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IntroductionCOVID-19 (Coronavirus Disease 19) has rapidly spread all around the world. Vaccination represents one of the most promising counter-pandemic measures. There is still little specific evidence in literature on how to safely and effectively program access and flow through specific healthcare settings to avoid overcrowding in order to prevent SARS-CoV-2 transmission. Literature regarding appointment scheduling in healthcare is vast. Unpunctuality however, especially when targeting healthcare workers during working hours, is always possible. Therefore, when determining how many subjects to book, using a linear method assuming perfect adhesion to scheduled time could lead to organizational problems.MethodsThis study proposes a “Queuing theory” based approach. A COVID-19 vaccination site targeting healthcare workers based in a teaching hospital in Rome was studied to determine real-life arrival rate variability. Three simulations using Queueing theory were performed.ResultsQueueing theory application reduced subjects queueing over maximum safety requirements by 112 in a real-life based vaccination setting, by 483 in a double-sized setting and by 750 in a mass vaccination model compared with a linear approach. In the 3 settings, respectively, the percentage of station's time utilization was 98.6, 99.4 and 99.8%, while the average waiting time was 27.2, 33.84, and 33.84 min.ConclusionsQueueing theory has already been applied in healthcare. This study, in line with recent literature developments, proposes the adoption of a Queueing theory base approach to vaccination sites modeling, during the COVID-19 pandemic, as this tool enables to quantify ahead of time the outcome of organizational choices on both safety and performance of vaccination sites.

Diabetes management can be considered the first paradigm of modern personalized medicine. An overview of the most relevant advancements in glucose sensing achieved in the last 5 years is presented. In particular, devices exploiting both consolidated and innovative electrochemical sensing strategies, based on nanomaterials, have been described, taking into account their performances, advantages and limitations, when applied for the glucose analysis in blood and serum samples, urine, as well as in less conventional biological fluids. The routine measurement is still largely based on the finger-pricking method, which is usually considered unpleasant. In alternative, glucose continuous monitoring relies on electrochemical sensing in the interstitial fluid, using implanted electrodes. Due to the invasive nature of such devices, further investigations have been carried out in order to develop less invasive sensors that can operate in sweat, tears or wound exudates. Thanks to their unique features, nanomaterials have been successfully applied for the development of both enzymatic and non-enzymatic glucose sensors, which are compliant with the specific needs of the most advanced applications, such as flexible and deformable systems capable of conforming to skin or eyes, in order to produce reliable medical devices operating at the point of care.

Due to global warming, animals are experiencing heat stress (HS), affecting many organic functions and species’ survival. In this line, some characteristics of immune cells in sea urchins subjected to short-term HS were evaluated. Paracentrotus lividus adult females were randomly divided into three groups and housed in tanks at 17 °C. In two of these tanks, the temperatures were gradually increased up to 23 and 28 °C. Celomatic fluid was collected after 3 and 7 days. The coelomocytes were morphologically typed and evaluated for their mitochondrial membrane potential (MMP), lipoperoxidation extent (LPO), and hydrogen peroxide content (H2O2). Respiratory burst was induced by treatment with phorbol 12-myristate 13-acetate (PMA). HS caused a significant change in the coelomocytes’ type distribution. MMP increased in the 23 °C-group and decreased in the 28 °C-group at both 3 and 7 days. LPO only increased in the 28 °C-group at 7 days. H2O2 progressively decreased together with the temperature increase. Respiratory burst was detected in all groups, but it was higher in the 17 °C group. In conclusion, the increase in temperature above the comfort zone for this animal species affects their immune cells with possible impairment of their functions.

Background: Standard precautions (SPs) are first-line strategies with a dual goal: to protect health care workers from occupational contamination while providing care to infected patients and to prevent/reduce health care-associated infections (HAIs). This study aimed at (1) identifying the instruments currently available for measuring healthcare professionals’ compliance with standard precautions; (2) evaluating their measurement properties; and (3) providing sound evidence for instrument selection for use by researchers, teachers, staff trainers, and clinical tutors. Methods: We carried out a systematic review to examine the psychometric properties of standard precautions self-assessment instruments in conformity with the COSMIN guidelines. The search was conducted on the databases PubMed, CINAHL, and APA PsycInfo. Results: Thirteen instruments were identified. These were classified into four categories of tools assessing: compliance with universal precautions, adherence to standard precautions, compliance with hand hygiene, and adherence to transmission-based guidelines and precautions. The psychometric properties of instruments and methodological approaches of the included studies were often not satisfactory. Only four instruments were classified as high-quality measurements. Conclusions: The available instruments that measure healthcare professionals’ compliance with standard precautions are of low-moderate quality. It is necessary that future research completes the validation processes undertaken for long-established and newly developed instruments, using higher-quality methods and estimating all psychometric properties.

Background: The Trust Me Scale is a widely used instrument to measure trust in healthcare providers. However, no Italian version of the scale exists yet, limiting its use in Italian-speaking populations. The aim of this study is to translate and validate the Trust Me Scale for use in Italian-speaking populations in nurses and nurse managers. Methods: The translation process involved methodological steps of collaborative and iterative translation with cultural adaptation. The validation process included a cross-sectional study enrolling a convenience sample of 683 nurses and 188 nurse managers who completed the Italian version of the Trust Me Scale and measures of intention to leave, satisfaction, and organizational commitment. Results: Item 5 was removed for poor factor loading, and items 11 and 13 were removed following an a priori strategy focused on deleting items with correlations between residual variables different than expected based on theoretical expectations derived from previous research. The final model fit well to sample statistics with a three-factor structure (harmony, reliability, and concern) and 13 items. A multiple-indicator multiple-cause model showed a measurement invariance between nurses and nurse coordinators. Construct validity was also supported by the evidence that the measured domains of trust align with the theoretical expectations and are related to the intention to leave, job satisfaction, and organizational commitment. Each dimension showed adequate scale reliability. Conclusions: The Italian version of the Trust Me Scale is a valid and reliable instrument to measure trust in nurses and nurse managers in Italian-speaking contexts. It can be used for research in nursing and leadership and evaluation of interventions aimed at improving trust in healthcare contexts.

Background: Nursing education consists of theory and practice, and student nurses’ perception of the learning environment, both educational and clinical, is one of the elements that determines the success or failure of their university study path. This study aimed to identify the currently available tools for measuring the clinical and educational learning environments of student nurses and to evaluate their measurement properties in order to provide solid evidence for researchers, educators, and clinical tutors to use in the selection of tools. Methods: We conducted a systematic review to evaluate the psychometric properties of self-reported learning environment tools in accordance with the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) Guidelines of 2018. The research was conducted on the following databases: PubMed, CINAHL, APA PsycInfo, and ERIC. Results: In the literature, 14 instruments were found that evaluate both the traditional and simulated clinical learning environments and the educational learning environments of student nurses. These tools can be ideally divided into first-generation tools developed from different learning theories and second-generation tools developed by mixing, reviewing, and integrating different already-validated tools. Conclusion: Not all the relevant psychometric properties of the instruments were evaluated, and the methodological approaches used were often doubtful or inadequate, thus threatening the instruments’ external validity. Further research is needed to complete the validation processes undertaken for both new and already developed instruments, using higher-quality methods and evaluating all psychometric properties.

Abstract Background Patient-reported data—satisfaction, preferences, outcomes and experience—are increasingly studied to provide excellent patient-centred care. In particular, healthcare professionals need to understand whether and how patient experience data can more pertinently inform the design of service delivery from a patient-centred perspective when compared with other indicators. This study aims to explore whether timely patient-reported data could capture relevant issues to improve the hospital patient journey. Methods Between January and February 2019, a longitudinal survey was conducted in the orthopaedics department of a 250-bed Italian university hospital with patients admitted for surgery; the aim was to analyse the patient journey from the first outpatient visit to discharge. The same patients completed a paper-and-pencil questionnaire, which was created to collect timely preference, experience and main outcomes data, and the hospital patient satisfaction questionnaire. The first was completed at the time of admission to the hospital and at the end of hospitalisation, and the second questionnaire was completed at the end of hospitalisation. Results A total of 254 patients completed the three questionnaires. The results show the specific value of patient-reported data. Greater or less negative satisfaction may not reveal pathology-related needs, but patient experience data can detect important areas of improvement along the hospital journey. As clinical conditions and the context of care change rapidly within a single hospital stay for surgery, collecting data at two different moments of the patient journey enables researchers to capture areas of potential improvement in the patient journey that are linked to the context, clinical conditions and emotions experienced by the patient. Conclusion By contributing to the literature on how patient-reported data could be collected and used in hospital quality improvement, this study opens the debate about the use of real-time focused data. Further studies should explore how to use patient-reported data effectively (including what the patient reports are working well) and how to improve hospital processes by profiling patients’ needs and defining the appropriate methodologies to capture the experiences of vulnerable patients. These topics may offer new frontiers of research to achieve a patient-centred healthcare system.

Os diversos tipos de representação semiótica são de grande relevância para compreender o desenvolvimento cognitivo dos sujeitos no que concerne à apropriação dos saberes matemáticos. Assim, as diferentes representações de um objeto matemático possibilitam a resolução e a comunicação de resultados obtidos em uma atividade. Para tanto, levanta-se a seguinte problematização: como são apresentados os diversos tipos de representações semióticas no capítulo de conjuntos de um livro didático (LD). Para responder a essa questão, buscou-se investigar como os registros de representação semiótica (RRS) são articulados no decorrer do capítulo de conjuntos de um LD e se essas coordenações proporcionam a conversão ou tratamento. Esta pesquisa é de abordagem qualitativa pela interpretação de Bogdan e Biklen, ancorada na análise documental, como processo de coleta de informação, na acepção de Tozoni- Reis. Dessa forma, buscou-se analisar o capítulo de conjuntos de um LD, obra aprovada pelo Programa Nacional do Livro Didático (PNLD) 2021. O referido capítulo foi analisado à luz da Teoria dos Registros de Representação Semiótica (TRRS), de Raymond Duval. Ao final dessa análise, constatou-se que o capítulo de conjuntos articula vários tipos de RRS e estes proporcionam a coordenação entre registros, bem como a conversão. Por fim, conclui-se que, apesar de o capítulo analisado proporcionar a coordenação entre registros, é necessário que os estudantes sejam estimulados a explorar mais de um registro de representação, fazendo, sempre que conveniente, a conversão de um registro em outro.

The COVID-19 emergency has led many health facilities to reorganize themselves in a very short time to meet the urgent needs for intensive, semi-intensive or ordinary care of SARS-CoV-2 patients. In this pandemic, characterized by speed of transmission and severity of respiratory symptoms, care has been affected by the increase in volume and clinical complexity of patients, the sudden and unpredictable staff decrease and the lack of support from family members / caregivers. At the same time, experience in the field has shown how “informal” resources have been activated, which enabled to treat the highest possible number of patients above the real availability of resources. The purpose of this study was to explore the experiences of nurses involved in frontline care (COVID Centers) during the pandemic with a particular focus on professional motivation and on the development of technical-professional and personal skills. A study with a qualitative research design using focus group technique was conducted. Two focus groups were held with nine nurses. Data were analyzed with inductive content analysis. The findings can be summarized in five main categories: professional identity; motivation and sense of mission; development of professional and personal skills; spirituality; person-centered care; uniqueness of the lived experience. These findings shed new light on the correlation between motivation, professional identity and value, sense of duty and sense of belonging to the professional group. Moreover, the experience in the COVID Centers represented a valuable opportunity for participants to rediscover some specific issues related to nursing professional identity and to develop new personal and technical-professional skills in a very short time. Finally, nurses experienced once again how the nurse-patient relationship and basic care are essential to provide effective and excellent care, even and especially for patients in critical conditions. Nurses re-discovered, in a careful body care and basic care, irreplaceable elements to give back to patients, often dying, their own dignity, and all the needed closeness and attention necessary also to compensate the absence of the loved ones. These elements represent a way to concretely and deeply express the ethics of a job well done in nursing.

Abstract Background Potential overlaps exist between psychopathological features of Anorexia Nervosa (AN) and Autism Spectrum Disorder (ASD). The impact of malnutrition on autistic traits in patients with AN should be considered. This study investigates possible associations among the psychopathology of Eating Disorders (EDs), ASD traits and BMI in a group of young patients with AN, using the EDI-3 (Eating Disorder Inventory-3) test and gold-standard measures for ASD. Methods Prospective study involving 23 inpatients admitted to an Italian Centre for paediatric ED. ASD traits and ED psychopathology were assessed administering the ADOS-2 (Autism Diagnostic Observation Schedule-2), AQ (Autism Quotient) and EDI-3 tests. Both present and past autistic traits were investigated using different versions of AQ. Correlations were adjusted for BMI, Obsessive Compulsive Disorder (OCD) comorbidity and concurrent antipsychotic treatments. Results An ASD diagnosis was possible in 22% of patients. Significant correlations were documented between ASD traits and ED psychopathology: AQ total-Interpersonal problems (IPC) (p = 0.041); AQ total-Global psychological maladjustment (GMPC) (p = 0.027); AQ social skills-Ineffectiveness (IC) (p = 0.018); AQ social skills-IPC (p = 0.019); AQ social skills-Affective problems (APC) (p = 0.025); AQ social skills-GMPC (p = 0.007); AQ attention switching-IPC (p = 0.020); ADOS-2 imagination-IC (p = 0.035). These correlations were independent of BMI, OCD and antipsychotic treatments. Conclusions ASD traits presented high prevalence in a group of young inpatients with AN. These traits were significantly correlated to 4 specific EDI-3 subscales and independent of BMI. This is the first study to investigate the relationship between ASD traits as measured with gold-standard measures, EDI-3 scores, and BMI.

In the last ten years, artificial intelligence (AI) techniques have been applied in archaeology. The ArchAIDE project realised an AI-based application to recognise archaeological pottery. Pottery is of paramount importance for understanding archaeological contexts. However, recognition of ceramics is still a manual, time-consuming activity, reliant on analogue catalogues. The project developed two complementary machine-learning tools to propose identifications based on images captured on-site, for optimising and economising this process, while retaining key decision points necessary to create trusted results. One method relies on the shape of a potsherd; the other is based on decorative features. For the shape-based recognition, a novel deep-learning architecture was employed, integrating shape information from points along the inner and outer profile of a sherd. The decoration classifier is based on relatively standard architectures used in image recognition. In both cases, training the algorithms meant facing challenges related to real-world archaeological data: the scarcity of labelled data; extreme imbalance between instances of different categories; and the need to take note of minute differentiating features. Finally, the creation of a desktop and mobile application that integrates the AI classifiers provides an easy-to-use interface for pottery classification and storing pottery data.

Abstract Low-grade manganese ores that are composed of manganese oxides, wad, quartz, iron oxides, gibbsite, and especially of spessartine (Mn3Al2(SiO4)3) are known as gondite. Spessartine is a mineral with a high content of silica (SiO2) and alumina (Al2O3) that causes a decrease of the enrichment in manganese oxide concentrates by flotation, giving this ore more complexity for processing. Thus, by ensuring a higher selectivity between manganese oxides minerals and silicates, the use of gondite reserves becomes viable, and the correct reagent type can be useful for this objective. Moreover, there are few publications devoted to the study of spessartine in flotation. So, this study investigated the effects of Mn2+ ions on quartz and spessartine depression and showed positive results with the reduction of quartz floatability from 7.06% to 1.23% and the spessartine from 27.30% to 17.12% respectively when the Mn2+ (1000 mg/L) was added previously to the depressant. Zeta potential determinations showed that Mn2+ can act as a silicate activator, possibly by facilitating the SiO(OH)3 - adsorption. Infrared spectroscopy analysis revealed absorption bands at 3,450 cm-1 and 3,400 cm-1 frequency for quartz and spessartine and the adsorption of Mn(OH)2 was responsible for this result.

Mussels (Mytilus spp.) tolerate infections much better than other species living in the same marine coastal environment thanks to a highly efficient innate immune system, which exploits a remarkable diversification of effector molecules involved in mucosal and humoral responses. Among these, antimicrobial peptides (AMPs) are subjected to massive gene presence/absence variation (PAV), endowing each individual with a potentially unique repertoire of defense molecules. The unavailability of a chromosome-scale assembly has so far prevented a comprehensive evaluation of the genomic arrangement of AMP-encoding loci, preventing an accurate ascertainment of the orthology/paralogy relationships among sequence variants. Here, we characterized the CRP-I gene cluster in the blue mussel Mytilus edulis, which includes about 50 paralogous genes and pseudogenes, mostly packed in a small genomic region within chromosome 5. We further reported the occurrence of widespread PAV within this family in the Mytilus species complex and provided evidence that CRP-I peptides likely adopt a knottin fold. We functionally characterized the synthetic peptide sCRP-I H1, assessing the presence of biological activities consistent with other knottins, revealing that mussel CRP-I peptides are unlikely to act as antimicrobial agents or protease inhibitors, even though they may be used as defense molecules against infections from eukaryotic parasites.

Collagen VI is a heterotrimeric protein expressed in several tissues and involved in the maintenance of cell integrity. It localizes at the cell surface, creating a microfilamentous network that links the cytoskeleton to the extracellular matrix. The heterotrimer consists of three chains encoded by COL6A1, COL6A2 and COL6A3 genes. Recessive and dominant molecular defects cause two main disorders, the severe Ullrich congenital muscular dystrophy and the relatively mild and slowly progressive Bethlem myopathy. We analyzed the clinical aspects, pathological features and mutational spectrum of 15 COL6-mutated patients belonging to our cohort of muscular dystrophy probands. Patients presented a heterogeneous phenotype ranging from severe forms to mild adult-onset presentations. Molecular analysis by NGS detected 14 different pathogenic variants, three of them so far unreported. Two changes, localized in the triple-helical domain of COL6A1, were associated with a more severe phenotype. Histological, immunological and ultrastructural techniques were employed for the validation of the genetic variants; they documented the high variability in COL6 distribution and the extracellular matrix disorganization, highlighting the clinical heterogeneity of our cohort. The combined use of these different technologies is pivotal in the diagnosis of COL6 patients.

Simple and inexpensive analytical methods for assessing redox balance in biological matrixes are widely used in animal and human diagnostics. Two of them, reactive oxygen metabolites (ROMs) and total oxidant status (TOS), evaluate the lipid hydroperoxide (LOOH) content of the sample and are based on iron-mediated mechanisms. However, these tests provide uncorrelated results. In this study, we compared these two tests in the blood serum of goat kids and lambs, together with an evaluation of ceruloplasmin (CP) oxidase activity. No significant correlation was found between ROMs and TOS, or between TOS and CP oxidase activity, in either species. Conversely, ROMs and CP oxidase activity were highly correlated in both kid and lamb samples (p < 0.001). A significant progressive reduction in the analytical signal in the ROMs assay was observed when sodium azide, an effective CP inhibitor, was added to the samples before the assay (p < 0.001). This decrease was related to sodium azide concentration (p < 0.01) and was not found when sodium azide was added at the same concentrations in the TOS assay. These findings suggest that ROMs, unlike TOS, may be affected by CP, which interferes with LOOH detection in blood samples.

Due to the growing presence of pesticides in the environment and in food, the concern of their impact on human health is increasing. Therefore, the development of fast and reliable detection methods is needed. Enzymatic inhibition-based biosensors represent a good alternative for replacing the more complicated and time-consuming traditional methods (chromatography, spectrophotometry, etc.). This paper describes the development of an electrochemical biosensor exploiting alkaline phosphatase as the biological recognition element and a chemically modified glassy carbon electrode as the transducer. The biosensor was prepared modifying the GCE surface by a mixture of Multi-Walled-Carbon-Nanotubes (MWCNTs) and Electrochemically-Reduced-Graphene-Oxide (ERGO) followed by the immobilization of the enzyme by cross-linking with bovine serum albumin and glutaraldehyde. The inhibition of the biosensor response caused by pesticides was established using 2-phospho-L-ascorbic acid as the enzymatic substrate, whose dephosphorylation reaction produces ascorbic acid (AA). The MWCNTs/ERGO mixture shows a synergic effect in terms of increased sensitivity and decreased overpotential for AA oxidation. The response of the biosensor to the herbicide 2,4-dichloro-phenoxy-acetic-acid was evaluated and resulted in the concentration range 0.04–24 nM, with a limit of the detection of 16 pM. The determination of other pesticides was also achieved. The re-usability of the electrode was demonstrated by performing a washing procedure.

Serological analysis may provide relevant information on endometritis diagnostics. Therefore, mares scheduled for AI with refrigerated semen, at the time of heat signs, underwent blood and uterine fluid samplings using a swab, uterine lavage for culture analysis, and treatment with human chorionic gonadotropin to induce ovulation. After 24–28 h, the mares were inseminated and, if positive at the culture test, treated with antibiotics chosen based on the susceptibility test. Uterine cells obtained by swabs were used for cytological examination with both classical and fluorescence techniques. Blood serum and uterine fluid samples were analyzed for assessing parameters related to redox balance, inflammation, and protease regulator potential. In blood serum, total antioxidant capacity, measured as the ferric reducing ability of plasma (FRAP), was significantly lower in cytologically endometritis-positive than -negative mares. In the uterine fluid, total thiol levels (TTL), nitric oxide metabolites (NOx), protease activity and total protein content varied significantly between groups. Although the cytological examination was more capable of discriminating between endometritis-positive and -negative mares in relation to the parameters examined, no statistically significant differences emerged in terms of pregnancy rate in relation to cytological and culture diagnosis as well as in mares diagnosed as positive and negative for endometritis.

Introduction: Work contexts can affect nurses’ work and work outcomes. Work context factors of nurses, patients, or workflow can modulate nurses’ organization of work and determine increased workloads. Aim: The aim of this research was to analyze relationships between factors regarding the patient, the nurse, workflow, and nurses’ work organization, to investigate whether work organization is related to physical, mental, and emotional workloads, and to explore whether one dimension of workload influences the other dimensions. Methods: We used a cross-sectional design based on the Job Demand-Resources theory. We asked registered nurses, working in nine medical-surgical wards across three hospitals in Italy, to self-report on work organization and workloads regarding randomized shifts over three consecutive weeks. Four scales from the QEEW 2.0 questionnaire were used on an online survey for data collection. multivariable linear regressions with structural equation modelling were tested. The study was approved by the three local Ethics Committees. Results: We received 334 questionnaires regarding 125 shifts worked. Patient complexity (β = 0.347), patient specialties (β = 0.127), adequacy of staffing (β = −0.204), collaboration with colleagues (β = −0.155), unscheduled activities (β = 0.213), supply search (β = 0.141), and documentation (β = 0.221) significantly influenced nurses’ work organization. Nurses’ work organization was significantly related to physical, mental, and emotional nursing workloads. Conclusions: the patient, the nurse, and workflow aspects influence nurses’ work organization and workloads. Healthcare organizations, managers, and nurses should explore work settings to identify work turbulences early and implement strategies to improve nursing work conditions and workloads.

Dual photoredox catalysis has revolutionized the field of cross‐coupling reactions, enabling the discovery of numerous highly efficient reactions. This breakthrough is attributed to the exceptional combination of nickel catalysis with photoredox catalysis. Nickel exhibits both oxidative addition and reductive elimination processes, and a wide range of oxidation states (ranging from I to IV) accessible within a single catalytic cycle. Furthermore, nickel complexes are capable of catalyzing various processes through radical mechanisms. The latest feature has proven to be incredibly potent in facilitating the formation of new C−C and C−X bonds (X=H, O, S, N). The powerful combination of photoredox and nickel catalysis reveals an expansive domain of unexplored possibilities. It offers unparalleled opportunities for improving reactions and exploring innovative pathways. Under photoredox conditions, it is possible to form nucleophilic reactive organometallic intermediates, useful in reaction with electrophiles. We have devoted a research program towards the rediscovery and use of organometallic reagents, introduced by Corey, Hegedus, and Semmelack many years ago. The results unveiled the extraordinary capabilities of photoredox catalysis, enabling the creation and efficient utilization of potent nucleophilic organometallic reagents under mild conditions, free from the need for strong bases or stoichiometric metal reductants. [ABSTRACT FROM AUTHOR]