We recently demonstrated the effectiveness of long-term treatment with rifaximin and the probiotic VSL#3 at improving urogenital and gastrointestinal symptoms in patients with both chronic inflammatory prostatitis (IIIa prostatitis) and diarrhea-predominant irritable bowel syndrome (IBS-D), relative to patients with IBS-D alone. Because low-grade inflammation of the intestine and prostate may be one of the reasons for co-developing both IIIa prostatitis and IBS-D, we designed the present study to once again evaluate the efficacy of combined rifaximin and VSL#3 treatment in patients affected by IIIa prostatitis plus IBS-D, but we also measured seminal plasma pro-inflammatory (IL-6) and anti-inflammatory (IL-10) cytokines before and after treatment. We consecutively enrolled 124 patients with IIIa prostatitis and IBS-D (diagnosed using the Rome III criteria). Patients were randomized into two groups: group A (n=64) was treated with rifaximin (seven days per month for three months) followed by VSL#3, and group B (n=60) was treated with a placebo. At the beginning of the study and after three months of treatment, all patients completed NIH-CPSI and IBS-SSS questionnaires to score the severity of their urogenital and gastrointestinal symptoms, and we measured seminal plasma levels of IL-6 and IL-10 using ELISA. We defined patients who improved following the treatment as those with a ≥6-point reduction in their NIH-CPSI score or ≥50-point reduction in their IBS-SSS score. By the end of the intervention, 68.7% and 62.5% of patients from group A reported improved NIH-CPSI and IBS-SSS scores, respectively, compared to only 3.3% and 5% of the placebo group. Group A patients also had significantly lower mean seminal plasma levels of IL-6 (11.3 vs 32.4 pg/mL) and significantly higher mean levels of IL-10 (7.9 vs 4.4 pg/mL) relative to baseline, whereas levels of IL-6 and Il-10 did not change in the placebo group. The co-occurrence of two clinical phenotypes (IBS-D plus IIIa prostatitis) result in increased intestinal inflammation and altered immune activation, both of which can be balanced by treatment with rifaximin and VSL#3.

Background: The surgical approach to treating calcaneal fractures, specifically Sanders types II, III, and IV, is still a subject of controversy. The decision to opt for open reduction and internal fix-ation (ORIF) or minimally invasive osteosynthesis (MIOS) remains uncertain owing to varying complication rates. This study intends to examine each treatment’s pros and cons in relation to the incidence of complications. Methods: In this retrospective study, we examined 70 patients treated between January 2018 and September 2022: 50 received ORIF, and 20 underwent MIOS. We evaluated functional outcomes with the Maryland Foot Score and the Creighton-Nebraska Health Foundation Assessment Scale (CNHFAS). We also assessed the amount of anatomical restoration using Böhler’s and Gissane’s angles, determined by radiographic checks, and the frequency of postoperative complications. Results: A significant reduction in the risk of reinter-vention was observed in patients with high anesthetic risks, polytraumatized individuals, and those with comorbidities who underwent MIOS. The chi-square test analysis of postoperative complications highlighted no substantial differences between the ORIF and MIOS groups in rela-tion to tendinitis, chronic pain and swelling, algodystrophy, and surgical wound infections (p > 0.20 for all). Conclusion: ORIF is more suitable for patients who have high motor function re-quirements, a long-term activity schedule and can endure potential additional procedures. This preference is because ORIF provides better anatomical restoration and features a lower osteoar-thritis occurrence rate.

The ECM is composed of a considerable number of biochemically and structurally diverse constituents. ECM is a highly dynamic system that constantly receives and sends biological, chemical and mechanical signals. Several studies suggest that mechanical signals derived from the extracellular microenvironment regulate skin regeneration and wound healing. We evaluated effects of a mixture of biomolecules extracted and purified from bovine colostrum on restoring the mechanical properties of ECM. Test measuring collagen contraction showed a significant difference in contraction activation in samples treated with the 2% colostrum derivative mixture compared to the control. The analysis of the supernatant showed an inhibition of metalloproteinase-2 expression and an increase in collagen secretion by fibroblasts in treatment samples. Our hypothesis is that the molecules extracted and purified from bovine colostrum restore the ECM environment qualitative and quantitative characteristics, thus guaranteeing through a mechanical action the restoration of the wound due to the transduction of the signal activated by the integrins.

In this article, we analyze the relationships that connect graduates from high school, the training system and employment rates and conditions in the Italian regions between 2004 and 2022. The data used refer to the Istat Bes database. The results show that the growth in the number of high school graduates is positively associated with higher university education and employment with the exception of job satisfaction. Subsequently we also present a clusterization with k-Means algorithm confronting the Silhouette Coefficient with the Elbow Method. Finally, we confront seven different machine-learning algorithms for the prediction of the level of graduated from high school. We also present economic policy suggestions to increase schooling in the Italian regions. The results are critically discussed.

In multi-objective optimization problems, the optimization target is to obtain a set of non-dominated solutions. Comparing solution sets is crucial in evaluating the performances of different optimization algorithms. The use of performance indicators is common in comparing those sets and, subsequently, optimization algorithms. A good solution set must be close to the Pareto-optimal front, well-distributed, maximally extended and fully filled. Therefore, an effective performance indicator must encompass these features as a whole and must be Pareto dominance compliant. Unfortunately, some of the known indicators often fail to properly reflect the quality of a solution set or cost a lot to compute. This paper demonstrates that the Degree of Approximation (DOA) quality indicator, is a weakly Pareto compliant unary indicator that gives a good estimation of the match between the approximated front and the Pareto-optimal front. Moreover, DOA computation is easy and fast.

In the following article, we analyzed a variable present in the ISTAT-BES dataset, namely "People You Can Count On"-PYCC for the Italian regions. Following an analysis of the time series aimed at highlighting the trends of the regions, we created a clustering with a k-Means algorithm optimized with the Silhouette coefficient. The data shows the presence of two clusters. We then present an econometric model aimed at estimating the value of PYCC based on a set of socio-economic variables. The results are also discussed in light of the economic policy implications.

Extracellular vesicles represent a large heterogeneous class of near and long-distance intercellular communication mediators, released by both prokaryotic and eukaryotic cells. Specifically, the scientific community has shown a growing interest in exosomes, which are nano-sized vesicles with an endosomal origin. Not so long ago, the physiological goal of exosome generation was largely unknown and required more investigation; at first, it was hypothesized that exosomes are able to remove excess, rejects and unnecessary constituents from cells to preserve cellular homeostasis. However, thanks to recent studies, the central role of exosomes in regulating cellular dialogue has emerged. Exosomes act as vectors on cell-cell signaling by their cargo, proteins, lipids, and nucleic acids, and influence physiological and pathological processes. The findings on exosomes are widespread in a large spectrum of biomedical applications from diagnosis and prognosis to thera-pies. In this review, we describe exosome biogenesis and the current methods for their isolation and characterization, emphasizing the role of their cargo in female reproductive processes, from gametogenesis to implantation, and the potential involvement in human female disorders.

This study investigates the impact of vertical greenery systems (VGS) applied to heavyweight walls on indoor thermal conditions in a building module situated in the Mediterranean climate of Catania, Italy. Using dynamic simulations in TRNSYS, the research compares the thermal behavior of walls constructed from hollow clay blocks (Poroton) and lava stone blocks with a lightweight wall setup already in place at the University of Catania. The primary focus is on evaluating the VGS’s effect on reducing peak inner surface temperatures and moderating heat flux fluctuations entering the building. The findings indicate that adding a vertical greenery layer to heavyweight walls can decrease the peak inner surface temperature by up to 1.0°C compared to the same wall without vegetation. However, the greenery’s impact on mitigating heat flux fluctuations is less pronounced than in the case of the lightweight wall. This research underscores the potential of green facades in enhancing indoor thermal comfort in regions with climates similar to the Mediterranean, providing valuable insights for sustainable building design and urban planning.

In this systematic review, the PRISMA method was applied to examine publications from the last two decades that have investigated the noxious gaseous emissions from dairy barns. The aim was to analyse the outcomes from literature studies estimating the quantities of polluting gases produced in dairy barns, with specific focus on ammonia (NH₃) emissions. The review also explores proposed methods to reduce the associated effects through mitigation strategies. Estimation of NH₃ emissions is significantly influenced by the complex interactions among several factors, including animal management practices, such as controlling animal behavioral activities; manure management, like utilising practices for floor manure removal; the type of structure housing the animals, whether it is naturally or mechanically ventilated; and environmental conditions, such as the effects of temperature, wind speed, relative humidity, and ventilation rate on NH₃ release in the barn. These influential components have been considered by researchers, identifying targeted mitigation strategies. Despite growing attention to the issue, gaps in the scientific literature were identified and discussed, particularly regarding the analysis of mitigation strategies and their long-term impacts (i.e., environmental, economic and productivity-wise).

This work aims to initiate a reflection on the awareness of environmental, social, and corporate governance issues, summarized in the acronym ESG (Environmental, Social, Governance), among Italian SMEs. The integration of ESG issues into business models has led to an expansion of the risk taxonomy affecting corporate management. In addition to traditional financial risks, new risks have emerged, primarily climate risk, environmental, and energy risks, which can significantly impact companies' ability to create economic value. This includes planning and designing virtuous initiatives focused on sustainability and the ability to build public-private partnerships with various stakeholders. After this theoretical framework aimed at highlighting the evolution of the concept of corporate sustainability following the introduction of ESG factors, a clustering of non-performing loans of Italian companies is proposed using a k-Means algorithm, comparing the results obtained through two different methods, namely the Elbow method and the Silhouette coefficient. Finally, using data on Italian regions between 2004 and 2023, an empirical analysis is conducted to provide an estimate of the relationship between non-performing loans and some variables related to ESG components.

The efficacy and safety of organic UV-filters could benefit from their incorporation into lipid nanoparticles because of the ability of such carriers to reflect solar radiations, thus acting synergically as physical sunscreens. In this work, bemotrizinol (BMTZ), a broad-spectrum UV-filter, was loaded into nanostructured lipid carriers (NLC) whose lipid matrix contained different oils to assess the effects of the lipid core composition on the properties of the resulting NLC. Subsequently, the effects of incorporating different concentrations of optimized BMTZ-loaded NLC on the technological properties of O/W emulsions (pH, viscosity, spreadability, occlusion factor, in vitro BMTZ release and skin permeation, in vitro sun protection factor) were assessed. Optimized BMTZ-loaded NLC showed mean size=190.6±9.8 nm, PDI=0.153±0.013, ζ-potential=-10.6±1.7 mV, loading capacity=8% w/w. The incorporation of increasing concentrations of optimized BMTZ-loaded into emulsions provided slight increase of spreadability, lower viscosity and no change of pH, occlusion factor and BMTZ release compared to the control. No BMTZ skin permeation was observed from all formulations. About 20% increase of sun protection factor values was obtained for vehicles containing BMTZ-loaded NLC. Therefore, BMTZ-loaded NLC incorporation into emulsions could be a promising strategy to develop safer and more effective sunscreen formulations.

The following article analyses the relationship between Non-Performing Loans and innovation systems at a global level. The analysed data were obtained from the World Bank and the Global Innovation Index for the period 2013-2022 for 149 countries. The analysis was conducted using clustering with the k-Means algorithm, optimized with the Silhouette coefficient and the Elbow method. Subsequently, econometric analysis was carried out using panel data with Random Ef-fects and Fixed Effects. The clustering results show that the optimal number of clusters is three. The econometric analysis highlights the positive relationship between Non-Performing Loans, the exports of cultural and creative services, and the Innovation Input Sub-Index. The results also show the negative relationship between Non-Performing Loans, the H-Index, and the exports and imports of ICT services.

To improve efficacy and safety of sunscreen emulsions, UV‐filter skin permeation could be kept as low as possible by reducing UV‐filter content or changing emulsion composition. In this work, different lipid phase ratio (12, 14 and 16% w/w) were assessed for their ability to affect the technological and sensory properties of O/W emulsions in which bemotrizinol (BMTZ), a broad spectrum sunscreen agent, was incorporated free or loaded into nanostructured lipid nanocarriers (NLC) to reduce its release from the vehicle and, hence, its skin permeation. The following technological properties were evaluated in vitro by suitable methodologies: spreadability, viscosity, pH, occlusion factor, BMTZ release, sun protection factor (SPF). Sensory attributes were assessed by trained panelists in three different phases: before/during pick‐up, rub‐in, after application. Raising the lipid phase ratio led to an increase of viscosity and to a corresponding drop of spreadability while the incorporation of BMTZ‐loaded NLC determined a decrease of occlusion factor and an increase of SPF. No BMTZ release was observed from all emulsions. Sensory attributes were mainly affected by lipid phase ratio. These results suggest that lipid phase ratio and BMTZ incorporation into NLC could contribute to determine technological and sensory properties of O/W emulsions.

Background: Tibial shaft fractures are the most common of long bone fractures. The gold standard for management is locked intramedullary nailing. The freehand method under fluoroscopic monitoring is the most often utilized method for distal screw locking. Electromagnetic guidance-based distal screw locking methods have gained popularity recently. The study's objective is to evaluate the system using electromagnetic tracking data against the free-hand technique. Methods: Sixty-three patients who received intramedullary nailing for tibial shaft fractures at our institute between January 2018 and May 2022, were included in this study. Two groups of patients were distinguished: Group FH underwent freehand distal locking and intramedullary nailing, while Group SS underwent electromagnetically guided locking. Radiation exposure period, as well as dose area product, were noted and statistically compared. Results: In terms of dose area product, a mean value of 43.57±31.57 cGy/cm2 in group FH and a mean value of 27.62±11.20 cGy/cm2 in group SS (p < 0.05) was assessed. Concerning the duration of surgery a mean value of 128.83±26.51 minutes was reported in group FH and a mean value of 126.42±48.31 minutes in group SS (p > 0.05). Conclusions: This study confirms the use of electromagnetic-guided locking distal screws reduces the total time of exposure to ionizing radiation, with no difference in operating time.

This study examines the integration of Environmental, Social, and Governance (ESG) factors into global banking practices and their impact on financial stability, measured by the Bank to Capital Asset Ratio. Through a comprehensive literature review and data analysis, the paper highlights the dual role of banks as catalysts for ESG investment and risk managers. It discusses the challenges and opportunities in transitioning to ESG-aligned business models, emphasizing the importance of regulatory frameworks and risk management approaches. The findings suggest that ESG integration enhances bank stability and competitiveness, contributing to sustainable economic development. The paper concludes with policy implications and recommendations for further integration of ESG factors into banking governance.

This paper explores the critical role of the banking sector in facilitating the ecological transition through the integration of ESG (Environmental, Social, and Governance) factors. By analyzing the intersection of ESG considerations and access to credit globally, the study highlights how banks can catalyze sustainable investments while balancing financial risks. Using a systematic literature review and k-Means clustering analysis, we assess the global landscape of credit access, emphasizing the implications of ESG adoption on financial stability and economic growth. The findings suggest that while ESG integration presents challenges, it offers significant opportunities for banks to enhance their competitiveness and foster resilient financial systems. The paper concludes by proposing policy recommendations aimed at improving the incorporation of ESG factors within credit risk management and promoting sustainable finance.

Treatment wetlands (TWs) are Nature-Based Solutions increasingly used worldwide for wastewater (WW) treatment able to remove mineral and organic pollutants through both physical and biochemical process. Besides the reusable effluent, the TWs produce as main output plant biomass that need to be harvested and disposed at least once a year with significant management costs and TW temporary out of service. This study aims (i) to evaluate the potential of TWs biomass for local energy production and (ii) to understand TW hydraulic conductivity (Ks) effects on the biomass biomethane yield. Specifically, it was addressed by determining the Biochemical Methane Potential of common reed (CR) (Phragmites australis) samples collected at three harvest times from the 10-years-old horizontal subsurface treatment wetland (HSTW) used as a secondary WW treatment system for the IKEA® store located in Catania (Eastern Sicily, Italy). Furthermore, the falling head test was conducted to assess the hydraulic conductivity (Ks) variation in the HSTW, in order to understand the influence on the CR biomethane production. Average methane content values were 130.57 Nm3CH4/tVS (±24.29), 212.70 Nm3CH4/tVS (±50.62) and 72.83 Nm3CH4/tVS (±23.19) in August, September, October 2022, respectively. Ks was correlated with both dry matter (R2 = 0.58) and fiber content (R2 = 0.74) and, consequently, affected the biomethane yield that increased at the Ks increases (R2 = 0.30 in August, R2 = 0.57 in September). In the framework of a circular economy, results showed the successfully possibility of integrating the bioenergy production into TWs. The research could contribute (i) to encourage plant operators to reuse biomass from TWs for local energy production and (ii) to help plant operators to understand Ks effects on the biomass biomethane yield, in order to increase the sustainability of the system and to reduce the maintenance costs.

Several coatings configurations of combined aluminizing and diffusion layered aluminide on 316 steel were produced and characterized. These coatings, typically employed as thermal barrier coating (TBC), can also be effective as vibration reduction elements at intermediate and high temperatures. This preliminary work has been focused on the microstructural design and processing effects of the coatings. The damping of the produced specimens was measured up to 450°C and compared with that of the steel substrate. The most performing coatings contain an Al-Si layer and exhibit a steep damping increase above 200 °C, reasonably due to dislocation movements by plastic straining of soft alloy layer and to the interface sliding between layers with different elastic moduli.

New digital interventions have shown potential in managing asthma and improving patients' quality of life compared with conventional interventions. Our objective was to conduct an exhaustive survey of the application of digital health technologies in evaluating, treating, and self-managing psychological and psychopathological elements linked to asthma. We analyzed a compendium of research papers and systematic reviews pertaining to asthma, encompassing themes such as outdoor air pollution, early life wheezing disorders, atopic dermatitis, digital strategies for asthma self-management, psychiatric conditions and asthma, familial impacts on pediatric asthma, and the utilization of mobile health apps for managing asthma. We scrutinized eight chosen studies to evaluate the capacity of digital health technologies to enhance the man-agement and treatment outcomes of psychological factors related to asthma. The studies under review indicate that eHealth interventions, mixed reality instruments, mHealth technolo-gy-augmented nurse-led interventions, and smartphone apps incorporating Bluetooth-enabled sensors for asthma inhalers can markedly enhance self-management of symptoms, quality of life, and mental health outcomes, particularly in children and adolescents with asthma. Nonetheless, additional research is required to ascertain their efficacy and practicability across diverse populations and environments. Customized interventions that cater to the unique needs and preferences of asthma patients and associated psychological elements are vital to ensure the persistent and equitable adoption of these technologies. We underscore the significance of addressing psychological elements in the management and treatment of asthma and advocate for ongoing research and development in this domain.

Precipitation patterns are critical for understanding the hydrological and climatological dynamics of any region. Sicily, the largest island of the Mediterranean sea, with its diverse topography and climatic conditions, serves as an ideal case study for analyzing precipitation data to gain insights into regional water resources, agricultural productivity, and climate change impacts. This paper employs advanced statistical physics methods, particularly Tsallis q-statistics, to analyze sub-hourly precipitation data from 2002 to 2023, provided by the Sicilian Agrometeorological Informative System (SIAS). We investigate several critical variables related to rainfall events, including duration, depth, maximum record, and inter-event time. The study spans two decades (2002-2012 and 2013-2023), analyzing the distributions of relevant variables. Additionally, we examine the simple returns of these variables to identify significant temporal changes, fitting these returns with q-Gaussian distributions. Our findings reveal the scale-invariant nature of precipitation events, the presence of long-range interactions and memory effects, characteristic of complex environmental processes.

Air pollution is a critical issue impacting urban environments, leading to severe health problems and environmental degradation. This comprehensive review examines the potential of green systems—specifically green walls, active green walls, and urban greenery systems—to mitigate atmospheric pollutants such as particulate matter (PM), volatile organic compounds (VOCs), and carbon dioxide (CO2). By systematically analyzing 44 recent studies, the review highlights the pollutant capture efficiency of various green technologies and plant species in both indoor and outdoor settings. Active green walls, particularly those utilizing plant species such as Chlorophytum comosum and Sansevieria trifasciata, were found to be highly effective, with VOC reduction efficiencies up to 96.34%, PM reductions by 65.42%, and CO2 reduction rates reaching 4.8% under optimal conditions. The review identifies key strengths in current research, including diverse experimental setups and the use of sophisticated measurement techniques, but also notes significant limitations such as variability in experimental conditions and a lack of long-term performance data. The study underscores the importance of proper maintenance to sustain green systems' efficacy and highlights the potential issue of pollutant resuspension, which remains under-researched. Practical implications for urban planning are discussed, advocating for the integration of effective green systems into urban infrastructure to enhance air quality and public health. Recommendations for future research include the need for standardized metrics, long-term studies, economic feasibility analyses, and real-world validation of simulation models to better understand and optimize green systems for urban air pollution mitigation.

This study explores the transformative potential of integrating Building Information Modeling (BIM) and Generative Design methodologies in heritage conservation and building management. By utilizing BIM, detailed architectural, structural, and MEP models were created, facilitating precise design and effective stakeholder collaboration. Generative Design enabled the exploration of multiple design solutions, optimizing spatial layouts and structural integrity. The project also integrated automated management systems and IoT sensors to enhance real-time monitoring, energy efficiency, and user comfort through the development of a digital twin. Despite encountering challenges such as technical complexities and budget constraints, the project successfully preserved the cinema's historical essence while incorporating modern functionalities. The findings highlight the contributions of BIM and Generative Design to the AEC industry, emphasizing their role in improving design accuracy, operational efficiency, and sustainability. This research provides valuable insights for future projects in heritage conservation, offering a blueprint for balancing historical preservation with contemporary needs. The revitalization of the "Ex Cinema Santa Barbara" in Paternò exemplifies these advancements, demonstrating how these technologies can restore and modernize culturally significant historical buildings effectively.

Augmented Reality (AR) and 3D printing (3DP) are novel technologies in the orthopedic field. Over the past decade, enthusiasm for these new digital applications is driving new perspectives in improving diagnostic accuracy and sensitivity in the field of traumatology. Currently, however, it is still difficult to quantify the value and impact in the medical-scientific field especially in the improvement of diagnostic in complex fractures. Acetabulum fractures have always been a challenge among orthopedics, for volumetric complexity and low diagnostic reliability.Background/Objectives: The goal of this study is to determine whether these methods can improve the learning aspect and diagnostic accuracy of complex acetabulum fractures compared to gold standard CT (computed tomography). Methods: Orthopedic residents of our department have been selected and divided into Junior (JUN) and Senior (SEN) groups. Associated fractures of acetabulum have been included in the study, obtaining : CT-scans, 3DP model, and AR model displayed on a tablet screen. In a double-blind questionnaire, each resident classified every fracture according to methods. Diagnostic accuracy (DA), response time (RT), agreement (R), and confidence (C) were measured. Results: 20 residents (JUN=10, SEN=10) classified five fractures. Overall DAs were 26% (CT), 18% (3DP), and 29% (AR). AR-DA resulted to be superior to 3DP-DA (p=0,04). DA means (JUN vs SEN respectively) were :CT-DA was 20% vs 32% (p<0.05), 3DP-DA was 12% vs 24% (p=0.08), and AR-DA was 28% vs 30% (p=0,80). Overall RT was 61.2 sec (±24,6) for CT, 35.8 sec (±20,1) for 3DP, and 46,7 sec (±20,8) for AR. R was fairly poor between methods and groups. 3DPs resulted to have superior overall C (65%). Conclusions: AR resulted to have the same Overall DA as CT, independent from experience, 3DP has minor DA and R, but it resulted to be the most confident and fast method. Intra and interobserver R between methods remain very poor in residents.

Background: Olecranon fractures are common injuries of the upper limb in adults. Simple dis-placed trasverse fractures are generally surgically treated with tension-band wiring (TBW) or plate fixation (PF). The purpose of this retrospective study is to compare the clinical-functional outcome, complications and reoperation rates between TBW and PF for Mayo IIA fractures. Methods: 72 patients treated with PF or TBW at our institution, completed our survey and clinical evaluation and their demographic and clinical data were recorded and analysed. The clini-cal-functional outcomes were evaluated assessing ROMs and three validated scoring systems: the Disabilities of the Arm, Shoulder, and Hand (DASH), the Mayo Elbow Performance Score (MEPS) and the Patient American Shoulder and Elbow Surgeons Standardized Elbow Assess-ment score (pASES-e). Results: 38 patients (53%) underwent TBW and 34 (47%) PF. The mean DASH, MEPS and pASES-e scores were respectively 14.5±17.2, 80.5±14.7 and 83.6±12.4 in the TBW group and 21±21.7, 75.6±15.3 and 75.1±19.2 in the PF group (p=0.16, p=0.17 and p=0.03). The mean duration of surgery and hospitalisation period were longer in the PF group (p=0.002, p=0.37) whereas the complication and reoperation rates were higher after TBW (p=0.15, p=0.24). Conclusion: According to the literature, both TBW and PF resulted comparable valid surgical op-tions for the treatment of simple isolated displaced olecranon fractures, revealing that they both provide good/excellent outcomes with no significant differences.

Melatonin is a ubiquitous molecule found in living organisms, ranging from bacteria to plants and mammals. It possesses various properties, partly due to its robust antioxidant nature and partly owed to its specific interaction with melatonin receptors present in almost all tissues. Melatonin regulates different physiological functions and contributes to the homeostasis of the entire organism. In the human eye, a small amount of melatonin is also present, produced by cells in the anterior segment and the posterior pole, including the retina. In the eye, melatonin may provide antioxidant protection along with regulating physiological functions of ocular tissues, including intraocular pressure (IOP). Therefore, it is conceivable that the exogenous administration of sufficiently high amounts of melatonin to the eye could be beneficial in several instances: for the treatment of eye pathologies like glaucoma, due to the IOP-lowering and neuroprotection effects of melatonin; for the prevention of other dysfunctions, such as dry eye and refractive defects (cataract and myopia) mainly due to its antioxidant properties; for diabetic retinopathy due to its metabolic influence and neuroprotective effects; for macular degeneration due to the antioxidant and neuroprotective properties; and for uveitis, mostly owing to anti-inflammatory and immunomodulatory properties. This paper reviews the scientific evidence supporting the use of melatonin in different ocular districts and provides data suggesting that the topical administration of melatonin as eye drops is a real possibility. This way, its distribution and concentration in different ocular tissues may support its pleiotropic therapeutic effects.

The selection of the best allogeneic donor for each specific patient is crucial for the success of allogeneic hematopoietic stem cell transplantation (HSCT). Besides the well-known patient’s characteristics, donor-related variables such as patient-donor histocompatibility and donor age are of utmost importance for the outcome after HSCT. However, there is still debate on the definition of the best stem cell donor when multiple suitable donors exist. By using own data from two transplant centers, we here developed a calculator able to provide the 2-year patients’ overall survival (OS) associated to each of the potential donor options during the selection process. Data on n=737 HSCTs performed from January 2010 to July 2022 have been retrospectively obtained. Donor types were HLA-identical siblings, unrelated or related haploidentical. Cox regression and parametric model indicates patients’ age, disease, comorbidity index and donor type as significant variables (p<0.05) able to predict 2-year OS with robustness (concordance index: 0.677). Estimates are provided with the three donor options for each single, specific patient. Of note, estimates express real data of the transplant centers and reflect their actual experience. In conclusion, we here present the prototype of a new tool for the calculation of patients’ outcome according to the stem cell donor type, guiding transplant physicians during the process of donor selection before HSCT. The novelty of this approach relies on the use of real data from the investigating centers, reflecting the local clinical experience. Improvements are planned by filling additional information and pooling data from more centers.

Musculoskeletal disorders are a common occurrence in Europe, affecting millions of people and costing billions of euros in social security services. Traditional treatments using drugs like non-steroidal anti-inflammatory drugs (NSAIDs) can cause gastric damage, making prolonged use difficult. To address this issue, the Author has developed NegEnt Spray - Muscles and Joints, a topical medical device that uses liposomal cannabidiol and chamomile hydrolate to reduce inflammation and pain in musculoskeletal disorders. The liposomal technology used in NegEnt Spray allows for better bioavailability and a more targeted action, while chamomile hydrolate provides a natural anti-inflammatory and soothing effect. The spray is non-greasy, absorbs quickly, and can be used under any circumstances. Its pocket-sized design makes it easy to carry and use throughout the day. With NegEnt Spray, patients can alleviate discomfort and pain associated with musculoskeletal disorders without worrying about the side effects of traditional treatments.

The current scenario of radioactive waste management requires innovative and automated solutions to ensure effectiveness and safety. In response to this need, the PI3SO (Proximity Imaging System for Sort and Segregate Operations) project was proposed. It is a gamma radiation proximity scanner system for radioactive waste with the primary goal of speeding up some aspects of the waste management cycle while reducing direct human operations. The system will provide proximity imaging for hot spot finding and spectral analysis for radiological characterization, enabling semiautomatic recognition, sorting and separation of radioactive waste. The core of the proposed scanning system consists of an array of 128 CsI(Tl) scintillators, 1 cm3 size, coupled with silicon photomultipliers (SiPM), installed on a motorized bridge sliding along a suitable table in order to scan the materials under investigation.

Infertility” is a condition defined by the failure to establish a clinical pregnancy after 12 months of regular, unprotected sexual intercourse or due to an impairment of a person’s capacity to reproduce either as an individual or with his/her partner’. The authors have set out to succinctly investigate, explore and assess infertility treatments harnessing the potential of stem cells to effectively and safely treat infertility, in addition to the legal and regulatory complexities at the heart of stem cell research, with an overview of the legislative state of affairs in six major European countries. In couples who cannot benefit from assisted reproductive technologies (ART) to treat their infertility, stem cells-based approaches have been shown to be a highly promising approach. Nonetheless, lingering ethical and immunological uncertainties require more conclusive findings and data before such treatment avenues can become mainstream and applied large scale. The isolation of human embryonic stem cells (ESCs) is ethically controversial, since their collection involves the destruction of human embryonic tissue. Overall, stem cell research has resulted in important new breakthroughs in the treatment of infertility. The effort to untangle the complex web of ethical and legal issues associated with such therapeutic approaches will have to rely on evidence-based, broadly shared standards, guidelines and best practices to make sure that the procreative rights of patients can be effectively reconciled with the core values at the heart of medical ethics.

Introduction: In recent years, generative Artificial Intelligence models, such as ChatGPT, have been increasingly utilized in healthcare. Despite acknowledging the high potential of AI models in terms of quick access to sources and formulating a response to a clinical question, the results obtained using these models still require validation through comparison with established clinical guidelines. This study compares the responses of the AI model to eight clinical questions with the Italian Association of Medical Oncology (AIOM) guidelines for ovarian cancer. Materials and Methods: The authors used the Delphi method to evaluate responses from ChatGPT and the AIOM guidelines. An expert panel of healthcare professionals assessed responses based on clarity, consistency, comprehensiveness, usability, and quality using a 5-point Likert scale. The GRADE methodology assessed the evidence quality and the recommendations' strength. Results: A survey involving 14 physicians revealed that the AIOM guidelines consistently scored higher averages compared to the AI models with a statistically significant difference. Post-hoc tests showed that AIOM guidelines significantly differed from all AI models, with no significant difference among the AI models. Conclusions: While AI models can provide rapid responses, they must match established clinical guidelines regarding clarity, consistency, comprehensiveness, usability, and quality. These findings underscore the importance of relying on expert-developed guidelines in clinical decision-making and highlight potential areas for AI model improvement.

This communication explores the transition from Cognitive Behavioural Therapy (CBT) to a more holistic model, named Complex Therapy, developed by Tullio Scrimali for explaining and treating mental disorders. The Author delves into the limitations of traditional CBT and introduces an innovative framework that integrates multiple therapeutic modalities. While CBT is based on the study and modification of behaviour and cognition, Complex Therapy includes, in its focus, the theory of human relationships, the attachment theory, neuroscience, applied neuroscience, complex systems theory and ecology.Complex Therapy addresses the multifaceted nature of mental health issues by combining evidence-based techniques with personalized care strategies. The goal is to enhance patient outcomes through a tailored, comprehensive treatment plan that adapts to the evolving needs of individuals facing mental health challenges.Two innovative and original items which Scrimali has developed, which are a device for Applied Neuroscience MindLAB Set and a new botanical drug, NegEnt, are presented and discussed.The topic also describes, an original and integrated protocol, named Negative Entropy, the author has developed for treating a challenging disorder, such as schizophrenia, he renamed Entropy of Mind.

Biopolymers are of growing interest, but to improve some of their poor properties and performance, it is required the formulation of bio-based blends and/or adding of nanoparticles. For this purpose, in this work, two different metal oxides, such as zinc oxide (ZnO) and titanium dioxide (TiO2), at different concentrations (0.5, 1 and 2 %wt.) have been added in polylactic acid (PLA) and polylactic acid/polyamide 11 (PLA/PA11) blends to establish their effects on solid-state properties, morphology, melt behaviour, and photo-oxidation resistance. It seems that the addition of ZnO in PLA leads to a significant reduction of its rigidity probably due to an inefficient dispersion in the melt state, while the addition of TiO2 does not penalise PLA rigidity. Interestingly, the addition of both ZnO and TiO2 in PLA/PA11 blend has a positive effect on the rigidity because of blend morphology refinement and leads to a slight increase in film hydrophobicity. The photo-oxidation resistance of neat PLA and PLA/PA11 blend is significantly reduced due to the presence of both metal oxides, and this must be considered when designing the potential applications. The last results suggest that both metal oxides could be considered as photo-sensitive degradant agents for biopolymer and biopolymer blends.

High-flow oscillatory ventilation (HFOV) is a common rescue treatment in infants and children with respiratory failure. This type of ventilation is an effective technique in numerous diseases that affect a child in the postnatal period, such as ARDS, meconium aspiration syndrome (MIS), postnatal pulmonary bleeding and idiopathic pulmonary hypertension (IPH). Although this ventilation technique is commonly recognized as a valuable therapeutic option in the general pediatric population, this is not the same for children with congenital cardiovascular diseases. The key mechanism of oscillatory ventilation is continuous positive pressure administered within the airways via a small tidal volume at high frequency. Tidal volumes are between 1 and 3 ml/kg delivered at 5 – 15 Hz equivalent to 300 – 900 breaths per minute. Few older studies conducted on humans and animals highlight that HFOV may be dangerous for congenital heart patients. According to these evidences, hemodynamic parameters such as blood pressure, wedge pressure, central venous pressure, heart rate and inotrope level can be dangerously changed for patients with congenital heart disease, therefore oscillatory ventilation should be avoided. Numerous retrospective studies have pointed out how oscillatory ventilation constitutes a valid therapeutic option in children with congenital heart disease. Recently, new evidences have highlighted how hemodynamic parameters are modified in a non-significant way by this type of ventilation, remaining beneficial as in the normal pediatric population. This narrative review aims to describe the mechanisms of oscillatory ventilation and collect all the available evidences to support its use in pediatric patients with congenital heart problems.

Previous studies show that women with a history of high-grade CIN have a greater risk of subsequent high-grade anogenital intraepithelial neoplasia or cancer, and the risk is greater for vaginal cancer than for anal and vulvar cancers. It is hypothesized that the laparoscopic hysterectomy procedure may cause a higher incidence of VaIN in hysterectomized women. There are few studies addressing this issue and they show mixed results. This study aimed to investigate the incidence of high-grade or worse VaIN in the population of women undergoing hysterectomy for CIN3 or benign uterine disease, illustrate treatment options and follow-up. Methods: This retrospective study was conducted on 170 women who underwent laparoscopic hysterectomy for high-grade cervical intraepithelial neoplasia (CIN3) or benign gynecological disease. The follow-up strategy included performing a cotest and colposcopy with biopsy if necessary. The median time between primary treatment and diagnosis of high-grade VaIN was 18 months. Results: High grade or worse VaIN was found in 8 patients after hysterectomy (4.7%). All cases of high-grade VaIN occurred in women with persistent HPV infection. The most frequent genotype was 16. Women hysterectomized for CIN3 showed an 8-fold greater risk than women hysterectomized for benign disease of developing high-grade VaIN. The risk of VaIN is low in women hysterectomized for benign disease. The risk of developing VaIN is greater in women with viral persistence Conclusion. All these elements suggest that it is the history of HPV-related disease of the lower genital tract and viral persistence, rather than hysterectomy itself, that should be considered a risk factor for the development of high-grade VaIN. After hysterectomy, patients with a history of CIN should undergo annual screening with vaginal dome cytology and HPV testing.

Time estimation was investigated in 24 healthy adults, 12 women and 12 men, before and after an exhaustive exercise. We compared the capability of estimating time intervals in the range from 1 to 5 s using tasks requiring mental count and tasks that did not allow the mental count. Time estimation and blood lactate levels were evaluated before and at the end of the exercise. We found that the perception of time intervals between 1 and 5 s was affected at the end of the exercise. The observed effects, associated with a significant increase in blood lactate levels, were different in the two types of time estimation used in the present study. In experimental conditions in which participants had to evaluate duration of the time interval by mental counting, at the end of exercise a significant reduction in the overestimation of time made at rest was observed. On the other hand, when participants had to assess the difference in duration between two events without the possibility to mentally count, at the end of the exercise a significant deterioration in performance was observed. In both cases, no gender differences were seen.

The impact of systemic vascular resistance (SVR) in hypertrophic (HCM) and amyloid cardio-myopathies has been seldom investigated. We studied pressure-strain loop derived myocardial work (MW) indices and SVR in patients with either sarcomere HCM or wild type transthyretin cardiac amyloidosis (ATTR), presented with heart failure and preserved left ventricular ejection fraction (HFpEF) at the outpatient cardiology units at Messina and Catania University Hospitals (Italy). Patients were in sinus rhythm and needed to have good transthoracic ultrasound imaging quality to undergo transthoracic strain-echocardiography. Other than conventional parameters, SVR and GWI (global work index) were measured. Based on cross-tabulation (a way to assess the ventricular-arterial coupling), the patients were then classified in 4 classes according to the cut-off values suggested by previous studies of 1,440 dyne/s/cm-5 for SVR (Stefadouros et al., 1973) and 1576 mm Hg% for GWI (Olsen et al., 2022). Sixty patients, 30 in each group, aged 61±16 years, 78% males, were studied. HCM were younger than ATTR patients and in a better clinical status (23% HCM vs 77% ATTR were NYHA class 3, p<0.001). Overall, 51 patients (85%) showed high SVR, of whom 21 were HCM (70%) and 30 ATTR (100%) (p<0.005). Both, SVR and GWI were impaired (the poorest class C) in 43% HCM patients (with greater left ventricular concentric hypertrophy) vs 93% of ATTR patients (in advanced NYHA class) (p<0.001). In conclusion, assessing SVR and GWI in HFpEF patients with HCM or ATTR can help clinicians to interpret the pathophysiological and clinical features of such complex diseases.

Background: high-altitude work exposes individuals to reduced oxygen levels, imposing physi-ological adaptations. These conditions can induce alterations in the cardiovascular system, po-tentially exacerbating pre-existing health issues and impacting overall well-being of workers in such environments. This study has investigated the cardiovascular challenges for the high-altitude worker on Etna volcano. Methods: Through an observational study, ten healthy, non-smoking male participants underwent cardiovascular and pulmonary function tests at alti-tudes below 500m and above 3000m, simulating work conditions on the volcano. Results: signif-icant findings include elevated systemic blood pressure and heart rate, indicating an increased cardiovascular workload necessary for adaptation to hypoxia. Conclusions: the study highlights the importance of acclimatization to high altitude for minimizing cardiovascular risks among workers. It calls for the development of safety protocols, underlining the critical role of preven-tative measures and specific safety protocols for high-altitude workers.

Direct competitions involve competitors that mutually contend for the same resource or objective. A controlled, well-documented, and data-rich field involving direct competition is represented by sports. Usually the winner of sports competitions is believed to be the one with the greatest talent, however, there are other factors that contribute to the outcome of a competition, there are in fact random, unpredictable events that can change the outcome of a competition. For this reason, if one wants to understand the properties of a competition is necessary to have a method to evaluate the importance of the talent or aptitude of a competitor, as opposed to the importance of chance, in determining the outcome of the competition itself. In this work we study the sport of tennis using the data obtained from the Association of Tennis Professionals (ATP) tournaments. We construct an agent-based model that is able to produce data analogous to the real one; this model depends on three parameters, the talent, the action of chance, and the weight of talent. In particular, we don't fix the values of these parameters and we fit the model results using a genetic algorithm, in this way, we study all the possible combinations of parameters, in the parameter space, that are able to reproduce the real systems data. We show that the model fits well the real data only for limited regions of the parameter space. On these limited regions of the parameter space are possible further optimization of the model results, limiting the values of parameters. In this way, our agent-based model, by means of this genetic algorithm calibration, is able to provide us with useful information without any a priori constraints.

The ovary is the major determinant of female reproductive health. Ovarian functions are mainly related to the primordial follicle pool, which is gradually loss with aging. Ovarian aging and reproductive dysfunctions share oxidative stress as common underlying mechanism. ROS signaling is essential for normal ovarian processes yet can contribute to various ovarian disorders when disrupted. Therefore, balance in the redox system is crucial for proper ovarian functions. In the present study, by focusing on mRNAs and ncRNAs described in the ovary and taking into account only validated ncRNA interactions, we built up an ovarian antioxidant ceRNA network, namely OvAnOx ceRNA, composed of 5 mRNAs (SOD1, SOD2, CAT, PRDX3, GR), 10 miRNAs and 5 lncRNAs (XIST, FGD5-AS1, MALAT1, NEAT1, SNHG1). Our bioinformatic analysis indicated that the components of the OvAnOx ceRNA not only contribute to antioxidant defence, but are also involved in other ovarian functions. Indeed, antioxidant enzymes encoded by mRNA of OvAnOx ceRNA operate within a regulatory network that impacts ovarian reserve, follicle dynamics, and oocyte maturation in normal and pathological conditions. The OvAnOx ceRNA represents a promising tool to unravel the complex dialogue between redox potential and ovarian signalling pathways involved in reproductive health, aging and diseases.

In the framework of the H2020 CLEANDEM project a small robotic vehicle was equipped with a series of different sensors, developed for the preliminary inspection of areas possibly contaminated by radiation. Such unmanned inspection allows to identify dangerous locations prior to the possible start of human operations. One of the developed devices, named MiniRadMeter, is a compact, low-cost sensor to perform gamma and neutron radiation field mapping of the environment. The MiniRadMeter was successfully tested in a simulated field mission with four "hidden" radioactive sources and a neutron generator. In this work we describe the test procedure and the results, also supported by the outcome of dedicated Monte Carlo simulations.

This comprehensive review examines the role of fenoldopam, a selective dopamine-1 receptor agonist, in preventing and treating acute kidney injury (AKI) during cardiac surgery. AKI remains a significant complication in cardiac surgery, associated with increased morbidity, mortality, and healthcare costs. The review explores fenoldopam's pharmacological properties, mechanism of action, and clinical applications, synthesizing evidence from randomized controlled trials, meta-analyses, and observational studies. While some studies have shown promising results in improving renal function and reducing AKI incidence, others have failed to demonstrate significant benefits. The review discusses these conflicting findings, explores potential reasons for discrepancies, and identifies areas requiring further research. It also compares fenoldopam to other renoprotective strategies, including dopamine, diuretics, and N-acetylcysteine. The safety profile of fenoldopam, including common side effects and contraindications, is addressed. Current guidelines and recommendations for fenoldopam use in cardiac surgery are presented, along with a cost-effectiveness analysis. The review concludes by outlining future research directions and potential new applications of fenoldopam in cardiac surgery. By providing a thorough overview of the current state of knowledge, this review aims to facilitate informed decision-making for clinicians and researchers while highlighting areas for future investigation.

Dissimilar welds between ferritic and austenitic steels represent a good solution for exploiting the best performance of stainless steels at high and low temperatures and in aggressive environments, while minimizing costs. Therefore, they are widely used in nuclear and petrochemical plants, however, due to the different properties of the steels involved, the welding process can be challenging. Fusion welding can be specifically addressed to connect low-carbon, or low-alloy steels, with high-alloy steels, which have similar melting point. Welding of thick plates can be performed with electric arc in multiple passes or in a single pass by means of a laser beam equipment. Since microstructure and consequently mechanical properties of the weld are closely related to composition, the choice of the filler metal and processing parameters, which in turn affects the dilution rate, plays a fundamental role. Numerous technical solutions were proposed for welding dissimilar steels and much research was developed on the weldment metallurgy; therefore, this article is aimed at a review of the most recent scientific literature on the issues relating to the fusion welding of ferritic / austenitic steels. Two specific sections are dedicated respectively to electric arc and laser beam welding; finally, metallurgical issues, related to dilution and thermal field are debated in the discussion section.

Cystic artery bleeding (CAB), a relatively uncommon entity, can arise from both traumatic and non-traumatic etiologies. This pictorial essay aims to elucidate the computed tomography (CT) findings associated with CAB in these distinct contexts. In traumatic CAB, particularly blunt or penetrating trauma, a cystic artery lesion is the culprit behind the hemoperitoneum characteristically located within the gallbladder fossa. Prompt diagnosis is crucial. Fortunately, trans-arterial embolization offers a successful treatment option for traumatic cystic artery lesions, especially in settings where non-operative management is preferred. Non-traumatic CAB, on the other hand, often stems from inflammation in the hepatobiliary and pancreatic system, gallbladder tumours, or iatrogenic injuries. The underlying mechanism typically involves cystic artery wall damage, either due to inflammation or procedural complications, leading to the formation of a cystic artery pseudoaneurysm (CAP). Notably, CAP bleeding can manifest long after the causative event, posing a diagnostic challenge with a variable clinical presentation. This pictorial essay serves to illustrate the CT signs and features of CAB in both traumatic and non-traumatic scenarios. Additionally, it will delve into the characteristic CT appearance of CAP.

A two-qubit Hamiltonian model exhibiting an SU(2) symmetry is considered. The related dynamical problem results to be then exactly solvable both in the time-independent and in the time-dependent case. Basing on the formal, general form of the related time evolution operator, the time-dependence of the level of entanglement of some initial conditions is studied within both the Rabi and the Landau-Majorana-Stückelber-Zener scenarios.

Micro-Raman spectroscopy was carried out to evaluate the localized residual stresses in commercial Gallium Nitride-based devices, specifically AlGaN/GaN High Electron Mobility Transistors (HEMTs) in a novel packaging design provided by STMicroelectronics S.r.l. The packaging plays a key role in protecting the device core against the external environment, thus minimizing damages caused by mechanical shocks, exposure to light, and contact with chemicals, conjointly achieving an efficient heat dissipation rate. Even though the packaging is a required step for the proper functioning of ready-to-use electronic devices, its application typically may introduce mechanical stress to AlGaN/GaN HEMTs, which can result in various reliability issues. In this paper, we investigate the impact of packaging on residual stress by analyzing the frequency shift of the E2 Raman peak along GaN layers and at the GaN/Si interface. An extensive evaluation was conducted using both a packaged device and a wafer-level device. The correlation between Raman frequency shifts of the E2 mode was accurately quantified, revealing a stress mitigation of approximately 0.1 GPa. This reduction is ascribed to the compressive stress introduced by the packaging, which partially offsets the intrinsic tensile stress of the wafer-level device. The proposed methodology could, in principle, be implemented to improve the development of a packaging.

Mediterranean countries are a cauldron of cultural exchange, with a strong emphasis on wild plants in cuisine traditions. Many of these plants belong to the family Apiaceae. The common climate determines the common range of distribution. While many plants have wide distribution, the range of distribution of others is restricted to Western Mediterranean or North Africa. This review investigates wild plants from the family Apiaceae traditionally used as food in 13 study sites - 11 countries in the Mediterranean and adjacent territories - the mainland and 3 islands. The aim is to trace patterns of native distribution versus consumption. As a result, 81 wild umbellifers are listed, traditionally used as food. Their consumption and distribution patterns are described and discussed. Interestingly in 8 of the 13 study sites (61.5%) are recorded 50 plants (66.7% of all wild umbellifers, traditionally used as food) which are consumed in only one particular country. These are as follows: 8 taxa in Morocco, 9 taxa in Spain, 2 taxa in Sicily, 3 taxa in Bulgaria 3 taxa in Crete, 8 taxa in Armenia, 14 taxa in Turkey, and 3 taxa in Jordan. However, these 50 restrictedly consumed plants are distributed in more than one country (except 15 taxa, which are endemics). Many of the plants that are used in certain countries are not consumed by the neighboring people. The results of the two statistical tests, namely Jaccard index and heatmap clustering (double dendrogram) are discussed. The presence of an outlier, such as Bulgaria, which shares borders, history, and culture with Greece and Turkey, emphasizes the importance of local climate on plant distribution and consumption over cultural interactions. The same was observed for some pairs of countries, such as Spain and Morrocco and Turkey and Armenia, although they had the highest number of common plants, that are both distributed and consumed as food.

Polystyrene (PS) is an extremely stable polymer with relatively high molecular weight and a strong hydrophobic character that makes it highly resistant to biodegradation. In this study, PS was subjected to biodegradation tests by Tenebrio Molitor (T. Molitor) and Zophobas Morio (Z. Morio) larvae. Specifically, six different experimental diets were compared: (i) T. Molitor fed with bran; (ii) T. Molitor fed only PS; (iii) T. Molitor fed only PS treated with H2O2; (iv) Z. Morio fed with bran; (v) Z. Morio fed only PS and (vi) Z. Morio fed only PS treated with H2O2. Therefore, the mass change of the larvae and the survival rate were measured periodically, while the frass collected after 15 and 30 days were analyzed by different analyses, such as spectroscopy (FTIR), spectrometry (molecular weight and polydispersity), and microscopy (scanning electron microscopy observations). The obtained results suggest that in the case of T. Molitor larvae, larvae feeding on bran showed the highest survival rate of ~94 % at 30 days, while in the case of the Z. Morio larvae, the highest survival rate was exhibited by larvae eating PS-H2O2. Although not strongly pronounced, the Mw and Mn of PS frass of both T. Molitor and Z. Morio larvae decreased over 30 days, suggesting the Ps biodegradation. Finally, the morphological analysis shows that PS samples isolated from the frass of T. Molitor and Z. Morio larvae showed completely different, rough and irregularly carved surface structures, in comparison to PS before biodegradation.

Objectives: To rate the effects of low molecular weight hyaluronic acid (LMWHA) solution and high concentration oxygen (HCO) through a specific medical device (Caress Flow©), compared to topical administration of hyaluronic acid (HA) alone on symptoms of mild and moderate stress and mixed urinary incontinence in women with genitourinary syndrome of menopause (GSM). Methods: A total of 68 postmenopausal women were enrolled (from October 2021 to September 2023). Patients were separated in two groups: one group used therapy with LMWHA solution and HCO combined and the second group used therapy with HA alone. Patient Global Impres-sion of Improvement (PGI-I) as the first outcome was used. As secondary outcomes International Consultation on Incontinence Questionnaire - short form (ICIQ-SF) questionnaire and Internation-al Quality of Life (IQoL) questionnaire were used. Results: Sixty-eight (68) women, 35 (51%) and 33 (49%), were treated with LMWHA solution and HCO combined and HA alone for 10 weeks, respectively. 28 (80%) versus 7 (20%) women reported an improvement (PGI-I score ≤3) of the symptoms in LMWHA solution and HCO com-bined group versus HA alone group. According to the ICIQ-SF, a statistically significant differ-ence was recorded after treatment between the two groups (median, 7 [5-11] vs 10 [8-11]; P = 0.03). According to the IQoL questionnaire, a statistically significantly lower median score was recorded in the LMWHA solution and HCO combined compared with the HA group, before (71 [IQR 55-81] vs 89 [IQR 67-94]; P < 0.01) and after (78 [IQR 65-86] vs 88 [IQR 72-99]; P = 0.04) treatment. Conclusions: LMWHA solution and HCO combined might improve the mild and moderate stress and mixed urinary incontinence in this set of women and that it is superior to HA therapy alone. However, these results need to be confirmed in further studies with a controlled design and a larger population.

In the digital age, Artificial Intelligence (AI) is emerging as a transformative force in various sectors, in-cluding medicine. This article explores the potential of AI, akin to the magical genie of Aladdin's lamp, particularly within thoracic surgery and lung cancer management. It examines AI applications like ma-chine learning and deep learning in achieving more precise diagnoses, preoperative risk assessment, and improved surgical outcomes. The challenges and advancements in AI integration, especially in computer vision and multi-modal models, are discussed alongside their impact on robotic surgery and operating room management. Despite its transformative potential, implementing AI in medicine faces challenges regarding data scarcity, interpretability issues, and ethical concerns. Collaboration between AI and medi-cal communities is essential to address these challenges and unlock the full potential of AI in revolution-izing clinical practice. This article underscores the importance of further research and interdisciplinary collaboration to ensure the safe and effective deployment of AI in real-world clinical settings.

This in-depth review navigates the intricate relationship between gender, hormonal influences, and the progression of autosomal dominant polycystic kidney disease (ADPKD), highlighting the limited literature on this crucial topic. The study explores the impact of female sex hormones on liver and renal manifestations, uncovering gender-specific differences in disease progression. Actually hormonal therapy in women with ADPKD remains a challenging issue and is a source of concern regarding its potential impact on disease outcomes, particularly at the hepatic level. Notably, women with ADPKD exhibit a slower renal disease progression compared to men, attributed to hormonal dynamics. The review sheds light on the role of estrogen in regulating pathways of the renin-angiotensin-aldosterone system, revealing its complex interplay and implications for cardiovascular and renal health. Therapeutic considerations for fertile women with ADPKD, including contraception options, are discussed, emphasizing the necessity for personalized approaches. In the postmenopausal phase, the review evaluates the role of hormonal replacement therapy, considering its potential benefits and risks in the context of ADPKD. The review concludes by underscoring the imperative need for tailored treatment approaches for ADPKD patients, considering individual risks and benefits. The scarcity of literature underlines the call for further research to enhance our understanding of optimal hormonal therapies in the context of ADPKD, ultimately paving the way for innovative and personalized therapeutic interventions.

Patients with Multiple Myeloma have an increased susceptibility to severe infections due to several various factors, especially the high tumor burden. The use of the anti-CD38 monoclonal antibodies-based therapies has changed the frequency and epidemiology of infections. We report herein the safety profile of the pivotal clinical trials conducted with anti-CD38 mAbs (daratumumab and isatuximab) and anti-SLAMF7 mAbs (elotuzumab) that led to the approval of regimens employed today in NDMM and RRMM patients.

In this study, Caciocavallo Ragusano, a typical cheese produced in Sicily Island (Italy), was ob-tained from milk of dairy cows fed with and without enriched olive cake (ECO and CTR, respec-tively) in order to evaluate nutritional, microbiological, volatile, and sensory differences in cheeses. ECO cheese showed greater (p < 0.05) MUFA and PUFA and polyphenols content, and lower SFA content than CTR cheese. Microbiological analyses revealed the absence of Salmonella, Listeria monocytogenes, Escherichia coli, and E. coli O157, and no significant differences in the vi-able counts of the remaining microbial groups analyzed, between samples. Thermophilic lacto-cocci were more prevalent in ECO cheese. The implementation of culture-independent method, such as PCR-DGGE analyses, revealed the presence of a more diverse microbial population in both cheeses. Regarding the volatile compounds profile, long-chain free fatty acids were more abundant in the ECO cheese resulting in a healthier free fatty acid profile. This study also showed that, especially for their appearance and taste, the consumers mostly appreciated the ECO cheese. Results showed that using enriched olive cake could enhance the sustainability and the quality of Ragusano cheese, improving not only the health of the consumers but also positively influencing tastes and acceptability.

The Active Distribution Networks (ADNs) are Multi-Input Multi-Output (MIMO) systems with coupled dynamics which cause interactions among the control loops of the Distributed Energy Resources (DERs). This undesired effect lead to performance degradation in the voltage control. To mitigate the effects of these unavoidable coupling, the present paper proposes a systematic design procedure based on the analysis of the interaction's sources. In details, each DER is equipped with a double loop PI to control the active and reactive powers output by the Voltage Source Converter (VSC) which connects the DER to the network's node. Furthermore, to guarantee Ancillary Services (ASs), the two loops are coupled by a simple mechanism of cooperation of the active power to voltage regulation realized by a filtered droop law. To achieve voltage regulation with reduced loop interactions, the PI parameters and the filter's pulse are designed according to a two sequential steps procedure based on the (Internal Model Control) IMC technique. Simulation studies are finally presented to demonstrate that the proposed design method achieves both reduction of the loop interaction and robust voltage control in presence of model parameter uncertainty in the MIMO model.

CPPU (Forchlorfenuron (1-(2-chloropyridin-4-yl)-3-phenylurea), a synthetic cytokinin, is extensively used to enhance fruit size and quality size in several crops, including kiwifruit. This study examines the effects of three different CPPU application strategies on two different crop loads on the main fruit quality parameters. Our results show that a two application of CPPU significantly increased fruit weight, especially under standard crop load conditions, due to better resource allocation. Fruit firmness improved with 2 and 3-times CPPU applications, likely due to enhanced cell wall development, and was consistently affected by crop load, with higher loads resulting in softer fruits. CPPU applied twice did not significantly influence soluble solids content. This parameter was instead significantly influenced by the crop load, with standard load fruit showing higher sugar accumulation. Fruit dry weight showed similar trends, with CPPU having a more pronounced effect under standard crop loads. Overall, CPPU proved to be a cost-effective strategy to enhance fruit quality, particularly in orchards with standard crop loads, by balancing yield and sugar content.

A low cost, scalable and robust process has been proposed as innovative method for coating solar mirrors with a self-cleaning, transparent in the full solar range and versatile material based on auxetic aluminium nitrides, previously obtained on the laboratory scale. This work presents the scaling-up of fabrication process from laboratory to prototypal scale and pre-liminary results of outdoor self-cleaning solar mirror prototypes testing in the demonstrative CSP plant ENEASHIP located in Casaccia (Rome) ENEA research centre. Prototypes 50x40cm have shown stability in external conditions: no degradation occurs during the test campaign. Their washing restores the initial reflectance affected by soiling and the self-cleaning performance allows the utilization of a reduced quantity of water for cleaning operations with respect to uncoated glass of back surface mirrors. A similar self-cleaning AlN coating could be utilized on other solar components affected by soiling, such as glass envelopes of heat collecting elements, PV panels and everywhere are required self-cleaning performance combined to optical ones.

The persistence of symptoms following COVID-19 infection represents a significant challenge in healthcare management. During the outbreak, tele-rehabilitation emerged as a new tool to support healthcare structures in providing rehabilitation services. This study assessed the effectiveness and the feasibility of a 3-week home-based motor and respiratory rehabilitation program for long COVID-19 individuals after traditional rehabilitation. Twenty-three patients completed the program and underwent functional tests at different time points (i.e. baseline, after hospital discharge, and after tele-rehabilitation). Motor function was evaluated using the instrumented Six-Minutes Walking Test (i6MWT), with monitored heart rate and oxygen saturation. Conversely, respiratory function was measured via forced vital capacity (FVC) and maximal voluntary ventilation (MVV) tests. Significant improvements (p &lt; 0.05) in motor and respiratory function were observed throughout the intervention, including an 18.3% increase in walked distance from the baseline. The findings suggest that a home-based tele-rehabilitation can enhance motor and respiratory function in post-COVID patients. Despite limitations such as sample size and lack of control group, the positive outcomes seem to support the feasibility of the proposed tele-rehabilitation program in managing long COVID symptoms and promoting functional recovery. Further research is needed to validate these findings and explore tele-rehabilitation’s potential in broader patient populations.

Introduction. Anesthesia is widely used in various fields of dentistry to reduce patient discomfort when the treatment would be painful. The dentist may need to infiltrate the anesthetic into multiple locations and this is usually done with the same needle which passes through the soft tissues several times to distribute the anesthetic solution over a larger area. The present study aims to evaluate, through a morphological analysis under a scanning electron microscope (SEM), how the beveled tip of a 30G needle, used to inject anesthetic several times into different areas of the vestibular mucosa, changes. Materials and methods. 30G needles with two different brands were tested, in vivo used for a variable number of sequential injections from 1 to 6 on 192 patients. The specimens were analyzed under SEM observation to evaluate any deformations induced by contact with the vestibular soft tissues. Results. The amount of deformation, measured along the axis parallel to the needle, was proportional to the number of injections. The protrusion of deformations, measured on an axis perpendicular to the needle, were maximum on the needles used 3 times. For the needles used 4,5 and 6 injections, no further increase in deformations was noted. Conclusion. From the data it seems that the tested needles are not produced to withstand multiple injections consequently after the first injection on soft tissues, they undergo a deformation which could increase the risk of injury to the mucosa itself or to nerves and vessels with which they come into contact. It would be advisable to use the single needle for a reduced number of injections.

Unmanned aerial vehicles (UAVs), commonly known as drones, present a cost-effective solution for the swift collection of data from vast and remote areas that are otherwise difficult to access. The Mediterranean Basin, known for being a hot spot for plant biodiversity, hosts several habitats and taxa of significant naturalistic value. However, many of these areas are often inaccessible to botanists, making exploration and research challenging. The aim of this paper is to involve the utilization of drone surveys and open-source software for botanical research. Our primary goal is to show the effectiveness of these tools in the field and demonstrate their practical application in Natura 2000 sites. The protected area chosen for this research is Rocca di Novara, situated in northeastern Sicily. Thanks to our drone investigations, we were able to capture images of the mountain’s side that is inaccessible to humans. This allowed us to observe the habitat of some species in detail. One of the most fascinating discoveries was the reappearance of Saxifraga callosa subsp. australis, which had not been confirmed in this area for over 140 years. Using drones for botanical research can boost field research, making monitoring easier and more cost-effective over time, especially in Natura 2000 sites.

Capturing atmospheric CO2 and storing it in natural rock systems (i.e., alkaline earth silicate and hydroxide minerals) through carbonation reactions is a promising greenhouse gas mitigation research, and largely depends on the use of hydrated ultramafic rocks (serpentinites), which are widespread in orogenic belts around the globe. The Jurassic ophiolites in the Southern Apennines represent a natural analogue and a great opportunity for the mineralogical sequestration of CO2. Serpentinites of the Pollino ophiolite Massif have been widely studied for their mineralogical, petrographic, and chemical characteristics, providing major findings on their impact on environmental and human health issues. Serpentinites here have been divided into cataclastic and massive types based on their structures and are characterized by pseudomorphic and vein textures. The mineralogy of the studied serpentinites consists of lizardite, antigorite, clino-crysotile, Cr-chlorite, magnetite, tremolite, actinolite, pyroxene and calcite, and the most commonly occurring serpentine minerals are polymorphs of serpentine including lizardite, clino-crysotile and antigorite. Systematic petrographic and mineralogical studies of serpentinites in ophiolites, such as those outcropping in the Southern Apennines can represent a starting point for the study of natural materials, which can be used for CO2 storage and sequestration. A particular attention must be given to those carbonate phases, produced by carbonation processes to check whether the serpentinites of the Pollino Massif can be used for the induced mineral Carbon Capture Storage (CCS). If successful, this technique and the Pollino Massif serpentinites can become highly significant in safeguarding the health of our planet's climate.

The paper analyzes the relationship between urban waste recycling and technological innovation systems in Europe. Data from the Global Innovation Index for 34 European countries in the period 2013-2022 was used. To analyze the characteristics of European countries in terms of waste recy-cling capacity, the k-Means algorithm optimized with the Elbow method and the Silhouette Coef-ficient was used. The results show that the optimal number of clusters is 3. Panel data results show that waste recycling increases with domestic market scale, gross capital formation, and the diffu-sion of Information and Communication Technologies (ICTs), while it decreases with the infra-structure index, business sophistication index, and the average expenditure in research and devel-opment of large companies.

The theory of heavy ion double charge exchange (DCE) reactions proceeding by effective rank–2 isotensor interactions is presented. Virtual pion–nucleon charge exchange interactions are investigated as the source for induced isotensor interactions, giving rise to the Majorana DCE (MDCE) reaction mechanism. MDCE is of a generic character, proceeding through pairs of complementary (π±,π∓) reactions in the projectile and target nucleus. The dynamics of the elementary processes is discussed where the excitation of pion–nucleon resonances are of central importance. Investigations of initial and final state ion–ion interactions show that these effects are acting as vertex renormalizations. In closure approximation, well justified by the finite pion mass, the second order transition matrix elements reduce to pion potentials and effective two–body isotensor DCE interactions, giving rise also to two–body correlations in either of the participating nuclei. Connections to neutrinoless Majorana double beta decay (MDBD) are elucidated at various levels of dynamics, from the underlying fundamental electro–weak and QCD scales to the physical scales of nuclear MDBD and MDCE physics. It is pointed out that heavy ion MDCE reactions may also proceed by competing electro–weak charge exchange processes, leading to lepton MDCE by electrons, positrons, and neutrinos.

Background: Patients with thromboembolic disease, prosthetic valves, or coagulation issues are commonly prescribed anticoagulants and antiplatelets. Although common professional oral hygiene might not represent a health concern for these patients, anticoagulant and antiplatelet medication might constitute a challenge for dentists and dental hygienists since possible prolonged bleeding might interfere with dental procedures. The aim of the present study was to investigate the bleeding time of different anticoagulants and antiplatelets during a professional hygiene session adapting the Ivy test to the oral environment; Methods: 93 consecutive patients undergoing professional oral hygiene were recruited. Debridement during oral hygiene was performed using ultrasonic mechanical instrumentation, and bleeding sites were assessed and treated with gentle pressure using sterile gauzes. The time for bleeding cessation was recorded. Patients were categorized into six groups based on their drug intake, Control: no anticoagulants or antiplatelets DTI: direct thrombin inhibitors (dabigatran) AntiXa: directa factor Xa inhibitors (endoxaban, apixaban, rivaroxaban) VKA: vitamin K antagonists (warfarin, acenocoumarol) SAPT: single anti-platelet therapy (acetylsalicylic acid or clopidogrel) DAPT: dual anti-platelet therapy (acetylsalicylic acid and clopidogrel). Bleeding time was measured in seconds and mean values were assessed among the different groups. Differences between groups were investigated with Kruskal-Wallis test followed by Dunn’s post-hoc correction for multiple comparisons or two-way ANOVA followed by Dunnett post-hoc; Results: Control patients presented the lowest bleeding time 50 sec, followed by AntiXa (98), SAPT (105), DTI (120), DAPT (190) and VKA (203). A statistically significant difference was present among control and DTI (p=0.004), VKA (p&lt;0.001), DAPT (p&lt;0.001). Conclusions: Based on the present outcomes, an increased risk of prolonged bleeding emerged in patients taking VKA and DAPT. However, bleeding did not interfere with the oral hygiene ses-sion The optimal period for dental treatment of these patients should be 2-3 hours before the next dose, without the need to temporarily suspend the medication.

This study explores innovation and sustainability within the Construction, Environment, and Territory (CAT) curriculum in Italian Upper Secondary Schools. It begins with an overview of Education for Sustainable Development (ESD) and its integration at various educational levels, focusing on technical/vocational curricula in Upper Secondary Education. The study examines the evolution of the technician's role, the CAT pathway in the Italian educational system, and comparisons with other European contexts. It analyzes the alignment between skills developed during the CAT course and the professional competencies required by the community and job market. A survey conducted among recent graduates and companies involved in the Pathways for Transversal Skills and Orientation (PCTO) at a CAT-focused school reveals significant training and professional needs related to Sustainable Development. To address these needs, the study proposes integrating ministerial programs in professional disciplines such as Topography, Building and Technological Systems Design, and Geopedology, Economics, and Appraisal, with new modules dedicated to Sustainable Development. These modules are to be integrated into the last three years of the course, utilizing the autonomy and flexibility in curricular planning per-mitted by current regulations. Additionally, the proposal includes actions to redistribute existing educational modules within ministerial programs without increasing teaching hours. An initial step in updating professional discipline programs involves implementing a cross-disciplinary educational path within Civic Education, focusing on Sustainable Mobility. The investigation, evaluation, and educational design process presented in this study aims to serve as a model for swiftly implementing structured curriculum reforms, emphasizing educational innovation and comprehensive student preparation to meet emerging social and professional needs.

This manuscript employs a surface stress-driven nonlocal model to explore the combined effects of long-range interaction and surface energy on higher vibration modes of functionally graded nanobeams. The nanobeam theory, based on Bernoulli-Euler kinematics, incorporates surface effects such as surface elasticity, surface residual stresses, surface density, and rotary inertia. Hamilton's principle is applied to derive the governing equation with size-dependent considerations. The main outcomes of a parametric investigation, considering four different kinematic boundary conditions (Cantilever, Simply-Supported, Clamped-Pinned, and Doubly-Clamped) while varying the nonlocal parameter and material gradient index, are presented and discussed. Additionally, the normalized natural frequencies for the second, third, fourth and fifth modes of vibrations are provided and analyzed for each case under study. The results underscore the model's effectiveness in capturing surface energy effects on the overall dynamic behavior of functionally graded Bernoulli-Euler nanobeams, offering a cost-effective approach for designing and optimizing nano-scaled structures.

Spatial attentional biases can be observed during the processing of linguistic material. For example, we previously reported that healthy subjects overestimate the semantic distance between word stimuli in the right vs left space. Here we explored whether attentional biases are also observed in tasks requiring evaluation of phonological distance between words in the right and left hemispace. Forty-one healthy subjects were presented with triplets of words arranged in space and were asked to indicate the side of space in which the phonological distance between the middle word and an outer word was smaller. In Experiment 1 real words and pseudowords were used, while in Experiment 2 only pseudowords and consonant strings were used. Subjects overestimated the phonological distance between the middle and outer words in the right space. These findings were specific to word stimuli. These results are consistent with the idea that semantic and phonological information may be internally mapped onto spatial representations.

Drug-induced liver disease represents one of the main problems in the therapeutic field. As with most pathologies, also in this case various risk factors can be recognised, such as age, sex, but also the gut microbiota. Therefore all drugs on the market can, in fact, cause hepatotoxicity of varying degrees. Drugs used in the treatment of IBD can also cause these adverse effects and even lead to DILI. In this review, the various classes of drugs used in the treatment of IBD were taken into consideration and the various adverse effects on the liver were illustrated. In particular, a major role has emerged regarding hepatotoxicity of immunosuppressants. Biological drugs, however, seem to be responsible for these complications to a much lesser extent.

Frequent and excessive consumption of alcohol, be it episodic or sustained misuse, ranks among the top causes of mortality globally. This comprehensive analysis seeks to elucidate how alcohol misuse precipitates death, with a particular focus on associated cardiac anomalies. Notably, the phenomenon of "Holiday Heart Syndrome," linked to binge drinking, is recognized for inducing potentially fatal cardiac arrhythmias. Moreover, persistent alcohol consumption is implicated in the development of alcoholic cardiomyopathy, a condition that underlies heart failure and arrhythmic disturbances of the heart. Additionally, individuals undergoing withdrawal from alcohol frequently exhibit disruptions in normal heart rhythm, posing a risk of death. This review further delves into additional alcohol-related mortality factors, including the heightened likelihood of hypertension, cerebrovascular accidents (strokes), and the connection between excessive alcohol use and Takotsubo syndrome.

Investigation of oomycete diversity in rice paddies of Fars Province in Iran led to the identification of two new Pythium sensu lato (s.l.) species as Globisporangium izadpanahii sp. nov. and Pythium banihashemianum sp. nov. The identification was based on morphological and physiological features as well as the phylogenetic analysis of nuclear (ITS and βtub) and mitochondrial (cox1 and cox2) loci using Bayesian inference and Maximum Likelihood. A major characteristic of G. izadpanahii was the production of globose hyphal swellings; this species did not produce vesicles and zoospores. The present paper describes formally these two new species and defines their phylogenetic relationships with other congeneric species. According to multiple gene genealogy analysis, G. izadpanahii grouped with other species of Globisporangium in the former clade G of Pythium s.l. and was closely related to both G. nagaii and the recently described G. coniferarum. The second species, designated P. banihashemianum, grouped with other species of Pythium sensu stricto in the former clade B of Pythium s.l. and according to the phylogenetic analysis shared an ancestor with P. plurisporium. In pathogenicity tests on rice seedlings, P. banihashemianum isolates were highly pathogenic causing severe root and crown rot, while G. izadpanahii isolates were not pathogenic.

Refractoriness to antiseizure medications is still a major concern in the pharmacotherapy of epilepsy. For this reason, we decided to evaluate the combination of levetiracetam and cannabidiol, administered at a subthreshold dose, to limit the possible adverse effects of this phytocannabinoid. We administered levetiracetam (300 mg/kg/day, via osmotic minipumps), cannabidiol (120 mg/kg/day, injected once a day subcutaneously), or their combination for one week in epileptic rats. Saline-treated epileptic rats were the control group. Animals were monitored with video electroencephalography the week before and after the treatment. No changes were found in the controls. Levetiracetam did not significantly reduce the total seizure number or the overall seizure duration. Still, the overall number of seizures (p&lt;0.001, Duncan’s new multiple range test) and their total duration (p&lt;0.01) increased in the week following treatment withdrawal. Cannabidiol did not change seizures when administered as a single drug. Instead, levetiracetam combined with cannabidiol resulted in a significant reduction in the overall number and duration of seizures (p&lt;0.05), when comparing values measured during treatment with both pre- and post-treatment values. These findings depended on changes in convulsive seizures, while non-convulsive seizures were stable. These results suggest cannabidiol determined a remarkable potentiation of levetiracetam antiseizure effects at a subthreshold dose.

Arthroplasty is commonly performed to treat advanced osteoarthritis or other degenerative joint conditions, but it can also be considered for young patients with severe joint damage that significantly limits their functionality and quality of life. Young patients are still at risk of aseptic mobilization and bone resorption due to the phenomenon of stress-shielding that causes an uneven distribution of tensions along the femoral contact surface prosthesis. This phenomenon can be limited by appropriately choosing the material of the prosthesis or by varying its stiffness, making sure that its mechanical behavior simulates that of the femur as much as possible. The aim of this study is to evaluate the mechanical behavior of a prosthesis optimized both in shape and material and in comparing the results with a standard titanium prosthesis. Methods: Through three-dimensional modeling and the use of software finite element method (FEM) such as ANSYS we simulate the mechanical behavior of traditional prosthesis and prosthesis optimized topologically respecting the ASTM F2996-13 standard Results: With topological optimization there is a stress reduction from 987 Mpa to 810 Mpa with a mass reduction of 30%. With the use of carbon fiber, it is possible to further reduce stress to 509 Mpa. Conclusions: The reduction of stress on the femoral stem allows an optimal distribution of the load on the cortical bone thus decreasing the problem of stress-shielding.

MzSTools is a plugin for QGIS developed by the Institute of Environmental Geology and Geoengineering of the National Research Council (CNR-IGAG). The plugin has been designed as a set of practical and easy-to-use tools to carry out seismic microzonation (SM) studies, by producing standard compliant geographic database and maps, thus making them accurate, homogeneous and uniform for all municipalities in Italy. A geodatabase based on SQLite/SpatiaLite Relational Database Management System (RDBMS) has been designed to collect and store data related to elements such as: geognostic surveys; bedrocks and cover terrains; superficial and buried geomorphological elements; tectonic-structural elements; elements of geological instability such as landslide zones, liquefaction zones and zones affected by active and capable faults; homogeneous microzones in seismic perspective, microzones characterized by a seismic amplification factor. MzSTools assembles in a single software environment a set of useful tools in a configurable QGIS project template, comprising layers, symbol libraries, cartographic styles and print layouts for the SM maps. The plugin is open source and hosted on the GitHub platform, and available via the official QGIS plugins repository (https://plugins.qgis.org/plugins/MzSTools/).

Background: Telemonitoring systems in cardiology have shown potential in improving chronic cardiovascular disease (CVD) management. This study aims to evaluate the impact of telemonitoring, mainly through mobile applications, on patient outcomes such as self-care, blood pressure control, quality of life, and hospitalization. Methods: We systematically reviewed studies assessing telemonitoring methods for patients with chronic CVD. The analysis included studies from various geographic regions and healthcare settings, focusing on qualitative outcomes without performing a meta-analysis. Results: Telemonitoring was found to aid in maintaining blood pressure and significantly enhance self-care abilities. Improvements in quality of life were observed in some studies, though results varied. Most studies indicated telemonitoring could effectively manage blood pressure and reduce hypertension-related complications. However, the heterogeneity of interventions and outcomes measured across trials posed challenges for a comprehensive meta-analysis. Conclusions: Integrating telemonitoring systems into routine care can significantly improve disease management and patient outcomes for chronic CVD patients. Future research should standardize telemonitoring interventions and outcome measures, conduct long-term studies, and evaluate the cost-effectiveness of these systems. Greater blindness in future randomized controlled trials and more studies on atrial fibrillation are also necessary. Significant potential exists for telemonitoring to improve patient outcomes and assist in managing chronic illnesses.

in the following article I analyze the trend of cultural and creative employment in the Italian regions between 2004 and 2022 through the use of ISTAT-BES data. After presenting a static analysis, I also present the results of the clustering analysis aimed at identifying groupings between Italian regions. Subsequently, an econometric model is proposed for estimating the value of cultural and creative employment in the Italian regions. Finally, I compare various machine learning models for predicting the value of cultural and creative employment. The results are critically discussed through an economic policy analysis.

Sorption of pure CO2 and CH4 and CO2/CH4 binary gas mixtures in amorphous glassy Poly(2,6-dimethyl-1,4-phenylene) oxide (PPO) at 35°C up to 1000 Torr is investigated. Sorption experiments were carried out using an approach that combines barometry with FTIR spectroscopy in the transmission mode to quantify the sorption of pure and mixed gases in polymers. The pressure range is chosen to prevent any variation of the glassy polymer density. The solubility within the polymer of the CO2 present in the gaseous binary mixtures is practically coincident with the solubility of pure gaseous CO2, up to a total pressure of the gaseous mixtures equal to 1000 Torr and for CO2 mole fraction of ~0.5 mol mol-1 and ~0.3 mol mol-1. The Non-Equilibrium Thermodynamics for Glassy Polymers (NET-GP) modelling approach has been applied to the Non-Random Hydrogen Bonding (NRHB) lattice fluid model to fit the solubility data of pure gases. We have assumed here that no specific interactions are occurring between the matrix and the absorbed gas. The same thermodynamic approach has been then used to predict the solubility of CO2/CH4 mixed gases in PPO resulting in a deviation lower than 9.5% from the experimental results for CO2 solubility.

Classically the walk in biped robotics was obtained controlling balance during the whole step, i.e. guaranteeing that the pressure point under the soles always stayed in the polygon of the supporting feet. However, this assumed that the feet were able to transfer torque to the ground during the whole gait cycle. In spite of the fact that the amount of transferrable torque in the feet-ground contact is limited, it is possible only during some phases of the step, and the overall process is energetically inefficient. On the other side, starting from the passive motion of the rimless wheel falling on an inclined surface, and ending to the inverted pendulum with a compass, balance in the whole was proven in spite of dynamical instability inside each step. Along this line results of Foot Placement Estimation (FPE) in 2-D and 3-D showed how energy efficient walk was possible, emulating the human walk with a free fall on the swing foot and energy restitution at the foot collision with the ground for the next step. This model assumes pointy feet, so without torque transfer to the ground. In the realm of FPE, in previous papers the present author adopted the 3-D inverted pendulum in polar coordinates (Spherical Inverted Pendulum - SIP) to introduce omnidirectional walks with arbitrarily changing characteristics. No torque control was used during the step, i.e the pendulum was always in free fall at each step, the only control actions were at the beginning of the next step. These actions are: the change of angular velocities at the start of a new step, with respect to those given after the collision (emulating the torque action in the brief double stance period), to recover for the losses, and the preparation of the position in the frontal and sagittal planes of the swing foot for the next collision. The present paper improves this paradigm, proposing a general model to account for all characteristics of the biped and of the gait, with adding a minimum of dynamical complexity with respect to the SIP. This model allows, not only to walk omnidirectionally on a flat surface, but also to go up and down staircases.

In the context of sustainable development, integrating the work aspect into health promotion systems is essential, ensuring that employees maintain a healthy balance between their professional and personal lives, which respects and amplifies the potential of every individual. Lately, there has been a noticeable shift of medical professionals from the public to the private sector. This trend paints a bleak picture, highlighting the vulnerabilities of a system teetering on the brink of failure, with significant impacts on patient care. Among the myriad reasons behind this shift, burnout stands out prominently. Medical professionals face increasing pressures due to understaffing, limited organizational support, and insufficient resources, leading to feelings of cynicism, exhaustion, and detachment from their roles. Utilizing the Maslach et al. questionnaire, we assessed the risk of burnout among physicians in public hospitals to identify and underscore preventive measures and improvements, correlating our findings with key aspects of organizational empowerment. Our research indicates that enhancing interpersonal relationships and resources—both within teams and between the organization and its physicians—is crucial for the revival of the healthcare system. This approach aims at improving the delivery of healthcare services and offering appropriate recognition to healthcare professionals, aligning with the principles of sustainable employment.

Background: Ankle fractures, comprising about 10% of musculoskeletal injuries, pose a significant healthcare burden with an increasing incidence, particularly among an aging population. This study focuses on isolated Danis-Weber type B fractures. Recent trends lean towards surgical intervention for anatomical restoration, quicker recovery, albeit with associated complications. This report aims to assess the safety and efficacy of NewClip narrow locking plate system with early weight bearing in treating isolated fibular fractures. Methods: The study includes patients with Danis-Weber type B fractures surgically treated with NewClip narrow locking plate system. Exclusions involved nondisplaced fractures, open fractures, or those requiring additional fixation.Results: Fifteen patients were enrolled in this study. Minor complications, including wound swelling, were observed in two cases. The Visual Analogue Scale (VAS) for pain exhibited a steady decline postoperatively, with almost complete resolution by the third month. At three months, the FAOS demonstrated excellent results, and final follow-up at twelve months revealed complete osseous healing without complications.Conclusions: The use of this type of plates in treating isolated fibular fractures with early weight bearing shows promising results in terms of fracture healing, pain resolution, and functional outcomes warranting further investigation with larger cohorts.

Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a genetic disorder characterized by the development and progression of multiple renal cysts, leading to progressive renal function decline. To date, the only approved treatment for this condition is able to slow down the loss of annual renal function, without stopping the disease progression. Furthermore, this therapy is approved only for patients with rapid disease progression and its compliance is problematic because of the impact of this drug on quality of life. The recent literature suggests that cystic cells are subject to metabolic dysregulation in the glucose pathway (Warburg Effect). This finding paved the way for new lines of research targeting potential therapeutic interventions for ADPKD. In particular, this review highlights the latest studies on the use of ketosis, through ketogenic dietary interventions (daily calorie restriction, intermittent fasting, time-restricted feeding, and ketogenic diets), as a potential strategy for patients with ADPKD, and the possible involvement of microbiota in the ketogenic interventions’ effect.

Background: Swimming and, specifically, front crawl, can be included among the "overhead" sports. Overhead sports are a risk factor for some problems of the musculoskeletal system, especially the shoulder. The aim of the study was assessing the incidence of shoulder and neck pain in a Masters Swimming Team and its correlation with the crawl stroke. Methods: It is an observational study through video-analysis of the stroke and a questionnaire. The participants are 61 athletes of a Master team, whose prevailing training stroke was the front crawl were selected for the present study. Their stroke was analyzed during training by a go-pro camera mounted on a sliding trolley on a track, evaluating with their trainer their technical defects. A questionnaire about frequency of shoulder and neck pain during the last five years was administered to all the participants at the study. Results: From the questionnaire, 45 and 55 out of 61 athletes had suffered from shoulder pain and cervical pain, respectively. Both types of pain were correlated with the weekly swimming volume. The swimmers with hyperflexion of the wrist and prolonged internal rotation in the pulling phase had shoulder problems. Those who suffered from current shoulder pain reduced the underwater time. The four swimmers with an excessive body roll during breathing and those who kept their heads extended, reported cervical pain. Conclusions: Shoulder and neck pain could be prevented with the correction of specific technical errors in crawl stroke.

A Digital Twin (DT) refers to a virtual representation or digital replica of a physical object, system, process, or entity. This concept involves creating a detailed, real-time digital counterpart that mimics the behavior, characteristics, and attributes of its physical counterpart. DTs have the potential to improve efficiency, reduce costs, and enhance decision-making by providing a detailed, real-time understanding of the physical systems they represent. While this technology is finding application in numerous fields, such as energy, healthcare, transportation, it appears to be a key component of the digital transformation of industries. In this paper, we present the research results achieved by IoTwins, a European research project aimed at investigating opportunities and issues of adopting DTs in the fields of industrial manufacturing and facility management. Particularly, we discuss a DT model and a reference architecture for use by the research community to implement a platform for the development and deployment of industrial DTs in the cloud continuum. Guided by the devised architectures’ principles, we implemented an open platform and a development methodology to help companies build DT-based industrial applications and deploy them in the so-called Edge/Cloud continuum. To prove the research value and the usability of the implemented platform, we discuss a simple yet practical development use case.

Performing optimisation and scale-up studies of crystallisation systems requires accurate and computationally efficient mathematical models. The assumption of the ideal mixing conditions in batch reactors typically produce inaccurate results while the computational expense of CFD models is still prohibitively high. Therefore, in this work, a new intermediary approach is proposed that takes into account the non-ideal mixing conditions in the reactor and requires less computational resources than full CFD simulations. Starting with the Danckwerts concept of the intensity of segregation, an analogy between its application to chemical reactions and the kinetics of the crystallisation phenomena (such as nucleation and growth) has been made. As a result, the modified kinetics expressions have been derived which incorporate the effect of non-idealities present in stirred reactors. This way, based on the experimental measurements of the mixing time using the Laser Induced Fluorescence (LIF) technique, computationally more efficient mathematical models can be developed in two ways: (1) the accurate semi-empirical correlations are available for standard mixing configurations with the most often used types of impellers, (2) CFD simulations can be utilised for estimation of the mixing time; in this case it is necessary to simulate only the mixing process. The benefits offered by the LIF experimental technique have been demonstrated and some frequent problems in its application analysed. The mixing time results for configurations with and without baffles for three types of impellers and four different rotational speeds have been presented. The false shorter mixing times in the non-baffled configurations have been observed and this phenomena explained by the existence of two segregated zones in the reactor and confirmed by additional experiments. The precise measurements in these cases have been shown as difficult using the LIF technique, particularly for higher rpms. The experimental data has been compared to the preliminary simulation results obtained from the Smoothed Particle Hydrodynamics method and the standard k-ε turbulence model with the modest success. The shortcomings of the SPH model have been recognized and the directions for the future work discussed.

(1) Background: Considering highly selected patients with ductal carcinoma in situ (DCIS), active surveillance is a valid alternative to surgery. Our study is aimed at showing the reliability of post-biopsy complete lesion removal, documented by mammogram, as additional criterion to select these patients. (2) Methods: 2173 Vacuum Assisted Breast Biopsies (VABB) documented as DCIS have been reviewed. Surgery has been performed in all cases. We retrospectively collected the reports of post-VABB complete lesion removal and the histological results of the biopsy and surgery. We calculated the rate of upgrade of DCIS identified on VABB upon excision for patients with post-biopsy complete lesion removal and for those showing residual lesion. (3) Results: We observed 2173 cases of DCIS: 408 classified as low grade; 1262 as intermediate grade; 503 as high grade. The overall upgrading rate to invasive carcinoma was 15.2% (330/2173). The upgrade rate was significantly lower (8.2%) when considering patients showing mammographically documented complete removal of the lesion. (4) Conclusion: The absence of mammographically documented residual lesion following VABB is associated to a lower upgrading rate of DCIS to invasive carcinoma on surgical excision and should be considered when deciding the proper management DCIS diagnosis.

This research explores how regional socioeconomic variables affect the perception of social trust and support networks (PYCC) in Italian regions, and examines the implications for public policy designed to strengthen social cohesion. This study examines the variable "People You Can Count On" (PYCC) from the ISTAT-BES dataset, focusing on its distribution across Italian regions between 2013 and 2022. Using clustering through a k-Means algorithm optimized with the Silhouette coefficient and the Elbow method, three distinct clusters of regions emerged, highlighting significant differences in social support networks. An econometric model was employed to estimate the PYCC variable, factoring in socioeconomic indicators such as employment rates, income inequality, and social participation. The results indicate a complex interplay between socioeconomic conditions and social trust, with regions in the South and Islands showing increased community support, while many Northern regions experienced declines. The study suggests that areas with lower economic conditions often foster stronger social networks, driven by necessity. These findings underline the importance of targeted public policies aimed at fostering social cohesion, particularly in regions facing economic challenges. Policy implications include enhancing education, supporting small enterprises, and promoting social housing and welfare initiatives. Strengthening community participation and volunteering are also highlighted as critical strategies to build resilient support networks. Overall, the research provides valuable insights into the regional disparities of social trust and the role of socioeconomic factors in shaping community support across Italy.

This study investigated whether export performance is correlated with innovation. We explicitly considered five types of innovation: a) process innovation; b) product innovation; c) process and product innovation; d) product innovation new to the firm; and e) product innovation new to the market. We en-larged the findings of R&D-export and R&D-investment relations using a vast sample of cross-European firms. We considered innovation as endogenous and determined by R&D through a process characterized by the role of the regional technological environment. Our analysis enabled us to propose an integrated model incorporating R&D, innovation and export, in a framework of simultaneous equations which consider their mutual correlations. To the best of our knowledge, this work is the first in recent years to empirically compute the relation between R&D and tangible investment at the micro level. Econometric results showed that product and process innovation are positively linked to the export intensity of European manufacturing firms. The results also showed complementarity effects between the two kinds of innovation. The av-erage effect on export intensity from carrying out process innovation is larger than that found for product innovation, except in cases where the product is new to the market. When both types of innovation have been carried out, a larger effect results than that found for product or process innovation alone. Furthermore, the average marginal effect on export intensity from innovations of any kind among those studied here is highly positive and significant.

Abstract: Rice is one of the most important food crops in sub-Saharan Africa. Climate change, variability, and economic globalization threaten to disrupt rice value chains across the subcontinent, undermining their important role in economic development, food security, and poverty reduction. This paper maps existing research on the vulnerability of rice value chains, synthesizes the evidence and the risks posed by climate change and economic globalization, and discusses agriculture and rural development policies and their relevance for the vulnerability of rice value chains in sub-Saharan Africa. Important avenues for future research are identified. These include the impacts of multiple, simultaneous pressures on rice value chains, the effects of climate change and variability on parts of the value chain other than production, and the forms and extent to which different development policies hinder or enhance the resilience of rice value chains in the face of climatic and other pressures.

Optimization of post polymerization processing of polyolefin elastomers (POE) is of considerable industrial interest. To this aim, experimental determination and theoretical interpretation of the thermodynamics and mass transport properties of POE-solvent mixtures is relevant. Sorption behaviour of n-hexane vapour in a commercial propylene-ethylene elastomer (V8880 VistamaxxTM from ExxonMobil) is addressed here, determining experimentally the sorption isotherms at temperatures ranging from 115 to 140 °C and pressure values of n-hexane vapour up to 1 atm. Sorption isotherms have been interpreted with the Non-Random-Hydrogen-Bonding Equation of State model retrieving, from data fitting, the value of the binary interaction parameter for the n-hexane/V8880 system. Both the case of temperature-independent and of temperature-dependent binary interaction parameter have been considered. Sorption kinetics was also investigated at different pressures and has been interpreted using a Fick’s model determining values of the mutual diffusivity as a function of temperature and of n-hexane/V8880 mixture composition. From these values, n-hexane intra-diffusion coefficient has been calculated interpreting its dependence on mixture concentration and temperature by a semi-empiric model based on free volume arguments.

(1) Methadone is a chiral synthetic opioid primarily used to treat heroin and prescription-opioid addiction: the (R)-enantiomer (Levomethadone) activates the µ-opioid receptor more potently than the (S)-enantiomer, which is a more potent blocker of the hERG potassium channels, resulting in QTc prolongation. The purpose of this study is to assess the effect of methadone on the QTc interval and to investigate the benefits of Levomethadone. (2) The electrocardiograms of 165 patients taking methadone at various dosages and for different periods of time were examined: the QTc value was manually measured and then adjusted using Bazett's formula. (3) Data analysis revealed a linear association between the dosage of methadone and QTc length; no correlation was found between the QTc value and gender, age, or duration of therapy. 14% of the sample (23 patients) showed a prolongation of the QTc interval. 10 of the 23 patients with QTc elongation underwent a change of therapy from Methadone to Levomethadone: in 90% of these patients, a normalization in the QTc length was established. (4) This study confirmed the role of methadone, specifically its dosage, in QTc prolongation and the efficiency of Levomethadone as an adequate therapeutic substitute in these circumstances. This study validates the importance of a careful electrocardiographic monitoring in methadone-treated patients.

In implantology, among the key choices, to obtain predictable results, it’s essential to establish, using CBCT, the bone site where to insert the implants; these sites must be identified on the mucosa and secondarily, during the surgical phase, on the cortical bone. Surgical templates are a valid aid especially in complex cases which require sev-eral implants. In cases of single implant, on the other hand, surgical guides are rarely used and the implant is inserted freehand and the identification of the implant site on the oral mucosa is more difficult; for this reason the clinician uses the teeth in the arch as a ref-erence. This experimental study is based on the use of a thermo-printed mask, con-taining radiopaque references which, worn by edentulous patients during the execu-tion of the CBCT, helps to evaluate the identification of the implant sites on the patient when surgical guides are not used and the free hand technique is adopted. This method is certainly reserved for experienced operators capable of identifying the correct angle of the implants with the freehand technique. The level of experience remains fundamental in the clinician's decision whether or not to use surgical guides; in fact, doctors with little experience should use surgical guides even in the simplest cases to reduce the risk of error.

In implantology, among the key choices, to obtain predictable results, it is essential to establish, on the basis of radiographic examinations, the bone site where to insert the implants; these selected locations must be identified first on the mucosa and then on the cortical bone. Surgical guides represent a valid aid especially in complex cases with more than 3 or 4 implants, whereas in single implant cases they are rarely used. This study evaluates the clinical precision with which the implant sites, on the patient's mucosa, are identified in surgical procedures planned without any templates. The verification of this precision is carried out through thermo-printed templates with radiopaque references which could however help the clinician to identify these sites in a simple, rapid and economical way.

In this paper we overview all analytical engineering solutions for corrosion problems in pressure vessels delivered over the past 60 years. We briefly detail strengths and weaknesses of existing approaches, thus demonstrating the need for novel uniform corrosion analysis methods for both current and new applications. To complement the review, we also present a new analytical model allowing to estimate the lifetime of pressured elastic vessels with mechanically assisted corrosion. Both internal/external pressure and internal/external corrosion are captured and dissolution driven corrosion is also considered. The readily implemented method improves existing analytical approaches and is shown to be effective for thin and thick shells, as well as various loading and corrosion intensity and geometrical conditions.

Introduction: Lung cancer remains a global health concern, with non-small cell lung cancer (NSCLC) comprising the majority of cases. Early detection of lung cancer has led to an increased number of cases identified in the earlier stages of NSCLC. This required the revaluation of the NSCLC treatment approaches for early-stage NSCLC. Methods: We conducted a comprehensive search using multiple databases to identify relevant studies on treatment modalities for early-stage NSCLC. Inclusion criteria prioritized but were not limited to, clinical trials and meta-analyses on surgical approaches to early-stage NSCLC conducted from 2021 onwards. Discussion: Minimally invasive approaches, such as VATS and RATS, along with lung resection techniques, including sublobar resection have emerged as treatments for early-stage NSCLC. Ground-glass opacities (GGOs) hve shown prognostic significance, especially when analyzing the consolidation-tumor ratio (CTR). There have also been updates on managing GGOs, including the non-surgical approaches, the extent of lung resection indicated, and the level of lymphadenectomy required. Conclusion: The management of early-stage NSCLC requires further assessment of treatment strategies. This includes understanding the required extent of surgical resection, interpreting the significance of GGOs (specifically GGOs with a high CTR), and evaluating the efficacy of alternative therapies. Customized treatment involving surgical and non-surgical interventions is essential for advancing patient care.

BACKGROUND Relaxin (RLX), a hormone-like molecule with pleiotropic effects, has been found to reduce matrix deposition and mediate collagen degradation in animal models of chronic liver injuries and might be considered as an adjuvant therapeutic agent for progressive liver diseases. AIMS In the present study, we evaluated whether RLX affects the development of liver fibrosis in an experimental mouse model of NASH in C57BL6 male mice fed with a methionine-choline deficient diet (MCD). Methods Mice were treated per os as we intended to assess the enteric absorption and bioavailability of orally administered RLX (RLX purified from pig ovaries, IBSA SA, Lugano, Switzerland). Mice were fed the MCD diet for 6 weeks. After the initial 3 weeks, one group received drinking water supplemented with RLX (25 mcg/ml) whereas the other continued to receive regular water. A third group of mice fed a regular diet served as control. After 3 additional weeks mice were anesthetized and sacrificed. Results A significant, reduced expression of the pro-inflammatory cytokines TNF-α and of relevant markers of active fibrogenesis and extracellular matrix deposition, Col1A1 and α-SMA, was observed in mice treated with RLX vs controls. RLX also induced a significant decrease of TIMP1 and an increase of both MMP 2 and 9 when evaluated by zymographic analysis in liver extracts. Conclusions Although preliminary pharmacokinetics experiments showed barely detectable amounts of RLX in the blood of mice treated per os, these data support the absorption of orally administered RLX and confirm its potential therapeutic use in the management of liver fibrosis.

Myasthenia gravis (MG) is a disease characterized by typical clinical and immunopathogenic pe-culiarities, which correlate with age and sex/gender. Accordingly, MG patients show thymic al-terations and auto-antibodies productions, that can be the expression of a different pathogenetic mechanism related to age and gender. This determines, in relation to age at and sex/gender, a dif-ferent MG onset, prognosis, and outcome. Therefore, diverse MG forms can be identified, classi-fied, and characterized in relation to their different features, and precisely there are early onset and late-onset forms of MG. It has been hypothesized that the cause of appearance the two diverse forms of MG can be ascribed mainly to the diverse genetic and epigenetic factors. In this narrative review, we will analyze and discuss about the interplay of age- and sex-related factors (i.e. genet-ic and epigenetic factors) related to two different MG forms and how they contribute to their di-verse pathogenesis.

Molecular-scale density fluctuations at equilibrium produce cavities in a liquid and can be analyzed to shed light on the statistics of the number of molecules occupying observation volumes of increasing radius. An information theory approach led to the conclusion that these probabilities should follow a Gaussian distribution function. This prediction has been confirmed by computer simulations in different liquid models if the size of the observation volume is not large. The reversible work of cavity creation is exactly linked to the probability of finding zero molecules in a given observation volume. The Gaussian formula for the latter probability is scrutinized to arrive at the enthalpy and entropy changes associated with cavity creation. The reversible work of cavity creation has a purely entropic origin due to the solvent-excluded volume effect produced by the inaccessibility of a given region of the configurational space. The consequent structural reorganization of liquid molecules leads to exactly compensating enthalpy and entropy changes. These results are in line with those obtained in a direct statistical mechanical study by Lee.

In the following article, we estimate the Renunciation of Healthcare Services-RHS in Italian regions in the context of the Environmental, Social and Governance-ESG model during the period 2004-2022. The data were acquired from the ISTAT-BES dataset. The data were analyzed using the following econometric techniques: Panel Data with Fixed Effects, Panel Data with Random Effects, Pooled Ordinary Least Squares-OLS, Weighted Least Square-WLS,. Results show that RHS tends to growth with the E-Component, is negatively associated to the S-Component, and positively associate with the G-Component within the ESG model. Furthermore, a clusterization with the unsupervised k-Means algorithm is presented and the results are discussed with a confrontation between optimal and suboptimal k values optimized with the Silhouette Coefficient. Finally, a confrontation among eight different machine-learning algorithms is performed to predict the future value of RHS. Outcomes show that the Simple Regression Tree is the best predictive algorithm and that the level of RHS is predicted to growth on average of 4.4% for the Italian regions. Results are critically discussed.

Graphs are largely used in computer science to model relations, or associations, among entities the compose complex systems. More recently, they found a broad field of application in bioinformatics and medical informatics supporting modelling, analysis of many systems. The applications span from representing interactions among molecules within cells, to model the functions of the brains. In order to support research, algorithms from graph theory that are able to extract knowledge from network should be coupled to efficient visualisation techniques. Although the importance of such topic, we retain that many challenges should be faced in the futures, such as automated pathway and network layout to better match biologists’ needs, the developing of a standard able to give more and better choices to represent nodes, edges finally, the developing of automated mechanism able to improve the network navigation methods that help users manage large and complex networks with the goal to improve the usability.

(1) Background: The interplay between coronavirus disease 2019 (COVID-19) and laryngeal cancer represents a substantial challenge for both patients and healthcare. To garner information on recent mortality data for laryngeal cancer, including during the COVID-19 pandemic, we analyzed real-world data from the US Centers for Disease Control and Prevention (CDC). (2) Methods: We searched the CDC WONDER on-line database 2018-2022 using with the ICD-10 code for laryngeal cancer (C32; malignant neoplasm of larynx). We also performed a sub-analysis between genders, and across ten-year age groups. Data were analyzed with one-way analysis of variance (ANOVA) and Tukey post-hoc test. (3) Results: The trend of age-adjusted mortality ×100,000 did not change significantly between 2018-2022 (p=0.553). Males had higher age-adjusted mortality rates (M/F ratios between 4.6 and 5.0), but no significant variation was found in both genders (males: p=0.676; females: p=0.596). Although the mortality rate remained unchanged in people aged 35-84 years, the variation reached statistical significance in those aged 85 or older (p=0.004), displaying significant increase in 2021 compared to 2018 (p=0.006) and 2019 (p=0.039). (4) Conclusions: The impact of the COVID-19 pandemic on mortality for laryngeal cancer seemed to be relatively modest in the general US population. Nevertheless, closer attention must be paid to older people, in whom the unfavorable consequences of misdiagnosis or mistreating can be exacerbated.

As of today, 20 disease modifying drugs (DMD) have been approved for the treatment of relapsing multiple sclerosis (MS) and, based on their efficacy, they can be grouped into moderate-efficacy DMDs and high-efficacy DMDs. The choice of the drug mostly relies on the judgement and experience of neurologists and the evaluation of therapeutic response can only be obtained by monitoring clinical and magnetic resonance imaging (MRI) status during follow up. In an era where therapies are focused on personalization, the aim of this study is to develop a modeling infrastructure to predict the evolution of relapsing MS and the response to treatments. We built a computational modeling infrastructure named UISS (Universal Immune System Simulator) able to simulate the main features and dynamics of the immune system activities. We extended UISS to simulate all the underlying MS pathogenesis and its interaction with the host immune system. This simulator is a multi-scale, multi-organ, agent based simulator with an attached module capable of simulating the dynamics of specific biological pathways at the molecular level. We simulated six MS patients with different relapsing-remitting courses. These patients were characterized on the basis of their age, sex, presence of oligoclonal bands, therapy and MRI lesion load at onset. The simulator framework is made freely available and can be used following the links provided in the availability section. Even though the model can be further personalized employing immunological parameters and genetic information, based on the available data we generated a few simulation scenarios for each patient, including those who matched the real clinical and MRI history. Moreover, for two patients, the simulator anticipated the timing of subsequent relapses, which really occurred, suggesting that UISS may have the potential to assist MS specialists in predicting the course of the disease and the response to treatment.

No one can dismiss the fundamental role played by water in several important biochemical processes, including the folding of globular proteins. The so-called hydrophobic effect is the theoretical construction to rationalize how water molecules stabilize the folded state. However, over the years, analyses have been published that lead to the conclusion that water destabilizes the folded state. The aim of the present work is to state that the gain in translational entropy of water molecules (due to the decrease in water accessible surface area associated with folding) is the driving force of protein folding.

Coronavirus disease 2019 (COVID-19) is a potentially serious acute respiratory infection caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Since the World Health Organization (WHO) declared COVID-19 a global pandemic, the virus has spread to more than 200 countries with more than 500 million cases and more than 6 million deaths reported globally. It has long been known that viral respiratory tract infections predispose patients to bacterial infections and that these co-infections often have an unfavourable clinical outcome. Moreover, nosocomial infections, also known as health care-associated infections (HAIs), are those infections that are absent at the time of admission and acquired after hospitalization. However, the impact of coinfections or secondary infections on the progression of COVID-19 disease and its lethal outcome is still debated. The aim of this review was to assess the literature on the incidence of bacterial co-infections and superinfections in patients with COVID-19. The review also highlights the importance of the rational use of antibiotics in patients with COVID-19 and the need to implement antimicrobial stewardship principles to prevent the transmission of drug-resistant organisms in healthcare settings. Finally, alternative antimicrobial agents to counter the emergence of multidrug-resistant bacteria causing healthcare-associated infections in COVID-19 patients will also be discussed.