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Abstract Background A manual toothbrush is an indispensable tool for promoting and maintaining oral health worldwide but given the non-biodegradable and non-recyclable thermoplastic materials from which it is made, it cannot be considered free of threats to the environment. Therefore, also in light of the World Dental Federation's goals to implement and initiate policies for sustainable dentistry, this study evaluates the sustainability of two materials most used for manual toothbrush bristles, namely nylon, and silicone. Objectives The objective is to investigate the optimal solution to reduce the environmental impact of toothbrushes, and how the environmental impact would change if only the brush head was changed instead of the entire toothbrush. Methods Life Cycle Assessment and Carbon Footprint were used. Four manual toothbrushes with nylon bristles, and a handle in polypropylene with/without silicone parts (N1, N2, N3, N4) and two manual toothbrushes, with silicone bristles, but one with polypropylene handle only (Si1), the other with polypropylene handle and silicone parts (Si2) were evaluated. Results A toothbrush with silicone bristles is more sustainable than one with nylon bristles in all 18 impact categories, with average values of − 14%. In addition, eliminating only the brush head instead of the entire toothbrush could result in savings of 4.69 × 10‒3 kg CO2 eq per toothbrush. Therefore, based on the results of this study and to meet Dentistry's need to reduce its environmental impact, the ideal toothbrush should be lightweight, with less superfluous material, and with less impactful materials such as silicone instead of nylon. Conclusions The concluding indications for improving the sustainability of toothbrushes are therefore: (i) eliminate the amount of superfluous material; (ii) develop lighter models; and (iii) develop models in which only the brush head is replaced rather than the entire toothbrush.

Abstract Background Humic acid affects plant growth. Its source and structure may play a central role to its functionality. The relationship between humic acid and plant bioactivity is still unclear. This study investigated the biostimulation effects of two natural humic acids derived from soil (SHA) and lignite (LHA) on Lepidium sativum in comparison to a synthetic humic acid model (HALP) with known structure. Results All humic acids positively affected cress seed germination and root elongation. Greater root hairs density and dry matter, compared to control, were observed using concentration of 5 mg L−1 for HALP, 50 mg L−1 for LHA, and 100 mg L−1 for SHA. The germination index was the largest (698% more effective than control) with 50 mg L−1 of SHA, while it was 528% for LHA, and 493% for HALP at 5 mg L−1. SHA contained the lowest aromatic and phenolic C content, the largest pK2 value of 9.0 (7.7 for LHA and 7.6 for HALP), the least ratio between the aromaticity index and lignin ratio (ARM/LigR) of 0.15 (0.66 for LHA and 129.92 for HALP), and at pH 6.3 the lowest amount of free radicals with a value of 0.567 × 1017 spin g−1 (1.670 × 1017 and 1.780 × 1017 spin g−1 for LHA and HALP, respectively), with the greatest g value of 2.0039 (2.0035 for LHA and 2.0037 for HALP). Conclusions The overall chemical structure of humic acids exerted a biostimulation of cress plantlets. The level of the intrinsic stable free radicals identified by EPR in the humic acids resulted well correlated to the ARM/LigR ratio calculated by NMR. Our results suggested that HA biostimulation effect is related to its applied concentration, which is limited by its free radical content. The modulation of the humic supramolecular structure by ROS and organic acids in root exudates can determine the release of bioactive humic molecules. When the content of the intrinsic humic free radicals is high, possible molecular coupling of the bioactive humic molecules may hinder their biostimulation activity. In such cases, a low humic acid concentration appears to be required to achieve the optimum biostimulation effects. Graphical Abstract

Abstract E3 ubiquitin protein ligase encoded by ARIH2 gene catalyses the ubiquitination of target proteins and plays a crucial role in posttranslational modifications across various cellular processes. As prior documented, mutations in genes involved in the ubiquitination process are often associated with autism spectrum disorder (ASD) and/or intellectual disability (ID). In the current study, a de novo heterozygous mutation was identified in the splicing intronic region adjacent to the last exon of the ARIH2 gene using whole exome sequencing (WES). We hypothesize that this mutation, found in an ASD/ID patient, disrupts the protein Ariadne domain which is involved in the autoinhibition of ARIH2 enzyme. Predictive analyses elucidated the implications of the novel mutation in the splicing process and confirmed its autosomal dominant inheritance model. Nevertheless, we cannot exclude the possibility that other genetic factors, undetectable by WES, such as mutations in non-coding regions and polygenic risk in inter-allelic complementation, may contribute to the patient's phenotype. This work aims to suggest potential relationship between the detected mutation in ARIH2 gene and both ASD and ID, even though functional studies combined with new sequencing approaches will be necessary to validate this hypothesis.

Community pharmacy practice in Indonesia has shifted to a patient-centered model, offering a range of services that include treatment advice, chronic disease management, and public health promotion. This shift benefits consumers who visit community pharmacies as their initial healthcare point. The Indonesian healthcare system, a mix of public and private providers, is governed by a decentralized structure, fostering significant investment in private healthcare despite access limitations due to financial capacity. Medicines distribution, managed by the District Health Office, ensures supply to primary healthcare facilities, with community pharmacies regulated by the Ministry of Health and the Indonesian National Food and Drug Agency. Despite stringent regulations mandating comprehensive services, most pharmacists are not remunerated for their services. Pharmacy staff, including formally qualified pharmacists and pharmacy technicians, are registered professionals, with recent trends indicating a shift towards employing pharmacy technicians to enable pharmacists to focus on clinical roles. Economic factors and innovative service delivery modes, such as telepharmacy and online purchasing, are expected to influence future practices, enhancing the pharmacist's role in chronic disease management and other health conditions. The evolving community pharmacy practice in Indonesia reflects broader changes in the healthcare system and professional roles, with continued progression anticipated.

SRY-box transcription factor (SOX) genes, a recently discovered gene family, play crucial roles in the regulation of neuronal stem cell proliferation and glial differentiation during nervous system development and neurogenesis. Whole exome sequencing (WES) in patients presenting with generalized epilepsy, intellectual disability, and childhood emotional behavioral disorder, uncovered a de novo variation within SOX12 gene. Notably, this gene has never been associated with neurodevelopmental disorders. No variants in known genes linked with the patient’s symptoms have been detected by the WES Trio analysis. To date, any MIM phenotype number associated with intellectual developmental disorder has not been assigned for SOX12. In contrast, both SOX4 and SOX11 genes within the same C group (SoxC) of the Sox gene family have been associated with neurodevelopmental disorders. The variant identified in the patient here described was situated within the critical high-mobility group (HMG) functional site of the SOX12 protein. This domain, in the Sox protein family, is essential for DNA binding and bending, as well as being responsible for transcriptional activation or repression during the early stages of gene expression. Sequence alignment within SoxC (SOX12, SOX4 and SOX11) revealed a high conservation rate of the HMG region. The in silico predictive analysis described this novel variant as likely pathogenic. Furthermore, the mutated protein structure predictions unveiled notable changes with potential deleterious effects on the protein structure. The aim of this study is to establish a correlation between the SOX12 gene and the symptoms diagnosed in the patient.

Abstract Human learning varies greatly among individuals and is related to the microstructure of major white matter tracts in several learning domains, yet the impact of the existing microstructure of white matter tracts on future learning outcomes remains unclear. We employed a machine-learning model selection framework to evaluate whether existing microstructure might predict individual differences in learning a sensorimotor task, and further, if the mapping between tract microstructure and learning was selective for learning outcomes. We used diffusion tractography to measure the mean fractional anisotropy (FA) of white matter tracts in 60 adult participants who then practiced drawing a set of 40 unfamiliar symbols repeatedly using a digital writing tablet. We measured drawing learning as the slope of draw duration over the practice session and measured visual recognition learning for the symbols using an old/new 2-AFC task. Results demonstrated that tract microstructure selectively predicted learning outcomes, with left hemisphere pArc and SLF3 tracts predicting drawing learning and the left hemisphere MDLFspl predicting visual recognition learning. These results were replicated using repeat, held-out data and supported with complementary analyses. Results suggest that individual differences in the microstructure of human white matter tracts may be selectively related to future learning outcomes.

Abstract Laser-driven dynamic compression experiments of plastic materials have found surprisingly fast formation of nanodiamonds (ND) via X-ray probing. This mechanism is relevant for planetary models, but could also open efficient synthesis routes for tailored NDs. We investigate the release mechanics of compressed NDs by molecular dynamics simulation of the isotropic expansion of finite size diamond from different P-T states. Analysing the structural integrity along different release paths via molecular dynamic simulations, we found substantial disintegration rates upon shock release, increasing with the on-Hugnoiot shock temperature. We also find that recrystallization can occur after the expansion and hence during the release, depending on subsequent cooling mechanisms. Our study suggests higher ND recovery rates from off-Hugoniot states, e.g., via double-shocks, due to faster cooling. Laser-driven shock compression experiments of polyethylene terephthalate (PET) samples with in situ X-ray probing at the simulated conditions found diamond signal that persists up to 11 ns after breakout. In the diffraction pattern, we observed peak shifts, which we attribute to thermal expansion of the NDs and thus a total release of pressure, which indicates the stability of the released NDs.

Abstract The increasing pervasiveness of ICT technologies and sensor infrastructures is enabling police departments to gather and store increasing volumes of spatio-temporal crime data. This offers the opportunity to apply data analytics methodologies to extract useful crime predictive models, which can effectively detect spatial and temporal patterns of crime events, and can support police departments in implementing more effective strategies for crime prevention. The detection of crime hotspots from geo-referenced data is a crucial aspect of discovering effective predictive models and implementing efficient crime prevention decisions. In particular, since metropolitan cities are heavily characterized by variable spatial densities of crime events, multi-density clustering seems to be more effective than classic techniques for discovering crime hotspots. This paper presents the design and implementation of MD-CrimePredictor (Multi- Density Crime Predictor), an approach based on multi-density crime hotspots and regressive models to automatically detect high-risk crime areas in urban environments, and to reliably forecast crime trends in each area. The algorithm result is a spatio-temporal crime forecasting model, composed of a set of multi-density crime hotspots, their densities and a set of associated crime predictors, each one representing a predictive model to forecast the number of crimes that are estimated to happen in its specific hotspot. The experimental evaluation of the proposed approach has been performed by analyzing a large area of Chicago, involving more than two million crime events (over a period of 19 years). This evaluation shows that the proposed approach, based on multi-density clustering and regressive models, achieves good accuracy in spatial and temporal crime forecasting over rolling prediction horizons. It also presents a comparative analysis between SARIMA and LSTM models, showing higher accuracy of the first method with respect to the second one.

IntroductionImplant-based breast reconstruction (IBR) is the predominant breast reconstruction technique post-mastectomy, with bacterial infections being a significant complication affecting patient recovery and quality of life. The following study aimed to determine the microbiological features of the causative agents responsible for breast implant infections, with more attention paid to the comparative analysis of Gram-positive and Gram-negative bacteria and their presentation.MethodsWe conducted a retrospective analysis of 214 patients who presented with periprosthetic infection and underwent implant removal following implant-based breast reconstruction at Humanitas Research Hospital and Istituto Europeo di Oncologia between January 2018 and March 2024.ResultsThe study revealed that Gram-positive bacteria were more prevalent, with Staphylococcus species, particularly Staphylococcus aureus, being the most isolated pathogen in both institutions (∼39.96%). In contrast, Gram-negative bacteria were less frequent, with a higher proportion of these pathogens being multi-resistant strains. A significant difference was observed (p = 0.007), indicating that individuals with normal BMI have a higher prevalence of Gram-positive infections (88.46%), whereas obese and overweight patients had higher proportions of Gram-negative infections (23.53% and 28.89%, respectively). In addition, smoking status was also significantly associated with pathogen distribution (p = 0.032), with active and past smokers being related to higher percentages of polymicrobial infections. Furthermore, positive prophylactic MSSA/MRSA swabs were significantly more associated with Staphylococcus aureus infections compared to those with negative results (p =

IntroductionVaccination practice is a well-known individual protective measure for biological risk in healthcare. During the COVID-19 pandemic vaccine hesitancy has grown among healthcare workers (HCWs). The study aims to investigate how vaccine hesitancy influences the psychological burden experienced by healthcare workers.MethodsThis study aimed to explore attitudes of HCWs in acceptance or refusal of vaccinations related to the risk of psychological impairment (PI) and describe the associated occupational factors, during the seasonal flu/COVID-19 vaccination campaign of 2022–2023. 302 HCWs were enrolled in the study. A questionnaire was self-administered, including two scales on the risk of psychological impairment (Psychological Injury Risk Indicator, PIRI) and vaccine hesitancy (Adult Vaccine Hesitancy Scale, AVHS).ResultsPIRI scores revealed that 29.8% of participants were at risk of PI. Differences in sex, age, occupational seniority, professional category, and night shifts were found between HCWs at risk of PI and those not at risk. Females registered a four-fold higher risk than males (85.6% vs. 14.4%, χ2 = 4.450, p

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

Arteriovenous malformation of the brain (bAVM) is a vascular phenotype related to brain defective angiogenesis. Involved vessels show impaired expression of vascular differentiation markers resulting in the arteriolar to venule direct shunt. In order to clarify aberrant gene expression occurring in bAVM, here we describe results obtained by methylome analysis performed on endothelial cells (ECs) isolated from bAVM specimens, compared to human cerebral microvascular ECs. Results were validated by quantitative methylation-specific PCR and quantitative realtime-PCR. Differential methylation events occur in genes already linked to bAVM onset, as RBPJ and KRAS. However, among differentially methylated genes, we identified EPHB1 and several other loci involved in EC adhesion as well as in EC/vascular smooth muscle cell (VSMC) crosstalk, suggesting that only endothelial dysfunction might not be sufficient to trigger the bAVM phenotype. Moreover, aberrant methylation pattern was reported for many lncRNA genes targeting transcription factors expressed during neurovascular development. Among these, the YBX1 that was recently shown to target the arteridin coding gene. Finally, in addition to the conventional CpG methylation, we further considered the role of impaired CHG methylation, mainly occurring in brain at embryo stage. We showed as differentially CHG methylated genes are clustered in pathways related to EC homeostasis, as well as to VSMC-EC crosstalk, suggesting as impairment of this interaction plays a prominent role in loss of vascular differentiation, in bAVM phenotype.

Recuperando algumas discussões sobre a performance docente de Gilles Deleuze, presentes em certa literatura francófona recente, esse ensaio apresenta algumas correlações dessa performatividade docente deleuziana com elementos da filosofia do autor. Para tanto, apresenta-se um breve panorama da discussão presente em uma leva de comentadores, articulando-as com discussões conceituais presentes no corpus deleuziano e deleuzo-guattariano. Como hipótese norteadora, defende-se haver em Deleuze uma preocupação em filosofar a partir de um lastro sensível mais do que racional, sendo impossível compreender sua prática docente sem levar em consideração seu apelo por uma sensibilidade filosófica.

As a result of improved diagnostic methods and higher cancer patient survival rates, leptomeningeal carcinomatosis is being found in internal medicine departments more frequently. Melanoma, lung cancer, and breast adenocarcinoma are the three cancers that are most commonly associated. When the main tumor diffuses through the bloodstream, cerebrospinal fluid, or direct diffusion and causes multiple focal neurological symptoms, it is known as leptomeningeal involvement; the prognosis is usually not good. Despite multimodal treatment, leptomeningeal carcinomatosis is an advanced form of cancer that frequently results in rapid death. Treatment is typically palliative and consists primarily of intrathecal or systemic radiation and/or chemotherapy. New experimental therapies and immunotherapy are promising means of lowering morbidity and mortality. Clinical cases of leptomeningeal carcinomatosis are reported; both cases were identified at the Ospedale dei Castelli’s Department of Internal Medicine and resulted from primary breast pathology.

The experience of the COVID-19 lockdown has suddenly accelerated the awareness process of the entire university faculty about the need to hybridise their teaching with digital tools (Trentin, Bocconi 2015; Perla, Scarinci, Amati 2021) transforming traditional scholarship of the Italian University in a gigantic field of experimentation of innovative practices (Perla, 2020, p. 562). This has brought out the importance of supporting the quality of university teaching through the commitment to address precise Faculty Development policies, specifically through the development of innovative experiences and the design of paths based on micro-credentials. This contribution reports some actions promoted by the University of Bari aimed at the innovation of university teaching and the results of a pilot course on micro-credentials.

Abstract In vitro models of pediatric brain tumors (pBT) are instrumental for better understanding the mechanisms contributing to oncogenesis and testing new therapies; thus, ideally, they should recapitulate the original tumor. We applied DNA methylation (DNAm) and copy number variation (CNV) profiling to characterize 241 pBT samples, including 155 tumors and 86 pBT-derived cell cultures, considering serum vs serum-free conditions, late vs early passages, and dimensionality (2D vs 3D cultures). We performed a t-SNE classification and identified differentially methylated regions in tumors compared to cell models. Early cell cultures recapitulate the original tumor, but serum media and 2D culturing were demonstrated to significantly contribute to the divergence of DNAm profiles from the parental ones. All divergent cells clustered together acquiring a common deregulated epigenetic signature suggesting a shared selective pressure. We identified a set of hypomethylated genes shared among unfaithful cells converging on response to growth factors and migration pathways, such as signaling cascade activation, tissue organization, and cellular migration. In conclusion, DNAm and CNV are informative tools that should be used to assess the recapitulation of pBT-cells from parental tumors.

Abstract Background Diabetes-induced trained immunity contributes to the development of atherosclerosis and its complications. This study aimed to investigate in humans whether epigenetic signals involved in immune cell activation and inflammation are initiated in hematopoietic stem/progenitor cells (HSPCs) and transferred to differentiated progeny. Methods and results High glucose (HG)-exposure of cord blood (CB)-derived HSPCs induced a senescent-associated secretory phenotype (SASP) characterized by cell proliferation lowering, ROS production, telomere shortening, up-regulation of p21 and p27genes, upregulation of NFkB-p65 transcription factor and increased secretion of the inflammatory cytokines TNFα and IL6. Chromatin immunoprecipitation assay (ChIP) of p65 promoter revealed that H3K4me1 histone mark accumulation and methyltransferase SetD7 recruitment, along with the reduction of repressive H3K9me3 histone modification, were involved in NFkB-p65 upregulation of HG-HSPCs, as confirmed by increased RNA polymerase II engagement at gene level. The differentiation of HG-HSPCs into myeloid cells generated highly responsive monocytes, mainly composed of intermediate subsets (CD14hiCD16+), that like the cells from which they derive, were characterized by SASP features and similar epigenetic patterns at the p65 promoter. The clinical relevance of our findings was confirmed in sternal BM-derived HSPCs of T2DM patients. In line with our in vitro model, T2DM HSPCs were characterized by SASP profile and SETD7 upregulation. Additionally, they generated, after myeloid differentiation, senescent monocytes mainly composed of proinflammatory intermediates (CD14hiCD16+) characterized by H3K4me1 accumulation at NFkB-p65 promoter. Conclusions Hyperglycemia induces marked chromatin modifications in HSPCs, which, once transmitted to the cell progeny, contributes to persistent and pathogenic changes in immune cell function and composition.

Abstract Background Hormonal doping in recreational sports is a public-health concern. The World Anti-Doping Agency (WADA) promoted the creation of the Athlete Biological Passport, aiming to monitor athlete’s biological variables over time to facilitate indirect detection of doping. Detection tests for anabolic androgenic steroids (AAS) and growth hormone (GH) are available while insulin abuse cannot be revealed. We have determined in recreational bodybuilders the metabolic effects associated with different patterns of hormone abuse. All analyses were conducted using Statistical Package for Social Sciences (SPSS) 21.0 software (SPSS Chicago, IL). Results We have assessed plasma concentrations of selected metabolic markers and fatty acid content in erythrocyte membranes of 92 male bodybuilders and in 45 healthy controls. Hormonal abuse was identified by anonymous questionnaires. 43% (%) of recruited bodybuilders regularly abused hormones, i.e., anabolic androgenic steroids (95%) often associated with GH (30%) and/or insulin (38%). HDL-cholesterol was lower in insulin and/or GH abusers. Alanine (ALT) and aspartic (AST) transaminases were greater in hormone abusing bodybuilders than in non-doping bodybuilders and controls. Insulin doping was selectively associated with increased plasma ALT-to-AST ratio. In erythrocyte membranes, elongase activity (i.e., stearic-to-palmitic ratio) was lower in insulin and/or growth hormone doping, whereas increased Δ-9 desaturase activity (i.e., palmitoleic-to-palmitic ratio) was selectively associated with insulin doping. Conclusions In conclusion, our study demonstrates that insulin and GH abuse are characterized by multiple alterations of specific metabolic markers. Although further studies are needed to test whether longitudinal monitoring of selected metabolic marker such as muscle contraction time, HDL levels, ALT-AST ratio as well as the activities of selected enzymes (e.g. Δ-9 desaturase and elongase), could contribute to the detection of insulin and GH abuse in sport.

Carbon fibre-reinforced ultra-high temperature ceramics (UHTCs) are considered a class of promising materials for several applications, the most appealing ones being in the aerospace sector. Reinforcement is necessary to overcome the brittleness and low thermal shock resistance of ceramics and is often provided through the addition of carbon fibres or other carbon-based phases, such as nanotubes, graphene, and graphite. The present work is focused on the toughening of UHTCs through incorporation of 30−50 vol% thin, ordered graphite layers from conventional filter paper followed by hot pressing sintering. Cellulose filter paper was selected because it undergoes thermolysis with no melting stage forming a strong carbonaceous residue that can be used as toughener. Microstructure and mechanical properties of toughened composites were compared to those of other materials reinforced with short carbon fibres and the effect of different distribution of graphite was studied. Addition of graphite allowed toughness to be increased from 3−4 MPa·m1/2 (for un-reinforced materials) to 5.1−5.5 MPa·m1/2, similar to results obtained with short fibre reinforcement. The high-temperature properties, such as strength and toughness as well as oxidation resistance at 1500 ℃, were also examined.

Abstract Data standardization promotes a common framework through which researchers can utilize others’ data and is one of the leading methods neuroimaging researchers use to share and replicate findings. As of today, standardizing datasets requires technical expertise such as coding and knowledge of file formats. We present ezBIDS, a tool for converting neuroimaging data and associated metadata to the Brain Imaging Data Structure (BIDS) standard. ezBIDS contains four major features: (1) No installation or programming requirements. (2) Handling of both imaging and task events data and metadata. (3) Semi-automated inference and guidance for adherence to BIDS. (4) Multiple data management options: download BIDS data to local system, or transfer to OpenNeuro.org or to brainlife.io. In sum, ezBIDS requires neither coding proficiency nor knowledge of BIDS, and is the first BIDS tool to offer guided standardization, support for task events conversion, and interoperability with OpenNeuro.org and brainlife.io.

Aiming to contribute to the energy transition, this study provides an integrated picture of the geothermal system hosted in the West Netherlands Basin and shows how the reconstruction of the basin's geological history can contribute to the correct exploration and exploitation of its geothermal resources. In the West Netherlands Basin, the main geothermal targets are found in the Cretaceous and Jurassic strata that were deposited during the rifting and post-rifting stages and were deformed during the subsequent basin inversion. Despite multiple studies on the tectonic setting, the timing and tectono-stratigraphic architecture of the rift system and its overall control on the development and evolution of geothermal systems are still to be fully deciphered. In this study, a detailed seismo-stratigraphic interpretation of the syn- and post-rift intervals in the West Netherlands Basin will be given within the framework of geothermal exploration. A recently released and reprocessed 3D seismic cube is used, covering a large portion of the onshore section of the basin. We identified two major Jurassic rifting episodes and a Late Cretaceous inversion event. During the Jurassic rifting phases, the compartmentalization of the basin and the creation of accommodation space led to the deposition of the Late Jurassic Nieuwerkerk Formation, which is the main regional geothermal producing target. Within this formation, we individuate growth synclines located in the central portions of the Jurassic half-grabens as sites that show good potential for geothermal exploration.

Abstract Age‐appropriate breastfeeding and introduction to complementary foods can shape child feeding practices, ensure adequate energy and nutrient intake and prevent linear growth faltering. This study aimed to assess mothers' and health workers' knowledge of timely introduction to complementary foods and evaluate the relationship between delays in complementary feeding and subsequent linear growth. We conducted two rounds of surveys (March/August 2017) among 249 health workers (n = 249) and caregivers (n = 2635) of children 6–23 months of age. We collected information about socio‐demographic characteristics, knowledge and practice related to timely introduction to complementary foods. The study was conducted in households from the Productive Safety Net Programme (PSNP) districts, in four highland regions of Ethiopia. Delays in the introduction to complementary feeding were widespread with 53% of children 6–8 months of age not consuming solid, semisolid or soft foods in the past 24 h. After controlling for child, caregiver and household characteristics, children not introduced to complementary foods by 6–8 months had a 0.48 SD lower length‐for‐age z‐score at 12–15 months. Caregivers' knowledge was strongly and inversely correlated with untimely introduction of complementary foods in logistic regressions (OR = 0.55, p

Abstract Child undernutrition disproportionally affects children in low‐ and middle‐income countries. In Ethiopia, both wasting and stunting are serious public health concerns, with high human and economic costs. Understanding the dynamics in ponderal and linear growth faltering is critical to inform the design of innovative interventions that can prevent both wasting and stunting in poor and complex settings. Using two longitudinal studies conducted in 2017 and 2019 in four highland regions of Ethiopia, we evaluated the dynamics and drivers of child growth faltering in children 6–23 months of age (N = 5003). Child wasting prevalence peaked during the first 6 months of life, whereas stunting increased significantly after 6 months of age. Male sex, child illnesses (i.e., diarrhoea or fever) and low consumption of fruits and vegetables were associated with higher odds of acute undernutrition (P

BackgroundPostoperative seroma is most frequent after mastectomy (ME) in combination with axillary lymph node dissection (ALND), and its reported incidence varies from 15.5% up to 90%. Seromas can be responsible for discomfort, infections and can lead to reconstruction failure. Therefore, many ways of seroma prevention have been studied, although from a recent overview it has become clear that no single method is reliably successful. Mechanical closure of the dead space, however, was consistently found to be significantly effective. The aim of our study is to evaluate if quilting of the axilla, in patients undergoing ME, immediate prosthetic breast reconstruction and ALND reduces the duration of drain maintenance, the incidence of seromas that require aspiration (clinically significant seromas, CSS) and reconstruction failure rate.Materials and methodsIn our study population we analyzed a total of 81 patients divided into two groups: 27 consecutive patients undergoing mastectomy, axillary lymph node dissection (ALND), breast reconstruction and quilting of the axilla. We subsequently randomly picked up a double number of patients (54) undergoing the same oncological and reconstructive procedures without undergoing axillary quilting, matched for clinical characteristics in order to analyze efficacy of the procedure while reducing any bias. Our observational retrospective data was collected from October 2016 to July 2020 in one single high-volume center. Our median follow-up time was of 40.6 months.ResultsIn the case group we observed a reduced time of drain maintenance: 16 vs. 20 days observed in the non-quilted group (p

Telemedicine applications present virtually limitless prospects for innovating and enhancing established and new models of patient care in the field of Internal Medicine. Although there is a wide range of innovative technological solutions in Europe, there are overarching elements associated with such technologies when applied to the practices of Internal Medicine specialists. The European Federation of Internal Medicine (EFIM) strongly advocates for active leadership and influence from the Internal Medicine societies and specialist physicians across Europe in the development and application of telemedicine and digital technologies in healthcare. This position paper’s conclusions were drawn via Delphi method, which was developed collaboratively from July 2021 to December 2023. The panel, consisting of experts in clinical medicine, public health, health economics and statistics, assessed various aspects related to telemedicine. Participants assigned scores on a Likert scale reflecting perceived value and potential risks. The findings were consolidated in a comprehensive checklist aligning with relevant literature and a SWOT analysis. Specifically, key issues that need to be addressed include promoting the professional development of e-health competencies in the healthcare and medical workforce, using educational campaigns to promote digital literacy among patients and caregivers, designing and implementing telemedicine applications tailored to local conditions and needs and considering the ethical and legal contexts under which these applications are employed. Importantly, there is currently no consensus on care models or standardized protocols among European Internal Medicine specialists regarding the utilization of telemedicine. This position paper aims to outline the opportunities and challenges associated with the application of telemedicine in Internal Medical practice in Europe.

GATA2 deficiency is one of the most common genetic predispositions to pediatric myelodysplastic syndrome (MDS) in children and adolescents. The wide spectrum of disease comprises, among others, hematological, immunological and pulmonary manifestations, as well as occasionally distinct organ anomalies. Due to the elevated risk of progression, nearly all individuals with GATA2-related MDS eventually undergo a hematopoietic stem cell transplantation (HSCT) at some point in their lives. Nevertheless, the optimal timing, method, and even the indication for HSCT in certain cases are still matter of debate and warrant further research. In this article, we report five patients with different hematological and immunological manifestations of GATA2 deficiency ranging from immunodeficiency and refractory cytopenia of childhood without chromosomal aberrations to relapsed MDS-related acute myeloid leukemia. We discuss the adopted strategies, including intensity of surveillance, indication and timing of HSCT, based on morphological, clinical and molecular markers, as well as individual patient needs. We conclude that a better characterization of the natural disease course, a better understanding of the prognostic significance of somatic aberrations and a thorough evaluation of patients´ perspectives and preferences are required to achieve a personalized approach aimed at improving the care of these patients.

IntroductionOver the course of four consecutive years, a comparative study, for the first time, was carried out to assess their growth characteristics, vegetative and productive performances. MaterialMicropropagated, grafted on not suckering rootstock and own-rooted plants by layering from three Italian hazelnut (Corylus avellana L.) cultivars were established in the same orchard and environmental condition.ResultsWe found that the micropropagated plants, regardless of the variety considered, even being smaller than the other plants at the beginning of the plantation, reached similar sizes as the other plants after four growing seasons. Furthermore, micropropagated plants exhibited greater uniformity in growth compared to grafted ones, while own-rooted plants displayed more variability. No significant differences in yield performance and canopy volume were observed among the three propagation methods. These results suggest that the in vitro propagation technique, even in hazelnut, allows standardizing the plant material while preserving cultivar characteristics. Finally, in vitro propagation as well as grafting can be safely recommended for the cultivation of hazelnut cultivars.

COVID-19 represents a threat for frailty patients. This study compares molnupiravir and nirmatrelvir for fragile COVID- 19 patients' efficacy, safety, and cost. An observational, prospective study allowed us to evaluate molnupiravir’s efficacy and safety in real life, compare it to a subgroup of patients treated with nirmatrelvir-ritonavir, and analyze its cost-effectiveness. From January to December 2022, 435 patients (225 males, 220 females; median age 72 years), were enrolled; 24 patients were unvaccinated, and 280 patients had ≥2 risk factors. Molnupiravir performed better clinically and economically. Compared to literature data, in these patients, hospitalization was 2.5% vs. 6.8% (P

Rome is vulnerable to chemical, biological, radiological, nuclear, and explosive (CBRNe) attacks. The study evaluates Rome’s advanced emergency departments’ state of emergency plans for massive influx of injures (PEIMAF) plans for CBRNe attacks. We propose a chemical attack on Saint Peter’s Square during the Pope’s General Assembly and its effects. The National Stockpile Antidotes’ activation and territorial distribution timing work well for chemical attacks. We also estimated activation timing. Our data show that despite a good organization, travel times can be improved. We also believe that all major Roman hospitals must develop the PEIMAF, which should be followed by an organized training plan involving theoretical teaching and indoor and outdoor simulation to train hospital staff and evaluate PEIMAF weaknesses and vulnerabilities. The effectiveness and efficiency of first aid depend on timing, and each PEIMAF analyzed, while coherent and adequate for internal purposes, fails to integrate with the other hospitals. Integration can speed up National Stockpile Antidotes delivery and save lives. For the best CBRNe response, detailed intervention protocols must be created, updated daily, and exercised.