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Motivational interviewing provides a framework and tools to promote patient-centered engagement and change. This article focuses on motivational interviewing at the clinical care level, with emphasis on the motivational interviewing spirit and its four elements: partnership, acceptance, compassion, and empowerment. Keywords: Motivational interviewing, ambulatory care, patient-centered care., The provision of health care in ambulatory care practice is a complex system. Embedded in this system are numerous practice specialties to address a wide range of medical needs. The [...]

As climate change accelerates and countries adopt more policies to address it, it is clear that economies must rely less on fossil fuels. (1) We have already seen significant growth [...]

We take care; we must take care, because history has sharpened their edges; sharpened our edges,' Sara Ahmed writes in Living a Feminist Life (2017). The planning of CARE SYLLABUS-a [...]

During 2019–21, the AutoTest VIH, Libre d'accéder à la connaissance de son Statut (ATLAS) programme distributed around 380 000 HIV self-testing kits to key populations, including female sex workers, men who have sex with men, and their partners, in Côte d'Ivoire, Mali, and Senegal. We aimed to estimate the effects of the ATLAS programme and national scale-up of HIV self-test distribution on HIV diagnosis, HIV treatment coverage, HIV incidence, and HIV-related mortality.

Given the problem of minimizing a possibly nonconvex and nonsmooth function in a real Hilbert space, we present a generalized epsilon-descent algorithm motivated from the abstract descent method introduced by Attouch et al. [Math. Program. 137 (2013) 91–129] with two essential additions, we consider scalar errors on the sufficient descent condition, as well as, on the relative inexact optimality condition. Under general conditions on the function to be minimized, we obtain that all accumulation points of the sequences generated by the algorithm, if they exist, are generalized critical limit points of the objective function.

This work examines the effect of incorporating a third cation M (M = Mg, Al, Mn, or Fe) into Nb-promoted NiO catalysts (Ni0.85Nb0.15O) on their physicochemical properties and catalytic performance in the oxidative dehydrogenation (ODH) of ethane into ethylene. Therefore, a series of mixed oxides with the composition Ni0.765Nb0.135M0.1O was synthesized, characterized, and analyzed for catalytic behavior. The addition of the third cation markedly modified the redox and semiconductive properties of the catalysts, thus affecting their ODH performance. The selectivity toward ethylene was strongly dependent on the cation modifier, as it modulated the density of nonselective sites on the catalyst surface. In the low-temperature region, Mn-NiNbO demonstrated the highest conversion rates but with the lowest ethylene selectivity, whereas Fe-NiNbO, despite being less active than the undoped NiNbO, exhibited the highest ethylene selectivity. Overall, undoped NiNbO emerged as the best catalyst in terms of both activity and selectivity at isoconversion. All catalysts underwent partial reduction under reaction conditions, with the degree of reduction inversely correlated with the specific reaction rates. Although none of the catalysts remained stable at 400 °C, Al-NiNbO showed the least deactivation over time. The deactivation was linked to a reduction in p-type conductivity and a loss of redox functionality during operation.

Objectives to evaluate long-term effectiveness and safety of fluocinolone acetonide (FAc) implant used as second-line treatment in patients with persistent diabetic macular edema (DME).Methods retrospective data chart review of 241 pseudophakic eyes of 178 patients treated with FAc from July 2017 to December 2021 in 10 medical retinal units in Italy. The primary endpoint was the change of best-corrected visual acuity (BCVA) and central macular thickness (CMT) at 2 years. A Student's paired t-test was used. Additional therapies for DME and intraocular pressure (IOP)-related events were also evaluated.Results efficacy of FAc was assessed in a subset of 111 eyes with at least 24 months of follow-up. Mean BCVA increased at 2 years by 5.1 ETDRS letters (95%CI = 2.6–7.5; p< 0.001) while mean CMT decreased by 189 µm (95% CI 151–227; p< 0.001). Thirty-eight of these eyes (34.2%) needed additional intravitreal treatments, mainly anti-VEGF. Safety was evaluated on the entire cohort of 241 eyes treated with FAc. Overall, 66 eyes (27.4%) required emergent IOP-lowering medications (typically within the first-year post FAc) while 14 eyes (5.8%) underwent trabeculectomy, mostly during the second year of follow-up.Conclusion FAc implant provides a substantial long-term functional and anatomical benefit when used as second-line treatment in eyes with DME. IOP rise can be adequately managed with topical agents although some eyes may require IOP-lowering surgery.

Ground-truth RGBD data are fundamental for a wide range of computer vision applications; however, those labeled samples are difficult to collect and time-consuming to produce. A common solution to overcome this lack of data is to employ graphic engines to produce synthetic proxies; however, those data do not often reflect real-world images, resulting in poor performance of the trained models at the inference step. In this paper we propose a novel training pipeline that incorporates Diffusion4D (D4D), a customized 4-channels diffusion model able to generate realistic RGBD samples. We show the effectiveness of the developed solution in improving the performances of deep learning models on the monocular depth estimation task, where the correspondence between RGB and depth map is crucial to achieving accurate measurements. Our supervised training pipeline, enriched by the generated samples, outperforms synthetic and original data performances achieving an RMSE reduction of (8.2%, 11.9%) and (8.1%, 6.1%) respectively on the indoor NYU Depth v2 and the outdoor KITTI dataset.

Since there is no current international consensus on the optimal approach for pain management in acute pancreatitis (AP), analgesic practices may vary across different healthcare settings. This study explored global disparities in analgesic use, in particular opioids, during admission and at discharge in hospitalised AP patients. This was a post hoc analysis of the prospective PAINAP database, which included all admissions for AP between April and June 2022 with a 1‐month follow‐up. Demographic details, analgesic use, and clinical outcomes were recorded during admission and at discharge. Odds ratios (ORs) for opioid use during admission and at discharge were identified using multivariable regression analyses. Amongst the 1864 patients (52% males, median age 56 (interquartile range, 41–71)) across three different continents, simple analgesics were predominantly used as the primary analgesic (70%). Opioid use during admission was lowest in European centres (67%). Admission in Asian (OR, 2.53 (95% confidence interval (CI), 1.59–4.04), p< 0.001), and Australian (OR, 5.81 (95% CI, 3.19–10.56), p< 0.001) centres was associated with opioid administration during admission compared with European centres. Increased pain severity, longer pre‐admission pain duration, organ failure, and longer length of admission increased opioid use during admission. At discharge, Asian (OR, 2.01 (95% CI, 1.40–2.88), p< 0.001) and Australian (OR, 1.91 (95% CI, 1.28–2.85), p= 0.002) centres were associated with opioid prescription compared with European centres. Increased pain severity, longer pre‐admission pain duration, acute necrotic collections, and walled‐off necrosis also increased the likelihood of opioid prescription at discharge. There are substantial intercontinental differences in opioid use for AP pain. Accordingly, there is a need for international guidelines on pain management in AP.

Inherited retinal diseases, which include retinitis pigmentosa, are a family of genetic disorders characterized by gradual rod-cone degeneration and vision loss, without effective pharmacological treatments. Experimental approaches aim to delay disease progression, supporting cones’ survival, crucial for human vision. Histone deacetylases (HDACs) mediate the activation of epigenetic and nonepigenetic pathways that modulate cone degeneration in RP mouse models. We developed new HDAC inhibitors (5a–p), typified by a tetrahydro-γ-carboline scaffold, characterized by high HDAC6 inhibition potency with balanced physicochemical properties for in vivo studies. Compound 5d(repistat, IC50HDAC6 = 6.32 nM) increased the levels of acetylated α-tubulin compared to histone H3 in ARPE-19 and 661W cells. 5dpromoted vision rescue in the atp6v0e1–/–zebrafish model of photoreceptor dysfunction. A single intravitreal injection of 5din the rd10mouse model of RP supported morphological and functional preservation of cone cells and maintenance of the retinal pigment epithelium array.

A simple waveguide-Floquet mapping is proposed and theoretically investigated that links the scattering response of a sub-wavelength metasurface unit cell under an infinite periodic array configuration and when measured inside a shielded rectangular waveguide environment. This mapping is based on extracting the effective surface susceptibilities as the fundamental constitutive parameters of the cells, via the generalized sheet transition conditions (GSTCs) of the unit cell using the waveguide measurements, and then reconstructing the unit-cell response at an arbitrary incidence angles. Using two examples of a transmissive Huygens’ metasurface and a purely reflective metasurface, the proposed waveguide-Floquet mapping is numerically confirmed to determine the complete angular scattering of the unit cells. The proposed waveguide-Floquet mapping thus represents a simple technique to experimentally determine the angular scattering characteristics of the unit cell using a low-cost effective waveguide measurements.

Vision Transformer (ViT) architectures are becoming increasingly popular and widely employed to tackle computer vision applications. Their main feature is the capacity to extract global information through the self-attention mechanism, outperforming earlier convolutional neural networks. However, ViT deployment and performance have grown steadily with their size, number of trainable parameters, and operations. Furthermore, self-attention's computational and memory cost quadratically increases with the image resolution. Generally speaking, it is challenging to employ these architectures in real-world applications due to many hardware and environmental restrictions, such as processing and computational capabilities. Therefore, this survey investigates the most efficient methodologies to ensure sub-optimal estimation performances. More in detail, four efficient categories will be analyzed: compact architecture, pruning, knowledge distillation, and quantization strategies. Moreover, a new metric called Efficient Error Rate has been introduced in order to normalize and compare models’ features that affect hardware devices at inference time, such as the number of parameters, bits, FLOPs, and model size. Summarizing, this paper first mathematically defines the strategies used to make Vision Transformer efficient, describes and discusses state-of-the-art methodologies, and analyzes their performances over different application scenarios. Toward the end of this paper, we also discuss open challenges and promising research directions.

While one of the main features of 5G networks is provisioning very high rates with low (or no) variability to cellular users, it has been shown that this turns out to be very ineffective for operators because it leads to an abundance of unused network resources. Yet, reallocating the unused resources to the same users, after providing them with the same constant rate, increases back the variability in data rates. A more efficient way would be to provide different low-variability data rates to the users depending on their channel conditions while trying to bring the wasted resources to the lowest possible extent. To that end, in this paper, two approaches are considered; one with reserved resources for every user and the other where the amount of resources is decided on the fly, depending on their current channel conditions. Then, for each approach, we look at different allocation policies and derive the corresponding maximum achievable constant rate for every user jointly with the level of resource utilization, showing which policy is more beneficial. Further, the performance is evaluated on a real 5G trace using both extensive simulations and real measurements conducted on OpenAirInterface. Results show that no-resource reservation policies increase the utilization of resources and data rates at the expense of increased rate variability across all the users. Moreover, all the policies proposed in this paper outperform state-of-the-art approaches by at least $\text{2}\times$2×, bringing the waste of resources down to 15%.

The increasing complexity of urban distributed energy systems demands effective strategies to tackle design and operational challenges. This study presents a framework for evaluating energy flexibility strategies in building clusters, aiming to minimize costs across various domains. By analysing thermostat adjustments and load adaptations, the study assesses the economic and non-economic costs, namely energy expenses and variation in occupant thermal comfort. A simulation platform has been developed to carry out multi-domain analyses, aiming to enhance the utilization of renewable energy and manage grid power demand. The model integrates detailed building energy models with a district grid model in co-simulation mode, augmenting the capabilities of current energy models in capturing multi-domain aspects of the design, such as occupants’ response to flexibility events. The model integrates distributed renewable energy sources and energy storage systems aggregated with different building typologies forming energy communities. Proof-of-concept simulations are conducted, showcasing the multi-faceted costs of implementing energy communities, including photovoltaic, battery energy storage, and a building cluster composed of residential, office, and service buildings. Sensitivity analysis evaluates the impact of flexibility strategies on renewable energy consumption and occupant comfort. The results of the study help to understand and quantify the impact of measures encouraging the engagement of citizens in such communities' response programs and inform the design and operation of such strategies. It is demonstrated that for the case study, the use of BESS in demand management raises the utilization of renewable energy by up to 25 %, while load adaptations lead to an 8 % increase in renewable energy consumption. The maximum variation in thermal comfort sensation is achieved adapting setpoint at lower aggregate load thresholds. Compared to previous district grid models, this framework provides a more comprehensive evaluation by quantifying the specific effects on renewable energy use and occupant comfort through detailed dynamic building simulation.

Byline: Florent. A. Zeng, Doudou. Gueye, Ndeye. Ndoye, Papa. Mbaye, Omar. Iq-Lefqih, Aloise. Sagna, Gabriel. Ngom Sir, Umbilical hernia is a common disease in African children, in whom it is [...]

Pulmonary nodules may be an early manifestation of lung cancer, the leading cause of cancer-related deaths among both men and women. Numerous studies have established that deep learning methods can yield high-performance levels in the detection of lung nodules in chest X-rays. However, the lack of gold-standard public datasets slows down the progression of the research and prevents benchmarking of methods for this task. To address this, we organized a public research challenge, NODE21, aimed at the detection and generation of lung nodules in chest X-rays. While the detection track assesses state-of-the-art nodule detection systems, the generation track determines the utility of nodule generation algorithms to augment training data and hence improve the performance of the detection systems. This paper summarizes the results of the NODE21 challenge and performs extensive additional experiments to examine the impact of the synthetically generated nodule training images on the detection algorithm performance.

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More than 90% of gestational diabetes cases are estimated to occur in low-income and middle-income countries (LMICs). Most current guidelines recommend an oral glucose tolerance test (OGTT) at 24–28 weeks of gestation. The OGTT is burdensome, especially in LMICs, resulting in a high proportion of women not being screened. We aimed to develop a simple and effective screening strategy for gestational diabetes.

The Isotope and Muon Production using Advanced-Cyclotron and Target Technology Project (IMPACT) foresees the introduction of two new target stations and three new beamlines: one for radionuclide production and two for surface muon production. The latter forms the project, High-Intensity Muon Beams (HIMB), which plans to increase the muon rate from the current world record of 108 µ+/s up to 1010 µ+/s. This work presents an overview of the future HIMB beamlines focusing on the magnet designs that have been developed to ensure increased muon rate production and transmission. Specific radiation-hard resistive coils, based on mineral insulation, are required in this case due to the proximity to the target station. A high muon capture and transmission efficiency requires solenoid-like magnets, as well as dipole magnets and crossed-field separators to select the desired particles, while suppressing unwanted background particles. The radiation-hard capture solenoid plays the most important role in the whole beamline since it must provide a high capture efficiency. Beam optics studies provided the on-axis field profile necessary for optimizing the size and shape of the capture solenoid. Therefore, the article will also elucidate on these solenoid design strategies for achieving the desired capture efficiency.

The flexural behavior of sandwich structures produced through the foam additive manufacturing (FAM) process was examined. FAM allows the creation of intricate foamed structures with varying morphology and density gradients using a physical blowing agent (PBA). This technology facilitates the production of complex, engineered parts made from a single material intentionally designed with different densities and mechanical properties in various sections, as well as enabling gradient structures. As foams are widely used in industrial applications for composite sandwich structures, the study aims to investigate the mechanical behavior under three-points loading of 3D printed foam sandwich structures produced with various printing parameters, resulting in distinct densities and mechanical properties. The failure modalities were analyzed by infrared thermography and microscopy. The results highlight the influence of printing parameters on the foam’s characteristics. The bending tests provide insights into the foam’s strength and energy absorption capabilities. Gibson–Ashby curve was built to provide the previsional mechanical strength of the foamed sandwich structures, based on their core shape and density. These findings contribute to optimizing FAM parameters for crafting lightweight, durable components with customized mechanical properties, achieved using monomaterial structures. This approach makes recycling easier and less impactful, benefiting industries such as aviation and automotive.

The precipitation of asphaltene damages rock formations and plugs pores, leading to significant hydrocarbon production losses. Accurately measuring asphaltene deposition in porous media at the laboratory scale is critical for understanding its development. However, technical difficulties with asphaltene cake formation in the core flooding inlets have led to short test periods, unreliable data, misleading interpretations, and a lack of full understanding of asphaltene deposition mechanisms. This paper provides an extended critical literature review and experimental development to identify the research gap in the field of asphaltene deposition in rocks. The literature review meticulously examines the key findings, advantages, and limitations of existing asphaltene experiments conducted over the past two decades. We then developed an experimental design, procedure, and workflow that enabled the continuous coinjection of solvent and oil to address the technical challenges of asphaltene deposition in the core inlet. To test our approach, we continuously injected oil and mixed gas into a Berea sandstone core plug at a pressure of 4500 psi and a temperature of 170 °F. Our test results reveal that 75% of asphaltene deposited in the last 2/3 of the core pore volume without asphaltene accumulations at the core front. We used several indicators of asphaltene deposition in rocks, including pore size reduction from nuclear magnetic resonance (NMR), wettability alteration from contact angle measurements, pressure buildups, and permeability reductions from flow tests. Furthermore, pressure buildups and permeability reductions were developed at various stages. Building upon this, we extended our study and proposed a conceptual model that vividly illustrates the evolution of the asphaltene mechanism including precipitation, flocculation, dissociation, deposition, and pore plug stages. This study improves our understanding of asphaltene-induced formation damage and impairment and may help in the design of proper treatment.

The efficacy and safety of Descemet's membrane endothelial keratoplasty (DMEK) and ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) have been recently compared in several systematic reviews (SRs). The aim of this study was to assess the evidence quality of such SRs, in order to obtain a scientifically rigorous comparison between the two techniques. We performed a systematic review of SRs and meta-analyses comparing the efficacy and safety between UT-DSAEK and DMEK up to 24th March 2023, using 3 electronic databases (PubMed, Cochrane Library, Google Scholar) plus manual reference search. Specific outcomes analyzed included best-corrected visual acuity (BCVA), endothelial cell density (ECD), rebubbling rate, and other postoperative complications. Of 90 titles/abstracts screened, four SRs met the inclusion criteria. All SRs adequately analyzed potential bias of the included studies. One SR raised concern for potential literature search bias and two SRs have heterogeneity in some outcomes analyzed. All SRs found higher BCVA after DMEK, but one SR reported significant heterogeneity. All SRs found significant heterogeneity in ECD analysis, with one SR providing inconsistent analysis of this outcome. Three SRs analyzed rebubbling rates, favoring UT-DSAEK over DMEK. Three SRs concluded a higher overall complication rate after DMEK, although rebubbling may be a confounding factor. This systematic review clarifies the strengths and weaknesses of published SRs and reinforces the conclusion that DMEK leads to superior visual outcomes compared to UT-DSAEK, with the trade-off of higher rebubbling rates and possibly other postoperative complications. Studies with longer follow-up are needed to ascertain these differences between procedures.

The 3,4-methylenedioxy-alpha-pyrrolidinohexanophenone (MDPHP) is a synthetic cathinone closely related to 3,4-methylenedioxypyrovalerone (MDPV), one of the most common synthetic cathinones present in the “bath salts”. MDPHP has recently gained attention due to increasing seizures and involvement in human intoxications which occurred in Europe and Italy in the last years, but currently there is a lack of information about its pharmaco-toxicological effects. With the aim at filling this gap, the present study is endeavoured to (i) evaluate the effects of acute administration of MDPHP (0.01–20 mg/kg; i.p.) on behaviour, cardiorespiratory and cardiovascular parameters in CD-1 male mice, comparing them to those observed after administration of MDPV; (ii) predict the ADMET profile of the two analogues using the Plus ADMET Predictor®; (iii) present clinical data related to MDPHP and MDPV-induced intoxications recorded between 2011 and 2023 by the Pavia Poison Control Centre (PCC) − National Toxicology Information Centre (Istituti Clinici Scientifici Maugeri, IRCCS Pavia, Italy). Our results substantiated that MDPHP and MDPV similarly affect sensorimotor and behavioural responses in mice, importantly increased locomotion and induced aggressive behaviour, and, at higher dosage, increased heart rate and blood pressure. These findings are in line with those observed in humans, revealing severe toxidromes typically characterized by Central Nervous System (CNS) alterations (behavioural/neuropsychiatric symptoms), including psychomotor agitation and aggressiveness, cardiovascular and respiratory disorders (e.g. tachycardia, hypertension, dyspnoea), and other peripheral symptoms (e.g. hyperthermia, acidosis, rhabdomyolysis).

Increasing rates of autoimmune and inflammatory disease present a burgeoning threat to human health1. This is compounded by the limited efficacy of available treatments1and high failure rates during drug development2, highlighting an urgent need to better understand disease mechanisms. Here we show how functional genomics could address this challenge. By investigating an intergenic haplotype on chr21q22—which has been independently linked to inflammatory bowel disease, ankylosing spondylitis, primary sclerosing cholangitis and Takayasu’s arteritis3–6—we identify that the causal gene, ETS2, is a central regulator of human inflammatory macrophages and delineate the shared disease mechanism that amplifies ETS2expression. Genes regulated by ETS2 were prominently expressed in diseased tissues and more enriched for inflammatory bowel disease GWAS hits than most previously described pathways. Overexpressing ETS2in resting macrophages reproduced the inflammatory state observed in chr21q22-associated diseases, with upregulation of multiple drug targets, including TNF and IL-23. Using a database of cellular signatures7, we identified drugs that might modulate this pathway and validated the potent anti-inflammatory activity of one class of small molecules in vitro and ex vivo. Together, this illustrates the power of functional genomics, applied directly in primary human cells, to identify immune-mediated disease mechanisms and potential therapeutic opportunities.

Polymers are extensively used for the realization of drug delivery systems across multiple scales, from nanomedicines to microparticles and macroscopic implantable devices, for their favorable biodegradation profiles and tunable physicochemical features. The accurate quantification of the polymer content is key to finely controlling drug loading and release and ensuring reproducibility, yet it continues to be a major challenge in the design and development of delivery systems. In this study, we introduce a novel protocol based on the PULCON technique to quantify, with a routine NMR spectroscopy analysis, the precise concentration of polymers in various delivery systems. Specifically, the PULCON protocol is applied to characterize the physicochemical and pharmaceutical properties of nanoparticles, microparticles, and implantable devices realized by combining three extensively used polymers, namely, poly(lactic-co-glycolic acid) (PLGA), poly(vinyl alcohol) (PVA), and poly(ethylene glycol) (PEG). Without using internal calibration procedures, in a single step, the PULCON protocol precisely quantifies the concentration of each polymer and the drug content. This approach can be readily implemented on standard NMR spectrometers, enabling accurate characterization of drug delivery systems and facilitating their effective development.

Deliberative polling has emerged as a promising method for promoting democratic reform and citizen engagement in various contexts, however, its potential and limitations in hybrid regimes, where democratic governance is challenged by a mix of democratic and authoritarian features, remain relatively unexplored. This paper focuses on the case of North Macedonia, as a country that has undergone significant political and societal transformation especially in the recent years. Despite efforts to promote democratic reforms, the country continues to face challenges in terms of ensuring democratic governance and citizen participation. In a hybrid regime, like North Macedonia’s, political leaders might not be inclined to value citizens’ input, and the media environment might not be free from influence, which limits access to varied and reliable sources of information. Civil society organizations may also encounter limitations on their operations, and institutional assistance may be insufficient. Additionally, the population’s diversity could make it difficult to reach and build trust with citizens. In this context, deliberative polling represents an opportunity to engage citizens in meaningful political dialogue and institutional reform. This paper examines the potential of deliberative polling as a tool for promoting governance in North Macedonia and highlights the challenges and limitations faced in this process.

Kids are flux capacitors. The moment you have one, everything you know about time changes forever. WHEN YOU HAVE children, the first thing more-seasoned parents tell you is that it [...]

Typha australis is an invasive plant from Senegal also found in wetlands. In order to limit its proliferation, typha australis is used in the energy sector but also in construction. This study contributes to the valorisation of typha australis in the field of biocomposites. For this purpose, typha fibres were used. The fibres were extracted manually using a plastic comb, then subdivided into three zones, namely the bottom, middle and top, and dried. The resulting fibres were characterised physically by measuring density, water content and absorption coefficient, and morphologically by determining the morphology but also of the section of the fibres. many respects, the physical property results concerning density show an average of the three areas of 1.53 g/cm3 with a water content between 6 and 10% and an absorption coefficient showing two main absorption phases. As for the tomography results, we directly notice the presence of fibre bundles and not of individual fibres due to the manual extraction method used. Nevertheless, the results obtained suggest a behaviour comparable to that of the most commonly used natural fibres, namely flax.

AbstractAntipermeation and anticorrosion coatings are being developed to reduce tritium permeation from liquid metal [LiPb of the water-cooled lithium-lead breeding blanket and Pb for lead-cooled fast reactors (LFRs)] to primary heat transfer systems. The facility APRIL (Alumina-coating for tritium Permeation Reduction for Innovative LFR) was designed and installed at ENEA Brasimone R.C. to characterize the permeation reduction factor (PRF) of the candidate coatings in static conditions.In the current configuration, APRIL is composed of three pipes, closed at one end, that simulate the heat exchangers of the ALFRED LFR. Two of the pipes are coated with 3 µm of alumina with pulsed laser deposition techniques, the reference method for a fission reactor. The third pipe is uncoated. During the tests, all the pipes are filled with pressurized steam at 100 bar and 480°C, the steam generator condition of the ALFRED LFR. The tests are made in the gas phase; indeed, the three pipes are installed in a chamber filled with helium with a known concentration of deuterium that simulates tritium. Deuterium permeates inside the pipes, allowing for the evaluation of the PRF by means of the ratio between the measured permeated flux in the uncoated pipe and in the coated ones. A first test with 0.5% of deuterium was carried out and the evaluated PRF was about 13.5.

Purpose: By considering the challenges of Industry 5.0, the purpose of this study is to analyze the role of heuristic factors in the technical qualities and emotions of Millennials and Generation Z (Gen Z) to assess their acceptance of the use of artificial intelligence (AI) devices such as robots. For this purpose, this paper uses the innovative AI device use acceptance (AIDUA) framework. This research evaluates the implications of human–machine interactions for the usage of robots and AI in daily life. Design/methodology/approach: The proposed AIDUA model is tested using data collected from Millennials and Gen Z. First, a principal components analysis technique is used to validate each measure. Second, a multiple regression analysis using IBM SPSS 26.0 is conducted. Findings: The results of this study suggest that human–machine interaction is a part of a complex process in which there are different elements determining individuals’ acceptance of the use of AI devices during daily life. This paper outlines both the theoretical and practical implications. This study enriches the AIDUA model by connoting it with features and emotions belonging to the younger generation. Additionally, this research offers technology companies suggestions for addressing future efforts on technical performance and on the alignments of the expectations of young people in Society 5.0. Originality/value: First, the originality of this paper lies in highlighting the binary role of emotions in triggering the use of AI devices and robots. Second, the focus on Millennials and Gen Z offers a new lens for the interpretation of longitudinal phenomena in the adoption of AI. Finally, the findings of this paper contribute to the development of a new perspective regarding a “heartly collaborative” approach in Society 5.0.

Lichen sclerosus (LS) is a frequently encountered inflammatory skin disorder characterized by whitened, atrophic patches that can cause pain and pruritus. The underlying cause of this condition remains unknown. Primarily affecting the genital area, this condition carries an increased risk of developing cutaneous cancers and frequently co-occurs with autoimmune disorders. Our retrospective study aimed to explore histologic features of LS, with a particular focus on a newly established finding and its potential implications. We examined 53 histologic cases of LS collected over 2 years. Experienced pathologists evaluated and reached a consensus on the assignment of histologic features. Patient charts were manually reviewed to gather relevant demographic and clinical data. Statistical analysis was performed using IBM SPSS Statistics (2021). Of the 53 total patients identified as meeting criteria for inclusion in this study, only 8 (15%) were male. Eight cases (15%) demonstrated perineural inflammatory infiltrate. Notably, half of all samples from male patients exhibited perineural inflammatory infiltrate. A statistically significant increase (P< 0.01) in the presence of dermal plasma cells was identified in cases with perineural inflammation versus cases without this feature. The findings of our study highlight the recurrent nature of perineural inflammation in LS, providing valuable insights into this condition. Furthermore, we observed a notable correlation between perineural inflammation, male patients, and the presence of dermal plasma cells. These discoveries contribute to a better understanding of the underlying mechanisms of LS and suggest avenues for future research into the condition.

ABSTRACTIntroductionThe therapeutic armamentarium for managing Crohn’s disease (CD) has expanded significantly in recent decades. Several biologics with three different mechanisms of action [anti-tumor necrosis factor (TNF)-α, anti-integrin α4β7, and anti-IL 12/23] are currently available to manage CD.Area coveredThis narrative review aims to summarize the most significant efficacy and safety data on the use of infliximab (IFX), adalimumab (ADA), vedolizumab (VDZ) and ustekinumab (UST) for the treatment of CD obtained from studies conducted in the real world (RW), compared to the results of randomized clinical trials (RCTs).Expert opinionRW studies reported that biologic agents included in this analysis have higher remission rates and lower adverse event rates than findings from RCTs for treating patients with CD. All biological agents have proven effective and safe in RW studies, even when using biosimilars or switching to subcutaneous administration of the molecules for which they are available. Finally, anti-TNF-α agents, particularly IFX, have a higher rate of adverse events (AEs) than VDZ and UST. Therefore, patients at higher risk of AEs may benefit from other biologics than anti-TNF-α. However, further long-term RW studies are needed to confirm these findings.

ABSTRACTThe thermal and mechanical properties of a lightweight alkali bonded material were investigated in correlation with the microstructure and porosity. The material was produced using fine granules of expanded perlite [...]

This paper analyzes market reactions to the 2013-2014 Fed announcements related to the tapering of asset purchases and examines how these reactions are influenced by financial depth. The study focuses on long-term government bond yields and uses daily data for all emerging markets. Controlling for all time-invariant country characteristics as well as time-varying macroeconomic fundamentals (changes in current account, fiscal balance, GDP growth, and inflation), countries with deeper domestic financial markets (as measured by higher bank credit, M2, M3, or stock market capitalization) experienced smaller increases in government bond yields during 4-day windows around Federal Open Market Committee announcements related to tapering. Countries with better macroeconomic fundamentals (measured by improvements in current account, fiscal balance, and GDP growth) also experienced smaller increases in government bond yields around such episodes.JEL Classification E44 F3 G14, 1 IntroductionIn the aftermath of the Global Financial Crisis, loose monetary policy in advanced economies prompted a global search for yields with investors flocking into emerging markets (EMs). This trend [...]

New potent, selective monoacylglycerol lipase (MAGL) inhibitors based on the azetidin-2-one scaffold ((±)-5a–v, (±)-6a–j, and (±)-7a–d) were developed as irreversible ligands, as demonstrated by enzymatic and crystallographic studies for (±)-5d, (±)-5l, and (±)-5r. X-ray analyses combined with extensive computational studies allowed us to clarify the binding mode of the compounds. 5vwas identified as selective for MAGL when compared with other serine hydrolases. Solubility, in vitrometabolic stability, cytotoxicity, and absence of mutagenicity were determined for selected analogues. The most promising compounds ((±)-5c, (±)-5d, and (±)-5v) were used for in vivostudies in mice, showing a decrease in MAGL activity and increased 2-arachidonoyl-sn-glycerol levels in forebrain tissue. In particular, 5vis characterized by a high eudysmic ratio and (3R,4S)-5vis one of the most potent irreversible inhibitors of h/mMAGL identified thus far. These results suggest that the new MAGL inhibitors have therapeutic potential for different central and peripheral pathologies.

ABSTRACTBackgroundUstekinumab (UST) is an interleukin-12/interleukin-23 receptor antagonist recently approved for treating ulcerative colitis (UC) but with limited real-world data. Therefore, we evaluated the effectiveness and safety of UST in patients with UC in a real-world setting.Research design and methodsThis is a multicenter, retrospective, observational cohort study. The primary endpoints were the clinical remission rate (partial Mayo score, PMS, ≤1) and the safety of UST. Other endpoints were corticosteroid-free remission (CSFR) rate, clinical response rate (PMS reduction of at least 2 points), and fecal calprotectin (FC) reduction at week 24.ResultsWe included 256 consecutive patients with UC (M/F 139/117, median age 52). The clinical remission and clinical response rates at eight weeks were 18.7% (44/235) and 53.2% (125/235), respectively, and 27.6% (42/152) and 61.8% (94/152) at 24 weeks, respectively. At 24 weeks, CSFR was 20.3% (31/152), and FC significantly dropped at week 12 (p = 0.0004) and 24 (p = 0.038). At eight weeks, patients naïve or with one previous biologic treatment showed higher remission (p = 0.002) and clinical >response rates (p = 0.018) than patients previously treated with ≥ 2. Adverse events occurred in six patients (2.3%), whereas four patients (1.6%) underwent colectomy.ConclusionThis real-world study shows that UST effectively and safely treats patients with UC.

Scientific evidence regularly guides policy decisions1, with behavioural science increasingly part of this process2. In April 2020, an influential paper3proposed 19 policy recommendations (‘claims’) detailing how evidence from behavioural science could contribute to efforts to reduce impacts and end the COVID-19 pandemic. Here we assess 747 pandemic-related research articles that empirically investigated those claims. We report the scale of evidence and whether evidence supports them to indicate applicability for policymaking. Two independent teams, involving 72 reviewers, found evidence for 18 of 19 claims, with both teams finding evidence supporting 16 (89%) of those 18 claims. The strongest evidence supported claims that anticipated culture, polarization and misinformation would be associated with policy effectiveness. Claims suggesting trusted leaders and positive social norms increased adherence to behavioural interventions also had strong empirical support, as did appealing to social consensus or bipartisan agreement. Targeted language in messaging yielded mixed effects and there were no effects for highlighting individual benefits or protecting others. No available evidence existed to assess any distinct differences in effects between using the terms ‘physical distancing’ and ‘social distancing’. Analysis of 463 papers containing data showed generally large samples; 418 involved human participants with a mean of 16,848 (median of 1,699). That statistical power underscored improved suitability of behavioural science research for informing policy decisions. Furthermore, by implementing a standardized approach to evidence selection and synthesis, we amplify broader implications for advancing scientific evidence in policy formulation and prioritization.

Abstract:Nurses working during the COVID-19 pandemic reported increased levels of burnout. Healthcare leaders have the unique role of mitigating burnout and improving working conditions. This article is a systematic review of the literature on how leaders can alleviate burnout among nurses during the COVID-19 pandemic. A systematic review was performed in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. The following recommendations from the systematic review include leadership visibility and compassion, provision of clear and timely communication, adequate medical supplies, a manageable workload, adequate training and orientation, psychological support, resilience resources, recognition, and acknowledgment of work.

Polylactic acid is one of the most used materials for polymer parts manufacturing, given its good mechanical properties combined with reusability and environmental-friendly nature. This work analyzes the effects of mechanical recycling and lauroyl peroxide additivation on the physical and mechanical properties of polylactic acid processed through conventional and an additive manufacturing processes, namely compression moulding and fused deposition modelling. Differential scanning calorimetry analysis, three-point bending and tensile tests were considered to assess the effects of the mentioned actions. The results showed that the effects of recycling become evident after the third iteration, with a notable inhibition effect caused by the addition of lauroyl peroxide. Furthermore, the experimentation demonstrated that the impact of recycling and additives on the ultimate properties of the products depends on the transformation process used, highlighting a greater sensitivity of the fused deposition modelling process compared to the traditional compression moulding one.

Abstract: Kant, in various parts of his treatment of causality, refers to determinism or the principle of sufficient reason as an inescapable principle. In fact, in the Second Analogy we find the elements to reconstruct a purely phenomenal determinism as a logical and tautological truth. I endeavour in this article to gather these elements into an organic theory of phenomenal causality and then show, in the third section, with a specific argument which I call the “paradox of phenomenal observation”, that this phenomenal determinism is the only rational approach to causality because any logico-reductivistic approach, such as the Humean one, would destroy the temporal order and so the very possibility to talk of a causal relation. I also believe that, all things said, Kant did not achieve a much greater comprehension of the problem than Hume did, in his theory of causality, for he did not free a phenomenal approach from the impasse of reductivism as his reflections on “simultaneous causation” and “vanishing quantities” indeed show, and this I will argue in Sect. 4 of this article.

JAK2V617F is the most recurrent genetic mutation in Philadelphia-negative chronic Myeloproliferative Neoplasms (MPNs). Since the JAK2locus is located on Chromosome 9, we hypothesized that Chromosome 9 copy number abnormalities may be a disease modifier in JAK2V617F-mutant MPN patients. In this study, we identified a subset of MPN patients with partial or complete Chromosome 9 trisomy (+9p patients), who differ from JAK2V617F-homozygous MPN patients as they carry three JAK2alleles as well as three copies of all neighboring gene loci, including CD274, encoding immunosuppressive Programmed death-ligand 1 (PD-L1) protein. Investigation of the clonal hierarchy revealed that the JAK2V617F occurs first, followed by +9p. Functionally, CD34+ cells from +9p MPN patients demonstrated increased clonogenicity, generating a greater number of primitive colonies, due to high OCT4and NANOGexpression, with knock-down of these genes leading to a genotype-specific decrease in colony numbers. Moreover, our analysis revealed increased PD-L1 surface expression in malignant monocytes from +9p patients, while analysis of the T cell compartment unveiled elevated levels of exhausted cytotoxic T cells. Overall, here we identify a distinct novel subgroup of MPN patients, who feature a synergistic interplay between +9p and JAK2V617F that shapes immune escape characteristics and increased stemness in CD34+ cells.

Introduction: The growing demographic presence of the transgender (TGD) population has sparked an increase in clinical investigations focusing on the impacts of gender-affirming hormone therapy (GAHT) in adults with gender dysphoria. Despite this surge in studies, there remains a significant gap in the literature regarding the health status of older TGD individuals. This review aims to assess prevalent pathological conditions within the TGD population, specifically concentrating on aging-related diseases investigated to date. Methods: A systematic search across Embase Ovid, Scopus, PubMed, Cochrane Library, and Web of Science databases was conducted to identify articles reporting on the aging process in TGD individuals. Methodological quality was evaluated using Newcastle–Ottawa Scale (NOS) scores. Results: Initial database searches yielded 12,688 studies, which were refined to 18 through elimination of duplicates and title/abstract review. Following a comprehensive appraisal, nine studies were included in the systematic review. These articles, published between 2017 and 2023, involved a total of 5403 participants. The evidence indicates a noteworthy percentage of the TGD population being at risk for cardiovascular diseases, experiencing depression or disability, and demonstrating hesitancy toward major recommended screening programs. Conclusions: Limited studies on older TGD individuals highlight not only an organic risk of chronic diseases but also a cognitive/psychiatric risk that should not be underestimated. Further research is imperative to deepen our understanding of the pathophysiological mechanisms involved in the health challenges faced by older TGD individuals.

Background: Belimumab (Benlysta) is currently approved for the treatment of active Lupus despite standard therapy. Few data are available on the efficacy of this drug in lupus nephritis (LN). Methods: 17 LN female followed in two Nephrology Italian Unit received belimumab for a median period of 36 months (range 6–42 months). The indications were: arthralgia in 3 patients, cutaneous manifestations in 2, residual proteinuria in 8, and the need to reduce steroids for severe side effects in 4. Of interest, 1 patient started therapy during Peritoneal Dialysis and continued after kidney transplantation due to non-responsive arthralgias. Results: Arthralgia and skin manifestations resolved in all patients. Proteinuria normalized in three patients and stabilized in all but one of the others. Steroids were indefinitely stopped in six patients (35%) and reduced to around 40% of the basal dosage in the other patients. During belimumab therapy, three extrarenal and one renal SLE flares were diagnosed accounting for a rate of renal flares of 0.02/patient/year. No major adverse events leading to therapy withdrawal occurred. Clinical case: Arthralgia resolved, immunological parameters improved and prednisone could be reduced within few months in the patient who started belimumab during peritoneal dialysis. After kidney transplantation belimumab was stopped but due to arthralgias unresponsive to standard immunosuppressive therapy it was restarted with success. Conclusions: Belimumab allows the achievement of complete response together with the withdrawal or the reduction of corticosteroids in almost all our patients. Of interest its satisfactory use in a patient in peritoneal dialysis and after kidney transplantation.

While the current deployment of 5G is concentrated on high-quality service delivery on a two-dimensional terrestrial area covering our planet’s surface, ongoing 5G standardization already addresses parts of the third dimension with 5G Non Terrestrial Networks (5G-NTN). 6G is expected to further leverage aeronautical communication towards a full exploration and comprehensive unification of all three dimensions. In this way, future communication systems will not only encompass all kinds of aeronautical platforms such as satellites, High-Altitude Platforms (HAPs), civil aircrafts, (self-)flying taxis, and UAVs but shall also enable the unification of terrestrial and non-terrestrial networks on a service platform level. This is further challenging, due to the rather closed aeronautical systems so far. We believe that emerging technology concepts such as Mobile Edge Computing (MEC) and Software-Defined Networking (SDN) can provide a basis for the full integration of aeronautical systems into their terrestrial counterpart. However, these technologies render the management and orchestration of aeronautical systems complex. As a step towards the integration of aeronautical communication and services into 6G, we propose a framework for the collection, monitoring, and distribution of resources in the sky among heterogeneous flying objects. This enables high-performance services for a new era of 6G aeronautical applications. Based on our proposed Aeronautical Federation Framework, we introduce emerging application use cases including aeronautical edge computing, aeronautical sensor networks, and aircraft cabin networks. In turn, we derive research challenges for 6G aeronautical networks.

The ubiquity of social media and the varying nature of subjective well-being (SWB) in a culturally heterogeneous world raises an essential question about how social media and culture jointly influence SWB. We argue that social media shapes the influence of cultural dimensions on SWB in nuanced ways, depending on the nature of the dimensions. Drawing on the affordance-based institutional logics perspective, we hypothesize that social media attenuates the adverse effects of power distance, masculinity, and uncertainty avoidance and amplifies the positive effects of individualism, long-term orientation, and indulgence on SWB. Using a dynamic panel model, our analysis shows that a degree of high social media diffusion in a country reduces the negative effect of power distance on SWB and increases the positive effect of individualism on SWB. These findings can help policymakers make informed decisions regarding increasing social media penetration as a means of overcoming negative cultural characteristics to enhance SWB.

In the banking literature, investigating banking risk and its determinants is a key topic, especially since the global financial crisis that emerged from 2007. However, it seems that scientific research in this field has so far focused its attention mainly on the macro determinants of banking risk. Using a sample of Italian banks over the period 2013–2020, and adopting a microfoundations perspective, this study investigates the relationship between gender diversity in top management positions and bank risk, with a special focus on the mediation mechanisms behind this relationship. Our results demonstrate that the presence of females in top positions increases bank stability via intense employee training. The research findings provide novel insights into the determinants of bank risk from a microlevel perspective, with subsequent theoretical and managerial implications regarding the potential of gender diversity in top management positions and the attention to employee training. These aspects complement the banks' sustainability strategies and will therefore receive increasing attention from the market.

Digitalization has transformed businesses, especially during the ongoing pandemic. Firms have gradually moved to digital ecosystems and e-marketplaces. Digital transformation (DT) has helped firms improve profit margins, better engage customers, improve productivity, and reduce any functional and operational lags. While some firms have strategically transformed themselves in the digital space, others have adopted technology in an unstructured way. As a result, these firms’ employees have been exposed to sets of new technologies. While some have adopted them based on their past experience, others have perceived them as challenges and have resisted change. This brings us to an important question of whether the DT is inclusive. In this article, the hedonic motivation system adoption model (HMSAM) and flow theory were used to investigate the inclusivity of DT and to propose a modified HMSAM model. As part of in their respective firms’ DT process, employees are exposed to a gamified environment. This article collected data from retail sector employees based in an emerging nation and tested hypotheses using structured equation modeling.