Search

We aimed to evaluate whether progression-directed radiation therapy (PDRT) can prolong the initiation of a subsequent systemic therapy regimen in a cohort of patients with oligoprogressive NSCLC. A retrospective analysis was conducted on NSCLC patients who underwent PDRT for extracranial oligoprogressive NSCLC, defined as limited (up to five) progressing lesions following initial complete, partial, or stable response to systemic therapy according to REC1ST 1.1 and/or PERCIST 1.0 criteria. Cox proportional hazard regressions were performed to identify factors influencing time to next treatment (TTNT), which was considered the primary endpoint. Forty patients were analyzed. First, second, and ≥3 lines of systemic therapy were administered in 22 (58.2%), 14 (27.2%), and 4 (14.6%) cases, respectively. The median total dose was 36 Gy (range: 12–60) in five fractions (1–10), with a median biological effective dose for tumor control (BED10) of 52 Gy (26.4–151.2). After a median follow-up of 11 months (2–50), PDRT delayed further systemic therapy in 32 (80.0%) treatments. Median TTNT was not reached at 8 months (1–47) with a one-year Kaplan–Meier estimate of 81.4% (95% CI: 75.0% to 87.8%). No >grade 3 adverse event was observed. On multivariate analysis, patients with ≥3 lines of systemic therapy and/or with larger CTV volumes did not benefit from PDRT. Despite the use of sub-ablative doses, our findings show that PDRT represents an effective, safe, and viable option for oligoprogressive NSCLC. Patients irradiated early during their systemic treatment course, with a low volume of disease and nonmetastatic oligoprogression, could derive substantial benefits from PDRT.

Abstract In this study, a fuzzy model is presented for predicting the possibility of degradation due to salt crystallisation cycles. The formalization of the proposed model has been based on the multivariable approach which considers environmental data (such as temperature, solar radiation, wind speed, rain quantity, relative humidity), characteristic inflection points of specific salts and stone features derived from laboratory characterizations (including mechanical properties, porosity, and mineralogical composition). Modeling results have been compared with experimental data elaborations acquired by monitoring a semi-confined archaeological site situated in the city of Cagliari (Munatius Irenaus cubicle), revealing substantial alignment in the degradation kinetics trends. Moreover, the achieved outcomes show the remarkable capability to identify salt crystallisation phenomenon type (efflorescence or subflorescence).

Abstract Sedentary behaviours in adults with intellectual disabilities (ID) negatively impact health-related determinants and increase the risk of physical dysfunction or chronic health issues. Inclusive sport practice can enhance social inclusion and fitness, benefiting overall person development and life quality. This study aimed to assess fitness level variation in athletes with and without ID before and after a 9-month inclusive (INC) and non-inclusive (N_INC) basketball training. 38 athletes with ID and 14 athletes without ID belonged to INC group, 38 athletes with ID belonged to N_INC group and 23 participants with ID belonged to the control group (CG). Before and after the intervention period, all participants performed anthropometric (body weight, body mass index, body fat percentage) and fitness tests (muscle strength and power, cardiovascular endurance, balance, flexibility, agility, movement speed, and coordination). ID and non-ID athletes of both INC and N_INC groups significantly improved in most of the tests (weight, balance, flexibility, muscle strength, endurance, agility, movement speed and coordination) while CG group significantly worsened weight, muscle endurance, flexibility, agility, movement speed and coordination, after the intervention (p

The ID10 beamline of the SESAME (Synchrotron-light for Experimental Science and Applications in the Middle East) synchrotron light source in Jordan was inaugurated in June 2023 and is now open to scientific users. The beamline, which was designed and installed within the European Horizon 2020 project BEAmline for Tomography at SESAME (BEATS), provides full-field X-ray radiography and microtomography imaging with monochromatic or polychromatic X-rays up to photon energies of 100 keV. The photon source generated by a 2.9 T wavelength shifter with variable gap, and a double-multilayer monochromator system allow versatile application for experiments requiring either an X-ray beam with high intensity and flux, and/or a partially spatial coherent beam for phase-contrast applications. Sample manipulation and X-ray detection systems are designed to allow scanning samples with different size, weight and material, providing image voxel sizes from 13 µm down to 0.33 µm. A state-of-the-art computing infrastructure for data collection, three-dimensional (3D) image reconstruction and data analysis allows the visualization and exploration of results online within a few seconds from the completion of a scan. Insights from 3D X-ray imaging are key to the investigation of specimens from archaeology and cultural heritage, biology and health sciences, materials science and engineering, earth, environmental sciences and more. Microtomography scans and preliminary results obtained at the beamline demonstrate that the new beamline ID10-BEATS expands significantly the range of scientific applications that can be targeted at SESAME.

The management of erectile dysfunction (ED) shows several gray zones, especially in terms of patients’ satisfaction and adherence to the treatment. The main and first-line treatment for ED is drug therapy, mainly phosphodiesterase-5 inhibitors (PDE5is), but adherence to the therapy is not optimal due to the low patient satisfaction reported in several cases. To address this issue, different administration routes and PDE5i pharmacological formulations have been introduced in the pharmacological market. The pharmaceutical market has recently seen the introduction of a novel sildenafil oral suspension. This device offers access to all therapeutic regimens in one device, releasing 0.5 mL of suspension containing 12.5 mg of sildenafil with each pulse. This formulation enables tailored dosing based on clinical requirements and the demands of ED patients. Here, we aim to give a brief narrative review of the management of this new oral suspension in order to provide readers with some suggestions to use in everyday clinical practice, on the basis of recent evidence, by using an easy and rapid-to-consult question and answer form. Also included are the conclusions of a board meeting of experienced andrologists regarding the most recent developments in this area.

(1) Background: Sleep-disordered breathing and asthma are often interrelated. Children and adults with asthma are more susceptible to sleep apnea. Inhaled corticosteroids effectively reduce inflammation and prevent structural changes in the airways. Objective: to explore the existing literature to determine whether inhaled corticosteroids play a role in sleep-disordered breathing in patients with asthma. (2) Methods: We conducted a thorough search of the PubMed, Scopus, and Web of Science databases for English-language articles published up to 12 May 2024. We utilized the ROBINS-E tool to assess the risk of bias. (4) Conclusions: 136 articles were discerned upon conducting the literature search. A total of 13 articles underwent exhaustive full-text scrutiny, resulting in 6 being considered non-relevant. The remaining seven articles, assessed for eligibility, were incorporated into the final analysis. Five studies were identified in adults and two in children. In adult patients, inhaled corticosteroids, especially at high doses, appear to increase the risk of sleep apnea in a dose-dependent manner. Moreover, the properties of inhaled corticosteroids, such as particle size, may impact the risk of developing sleep apnea. In children, the severity of asthma is a key factor affecting the prevalence of sleep apnea, whereas inhaled corticosteroids appear to be a less significant risk factor compared to adults. All of the studies reviewed were classified as having a high risk of bias or some concerns regarding bias. Each study revealed at least one type of bias that raised notable concerns. This research highlights a complex interaction between the use of inhaled corticosteroids, the severity of asthma, and the onset of sleep apnea. Additional research is necessary to investigate these relationships further.

Abstract Women constitute over half of the global refugee population, yet they are underrepresented among asylum-seeker applicants in Europe. In this study, we analyse asylum application decisions in Italy between 2008 and 2022 using Eurostat data and a comprehensive set of indicators to assess political conditions and gender discrimination in the applicants’ countries of origin. Our analysis unveils a limited ‘female advantage’ in asylum applications, revealing a complex relationship between gender, country of origin characteristics, and the asylum decision process. Interestingly, the observed advantage for women is contingent on the applicant's country of origin. In countries marked by war, autocracy, or severe discrimination towards women, the gender of the applicants does not significantly correlate with asylum decisions, as recognition rates are high for both men and women. Conversely, women from countries with moderate political and discrimination issues have higher chances of success than men in their asylum applications. The understanding of how gender intersects with other factors in asylum decisions is imperative for developing more equitable asylum policies and practices.

This paper presents a novel landslide susceptibility map of Rwanda (Central Africa), sadly acknowledged as highly exposed to natural hazards and affected by recurring landslide phenomena. The susceptibility assessment was performed using an integrated approach based on morphometric analysis in a Geographic Information System (GIS), supported by orthophoto analysis and geomorphological field mapping. The analysis was completed following a heuristic approach; 10 landslide controlling parameters were identified. Each parameter was assigned an appropriate weight based on expert judgement and analysed to realize thematic maps. All the data collected were mapped through a process of cartographic overlap to carry out the final zonation. The resulting map was grouped into five susceptibility classes (very low, low, medium, high, and very high), identifying areas with different probabilities of being affected by landslides. The Main Map represents a valuable tool to support sustainable territorial planning and landslide hazard assessment.

Objective To assess the prevalence and the characteristics of pelvic floor dysfunction (PFD) in women with endometriosis.Methods This is a methodological paper that describes the ‘Endometriosis and Pelvic Floor Dysfunction’ (EndoPFD) multicenter study protocol. It involves three sites: the University Hospital of Pisa, the San Raffaele Hospital of Milan and the Vanvitelli University Hospital of Naples. Women are recruited through web links and are asked whether they want to participate to the clinical evaluation or only to the web survey. The web survey gathers personal history, endometriosis history and symptoms, and performs a subjective evaluation of PFD through questionnaires: Urinary Distress Inventory 6, Colorectal-Anal Distress Inventory 8, Wexner Scale for Fecal Incontinence, Wexner Constipation Scoring System, and Female Sexual Function Index. Those interested in the clinical evaluation will add to the questionnaires the following exams: gynecological and proctological exam, pelvic ultrasound, urodynamic test, and anorectal manometry.Preliminary results Recruitment for the web survey was completed. A total of 1,149 women signed the electronic consent, 329 were excluded due to inclusion/exclusion criteria; hence, 525 completed all the questionnaires (response rate of 64.02%). Recruitment for the clinical evaluation is ongoing.Discussion This study protocol offers the possibility to define the prevalence of PFD in endometriosis patients with a subjective and an objective assessment of signs and symptoms. This may pave the way for changing the approach to patients with endometriosis. Moreover, it demonstrates the validity of the method used (online survey and recruitment) to reach a high number of patients.

Abruzzo Periadriatic Area (Central Italy) is sadly acknowledged as highly exposed to geo-hydrological hazards, with small-to-medium size catchments and urban areas strongly affected by natural phenomena. In the present work, the Pescara River basin, hit in the past by several floods and concurrent superficial landslides due to localized and intense rain events, has been studied. A screening of morphometry, land use changes, rainfall datasets, and flooding-related effects on landscape has been carried out, both at the catchment and local scales. A morphometric and geomorphological approach was applied, supported by GIS software and implemented with literature data. It allowed us to derive insights about the interaction between land use changes and geo-hydrological phenomena. Over the past 60 years, the study area underwent increases in built-up areas from ~16 km2 in 1955 to ~67 km2 in 2019 with significant sprawl at low altitude. Rainfall datasets outlined moderate-to-low annual precipitation with occasional heavy rainfall events (>100 mm/d and 30–40 mm/h). Historical and recent events (~35 events over a 100-year period) linked to landscape and geomorphological processes were also counted. Resulting data allowed to implement knowledge about the present-day geomorphological arrangement of the basin, providing information for land management in a changing environment. These findings provide valuable insights for future urban planning, policy formulation, and sustainable development initiatives, readily available to interested stakeholders.

In this study, a fuzzy model has been proposed for the control of the degradation process in Cultural Heritage. Specifically, the focus has been on the Nuragic building, Genna Maria, in Villanovaforru, Sardinia. Environmental data and material properties were considered to formalize inferences between different variables of the model. The results highlight the possibility of significant decay processes, such as salt crystallization and freeze-thaw cycles, estimated for all months of the year. A comparison between model elaborations and experimental data (material characterization, environmental data, accelerated ageing) demonstrates the reliability of the proposed procedure.

AimsThis study aims to assess the diagnostic accuracy of diffusion-weighted Magnetic Resonance Imaging (DW-MRI) and determine the inter-reader agreement between two expert radiologists in detecting pyelonephritic foci during the initial episode of febrile urinary tract infection (fUTI) in children aged 0–5 years. Also, we aim to establish the correlation between clinical data and DW-MRI findings.MethodsChildren aged 0–5 years presenting with their first episode of fUTI were included in the study and underwent DW-MRI and Ultrasound (US) examinations within 72 h of admission. Inter-observer agreement between the two expert radiologists in assessing DW-MRI scans was evaluated using Cohen's kappa statistic. Clinical and laboratory data were subjected to statistical analysis.Results84 children (40 male, 44 female) with a mean age of 7.3 (SD 6.2) months were enrolled. DW-MRI detected pyelonephritis in 78 out of 84 cases (92.9%), with multiple foci observed in 73 out of 78 cases (93.6%). There was a “substantial” level of agreement between the two expert radiologists (κ = 0.725; observed agreement 95.2%). Renal US revealed pyelonephritis in 36 out of 78 cases (46.2%). White blood cell (WBC) count (p = 0.04) and lymphocyte count (p = 0.01) were significantly higher in patients with positive DW-MRI. Although not statistically significant, patients with positive DW-MRI had higher mean values of C-Reactive Protein, Procalcitonin, and neutrophil WBC count (7.72 mg/dl, 4.25 ng/dl, and 9,271 /μl, respectively).ConclusionsDW-MRI exhibited excellent diagnostic performance in detecting pyelonephritic foci, with substantial inter-reader agreement among expert radiologists, indicating the reliability of the technique. However, a weak correlation was observed between laboratory parameters and DW-MRI results, potentially because of the low rate of negative DW-MRI findings.

Purpose: To evaluate the safety of subretinal injection of cord blood platelet-rich plasma (CB-PRP) and its possible effect in eyes affected by geographic atrophy (GA) associated with dry age-related macular degeneration (d-AMD). Design: Interventional, open-label study started in January 2021 with follow-up at 12 months (the Si.Cord Study). This study was a single-center, nonrandomized, sequential-assigned clinical trial conducted in Rome, Italy, at Fondazione Policlinico Universitario Agostino Gemelli IRCCS (ClinicalTrials.gov NCT04636853). Participants: Thirteen patients (26 eyes) with bilateral d-AMD-related GA were enrolled. One eye from each patient (with more advanced GA) underwent CB-PRP treatment, and the fellow eye was considered the control. All patients participated in follow-up at 12 months. Intervention: All 13 eyes received 23-gauge (G) vitrectomy and subretinal injection of CB-PRP using a 41-gauge needle. Main Outcomes and Measures: Best-corrected visual acuity (BCVA) with ETDRS letters, central macular thickness using OCT, and atrophic area measured on en face OCT images were assessed at baseline, 1, 3, 6, and 12 months. Results: The BCVA in the treated group was 34.46 ± 20.8 ETDRS at baseline, 40.84 ± 20.52 at 1 month, 40.07 ± 20.34 at 3 months, 39.38 ± 19.84 at 6 months, and 35.84 ± 18.38 at 12 months. In the untreated group, the BCVA was 53 ± 21.1 ETDRS letters at baseline, 51.54 ± 20.99 at 1 month, 46.62 ± 19.47 at 3 months, 46.85 ± 18.58 at 6 months, and 43.92 ± 17.97 at 12 months (2-way analysis of variance: interaction of treatment by eye or time, P = 0.084). Central macular thickness did not show a significant intereye difference at 12 months (P = 0.97). The atrophic geographic areas tended to increase in both treated and fellow eyes at 12 months (P < 0.0001). No inflammatory reaction, endophthalmitis, retinal detachment, uveitis, or other complications due to the subretinal injection of CB-PRP were observed during the follow-up. Conclusions: Subretinal injection of CB-PRP could be safely used for d-AMD in its GA form. Despite its safety, a larger cohort of patients, and probably a new way of administration, will be needed to understand whether the CB-PRP could have a role in the GA treatment. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Mapping hazelnut orchards can facilitate land planning and utilization policies, supporting the development of cooperative precision farming systems. The present work faces the detection of hazelnut crops using optical and radar remote sensing data. A comparative study of Machine Learning techniques is presented. The system proposed utilizes multi-temporal data from the Sentinel-1 and Sentinel-2 datasets extracted over several years and processed with cloud tools. We provide a dataset of 62,982 labeled samples, with 16,561 samples belonging to the ‘hazelnut’ class and 46,421 samples belonging to the ‘other’ class, collected in 8 heterogeneous geographical areas of the Viterbo province. Two different comparative tests are conducted: firstly, we use a Nested 5-Fold Cross-Validation methodology to train, optimize, and compare different Machine Learning algorithms on a single area. In a second experiment, the algorithms were trained on one area and tested on the remaining seven geographical areas. The developed study demonstrates how AI analysis applied to Sentinel-1 and Sentinel-2 data is a valid technology for hazelnut mapping. From the results, it emerges that Random Forest is the classifier with the highest generalizability, achieving the best performance in the second test with an accuracy of 96% and an F1 score of 91% for the ‘hazelnut’ class.

(1) Background: Sudden Infant Death Syndrome (SIDS) represents sudden and unexplained deaths during the sleep of infants under one year of age, despite thorough investigation. Screening for a prolonged QTc interval, a marker for Long QT Syndrome (LQTS), should be conducted on all newborns to reduce the incidence of SIDS. Neonatal electrocardiograms (ECGs) could identify congenital heart defects (CHDs) early, especially those not detected at birth. Infants with prolonged QTc intervals typically undergo genetic analysis for Long QT Syndrome. (2) Methods: The study involved infants aged 20–40 days, born with no apparent clinical signs of heart disease, with initial ECG screening. Infants with prenatal diagnoses or signs/symptoms of CHDs identified immediately after birth, as well as infants who had previously had an ECG or echocardiogram for other medical reasons, were excluded from the study. We used statistical software (SPSS version 22.0) to analyze the data. (3) Results: Of the 42,200 infants involved, 2245 were enrolled, with 39.9% being males. Following this initial screening, 164 children (37.8% males) with prolonged QTc intervals underwent further evaluation. Out of these 164 children, 27 children were confirmed to have LQTS. However, only 18 children were finally investigated for genetic mutations, and mutations were identified in 11 tests. The most common mutations were LQT1 (54.5%), LQT2 (36.4%), and LQT3 (1 patient). Treatment options included propranolol (39.8%), nadolol (22.2%), inderal (11.1%), metoprolol (11.1%), and no treatment (16.7%). The most common abnormalities were focal right bundle branch block (54.5%), left axis deviation (9.2%), and nonspecific ventricular repolarization abnormalities (7.1%). Multiple anomalies were found in 0.47% of children with focal right bundle branch block. Structural abnormalities were associated with specific features in 267 patients (11.9%), primarily isolated patent foramen ovale (PFO) at 61.4%. (4) Conclusions: This screening approach has demonstrated effectiveness in the early identification of LQTS and other cardiac rhythm anomalies, with additional identification of mutations and/or prolonged QTc intervals in family members. Identifying other ECG abnormalities and congenital heart malformations further enhances the benefits of the screening.

Abstract Background This report presents a clinical case of syndromic rod-cone dystrophy due to a splice site variant in the ARL2BP gene causing situs inversus, asthenozoospermia, unilateral renal agenesis and microcysts. The presence of renal agenesis and cryptorchidism expands the clinical manifestations due to ARL2BP variants. The detailed, long-term follow-up contributes valuable insights into disease progression, aiding clinical diagnosis and patient management. Case Presentation The male patient complained of photophobia as the first symptom when he was 20 years old followed by nyctalopia, loss of central visual acuity and peripheral visual field ten years later. Genetic analysis identified a likely pathogenic homozygous variant (c.294-1G > C) involving the splicing acceptor site of intron 4. Reported symptoms together with full-field stimulus threshold testing, electroretinogram and advanced multimodal imaging allowed us to recognize the typical characteristics of a mixed retinal dystrophy. Despite the end-stage retinal disease, this patient still retained a useful residual vision at 63 years and had a slow disease progression during the last 5 years of evaluation. Discussion and conclusions Our findings underscore the variable clinical presentation of ARL2BP variants, emphasizing the importance of a nuanced approach in diagnosing and managing patients. The presence of renal cysts warrants consideration of a differential diagnosis, particularly with Senior-Loken (SLS), Bardet-Biedl (BBS) and Joubert syndromes (JS) but also with Short Rib Thoracic Dysplasia 9, highlighting the need for careful phenotypic evaluation in these cases.

Abstract Background In response to the imperative need for standardized support for adolescent Gender Dysphoria (GD), the Italian Academy of Pediatrics, in collaboration with the Italian Society of Pediatrics, the Italian Society for Pediatric Endocrinology and Diabetes, Italian Society of Adolescent Medicine and Italian Society of Child and Adolescent Neuropsychiatry is drafting a position paper. The purpose of this paper is to convey the author's opinion on the topic, offering foundational information on potential aspects of gender-affirming care and emphasizing the care and protection of children and adolescents with GD. Main body Recognizing that adolescents may choose interventions based on their unique needs and goals and understanding that every individual within this group has a distinct trajectory, it is crucial to ensure that each one is welcomed and supported. The approach to managing individuals with GD is a multi-stage process involving a multidisciplinary team throughout all phases. Decisions regarding treatment should be reached collaboratively by healthcare professionals and the family, while considering the unique needs and circumstances of the individual and be guided by scientific evidence rather than biases or ideologies. Politicians and high court judges should address discrimination based on gender identity in legislation and support service development that aligns with the needs of young people. It is essential to establish accredited multidisciplinary centers equipped with the requisite skills and experience to effectively manage adolescents with GD, thereby ensuring the delivery of high-quality care. Conclusion Maintaining an evidence-based approach is essential to safeguard the well-being of transgender and gender diverse adolescents.

Abstract Moiré excitons (MXs) are electron-hole pairs localised by the periodic (moiré) potential forming in two-dimensional heterostructures (HSs). MXs can be exploited, e.g., for creating nanoscale-ordered quantum emitters and achieving or probing strongly correlated electronic phases at relatively high temperatures. Here, we studied the exciton properties of WSe2/MoSe2 HSs from T = 6 K to room temperature using time-resolved and continuous-wave micro-photoluminescence also under a magnetic field. The exciton dynamics and emission lineshape evolution with temperature show clear signatures that MXs de-trap from the moiré potential and turn into free interlayer excitons (IXs) for temperatures above 100 K. The MX-to-IX transition is also apparent from the exciton magnetic moment reversing its sign when the moiré potential is not capable of localising excitons at elevated temperatures. Concomitantly, the exciton formation and decay times reduce drastically. Thus, our findings establish the conditions for a truly confined nature of the exciton states in a moiré superlattice with increasing temperature and photo-generated carrier density.

Background The WHO tube bioassay is a method for exposing mosquitos to determine susceptibility to insecticides, with mortality to discriminating doses 90% power). However, as the mortality of either group gets closer to 50%, a 10% difference between groups is more difficult to reliably detect. In the worst-case scenario where the mortality of either group is 50%, the mortality difference must be >22.5% to be detected with 80% power. We provide an R shiny application to assess power for other comparisons. Conclusions Our findings indicate that detecting synergism with the WHO tube assay is more difficult than assumed by the current WHO guidelines. Additionally, we demonstrate the value of using a Shiny application to make the outputs of simulation-based power analysis readily available to end-users, allowing them to determine the number of tubes needed to detect a given mortality difference.

This article presents an analysis method based on lumped-parameters (LP) and computational fluid dynamics (CFD) to evaluate the behavior and calibrate the lubrication (LUB) circuit in an agricultural dual-clutch transmission. Gearbox LUB is crucial because it affects reliability, life, and transmission efficiency. The transmission’s hydraulic circuit consists of the higher pressure power transmission control and actuation circuit and the low pressure LUB circuit. The former was analyzed with LP approach, instead the latter was modeled with CFD approach due to its geometric complexity. The results will be contextualized by commenting on the advantages and limitations of LP and CFD analysis, finally outlining a mixed analysis methodology. The simulations are solved for different engine speed. The results are used to calibrate a comprehensive LP model (model) and to optimize the LUB circuit by adjusting some critical design parameters. As an experimental approach, simplified tests are usually performed ignoring the action of the centrifugal force, which has a great impact on the flow regime inside the LUB ducts. This work aims to develop a methodology for analyzing LUB in all parts of the gearbox, which can help designers test various combinations within industrial timeframes and obtain reliable and the most efficient configuration.

Summary: Since the nineties, the incidence of sporadic early-onset (EO) cancers has been rising worldwide. The underlying reasons are still unknown. However, identifying them is vital for advancing both prevention and intervention. Here, we exploit available knowledge derived from clinical observations to formulate testable hypotheses aimed at defining the causal factors of this epidemic and discuss how to experimentally test them. We explore the potential impact of exposome changes from the millennials to contemporary young generations, considering both environmental exposures and enhanced susceptibilities to EO-cancer development. We emphasize how establishing the time required for an EO cancer to develop is relevant to defining future screening strategies. Finally, we discuss the importance of integrating multi-dimensional data from international collaborations to generate comprehensive knowledge and translate these findings back into clinical practice.

Wheezing is a common condition in childhood, and its prevalence has increased in the last decade. Up to one-third of preschoolers develop recurrent wheezing, significantly impacting their quality of life and healthcare resources. Artificial Intelligence (AI) technologies have recently been applied in paediatric allergology and pulmonology, contributing to disease recognition, risk stratification, and decision support. Additionally, the COVID-19 pandemic has shaped healthcare systems, resulting in an increased workload and the necessity to reduce access to hospital facilities. In this view, AI and Machine Learning (ML) approaches can help address current issues in managing preschool wheezing, from its recognition with AI-augmented stethoscopes and monitoring with smartphone applications, aiming to improve parent-led/self-management and reducing economic and social costs. Moreover, in the last decade, ML algorithms have been applied in wheezing phenotyping, also contributing to identifying specific genes, and have been proven to even predict asthma in preschoolers. This minireview aims to update our knowledge on recent advancements of AI applications in childhood wheezing, summarizing and discussing the current evidence in recognition, diagnosis, phenotyping, and asthma prediction, with an overview of home monitoring and tele-management.

Hypereosinophilic syndromes (HES) represent a group of rare dis-immune conditions characterized by blood hyper-eosinophilia and eosinophilic related burden. Especially the idiopathic subtype (I-HES) is particularly difficult to diagnose because of its heterogeneous clinical presentation, the lack of specific findings on physical exam, lab tools, and imaging informative enough to unequivocally confirm the diagnosis and the overlap with other entities, including eosinophilic organ-diseases or systemic dis-immune conditions other than I-HES (from atopy to eosinophilic granulomatosis with polyangiitis [EGPA], the last often extremely difficult to distinguish from HES). Taken together, all the features mentioned above account for an extremely difficult early recognition HES and on-time referral to a specialized centre. The referral itself is challenging due to a not univocal specialist identification, because of the variability of physicians managing HES in different settings (including allergist/clinical immunologist, haematologist, internal medicine doctors, pulmonologist, rheumatologist). Furthermore, the approach in terms of personalized treatment identification and follow-up plan (timing, organ assessment), is poorly standardized. Further translational and clinical research is needed to address the mentioned unmet needs, but on practical grounds increasing the overall clinicians’ awareness on HES and implementing healthcare pathways for HES patients represent a roadmap that every clinician might try to realize in his specific setting.The present review aims at providing an overview about the current challenges and unmet needs in the practical approach to HES and rare hypereosinophilic allergo-immunological diseases, including a proposal for an innovative multidisciplinary organizational model.

Background: Type 2 inflammation is the principal determinant of asthma in children, and it leads to the downstream activation of eosinophils (EOS), the production of immunoglobulin-E (IgE), and increased levels of fraction of exhaled nitric oxide (FeNO). Dupilumab received the approval for the treatment of uncontrolled severe Type 2 asthma in children. Objective: The aim of this analysis was to calculate the Type 2 severe asthma paediatric population who would be eligible for treatment with dupilumab in Italy and characterize them by expected biomarker status. Methods: The calculation of the dupilumab-eligible population employed a two-phase approach: 1) estimating the total number of children aged 6–11 years with uncontrolled severe asthma; and 2) stratifying the severe uncontrolled asthma population, based on appropriate biomarker levels, thus identifying patients eligible for treatment with dupilumab. The VOYAGE study provided the data for this analysis. Results: The two-phase approach utilizing VOYAGE data revealed that the average number of paediatric patients with uncontrolled severe asthma was N = 1007. Stratification of these patients, as per VOYAGE data, indicated that the majority (N = 740; 73.5%) would have ≥2 elevated biomarkers, and over one-third patients (N = 434, 43.1%) would exhibit simultaneously elevated levels of EOS, FeNO and IgE. Of the paediatric patients, N = 864 were identified as eligible to dupilumab treatment, constituting 85.8% of the target population. Notably, nearly half eligible patients (N = 454) displayed elevated levels of both EOS and FeNO biomarkers, while the substantial majority (81.1%) exhibited at least an increase of EOS levels (N = 817). Patients with increased FeNO levels without a concurrent increase in EOS were less frequent (N = 47; 5.4% of the eligible population). Conclusion: The simultaneous testing of multiple biomarkers during baseline patient assessment and disease follow-up is highly recommended. Utilizing cost-effective tests, physicians can estimate the prevalence of severe Type 2 asthma, categorize patients into distinct phenotypes (eosinophilic, allergic, or mixed), and consequently identify and prescribe the most suitable therapeutic interventions. This approach also facilitates the ongoing evaluation and adjustment of the treatment strategies based on individual patient responses.

Abstract In the rate‐state friction law framework, the transition from velocity weakening (V‐W) to velocity strengthening (V‐S) behavior marks the base of the seismogenic crust. Here we investigate the role of fault slip displacement under hydrothermal conditions in controlling the V‐W to V‐S transition. We shear simulated gabbro gouges at slip velocities ranging from 16 nm/s (∼50 cm/year) to 10 μm/s (∼8 cm/day) under hydrothermal conditions (300–400°C temperature; 30 MPa pore fluid pressure). We observe that cumulative fault slip increases the critical velocity for the V‐W to V‐S transition. The transition is accompanied by localized to distributed deformation mode, the formation of smectite‐type clays and occurrence of intergranular mass transfer. Our results provide insights into understanding the deepening and shallowing of V‐W/V‐S boundary (lower limit of the seismogenic zone) following a mainshock. Besides strain rate effects, slip‐enhanced chemical alteration and grain size‐sensitive deformation may temporarily contribute to the shallowing process.

The ammonia (NH3) stripping process can recover nitrogen (N) from slurry and digestates as a mineral fertilizer, but it is currently expensive and difficult to manage at the farm level. Hence, a simple process is required. This study aimed to test a modular (based on farm N surplus) slow-release NH3 stripping process at a pilot plant scale. NH3 volatilization was promoted in a closed reactor, and then, the NH3 was removed by an air stream through the reactor headspace. The NH3-loaded air was purified in a scrubber, where NH3 reacted with sulfuric acid to form ammonium sulfate (AS). In total, 11 trials were conducted using pig slurry, dairy cattle slurry, and digestates: 7 trials were carried out with the reactors heated to 40°C, 2 trials were carried out at an ambient temperature, and the other 2 trials were carried out with the addition of sodium hydroxide (NaOH). To assess the technical–economic sustainability of the pilot plant, the total ammoniacal nitrogen (TAN) removal rate, electricity consumption, acid requirements, and AS quality and costs were evaluated. The pilot plant yielded TAN recovery amounts of 45% in 2 weeks with the reactors heated to 40°C, 64% in 1 week with NaOH addition, and 25% in 2 weeks at an ambient temperature. The N concentration in the AS solution reached 85.9 g kg−1, with an average value of 35.2 g kg−1. The electricity consumption, acid requirement, and operational costs in an optimized system were approximately 0.52 kWh kgN−1 recovered, 3.5 kg pure acid kgN−1 recovered, and 0.86 € kgN−1 recovered, respectively. Compared to other technologies, the simplified stripping process is slower but with similar removal efficiencies and lower energy consumption. Thus, this finding could be suitable for improving the N use in intensive livestock farms.

Summary: Cortical tracking of speech is relevant for the development of speech perception skills. However, no study to date has explored whether and how cortical tracking of speech is shaped by accumulated language experience, the central question of this study. In 35 bilingual children (6-year-old) with considerably bigger experience in one language, we collected electroencephalography data while they listened to continuous speech in their two languages. Cortical tracking of speech was assessed at acoustic-temporal and lexico-semantic levels. Children showed more robust acoustic-temporal tracking in the least experienced language, and more sensitive cortical tracking of semantic information in the most experienced language. Additionally, and only for the most experienced language, acoustic-temporal tracking was specifically linked to phonological abilities, and lexico-semantic tracking to vocabulary knowledge. Our results indicate that accumulated linguistic experience is a relevant maturational factor for the cortical tracking of speech at different levels during early language acquisition.

This case study explores the utilization of distributed fiber optic sensors (DFOS) in wooden foundation piles, for assessing and monitoring the stress distribution along their length. Three spruce and three pine foundation piles instrumented with DFOS were driven into the soil in a testing field in Amsterdam and axially loaded in compression. Since DFOS provided strain information, calculating the stress distribution in the piles required knowledge of their stiffness properties, which inherently vary from the head to the tip. Consequently, the piles were extracted and their overall wet dynamic elastic modulus (Ec,0,dyn,wet) was determined through frequency response measurements. Subsequently, the piles were segmented, transported to the TU Delft Laboratory and subjected to mechanical testing. For each segment, the mechanical properties were determined and their variability along the pile was studied, in particular for the static modulus of elasticity (Ec,0,stat,wet). This enabled a comprehensive assessment of the actual in-situ stress distribution (Δσactual,stat and Δσactual,dyn) along the length of the piles, calculated with DFOS strains and the pile stiffness (Ec,0,stat,wet and Ec,0,stat,dyn). Given the novelty of the DFOS application to timber piles, a validation of the accuracy was conducted on 3 pile segments equipped with DFOS. These segments underwent laboratory compression testing, allowing for a direct comparison between DFOS strain readings and strains measured with linear potentiometers attached to the pile segments. The results revealed good accuracy of DFOS in controlled lab conditions, with a maximum stress deviation of 0.65 MPa. Since the testing field featured a 6-meter-deep predrilled layer, where negligible shaft friction was mobilized, the no-friction stress (Δσno-friction) approximately aligned with Δσactual,stat on the piles. At pile tips, the maximum applied 300–350 kN compressive load (i.e. Δσno-friction = 20–26 MPa), resulted in Δσactual,stat = 4–7 MPa, highlighting shaft friction effect. The calculated Δσactual,dyn with a single Ec,0,stat,dyn for the whole pile, led to 3 MPa stress overestimation at pile tip. Although this calculation is conservative, the detailed knowledge of the variation of stiffness properties along the pile would result in a more efficient structural use.

Abstract Asthma is one of the most common non-communicable diseases, and its prevalence and morbidity are influenced by a wide array of factors that are only partially understood. In addition to individual predisposition linked to genetic background and early life infections, environmental factors are crucial in determining the impact of asthma both on an individual patient and on a population level. Several studies have examined the role of the environment where asthmatic subjects live in the pathogenesis of asthma. This review aims to investigate the differences in the prevalence and characteristics of asthma between the pediatric population residing at higher altitudes and children living at lower altitudes, trying to define factors that potentially determine such differences. For this purpose, we reviewed articles from the literature concerning observational studies assessing the prevalence of pediatric asthma in these populations and its characteristics, such as spirometric and laboratory parameters and associated sensitization to aeroallergens. Despite the heterogeneity of the environments examined, the hypothesis of a beneficial effect of residing at a higher altitude on the prevalence of pediatric asthma could be confirmed, as well as a good profile on airway inflammation in asthmatic children. However, the possibility of a higher hospitalization risk for asthma in children living at higher altitudes was demonstrated. Moreover, a positive association between residing at a higher altitude and sensitization to pollens and between lower altitude and sensitization to house dust mites could be confirmed in some pediatric patients, even if the results are not homogeneous, probably due to the different geographical and climatic regions considered. Nonetheless, further studies, e.g., extensive and international works, need to be conducted to better understand the complex interplay between different environmental factors, such as altitude, and the pathogenesis of asthma and how its prevalence and characteristics could vary due to climate change.

Introduction: Addressing post traumatic lower limb neuropathic pain is challenging across medical specialties. To address this potentially devastating condition, several invasive and non-invasive approaches have been proposed with inconsistent results. Adipose fat transfer (AFT), also known as fat grafting, is a regenerative medicine technique in which a patient's own fat is harvested from one area of the body (usually through liposuction) and then injected into another area for various purposes, such as aesthetic contour enhancement or reconstruction and regeneration of scarred tissues. Methods: We analyze the effects of fat grafting for neuropathic pain combined with neuroma excision (hybrid technique, hAFT) or alone (AFT). A retrospective review was conducted on 22 patients with neuropathic lower limb pain, after trauma or orthopedic surgery treated with hAFT (n = 9) or AFT (n = 13). Results: Reduction in VAS scale more than 50 % was observed in 6 patients (66 %) treated with hybrid technique and in eleven patients (85 %) treated with AFT alone. Among these, complete pain reduction (>91 %) was achieved in 33.3 % of hAFT and 54 % of AFT technique. A 3.2 points reduction in VAS was found in the hAFT group versus 5.8 points in the AFT group (p = 0.035). Conclusion: This pioneering use of AFT emerges as a minimally invasive breakthrough, promising significant improvement in reconstructing scarred subcutaneous tissue and managing neuropathic pain.

Summary: Background: Temporal migraines (TM) present with throbbing, pulsating headaches in the temporal area. Different surgical techniques ranging from resecting the auriculotemporal nerve (ATN) and or ligating the superficial temporal artery (STA) have shown similar good results to decrease TM symptoms. No conclusive data supports a specific disease of the STA in TM patients. A minimally invasive technique is proposed to preserve both vascular and nerve structures. Methods: Patients with drug resistant TM were selected and treated with two techniques: nerve sparing and nerve and artery sparing. The study included 57 patients with TM, with an average age of 47.5 years. TM improvement was quantified after at least one year of follow up time. STA biopsies were sent for histological analysis. Results: Forty-two patients underwent nerve-sparing decompression, with a therapeutic success rate of 78.6%, corresponding to 22.1 days with migraine per month decreasing to 6.2. Histological analysis of the STA showed varying degrees of endofibrosis in 75% of the samples. Histological results do not correlate with the intensity of symptoms before or after surgery. Fifteen patients underwent nerve and artery sparing arteriolysis, with an overall therapeutic success rate of 86.6% of which 80% had >90% improvement. The average migraine days dropped from 24 to 2.5 days per month in this group. Conclusion: Minimally invasive nerve sparing approaches are an effective and safe treatment to improve drug resistant TM symptoms. Endofibrosis of the STA was present in 75% of the cases, but it was found to be unrelated to pre-operative symptoms and outcome. Results are promising, but the limited numbers of patients treated with artery and nerve sparing technique needs further investigations.

Atopic dermatitis is a chronic inflammatory skin disease. The treatment plays an important role in influencing the patients’ quality of life. The basic management consists of appropriate skin cleansing, including bathing and eventually using bathing additives. Recommendations regarding frequency and duration of bathing, water temperature and usefulness of bathing additives are widely different, often leading to confusion among patients. This review aims to give insights into the best bathing practices and the use of bathing additives in atopic dermatitis in children. Several bathing additives, including bleach baths, commercial baby cleansers, bath baby oils and bath salt, appear to be promising adjunctive therapies for atopic dermatitis due to their anti-inflammatory, anti-bacterial, anti-pruritus and skin barrier repair properties through different mechanisms of action. However, their efficacy and safety are not fully understood in some cases. The usefulness of other bath additives, such as acidic and more natural substances (green tea extracts, pine tar, sodium bicarbonate), is still under investigation. Further studies are needed to determine their optimal use to achieve clinical benefit safely.

Optimizing traffic dynamics in an evolving transportation landscape is crucial, particularly in scenarios where autonomous vehicles (AVs) with varying levels of autonomy coexist with human-driven cars. While optimizing Reinforcement Learning (RL) policies for such scenarios is becoming more and more common, little has been said about realistic evaluations of such trained policies. This paper presents an evaluation of the effects of AVs penetration among human drivers in a roundabout scenario, considering both quantitative and qualitative aspects. In particular, we learn a policy to minimize traffic jams (i.e., minimize the time to cross the scenario) and to minimize pollution in a roundabout in Milan, Italy. Through empirical analysis, we demonstrate that the presence of AVs can reduce time and pollution levels. Furthermore, we qualitatively evaluate the learned policy using a cutting-edge cockpit to assess its performance in near-real-world conditions. To gauge the practicality and acceptability of the policy, we conduct evaluations with human participants using the simulator, focusing on a range of metrics like traffic smoothness and safety perception. In general, our findings show that human-driven vehicles benefit from optimizing AVs dynamics. Also, participants in the study highlight that the scenario with 80% AVs is perceived as safer than the scenario with 20%. The same result is obtained for traffic smoothness perception.

Infantile haemangiomas (IHs) affect 3–10% of infants, 10% of whom need topical or systemic beta-blocker therapy. Propranolol is the first choice for IHs with a high risk of complications. Since more than half of IHs leave a permanent mark, to reduce outcomes, it is essential to start oral propranolol (2–3 mg/kg/day in 2 doses/day) within the 5th month of life (i.e., during the proliferative phase) and to complete the therapy cycle for at least 6 months. This review aims to summarise the epidemiology, clinical presentation, diagnosis, and treatment of IHs and to highlight the importance of proper referral to specialised hub centres. Patients with vascular anomalies, particularly those suspected of having IH, should be referred to a specialised centre for accurate diagnosis, management by a multidisciplinary team, and timely treatment. IHs may pose life-threatening, functional, and aesthetic risks or may ulcerate. Segmental infantile haemangioma of the face/neck and the lumbosacral regions can be associated with various malformations. To ensure timely specialist evaluation and treatment to reduce the potential risk of complications, it is essential to identify high-risk IHs rapidly. The Infantile Haemangioma Referral Score (IHReS) scale is an important tool to assist primary care paediatricians and general dermatologists.

Background and Objectives: Periodontal therapy aims to arrest the progression of periodontal diseases and possibly to regenerate the periodontal apparatus. To shift healing from repair to regeneration, the blood clot that fills the periodontal defect and remains in contact with structures such as tooth root, mucosa and bone needs to be stable, which is a reason why the treatment of non-containing periodontal bone defects, in which the clot may undergo displacement, is challenging. The gingival soft tissue, properly sutured, may act as a wall for blood clot stabilization. Knowledge on the response of the blood clot to stress and how it might vary according to the characteristics of the tissues it gets in contact with might be deepened. The aim of this study was to investigate in vitro, by means of a micro-loading device, the response of the complex formed by a blood clot and diverse tissues, simulating those involved in periodontal regeneration, to a displacing tensile test. Materials and Methods: Experimental samples made of two layers of either hard dental tissues, cancellous bone or oral mucosa, between which fresh blood was interposed, underwent a debonding experiment by means of a micro-loading device that measured their response to uniaxial tensile stress. Results: The peak of tensile stress and the overall work needed for the complete rupture of the clot’s fibrin filaments were significantly higher for hard dental tissues than for other tissues. However, mucosa sustained the highest maximal strain in terms of relative displacement between the plates of the micro-loading device to accomplish the complete rupture of the fibrin filaments compared to the other tissues, suggesting that the mucosa might act as a stable interface with the clot and be able to sustain tensile stresses. Conclusions: This in vitro study seems to support the use of mucosa to act as a wall for regenerative procedures of suprabony periodontal defects given its capability to form a stable interface with the clot.

Background: Several free flaps are nowadays available for functional reconstruction after hemi-glossectomy in head and neck oncologic surgery. Radial forearm free flap (RFFF) and anterolateral thigh (ALT) have been played a workhorse role until recent years, when other valuable options such as Medial Sural Artery Perforator (MSAP) flap and Profunda Artery Perforator (PAP) flap demonstrated to be suitable contenders and are increasingly taken into account. This study aims to investigate the preference of the donor site in the light of esthetical and functional outcomes. Methods: The participants attended a one-to-one interview with a surgeon explaining a standardized head and neck oncological procedure requiring a soft tissue reconstruction. The donor site preference in terms of esthetical, functional and overall outcomes among these four flap options was investigated. Results: Univariable and multivariable analysis were performed comparing the donor site preference between the two most widespread free flap RFFF vs ALT. Subsequently, the analysis was performed comparing RFFF, ALT, MSAP and PAP. Conclusions: The study illustrated that a diverse group of patients exhibits similarly diverse preferences and expectations. As we observe a shift in the age distribution of patients with OSCC from the fifth-sixth decade towards the two extremes, and an increased incidence in the female population, it becomes essential to enhance reconstructive options provided to patients. This ensures that, while maintaining an equivalent functional outcome, we maximize patient satisfaction to the fullest extent possible.

Background Resistance monitoring is a key element in controlling vector-borne diseases. The World Health Organization (WHO) and Centres for Disease Control and Prevention (CDC) have each developed bottle bioassay methods for determining insecticide susceptibility in mosquito vectors which are used globally. Methods This study aimed to identify variations in bottle bioassay methodologies and assess the potential impact on the data that is generated. Our approach involved a systematic examination of existing literature and protocols from WHO and CDC, with a focus on the specifics of reported methodologies, variation between versions, and reported outcomes. Building on this, we experimentally evaluated the impact of several variables on bioassay results. Results Our literature review exposed a significant inconsistency in the how bioassay methods are reported, hindering reliable interpretation of data and the ability to compare results between studies. The experimental research provided further insight by specifically identifying two key factors that influence the outcomes of bioassays: mosquito dry weight and relative humidity (RH). This finding not only advances our comprehension of these assays but also underscores the importance of establishing precisely defined methodologies for resistance monitoring. The study also demonstrates the importance of controlling bioassay variables, noting the significant influence of wing length, as an indicator of mosquito size, on mortality rates in standardized bioassays. Conclusions Generating data with improved protocol consistency and precision will not only deepen our understanding of resistance patterns but also better inform vector control measures. We call for continued research and collaboration to refine and build consensus on bioassay techniques, to help bolster the global effort against vector-borne diseases like malaria.

Every transition introduces a moment of novelty; however, in the environmental and landscape field, the effects of this change can be critical for various reasons. The first reason relates to the impacts of industrial infrastructures, mobility and the management of environmental processes, and is related to the lack of cohesion between the structures and the landscape. A second issue relates to decision-making processes and the principle of accountability of the same especially in environmental matters. Finally, the third point involves the temporal dimension and, more generally, the design of time as a system of relationships. This contribution aims, therefore, to reflect on the role of architectural design in complex contexts, providing operational indications and establishing the need to ‘read’ the present world and interpret it critically, avoiding exclusive technocratic dominion in issues that affect the future of the next generations and the destinies of our landscape. Article info Received: 11/04/2024; Revised: 19/04/2024; Accepted: 08/05/2024

Tumours of the central nervous system (CNS) represent the most common group of solid tumours in children and adolescents up to the age of 18 years. They comprise several biological entities, subgroups, and subtypes. These subtypes and additional factors, including age at diagnosis, location, stage, or genetic characteristics of the tumours result in a very heterogeneous spectrum of treatment-relevant strata for risk-adapted multimodal treatment recommendations, clinical courses, and long-term outcomes. Multidisciplinary teams with highly experienced members are needed to treat these children and adolescents to achieve the best possible outcome in the short and long-term. This is particularly important for the new CNS tumour entities with no established standard of care. On behalf of the Brain Tumour Group of the European Society for Paediatric Oncology, we summarize the key statements of the involved disciplines that need to cooperate in the diagnosis and risk-adapted treatment of children with CNS tumours: neuroradiology, neurosurgery, neuropathology, radiotherapy, endocrinology, neuro-ophthalmology, and quality of survival professionals, covering what should be considered standard clinical practice for diagnostic assessments, treatment modalities, and follow-up of children with CNS-tumours.

IntroductionThe increasing population of survivors of head and neck carcinomas is becoming more conspicuous. Consequently, the pivotal role of quality of life, particularly elucidated through the assessment of dysphagia and dysphonia, is progressively influencing the decision-making process. The current study aims to assess whether VITOM 3D could offer a comparable post-treatment quality of life to traditional approaches for patients with laryngeal cancer and oro-hypopharyngeal cancer.MethodsA case series of laryngeal cancer and oro-hypopharyngeal cancer patients treated either with an exoscopic-assisted surgical setup and with conventional treatments (transoral microsurgery and radio-chemotherapy) at the Otolaryngology Unit of IRCCS San Martino Hospital, Genoa, is presented. The post-treatment quality of life of the two cohorts were compared through the administration of the University of Washington Quality of Life Questionnaire, Voiceik Handicap Index-10, M.D. Anderson Dysphagia Inventory were administrated to both cohorts of patients.ResultsIn the laryngeal cancer group, a total of 79 patients were included. Of these, 50.1% underwent transoral exoscope-assisted surgery, while 49.9% underwent primary transoral microscopic-assisted surgical approach. No significant differences were observed in terms of the University of Washington Quality of Life Questionnaire and Voice Handicap Index-10 between the two subgroups. Conversely, in the oro-hypopharyngeal cancer group, 43 patients were included. Of these, 37.2% underwent primary transoral exoscope-assisted surgery, while 62.8% received (chemo)radiotherapy. No notable differences were reported in terms of the University of Washington Quality of Life Questionnaire and M.D. Anderson Dysphagia Inventory between the transoral exoscope-assisted surgery and (chemo)radiotherapy subgroups.ConclusionsAssessments of quality of life, conducted through the University of Washington Quality of Life Questionnaire questionnaire, dysphonia evaluations using the Voice Handicap Index-10, and dysphagia assessments employing the M.D. Anderson Dysphagia Inventory questionnaire, demonstrate analogous outcomes between conventional treatment modalities and transoral interventions utilizing the 3D exoscope.

Abstract This study assessed whether Non-native Directed Speech (NNDS) facilitates second language (L2) learning, specifically L2 word learning and production. Spanish participants (N = 50) learned novel English words, presented either in NNDS or Native-Directed Speech (NDS), in two tasks: Recognition and Production. Recognition involved matching novel objects to their labels produced in NNDS or NDS. Production required participants to pronounce these objects’ labels. The novel words contained English vowel contrasts, which approximated Spanish vowel categories more (/i-ɪ/) or less (/ʌ-æ/). Participants in the NNDS group exhibited faster recognition of novel words, improved learning, and produced the /i-ɪ/ contrast with greater distinctiveness in comparison to the NDS group. Participants’ ability to discriminate the target vowel contrasts was also assessed before and after the tasks, with no improvement detected in the two groups. These findings support the didactic assumption of NNDS, indicating the relevance of the phonetic adaptations in this register for successful L2 acquisition.

Obstructive sleep apnea (OSA) affects neurobehavioral, cognitive, and cardiovascular aspects, particularly in children, by obstructing the upper airways during sleep. While its impact in adult ocular health is recognized, there is ongoing debate about OSA’s relevance in pediatrics. This review explores the relationship between OSA and ocular health in children, focusing on the effects and potential improvements through treatment. A systematic search found 287 articles through PubMeD/MEDLINE, Scopus, Web of Science, and ScienceDirect; 94.4% were excluded. After careful selection, six English articles were included, addressing the effects of OSA on children’s eyes. Three studies examined choroidal alterations, three explored retinal and optic nerve changes, and two analyzed ocular changes following otorhinolaryngological intervention. The immediate correlation in children is inconclusive, but age may be a contributing factor. Pediatric OSA patients exhibit corneal anomalies and increased optic nerve thickness, possibly due to intermittent hypoxia. OSA influences retinal vascular density in children, with increased density after treatment and reduced choroidal thickness in cases of adenotonsillar hypertrophy. This review emphasized OSA’s significant impact on children’s ocular health, revealing alterations in the optic nerve, choroid, retina, and cornea. While the direct correlation with the optic nerve is not always evident, OSA raises intraocular pressure and induces structural changes. Treatment holds promise, highlighting the need for regular monitoring to promptly address childhood OSA.

Abstract Cerebral ventriculitis is a life-threatening condition that requires prompt and effective pharmacological intervention. The continuous irrigation of the cerebral ventricles with fluid and its drainage is a system to remove toxic substances and infectious residues in the ventricles; this system is called IRRAflow®. We used this kind of ventricular irrigation/drainage system to treat two patients with post-surgical cerebral ventriculitis and a patient with bacterial meningitis complicated with ventriculitis. In this case series, we discuss the management of these three cases of cerebral ventriculitis: we monitored cytochemical parameters and cultures of the cerebrospinal fluid of patients during their ICU stay and we observed a marked improvement after irrigation and drainage with IRRAflow® system. Irrigation/drainage catheter stay, mode settings, and antibiotic therapies were different among these three patients, and neurological outcomes were variable, according to their underlying pathologies. IRRAflow® system can be applied also in other types of brain injury, such as intraventricular hemorrhage, intracranial abscess, subdural hematomas, and intracerebral hemorrhage, with the aim to remove the hematic residues and enhance the functional recovery of the patients. IRRAflow® seems a promising and useful tool to treat infectious and hemorrhagic diseases in neuro-intensive care unit.

A great deal of the literature has underlined how job quality is a key element in individual well‐being. However, the rise in platform work challenges this issue, since not only do “plat‐firms” play an increasingly important role in job matching, work organization, and industrial relations, but they also increase the risks of a poorly inclusive socio‐technical system in terms of the quality of working conditions and accessibility. In this sense, the platform economy is intertwined with multiple forms of social exclusion by acting on pre‐existing inequalities that stratify workers within the labor market. This is particularly true in Italy, a country with a strongly dualistic labor market, which leads to a remarkable gap between insider and outsider workers. Therefore, the goal of our analysis is to evaluate the impact of the platform model on job quality in the Italian context. This will be accomplished by adopting an integrated and multidimensional perspective through the application of the OECD Job Quality Framework. The analysis identifies how job quality is differently affected by the type of platform work involved in terms of creating differentiated patterns of social inclusion/exclusion in the case of platform workers.

Bronchopulmonary dysplasia (BPD) is the most common respiratory disease in preterm and is still associated with increased mortality and morbidity. The great interest lies in identifying early biomarkers that can predict the development of BPD. This pilot study explores the potential of e-nose for the early identification of BPD risk in premature infants by analyzing volatile organic compounds (VOCs) in the exhaled breath condensate (EBC). Fourteen mechanically ventilated very preterm infants were included in this study. The clinical parameters and EBC were collected within the first 24 h of life. The discriminative ability of breath prints between preterms who did and did not develop BPD was investigated using pattern recognition, a machine learning algorithm, and standard statistical methods. We found that e-nose probes can significantly predict the outcome of “no-BPD” vs. “BPD”. Specifically, a subset of probes (S18, S24, S14, and S6) were found to be significantly predictive, with an AUC of 0.87, 0.89, 0.82, 0.8, and p = 0.019, 0.009, 0.043, 0.047, respectively. The e-nose is an easy-to-use, handheld, non-invasive electronic device that quickly samples breath. Our preliminary study has shown that it has the potential for early prediction of BPD in preterms.

Down’s syndrome (DS), or Trisomy 21, represents the most common chromosomal abnormality in live births, characterized by an extra chromosome 21. Children affected by Down’s syndrome are more susceptible to the development of obesity and of becoming overweight compared with other children. Furthermore, they seem to present a more unfavorable lipid profile than the non-DS obese pediatric population. Diet and physical activity are closely related to the development of overweight and obesity, and they can be assessed using questionnaires such as the Mediterranean Diet Quality Index in children and adolescents (KIDMED) and the Godin–Shephard Leisure-Time Physical Activity Questionnaire. This review aims to undertake a comprehensive analysis of the intricate interplay between diet and physical activity in children affected by Down’s syndrome. Specifically, it seeks to deepen understanding regarding the question of how diet and exercise can influence and prevent the development of overweight and obesity in that special pediatric population.

Autosomal dominant polycystic kidney disease (ADPKD) is a hereditary disorder characterized by the formation of numerous fluid-filled cysts in the kidneys, leading to progressive renal failure and various extrarenal complications, including hypertension. This review explores the genetic basis of ADPKD, including emerging evidence of epigenetic mechanisms in modulating gene expression and disease progression in ADPKD. Furthermore, it proposes to examine the pathological characteristics of this condition at the nephrological, cardiovascular, nutritional, and psychological levels, emphasizing that the follow-up of patients with ADPKD should be multidisciplinary from a young pediatric age.

In the last few years, blockchain has emerged as a cutting-edge technology whose main advantages are transparency, traceability, immutability, enhanced efficiency, and trust, thanks to its decentralized nature. Although many people still identify blockchain with cryptocurrencies and the financial sector, it has many prospective applications beyond digital currency that can serve as use cases for which traditional infrastructures have become obsolete. Governments have started exploring its potential application to public services provision, as confirmed by the increasing number of adoption initiatives, projects, and tests. As the current public administration is often perceived as slow, bureaucratic, lacking transparency, and failing to involve citizens in decision-making processes, blockchain can establish itself as a tool that enables a process of disintermediation, which can revolutionize the way in which public services are managed and provided. In this paper, we will provide a survey of the main application areas which are likely to benefit from blockchain implementation, together with examples of practical implementations carried out by both state and local governments. Later, we will discuss the main challenges that may prevent its widespread adoption, such as government expenditure, technological maturity, and lack of public awareness. Finally, we will wrap up by providing indications on future areas of research for blockchain-based technologies.

Preparation of myrtle liqueur through ethanol-based extraction is a widely employed methodology. Nevertheless, optimization of existing processes is possible, especially through a modern statistical multivariate approach. In this context, a Design of Experiments (DoE) approach was used to quantitatively assess for the first time the effect of the time, ethanol concentration, temperature, and the ratio between the Myrtus communis berries’ weight and the extractant volume (v/w) on the amounts of anthocyanins, volatile compounds and dry residues in the liqueur. The kinetic profile relative to the volatile fraction variation during the process was described by gas chromatography (GC), while spectrophotometric analysis allowed quantification of the total anthocyanins and total polyphenols. Multiple response analysis showed that the maximum efficiencies in terms of the considered parameters (desirability function) were reached by setting the temperature to 25 °C and the ethanol percentage to 96% after 20 days of processing. Some hints as to the chemical instability and not negligible sensitivity of anthocyanins in relation to the experimental conditions for longer extraction times were also observed. The statistical model represents a novel tool for industrial production of myrtle liqueur.