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Circadian rhythms have been shown in the subthalamic nucleus (STN) in Parkinsons disease (PD), but only a few studies have focused on the globus pallidus internus (GPi). This retrospective study investigates GPi circadian rhythms in a large cohort of subjects with PD (130 recordings from 93 subjects) with GPi activity chronically recorded in their home environment. We found a significant change in GPi activity between daytime and nighttime in most subjects (82.4%), with a reduction in GPi activity at nighttime in 56.2% of recordings and an increase in activity in 26.2%. GPi activity in higher frequency bands ( > 20 Hz) was more likely to decrease at night and in patients taking extended-release levodopa medication. Our results suggest that circadian fluctuations in the GPi vary across individuals and that increased power at night might be due to the reemergence of pathological neural activity. These findings should be considered to ensure successful implementation of adaptive neurostimulation paradigms in the real-world.

Abstract Background The COVID-19 pandemic has led to the popularization of information and communication technology in medical education. This study aimed to compare the objective structured clinical examination (OSCE) and the virtual objective structured clinical examination (vOSCE), based on expert opinion, as tools for assessing the competencies needed under medical curriculum guidelines in Brazil. Methods In this multicenter study, the suitability levels of the OSCE and vOSCE for assessing the competencies needed under the Brazilian National Curriculum Guidelines (DCNs) were compared. The DCNs encompass five groups of domains, namely, health education; general; health management; public health needs; and individual health needs. Sixteen teaching experts served as judges. They responded to a questionnaire with the provided Likert scores indicating the ability of the OSCE and vOSCE to assess each type of competency. Virtual meetings were held via the Delphi method and a focus group-based approach to enable the experts to reach a consensus. Results A total of 200 items included in the guidelines (100 for the OSCE and 100 for the vOSCE) were evaluated across a total of 3,200 responses. Analysis via the Likert scale revealed a high proportion of positive evaluations for the use of the vOSCE, with kappa values ​​ranging from 0.4 to 0.72. The values ​​of the absolute agreement (positive view) between examiners and equivalence with the kappa statistic for the adoption of the vOSCE ranged from 0.38 to 0.72. Via the use of virtual meetings (Delphi and focus groups), consensus was reached regarding the capacity of the OSCE and vOSCE to evaluate 97% and 92% of these items, respectively. Conclusion The vOSCE can be employed to assess relevant competencies. However, it faces limitations regarding 8% (8/100) of the items, and some items (3%) cannot be assessed via either method. The difference in results between the two assessment methodologies (OSCE and vOSCE) is 5%. It is necessary to invest in the creation of instruments that can be used to apply the vOSCE and to conduct cost‒benefit analysis of its broader application in health education institutions. We conclude that the vOSCE is an effective tool for assessing most competencies of medical professionals and students required under Brazilian guidelines.

New Italian data on the distribution of some of the Annex I Habitats are reported in this contribution. Specifically, 16 records are presented including 9 new occurrences in Natura 2000 sites, and 27 new cells are added in the EEA 10 km × 10 km reference grid. The new data refer to the Italian administrative regions of Abruzzo, Apulia, Latium, Marche, Lombardy, Piedmont, Sardinia, Sicily, Tuscany, and Veneto.

Abstract Neutrophils (PMNs) are key players of innate immune responses through the release of cytoplasmic granule content and the formation of neutrophil extracellular traps (NETs). RNASET2 is an acidic ribonuclease, recently proposed as an alarmin signal associated with inflammatory responses. Here we show that, along the neutrophil maturation cascade, RNASET2 is expressed in segmented and mature PMNs. In human PMNs, RNASET2 colocalized with primary and tertiary granules and was found to be associated with NETs following PMA or Nigericin stimulation. Similarly, activation of PMNs by soluble immune complexes, a hallmark of several autoimmune diseases, also induced RNASET2-associated NETs. Genome-wide association studies recently identified RNASET2 among a cluster of genes associated with increased susceptibility to develop autoimmune diseases, including rheumatoid arthritis (RA). RNASET2 was found expressed by PMNs and macrophages infiltrating inflamed joints in a murine model of RA (K/BxN Serum-Transfer-Induced Arthritis, STIA), by immunostaining. Similar results were found in synovial biopsies of RA patients with active disease. In addition, we demonstrate that RNASET2 circulating levels correlated with the onset and the severity of disease in two mouse models of inflammatory arthritis, STIA and CIA (Collagen-Induced Arthritis) and in serum of RA patients. These results show that PMNs are an important source of RNASET2 and that its circulating levels are associated with RA development suggesting a role for RNASET2 in the pathogenesis of immune-mediated diseases.

Abstract Background The physiological relevance of cell-to-cell communication mediated by small extracellular vesicle-encapsulated microRNAs (sEV-miRNAs) remains debated because of the limiting representativity of specific miRNAs within the extracellular pool. We hypothesize that sEV-miRNA non-canonical function consisting of the stimulation of Toll-like receptor 7 (TLR7) may rely on a global shift of the sEV cargo rather than on the induction of one or few specific miRNAs. Psoriasis represents an ideal model to test such hypothesis as it is driven by overt activation of TLR7-expressing plasmacytoid dendritic cells (pDCs) following keratinocyte damage. Methods To mimic the onset of psoriasis, keratinocytes were treated with a cocktail of psoriatic cytokines or UV-irradiated. SmallRNA sequencing was performed on sEVs released by healthy and UV-treated keratinocytes. sEV-miRNAs were analyzed for nucleotide composition as well as for the presence of putative TLR7-binding triplets. Primary human pDCs where stimulated with sEVs +/- inhibitors of TLR7 (Enpatoran), of sEV release (GW4869 + manumycin) and of TLR7-mediated pDC activation (anti-BDCA-2 antibody). Secretion of type I IFNs and activation of CD8+T cells were used as readouts. qPCR on psoriatic and healthy skin biopsies was conducted to identify induced miRNAs. Results sEV-miRNAs released by damaged keratinocytes revealed a significantly higher content of TLR7-activating sequences than healthy cells. As expected, differential expression analysis confirmed the presence of miRNAs upregulated in psoriatic skin, including miR203a. More importantly, 76.5% of induced miRNAs possessed TLR7-binding features and among these we could detect several previously demonstrated TLR7 ligands. In accordance with this in silico analysis, sEVs from damaged keratinocytes recapitulated key events of psoriatic pathogenesis by triggering pDCs to release type I interferon and activate cytotoxic CD8+T cells in a TLR7- and sEV-dependent manner. Discussion Our results demonstrate that miR203a is just one paradigmatic TLR7-activating miRNA among the hundreds released by UV-irradiated keratinocytes, which altogether trigger pDC activation in psoriatic conditions. This represents the first evidence that cell damage shifts the miRNA content of sEVs towards a TLR7-activating cargo capable to propagate inflammation and immunity, offering strong support to the physiological role of systemic miRNA-based cell-to-cell communication.

Abstract Background Prevention and treatment of metastatic breast cancer (BC) is an unmet clinical need. The retinoic acid derivative fenretinide (FeR) was previously evaluated in Phase I-III clinical trials but, despite its excellent tolerability and antitumor activity in preclinical models, showed limited therapeutic efficacy due to poor bioavailability. We recently generated a new micellar formulation of FeR, Bionanofenretinide (Bio-nFeR) showing enhanced bioavailability, low toxicity, and strong antitumor efficacy on human lung cancer, colorectal cancer, and melanoma xenografts. In the present study, we tested the effect of Bio-nFeR on a preclinical model of metastatic BC. Methods We used BC cell lines for in vitro analyses of cell viability, cell cycle and migratory capacity. For in vivo studies, we used HER2/neu transgenic mice (neuT) as a model of spontaneously metastatic BC. Mice were treated orally with Bio-nFeR and at sacrifice primary and metastatic breast tumors were analyzed by histology and immunohistochemistry. Molecular pathways activated in primary tumors were analyzed by immunoblotting. Stem cell content was assessed by flow cytometry, immunoblotting and functional assays such as colony formation ex vivo and second transplantation assay in immunocompromised mice. Results Bio-nFeR inhibited the proliferation and migration of neuT BC cells in vitro and showed significant efficacy against BC onset in neuT mice. Importantly, Bio-nFeR showed the highest effectiveness against metastatic progression, counteracting both metastasis initiation and expansion. The main mechanism of Bio-nFeR action consists of promoting tumor dormancy through a combined induction of antiproliferative signals and inhibition of the mTOR pathway. Conclusion The high effectiveness of Bio-nFeR in the neuT model of mammary carcinogenesis, coupled with its low toxicity, indicates this formulation as a potential candidate for the treatment of metastatic BC and for the adjuvant therapy of BC patients at high risk of developing metastasis.

Crouzon syndrome is a rare genetic craniofacial malformation caused by heterozygous gain-of-function mutations in the FGFR2 gene. The resulting constitutive activation of the FGFR2 signaling causes the premature osteogenic differentiation of calvarial mesenchymal stromal cells in skull sutures, leading to early suture ossification. Craniectomy is the gold standard treatment, being invasive and burdened by complications. To address these issues, we developed personalized allele-specific (AS) small interfering RNA (siRNA) to knockdown the expression of the FGFR2 mutant allele in Crouzon patient-derived suture cells. The selected therapeutic siRNA mitigated FGFR2 cascade downregulating phosphorylation of FGFR2 (48%) and of its key effector ERK1/2 (77%) as RUNX2 protein levels (34%). This effect was confirmed by the reduced osteogenic commitment and differentiation of treated cells, evidenced by decreased expression of osteogenic marker genes and a 5-fold decrease in mineralized matrix deposition. We developed a highly biocompatible delivery system for siRNAs, based on human recombinant ferritin nanoparticles (NPs), combining cell targeting with improved nucleic acid encapsulation and endosomal escape properties. We demonstrated the ability of these NPs to deliver and release siRNAs within target cells, sustaining their inhibitory and AS effects. Here, we show that ferritin-mediated AS FGFR2 knockdown by siRNA represents a suitable strategy to dampen FGFR2 overactivation in patients’ cells.

Objective: Venous thromboembolism (VTE) is a global disease with significant morbidity and mortality. However, variations in presentation and management of VTE between different continents have not been studied. This retrospective analysis of prospectively collected registry data compares presenting symptoms and treatment modalities of patients with VTE in three continents: Europe, America, and Asia. Methods: The data from the Registro Informatizado de la Enfermedad ThromboEmbólica registry (2011-2021) were reviewed. The Registro Informatizado de la Enfermedad ThromboEmbólica is the largest international registry dedicated to VTE that started in Spain and expanded worldwide. Patient characteristics and treatments were compared between Europe, America, and Asia using standardized differences. Results: There were a total of 61,531 patients with VTE with the majority from Europe (90.3%), followed by Asia (6.3%) and America (3.3%). Patients diagnosed with VTE in America were significantly younger than the other continents. VTE patients in America were more likely to be Black and patients in Asia were more likely to have a lower body mass index when compared with patients from Europe and America. Patients with VTE in Asia presented with significantly more comorbidities including diabetes, coronary artery disease, and ischemic stroke. Also, patients from Asia were more likely to have recent major bleeding and active cancer. Conversely, patients from America had a significantly greater likelihood of having VTE related to travel. Anatomically, European patients were more likely to present with proximal DVT compared with patients from Asia and America. Patients in America were more likely to have low-risk pulmonary embolism (PE) and less likely to have intermediate-risk PE compared with patients from Europe and Asia. There was no difference in the proportion of patients with high-risk PE between continents. There was significant variation in the choice of initial and outpatient anticoagulation; vitamin K antagonists were more commonly used in Europe, whereas direct oral anticoagulants were more commonly used in America, and low-molecular-weight heparins were favored in Asia. Patients in Asia were less likely to receive systemic thrombolytic therapy. In terms of endovascular treatment, pharmacological thrombolysis was used more often for the treatment of PE in Europe compared with Asia and open pulmonary embolectomy was more common among American patients in the registry. Conclusions: There is significant intercontinental variation in VTE presentation and management. Future analyses should evaluate the relationship of these variations with clinical outcomes. Comparative research using a global registry could shed light on VTE biology and treatment.

We studied the vascular flora of the isthmus of Feniglia, a Nature Reserve in southern Tuscany stretching between the Italian Peninsula and Mt. Argentario. Since the nineteenth century, the area has undergone significant environmental modifications due to intensive grazing and deforestation. Later, rehabilitation interventions were carried out, including reforestation and planting of dune species, making it an interesting protected area to study for its botanical aspects. Therefore, we aim to compile the floristic inventory of this distinctive Mediterranean area by integrating old and new data. The checklist comprises 502 specific and subspecific taxa of vascular plants. The life-form spectrum shows a predominance of therophytes, followed by hemicryptophytes. The chorological spectrum highlights the dominance of Mediterranean species, followed by Euromediterranean and Eurasian species. The presence of 15 species of regional importance, 3 species of the Italian red list and 3 Italian endemics (Ornithogalum exscapum Ten., Limonium multiforme Pignatti, Linaria purpurea (L.) Mill.) is noteworthy. Despite the environmental changes undergone in this area, our study reports the presence of remarkable species, including rare ones such as Atriplex littoralis L., Ruppia spiralis L. ex Dumort., and species at their distribution margin in the Italian Peninsula, such as Staphisagria macrosperma Spach, Juncus sorrentinoi Parl. and Maresia nana (DC.) Batt. Additionally the presence of 26 alien species, of which 15 are invasive, 9 naturalized and 2 casual, indicates a relatively low presence of alien species. Notwithstanding the significant environmental changes that the Feniglia isthmus has experienced in the last century and the high tourist pressure during the summer, the presence of the protected area suggested the effectiveness and benefits of such a form of protection for plant diversity.

Mapping habitats on coastal dunes, crucial yet highly vulnerable ecosystems, requires objectivity and repeatability, which are still lacking in the implementation of the Habitats Directive. Although remote sensing offers promising solutions, the effectiveness of distinguishing habitats on coastal dunes from satellite imagery remains uncertain. In this study, we compare crisp and fuzzy classification approaches using WorldView-3 imagery to map coastal dune habitats in two Natural Parks of Tuscany (Italy).Field-collected vegetation data were classified into Annex I habitats of Habitats Directive and EUNIS habitats. Using field data as reference, we performed image classifications with a crisp method (Random Forests) and three fuzzy methods, namely Random Forests, Spectral Angle Mapper and Multiple Endmember Spectral Mixture Analysis. Metrics of overall accuracy and Mantel tests were used to compare the results.EUNIS habitats exhibited the best performance in terms of classification accuracy, likely due to the simpler classification system. We observed a great disparity among habitats, with coastal dune scrubs and white dunes generally achieving the highest accuracy. Fuzzy classifications, despite yielding lower overall accuracy than the crisp classification, provided a more realistic representation of vegetation patterns, highlighting the inherent fuzziness of vegetation in coastal dunes. Despite challenges related to image resolution and habitat heterogeneity, combining satellite imagery with field surveys proved valuable for mapping coastal dune habitats, contributing essential data to the conservation of these fragile ecosystems. We provide a novel and effective tool, which will reduce the economic and physical efforts needed for habitat search and sampling in the field.

European beech (Fagus sylvatica L.) forests can have a high variability in plant species richness and abundance, from monospecific stands to highly species-rich communities. To understand what causes the low plant diversity observed in some beech forests, we analyzed the drivers of plant community completeness in 155 vegetation plots. Data were collected in mature, closed-canopy beech forests in Tuscany, central Italy. Site-specific species pools were estimated based on species co-occurrences. We used Generalized Least Squares linear modeling to assess the effects of anthropogenic and environmental drivers on the community completeness of whole communities and on the set of specialist species of beech forests. We also tested the response of the total cover of the herb layer to the selected predictors and related both the predictive and response variables to species composition in a Non-metric Multidimensional Scaling ordination. The community completeness of whole communities and that of beech forest specialists were negatively affected by total beech cover and positively influenced by slope. Moreover, the community completeness of whole communities was negatively impacted by elevation and positively influenced by disturbance frequency. The cover of the herb layer decreased with increasing beech cover, elevation, and precipitation. High community completeness and high cover of the herb layer were associated with the presence of thermophilic species of mixed deciduous woods in low-elevation beech forests. Our results suggest that a low plant community completeness and a low cover of the herb layer are mainly due to the competition by beech itself when it forms pure forests in its ecological optimum. Such competition is better exerted at upper elevations and in sites with low slopes, where beech litter accumulation is a limiting factor for understory species. Such evidence suggests that species absence in mature beech forests is mainly due to natural drivers and should therefore not be considered an indicator of ecological degradation of the forest.

Objective:. The aim of this study is to provide solid evidence to update the management of stage I colon cancer (CC) after surgery. Background:. Given the low risk of recurrence of stage I CC, some international guidelines do not recommend intensive follow-up after surgery. However, data on the actual incidence, risk factors, and site of recurrences are scarce. Methods:. This is a retrospective multicenter cohort study considering patients who underwent surgery at 25 Italian centers between 2010 and 2019, with a minimum follow-up of 24 months. A total of 1883 consecutive adult patients with stage I CC treated with curative surgery were considered, and 1611 fulfilled the inclusion criteria. The primary outcome was the rate of recurrence. Secondary outcomes included survival and risk factors for recurrence. Results:. Eighty patients developed cancer recurrence (5.0%), of which 90% was systemic relapse. The event was more frequent in pT2 (6.0% vs 3.2%, P = 0.013), male patients (6.1% vs 3.6%, P = 0.021), in the presence of lymphovascular invasion (7.2% vs 3.6%, P = 0.01), and in cases of partial resection (11.1% vs 4.6%, P = 0.011). Also, preoperative carcinoembryonic antigen (P = 0.007) and tumor diameter (P < 0.001) were higher in the group who relapsed. Most patients had isolated cancer recurrence (90%). Recurrences peaked between 10 and 18 months after surgery and declined over time. Adjusted Cox regression analysis identified tumor diameter, carcinoembryonic antigen level, lymphovascular invasion, male gender, and less than 12 analyzed lymph nodes as significant risk factors for worse recurrence-free survival. Conclusions:. This study showed that a not negligible rate of stage I CC recur after curative surgery. Most relapses occur at a single site within the first 3 years after surgery. This evidence could be used to optimize postoperative follow-up.

BackgroundInterstitial lung diseases (ILDs) comprise a family of heterogeneous entities, primarily characterised by chronic scarring of the lung parenchyma. Among ILDs, idiopathic pulmonary fibrosis (IPF) is the most common idiopathic interstitial pneumonitis, associated with progressive functional decline leading to respiratory failure, a high symptom burden, and mortality. Notably, the incidence of lung cancer (LC) in patients already affected by ILDs—mainly IPF—is significantly higher than in the general population. Moreover, these cases are often neglected and deprived of active oncologic treatments.MethodsWe here aim to identify variables predictive of outcome (mortality) in a multicentre retrospective cohort of ILD associated with lung cancer, collected from 2018 to the end of 2023. Overall, 73 cases were identified, and exhaustive clinicopathologic data were available for 55 patients. Among them, 42 had IPF. The entire dataset was then analysed by using the JMP partition algorithm (JMP-Statistical Discoveries, from SAS), which can choose the optimum splits from many possible trees, making it a powerful modelling and data discovery tool.ResultsThe average age at lung cancer diagnosis was 71.4 years, whereas the average age at IPF diagnosis was 69.5 years. The average Charlson Comorbidity Index was 4.6. Female patients constituted 28.3% (15) of the evaluated cases. The most frequent tumour histotype was adenocarcinoma (45.2%), and in more than 60% of the cases (67.9%), cancer was diagnosed at an early stage (TNM I–II–IIIA). A significant gender difference emerges regarding the overall patient survival, and quite unexpectedly, surgical approach to IPF-associated LC and the detection of serum autoantibodies are among the strongest outcome predictors.ConclusionsThe analysis performed is descriptive and successfully identifies key features of this specific and rare cancer population. IPF-associated LC emerges as a unique malignant disease defined by specific gender and histopathologic clinical and molecular parameters, which might benefit from active treatments.

Mosses are important pioneer organisms in cold and wet habitats, such as glacial and periglacial habitats of the European Alps. These habitats include glaciers and rock glaciers, respectively, and are of increasing interest for being directly threatened by climate change and for hosting a specialized and often rare and endemic biodiversity (EU Habitats Directive, habitat code 8340, Natura 2000 network). However, the moss flora of rock glaciers was never studied, and, in general, few studies were performed specifically on mosses of ice-related landforms in the European Alps. The aim of this work is to give a first comparative checklist from two Alpine sites, the rock glacier of Lazaunkar (Bolzano, Italy) and the debris-cover glacier and rock glacier of Cima Uomo (Trento, Italy), with different bedrock compositions. Threatened species (according to IUCN red lists) and extremely specialized high-elevation species were found in both sites, but mostly on crystalline bedrock in Lazaunkar. This biodiversity is the most threatened by climate change. These findings highlight how these habitats still need to be studied and monitored in the future.

The issue of sustainable food production has become increasingly important in recent years, starting from Sustainable Development Goals in 2015, moving through important events like Farm to Fork strategy up until the United Nations Food System Summit in 2021. The wine industry also, as a niche of the agri-food sector, has been influenced by this change, but despite its economic and cultural value, its sustainability issues have not been sufficiently explored by academia. The present research expands the debate on environmental sustainability in the wine industry by observing how management academia has addressed this topic over the last twelve years, defining the state of the art of a quite new and unexplored topic. The research has been structured as a systematic literature review of academic papers from 2009 till the first half of 2022. This methodology provides a clear overview of sustainable management practices, effective and potential, throughout the entire agri-food wine production process.The papers identified are categorized and divided into major (most recurrent) and secondary topics, according to the prevalence criterion.The findings and discussion section provides an in-depth description and analysis of each category, as well as research gaps identification and possible academic issues. Since it was not possible to find similar works, this research would like to be seen as an opportunity to develop the research on environmental sustainability in the wine industry and align the interest of academia and wine stakeholders defining the path for future research.

Effective conservation planning requires identifying priority hotspots to allocate resources. To preserve biodiversity, it is crucial to consider α, β and γ-diversity and protect the irreplaceable sites with high ecological uniqueness, which can host uncommon species assemblages that would be lost if only species-rich sites were protected. Coastal dunes, hosting highly specialized plant communities, are among the most threatened ecosystems worldwide. In this study, we identified conservation priority hotspots to assess the effectiveness of the network of protected areas in coastal dunes of Tuscany (central Italy), using data on plant communities collected in 506 plots. We additively partitioned γ-diversity in its α and β components, observing a significant variation at all spatial levels only for dune species. In terms of α-diversity, we found that Northern protected sites were richer in dune species, while synanthropic and alien species were equally present inside and outside protected areas of the region. By partitioning the total β-diversity into its components (replacement and richness difference), we found a prevalence of replacement for dune species, indicating the most unique sites as the ones to favor for conservation. Unique sites were identified through Local Contributions to Beta Diversity and their conservation value was determined by their species composition and the relationship with landscape variables. Unique sites with high conservation value were only partly protected, while some protected sites were altered and required restoration. Our approach proved effective for identifying the most unique sites, indicating some issues in the existing protected network, while providing valuable information on sites to prioritize for future conservation actions.

In this contribution, new data concerning algae, bryophytes, fungi and lichens of the Italian flora are presented. It includes new records and confirmations for the algal genera Chara and Nitella, the bryophyte genera Brachythecium, Didymodon, Fissidens, Physcomitrium, and Riccia, the fungal genera Biatoropsis, Cantharellus, Coprinellus, Dacrymyces, Inosperma, Nigropuncta, Urocystis, and Xanthoriicola, and the lichen genera Arthonia, Bellemerea, Circinaria, Lecania, Lecanora, Lecidella, Mycobilimbia, Naetrocymbe, Parmelia, Peltigera, Porpidia, Scytinium, and Usnea.

Camera trap studies on ocelots in Mexico have focused on abundance, habitat use, and activity patterns, mainly within Protected Areas of tropical humid forests in southern regions. However, their ecology, including breeding effort and productivity in seasonal dry Pacific forests and areas outside Protected Areas, has received less attention. The species’ low reproductive rates make their populations vulnerable to decline. In evaluating the reproduction, the species’ breeding activity was examined for two survey periods performed during 2010–2016. We estimated the percentage of females raising young in the surveys and their associated fecundity–”productivity”. The overall results revealed a population of 26 males and 46 females that included 10 females (21%) rearing 12 young, defined as kittens, cubs, or juveniles, for an effective sample area (ESA) of 200 km2. Overall, the productivity averaged 2.05/100 km2 per season. All parameters varied between the two areas, and productivity was not constant in time in either area or site. Information on species breeding activity in combination with density estimations may facilitate determining the minimum area required for a viable ocelot population in the region. Protected Areas are required in the studied region for the ocelot in order to maintain a viable local population. This is due to the increasing fragmentation caused by agriculture, cattle ranching, and forest fires, and it is hypothesized that ocelots do not tolerate disturbance or severe fragmentation.

Abstract Background Limited data existed on the burden of coronavirus disease 2019 (COVID-19) renal complications and the outcomes of the most critical patients who required kidney replacement therapy (KRT) during intensive care unit (ICU) stay. We aimed to describe mortality and renal function at 90 days in patients admitted for COVID-19 and KRT. Methods A retrospective cohort study of critically ill patients admitted for COVID-19 and requiring KRT from March 2020 to January 2022 was conducted in an Italian ICU from a tertiary care hospital. Primary outcome was mortality at 90 days and secondary outcome was kidney function at 90 days. Results A cohort of 45 patients was analyzed. Mortality was 60% during ICU stay and increased from 64% at the time of hospital discharge to 71% at 90 days. Among 90-day survivors, 31% required dialysis, 38% recovered incompletely, and 31% completely recovered renal function. The probability of being alive and dialysis-free at 3 months was 22%. Conclusions Critically ill patients with COVID-19 disease requiring KRT during ICU stay had elevated mortality rate at 90 days, with low probability of being alive and dialysis-free at 3 months. However, a non-negligible number of patients completely recovered renal function.

Background: Human-Machine Interaction (HMI) has been an important field of research in recent years, since machines will continue to be embedded in many human actvities in several contexts, such as industry and healthcare. Monitoring in an ecological mannerthe cognitive workload (CW) of users, who interact with machines, is crucial to assess their level of engagement in activities and the required effort, with the goal of preventing stressful circumstances. This study provides a comprehensive analysis of the assessment of CW using wearable sensors in HMI. Methods: this narrative review explores several techniques and procedures for collecting physiological data through wearable sensors with the possibility to integrate these multiple physiological signals, providing a multimodal monitoring of the individuals’CW. Finally, it focuses on the impact of artificial intelligence methods in the physiological signals data analysis to provide models of the CW to be exploited in HMI. Results: the review provided a comprehensive evaluation of the wearables, physiological signals, and methods of data analysis for CW evaluation in HMI. Conclusion: the literature highlighted the feasibility of employing wearable sensors to collect physiological signals for an ecological CW monitoring in HMI scenarios. However, challenges remain in standardizing these measures across different populations and contexts.