The contribution aims to reconstruct the trajectory of urban morphology studies focused on the graphical understanding of the transformation phenomena within historical and contemporary fabrics. Highlighting some analogies with urban morphology studies present in the theories and design experiments of authors such as Aldo Rossi, Carlo Oswald W. Ungers, Hans Kollhoff, Saverio Muratori, Gianfranco Caniggia, and Giancarlo De Carlo. These studies mostly matured and de-veloped within a favorable cultural environment, which, albeit with due distinctions, saw them aligned on the same front in the practice of analogical procedures (Zambelli, 2021), expressing and anticipating in architectural facts the contemporary concept of urban acupuncture (M. Casagrande, 2010). An emerging notion used to designate the episodic and local character, with urban and ter-ritorial impact of new interventions that aim to oppose the contemporary practice of grand self-celebratory authorial interventions intentionally in dissonance with the context. These inter-ventions are promoted both by liberal and capitalist culture as well as by socialist-inspired culture (Sudjic, 2012). Lastly, it highlights the multiscale nature present in urban morphology studies as well as, at least in intentions, in urban acupuncture projects. Evident in the correlation between expression and content, form and emerging significance, wherein (Foucault, 1969) each change in form, to-gether with a change in scale, corresponds to a new morphological adaptation and consequently a redefinition of rules and 'urban grammar', usable in urban projects with territorial significance. Today, enriched by new digital monitoring tools that graphically render real-time socio-economic flows and dynamics, confirming those insights and syntheses that morphology and typology had suggested in forms that we could now define as acupuncture urban interventions.

Introduction: Contrast-enhanced spectral mammography (CESM) is a novel technique employed in breast cancer screening and detection. In this systematic review, we aim to compare the diagnostic performance of CESM with magnetic resonance imaging (MRI) in the context of breast cancer diagnosis. Material and Method: We have searched for paper in Pubmed and Scopus from July 2023 to February 2024, finding 256 suitable papers according to our selection criteria (perspective or retrospective studies, women diagnosed with breast cancer, comparison of Contrast-enhanced Spectral Mammography and Magnetic Resonance Imaging, sensitivity and specificity metrics provided). Every paper was then checked for quality using the QUADAS 2 assesement score. Sensibility, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and accuracy were recorded. Results: 15 studies were selected for analysis. CESM demonstrated comparable sensitivity to MRI, with values ranging from 36.4% to 100% for CESM and 0% to 100% for MRI. Specificity varied between the modalities, with CESM showing specificity ranges of 17% to 100% compared to 23% to 92.31% for MRI. Discussion and Conclusion: CESM has comparable diagnostic validity to MRI, and is a valuable tool in detecting breast cancer.

Leaky-wave antennas (LWAs) represent a recent class of radiating systems, first appeared in the second half of the past century. Initially treated with a certain dose of skepticism due to the apparent non-physical nature of supported wave solutions, LWAs have so far deeply evolved from the original configuration of slotted metallic lossy waveguide and adapted to a huge number of practical application fields, from microwave to millimeter waves and even up to the terahertz frequency range. Due to physics of relevant working principle, LWAs are often found in planar and low-profile configurations, being critically required in many cutting-edge applications, where device miniaturization, scaling and integration are required. Here we propose a review of some of the most recent and perspective array-fed 2-D LWAs, selecting two of most widespread categories in applications, Fabry–Perot Cavity Antennas (FPCAs) and Bull’s-Eye Antennas (BEAs), discussing and illustrating some advanced features recently proposed.

To handle the challenges and uncertainties of the actual labor market, the concept of employability becomes increasingly relevant, especially for graduates facing the transition from university to work. Graduate employability is a complex concept comprising different dimensions that may trigger effective job search and career management. This study introduces a new multifaceted tool, labeled the Orientamentis Questionnaire, to assess graduate employability from an agentic perspective, testing its psychometric properties. The Orientamentis questionnaire measures 14 dimensions merged into four 4 areas, namely graduate psychological capital, graduate agentic capabilities, graduate career perspective, and graduate proactive strategies. The tool was administered to a sample of 1238 graduate students (66% females) examining its factorial structure and reliability. To test its criterion validity, associations with three occupational outcomes collected one year later were explored on a subsample of 273 participants (66% females). Results attested the factorial structure of the Orientamentis questionnaire and the reliability of all dimensions. Moreover, the four areas and most of the dimensions were differently related to at least one subsequent occupational outcome. The Orientamentis Questionnaire represents a sound and reliable tool providing a multifaceted profile of graduate employability strengths and weaknesses, that could be used in academic placement programs to foster graduates’ self-awareness and proactive job search.

Background: Gender differences characterize the prevalence and attitudes toward weight management. Despite limited evidence suggesting greater weight loss in women with anti-obesity pharmacotherapy, gender-specific analysis remains underexplored. This retrospective study aimed to evaluate the gender-specific response to liraglutide 3.0 mg treatment in people with obesity without type 2 diabetes (T2D). Methods: Data were collected from 47 patients (31 women, 16 men), with age > 18 years, BMI ≥ 30 kg/m^2, absence of T2D, and with exclusion of prior anti-obesity treatment, comorbidities, or bariatric surgery. Only patients who maintained the liraglutide 3.0 mg dose for at least 6 months were included. Results: Both sexes showed significant reductions in weight and BMI at 3 and 6 months. Men achieved greater weight loss (WL), BMI reduction, % WL, WL >5% and >10% than women, and they also showed more significant improvements in metabolic parameters (total and LDL cholesterol, Fibrosis-4 Index FIB-4). No significant gender differences were observed in glucose metabolism or renal function. Conclusion: This study showed a greater therapeutic effect of liraglutide 3.0 mg in men. Given men's higher risk of cardiovascular disease (CVD), and underrepresentation in clinical weight loss programs, these findings may increase male engagement and improve their CVD risk.

Background: Mental capacity is a fundamental aspect that enables patients to fully par-ticipate in various healthcare procedures. To assist healthcare professionals (HCPs) in assessing patients' capacity, especially in the mental health field, several standardized tools have been developed. These tools include the MacArthur Competence Assessment Tool for Treatment (MacCAT-T), the MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR), and the Competence Assessment Tool for Psychiatric Advance Directives (CAT-PAD). The core dimensions explored by these tools include Understanding, Appreciation, Reasoning, and Expression of a choice. Objective: This meta-analysis aimed to investigate potential differences in deci-sion-making capacity within the healthcare context among groups of patients with bi-polar disorder (BD) and schizophrenia spectrum disorder (SSD). Methods: A systematic search was conducted on Medline/Pubmed, and Scopus. Addi-tionally, Google Scholar was manually inspected, and a manual search of emerging re-views and reference lists of the retrieved papers was performed. Eligible studies were specifically cross-sectional, utilizing standardized assessment tools, and involving pa-tients diagnosed with BD and SSD. Data from the studies were independently extracted and pooled using random-effect models. Hedges g was used as a measure for outcomes. Results: Six studies were identified, with three studies using the MacCAT-CR, two studies the MacCAT-T, and one the CAT-PAD. The participants included 189 individuals with BD and 324 individuals with SSD. The meta-analysis revealed that patients with BD performed slightly better, and the difference was statistically significant, compared to patients with SSD, particularly in the domain of Appreciation (ES=0.23, 95% CI: 0.01 to 0.04, p=0.037). There was no statistically significant difference between the two groups for Understanding (ES=0.09, 95% CI: - 0.10 to 0.27, p=0.352), Reasoning (ES=0.18, 95% CI: - 0.12 to 0.47, p=0.074), and Expression of a choice (ES = 0.23, 95% CI: - 0.01 to 0.48, p=0.60). In the sensitivity analysis, furthermore, when considering only studies involving patients in symptomatic remission, the difference for Appreciation also resulted in non-significant (ES=0.21, 95% CI: -0.04 to 0.46, p=0.102). (ES=0.21, 95% CI: -0.04 to 0.46, p=0.102). Conclusions: These findings indicate that there are no significant differences between patients with BD and SSD during remission phases, while differences are minimal during acute phases. The usefulness of standardized assessment of capacity at any stage of the illness should be considered, both for diagnostic-therapeutic phases and for research and advance directives. Further studies are necessary to understand the reasons for the overlap in capacity between the two diagnostic categories compared in this study.

SARS-CoV-2 is the Coronavirus responsible for the COVID-19 pandemic. Even though we are no more in a pandemic situation, people are getting infected some of them needing hospitalization, and a few of them die. Methods: We did a retrospective study including 445 patients who accessed the Emergency Section of Policlinico Umberto I, Rome, Italy, where they had routine blood exams. In this study, we concentrated on the complete blood count, creatinine, and azotemia. The data was analyzed using ANOVA, Spearman correlation, and ROC analysis. They were divided into four groups based on their outcome: (1) the emergency group (patients with mild forms who were quickly discharged); (2) the hospital ward group (patients who after admission to the emergency section were hospitalized in a COVID-19 ward); (3) the intensive care unit (ICU) group (patients that after the admission in the emergency section required intensive assistance); (4) the deceased group (patients that after the admission in the emergency section had a fatal outcome). Results: We found significant changes for creatinine, azotemia, hematocrit, mean corpuscular hemoglobin concentration, basophils, monocytes, red blood cell distribution width, hemoglobin, hematocrit, and red blood cell numbers by ANOVA according to their outcomes, particularly for the deceased group. Also, we found outcome correlations for eosinophils, hemoglobin, hematocrit, mean corpuscular hemoglobin concentration, lymphocyte, neutrophil, platelet, and red blood cell number and red blood cell distribution width. Conclusions: This study discloses an association between “classical” routine blood biomarkers and the severity of outcomes in Omicron patients.

Background: given the various clinical manifestations that characterize coronavirus disease 2019 (COVID-19), the scientific community is constantly searching for biomarkers with prognostic value. Surfactant protein A (SP-A) and D (SP-D) play a crucial role in ensuring proper alveolar function and an alteration of their serum levels have been reported in several pulmonary diseases characterized by acute respiratory distress syndrome (ARDS) and pulmonary fibrosis. Consid-ering that such clinical manifestations can also occur during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, we wondered if these collectins could act as prognostic markers. Methods: in this regard, serum levels of SP-A and SP-D were measured by enzyme immunoassay in patients with SARS-CoV-2 infection (n=51) at admission (T0) and after 7 days (T1) and compared with healthy donors (n=11). Results: SP-D increased in COVID-19 patients com-pared to healthy controls during the early phases of infection, while a significant reduction was observed at T1. Stratifying SARS-CoV-2 patients according to disease severity, increased serum SP-D levels were observed in severe compared to mild patients. Conclusions: In the light of these results SP-D, but not SP-A, seems to be an eligible marker of COVID-19 pneumonia and the early detection of SP-D serum levels could be crucial for a preventive clinical management.

The increasing availability of longitudinal data (repeated numerical observations of same units at different times) requires the development of flexible techniques to automatically detect common errors in such data. Besides obvious and easily identifiable cases, such as missing or out-of-range data, large longitudinal dataset often present problems not easily traceable by the techniques used for generic datasets. In particular, elusive and baffling problems are i) inversion of one or more values from one unit to another; ii) anomalous jumps in the series of values, iii) errors in the timing of the values due to a recalculation operated by the data providers to compensate previous errors. This work proposes a statistical-mathematical approach based on a system of indicators that is able to capture the complexity of the described problems by working at the formal level, regardless of the specific meaning of the data. The proposed approach identifies suspect erroneous data and is applicable in a variety of contexts. We implement this approach in a relevant database of European Higher Education institutions (ETER) by analyzing Total academic staff, that is one of the most important variables, used in empirical analysis as proxy of size and also considered by policy makers at European level.

Distracted driving is a major cause of road traffic crashes in Yaoundé. Partly due to scarcity of enforcement, lack of evidence and investigation of distraction safety performance indicator (SPI), hindering evidence-based intervention. This study aimed to address this evidence gap by evaluating the distraction SPI using proven methodology. Data on distracted driving (handheld mobile device; interaction; eating/smoking/drinking) were collected from roadside observation on 36 randomly selected road sections carefully spread to cover the city. SPI were computed and weighted with traffic volume to ensure representativeness of values. A total of 41,004 drivers were observed (38,248 in car; 1,116 in van; 977 in truck; 663 in bus). The prevalence of distracted driving in Yaoundé is 13.69% for the three distractions type combined. The prevalence is 7.84% for interaction, 4.89% for handled mobile device usage and 0.96% for eating/smoking/drinking. Leveraging these insights, a seven year (2024 - 2030) fighting strategy aiming at halving the prevalence was developed. The strategy contains intervention including on legislation/enforcement, which have been proven effective. This study, pioneer in Yaoundé, provide stakeholders with evidence of the issue and measures to implement and can also serve when developing road safety strategy.Future research should consider investigation at national level.

Speeding is a significant global issue, with disparities in speed outcome and speed research between low- and middle-income countries (LMICs) and high-income countries (HICs). This study aims to address speed research gaps by examining the prevalence of self-reported speeding and factors influencing drivers' speeding behavior (SB) using the Theory of Planned Behavior (TPB). An online survey involving 387 anonymous drivers was conducted in Yaoundé. Results showed that all drivers reported exceeding speed limits, with 81% exceeding by 5km/h, 12% by 10km/h, and 7% by more than 10km/h in urban areas. On highways, 54% reported exceeded the limit by more than 10km/h. Age, driver's license, and gender showed significant associations with speed limits non-compliance. The study results suggests that the TPB can be useful in assessing speeding behavior, as the inclusion of TPB variables led to a more than 50% proportionate increase in SB variance. Structural equation modeling revealed attitude towards speeding as the strongest predictor of speeding intention (SI), along with certain demographics indirectly influencing SB through SI. Perceived behavioral control (PBC) and SI directly influenced SB. These findings emphasize the potential of interventions targeting attitude, intentions, and perceived behavioral control to modify speeding behavior and improve road safety.

In Yaoundé, Cameroon, excessive and inappropriate speeding remains a major public health concern. Part of the problem are the unsafe speed limits, lack of evidence, and effective evaluation of speeding safety performance indicators (SSPIs), and the absence of speed management, hindering the city's ability to mitigate the risks associated with speeding. This study aimed to address this knowledge gap by assessing SSPIs using a well-defined methodology and suggesting speed management strategies. Data on speed, traffic volumes and road attributes were collected from a random selection of 16 representative road sections in Yaoundé. Seven SSPIs were calculated, and weights were assigned to evaluate city-level SSPIs. The findings showed that 66.8% of drivers drive within the speed limit, generally operating at speeds of 54 km/h with a speed variation of 26 km/h. Based on the speed analysis, evidence-based strategies are proposed, and implementing these strategies could potentially reduce fatalities and serious injuries by 16% to 84% across study locations, as indicated by Elvik's model. These findings have significant policy implications for reducing speeding in Yaoundé, and the methodological approach can be replicated in other urban settings. Future research should extend SSPI evaluation to the national level and test the effectiveness of the recommended strategies.

The seed habit is the most complex and successful method of sexual reproduction in vascular plants. It represents a remarkable moment in the evolution of plants that afterwards spread on land. In particular, seed size had a pivotal role as for evolutionary success and agronomic trait, especially in the field of crop domestication. Given that crop seeds constitute one of the primary products for consumption, it follows that seed size represents a fundamental determinant of crop yield. This adaptative feature is strictly controlled by genetic traits from both maternal and zygotic tissues, although seed development and growth are also affected by environmental cues. Despite being a highly exploited topic for both basic and applied research, there are still many issues to be elucidated as for developmental biology as well as for agronomic science. This review addresses a number of open questions related to cues that influence seed growth and size, and how developmental processes are influenced by them. Besides, new insights on the genetic-molecular control of this adaptive trait are presented.

Background: Early postoperative airway management after laryngo-tracheal surgery is crucial. Acute respiratory failure due to glottis’ oedema may occur, requiring reintubation. This can prolong ventilatory assistance, jeopardizing the anastomosis. To date, only judicious steroid administration and fluid management are available to avoid more invasive procedures. High-Flow-Oxygen-Therapy(HFOT) is a noninvasive O2 support method providing humidification, warmed air, Positive-End-Expiratory-Pressure(AIRVO2). No data exist about HFOT use to prevent early complications after laryngo-tracheal surgery. Methods: Between Sept.2020-Sept.2022, 107 consecutive patients underwent laryngo-tracheal surgery received HFOT(Group A). Data and long-term results were compared with those of 80 patients operated between Sept.2018-Aug.2020(Group B), when HFOT was not available. All patients were operated in a single center. No pre- or post-operative settings changed, except for HFOT introduction. We analyzed and compared the risk for “delayed” reintubation (unexpected reintubation within the first 24-48 hours after extubating/laryngeal mask removal) in the two groups. Results: No patients reported HFOT-related adverse events. Control group(B) presented “delayed” reintubation in 37% (p= 0.027), Intensive Care Unit admission in 67%(p=0.005) and longer hospital stay(p=0.001) compared to HFOT group(A). Minor complications rate was 3% in both group and overall mortality was 0%. Re-stenosis was described in 4.6% of HFOT group, without a statistically significant difference (p=0.7006). Conclusions: Our study is the first to investigate HFOT use in patients undergoing laryngo-tracheal surgery, potentially representing a consistent innovation in the peri-operative management of these patients. With the limit of a retrospective series, we would suggest HFOT use for preventing post-operative reintubation rate, possibly reducing ICU admission and hospital stay.

Background: Endovascular treatment of popliteal aneurysms (PA) has increased in the last few years, quickly becoming the main treatment in many vascular centers, based on the acceptable and promising outcomes reported in the literature. However, endograft infections are the most dangerous complication as a serious local compromise and usually require open surgical conversion and device explantation to preserve the affected extremity. Case report: We reported two patients admitted to the emergency room for pain and edema in the lower leg. Both patients have undergone exclusion of ruptured PA a few years before by endovascular graft. CTA showed a significant volume of fluid-corpuscular collection related to perianeurysmal abscess collection in both cases. Blood cultures and drained material cultures were positive for Staphylococcus Capitis in the first case and S. Aureus in the second. The antibiotics prophylaxis was performed for 10 days, then, patients underwent an open surgical conversion with a complete explantation of endovascular material and a femoro-popliteal bypass using an autologous vein in the first case and biological bovine pericardium prosthesis in the other case. Furthermore, we have questioned the literature and found eight more cases described in case report article referred to popliteal graft infections by different microorganisms, mostly presenting acute limb ischemia as the first symptom and suggesting endograft explantation with open conversion and autologous vein bypass as the commonest therapeutic choice. Conclusions: Open surgical conversion of popliteal endograft infection is the best strategy to manage peripheral infection of the popliteal stent.

(1) Background: Acute myocardial infarction in pregnancy (pAMI) is a rare event, often caused by non-classical factors rather than atherosclerosis. The management of such a complicationrequires a multidisciplinary team and it is important to bring together the specialities involved to ensure that these teams are coordinated and ready to respond. The management of pAMI poses unique challenges as it requires considering both maternal and fetal well-being. (2) Methods: We present the case of a 36-week pregnant woman who presented with antero-lateral ST elevation myocardial infarction (STEMI) complicated by cardiogenic shock. To ensure comprehensive decision-making, an emergency Pregnancy Heart Team meeting was convened, comprising interventional cardi-ologists, gynecologists, and anesthesiologists. The team prioritized interventional treatment for pAMI, according to ESC guidelines, and opted for primary percutaneous coronary intervention (PCI) due to the unstable maternal condition.; (3) Results: The patient underwent primary PCI as the chosen intervention for pAMI. A rapid response gynecology team closely monitored the procedure and was prepared to intervene in case of irreversible hemodynamic compromise leading to cardiac arrest. An emergency caesarean section was deemed necessary if cardiac ac-tivity was not restored within 4 minutes.; (4) Conclusions: Managing pAMI requires a multidis-ciplinary approach that balances the maternal and fetal well-being. In this particular case, the Pregnancy Heart Team decided to prioritize interventional treatment with primary PCI due to the unstable maternal condition. The presence of a closely monitored gynecology team ensured prompt action in case of complications.

Fetal Alcohol Spectrum Disorders (FASD) represent a continuum of lifelong impairments resulting from prenatal exposure to alcohol, with significant global impact. The “spectrum” of disorders includes a continuum of physical, cognitive, behavioral, and developmental impairments, which can have profound and lasting effects on individuals throughout their lives impacting their health, social interactions, psychological well-being and every aspect of their lives. This narrative paper explores the intricate relationship between oxidative stress and epigenetics in FASD pathogenesis and its therapeutic implications. Oxidative stress, induced by alcohol metabolism, disrupts cellular components, particularly in the vulnerable fetal brain, leading to aberrant development. Furthermore, oxidative stress is implicated in epigenetic changes, including alterations in DNA methylation, histone modifications, and microRNA expression, which influence gene regulation in FASD patients. Moreover, mitochondrial dysfunction and neuroinflammation contribute to epigenetic changes associated with FASD. Understanding these mechanisms holds promise for targeted therapeutic interventions. This includes antioxidant supplementation and lifestyle modifications to mitigate FASD-related impairments. While preclinical studies show promise, further clinical trials are needed to validate these interventions' efficacy in improving clinical outcomes for individuals affected by FASD. This comprehensive understanding of the role of oxidative stress on epigenetics in FASD underscores the importance of multidisciplinary approaches for diagnosis, management, and prevention strategies. Continued research in this field is crucial for advancing our knowledge and developing effective interventions to address this significant public health concern.

The amino acid proline accumulates in plants during abiotic stresses such as drought and salinity and is considered a reliable marker of environmental stress. While its accumulation is well established, its precise role in stress tolerance and its underlying molecular mechanism remain less clear. To address these issues, we performed a meta-analysis - a robust statistical technique that synthesizes results from multiple independent studies while accounting for experimental differences. We focused on 16 physiological and morphological parameters affected by drought and salt stress in transgenic plants expressing proline metabolic genes. For each parameter, we calculated the effect size as the response ratio (RR), which represents the logarithm of the mean value in the transgenic group over the mean value of the control group (lnRR). Under stress, most parameters exhibited significantly higher response ratios in the transgenic group, confirming the beneficial effects of proline during drought and salt stress. Surprisingly, under non-stressed conditions, most stress markers showed no significant differences between transgenic and non-transgenic plants, despite elevated proline levels in the former. These results suggest that the benefits of proline may be related to proline catabolism or may only become apparent during stress, possibly due to interactions with reactive oxygen species (ROS), which accumulate predominantly under stress conditions.

The transition to sustainable mobility is a recognized socio-economic and environmental challenge, particularly among young adults in low- and middle-income countries (LMICs). This paper addresses the lack of comprehensive research on mobility patterns for LMICs by examining the travel patterns of students, staff, and lecturers at the National Advanced School of Public Works, Yaoundé (NASPW) to understand transport mode choices and barriers to the use of public and active transport modes. Data was collected through online questionnaires from 425 participants. Findings revealed that most students (27.5%) used multiple modes of transport, with moto-taxis being the most common (21%). Lecturers primarily used private cars (50%), while staff relied on taxis or multiple modes (33%). Accessibility, vehicle speed, and flexibility appeared as the most important reasons for the preferred modes of transport. Barriers included long waiting times and traffic congestion for public transport, and distance and inadequate infrastructure for active mobility. The usage of public transportation was encouraged by its affordability and reduced travel time, whilst active options were preferred due to their cost savings and health benefits. To promote sustainable mobility for campus travel, it is crucial to encourage active modes, develop mass transport systems, and raise awareness through symposiums and conferences among students and staff.

Indoor environmental comfort is fundamental to human health as people spend 90% of their time indoors. This aspect is even more crucial in hospitals, where the concept of health is closely linked to well-being, ethics, and environmental aspects. Emerging methodologies and technologies such as Digital Twin, Building Information Modeling, the Internet of Things, sensing technologies, and data analytics offer new opportunities to ensure healthier environments and more efficient building management. This paper provides an assessment of how digitalization can support decision-making processes related to maintaining high levels of indoor environmental comfort in hospital settings, particularly by analyzing how real-time data processing and the application of machine learning can promote proactive interventions in these facilities. The methodological approach was based on four phases: defining the objectives of the digital twin, identifying the input data to build and feed the digital model, defining the KPIs to evaluate the system's correct functioning, and identifying the enabling technologies to be integrated into the system to achieve the set goal. The result is a digital twin for managing the operating room and its related services, with the aim of guiding decisions based on accurate data and improving operational efficiency, levels of environmental comfort, and safety regarding the diffusion of medical gases.

Technology-based approaches for upper limb (UL) motor rehabilitation after stroke are designed mostly for severely affected patients to increase their recovery chances. However, the available randomised controlled trials (RCTs) focused on efficacy of technology-based interventions often include patients with a wide range of motor impairment. This scoping review aims at overviewing the actual severity of stroke patients enrolled in RCTs which claim to specifically address UL severe motor impairment. The literature search was conducted on Scopus and PubMed databases and included articles from 2008 to May 2024, specifically RCTs investigating the impact of technology-based interventions on UL motor functional recovery after stroke. Forty-eight studies were selected. They showed that upon patients’ enrolment the values of the UL Fugl-Meyer Assessment and Action Research Arm Test covered the whole range of both scales, thus revealing the non-selective inclusion of severe impaired patients. Heterogeneity in terms of numerosity, characteristics of enrolled patients, trial design, implementation, and reporting were present across studies. No clear difference in the severity of the included patients according to the intervention type was found. Patient stratification upon enrolment is crucial to best direct resources to those patients who will benefit the most from a given technology-assisted approach (personalised rehabilitation).

Hereditary cardiomyopathies (CMPs), including Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC), Dilated Cardiomyopathy (DCM), and Hypertrophic Cardiomyopathy (HCM), represent a group of heart disorders that significantly contribute to cardiovascular morbidity and mortality and are often driven by genetic factors. Recent advances in Next-Generation Sequencing (NGS) technology have enabled the identification of rare variants in both well-established and minor genes associated to CMPs. Nowadays, a set of core genes is included in diagnostic panels for ARVC, DCM, HCM. On the other hand, despite their lesser-known status, variants in the minor genes may contribute to disease mechanisms and influence prognosis. This review evaluates the current evidence supporting the involvement of the minor genes in CMPs, considering their potential pathogenicity and clinical significance. A comprehensive analysis of databases such as ClinGen, ClinVar, and GeneReviews, along with recent literature and diagnostic guidelines, provides a thorough overview of the genetic landscape of minor genes in CMPs and offers insights for future research and translation to clinical practice. Given the increasing knowledge on these less-understood genetic factors, future studies are essential to clearly assess their roles, ultimately leading to improved diagnostic precision and therapeutic strategies in hereditary CMPs.

In Yaoundé, Cameroon, where walking is a leading transport mode, pedestrian safety remains an issue as they account for a fair share of road traffic casualties, partly due to the lack of walking policies and data on pedestrian facilities safety, hindering targeted intervention. This study investigated road segments using the Pedestrian Safety Index (PSI) and the Global Walkability Index (GWI) across 12 key roads frequented by diverse pedestrian groups, especially students. The indexes were graded from E to A and analyzed using description and rank correlation analysis. Only one segment (R7) achieved a grade C, while the remainder scored D or E, indicating poor pedestrian safety conditions and unpleasant walking experience. The strong correlation coefficient (0.69) between the PSI and GWI at a 99% significance level validated the safety assessment, providing confidence in the safety results. Leveraging these findings, a seven-year (2024-2030) safety strategy was developed aiming to upgrade all roads to grade B. This strategy contains interventions including engineering improvement, proven effective. The study offers evidence for city officials to improve pedestrian safety and informs walking policies development and upcoming projects implementation. Future research should include more road segments and validate indexes with crash or conflict data.

Due to environmental concerns, natural refrigerants and their use in refrigeration and air conditioning systems are receiving more attention from manufacturers, end users and the scientific community. The study of heat transfer and pressure drop is essential for accurate design and more energy efficient cycles using natural refrigerants. The aim of this work is to provide an overview of the latest outcomes related to heat transfer and pressure drop correlations for ammonia, propane, isobutane and propylene and to investigate the current state of the art in terms of operating conditions. Available data on the existing correlations of heat transfer coefficient and pressure drop for natural refrigerants have been collected through a systematic search. Whenever possible, validity intervals are given for each correlation and the error is quantified. It is the intention of the authors that this could be a valuable support for researchers and an aid to design, with particular reference to heat pumps. A procedure based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was adopted, and the Scopus database was used to query the relevant literature. A total of 135 publications qualified for inclusion in the survey; 34 articles report experimental investigations for not usual geometric conditions. Of the 101 selected papers related to usual geometric conditions, N = 50 deal only with HTC, N = 16 deal only with pressure drop and the remainder (N = 35) analyse both HTC and pressure drop. Among the 85 HTC papers (N = 53) deal with the evaporating condition, N = 30 with condensation and only N = 2 with the heat transfer correlations under both conditions. Most of the 101 articles concern propane and isobutane. The high temperatures are less widely investigated.

PFAS are a variety of ecologically persistent compounds of anthropogenic origin loosely included in many industrial products, in which the carbon chain can be fully (perfluoroalkyl substances) or partially (polyfluoroalkyl substances) fluorinated. Their ubiquitous presence in many environmental compartments over the years, and highly long-lasting nature, arose concern because of the possible adverse effects of PFAS on ecosystem and human health. Between the remediation technologies, adsorption has been demonstrated to be a maneageble and cost-effective method for the removal of PFAS in aqueous media. This study tested two novel and eco-friendly adsorbents (pinewood and date seeds biochar) on 6 different PFAS (PFOS, GenX, PFHxA, PFOA, PFDA, PFTeDA). Batch sorption tests (24 hours) were carried out to evaluate the removal efficiency of each PFAS substance in relation to the two biochars. All samples of liquid phase were analysed by a developed and then well-established method: i) pre-treatment (centrifugation and filtration); ii) determination by high-performance liquid chromatography coupled with mass spectrometry (HPLC-MS/MS). Results evidenced a comparable adsorption capacity of both materials, but greater for the long-chain PFAS. Such findings may lead to a promising path for the use of waste origin materials in the PFAS remediation field.

Given the long-standing debate about the nature of the concept of disease, the objective of this study was to understand how doctors categorize a condition as a disease or not and what kind of information they use. A survey with a set of clinical vignettes was designed, and a group of physicians were asked to interpret those situations as a disease or not and to motivate their choice with a short written text. Thematic analysis of the answers resulted in four themes: the temporal dimension of a disease, reification of disease, disease as an existential condition, and disease as a motivation to action. The respondents’ interpretations were very heterogeneous, supporting the idea that physicians do not share a common prototypical concept of disease. An interpretation of these results according to a critical realist and systemic approach suggested that the doctor-patient relationship is the context able to influence the interpretation of a condition as a disease or not as the final outcome of a process in which both objective, subjective, and socially mediated elements are taken into consideration.

Cars are a highly inefficient mode of urban transport with significant negative impacts. Electric vehicles make it possible to eliminate direct CO2 emissions (though the total over a vehicle’s entire life cycle greatly offsets the advantages) but leave unchanged – or even aggravate – all the other negative effects on the quality of urban environments. Three visions for urban transport were presented: automobility, multimodality and accessibility. The first dominates North American cities, the second European one. The anomalies of these two visions have been examined. The automobility cities cannot manage the congestion and the attempts are self- defeating. The anomalies of multimodality city are related to the public space consumption for mobility and the impossibility to plan spatial proximity. The sustainable vision, that resolve the anomalies, is represented by the accessibility city in the Triple Access System (TAS) version which, however, still has a long way to go to be accepted and implemented.

Introduction: Anterior cervical discectomy and fusion (ACDF) for cervical disc herniation (CDH) is commonly performed. Specific postoperative complications include dysphagia, dysphonia, cervicalgia, adjacent segment disorder, cage subsidence, and infections. However, interscapular pain is commonly reported by these patients after surgery, although its mechanisms have been not clarified yet. Methods: This retrospective series of 31 patients undergoing ACDF for CDH at a single Academic Hospital. Baseline and postoperative clinical, radiological, and surgical data were analyzed. The linear regression analysis was conducted to identify any factor independently influencing the occurrence rate of postoperative interscapular pain. Results: The mean age was 57.6±10.8 years, and the M:F ratio was 2.1. The preoperative mean VAS-arm was 7.15±0.81 among the 20 patients reporting brachialgia, and the mean VAS-neck was 4.36±1.43 among those 9 patients reporting cervicalgia. At 1 month interscapular pain was still reported by 8 out of the 17 patients who experienced it postoperatively, and it was recovered in all patients after 2 months. The regression analysis showed how the interscapular pain was not directly associated to age(p=0,74), gender(p=0,46), smoking status(p=0,44), diabetes(0,42), preoperative brachialgia(p=0,21) or cervicalgia(p=0,48), symptoms duration(p=0,13), baseline VAS-arm(p=0,11), VAS-neck(p=0,93), or mJOA(p=0,63) scores, or disc height modification(p=0,90). However, the postoperative increase of the mean zygapophyseal joint rims distance was identified as an independent factor in determining interscapular pain (p=0,02). Conclusions: Our study revealed that the onset of interscapular pain following ACDF may be determined by over-distraction of the zygapophyseal joints rim. Then, proper sizing of prosthetic implants could reduce this painful complication.

MicroRNAs are small non-coding RNAs, which contribute to the regulation of many physiolog-ical and pathological processes. Conventionally, miRNAs perform their activity in the cyto-plasm, where they regulate gene expression by interacting in a sequence-specific manner with mature messenger RNAs. Recent studies point to the presence of mature miRNAs in the nucleus. This review summarizes current findings regarding the molecular activities of nuclear miRNAs. These molecules can regulate gene expression at the transcriptional level by directly binding DNA on the promoter or the enhancer of regulated genes. MiRNAs recruit to these regions dif-ferent protein complexes, resulting both in activation or repression of transcription, through a number of molecular mechanisms. Haematopoiesis is presented as a paradigmatic biological process whereby nuclear miRNAs possess a relevant regulatory role. Nuclear miRNAs may af-fect gene expression also acting on nuclear mRNA processing and on the biogenesis of miRNA themselves by regulating pri-miRNA maturation. Overall, nuclear miRNAs are biologically ac-tive molecules that can be critical for the fine tuning of gene expression and deserve further studies in a number of physiological and pathological conditions

Puberty identifies the transition from childhood to adulthood. It normally lasts from 3 to 5 years and begins from 9 years in males and 8 years in females, although with differences related to familiarity and geographical origin. Precocious puberty is the onset of signs of pubertal development before age 8 in girls and before age 9 in boys, it has an incidence of 1/5000–1/10.000 with an F:M ratio ranging from 3:1 to 20:1. Based on the mechanism that triggers puberty, precocious puberty can be classified as central, also known as gonadotropin-dependent precocious puberty or true precocious puberty, and peripheral, also known as gonadotropin-independent precocious puberty or precocious pseudopuberty. Thus, the main aim of this narrative report is to describe the standard clinical management and therapy of precocious puberty according to the experience and expertise of pediatricians and pediatric endocrinologists at Policlinico Umberto I, Sapienza University of Rome, Italy. In the suspicion of early sexual maturation, it is important to collect information regarding the age of onset, the speed of maturation of secondary sexual characteristics, exposure to exogenous sex steroids and the presence of neurological symptoms. The objective examination, in addition to the evaluation of secondary sexual characteristics, must also include the evaluation of auxological parameters. Initial laboratory investigations should include serum gonadotropin levels (LH and FSH) and serum levels of the sex steroids. Brain MRI should be performed as indicated by the 2009 Consensus Statement in all boys regardless of chronological age and in all girls with onset of pubertal signs before 6 years of age. The gold standard in the treatment of central precocious puberty is represented by GnRH analogs, whereas as far as peripheral forms are concerned, the triggering cause must be identified and treated. At the moment there are no reliable data establishing the criteria for discontinuation of GnRH analogs therapy. However, numerous pieces of evidence suggest that the therapy should be suspended at the physiological age at which puberty occurs.

In recent years, there has been an increasing interest in adopting novel sensing technologies for the continuous monitoring of structural systems. In this respect, Micro-Electro-Mechanical System (MEMS) sensors are widely used in several applications, including Structural Health Monitoring (SHM). Thanks to their significantly lower cost, ease of installation on the structure, and lower power consumption, they enable extensive, pervasive, and battery-less monitoring systems. This paper presents an innovative high-performance device for SHM applications, based on a low-noise triaxial MEMS accelerometer, providing a guideline and insightful results about the opportunities and capabilities of these devices. Sensor nodes have been designed, developed, and calibrated to meet structural vibration monitoring and modal identification requirements. These components include a protocol for reliable command dissemination through the network and data collection, and improvements to software components for data pipelining, jitter control, and high-frequency sampling. Devices were tested in the lab using shaker excitation. Results demonstrate that MEMS-based accelerometers are a feasible solution to replace expensive piezo-based accelerometers. Deploying MEMS is promising to minimize sensor node energy consumption. Time and frequency domain analysis show that MEMS can correctly detect modal frequencies, useful parameters for damage detection. The acquired data from the test bed were used to examine the functioning of the network, data transmission, and data quality. The proposed architecture has been successfully deployed in a real case study to monitor the structural health of the Marcus Aurelius Exedra Hall within the Capitoline Museum of Rome. The performance robustness was demonstrated and the results showed that the wired sensor network provides dense and accurate vibration data for structural continuous monitoring.

Osteosarcoma (OS) are the most prevalent malignant bone tumors in adolescents and young adults.. OS cells grow in a permissive local microenvironment which modulates their behavior and facilitates all steps in tumor development (e.g., proliferation/quiescence, invasion/migration, drug resistance) and contributes to their intrinsic heterogeneity. The lung parenchyma is the most common metastatic site in OS, and metastatic foci are frequently associated with a poor clinical outcome. Although multiple factors may be responsible for the disease, including genetic mutations (e.g., Rb, p53), the molecular mechanism of development of OS remains unclear and the conventional treatment for OS is still based on a sequential approach that combines chemotherapy and surgery. Also, despite the increase in clinical trials, the survival rates for OS have not improved. Non-specific targeting therapies thus show poor therapeutic effects with side effects at high doses. For these reasons, many efforts have been done to characterize the complex genome of osteosarcoma thanks to the whole exome analysis with the aim to identify predictive biomarkers to give to these patients a better therapeutic option. This review aims to summarize and discuss the main recent advances in OS molecular research for precision medicine.

Abstract: Lipodystrophies (LDs) are rare, complex disorders of the adipose tissue characterized by selective fat loss, altered adipokines profile and metabolic impairment. Sirtuins (SIRTs) are class III NAD+-dependent histone-deacetylases linked to fat metabolism. SIRT1 plays a critical role in metabolic health by deacetylating target proteins in tissues including liver, muscle and adipose tissue. Circulating SIRT1 levels have been found to be reduced in obesity while increased in anorexia nervosa and in patients experiencing weight loss. We evaluated circulating SIRT1 levels in relation to fat amount in 32 lipodystrophic patients affected by congenital or acquired LDs compared to non-LD subjects (24 with anorexia nervosa, 22 normal weight and 24 with obe-sity). SIRT1 serum levels were higher in LDs as compared with normal weight subjects (mean ± SEM: 4.17 ± 0.48 vs. 2.59 ± 0.20 ng/mL) or subjects with obesity (1.7 ± 0.39 ng/mL), whereas they were close to those measured in anorexia nervosa (3.44 ± 0.46 ng/mL). Our findings show that within the LD group there was no relationship between SIRT1 levels and the amount of body fat. The mechanisms responsible for secretion and regulation of SIRT1 in LD deserve further investi-gation.

Background: The accurate diagnosis of regional lymph node metastasis is critical for guiding treatment decisions in head and neck cancer patients. Despite advances in imaging techniques, detecting nodal metastasis remains challenging, leading to potential undertreatment or overtreatment. This systematic review aims to identify molecular markers associated with occult metastasis in Head and Neck Squamous Cell Carcinoma (HNSCC) patients. Methods: The present research was conducted following PRISMA guidelines. Prospero registration nr. CRD42024522985. Results: Through a comprehensive literature search and review process, 634 articles were considered, 103 of them were finally included. Conclusions: Several promising markers were identified, including miR-205, DSG3, pan-CK AE1/AE3, HPV-16, Activin-A, Cyclin D1, and NPL that demonstrated effectiveness across multiple studies. Future research should focus on exploring combination scoring systems to improve diagnostic precision and optimize treatment selection in HNSCC patients.

Extreme weather events, such as heat waves and heavy precipitation, are becoming increasingly frequent due to climate change, necessitating the development of effective early warning systems (EWS) to mitigate their impacts. This study introduces an advanced EWS designed specifically for Italy, which integrates the FourCastNet global forecasting model with Elevation-integrated TEmperature and Precipitation SRGAN downscaling (E-TEPS) to enhance the spatial resolution and accuracy of climate predictions. Building on previous work that demonstrated E-TEPS's effectiveness in downscaling temperature and total precipitation variables, this research applies the integrated system to two severe weather events in Central Italy: the Emilia-Romagna floods of 2023 and the Marche floods of 2022. The system's performance was evaluated using key metrics, including Mean Absolute Error (MAE), Root Mean Square Error (RMSE), and Pearson Correlation, by comparing downscaled outputs from FourCastNet and ERA5 datasets against high-resolution ground truth data from the Euro-Mediterranean Center on Climate Change (CMCC) dataset. The results indicate that the integrated system offers improved predictive accuracy, particularly in capturing critical climate variables, with the entire EWS delivering high-resolution forecasts and final outputs in under one minute. Although potential limitations were identified due to biases in the underlying datasets, which could affect forecast reliability in regions with complex topography or extreme weather conditions, this research highlights the potential of combining machine learning models with downscaling techniques to enhance EWS precision, providing valuable insights for future climate forecasting and disaster preparedness strategies.

Darier disease (DD) is an autosomal dominant disorder due to mutation of ATP2A2 gene causing an isolated skin manifestation based on keratinocyte disconnection and apoptosis. Systemic manifestations of DD have not been demonstrated so far although a high incidence of neuropsychiatric syndromes suggest an involvement of central nervous system. A Novel ATP2A2 Gene Mutation c.118G>A, causing keratinocyte and cardiomyocyte disconnection in Darier disease, is reported. Their common pathologic pathway, still unreported, was documented by both skin and left ventricular endomyocardial biopsy because of cardiac dilatation and dysfunction appeared several decades after skin manifestations.Keratinocyte disconnection was paralleled by cardiomyocyte separation at lateral junction. Cardiomyocyte separation was associated to cell disarray, sarcoplasmic reticulum dilatation and increased myocyte apoptosis. Clinically, hyperkeratotic skin papules were associated to chest pain, severe muscle exhaustion and ventricular arrhythmias that improved following administration of aminophylline, a phosphodiesterase inhibitor enhancing SERCA2 protein phosphorylation.Specific mutations of ATP2A2 gene may cause cardiac involvement in patients with DD. Cardiac pathologic changes are similar to those documented in the skin including cardiomyocyte disconnection that promotes precordial pain and cardiac arrhythmias. Phosphodiesterase inhibitors, enhancing SERCA2 protein phosphorylation may substantially attenuate the symptoms.

In this work, we introduce the design a 16-channel in-pixel neural analog front-end which employs a current-based summing approach to establish a common-mode feedback loop. The primary aim of this novel structure is to enhance both the system common-mode rejection ratio (SCMRR) and the common-mode interference (CMI) range. Compared to more conventional designs, the hereby proposed front-end utilizes DC-coupled inverter-based main amplifiers, which significantly reduce the occupied on-chip area. Additionally, the current-based implementation of the CMFB loop obviates the need for voltage buffers, replacing them with simple common-gate transistors and in turn decreasing both area occupancy and power consumption. The proposed architecture is further examined from an analytical standpoint, providing a comprehensive evaluation through design equations of its performance in terms of gain, common-mode rejection and noise power. A 50μm×65μm compact layout of the pixel amplifiers that make up the recording channels of the front-end was designd in a 180 nm CMOS process. Simulations conducted in Cadence Virtuoso reveal an SCMRR of 80.5 dB and a PSRR of 72.58 dB, with a differential gain of 44 dB and a bandwidth that fully encompasses the frequency range of the bio-signals that can be theoretically captured by the neural probe. The noise integrated in the range between 1 Hz and 7.5 kHz results in an IRN of 4.04 μVrms. Power consumption is also tested, with a measured value of 3.77 μW per channel, corresponding to an overall consumpution of about 60 μW. To test its robustness with respect to PVT and mismatch variations, the front-end is evaluated by means of extensive parametric simulations and Monte Carlo simulations, revealing favorable results.

The onset of neurodegenerative diseases involves a complex interplay of pathological mecha-nisms, including protein aggregation, oxidative stress, impaired autophagy. This review focuses on the intricate connection between oxidative stress and autophagy in neurodegenerative disor-ders, highlighting autophagy as pivotal in disease pathogenesis. Reactive oxygen species (ROS) play dual roles in cellular homeostasis and autophagy regulation, with disruptions of redox sig-naling contributing to neurodegeneration. The activation of the Nrf2 pathway represents a criti-cal antioxidant mechanism, while autophagy maintains cellular homeostasis by degrading al-tered cell components. The interaction between p62/SQSTM1, Nrf2 and Keap1 forms a regulatory pathway essential for cellular stress response, whose dysregulation leads to impaired autophagy and aggregate accumulation. Targeting the Nrf2-p62/SQSTM1 pathway holds promise for thera-peutic intervention, mitigating oxidative stress and preserving cellular functions. Additionally, the review explores the potential synergy between the endocannabinoid system and Nrf2 signal-ing for neuroprotection. Further research is needed to elucidate the involved molecular mecha-nisms and develop effective therapeutic strategies against neurodegeneration.

Background/Aim: Performing emergency surgery for bowel obstruction continues to place a significant strain on the healthcare system. Conventional assessment methods for outcomes in bowel obstruction cases often concentrate on isolated factors, and the evaluation of results for individuals with bowel obstruction remains poorly studied. This study aimed to examine the risk factors associated with major postoperative complications. Methods: We retrospectively analyzed 99 patients undergoing surgery from 2015 to 2022. We divided the patients into two groups: 1) benign related obstruction (n=68), 2) cancer related obstruction (n=31). We used logistic regression, KNN and XGBOOST. We calculated the receiver operating characteristic curve, and accuracy of the model. Results: Colon obstructions were more frequent in the cancer group (p=0.005). Operative time, intestinal resection and stoma were significantly more frequent in the cancer group. Major complications were 41% for the cancer group vs. 20 in the benign group (p=0.03). Uni-and multivariate analysis shows that significant risk factors for major complication were cancer related obstruction and CRP. The best model was KNN with an accuracy of 0.82. Conclusion. Colonic obstruction is associated with a tumor-related blockage. Malignant cancer and an increase in C-reactive protein (CRP) are significant risk factors for patients who have undergone emergency surgery due to major complications. KNN could improve the process of counseling and the perioperative management of patients with intestinal obstruction in emergency settings.

The optimal surgical approach for thymoma resection is still an object of debate. The increasing experience in robotic-assisted thoracic surgery (RATS) has led to the progressive affirmation of this technique as a valid alternative to Video-Assisted Thoracic Surgery (VATS), sternotomy and thoracotomy in this setting. The present study aims to compare the post-operative and short-term results of RATS Thymectomy for thymoma with those of other main surgical approaches (sternotomy, thoracotomy, and VATS) from a high-volume single center.Between May 2021 - September 2023, 40 consecutive patients underwent RATS Thymectomy for I to limited-stage III thymoma in our center. Three homogenous groups of consecutive patients who received thymic surgery by main alternative approaches (sternotomy, thoracotomy, VATS) over the last 5 years, were identified in order to perform a comparative analysis. Data of operative technique, time of surgery, associated resections, conversion rate, overall morbidity, tumor size, radicality, postoperative pain, length of hospital stay, and cosmetic results were recorded and compared between each control group and the RATS group. Tumor size was higher in the sternotomy group, but not significantly. The mean operative time of RATS interventions was significantly lower than that of sternotomy and VATS. It was significantly shorter compared to thoracotomy if excluding docking-undocking time. Higher rate of associated adjacent structures resection was reported in the sternotomy group (p=0.005). Conversion rate was significantly higher in VATS group (p= 0.026) compared to RATS. Postoperative pain at 24 and 48 hours was significantly lower in RATS group compared to the others. Improved cosmetics results were reported after RATS compared to sternotomy (p= 0.0001) and thoracotomy (p= 0.001) groups, with a trend towards better results compared to VATS (p=0.05). Length of hospital stay was shorter in the RATS group with a significant difference vs. the sternotomy group (p<0.001). These results from a single center confirm the safety and effectiveness of RATS for the treatment of limited stage thymoma. Advantage in terms of operative outcomes, post-operative pain, cosmetic results, and hospital stay was observed if compared to the alternative approaches. Short-term oncologic outcome was excellent based on the high complete excision rate of the tumor.

Introduction Emergency laparotomy is a surgical procedure associated with significantly higher mortality rates compared to elective surgeries. Awake laparotomy under neuraxial anaesthesia has recently emerged as a promising approach in abdominal surgery to improve patient outcomes. This study aims to evaluate the feasibility and potential benefits of using lumbar spinal anaesthesia as the primary anaesthetic technique in emergency laparotomies. Methods We conducted a case series involving 16 patients who underwent emergency laparotomy for bowel ischemia, perforation, or occlusion. Lumbar spinal anaesthesia was employed as the main anaes-thetic technique. We analysed patient demographics, clinical characteristics, intraoperative details, and postoperative outcomes. The primary outcome measures included the adequacy of postoper-ative pain control, the incidence of postoperative complications, and mortality rates. Results Among the 16 patients, adequate postoperative pain control was achieved, with only 2 patients requiring additional analgesia. Postoperative complications, including sepsis, wound dehiscence, and pneumonia, were observed in 7 patients (44%). The observed mortality rate was relatively low at 6% (1 patient). Notably, conversion to general anaesthesia was not necessary in any of the cases, and no early readmissions were reported. Discussion Our findings highlight the feasibility and potential benefits of using neuraxial anaesthesia in emergency laparotomies. The observed low mortality rate and the avoidance of conversion to general anaesthesia suggest that lumbar spinal anaesthesia may be a useful alternative in emer-gency settings. However, the occurrence of postoperative complications in 44% of patients indi-cates the need for cautious patient selection and close monitoring. Further research with larger sample sizes is warranted to fully elucidate the efficacy, safety, and potential impact of this tech-nique on patient outcomes in emergency laparotomies.

Abstract: Purpose: High-grade isthmic spondylolisthesis (HGISL) is a severe condition, associated with low-back pain (LBP) and radiculopathies. The present study is a monocentric prospective observational study investigating the clinical-radiological outcomes of a bilateral minimally invasive TLIF (bm-TLIF) for HGISL. Material and Methods: Patients who underwent bm- TLIF for HGISL at our institution, were considered for inclusion. Clinical-radiological outcomes and complications were collected. Results: Twenty-one patients (14M:7F) were included and the mean clinical follow-up (FU) time was 27(±6) months. There was a significative improvement of the mean VAS-back, VAS-legs, ODI, and SF-36 PCS scores, comparing pre- and last FU measurements. The mean pelvic tilt (p0,05). The univariate analysis showed that residual slip angle (> or  10°) may independently influence VAS-b (p

Endodontic treatments are performed to avoid extractions and maintain the natural dentition. Root canal treatments are undertaken to eliminate or prevent an infection within the root canal system. Chemical and mechanical root canal debridement are the main methods used in endo-dontics to remove necrotic tissue, microorganisms, and microbial byproducts from the canal. However, to date there is no objective method to clinically determine the proper root canal disin-fection level and thus proceed with the obturation. Clinicians just rely on their experience and habits or can trust in empirical methods such as the insertion of paper cones inside the channel and then check their appearance after the removal. Even in the in vitro and ex vivo scientific stud-ies there is no objective method to analyze and compare the efficacy of different endodontic chemo-mechanical techniques and materials. The most frequently used method is to visually an-alyze some areas with a scanning electron microscope (SEM), even if the resulting images are hardly quantifiable and could greatly vary according to the analyzed area. A new device to clin-ically test the cleanliness of a root canal and display the result in an objective score was recently developed. The device analyzes the luminescence generated by an enzyme cycling method that process the adenosine triphosphate (ATP), adenosine diphosphate (ADP) and adenosine mono-phosphate (AMP) present in organic residues. The aim of the present in vitro study was to test the efficacy and reliability of this novel device in a controlled in vitro environment, before using it in clinical practice.

Previous studies reported a reduction of the perceived effort and an improvement of the perfor-mances of healthy subjects and patients when a motor task was combined with artistic images with respect to non-artistic images. This phenomenon, called Michelangelo effect, could contribute to the efficacy of art therapy in neurorehabilitation. In this study, the possible occurrence of this effect was tested in a cognitive task by asking to 15 healthy subjects and 17 patients with stroke to solve a digital version of the classical memory card game. Three different types of images were used in a randomized order: French cards, artistic portraits, and photos of famous people (to compensate the possible effects of face recognition). Healthy subjects were involved to test the usability and the load demanding of the developed system, reporting no statistically significant differences among the three sessions (p > 0.05). Conversely, patients had a better performance in terms of time (p = 0.014) and number of trials (p = 0.007) needed to complete the task in presence of artistic stimuli, accompanied by a reduction of the perceived effort (p = 0.033). Furthermore, artistic stimuli, with respect to the other two types of images, seemed more associated to visuo-spatial control than to linguistic functions.

Introduction: maxillary hypoplasia and mandibular asymmetry may be corrected with orthognathic surgery at the completion of growth. Many patients require segmental Le Fort I osteotomies to obtain the most stable results. Unfortunately, if Invisalign is chosen for pre-surgical preparation, ClinCheck © software does not allow for prediction when these complex surgeries are planned. The objective of this paper was to show the potential of aligners beyond its software in most complex cases like multiple-piece maxillary osteotomies in cleft and non-cleft patients. Method: Thirteen patients who underwent pre-surgical treatment with clear aligners-Invisalign (study group) were matched in terms of diagnosis, surgical procedure, and orthodontic complexity with thirteen patients treated using fixed appliances (control group). A technique based on simple superimposition was devised to enhance the software for creating a suitable occlusion for segmental pre-surgical treatments. Virtual curves following the lower arch were employed to guide the correct pre-surgical positions of the upper teeth. The amount of impressions required in both groups to achieve satisfactory pre-surgical alignment of the segmented arches was compared. Results: one or no refinement phase were needed in the Invisalign group to reach an acceptable pre-surgical occlusion while the amount of pre-surgical impressions taken in order to reach adequate coordination with fixed appliance treatment was slightly higher. The average overall treatment duration did not show a statistically significant variation between the groups. Conclusions: it appears that clear aligner could serve as an effective treatment for individuals with skeletal discrepancies, including cleft and craniofacial anomalies, necessitating segmental Le Fort I osteotomies when aided by the suggested superimposition approach during digital pre-surgical movement simulations. More sophisticated softwares will certainly be implemented in the future.

Detecting volatile organic compounds (VOCs) emitted from different plant species and their or-gans can provide valuable information about plant health and environmental factors that affect them. For example, limonene emission can be a biomarker to monitor plant health and detect stress. Traditional methods for VOC detection encounter challenges, prompting the proposal of novel approaches. In this study, we proposed integrating electrospinning, molecular imprinting, and conductive nanofibers to fabricate limonene sensors. In detail, polyvinylpyrrolidone (PVP) and polyacrylic acid (PAA) served here as fiber and cavity formers, respectively, with multi-walled carbon nanotubes (MWCNT) enhancing conductivity. We developed one-step monolithic molecularly imprinted fibers, where S(-)-limonene was the target molecule using electrospinning technique. The functional cavities were fixed using UV curing method, followed by a target mol-ecule washing. This procedure enabled the creation of recognition sites for limonene within the nanofiber matrix, enhancing sensor performance and streamlining manufacturing. Humidity was crucial for sensor working, with optimal conditions at about 50% RH. The sensors rapidly re-sponded to S(-)-limonene, reaching a plateau within 200 seconds. Enhancing fiber density im-proved sensor performance, resulting in a lower limit of detection (LOD) of 137 ppb. However, excessive fiber density decreased accessibility to active sites, thus reducing sensitivity. Remarka-bly, the thinnest mat on the fibrous sensors created provided the highest selectivity to limonene (Selectivity Index: 72%) compared to other VOCs, such as EtOH (used as a solvent in nanofiber development), aromatic compounds (toluene), and two other monoterpenes (α-pinene and linalo-ol) with similar structure. These findings underscored the potential of the proposed integrated approach for selective VOC detection in applications such as precision agriculture and environ-mental monitoring.

This qualitative study explores the dynamics of customer satisfaction and supplier collaboration within Italian restaurant operations. Through in-depth interviews, participant observations, and document analysis, the research investigates key factors influencing these relationships. Trust and communication emerged as foundational elements, crucial for ensuring reliable ingredient supply and maintaining culinary authenticity. Quality and authenticity of ingredients were identified as primary drivers of customer satisfaction, underscoring the strategic role of suppliers in delivering superior dining experiences. Customer feedback played a pivotal role in shaping operational practices, highlighting the iterative process of adapting to customer preferences to enhance service delivery and loyalty. Emotional intelligence among managers facilitated effective supplier relationships, fostering collaborative partnerships and navigating operational challenges with empathy and skill. Economic considerations were vital in balancing cost efficiencies with quality standards, guiding strategic decisions in supplier management. Technological integration enhanced supply chain management, optimizing logistics and responsiveness to market demands. The adoption of sustainable sourcing practices reinforced restaurants’ commitment to environmental stewardship and community engagement, aligning with consumer preferences for ethical dining options. The findings suggest actionable insights for restaurant managers to optimize supplier collaborations, enhance operational efficiency, and sustain competitive advantage in the hospitality industry.

This study explores the intricate dynamics of customer-centric supply chains and the pivotal role of marketing innovations in enhancing efficiency and customer satisfaction. Employing a qualitative research methodology, semi-structured interviews were conducted with key stakeholders in supply chain management across various industries, providing rich insights into the practices and perceptions related to customer-centric strategies. The findings highlight the centrality of understanding and anticipating customer needs, which necessitates a cultural shift within organizations to prioritize customer satisfaction at all levels. Digital marketing tools, data analytics, e-commerce platforms, and social media emerged as critical enablers of these customer-centric supply chains, facilitating real-time insights, direct customer engagement, and personalized experiences. The integration of these technologies has led to more accurate demand forecasting, optimized inventory levels, and enhanced agility and responsiveness in operations. Furthermore, the study underscores the importance of collaboration and partnership within the supply chain network, emphasizing joint initiatives and strong relationships with stakeholders as key drivers of improved resource utilization and service levels. Sustainability, entrepreneurship, and emotional intelligence also play significant roles in shaping effective customer-centric supply chains. Sustainable practices meet growing consumer demands for environmental and social responsibility, while an entrepreneurial mindset fosters continuous innovation and competitiveness. Emotional intelligence among leaders and employees enhances trust, conflict resolution, and collaboration, contributing to a positive organizational culture and superior customer satisfaction. Overall, this study provides comprehensive insights and actionable recommendations for businesses seeking to navigate the complexities of customer-centric supply chain management and leverage marketing innovations to achieve sustainable competitive advantage.

This qualitative research explores the dynamics of collaborative marketing and supply chain strategies for enhanced product lifecycle management. Through in-depth interviews with industry stakeholders, key themes, challenges, and implications of collaboration emerge. Trust, communication, technology, strategic alignment, and sustainability are identified as critical factors driving successful collaboration. The study highlights the transformative potential of collaboration in driving innovation, efficiency, and customer satisfaction. Despite challenges such as aligning objectives and ensuring data security, collaborative strategies offer significant opportunities for value creation and differentiation. The findings underscore the importance of building trust, leveraging technology, and integrating sustainability considerations in collaborative efforts. Strategic alignment and cultural fit among partners are essential for overcoming differences and achieving common goals. The implications of the research extend to practitioners seeking to enhance collaboration in their organizations and researchers exploring collaborative practices in different industries and contexts. Future research could further explore the impact of collaboration on stakeholder perspectives and outcomes. By addressing challenges and leveraging opportunities, organizations can maximize the benefits of collaborative marketing and supply chain strategies to drive sustainable growth and competitive advantage in today's dynamic business landscape.

Fatigue is a recognized concern in air traffic management, prompting international bodies like ICAO and EASA to advocate for Fatigue Risk Management Systems (FRMS). EU Regulation 2017/373, effective since January 2020, imposes specific requirements on air traffic service providers regarding controllers' fatigue, stress, and rostering systems, as part of safety management protocols. Despite active campaigns promoting fatigue awareness in air traffic control (ATC), there remains a need for standardized operational requirements. Eurocontrol recently published "Guidelines on fatigue management in ATC rostering systems" (April 23), aiming to facilitate the adoption of common fatigue operational standards. However, neither EU Regulation 2017/373 nor existing documentation specifies exact rostering criteria. Air Navigation Service Providers (ANSPs) typically derive these criteria from scientific literature, best practices, historical data, and legal and operational necessities. Yet, assessing and monitoring fatigue in operational settings can be complex and require long-term studies due to its multifaceted nature, spanning factors such as sleep quality, circadian rhythms, psychosocial influences, individual traits, and environmental conditions. The case studies reported in this paper represent an attempt to create an evidence-based protocol for fatigue risk monitoring in ATC operations, utilizing a non-invasive approach and collecting multidimensional data. The two case studies involved en-route and tower controllers from different ATC Centers, and the results underscore the importance of fatigue assessment in ATC and elucidates challenges in implementing fatigue monitoring within operational contexts.

Weather conditions appear to be undergoing significant deviations from the long-term average, marked by pronounced extremes of heat, prolonged droughts, and heightened rainfall occurring with greater frequency worldwide. Consequently, new patterns of extreme weather are emerging, like the unusual and unorganized tropical cyclone called "Yaku", that influenced the extreme amount of rain that between March 6th to 10th, 2023 hits more than 1000 districts in the northwestern of Peru. One of the district more affected was Íllimo, in the Lambayeque province, due to the river that pass through the city, so called “La Leche”, after the continuous and intensive rain overflow devastating his surrounding areas and causing victims and damage. This emergency provided and excellent opportunity to apply, on the aforementioned areas, the “change detection” technique, that allows identifying areas of change between data obtained before and after of emergency events. In this research, optical data (Sentinel-2, Landsat, MODIS Terra and Aqua, and PeruSAT-1) and synthetic aperture radar (SAR) data (Sentinel-1 and COSMO SkyMed) were analyzed. A benchmark could also be carried out between open-source and commercial spatial analysis tools. The results indicated that in an extreme rain event the optical data are obscured by clouds and do not allow their use, while SAR data overcome clouds, and can be used for this research. The benchmark indicated that using the Jaccard index score, the Sentinel-1A set showed a 33% of correlation, while COSMO SkyMed demonstrated a 38% of match between the maps. The results obtained could be used to sensitize the population and develop a better management of future emergency events (floods) in different areas of Peru.

Background: There has been a lack of tools to identify listening difficulties in school settings for both hearing and hearing-impaired Italian students. Thus, the present study aimed to realize cross-cultural adaptation and validation of the Listening Inventory for Education-Revised for Italian students (LIFE-R-ITA). Methods: Following the validation of two forward-backward translations by a multidisciplinary committee, the content validation for the LIFE-R-ITA was performed by pre-testing six implanted children (8-18 years old). After minor cross-cultural adaptations, normative data were collected from a sample of 223 hearing students enrolled in different school settings and educational degrees. Results: For the LIFE-R-ITA, hearing students showed an average score of 72.26% (SD=11.93), reflecting some listening difficulties. The subscales (LIFE total, LIFE class, and LIFE social) indicated good internal consistency. All items were shown to be relevant. Most challenging situations happened when listening in large rooms, especially when other students made noise. LIFE social scores were significantly worse than those of LIFE class (p &lt; 0.001). Conclusions: The LIFE-R-ITA may support teachers and clinicians in assessing students’ self-perception of listening at school. Such understanding may help students overcome their listening difficulties, by planning and selecting the most effective strategies among classroom interventions.

The research theme originates as a design experiment for a sustainable housing system built on-site. The context is Niamey, the capital of Niger. The study takes into account the environmental issues in the construction sector and aims to find a solution capable of meeting housing, environmental, and economic needs. In the field of earthen construction, the most important developments have been achieved in manufacturing methods. In particular, the use of an additive digital manufacturing system, such as large-scale 3D printing, allows the construction of complex shapes derived from structural and thermal studies, maintaining a high degree of automation in the construction process, reducing construction times and labor costs. The research investigates the possibility of responding to housing and environmental needs with a settlement system made entirely of printed earth, maintaining the highest possible degree of automation. Starting from a study on the state of the art of 3D printing in architecture and printable earthen compounds, the design choices of similar cases are analyzed to understand the construction techniques, potentials, and limitations of the medium. Finally, a design proposal is developed based on the definition of a fully printable functional module, which, upon aggregation, determines the characteristics of the final settlement.

Most European cities are characterized by very large areas, often formed by buildings with low quality, from a series of point of view. The possibility of renovating them is strategic to improve both the quality of life and to the possibility of economic recovery for building companies. In the last decades, the attention of the scientific community has been addressed to the energy renovation, thanks to the strong activities of the European Community in this field. However, since a relevant part of the EC territory is at risk of earthquake, the possibility to combine both energy and seismic renovation actions may be strategic for many countries. In particular, Italy and Romania are linked by a common social tradition that springs from the Roman Empire. Nowadays, this link is stronger, thanks to common interests in social, cultural and business fields. Therefore, the investigation of possible synergies for seismic and energy renovation strategies may be really interesting for both countries. This paper represents the first step in this direction. After an overview of regulations and common practices for buildings with reinforced concrete structures, in both states, some key combined renovation interventions will be described and discussed, as well as advantages and perspectives of integrated renovation approaches.

Purpose: This research investigates the influence of supplier relationship management methods on the operational efficiency and customer satisfaction of Italian restaurants.Design/Methodology/Approach: Employing a qualitative research methodology, data was gathered via interviews and questionnaires from a sample of 200 individuals across many Italian restaurants throughout Italy.Findings: The investigation uncovered robust relationships between supplier relationship management approaches and other operational factors, highlighting the interdependence of management tactics. Efficient management of supplier relationships not only improves the efficiency of the supply chain, but also has an impact on the procurement of ingredients, the variety of menu options, and the integration of technology.Research Limitations/Implications: Although technology developments were shown to enhance operational efficiency, their influence on customer satisfaction was minimal. The research highlights the complex nature of factors that influence customer happiness, indicating the need of adopting a well-rounded strategy that combines technology with personalised care. Identified continuous improvement opportunities provide valuable insights for restaurant owners to enhance strategy and better meet consumer expectations.Practical Implications: This research provides useful insights on the management of Italian restaurants, but it has limitations due to its qualitative approach and dependence on self-reported data.Social Implications: However, the results add to the current knowledge and provide practical consequences for restaurant owners who want to improve their operational efficiency and customer pleasure.Originality/Value: Italian restaurants may achieve long-term success in a highly competitive culinary industry by acknowledging the interdependence of management strategies and using customer-focused techniques.

The paper examines the evolution and crucial role of energy communities in the context of the transition to renewable energy sources. Such communities are presented as an innovative and resilient response to the challenges posed by climate change. Their importance emerges from their ability to decentralise energy production, increasing local security and reducing dependence on non-renewable energy sources and external suppliers. However, despite the obvious benefits, the contribution highlights several challenges, such as the need for significant upfront investment and the presence of regulatory barriers that may hinder the integration of these solutions into existing energy systems. A detailed bibliometric analysis is used, focusing on specific research areas and using tools to map the most relevant keywords and emerging trends. The results of the bibliometric analysis highlight how energy communities are emerging as key players in the sustainability landscape, capable of addressing and overcoming contemporary environmental challenges. The research reaffirms the transformative potential of energy communities in promoting a more sustainable and resilient future.

We propose a new methodology for long-time biopotential recording based on MEMS multisensor integrated platform featuring a commercial electrostatic charge transfer sensor. That family of sensors was originally intended for presence tracking in automotive, so the existing setup has been engineered for the acquisition of electrocardiogram, electroencephalogram, electrooculogram and electromyography, designing a dedicated front-end and writing a proper firmware for the specific application. Systematic tests on controls and nocturnal acquisitions from patients in domestic environment will be discussed in detail. The excellent results candidate this technology to provide a low power, unexplored solution to biopotentials acquisition. The technology breakthrough is in that it enables adding this type of functionality to existing MEMS boards at near-zero additional power consumption. For these reasons, they open to additional possibilities for wearable sensing and strengthen the role of MEMS technology in medical wearable applications for long time synchronous acquisition of a wide range of signals.

(max 200 words): The contamination of groundwater is a serious concern for ecosystems and human health. In this regard, biochar represents a promising low-cost and sustainable material for in-situ groundwater remediation. Herein, biochar waste of biomass energy production process derived from pine wood gasification at 950°C was used as active carbonaceous material in combination with different biopolymers: chitosan (CS), alginate (ALG), potato starch (PST), and carboxymethylcellulose (CMC) to produce BC@biopolymer composite materials. Different concentrations of biochar (0.3–1.0 g·L-1) and biopolymers (0.2–20.0 g·L-1) were tested and blending mode was used as simple and straightforward strategy to obtain BC composites. Scanning electron microscopy (FE-SEM), UV-Visible, infrared (FT-IR) spectroscopy, specific surface area (BET method), pore volume, and pore size distribution (textural parameters), dynamic light scattering (DLS), and ζ-potential were used to investigate the composite chemical structure, stability, and to assess the interaction among counterparts. On optimized formulations, breakthrough tests and batch adsorption isotherms on trichloroethylene (TCE) as a model contaminant were performed to evaluate the capability of composites to be delivered through a porous medium determining the transport properties, (hydrodynamic dispersion retention percentage, and adsorption capacity). This biopolymer-modified biochar holds significant promise as a sustainable and effective solution to address various groundwater pollution challenges.

Cocoa is a natural resource that plays a very important role globally, being one of the most produced and traded commodities. Being a labor-intensive product and considering that its cultivation involves about 50 million people globally, it seems significant to explore its social sustainability. In light of this, this research aimed to map social risks within the cocoa supply chain from a life cycle perspective. Therefore, according to a Reference Scale Approach, or Type I, the Social Life Cycle Assessment was used, considering the two most influential Countries in its production, i.e. Côte d'Ivoire and Ghana. The results showed that there could be a very high risk that more than half of the cocoa globally is produced through child labour and with wages too low to guarantee workers a decent living, returning incomes of $30-38/month. Forced labour is much less frequent than child labour, while cocoa from Ghana may induce a high risk of improper work, considering the 30.2 hours per week worked by farmers. This is mainly due to the low association power of 10-16%, which reveals a high risk that workers may not organize themselves into trade unions. Finally, at 23-25%, there is also a very high risk of discrimination due to the high presence of migrant labour. The S-LCA results, therefore, showed that the cocoa industry is still characterized by socially unsustainable sourcing.

This article examines the sustainability of beer production through a review of the available scientific literature. Beer production, a beverage of both cultural and industrial importance at a global level, significantly impacts the environment due to the use of natural resources and emissions generated during the various stages of the production process. This study adopts the Life Cycle Analysis (LCA) approach to assess the environmental impact of beer production, from the extraction of raw materials to the disposal of the finished product. Only peer-reviewed studies published between 2001 and July 2024 that address at least one stage of the beer production process were included in the review. The results highlight the critical points of the production cycle and suggest sustainable practices to reduce the environmental impact. This study provides a detailed overview of LCA methods applied to beer production, including defining objectives and scope, life cycle inventory, impact assessment and interpretation of results, and providing recommendations to improve sustainability in the brewing sector. The objectives of this study were to identify the critical point within the beer production cycle that significantly contributes to environmental impacts and to suggest sustainable practices and strategies that can be adopted to reduce the environmental footprint of beer production.

This qualitative study explores the dynamics of supplier relationships among Italian restaurant managers, aiming to uncover the strategic practices and challenges in supplier relationship management (SRM) within the culinary industry. Through semi-structured interviews with a diverse sample of restaurant managers across Italy, the study examines how trust, communication, adaptive sourcing strategies, and innovation influence supplier interactions and operational outcomes. Findings reveal that trust-building is foundational to establishing reliable supplier partnerships, crucial for ensuring consistent delivery of high-quality ingredients essential for culinary excellence. Effective communication channels and negotiation techniques are pivotal in clarifying expectations, resolving conflicts, and fostering collaborative relationships with suppliers. Adaptive sourcing strategies, including diversification of supplier bases and local sourcing initiatives, enable managers to navigate market dynamics and meet consumer demands effectively. Innovation emerges as a catalyst for differentiation and sustainability in supplier relationships, with managers engaging in collaborative product development and embracing sustainability initiatives to align with consumer preferences and corporate values. Despite facing challenges such as pricing pressures, supply chain logistics complexities, and regulatory compliance, proactive management strategies and operational agility enable managers to mitigate risks and capitalize on opportunities in supplier management. Theoretical implications enrich understanding of SRM dynamics in the culinary sector, while practical implications suggest strategies for optimizing supplier relationships, enhancing operational efficiency, and sustaining competitive advantage. Future research could explore technological advancements, consumer trends, and longitudinal impacts of SRM practices on business performance within the restaurant industry.

This qualitative study explores the complexities of managing suppliers for quality among Italian restaurant owners, investigating their perspectives, challenges, and strategic approaches in supplier management. Through semi-structured interviews with 15 restaurant owners across diverse regions of Italy, key themes emerged regarding supplier selection criteria, challenges in supplier management, strategies for ensuring quality, and the impact of external factors on supply chain dynamics. Findings reveal that authenticity, reliability, and sustainability are paramount in supplier selection, aligning with consumer expectations for genuine Italian ingredients and culinary excellence. Economic pressures, operational disruptions, and external influences, exacerbated by events like the COVID-19 pandemic, necessitate adaptive strategies such as cost-effective sourcing, rigorous quality control measures, and technological integration to maintain supply chain continuity and uphold quality standards. Strategic initiatives, including rigorous quality assurance protocols, digital procurement platforms, and collaborative partnerships with suppliers, enhance transparency, efficiency, and responsiveness in supply chain operations. Entrepreneurial initiatives and emotional intelligence play crucial roles in fostering innovative sourcing strategies and building trust-based relationships with suppliers, enhancing supply chain resilience and responsiveness to market demands. External factors, such as market dynamics and sustainability trends, underscore the need for continuous adaptation and strategic foresight in supplier management practices. The study contributes to understanding the intricate dynamics of supplier management in Italian cuisine, offering insights for enhancing operational efficiency, maintaining quality standards, and fostering sustainable supplier relationships in the food service industry.

This study investigates the impact of integrated marketing strategies on supply chain efficiency in retail businesses. Through qualitative research methods including in-depth interviews and case studies, the study explores how aligning marketing activities with supply chain operations influences various aspects of retail performance. The findings reveal that integrated marketing strategies lead to enhanced demand forecasting accuracy, improved customer satisfaction, and greater operational efficiency. By leveraging technology, such as artificial intelligence and data analytics, retailers can optimize inventory management, personalize offerings, and anticipate consumer preferences in real-time. Cross-functional collaboration and effective leadership emerge as crucial factors in fostering integration and overcoming challenges such as data management and cultural resistance. Additionally, the study highlights the significance of sustainability and entrepreneurship in driving integrated strategies, with implications for long-term competitiveness and brand reputation. The findings underscore the importance of viewing marketing and supply chain functions as interconnected elements of a holistic business strategy, rather than operating in silos. The study offers valuable insights for theory, practice, and future research, emphasizing the need for holistic and collaborative approaches to integration in the dynamic retail landscape. By embracing integrated marketing strategies, retailers can position themselves for success in an increasingly competitive market environment, driving innovation, efficiency, and customer satisfaction.

Purpose: This study aims to investigate the role of blockchain technology in enhancing supply chain transparency in Italy.Design/Methodology/Approach: A quantitative research approach was employed, with data collected through a structured questionnaire distributed to 240 companies across various industries in Italy. The questionnaire focused on assessing blockchain adoption rates, interoperability standards, stakeholder collaboration, regulatory support, cost considerations, and perceived impacts on supply chain transparency.Findings: The findings reveal high levels of blockchain adoption among surveyed companies, with strong positive correlations observed between blockchain adoption and interoperability standards, stakeholder collaboration, and regulatory support. However, challenges such as cost considerations and potential trade-offs between interoperability and transparency were also identified. Overall, blockchain technology shows promise in improving supply chain transparency in Italy.Research Limitations/Implications: This study is limited by its focus on a specific geographical context (Italy) and the use of self-reported data. Future research could explore the dynamics of blockchain adoption in other regions and employ objective measures to assess supply chain transparency.Practical Implications: The findings offer practical insights for businesses and policymakers aiming to leverage blockchain technology to enhance supply chain transparency and efficiency.Social Implications: Blockchain adoption has the potential to foster greater trust and accountability within supply chains, benefiting various stakeholders including consumers, producers, and regulators.Originality/Value: This study contributes to the growing body of literature on blockchain technology in supply chain management, particularly within the Italian context, by providing empirical evidence on its adoption and impact on transparency.Limitations: Despite the robust methodology employed, limitations include the reliance on self-reported data and the exclusion of qualitative insights.

Background: Knowledge of vascular anatomy and its possible variations is essential for performing embolization or revascularization procedures and complex surgery in the pelvis. The obturator artery (OA) is a branch of the anterior division of the internal iliac artery (IIA), and it has the highest frequency of variation between branches of the internal iliac artery. Possible anomalies of the origin of the obturator artery (OA) should be known when performing pelvic and groin surgery, where its control or ligation may be required. The purpose of this systematic review and meta-analysis, based on Sanudo’s classification, is to analyse the origin of the obturator artery (OA) and its variants. Methods: Thirteen articles, published between 1952 and 2020, were included in this systematic review and meta-analysis. Results: The obturator artery (OA) was present in almost all cases (99.8%): the pooled prevalence estimate for internal iliac artery (IIA) was 77.7% (95% CI 71.8% – 83.1%) vs 22.3% (95% CI 16.9% – 28.2%) for the external iliac artery (EIA). In most cases, the obturator artery (OA) originated from the anterior division trunk of the internal iliac artery (IIA) (61.6%). Conclusion: Performing preoperative radiological studies to know the pelvic vascular pattern and having awareness to evaluate possible changes in the obturator artery can reduce the risk of iatrogenic injury and complications

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.

Traversal time in tunneling effect for ultrasonic waves in tapered waveguides is derived considering its analogy with quantum and electromagnetic waves tunneling. If, as traversal time, the so called phase time is considered, the ultrasonic wavepacket shows the equivalent in acoustics of superluminality i.e. the derived velocity , crosses the limit of bulk transverse ultrasonic waves in the medium of the waveguide that is the equivalent of c in the quantum and electromagnetic cases. Graphs clearly illustrating this so called Hartman effect are obtained confirming the experimental results in the three different fields.

Mast cells are tissue-resident immune cells distributed in all tissues and strategically located close to blood and lymphatic vessels and nerves. Thanks to the expression of a wide array of receptors, mast cells act as tissue sentinels, able to detect the presence of bacteria and parasites and to respond to different environmental stimuli. Mast cells originate from bone marrow progenitors that enter the circulation and mature in peripheral organs under the influence of microenvironment factors, thus differentiating in heterogeneous tissue-specific subsets. Even though mast cell activation has been traditionally linked to IgE-mediated allergic reactions, a role for these cells in other pathological conditions including tumor progression has recently emerged. However, several aspects of mast cell biology remain to be clarified. The advent of single-cell RNA sequencing platforms has provided the opportunity to understand mast cell origin and differentiation as well as the phenotype and functions within different tissues, including the gut. This review recapitulates how single cell transcriptomic studies provided insight into mast cell development as well as into the functional role of intestinal MC subsets in health and disease.

Background: Over the past decades, efforts have been made to improve the nutritional well-being in people with cystic fibrosis (pwCF). Due to the correlation observed between nutritional indices and lung function, prevailing recommendations consistently advocate for BMI percentile goals at or above the 50th percentile in pwCF. Recent global trends show a notable increase in overweight and obese statuses among pwCF. This study aims to explore the nutritional status of Italian pwCF. Methods: Data from the Italian CF Patient’s Registry were analysed to assess the proportion of individuals categorized as underweight, target weight, overweight, and obese from 2010 to 2021. Patient-level comparison data from 2021 were also examined to identify potential determinants of overweight and obesity. Results: Analysis spanning 2010 to 2021 reveals a decrease of approximately 40% in underweight status among adults, while the proportion of malnourished patients 90, and lower prevalence of Pseudomonas aeruginosa colonization. Conclusions: Our study confirms the evolving nutritional status landscape among Italian adult pwCF, with a significant shift towards overweight and obesity over the past decade. These trends highlight the need for proactive measures within CF standards of care to adapt and address the changing needs of patients.

In this work, the first phytochemical analysis ever performed on the whole cone of Araucaria bidwillii Hook is presented. This was carried out by means of column chromatography, NMR spectroscopy and MS spectrometry on the female cone, evidencing the presence of forty metabolites, thirty-three of which are primary metabolites whilst the remaining are secondary metabolites. A chemophenetic evaluation was also performed reporting seven new compounds for the species. These results are important since they provide more information on the phytochemistry of this species and also underline the need to study more of its populations.

This paper presents an innovative approach for improving the seismic protection of existing structures by introducing an additional dissipative structure (ADS). The seismic energy impacting the building can be dissipated through the contribution provided by the ADS, thereby reducing the need for the existing building to ensure its seismic capacity. This retrofitting technique is well-suited for structures facing architectural restrictions or challenging-to-update elements. It can help address foundation issues by applying loads to new external components. This paper describes the design of the ADS and proposes a displacement-based design procedure. The design process involves a non-linear static analysis and a simple procedure that must be iteratively repeated until the retrofitting target is achieved. This approach is simple and computationally efficient and can also be used for complex and irregular structures. Such structures are frequently encountered, and existing structures often exhibit unusual geometries and materials requiring extensive numerical modeling. The efficacy of the technique was evaluated using the case studiy of a school building located in central Italy. The results of numerical analyses indicated that owing to the ADS’s contribution, the seismic capacity of both buildings was enhanced, addressing the challenges associated with complex foundation interventions.

We present a case report of a 26-years-old female suffering from Coffin Siris Syndrome, who underwent orthodontic treatment and surgery to solve her malocclusion and improve her aes-thetics and functional occlusion. Methods: The presurgical phase involved multibracket self-ligating attachments, Damon prescription. The patient underwent maxillofacial surgery to correct the severe skeletal malocclusion and relocate the bone bases in the right relationship. The post-surgical orthodontic treatment was performed to complete the alignment. Results: The pa-tient improved her aesthetics and functional abilities. Conclusions: Syndromic patients can un-dergo orthodontictreatment if comorbidities and collaboration allow it. Support and collaboration of families and psychotherapists must be considered, but clinical cases of syndromic patients can be faced and solved. Obviously, each syndromic patient is considered unique, and the risk-benefit ratio must be correctly assessed for each one.

Increasingly, information technology facilitates the storage and management of data useful for risk analysis and event prediction. Studies on data extraction related to occupational health and safety are increasingly available; however, due to its variability, the construction sector warrants special attention. This review is conducted under the research programmes of the National Institute for Occupational Accident Insurance (Inail). Objectives: The research question focuses on identifying which data mining (DM) methods, among supervised, unsupervised, and others, are most appropriate to be applied to certain investigation objectives, types, and sources of data, as defined by the authors. Methods: Scopus and ProQuest were the main sources from which we extracted studies in the field of construction, published between 2014 and 2023. The eligibility criteria applied in the selection of studies, were based on the Preferred Reporting Items for Systematic Review and meta-analysis (PRISMA). For exploratory purposes, we applied hierarchical clustering, while for in-depth analysis, we use principal component analysis (PCA) and meta-analysis. Results: The search strategy based on the PRISMA eligibility criteria, provided us with 61 out of 2,234 potential articles, 202 observation, 91 methodologies, 4 survey purposes, 3 data sources, 7 data types, and 3 resource type. Cluster analysis and PCA organized the information included in the paper dataset into two dimensions and labels: "supervised methods, institutional dataset, and predictive and classificatory purposes" (correlation 0.97÷8.18E-01; p-value 7.67E-55÷1.28E-22) and the second, Dim2 "not-supervised methods; project, simulation, literature, text data; monitoring, decision-making processes; machinery and environment" (corr. 0.84÷0.47; p-value 5.79E-25÷3.59E-06). We answered the research question regarding which method, among supervised, unsupervised, or other, is most suitable for application to data in the construction industry. Conclusions: The meta-analysis provided an overall estimate of the better effectiveness of supervised methods (Odds Ratio = 0.71, Confidence Interval 0.53÷0.96) compared to not-supervised methods.

Despite the successes earned in cataloguing and finding the role of the most of molecular components in living matter, the “biochemical and molecular” perspective, popular in biology, medicine and genetics, is unable to give account for crucial topics as the faculty of living systems to “feel”, to “perceive” what a given stimulus implies (means, indeed) for their survival. Condensed matter physics too, if bounded to a local, short-range, and perturbative approach, fails dramatically. This is also due to the role commonly assigned to water – actually the main constituent of living matter – deemed for long time to be merely chemical (as “solvent” or a reactant/product). Nonetheless, today many evidences show how living matter can be right conceived as a super-structured coherent water-based matrix, suggesting that the characterization of bio(electro)chemical and physical processes undertaken at molecular level in living matter, would let us unable to answer a question like this: what allows an amoeba, moreover without any neurons, to “know” to get closer to a nutrient or escape away from a toxin? I propose that to pursue such a fundamental inquiry it’s necessary an essentially relational approach, that is: to consider the living being at its grounding as the outcome of a physical history of relationships where symmetry-breakings, dissipation and coherence yield the emergence of the living state of matter, conceivable only as a time-dependent open process, and not as a portraited “body”. The effective tools to build up such an approach may be retrieved in far-from-equilibrium thermodynamics (TD), symmetry-breakings and gauge-fields theory, science of complexity, within the framework of a Quantum Field Theory. Indeed, within a field-view of matter, and of water especially, as it has been developed by a Quantum Electrodynamic (QED) description of condensed matter, it’s possible to give account for a physical basis too such an epistemologically elusive, though crucial, feature of living systems (i.e.: perception and meaning). The emerging landscape allows some important meditations about adaptation, evolution, ecodynamics, and about different conceptions of complexity and “information” in living realm. Furthermore, some neuroscientific themes like consciousness, qualia and their links to artificial intelligence could be supplied with due insights.

Nietzsche is almost always regarded as one of the thinkers who advocate extreme individualism, totally indifferent to or exclusively polemical towards the public human dimension. While this is very difficult to contradict, if we read his texts carefully we can see how his constant celebration of the individual runs parallel to an acute awareness of living in a new era, which he defined as ‘the century of the multitude and the masses’. The herd, conformism, mediocrity, public opinion: a civilisation in which community attempts suffocate all individual inspiration, and which therefore seems to row in the opposite direction. Although Nietzsche often uses collective life merely as a negative pole for more effectively emphasising the individual, his provocative words—pushed to the limits of the inexorable victory of the herd and of the paradoxical impossibility of all that is ‘public’—offer us a direct testimony of the tragic way of life of the man of his time. This provides us with an extremely clear and interesting phenomenological cross-section of the social sphere, as well as a very finely tuned and valuable seismograph for the continual monitoring of our everyday coexistence with and perception of the constantly incumbent dangers of its degeneration.

Background: This systematic review aims to investigate whether percutaneous transhepatic gallbladder drainage (PTGDB), as definitive treatment, is superior to emergency cholecystectomy (EC) in high-risk patients with acute cholecystitis (AC). Material and methods: A systematic literature search was performed until December 2022 using Scopus, Medline/PubMed and Web of Science databases in order to compare PTGDB as definitive treatment vs EC in AC. Results: Seventeen studies (1 Randomized Control Trials and 16 observational studies) have been included with a total of 783,672 patients (32,634 treated with PTGDB vs 4,663 who underwent laparoscopic cholecystectomy, 343 who underwent open cholecystectomy and 746,032 who underwent cholecystectomy, but without laparoscopic or open approach being specified). The quality assessment (ROBINS-I) of the not randomized studies showed a serious risk, differently the evaluation of the randomized study (RoB 2) showed a low risk of bias. Analysis of the results shows that PTGDB, despite being minimally invasive, do not have different incidence of complications than EC (RR 0.77 95% CI [0.44 to 1.34]; I2 = 99%; P=0.36). A lower postoperative mortality was reported in patients who underwent EC (2.37%) than in PTGDB group (13.78 %) (RR 4.21; 95% CI [2.69 to 6.58]; P < 0.00001), furthermore the risk of hospital readmission for biliary complications (RR 2.19 95% CI [1.72 to 2.79]; I2 = 48 %; P<0.00001) and hospital stay (MD 4.29 95% CI [2.40 to 6.19]; P<0.00001) were lower in EC group. Conclusions: No advantage in using PTGDB as a definitive treatment over EC in the management of critically ill patients with AC has been demonstrated; the results of our systematic review and meta-analysis suggest using EC as the treatment of first choice, even for very high-surgical-risk patient in which PTGDB should be reserved. The major limitation of this systematic review and meta-analysis is associated to a low quality of evidence for the serious bias in the not randomized studies. For this reason, new high powered and well-designed clinical trials are needed to recommend PTGDB as definitive treatment in patients unfit for surgery or those who refuse to undergo surgery.

Viscum album L., also known as “Mistletoe”, is a hemiparasitic plant native to the European continent that grows on various host trees. This plant contains a wide variety of active compounds that can be used for treat various diseases, such as diabetes, hypertension, as an anti- inflammatory and antioxidant. However, it is most indicated in human medicine for the adjuvant treatment of cancer patients. Both for its properties directed against neoplastic cells and for its antioxidant and anti-inflammatory properties. In Veterinary Medicine, I am very few studies are recorded for animals, although formulations are available for commercial use in oral and injectable form, mostly for homeopathic use. Many studies have been conducted on a large scale by groups of independent researchers and doctors in several countries, such as Switzerland, Germany and Brazil. Therefore, this review aimed to collect data on the use of Viscum album in Veterinary Medicine in order to encourage research in this sector not only in oncological diseases but in other directions in which Viscum can find use as an anti-pretensive and anti-diabetic agent. Introduction: Lectins, flavonoids, phenols such as phenylpropanoids, coumarins, sterols, lignans, terpenoids, phenylpropanoids, alkaloids, fatty acids and viscotoxins are among the main active ingredients present in the phytocomplexes of the Viscum album plant. In particular, Attention should be given to specific oligoproteins in consideration of their activity biological [1]. present in The foliage and fruits of V. album, as in other related species, contain low-weight proteins molecular type of thionin, called viscotoxins, as well as characteristic lectins, called viscolectins, both can contribute to its system defense and can be found in extracts and related products. These classes of Viscum microproteins have received considerable attention due to their contribution to effects cytotoxics and immunostimulants of mistletoe extracts used in medicine, as discussed later, including their mechanism of action [ 2–3] viscotoxins can increase the number of cells circulating naturalkillers and consequently improve the response host antitumor immunity [ 8]. Likewise, the a viscotoxin has an effective immunomodulatory impact on human and animal granulocytes [ 9, 10] and also acts on cellular apoptosis [11]. The cytotoxic action of viscotoxin is comparable to that of conventional chemotherapeutic agents [ 12].

The interaction of ultraviolet radiation with biological matter results in direct damage such as pyrimidine dimers in DNA. It also results in indirect damage provoked by the production of Reactive Oxygen Species (ROS) catalyzed by photo-sensitizers. Photosensitizers can be endogenous (e.g. Tryptophan) or exogenous (e.g. TiO2 and other photo-stable UVA sunscreens). Direct damage triggers an inflammatory response and the oxidative and proteolytic bursts that characterize its onset. The inflammatory reaction multiplies the effects of one single photon. Indirect damage, such as the peroxidative cascade in membrane lipids, can extend to thousands of molecular modifications per absorbed photon. Sunscreens should therefore be formulated in the presence of appropriate anti-oxidants. Superoxide and Singlet Oxygen are the main ROS that need to be tackled: this review describes some of the molecular, biochemical, cellular and clinical consequences of exposure to UV radiation as well as some results associated with scavengers and quenchers of Superoxide and Singlet Oxygen, as well as with inhibitors of singlet Oxygen production.

The investigation of submerged speleothems for sea level studies has made significant contributions to the understanding of the global and regional sea level variations during the Middle and Late Quateranry. This has been especially the case for the Mediterranean Sea, where more than 300 submerged speleothems sampled in 32 caves have been analysed so far. Here, we present a comprehensive review of the results obtained from the study of submerged speleothems since 1978. The studied speleothems cover the last 1.4 Ma and are focused mainly on Marine Isotope Stages (MIS) 1, 2, 3, 5.1, 5.3, 5.5, 7.1, 7.2, 7.3 and 7.5. Results reveal that submerged speleothems represent extraordinary archives providing accurate information on former sea level changes, also considering that the Mediterranean Sea is devoid of any tropical corals since the Miocene. New results from a stalagmite collected at Palinuro (Campania, Italy) characterized by marine overgrowth are also reported. The measured elevations of speleothems are contaminated by the local response to glacial- and hydro-isostatic adjustment (GIA), and thus might significantly deviate from the global eustatic signal. Age and altitude comparation between Mediterranean speleothems, flowstone from Bahamas with local GIA provide a new scenario for MIS 5 and 7 sea level reconstrutions.

Nowadays a recognized need for accurate observations of atmospheric aerosols (AEs) and reactive gases (RGs) exists in the framework of regional, national and global near-surface networks based on permanent or mobile measurement stations. In this context, a paramount and not-trivial issue is related to the correct execution of continuous sampling of ambient air and its subsequent distribution to measurement analyzers hosted inside the stations. Sampling artifacts must be minimized for obtaining reliable pictures of ambient air composition. To respond to this need, a suite of novel “smart” and relatively low-cost systems for the continuous sampling of ambient air was developed in the framework of the Project I-AMICA (2012 – 2015, www.i-amica.eu). These systems were designed to execute AE and RG measurements according with WMO/GAW and ACTRIS recommendations and standard operation procedures. A particular attention was dedicated to the stabilization and control of the sampling flow rates and temperatures. The analysis of one full year of operations at the WMO/GAW regional station of Capo Granitola (GAW ID: CGR, Italy), allowed to conclude that these systems are effective in meeting the technical requirements for correct execution of AE and RG measurements

Analytical modeling has symmetries and aesthetic-mathematical characteristics that distinguish it from numerical computation. Nanoscience plays an extremely important role in unification efforts that also include holistic aspects of reality. In this paper I present new discovered results about the complete analytical quantum relativistic form of the mean square deviation of position false related to a lately appeared Drude-Lorentz-like model (DS model), already performed at classical, quantum and relativistic level. The function false gives precise information about the distance crossed by carriers (electrons, ions, etc.) inside a nanostructure, considering both quantum effects and relativistic velocities. The model has a wide scale range of applicability; the nanoscale is considered in this paper, but it holds from sub-pico-level to macro-level because of the existence of a gauge factor, making it applicable to every oscillating processes in Nature. Examples of application and suggestions supplement the paper, as well as interesting developments to be studied related to the model and to one of the basic elements of a current unified holistic approach based on the vacuum energy.

Background: This systematic umbrella review aims to investigate whether provide an analysis of guidelines regarding the treatment of diverticular abscesses summarizing the evidences from the best available practice. Material and methods: A systematic literature search was performed until using the Cochrane Overviews of Reviews model for search the ‘Clinical Practice Guidelines’; at the end of initial search only 12 guidelines, whose characteristics are reported in the following table were included in this analysis. The quality of the guidelines was assessed by adopting the 2017 updated version of the “Appraisal of Guidelines for Research and Evaluation II” (AGREE II). The comparative analysis of these guidelines has highlighted the presence of some differences regarding the recommendations on the treatment of diverticular abscesses. In particular, there are some controversies about the diameter of abscess to be used in order to decide between medical treatment and percutaneous drainage. Different guidelines propose different abscess diameter cutoffs, such as 3 cm, 4-5 cm, or 4 cm, for distinguishing between small and large abscesses. Conclusions: Currently, a lot of scientific societies recommend that diverticular abscesses with diameters larger than 3 cm should be considered for percutaneous drainage whereas abscesses with diameters smaller than 3 cm could be appropriately treated by medical therapy with antibiotics; only, few guidelines, suggest the use of percutaneous drainage for abscess with a diameter greater than 4 cm .The difference among guidelines is the consequence of the different selection of scientific evidences. In conclusion, our evaluation has revealed the importance of seeking new scientific evidence with higher quality to either confirm, reinforce or potentially weaken the existing recommendations from different societies.

The purpose of this paper is to examine the role and impact of public governance on European supranational public policies that seek to foster scientific and economic growth within innovation ecosystems (IEs) through the PITCCH initiative. The PITCCH is a European innovation development initiative funded by Horizon 2020 under the 'Innovation in SMEs' measure.The research methodology for this study is based on a 10-month real-time ethnographic field study of the PITCCH project, which allowed for the observation of the project governance and the capture of the perspectives of innovation-driven small and medium enterprises (i-SMEs) in their engagement with IE stakeholders.The findings of this research demonstrate the role of public governance in providing result-oriented practical support to the IE through the lens of i-SMEs, and they contribute to the existing literature on regional economic growth supported by supranational public policies. These findings have both academic and practical applications. They enrich the current literature on this topic and provide insights for policymakers and governing representatives seeking to implement effective public policies.

A recent research has identified an inverse amplitude link between obliquity damping and short eccentricity amplification during Mid-Late Pleistocene based on LR04 δ18O and equatorial Pacific Site 846 sea surface temperature records, which is associated with the Earth's long-term cooling. In the present study, new evidence of this anticorrelation is presented from Antarctic D-CO2-CH4 records, global benthic-planktic δ18O, and regional (Atlantic, Pacific, Mediterranean, and Indian) climate-related proxies. Based on a critical review of theoretical constrains (Earth's oblateness changes and ice-volume phase lag in the obliquity band <5.0 kyr), this widespread and symmetric (bipolar) obliquity response damping has been interpreted as an effect of the obliquity-oblateness feedback, which could be the latent physical mechanism at the origin of the Mid-Pleistocene Transition (MPT). Indeed, results and considerations of the present work suggest that fast and positive/negative net variation of the Earth's oblateness in the obliquity band was controlled by dominant glacio-eustatic water mass component and, assuming a rapid response of the ice-volume to surface temperature changes, the mean obliquity lag response is estimated to be <5.0 kyr over the past 800 kyr. These elements may explain the interglacial/glacial damping observed in the obliquity response. The consolidation of the Earth's long-term icy-state in the subtrend IV, culminated with the post-MPT obliquity damping, might have contributed to the strengthening of the short eccentricity response by mitigating the obliquity ‘ice-killing’ during obliquity maxima (interglacials), favouring the obliquity-cycle skipping and a feedback amplified ice-growth in the short eccentricity band (obliquity damping hypothesis). This could suggest a different impact of the climate friction than what is generally believed, which is presumably the latent physical mechanism that triggers transient ‘competitive’ interaction between obliquity and short eccentricity started early during the Piacenzian.

To evaluate the nutrient load due to the grazing of laying hens in outdoor runs, soil characteristics were monitored in three Italian organic farms. For each farm, soil samples were taken from three increasing distances from the hen house and two depths and different chemical parameters were evaluated. The comparison among the results from the different distances shows that N-NO3 and Olsen P are the most affected parameters by hen faeces: both present high values with a statistically significant difference in the area close to the poultry house and for the most superficial layer. Even TKN and TOC show significant differences between the concentrations of the first layer (more concentrated) and those of the second layer (less concentrated). In general, the surface soil layer closest to the chicken house is the portion of the outdoor run most affected by chicken droppings and represents the most critical point in terms of potential environmental impact. Therefore, it is necessary to intensify the management of the outdoor run with tools that can facilitate the grazing of animals and with vegetation that can absorb nutrients by limiting leaching and run-off.

The hemodynamic consequences of the aortic stenosis (AS) on supraortic trunks may have a po-tential role in the diagnosis of concomitant internal carotid artery (ICA) stenosis by dampening blood flow velocity. To investigate the effect of AS on ICA blood flow we evaluated carotid and vertebral blood flow velocity indexes in patients undergoing transcatheter aortic valve implanta-tion (TAVI). Eighty-five patients admitted for endovascular treatment of a severe AS underwent supra-aortic Duplex ultrasound (DUS) examination prior and after TAVI to be enrolled in the study. Patients with other cardiac impairments that could configure a confounding factor were excluded. Pa-tients with symptomatic or severe ICA stenosis defined according to NASCET criteria were ex-cluded. Forty-five patients of a median age of 80 years met the study inclusion criteria. The peak systolic velocity (PSV) of the assessed supraortic arteries increased after TAVI: respectively common ca-rotid artery (CCA) 64 ± 17 cm/s vs 78 ± 23 cm/s, p= 0,01; ICA 68 ± 23 cm/s vs 96 ± 35 cm/s, p= 0,01; vertebral artery (VA) 45 ± 14 cm/s vs 52 ± 15 cm/s, p=0,03. Similarly, the end diastolic velocity (EDV) increased after TAVI: respectively CCA 13 ± 6 cm/s vs 15 ± 7 cm/s, p=ns; ICA 20 ± 9 cm/s vs 24 ± 9 cm/s, p= 0,01; VA 9 ± 4 cm/s vs 11 ± 4 cm/s, p=0,01. Consistently, the mean acceleration time (AC) decreased after TAVI: respectively CCA 0,17 ± 0,05 s vs 0,12 ± 0,05 s, p= 0.01; ICA 0,1 8 ± 0,05 s vs 0,12 ± 0,04 s, p= 0,01; VA 0,16 ± 0,05 s vs 0,11 ± 0,05 s, p=0,02. Severe AS significantly affects supra-aortic arteries blood flow as assessed by duplex, by de-creasing both PSV and EDV and increasing AC. This study suggests that carotid ultrasound cri-teria to assess ICA stenosis severity should be re-evaluated in larger multicenter studies to vali-date their predictive values in patients with concomitant AS.

ABSTRACT: Background: Virtual Reality (VR) emerges as a promising non-pharmacological intervention for managing symptoms and providing distraction during chemotherapy. This study aims to assess VR's effectiveness on cancer-related symptoms, vital signs, and patients' perception of the chemotherapy in lung cancer patients. Methods: A quasi-experimental study was conducted on 100 patients. Participants were allocated into an intervention group (n = 55), which experienced immersive VR, and a comparison group (n = 45), which received usual care. Data were collected through questionnaires and checklists, including feedback on the VR experience, pain, vital signs, and common cancer symptoms, assessed through the Edmonton Symptom Assessment Scale. Results: VR had a significant impact on reducing the perception of the chemotherapy length. Patients reported high levels of satisfaction and tolerability. No adverse events were observed. VR did not have significant influence on pain intensity and vital signs. The only exceptions were oxygen saturation, where a significant difference (p = 0.02) was reported, and perception of chemotherapy duration. Conclusions: As a non-pharmacological intervention, VR proves beneficial in minimizing the perceived length of chemotherapy session for lung cancer patients, enhancing their overall treatment experience. The intervention showed to be a safe, feasible, and well-accepted distraction technique. Future research should explore VR's potential effects on a wider range of symptoms and evaluate its impact on long-term outcomes.

This paper presents the results of investigations into the pyrolysis of waste polypropylene in a laboratory fixed-bed batch reactor. The experiments were designed and verified in such a way as to allow the application of the Response Surface Methodology (RSM) in the development of an empirical mathematical model that quantifies the impacts mentioned above. The influence of the mass of the raw material (50, 100 and 150 g), together with the reactor temperature (450, 475 and 500 °C) and the reaction time (45, 50 and 75 min) was examined. It has been shown that the mass of the raw material, i.e. the filling volume of the reactor, has a significant influence on the pyrolysis oil yield. This influence exceeds the influence of reactor temperature and reaction time. This was explained by observing the temperature change inside the reactor at three different spots at the bottom, middle and top of the reactor. Recorded temperature diagrams show that with greater masses of feedstock, local overheating occurs in the middle part of the reactor, which leads to overcracking of vapor products, and from there to an increased formation of non-condensable gases, i.e. reduced yield of pyrolytic oil.

We propose novel spectrometer designs that aim to enhance the measured spectral range 1 of ions on a finite-sized detector. In contrast to the traditional devices that use uniform magnetic 2 field, in which the deflection of particles increases inversely proportional to their momentum, in a 3 gradient magnetic field, the deflection of particles will be decreased due to the reduction of the 4 magnetic field along their propagation. Low energy ions are particularly impacted, as they are 5 deflected less and are more likely to reach the detector compared to being driven out of it while 6 using a uniform magnetic field. By the means of a gradient magnetic field, the nonlinear dispersion 7 of ions in a homogeneous magnetic field can approach a nearly linear dispersion. Nonetheless, 8 the dispersion of low energy ions in a homogeneous magnetic field remains unnecessarily high. 9 In this article, we explore linear, quadratic, and higher-order field profiles in comparison to the 10 homogeneous field case. We discuss the employed methodology and present simulation results of 11 the spectrometer with an extended ion spectral range, focusing on the minimum detectable energy 12 (energy dynamic range) and energy resolution

Aims. In a male Italian cohort (initially aged 40-59, n=1712) followed-up during 61 years and reaching practical extinction, the natural history of major CVD mortality categories including coronary heart disease (CHD), stroke and other Heart Diseases of Uncertain Etiology (HDUE, including congestive heart failure) were studied along with their risk factor relationships. Methods and Results. Cox models were run with 12 covariates measured at entry as possible predictors. About 93% of all CVD deaths were covered by the 3 major groups selected here (N=751): 37.4% of them were diagnosed as CHD, 30.6% as stroke and 28.5 % as HDUE. CHD declined in the last 20 years of follow-up, while a sharp increase of HDUE mortality was seen. Baseline mean levels of serum cholesterol were 209.6, 204.2 and 198.0 mg/dl respectively for CHD, stroke and HDUE deaths: the multivariable coefficients of serum cholesterol were positive and significant for CHD (p<0.0001) and stroke (p=0.0203) and not significant for HDUE (p=0.3467). In Fine-Gray models, the algebraic signs of cholesterol coefficients were opposite for CHD versus the other mortality categories (t=3.13). The predictive performances of remaining risk factors were varied whereas that of Cox models was not very good, probably due to the attrition phenomenon and possible competing risks. Conclusion. Large differences in natural history and risk factors were found comparing the 3 CVD conditions, potentially indicating different etiologies and pointing to the need of not mixing them up in a grouped CVD category.

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.

For its microtubule-binding properties, the expression level of the neurodegeneration-associated protein Tau is pondered as a potential modifier of cancer resistance to chemotherapy since decades. Indeed, Tau binds microtubules at the same site as taxanes, a class of chemotherapeutic drugs designed to stabilize the microtubule network in order to stall cell division and to induce tumor cell death. Whilst independent studies report the association between low Tau expression and superior taxane response, the data were refused by a meta-analysis, suggesting interference of other parameters. Unpredictably, Tau expression level was identified as a prognostic cancer marker, whereby its positive or negative predictive value for survival depended on the cancer type. With recent experimental evidence linking Tau to P53 signaling, DNA stability and protection and to the implication of Tau in cancer is strengthened. The identification of a role of Tau at the interface between two major aging-related disorder families, neurodegeneration and cancer, offers clues for the epidemiological observation inversely correlating these disorders. Elucidating how Tau is mechanistically implicated in cellular pathways common to these devastating illnesses may extend the Tau-targeting therapeutic opportunities to cancer.

Meat loss and waste are estimated at each stage along the food chain, but the methods used are complex and the data needed often fragmented. We, therefore, evaluated the feasibility of estimating meat loss and waste using a simpler method comparing meat availability and consumption, using Swiss meat consumption according to a national nutrition survey and Swiss meat availability according to food balance sheets. As availability is reported at the fresh meat level and consumption as consumed, items of the latter were converted to fresh meat equivalents before comparing consumption with availability. Consumed unprocessed meat was directly converted to fresh meat equivalents and consumed meat products after having identified their meat ingredients. Meat availability, meat consumption as consumed and as fresh meat equivalent were 138.4 g/d, 105.5 g/d, and 112.1 g/d, respectively. The resulting total meat loss and waste was 19% and varied from −36% to 38% for the different meat types. Estimating meat loss and waste based on meat availability and consumption derived from a national nutrition survey yielded results varying to such an extent that the evaluated method to estimate meat loss and waste cannot be recommended.

This paper discusses complexity theory, that is, the many theories that have been proposed for emergence of complexity from the underlying physics. Our aim is to identify which aspects have turned out to be the more fundamental ones as regards the emergence of biology, engineering, and digital computing, as opposed to those that are in fact more peripheral in these contexts. In the cases we consider, complexity arises via adaptive modular hierarchical structures that are open systems involving broken symmetries. Each emergent level is causally effective because of the meshing together of upwards and downwards causation that takes place consistently with the underlying physics. Various physical constraints limit the outcomes that can be achieved. The underlying issue concerns the origin of consciousness and agency given the basis of life in physics, which is structured starting from symmetries and variational principles with no trace of agency. A possible solution is to admit that consciousness is an irreducible emergent property of matter.

During the 3rd millennium cal BC, the Indus communities exploited great quantities of chert from the Rohri Hills mines in Upper Sindh for making different types of artefacts. This paper discusses the way chert was transported to the Indus Civilization centres and the problems related to the type, quantity and quality of raw material and artefacts that were transported, when, why, and where. This paper raises the question of land and water transport. Both these methods were probably used according to the landscape location of the Indus sites. Another problem regards the landscape characteristics of the Indus Valley during the Bronze Age before the climate changes which took place around the end of the 3rd millennium cal BC, and the disappearance of the Hakra River, which was an important watercourse during the Indus phase. What do we know of the way the Indus communities exploited, transported, and circulated knappable chert? Why the Indus settlements excavated around the Rohri Hills, the largest chert mines of the Indian Subcontinent, have yielded little evidence of chert artefacts and nodules? What do we know of this important problem which is strictly related with the everyday life of the Indus communities and their economy? Why this problem has been systematically neglected by most archaeologists despite its importance?

This work describes and compares the backpropagation algorithm with the Extended Kalman filter, a second-order training method which can be applied to the problem of learning neural network parameters and is known to converge in only a few iterations. The algorithms are compared with respect to their effectiveness and speed of convergence using simulated data for both, a regression and a classification task.

Coronaviruses (CoVs) are a well-known group of viruses in veterinary medicine. We currently know four genera of Coronavirus, alfa, beta, gamma and delta. Wild, farmed and pet animals are infected with CoVs belonging to all four genera. Seven human respiratory coronaviruses have still been identified, four of which cause upper respiratory tract diseases, specifically, the common cold, and the last three that have emerged cause severe acute respiratory syndromes, SARS-CoV-1, MERS-CoV and SARS-CoV-2. In this review we briefly describe animal coronaviruses and what we actually know about SARS-CoV-2 infection in farm and domestic animals.

Polymyalgia rheumatica (PMR) is the most common inflammatory rheumatic disease among people over the age of 50 and occurs with symptoms such as musculoskeletal pain and stiffness in the neck, shoulders and hips. To date, corticosteroids represent the cornerstone of PMR treatment, although it is well known that their prolonged use is associated with several adverse effects, making it crucial to find therapeutic alternatives to their use. The purpose of this case report was to describe the effectiveness of 10 whole-body cryostimulation (WBC) sessions on a 74-year-old woman suffering from PMR. An improvement in disease impact, fatigue, pain, quality of sleep and total physical activity was observed after WBC. Moreover, the patient reduced her daily drug intake by 67% following WBC treatments. Given the increasing prevalence of PMR and considering the side effects that drug treatments can lead to, WBC could represent a valuable adjuvant and well-tolerated alternative for the treatment of PMR.

Rapid haemostasis during surgery is essential when one wants to reduce the duration of opera-tions, reduce the need for transfusions, and above all when one wants to achieve better patient management. The use of haemostatic agents, sealants and adhesives improves the haemostatic process by offering several advantages, especially in vascular surgery. These agents vary widely in their mechanism of action, composition, ease of application, adhesion to wet or dry tissue, im-munogenicity and cost. The most used are cyanoacrylate-based glues (Glubran 2) or polysaccharide hydrogel-microsphere powder (AristaTMAH). This work is based on a retrospective study carried out on a sample of patients with different vascular diseases (FAV, pseudoaneurysm and PICC application) in which two different haemostatic sealants were used. The aim was to assess the safety, the advantages and the ability of both sealants to activate the haemostatic process at the affected site, also in relation to their chemical-physical characteristics. The obtained results showed that the application of Glubran 2 and AristaTMAH as surgical wound closure systems is effective and safe as the success achieved was ≥94% on anastomoses of FAV; 100% on stabilization of Picc catheters; ≤95% on pseudoaneurysms.

Land-use planning review seems relatively lower in publication rate and in coverage of content. This review contributes its part in two dimensions. First, it assesses ability of the popularly growing bibliometric method in tracking the real contribution of publications. Then it summarizes developments in the land use planning literature in three themes - general literature path building, land use planning context, and development of methods. It is observed that bibliometric method rewards information carriage paper more than the original contributors. Key planning context gaps include detachment of the general goal-oriented objective formulations from the basic land use allocation theories and models and certain urban land use optimization objectives even contradict the original though of sustainable city. Key research frontiers include: linking basic land use allocation and utility theories in urban land use planning; shifting the current urban land use planning from spatial optimization to activities into optimizing flow resources to available spatial configurations; evaluating existing built environment for optimality; transferring knowledge from rural land-use planning to urban land use planning. In method development, the key frontier would be advancing the current loosely coupled methods into more integrated systems.