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OBJECTIVE: Noise is still today one of the main causes of occupational diseases; in fact, in Italy in the three-year period 2019-2022, hearing loss represented 15% of all occupational diseases recognized by the National Institute for Insurance against Accidents at Work. The extra-auditory effects related to noise exposure also require particular attention, because they can interfere with mental activities that require concentration, memory and ability to deal with complex problems, causing sleep and learning disorders. For this reason, acoustic comfort is considered a fundamental requirement for obtaining an optimal degree of well-being in closed environments. In schools, a high degree of noise pollution not only makes it difficult for students to listen and learn, but also affects school workers. The aim of this study was to perform a systematic review of international literature and analysis of the preventive measures of extra-auditory effects among school workers. MATERIALS AND METHODS: The presentation of this systematic review is in accordance with the PRISMA statement. The methodological quality of the selected studies was assessed with specific rating tools (INSA, Newcastle Ottawa Scale, JADAD, JBI scale and AMSTAR). Only publications in English were selected. No restrictions were applied for the publication type. We excluded articles not concerned with the extra-auditory effects of noise exposure in school workers and preventive measures, findings of less academic significance, editorial articles, individual contributions, and purely descriptive studies published in scientific conferences. RESULTS: Online research indicated 4,363 references: PubMed (2,319), Scopus (1,615) and Cochrane Library (429) have been consulted; 30 studies were included in this review (5 narrative or systematic reviews and 25 original articles). Regarding the scores of narrative reviews, the INSA score showed an average and a median value of 6.5, thus indicating an intermediate/high quality of the studies. Regarding the scores of systematic reviews, the AMSTAR score showed an average of 6.7 and a median and a modal value of 6, thus indicating a high quality of the studies. The scores assigned to the original articles have an average and median value of 7 and a modal value of 6 and this demonstrates an intermediate/high quality of the studies. CONCLUSIONS: We can assume that, as it is highlighted by this study, to date these consequences are not considered at the legislative level for the protection of exposed workers. The extra-auditory effects impacting health afterward environmental noise exposure are many and widespread. Therefore, there is a need for interventions to be carried out by institutions and that the physician of the schools, during health surveillance, investigates the effects and clinical manifestations, in order to prevent disorders and deficits highlighted by our study. [ABSTRACT FROM AUTHOR]

• Total Body Irradiation in-vivo dosimetry data over 10 years were analyzed. • Monitor Units' median percentage difference from planned was limited. • Median percentage dose difference at six anatomical locations was inside 10 % range. • The neck region showed the highest dosimetric differences from planned. • In-vivo dosimetry omission impact was evaluated, leading to interesting results. Myeloablative Total Body Irradiation (TBI) used in our Institution, as part of the conditioning scheme for haematopoietic stem cell transplantation, is an extended-distance supine technique that has been implemented using a 15 MV LINAC beam, lead lung compensators, PMMA, and water bolus to improve homogeneity. This study reviews in-vivo dosimetry (IVD) over 10 years of treatments, assessing the technique's robustness, accuracy, and efficiency. A 2-lateral opposite fields plan was calculated from planning CT with validated Oncentra TPS (Elekta AB, Sweden). Monitor units (MUs), lung compensators shape and thickness were calculated to deliver the prescription dose (12 Gy in 6 bi-daily fractions or 9.9 Gy in 3 daily fractions) to the patient's abdomen midline at the umbilical level, maintaining lung dose within ±5 % range of prescription. Data from 103 patients, of which more than 87 % were pediatric, were retrieved and analyzed for a total of 537 treatment fractions. The impact of IVD omission was evaluated, supposing doing it only once or in the first two fractions, if necessary. Median ΔMU from planned was −1.2 %. Median percentage dose deviation from prescription in 6 anatomical regions was below 2 %. IVD omission could have resulted in an increase of 7 patients registering at least one anatomical region outside the ±5 % dose range at the end of treatment. It is possible to confirm the implemented technique's robustness and accuracy in delivering the prescribed dose under IVD monitoring. Nevertheless, this technique and associated IVD are time-consuming and IVD omission could be assessed with limited drawbacks. [ABSTRACT FROM AUTHOR]

In the Emilia-Romagna region of Italy, a unique Hub and Spoke model was adopted to recognize BRCA -related breast cancer (BC) patients. Characteristics and outcomes of tumors identified by this model will be presented. This multicenter retrospective cohort study involved patients diagnosed with BRCA -related BC identified in the Emilia-Romagna region between January 2000 and December 2013. Seven provinces collected data on patient and tumor characteristics; clinical and gene testing information were also registered. Comparisons between BRCA1 and BRCA2 BC were performed. To balance different variants to identify significant predictors of survival, an inverse probability of treatment weighting (IPTW) analysis on Cox regression was conducted. From 2000 to 2013, 284 BRCA -related BC were registered (171 BRCA1 , 110 BRCA2 , and 3 BRCA1 and BRCA2). BRCA1 were diagnosed at an earlier stage compared to BRCA2 (50.1 % vs 30 %, respectively, in stage I, P = 0.0015). BRCA2 patients underwent more up-front surgery (85 % vs. 74.9 %, P = 0.049) and less chemotherapy (69.1 % vs 88.9 %, P = 0.004) than BRCA1 patients. At 11.8 years median follow-up, BRCA1 patients developed more second contralateral BC (P = 0.09), while BRCA2 had more visceral relapses (P = 0.013). No differences in overall survival (OS) between BRCA1 and BRCA2 patients (P = 0.07) were found. An advantage in OS was independently seen for patients who underwent contralateral prophylactic mastectomy (P = 0.0001) and oophorectomy (P < 0.0001). In conclusion, adopting a homogeneous regional framework provides important information about prevention and treatment strategies of BRCA -related BC and suggests using maximal surgery to improve OS. [ABSTRACT FROM AUTHOR]

Osteoarthritis (OA) is a clinical state which is identified by the degeneration of articular cartilage. OA is a common condition (>500 millions of people affected worldwide), whose frequency is anticipated to continue to rise (> 110 % increase worldwide since 2019). The treatment for early-stage OA is based on a combination of therapeutic approaches, which can include regenerative medicine based on Adipose Derived Stem Cells (ADSCs). Germanium embedded Incrediwear® functional Cred40 fabric has been shown to have positive effects on OA clinically and is envisaged to give encouraging effects also on tissue regeneration. Still, the biological mechanisms underlying this therapeutic modality have not yet been fully defined. We tested the hypothesis that Germanium-embedded Incrediwear® functional Cred40 fabric could enhance chondrogenic differentiation. To this purpose, we applied Incrediwear® to human adipose-derived stem cells (hADSCs) induced to chondrogenic differentiation in vitro. Chondrogenic markers (ACAN, SOX9, RUNX2, COL2A1, COL10A1) were quantified following 21 days of treatment. We also assessed extracellular matrix (ECM) deposition (specifically Collagen and glycosaminoglycans (GAGs)) using Alcian Blue and Sirius Red staining. Here, we provide pilot data to demonstrate that Germanium-embedded Incrediwear® functional Cred40 fabric can enhance hADSCs chondrogenic differentiation and maturity and potentially induce events of cartilage regeneration. • Progressive degeneration and damage of the surface of joints cartilage is driven by its low self-repair potential. • Adipose-Derived Stem Cells (ADSCs) are promising in articular cartilage tissue rigeneration. • Germanium-embedded functional Cred40 fabric has shown an enhancement on hADSCs chondrogenic differentiation. • A novel frontier in the management of cartilage demage is represented by the application of treatments based on Germanium-based devices. [ABSTRACT FROM AUTHOR]

• Pelvis auto-segmentation tools were compared, from atlas-techniques to deep learning. • Deep learning showed better and faster segmentation results. • Differences found in cervical cancer tapered off in prostate cancer contouring. • Expert radiation oncologists qualitatively preferred deep learning. • Automated tools allow for faster radiotherapy workflow and high-quality treatments. Artificial intelligence can standardize and automatize highly demanding procedures, such as manual segmentation, especially in an anatomical site as common as the pelvis. This study investigated four automated segmentation tools on computed tomography (CT) images in female and male pelvic radiotherapy (RT) starting from simpler and well-known atlas-based methods to the most recent neural networks-based algorithms. The evaluation included quantitative, qualitative and time efficiency assessments. A mono-institutional consecutive series of 40 cervical cancer and 40 prostate cancer structure sets were retrospectively selected. After a preparatory phase, the remaining 20 testing sets per each site were auto-segmented by the atlas-based model STAPLE, a Random Forest-based model, and two Deep Learning-based tools (DL), MVision and LimbusAI. Setting manual segmentation as the Ground Truth, 200 structure sets were compared in terms of Dice Similarity Coefficient (DSC), Hausdorff Distance (HD), and Distance-to-Agreement Portion (DAP). Automated segmentation and manual correction durations were recorded. Expert clinicians performed a qualitative evaluation. In cervical cancer CTs, DL outperformed the other tools with higher quantitative metrics, qualitative scores, and shorter correction times. On the other hand, in prostate cancer CTs, the performance across all the analyzed tools was comparable in terms of both quantitative and qualitative metrics. Such discrepancy in performance outcome could be explained by the wide range of anatomical variability in cervical cancer with respect to the strict bladder and rectum filling preparation in prostate Stereotactic Body Radiation Therapy (SBRT). Decreasing segmentation times can reduce the burden of pelvic radiation therapy routine in an automated workflow. [ABSTRACT FROM AUTHOR]

In the last decades, interest in species distribution models (SDMs) has grown greatly. The descriptive and predictive power of correlative SDMs is highly valued to meet the high demand for filling gaps in the spatial ecology of wide-ranging and elusive species, such as cetaceans and sea turtles, living in habitats that are technically challenging to survey and where the availability of high quality, unbiased data at appropriate spatial and temporal resolution is not straightforward. This study endeavours to offer a comprehensive global overview of recent advancements in modelling techniques within the realm of SDMs applied to cetaceans and sea turtles. Through a rigorous systematic review of 295 research papers, we identified gaps in species and geographic coverage and highlighted the underrepresentation of biotic, anthropogenic, and water column variables. Our examination revealed a diverse array of modelling approaches, showcasing a notable preference for standard regression-based or machine-learning models, such as GAMs or Maxent, with Bayesian-based models emerging and experiencing growing development. Critical limitations and decisions in constructing and evaluating SDMs were discussed, proposing best practices for future studies. Emphasis was placed on the importance of validating models using fully independent datasets, particularly in the context of conservationist studies. This work not only sheds light on the state of the field but also serves as a valuable tool for those interested in modelling the distribution of these magnificent and enigmatic animals, as well as other cryptic species, offering insights that can guide researchers in making informed decisions in the realm of SDMs. • Exponential growth in the use of Species Distribution models worldwide; • Gaps in representing all relevant ecological and anthropic processes within the models; • Regression-based models as the most utilised; • Increasing trend towards the adoption of diverse machine learning approaches; • Ambiguity in the modelling terminology and decision-making processes at each stage; [ABSTRACT FROM AUTHOR]

OBJECTIVE: Poor oral health and oral diseases are common among people experiencing homelessness. The aim of this study was to evaluate the dental demands and needs of a population of homeless persons in the city of Rome, Italy. PATIENTS AND METHODS: The clinical records of 165 homeless patients admitted between October 2020 and October 2021 to the dental service of the Primary Care Services of the Eleemosynaria Apostolica, Vatican City, were retrospectively reviewed. The service employed dentists to evaluate dental needs and oral conditions in patients experiencing homelessness. The main dental and oral pathological conditions were noted. RESULTS: One hundred and sixty-five records of homeless patients were included in the study. The sample consisted in 138 males (76.97%) and 27 females (23.03%) with a mean age of 46.9 years (range 7-85 years). Acute tooth pain was reported by 132 (80%) patients, 42 (25.45%) had edentulism or missing teeth and 18 (10.91%) patients had oral lesions. Both dental and oral pathologies were intercepted and managed in secondary healthcare facilities. CONCLUSIONS: Given the specific peculiarities of this vulnerable population, it is important to implement strategies that facilitate the access of persons experiencing homelessness to dental evaluation with a preventive and curative perspective. [ABSTRACT FROM AUTHOR]