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Giorgio Bertolotti,1 Paolo Michielin,2 Giulio Vidotto,2 Ezio Sanavio,2 Gioia Bottesi,2 Ornella Bettinardi,3 Anna Maria Zotti4 1Psychology Unit, Salvatore Maugeri Foundation, IRCCS, Scientific Institute, Tradate, VA, 2Department of General Psychology, Padua University, Padova, 3Department of Mental Health and Addictive Behavior, AUSL Piacenza, Piacenza, 4Salvatore Maugeri Foundation, IRCCS, Scientific Institute, Veruno, NO, Italy Background: Cognitive behavioral assessment for outcome evaluation was developed to evaluate psychological treatment interventions, especially for counseling and psychotherapy. It is made up of 80 items and five scales: anxiety, well-being, perception of positive change, depression, and psychological distress. The aim of the study was to present the metric qualities and to show validity and reliability of the five constructs of the questionnaire both in nonclinical and clinical subjects. Methods: Four steps were completed to assess reliability and factor structure: criterion-related and concurrent validity, responsiveness, and convergent–divergent validity. A nonclinical group of 269 subjects was enrolled, as was a clinical group comprising 168 adults undergoing psychotherapy and psychological counseling provided by the Italian public health service. Results: Cronbach’s alphas were between 0.80 and 0.91 for the clinical sample and between 0.74 and 0.91 in the nonclinical one. We observed an excellent structural validity for the five interrelated dimensions. The clinical group showed higher scores in the anxiety, depression, and psychological distress scales, as well as lower scores in well-being and perception of positive change scales than those observed in the nonclinical group. Responsiveness was large for the anxiety, well-being, and depression scales; the psychological distress and perception of positive change scales showed a moderate effect. Conclusion: The questionnaire showed excellent psychometric properties, thus demonstrating that the questionnaire is a good evaluative instrument, with which to assess pre- and post-treatment outcomes. Keywords: outcome evaluation, well-being, treatment effects, patient perception, anxiety, depression, questionnaire

Cet article explore une approche de communication des organisations sur le web fondée sur le modèle orchestral de la communication, dans le but de promouvoir le tourisme durable au sein de l'écosystème touristique d'un espace protégé. Cette approche vise à renforcer l'efficacité des stratégies de communication web afin de mieux répondre aux besoins des divers acteurs impliqués. Sa mise en œuvre nécessite des négociations et des discussions entre les parties prenantes ; ainsi, une méthodologie basée sur la théorie de l'acteur-réseau est proposée pour soutenir cette démarche. Cette méthodologie encourage la collaboration entre les acteurs afin de sensibiliser les touristes à adopter des comportements respectueux de l'environnement, dans le cadre d'une communication web axée sur l'environnement.

Nasogastric Tubes (NGT) are widely used in hospitals, e.g. for the administration of nutrients or drugs and gastric release after major surgeries. Blind insertion of these tubes is usually performed by nurses, residents, and other health care providers. In this case report, we present an incident of misplacement of the NGT, located in the pleural space, and causing pneumothorax. NGT can be inserted accidentally into the airways leading to complications like pneumonia, pneumothorax, and even death. Mechanically ventilated patients are at high risk of having an NGT misplaced, since they often have reduced consciousness and weak cough reflex.

Determining the chemical quality of soil organic matter and decomposing organisms is critical for predicting carbon fluxes in ecosystems. However, the classical C/N and lignin/N ratios have been criticized for their capability in predicting ecosystem function including litter decay rate, nitrogen mineralization and soil aggregation. Therefore, with our work we aim to complement information on the chemical properties of primary producers and decomposers based on 13C NMR. Overall, 108 unique 13C NMR spectra were collected from higher plant tissues including leaf litter, fine roots, woody debris, as well as a range of microbes i.e. bacteria, fungi, and marine algae. Results showed clear discrimination between organisms belonging to different kingdoms, but with limited variability within bacteria, fungi, and microalgae. In detail, bacteria were found to be distinct not only from plant tissues but also from fungi, characterized by a high proportion of alkyl and carbonyl C types and a rather low relative abundance of O Alkyl C and di-O Alkyl C types. Among the fungi, we found clear separation between yeasts, which are more similar to bacteria, and filamentous species, which are rich in O Alkyl and di-O Alkyl C types. Microalgae are characterized by a high content of aliphatic, carboxylic and methoxyl C fractions. In the spectra of terrestrial plants, the O Alkyl C region, associated with sugars and cellulose, is more abundant compared to algae and bacteria. In addition, the aromatic carbon signal, which is mainly associated with lignin, is much higher for higher plants than in microorganisms. As for plant tissues, woody tissues are clearly different from leaves and fine roots, with grasses, sedges, and ferns being well distinguished from forbs, coniferous and deciduous trees. In summary, our study contains the largest freely available 13C NMR spectral library of bacteria, fungi, algae, and higher plant tissues. However, the data from higher plants are sufficient to cover different functional types, which is not yet possible for bacteria and fungi.

IntroductionNeonatal sepsis, classified into early-onset and late-onset based on symptom timing, poses significant risks of morbidity and mortality, especially in low birth weight infants. Effective clinical risk management protocols are crucial in reducing these risks.MethodsThis before-and-after study evaluated the impact of a newly implemented clinical risk management protocol in the Neonatology and Neonatal Intensive Care Unit (NICU) at Policlinico Hospital-University of Bari. The study included 399 neonates over three years, comparing pre- and post-protocol outcomes. Data collection focused on maternal and neonatal demographics, infection rates, and hospital stay lengths. Statistical analysis included t-tests, Wilcoxon-Mann–Whitney tests, and logistic regression models.ResultsThe study found no significant differences in neonatal pathologies or demographics between pre- and post-protocol groups. However, post-protocol implementation showed a notable reduction in umbilical venous catheter (UVC) infections (p = 0.018) and improved hospital stay lengths. Blood and urine cultures did not show significant changes in microbial patterns post-protocol.DiscussionThe findings underscore the effectiveness of structured clinical risk management protocols in enhancing neonatal outcomes, particularly in reducing specific infection risks. Despite the study’s limitations, including its observational nature and sample size, the results advocate for broader adoption and further research on these protocols in diverse healthcare settings. The positive outcomes highlight the importance of continuous clinical risk management efforts in high-risk neonatal environments.

The topic of diagnostic imaging error and the tools and strategies for error mitigation are poorly investigated in veterinary medicine. The increasing popularity of diagnostic imaging and the high demand for teleradiology make mitigating diagnostic imaging errors paramount in high-quality services. The different sources of error have been thoroughly investigated in human medicine, and the use of AI-based products is advocated as one of the most promising strategies for error mitigation. At present, AI is still an emerging technology in veterinary medicine and, as such, is raising increasing interest among in board-certified radiologists and general practitioners alike. In this perspective article, the role of AI in mitigating different types of errors, as classified in the human literature, is presented and discussed. Furthermore, some of the weaknesses specific to the veterinary world, such as the absence of a regulatory agency for admitting medical devices to the market, are also discussed.

Background: Antimicrobial stewardship (AMS) programs have been differently implemented across Europe. This study primarily aimed to compare AMS in two European regions. Secondarily, the study explored the COVID-19 pandemic impact on surrogate outcome indicators of AMS. Methods: A retrospective observational study was conducted in Piedmont (Italy) and Catalonia (Spain). AMS programs were compared through structure and process indicators in 2021. Changes in surrogate outcome indicators (antimicrobial usage; alcohol-based sanitizer consumption; antimicrobial resistance, AMR) from 2017 to 2021 described the pandemic impact. Results: Seventy-eight facilities provided structure and process indicators. Catalonia showed better structure scores (p

A enfermagem desempenha um papel vital no sistema de saúde, abrangendo cuidados diretos, educação em saúde, prevenção de doenças e promoção do bem-estar. A diversidade cultural, socioeconômica e epidemiológica global impõe desafios e oportunidades, exigindo abordagens personalizadas para garantir a qualidade do atendimento. Objetivos: Explorar como as práticas de enfermagem, quando adequadamente adaptadas e implementadas em diversos contextos clínicos, podem melhorar significativamente a qualidade do atendimento e os resultados clínicos dos pacientes. Metodologia: Análise comparativa da literatura científica e de casos práticos de diferentes regiões. Resultados e Conclusão: Práticas de enfermagem diversificadas requerem adaptação e inovação. A colaboração internacional e a troca de conhecimentos promovem um cuidado mais equitativo e acessível, fortalecendo os sistemas de saúde globalmente.

Abstract Many mushroom-forming fungi can develop circular colonies affecting the vegetation in a phenomenon named fairy rings. Since the nineteenth century, several hypotheses have been proposed to explain how fairy ring fungi form ring-like shapes instead of disks and why they produce negative or positive effects on the surrounding vegetation. In this context, we present a novel process-based mathematical model aimed at reproducing the mycelial spatial configuration of fairy rings and test different literature-supported hypotheses explaining the suppressive and stimulating effects of fungi on plants. Simulations successfully reproduced the shape of fairy rings through the accumulation of fungal self-inhibitory compounds. Moreover, regarding the negative effects of fungi on vegetation, results suggest that fungal-induced soil hydrophobicity is sufficient to reproduce all observed types of fairy rings, while the potential production of phytotoxins is not. In relation to the positive effects of fungi on plants, results show that the release of phytostimulants is needed to reproduce the vegetation patterns associated to some fairy ring types. Model outputs can guide future experiments and field work to corroborate the considered hypotheses and provide more information for further model improvements.

Abstract The aim of this study was to develop and test an artificial intelligence (AI)-based algorithm for detecting common technical errors in canine thoracic radiography. The algorithm was trained using a database of thoracic radiographs from three veterinary clinics in Italy, which were evaluated for image quality by three experienced veterinary diagnostic imagers. The algorithm was designed to classify the images as correct or having one or more of the following errors: rotation, underexposure, overexposure, incorrect limb positioning, incorrect neck positioning, blurriness, cut-off, or the presence of foreign objects, or medical devices. The algorithm was able to correctly identify errors in thoracic radiographs with an overall accuracy of 81.5% in latero-lateral and 75.7% in sagittal images. The most accurately identified errors were limb mispositioning and underexposure both in latero-lateral and sagittal images. The accuracy of the developed model in the classification of technically correct radiographs was fair in latero-lateral and good in sagittal images. The authors conclude that their AI-based algorithm is a promising tool for improving the accuracy of radiographic interpretation by identifying technical errors in canine thoracic radiographs.

IRIDE, a cutting-edge constellation in the Earth Observations scenario, stands out for its ability to integrate optical, SAR and hyperspectral sensors under a single command system, creating new opportunities for the operational use of satellite data. The project was born and developed thanks to the PNRR program, which directed its development and defined the implementation methods, following an AGILE method inspired by the software development practices of the same name. Below we develop the challenges and opportunities of this program through a lens particularly focused on the Italian industrial landscape. This analysis aims to explore IRIDE as a catalyst of innovation and growth for the national industry in the sector. From this point of view, the importance of the project emerges not only as a significant technological undertaking, but as a milestone that marks a turning point for the Italian industrial ecosystem in Earth observation.

Abstract Background Radiology and computed tomography are the most commonly available diagnostic tools for the diagnosis of pathologies affecting the head and skull in veterinary practice. Nevertheless, accurate interpretation of radiographic and CT studies requires a thorough knowledge of the gross and the cross-sectional anatomy. Despite the increasing success of reptiles as pets, only a few reports over their normal imaging features are currently available. The aim of this study is to describe the normal cadaveric, radiographic and computed tomographic features of the heads of the green iguana, tegu and bearded dragon. Results 6 adult green iguanas, 4 tegus, 3 bearded dragons, and, the adult cadavers of : 4 green iguana, 4 tegu, 4 bearded dragon were included in the study. 2 cadavers were dissected following a stratigraphic approach and 2 cadavers were cross-sectioned for each species. These latter specimens were stored in a freezer (−20°C) until completely frozen. Transversal sections at 5 mm intervals were obtained by means of an electric band-saw. Each section was cleaned and photographed on both sides. Radiographs of the head of each subject were obtained. Pre- and post- contrast computed tomographic studies of the head were performed on all the live animals. CT images were displayed in both bone and soft tissue windows. Individual anatomic structures were first recognised and labelled on the anatomic images and then matched on radiographs and CT images. Radiographic and CT images of the skull provided good detail of the bony structures in all species. In CT contrast medium injection enabled good detail of the soft tissues to be obtained in the iguana whereas only the eye was clearly distinguishable from the remaining soft tissues in both the tegu and the bearded dragon. Conclusions The results provide an atlas of the normal anatomical and in vivo radiographic and computed tomographic features of the heads of lizards, and this may be useful in interpreting any imaging modality involving these species.

We exploit the DustPedia sample of galaxies within approximately 40 Mpc, selecting 388 sources, to investigate the correlations between IR luminosity (LIR), the star formation rate (SFR), and the CO(1-0) luminosity (LCO) down to much lower luminosities than reached by previous analyses. We find a sub-linear dependence of the SFR on LIR. Below log(LIR/L⊙)≃10 or SFR≃1M⊙yr−1, the SFR/LIR ratio substantially exceeds the standard ratio for dust-enshrouded star formation, and the difference increases with decreasing LIR values. This implies that the effect of unobscured star formation overcomes that of dust heating by old stars, at variance with results based on the Planck ERCSC galaxy sample. We also find that the relations between the LCO and LIR or the SFR are consistent with those obtained at much higher luminosities.

IntroductionResidents of long-term care facilities (LTCFs) are a population at high risk of developing severe healthcare associated infections (HAIs). In the assessment of HAIs in acute-care hospitals, selection bias can occur due to cases being over-represented: patients developing HAIs usually have longer lengths of stays compared to controls, and therefore have an increased probability of being sampled in PPS, leading to an overestimation of HAI prevalence. Our hypothesis was that in LTCFs, the opposite may occur: residents developing HAIs either may have a greater chance of being transferred to acute-care facilities or of dying, and therefore could be under-represented in PPS, leading to an underestimation of HAI prevalence. Our aim was to test this hypothesis by comparing HAI rates obtained through longitudinal and cross-sectional studies.MethodsResults from two studies conducted simultaneously in four LTCFs in Italy were compared: a longitudinal study promoted by the European Centre for Disease Prevention and Control (ECDC, HALT4 longitudinal study, H4LS), and a PPS. Prevalence was estimated from the PPS and converted into incidence per year using an adapted version of the Rhame and Sudderth formula proposed by the ECDC. Differences between incidence rates calculated from the PPS results and obtained from H4LS were investigated using the Byar method for rate ratio (RR).ResultsOn the day of the PPS, HAI prevalence was 1.47% (95% confidence interval, CI 0.38-3.97), whereas the H4LS incidence rate was 3.53 per 1000 patient-days (PDs, 95% CI 2.99-4.08). Conversion of prevalence rates obtained through the PPS into incidence using the ECDC formula resulted in a rate of 0.86 per 1000 PDs (95% CI 0-2.68). Comparing the two rates, a RR of 0.24 (95% CI 0.03-2.03, p 0.1649) was found.ConclusionsThis study did not find significant differences between HAI incidence estimates obtained from a longitudinal study and through conversion from PPS data. Results of this study support the validity of the ECDC method.