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The honeycomb worm Sabellaria alveolata is a gregarious tube-dwelling polychaete that builds remarkable biogenic reefs in marine coastal waters. Sabellaria alveolata reefs are considered valuable marine habitats requiring protection measures for their conservation, as they play a key role in the functioning of coastal ecosystems. Sabellarid reefs are extensively developed along the Atlantic coasts of Europe and reported for the Mediterranean Sea and the Italian coasts, where large reefs have been recorded in several localities. Fragmentary information is available on their health status, Sabellaria reefs thus being listed as “Data Deficient” in the Red List of Marine Habitats. To fill this knowledge gap, this study focused on the analysis of the structure of three reefs found along the southern coast of Sicily. In particular, we aimed to assess their phases with respect to the natural cycle that characterizes the sabellarid reefs. Reef features were analyzed both on the macroscale, based on the bioconstruction size (diameter and thickness) and degree of fragmentation, and on the microscale, based on the measurement of worm density, opercular length and sand porch presence. This study reveals relevant differences among reefs of the studied locations. These differences we attributeto the temporal shift linked to the natural reef phases, albeit further analyses are needed to understand the possible effect of natural and anthropogenic sources of variation on the Southern Sicilian reefs. In conclusion, Sabellaria reefs are a unique and persistent habitat along the Sicilian coast requiring proper management and conservation measures.

Background: Adding immunotherapy to first-line chemotherapy might improve outcomes for patients with advanced or recurrent endometrial cancer. We aimed to compare carboplatin and paclitaxel versus avelumab plus carboplatin and paclitaxel as first-line treatment with avelumab given concurrent to chemotherapy and as maintenance after the end of chemotherapy. Methods: MITO END-3 is an open-label, randomised, controlled, phase 2 trial conducted at 31 cancer institutes, hospitals, and universities in Italy. Eligible patients were aged 18 years or older with histologically confirmed advanced (FIGO stage III–IV) or recurrent endometrial cancer, an Eastern Cooperative Oncology Group (ECOG) performance status of 0–1, and no previous systemic anticancer therapy as primary treatment for advanced or metastatic disease. Participants were randomly assigned (1:1) using a computerised minimisation procedure stratified by centre, histology, and stage at study entry, to either receive carboplatin (area under the curve [AUC] 5 mg/mL × min) and paclitaxel (175 mg/m2; standard group) intravenously every 3 weeks for six to eight cycles or avelumab (10 mg/kg intravenously) added to carboplatin and paclitaxel (experimental group) every 3 weeks and then every 2 weeks as a single maintenance treatment after the end of chemotherapy until disease progression or unacceptable toxicity. Patients, treating clinicians, and those assessing radiological examinations were not masked to study treatment. The primary endpoint was investigator-assessed progression-free survival, measured in the intention-to-treat (ITT) population. Patients who received at least one dose of study drug were included in the safety analysis. Experimental group superiority was tested with 80% power and one-tailed α 0·20. This trial is registered with ClinicalTrials.gov (NCT03503786) and EudraCT (2016–004403–31). Findings: From April 9, 2018, to May 13, 2021, 166 women were assessed for eligibility and 39 were excluded. 125 eligible patients were randomly assigned to receive carboplatin and paclitaxel (n=62) or avelumab plus carboplatin and paclitaxel (n=63) and included in the ITT population. The median follow-up was 23·3 months (IQR 13·2–29·6) and was similar between the two groups. 91 progression-free survival events were reported, with 49 events in 62 patients in the standard group and 42 events in 63 patients in the experimental group. The median progression-free survival was 9·9 months (95% CI 6·7–12·1) in the standard group and 9·6 months (7·2–17·7) in the experimental group (HR of progression or death 0·78 [60% CI 0·65–0·93]; one-tailed p=0·085). Serious adverse events were reported more frequently in the experimental group (24 vs seven events in the standard group); neutrophil count decrease was the most frequent grade 3–4 adverse event (19 [31%] of 61 patients in the experimental group vs 26 [43%] of 61 patients in the standard group). Two deaths occurred in the experimental group during treatment (one respiratory failure following severe myositis [possibly related to treatment] and one cardiac arrest [not related to treatment]). Interpretation: Adding avelumab to first-line chemotherapy deserves further testing in patients with advanced or recurrent endometrial cancer, although consideration of mismatch repair status is warranted.

Background and aims: The optimal management of naïve and not naïve Helicobacter pylori patients remains unclear. Therefore, it is essential to evaluate whether the actual clinical practice mirrors the indications suggested by the guidelines. This study aimed to assess the effectiveness and the safety of the empirical first- and second-line treatments prescribed to patients enroled at Italian centres participating in the European Registry on H. pylori Management (Hp-EuReg). Methods: The Hp-EuReg is an international multicentre prospective non-interventional registry starting in 2013 aiming to evaluate the management of H. pylori infection by European gastroenterologists. Patients were registered in an e-CRF by AEG-REDCap. Variables assessed included demographics, previous eradication attempts, treatment regimen, effectiveness, and tolerance. Results: Overall, 3723 patients from 2013 to February 2021 were included: 2996 and 727 received an empirical first- and second-line treatment, respectively. According to the modified ITT analysis, among the first-line regimens, only the bismuth quadruple therapy with three-in-one-single capsule (BQT-TSC), the concomitant, and the sequential treatment - all lasting 10 days - achieved an eradication rate >90%. Among the second-line regimens, only the 10-day BQT-TSC reported an effectiveness >90%. High-dose PPI twice daily also significantly increased the effectiveness of some therapies. The BQT-TSC was the regimen with the highest incidence of adverse events. Conclusions: Only quadruple therapies lasting at least 10 days achieved over 90% eradication rates among the empirical first- and second-line regimens. It remains unclear whether high-dose PPI twice daily can improve the efficacy of quadruple treatment.

Background: Ulcerative colitis may impair anorectal function, causing disabling symp-toms such as incontinence and/or increase in the stool frequency, urgency and tenesmus. Data on anorectal function in these patients evaluated by conventional anorectal manometry are conflicting. Objectives: The aim of this prospective study was to assess by means of high resolution anorectal manometry the anorectal function in patients with mild-to-moderate ulcerative colitis at presentation and after remission. Anorectal function of ulcerative colitis patients was compared to that observed in healthy volunteers. Methods: 20 patients with mild to moderate left-sided ulcerative colitis or proctitis and 20 healthy volunteers were prospectively enrolled. All ulcerative colitis patients underwent high resolution ano-rectal manometry before treatment and after clinical remission. Results: Ulcerative colitis patients showed similar values for anal sphincter function as healthy vol-unteers, whereas rectal threshold volume for the first sensation, desire to defecate, urgency to defecate and maximum discomfort were significantly lower than in healthy volunteers (p Conclusions: Ulcerative colitis patients show altered rectal function, with increased rectal sensitivity and lower compliance, compared to controls. This altered function is restored after successful treat-ment of the underlying inflammatory process. Finally high resolution anorectal manometry provides useful information on anorectal functionality and, in our opinion, should be preferred over conven-tional manometry.

Gastroenterology, Digestive Endoscopy and Hepatology have faced significant improvements in terms of diagnosis and therapy in the last decades. However, many fields still remain poorly explored, and many questions unanswered. Moreover, basic-science, as well as translational and clinical discoveries, together with technology advancement will determine further steps toward a better, refined care for many gastroenterological disorders in the future. Therefore, the Young Investigators of the Italian Society of Gastroenterology (SIGE) joined together, offering a perspective on major future innovations in some hot clinical topics in Gastroenterology, Endoscopy, and Hepatology, as well as the current pitfalls and the grey zones.

Frailty is a clinically measurable state of vulnerability to developing increased dependency and/or mortality when exposed to a stressor. Chronic diseases, aggressive treatments, antibiotic overuse, microbiota changes, immune senescence, and increased use of medical devices and implants (i.e., central lines and catheters) expose modern patients to healthcare-associated infections (HAIs), multidrug-resistant bacteria, and new and unusual opportunistic pathogens. Older adults are among the main victims of HAIs and are associated with high costs, disability, morbidity, and mortality. Ralstonia pickettii is an emerging opportunistic pathogen that causes rare nosocomial infections in frail individuals. Herein, we present a case of bloodstream infection caused by R. pickettii in an 88-year-old woman with a relatively mild course. In addition to describing this unusual finding, this report discusses the problem of HAIs in older adults. Older age, comorbidities, and hospital admissions were among the main risk factors for HAIs. Adherence to guidelines, training, auditing, and surveillance is crucial for reducing the burden of HAIs in acute settings. Furthermore, avoiding incongruous hospitalizations would have positive implications both for preventing HAIs and improving patient quality of life.

Identificar na literatura mundial o conhecimento e ações de promoção da saúde promovidas em instituições de ensino superior direcionadas a graduandos que vivem ou não com a Doença Falciforme. Trata-se de uma revisão de escopo baseada no método do Instituto Joanna Briggs norteado pelo Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMAScR). Foram selecionadas 11 publicações. Observou nos estudos apresentados, a necessidade de fomentar ações de promoção da saúde com os graduandos voltadas para a discussão e produção de conhecimento a cerca dessa doença. Buscou-se agrupar as discussões semelhantes em duas categorias temáticas: Nível de conhecimento e intervenção de educação em saúde com graduandos sobre a Doença Falciforme e Conscientização dos graduandos sobre aconselhamento genético e triagem pré-marital. Há uma escassez de estudos sobre ações de promoção da saúde em instituições de ensino superior com graduandos da área da saúde com foco na Doença Falciforme. Descritores: Anemia Falciforme, Promoção da Saúde, Instituições de Ensino Superior, Educação em Saúde. Health promotion of undergraduates about sickle cell disease: scoping review Abstract: To identify in the world literature the knowledge and health promotion actions promoted in higher education institutions aimed at undergraduates who live or not with Sickle Cell Disease. This is a scope review based on the Joanna Briggs Institute method guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMAScR). Eleven publications were selected. It was observed in the studies presented, the need to promote health promotion actions with undergraduates aimed at the discussion and production of knowledge about this disease. We sought to group similar discussions into two thematic categories: Level of knowledge and health education intervention with undergraduates about Sickle Cell Disease and Awareness of undergraduates about genetic counseling and premarital screening. There is a scarcity of studies on health promotion actions in higher education institutions with undergraduates in the health area with a focus on Sickle Cell Disease. Descriptors: Sickle Cell Anemia, Health Promotion, Higher Education Institutions, Health Education. Promoción de la salud de estudiantes universitarios sobre la enfermedad de células falciformes: revisión de alcance Resumen: Identificar en la literatura mundial el conocimiento y las acciones de promoción de la salud promovidas en las instituciones de educación superior dirigidas a los estudiantes de grado que viven o no con Anemia de Células Falciformes. Esta es una revisión de alcance basada en el método del Instituto Joanna Briggs guiado por los elementos de informe preferidos para revisiones sistemáticas y extensión de metanálisis para revisiones de alcance (PRISMAScR). Se seleccionaron once publicaciones. Se observó en los estudios presentados, la necesidad de promover acciones de promoción de la salud con los estudiantes de graduación dirigidas a la discusión y producción de conocimiento sobre esta enfermedad. Buscamos agrupar discusiones similares en dos categorías temáticas: Nivel de conocimiento e intervención de educación en salud con estudiantes universitarios sobre la enfermedad de células falciformes y Conciencia de los estudiantes universitarios sobre el asesoramiento genético y la detección prematrimonial. Hay escasez de estudios sobre acciones de promoción de la salud en instituciones de enseñanza superior con graduación en el área de la salud con enfoque en la Enfermedad de Células Falciformes. Descriptores: Anemia de Células Falciformes, Promoción de la Salud, Instituciones de Enseñanza Superior, Educación en Salud.

To confirm the correlation between post-void residual urine ratio (PVR-R) and BOO diagnosed by pressure-flow studies (PFS) in males with lower urinary tract symptoms (LUTS) and to develop a clinical nomogram.A consecutive series of patients aged 45 years or older with non-neurogenic LUTS were prospectively enrolled. Patients underwent standard diagnostic assessment for BOO including International Prostatic Symptoms Score, uroflowmetry, urodynamic studies, suprapubic ultrasound of the prostate, and ultrasound measurements of the bladder wall thickness (BTW). PVR-R was defined as follows: PVR-R = (PVR/total Bladder Volume [BV]) × 100). Logistic regression analysis was used to investigate predictors of pathological bladder emptying (BOO) defined as Schafer II. A nomogram to predict BOO based on the multivariable logistic regression model was then developed.Overall 335 patients were enrolled. Overall, 131/335 (40%) presented BOO on PFS. In a multivariable logistic age-adjusted regression model BWT (odds ratio [OR]: 2.21 per mm; 95% confidence interval [CI], 1.57-3.09; p = 0.001), PVR-R (OR: 1.02 per %; 95% CI, 1.01-1.03; p = 0.034) and prostate volume (OR: 0.97 per mL; 95% CI, 0.95-0.98; p = 0.001) were significant predictors for BOO. The model presented an accuracy of 0.82 and a clinical net benefit in the range of 10-90%.The present study confirms the important role of PVR-ratio in the prediction of BOO. For the first time, we present a clinical nomogram including PVR-ratio for the prediction of BOO.

Recent years have witnessed an increasing popularity of wireless body area network (WBAN), with which continuous collection of physiological signals can be conveniently performed for healthcare monitoring. Energy consumption is a critical issue because it directly affects the duration of the equipped sensors. In this paper, we propose a low-cost and confidential electrocardiogram (ECG) acquisition approach for WBAN. The compressed sensing (CS) is employed for low-cost signal acquisition, and its cryptographic features are exploited for promoting the framework's confidentiality. In particular, the RIPless measurement matrix is used to give CS the resistance against plaintext attack, while the first-order Σ∆ quantizer is employed to embed the cryptographic diffusion feature into the whole system. Two chaotic systems are employed for generating the required secret elements for the acquisition and encryption. Experiment results well demonstrate the signal reconstruction and security performance of the proposed framework.

Environmental context We present a chemical characterisation of the seasonal snowpack sampled for four consecutive years at the Calderone, the southernmost glacier still surviving in peninsular Italy. This debris covered glacier recently split into two little ice bodies, whose evolution could be influenced by the snowpack properties. In particular the impact of long-range aerosol advections on concentrations of impurities in the snowpack over the local background is discussed. Rationale The Calderone Glacier (Central Apennine, Gran Sasso d’Italia mountain group) is the southernmost glacial apparatus in Europe, split into two glacierets (Upper and Lower Calderone) since the end of the last millennium. Because of its location and altitude, this site is mainly characterised by the long-range transport of air masses which arise from different Mediterranean source regions. Therefore, the seasonal snowpack’s chemistry is strongly affected by the dry and wet deposition of contaminants associated with anthropogenic and natural sources. Methodology In the present study, the seasonal snowpack stratified on the Calderone glacier has been characterised for four consecutive years (2017–2020) in the same monitoring site (2700 m asl), where a snow pit has been dug yearly, to observe the modification of chemical and physical properties depending on local and long-range atmospheric contributions. We determined the concentrations and fluxes of major inorganic ions (MIs) by ion chromatography and of 31 trace elements (TEs) by triple quadrupole ICP-MS. Results Major and trace element concentration profiles along the snowpack allowed to discriminate the snow layers contaminated by long range advections from the uncontaminated ones. The uncontaminated snow layers’ concentrations were used to calculate regional background values. The results have been compared to other remote sites to assess their robustness. Discussion Different source contributions have been recognised using enrichment factors for the trace elements, particularly crustal, marine and anthropogenic. Deposited atmospheric aerosols, found in the snowpack as distinct layers generated during intense air mass advections, have been correlated to these contributions.

Purpose: The Italian Registry of Contrast Material use in Cardiac Computed Tomography (iRCM-CCT) is a multicenter, multivendor, observational study on the use of contrast media (CM) in patients undergoing cardiac computed tomography (CCT). The aim of iRCM-CCT is to assess image quality and safety profile of intravenous CM compounds. Materials and methods: iRCM-CCT enrolled 1842 consecutive patients undergoing CCT (≥50 per site) at 20 cluster sites with the indication of suspected coronary artery disease. Demographic characteristics, CCT, and CM protocols, clinical indications, safety markers, radiation dose reports, qualitative (ie, poor vascular enhancement) and quantitative (ie, HU attenuation values) image parameters were recorded. A centralized coordinating center collected and assessed all image parameters. Results: The cohort included 891 men and 951 women (age: 63±14 y, body mass index: 26±4 kg/m2) studied with ≥64 detector rows computed tomography scanners and different iodinated intravenous CM protocols and compounds (iodixanol, iopamidol, iohexol, iobitridol, iopromide, and iomeprol). The following vascular attenuation was reported: 504±147 HU in the aorta, 451±146 HU in the right coronary artery, 474±146 HU in the left main, 451±146 HU in the left anterior descending artery, and 441±149 HU in the circumflex artery. In 4% of cases the image quality was not satisfactory due to poor enhancement. The following adverse reactions to CM were recorded: 6 (0.3%) extravasations and 17 (0.9%) reactions (11 mild, 4 moderate, 2 severe). Conclusions: In a multicenter registry on CM use during CCT the prevalence of CM-related adverse reactions was very low. The appropriate use of CM is a major determinant of image quality.

Hard disk drive failures are one of the most common causes of service downtime in data centers. Predictive maintenance techniques have been adopted to extend the Remaining Useful Life (RUL) of these drives, and minimize service shortage and data loss. Several approaches based on machine and deep learning techniques have been proposed to address these issues, mostly exploiting models based on Self-Monitoring analysis and Reporting Technology (SMART) attributes. While these models have proven to be reliable, their performance is affected by the lack of information about the proximity of disk failure in time. Moreover, many of these techniques are sensitive to the highly unbalanced nature of existing data-sets, in terms of good to failed hard disk ratio. In this paper, we propose a LSTM based model combining SMART attributes and temporal analysis for estimating a hard drive health status according to its time to failure. Our approach outperforms state-of-the-art methods when evaluated on two data-sets, one containing hourly samples from 23,395 disks and the other reporting daily samples from 29,878 disks. Experimental results showed that our approach is well suited to data-sets with different sampling periods, being able to predict hard drive health status up to 45 days before failure.

The widespread use of fingerprint authentication systems (FASs) in consumer electronics opens for the development of advanced presentation attacks, that is, procedures designed to bypass a FAS using a forged fingerprint. As a consequence, FAS are often equipped with a fingerprint presentation attack detection (FPAD) module, to recognise live fingerprints from fake replicas. In this work, a novel FPAD approach based on Convolutional Neural Networks (CNNs) and on an ad hoc adversarial data augmentation strategy designed to iteratively increase the considered detector robustness is proposed. In particular, the concept of adversarial fingerprint, that is, fake fingerprints disguised by using ad hoc fingerprint adversarial perturbation algorithms was leveraged to help the detector focus only on salient portions of the fingerprints. The procedure can be adapted to different CNNs, adversarial fingerprint algorithms and fingerprint scanners, making the proposed approach versatile and easily customisable todifferent working scenarios. To test the effectiveness of the proposed approach, the authors took part in the LivDet 2021 competition, an international challenge gathering experts to compete on fingerprint liveness detection under different scanners and fake replica generation approach, achieving first place out of 23 participants in the ‘Liveness Detection in Action track’.

Burkitt-like lymphoma with 11q aberration is a rare condition that poses a diagnostic challenge due to similarities with Burkitt’s lymphoma. Due to the rarity of cases, no specific guidelines exist for therapy, and it is treated the same way as Burkitt’s lymphoma. We present such a case with initial orbital involvement, an unusual manifestation. Our patient achieved remission with induction chemotherapy, although he will need regular follow-up given the paucity of information on long-term monitoring in these patients.

In this study, the anthropogenic contamination in Trasimeno lake (Central Italy) was investigated using three sediment cores spanning over the last 150 years (Anthropocene) to identify the primary sources of pollution and quantify the level of contaminant enrichment in the basin. First, based on the relative cumulative frequency and linear regression methods, we obtained a geochemical baseline for the lake using the deeper parts of the sediment cores. The geochemical baseline allowed us to determine the values of trace elements enrichment factors. On this knowledge, as a second result, we were able to reconstruct the natural sources and the anthropogenic impact on the lake with a biennial resolution. This goal has been obtained by combining different inorganic and organic chemical proxies such as trace elements, polycyclic aromatic hydrocarbons, and lead isotope ratios and exploiting both principal component and factor analysis to associate chemical proxies to human-driven contamination processes. Five different groups of elements have been identified, one of which is of natural origin and four of anthropogenic origin. In particular, it was possible to identify the times and impacts of the industrial activities during the Second World War, which dispersed heavy metals in sediments. Moreover, we found evidence of the recent human activities that have characterized the surroundings of the basin, such as Pb inputs related to the use of gasoline and the enrichment of certain elements generally used in agricultural activities (such as P, Cu, and Mn) due to the development of this sector in the last 40 years.

Soft electronics have been widely applied to wearable electronics, hand gesture detection and human robot interaction (HRI). Soft wrist-worn sensor system (SWSS) with electromyography (EMG), strain/pressure sensing abilities has been created for continuous hand gesture recognition, which includes multi-source data sensing, data collection and process, and wireless communication. SWSS is conformal contact with skin surface as the softness of SWSS, and it would improve the wearability with the wrist during long-term hand gesture monitoring. Linear discriminant analysis (LDA) and support vector machines (SVM) algorithms are applied to hand gesture recognition with average accuracy 83.67%, 86.8% for Group #1 (wrist flexion (WF), wrist extension (WE), finger flexion (FF), finger extension (FE), radial deviation (RD), and ulnar deviation (UD)) and 84.71%, 88.53% for Group #2 (sign language 0-9 digits), respectively. It is found that the recognition accuracy has just a little decreased during the long-term hand gesture detection at different sessions (at initial time, one day after, three days after and seven days after). This paper demonstrated the feasibility of gesture recognition via SWSS on wrist, and it could be integrated into wrist-worn electronic system for human robot interaction.

The development of activity recognition based on multi-modal data makes it possible to reduce human intervention in the process of monitoring. This paper proposes an efficient and cost-effective multi-modal sensing framework for activity monitoring, it can automatically identify human activities based on multi-modal data, and provide help to patients with moderate disabilities. The multi-modal sensing framework for activity monitoring relies on parallel processing of videos and inertial data. A new supervised adaptive multi-modal fusion method (AMFM) is used to process multi-modal human activity data. Spatio-temporal graph convolution network with adaptive loss function (ALSTGCN) is proposed to extract skeleton sequence features, and long short-term memory fully convolutional network (LSTM-FCN) module with adaptive loss function is adapted to extract inertial data features. An adaptive learning method is proposed at the decision level to learn the contribution of the two modalities to the classification results. The effectiveness of the algorithm is demonstrated on two public multi-modal datasets (UTD-MHAD and C-MHAD) and a new multi-modal dataset H-MHAD collected from our laboratory. The results show that the performance of the AMFM approach on three datasets is better than the performance of the video or the inertial-based single-modality model. The class-balanced cross-entropy loss function further improves the model performance based on the H-MHAD dataset. The accuracy of action recognition is 91.18%, and the recall rate of falling activity is 100%. The results illustrate that using multiple heterogeneous sensors to realize automatic process monitoring is a feasible alternative to the manual response.

This paper presents the results of an experimental study on a full-scale precast concrete frame reinforced with glass fibre reinforced polymer (GFRP) bars that was tested to failure under lateral cyclic loading. Within the frame four different pocket connections are tested that will lead to accelerated construction. Traditionally, a pocket connection is comprised of a column that is extended into a recessed portion of the connecting beam and the pocket is filled with grout to create a moment-resisting connection. In order to accelerate the construction process, quicker setting epoxy resin was used in place of grout. The results show that while the epoxy resin could significantly accelerate and simplify the construction procedure due to its workability in addition to its high early strength and non-shrinkable properties, its thickness and low modulus of elasticity significantly affected the performance of the pocket joint. The test frame showed a flag-shaped hysteretic behaviour with narrow loops and small residual displacement thus illustrating desirable frame self-centring behaviour. This self-centring behaviour was due to rocking of the column in the pocket connection. The frame displaced with a large displacement ductility of approximately 7.0, however, the level of energy dissipation and damping ratio was very low when compared with conventional concrete structures. This experimental study shows that pocket connections can be used for GFRP reinforced precast concrete elements, however, they should be designed carefully to account for the lower stiffness of GFRP reinforcement. Also, to avoid premature failure and achieve a higher capacity of the pocket connections, the material used in the pocket to fill the gap between column and beam is recommended to have higher strength and elastic modulus compared to the surrounding precast concrete. Refereed/Peer-reviewed

This study presents a systematic investigation of the bond behaviour of rubberized concrete. The local and global bond behaviours of rubberized concrete are studied experimentally using concentric pull-out test and beam end test, respectively. The test parameters include concrete strength grade, bar embedded length, bar diameter and rubber content. In addition to the bond tests and the ancillary material property tests, six large-scale reinforced rubberized concrete beams are also tested under flexural bending to evaluate the influence of the alteration of bond behaviour owing to rubber incorporation on the flexural performance of the beams. The higher deformability of rubberized concrete compared to conventional concrete at each strength grade results in altered local and global bond behaviour, where the reduced peak bond stress and an increase in the slip at the peak bond stress are observed. The altered bond in conjunction with the other reduced mechanical properties of rubberized concrete subsequently led to a reduction in the flexural stiffness at the elastic stage and a reduction in ductility at the post-peak stage of a corresponding reinforced concrete beam containing rubber. The results of the mechanics-based and code-based models for predicting the development length for a reinforced bar in rubberized concrete indicated that the code-based model to design the anchorage length in rubberized concrete could be used with confidence Refereed/Peer-reviewed

Background: Patients affected by gastrointestinal disorders often experience sexual dysfunction (SD). This creates stress and anxiety which impact on patients’ and/or their partners’ quality of life. A multidisciplinary approach to SD is often advisable in these patients. This survey assessed if gastroenterologists routinely discuss SD with their patients and the barriers toward discussing SD in clinical practice. Methods: A 29-item questionnaire was sent to members of the Italian Society of Gastroenterology and Digestive Endoscopy (SIGE). A descriptive analysis of responses was performed. Results: Out of 714 eligible gastroenterologists, 426 (59.7%), responded.The majority (>70%) never/infrequently investigated SD with their patients and, similarly, most patients never discussed SD during the visit. The most reported reasons were lack of knowledge (58%), time (44%), and embarrassment (30%). However, more than 70% of respondents indicated that all specialists should be able to manage sexual problems, and more than 80% declared that it would be useful for gastroenterologists to attend courses dedicated to the problem of SD. Conclusion: Despite the high prevalence of SD, counselling was not routinely performed in gastroenterological care. Lack of education/knowledge appeared as the most important factor. Most of responders felt that attending a course on SD might increase the awareness of SD.

This paper discusses the bond performance of prestressed carbon fiber reinforced polymer to concrete under service fatigue loading at high temperatures. Fatigue tests were performed in reinforced concrete beams at 4Hz, with minimum and maximum stress corresponding to 50% and 60% of the steel yielding obtained from the static 6-point bending test, and an R ratio of 0.60). The test conditions (5M cycles at ambient temperature, 5M cycles at 50oC, and 2M cycles at 75oC) reflect the typical degradation processes of conventional reinforced concrete bridges, in which the synergy between the high temperatures reached by the asphalt pavement and the service fatigue loading may shorten the frequency of maintenance operations. In the 5 to 10M cycles interval, the decrease of the adhesive's mechanical properties induced a shear stress redistribution with a decrease in the interfacial shear stresses due to the softer behavior of the adhesive. The high temperature raised the stiffness loss and induced local debonding in the 10 to 12M cycles interval, with no damage in the non-mechanical anchorage zone and the adjacent strengthening lengths. The combined effects of fatigue and temperature showed to be strongly influenced by the glass transition temperature of the epoxy resin and cyclic loading conditions and may induce interfacial debonding., Paper 106

Abstract: Since the discovery of the first antiepileptic compound, increasing attention has been paid to antiepileptic drugs (AEDs), and recently, with the understanding of the molecular mechanism underlying cells death, a new interest has revolved around a potential neuroprotective effect of AEDs. While many neurobiological studies in this field have focused on the protection of neurons, growing data are reporting how exposure to AEDs can also affect glial cells and the plastic response underlying recovery; however, demonstrating the neuroprotective abilities of AEDs remains a changeling task. The present work aims to summarize and review the literature available on the neuroprotective properties of the most commonly used AEDs. Results highlighted how further studies should investigate the link between AEDs and neuroprotective properties; while many studies are available on valproate, results for other AEDs are very limited and the majority of the research has been carried out on animal models. Moreover, a better understanding of the biological basis underlying neuro-regenerative defects may pave the way for the investigation of further therapeutic targets and eventually lead to an improvement in the actual treatment strategies.

Rice is one of the main staple foodstuffs for the world's population; however, several diseases caused by phytopathogens cause yield losses in rice crop. Rice crinkle is an emerging disease in rice cultivation, caused by rice stripe necrosis virus (RSNV). RSNV is transmitted by the soil plasmodiophoromycete, Polymyxa graminis, which can remain in the soil through resistance structures for decades. The symptoms caused by the virus are often confused with other causes, making a correct diagnosis and the adoption of effective management and control measures difficult. RSNV is detected through tests such as plate trapped antigen – enzyme-linked immunosorbent assay (PTA-ELISA) and conventional reverse transcription polymerase chain reaction RT-PCR. The objective of this study was to develop a protocol for RSNV detection via real-time RT-PCR using a TaqMan probe associated with direct sample preparation methods, which has not been published to date. The RT-PCR detection protocol developed was 100–1,000 times more sensitive than conventional RT-PCR, allowing for the detection of RSNV in contaminated plant material and soil. The direct sample preparation method associated with real-time RT-PCR exhibited similar sensitivity to the nucleic acid purification methods.

The classic paradigm, not always unequivocal though, that seagrass macrobenthic abundance and diversity are greater than those in adjacent unvegetated areas, was tested in a Mediterranean lagoon for which evidence is lacking. We compared the community structure and species composition of macrobenthic assemblages in three distinct areas of the Mistras Lagoon (Sardinia, Italy) dominated by i) the seagrass Cymodocea nodosa (Cym), ii) mixed-macrophyte/detritus (Mix), and iii) unvegetated sediments (Unv). Samplings were conducted in each area twice in spring (April and May) and twice in autumn (October and November) 2010. Multivariate analyses showed significant differences among the three areas and a marked separation between the two vegetated (Cym and Mix) and the unvegetated (Unv) areas. The top discriminating species, indicated by SIMPER analysis, were characterized by direct development lacking free living larvae. They included marine species, e.g. Cerithium lividulum, Microdeutopus gryllotalpa, Loripes orbiculatus and Gammarus aequicauda, at Cym vs Mix, whereas the pair discrimination of the areas Cym vs Unv and Mix vs Unv mostly depended on the marine Abra tenuis, the opportunistic Chironomidae and Capitella capitata, and the brackish Hydrobia acuta. Both vegetated areas showed a higher species number than the unvegetated area. Differently, abundance was higher in Unv than in Cym and Mix in all sampling dates, most notably in spring likely because of reproductive events, due to both opportunistic (C. capitata, chironomids) and halolimnobic (H. acuta, Cerastoderma glaucum) species. Overall, the present study demonstrated the importance of biological factors in structuring the macrobenthic assemblages of the Mistras Lagoon. Habitatforming phanerogams hosted species-rich assemblages, species-specific reproductive cycles and adaptive strategies contributed to drive species colonization and abundance distribution. Both vegetated and unvegetated patches were found to contribute greatly to the local-scale heterogeneity of the habitat, highlighting the importance of coastal lagoons as hotspots for benthic biodiversity. For these reasons, lagoons must be considered major targets for conservation measures.

In 2010 in Italy a major change in Upper secondary school guidelines have been implemented, and the topic "Natural Science" was strongly affected by this reform (MIUR, 2010). Thanks to the new guidelines Earth science topics were distributed along 5 years of curricula in some fields of study, while before the reform geology topics were studied only during one school year. The new guidelines promoted the use of an experimental and multidisciplinary approach in natural science teaching and outdoor activities. After this reform, Realdon et al (2016) investigated how teachers implemented the new Earth Sciences curriculum through the five teaching years by means of a survey. The aim of this research was to understand the implementation of the new guidelines after the end of the first cycle of studies. Realdon et al (2016) results showed that most of the teachers interviewed did not follow strictly the new guidelines, in fact, there was a tendency to follow old teaching habits and practices, and theoretical teaching was still prevailing as the scarce use of laboratory.In 2022 the eighth cycle of students completed their upper secondary school studies according to MIUR (2010) guidelines, for this reason, we decided to distribute a new survey to natural science teachers to study the state of the art of earth science topics in Italian upper secondary school. The aim of the survey is to understand how to support Italian natural science teachers in their didactical activities with reference to Earth Science topics. This research is needed due to the major change that happened in Italian upper secondary schools after the Covid emergency and the remote learning experience, and evaluate the actual possibility for upper secondary school teachers to work multidisciplinary on civic education, and in particular on Sustainable Development Goals (SDGs). In the survey we investigated the use of digital and online line tools to support earth science teaching, and if there are other types of didactical support needed by teachers. In this poster, we will present the first result of the survey, in particular, the needs expressed by Italian teachers and how they can be supported by Earth Science Faculties and the Italian ministry of education.MIUR , Indicazioni nazionali (D.M. n 211 del 7/10/2010) “Indicazioni nazionali riguardanti gli obiettivi specifici di apprendimento concernenti le attività e gli insegnamenti compresi nei piani degli studi previsti per i percorsi liceali”Realdon, G., Paris, E., & Invernizzi, M. C. (2016). Teaching Earth Sciences in Italian liceo high schools following the 2010 reform: a survey. Rendiconti Online Società Geologica Italiana, 40, 71-79.

Background: The increased prevalence of irritable bowel syndrome (IBS) among medical and nursing students is a global challenge. Unfortunately, data on the Italian medical and nurse student population are scarce. Therefore, this study was designed to assess the prevalence of IBS in this setting and to evaluate the demographic, university, Mediterranean diet adherence, and anxiety factors associated with its increased presence. Objective: To assess the prevalence of IBS, anxiety levels, and adherence to the Mediterranean diet in medical and nursing university students Methods: An anonymous online questionnaire was sent to participants. Several demographic and educational variables were assayed, and the presence of symptoms associated with the definition of IBS (according to Rome IV criteria). In addition, anxiety levels and adherence to the Mediterranean diet were also assessed. Results: Of 161 students, 21.11% met the Rome IV criteria for IBS. Some subgroups, the out-ofcourse students or no scholarship recipients, were found to have a higher percentage of IBS (p < 0.05). Being out-of-course was shown to be associated with an increased and unreported risk of presenting IBS (OR: 8.403, p < 0.001). Levels of anxiety and adherence to the Mediterranean diet were significantly worse in the IBS group (p < 0.01). Adherence to the Mediterranean diet was associated with a reduced risk of presenting IBS in our setting (OR 0.258, p = 0.002). Conclusion: Our sample of Italian medical and nursing students recorded a non-negligible percentage of IBS. Therefore, screening and awareness campaigns could be suggested.

Anorexia Nervosa (AN) and atypical anorexia nervosa (AAN) can present with profound effects on multiple organ systems as a result of malnutrition. Enteral tube nutrition (EN) may be indicated as a means of vital nutritional rehabilitation in individuals with medical instability, food refusal or inability in accepting enough oral nutrition or may be used as part of a refeeding protocol in some centres. Individuals treated with EN will need to transition back to oral intake to continue their nutritional rehabilitation. This transition may affect outcomes related to nutritional and psychological parameters as well as longer term outcomes such as length of treatment and rates of relapse. Previous systematic reviews have considered outcomes related to nasogastric tube feeding or EN in eating disorders or comparisons with oral intake where available. This systematic scoping review will endeavour to add to the evidence base by examining outcomes related to EN in AN and AAN while also specifically considering transition from EN back to oral intake and any gaps in literature in these contexts. Methods employed will be database searches following the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping reviews (PRISMA-ScR). Data extracted will be synthesised based on outcomes related to early and established EN as well as transition to oral intake.

Context: Each year the European Association of Urology (EAU) produce a document based on the most recent evidence on the diagnosis, therapy, and follow-up of testicular cancer (TC). Objective: To represent a summarised version of the EAU guidelines on TC for 2023 with a focus on key changes in the 2023 update. Evidence acquisition: A multidisciplinary panel of TC experts, comprising urologists, medical and radiation oncologists, and pathologists, reviewed the results from a structured literature search to compile the guidelines document. Each recommendation in the guidelines was assigned a strength rating. Evidence synthesis: For the 2023 EAU guidelines on TC, a review and restructure were undertaken. The key changes incorporated in the 2023 update include: new supporting text regarding venous thromboembolism prophylaxis in males with metastatic germ cell tumours receiving chemotherapy; quality of life after treatment; an update of the histological classifications and inclusion of the World Health Organization 2022 pathological classification; inclusion of the revalidation of the 1997 International Germ Cell Cancer Collaborative Group prognostic risk factors; and a new section covering oncology treatment protocols. Conclusions: The 2023 version of the EAU guidelines on TC include the highest available scientific evidence to standardise the management of TC. Better stratification and optimisation of treatment modalities will continue to improve the high survival rates for patients with TC. Patient summary: This article presents a summary of the European Association of Urology guidelines on testicular cancer published in 2023 and includes the latest recommendations for management of this disease. The guidelines are a valuable resource that may help patients in understanding treatment recommendations.

BackgroundWhile neurological manifestations are core features of Fabry disease (FD), quantitative neuroimaging biomarkers allowing to measure brain involvement are lacking. We used deep learning and the brain-age paradigm to assess whether FD patients’ brains appear older than normal and to validate brain-predicted age difference (brain-PAD) as a possible disease severity biomarker.MethodsMRI scans of FD patients and healthy controls (HC) from a single Institution were retrospectively studied. The Fabry stabilization index (FASTEX) was recorded as a measure of disease severity. Using minimally preprocessed 3D T1-weighted brain scans of healthy subjects from 8 publicly available sources (N=2160; mean age=33y[range 4-86]), we trained a model predicting chronological age based on a DenseNet architecture and used it to generate brain-age predictions in the internal cohort. Within a linear modeling framework, brain-PAD was tested for age/sex-adjusted associations with diagnostic group (FD vs HC), FASTEX score, and both global and voxel-level neuroimaging measures.ResultsWe studied 52 FD patients (40.6±12.6y; 28F) and 58 HC (38.4±13.4y; 28F). The brain-age model achieved accurate out-of-sample performance (mean absolute error=4.01y, R2=0.90). FD patients had significantly higher brain-PAD than HC (estimated marginal means: 3.1vs-0.1, p=0.01). Brain-PAD was associated with FASTEX score (B=0.10, p=0.02), brain parenchymal fraction (B=-153.50, p=0.001), white matter hyperintensities load (B=0.85, p=0.01), and tissue volume reduction throughout the brain.ConclusionsWe demonstrated that FD patients’ brains appear older than normal. Brain-PAD correlates with FD-related multi-organ damage and is influenced by both global brain volume and white matter hyperintensities, offering a comprehensive biomarker of (neurological) disease severity.Summary StatementUsing deep learning and the brain-age paradigm, we found that Fabry disease is associated with older-appearing brains. The gap between brain-predicted and chronological age correlates with multi-organ disease severity, offering a novel quantitative neuroimaging biomarker.Key PointsPatients with Fabry disease show significantly higher brain-predicted age difference values compared to healthy controls (estimated marginal means: 3.1 vs -0.1, p=0.01).Brain-predicted age difference correlates with multi-organ disease severity and is associated with brain parenchymal fraction, white matter hyperintensities load, and tissue volume throughout the brain.Brain-predicted age difference might represent a sensitive quantitative biomarker of brain involvement in Fabry disease, with potentially relevant implications for patient stratification and treatment response monitoring.

Multimodal treatment has improved the outcome of many solid tumors, and in some cases the use of radiosensitizers has significantly contributed to this gain. Activation of the extracellular signaling kinase pathway (MEK/ERK) generally results in stimulation of cell growth and confers a survival advantage playing the major role in human cancer. The potential involvement of this pathway in cellular radiosensitivity remains unclear. We previously reported that the disruption of c-Myc through MEK/ERK inhibition blocks the expression of the transformed phenotype; affects in vitro and in vivo growth and angiogenic signaling; and induces myogenic differentiation in the embryonal rhabdomyosarcoma (ERMS) cell lines (RD). This study was designed to examine whether the ERK pathway affects intrinsic radiosensitivity of rhabdomyosarcoma cancer cells. Exponentially growing human ERMS, RD, xenograft-derived RD-M1, and TE671 cell lines were used. The specific MEK/ERK inhibitor, U0126, reduced the clonogenic potential of the three cell lines, and was affected by radiation. U0126 inhibited phospho-active ERK1/2 and reduced DNA protein kinase catalytic subunit (DNA-PKcs) suggesting that ERKs and DNA-PKcs cooperate in radioprotection of rhabdomyosarcoma cells. The TE671 cell line xenotransplanted in mice showed a reduction in tumor mass and increase in the time of tumor progression with U0126 treatment associated with reduced DNA-PKcs, an effect enhanced by radiotherapy. Thus, our results show that MEK/ERK inhibition enhances radiosensitivity of rhabdomyosarcoma cells suggesting a rational approach in combination with radiotherapy. Mol Cancer Ther; 10(1); 159–68. ©2011 AACR.