Virtual Reality technique, some visual and acoustical aspects of the impact of a wind farm on a sample of subjects were assessed and analyzed. The subjects were immersed in a virtual scenario that represented a situation of a typical rural outdoor scenario that they experienced at different distances from the wind turbines. The influence of the number and the colour of wind turbines on global, visual and auditory judgment were investigated. The main results showed that, regarding the number of wind turbines, the visual component has a weak effect on individual reactions, while the colour influences both visual and auditory individual reactions, although in a different way.

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Background: Neurofilament light chain (NfL) is a validated biofluid marker of neuroaxonal damage with great potential for monitoring patients with neurodegenerative diseases. We aimed to further validate the clinical utility of plasma (p) vs. CSF (c) NfL for distinguishing patients with Amyotrophic Lateral Sclerosis (ALS) from ALS mimics. We also assessed the association of biomarker values with clinical variables and survival and established the longitudinal changes of pNfL during the disease course.Methods: We studied 231 prospectively enrolled patients with suspected ALS who underwent a standardized protocol including neurological examination, electromyography, brain MRI, and lumbar puncture. Patients who received an alternative clinical diagnosis were considered ALS mimics. We classified the patients based on the disease progression rate (DPR) into fast (DPR > 1), intermediate (DPR 0.5–1), and slow progressors (DPR < 0.5). All patients were screened for the most frequent ALS-associated genes. Plasma and CSF samples were retrospectively analyzed; NfL concentrations were measured with the SIMOA platform using a commercial kit.Results: ALS patients (n = 171) showed significantly higher pNfL (p < 0.0001) and cNfL (p < 0.0001) values compared to ALS mimics (n = 60). Both cNfL and pNfL demonstrated a good diagnostic value in discriminating the two groups, although cNfL performed slightly better (cNfL: AUC 0.924 ± 0.022, sensitivity 86.8%, specificity 92.4; pNfL: AUC 0.873 ± 0.036, sensitivity 84.7%, specificity 83.3%). Fast progressors showed higher cNfL and pNfL as compared to intermediate (p = 0.026 and p = 0.001) and slow progressors (both p < 0.001). Accordingly, ALS patients with higher baseline cNfL and pNfL levels had a shorter survival (highest tertile of cNfL vs. lowest tertile, HR 4.58, p = 0.005; highest tertile of pNfL vs. lowest tertile, HR 2.59, p = 0.015). Moreover, there were positive associations between cNfL and pNfL levels and the number of body regions displaying UMN signs (rho = 0.325, p < 0.0001; rho = 0.308, p = 0.001). Finally, longitudinal analyses in 57 patients showed stable levels of pNfL during the disease course.Conclusion: Both cNfL and pNfL have excellent diagnostic and prognostic performance for symptomatic patients with ALS. The stable longitudinal trajectory of pNfL supports its use as a marker of drug effect in clinical trials.