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Enrico Peiretti,1 Chiara Ascardi,2 Francesco Bandello,3 Francesco Boscia,4 Monica Varano,5 Marta Bartezaghi,2 Lorenzo De Santi,2 Giovanni Staurenghi6 1Clinica Oculistica, San Giovanni di Dio Hospital, Azienda Ospedaliera, Universitaria di Cagliari, Cagliari, Italy; 2Novartis Farma S.p.A, Milan, Italy; 3Department of Ophthalmology, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy; 4Department of Medical Science, Neuroscience and Sense Organs, Eye Clinic, University of Bari, Azienda Ospedaliero-Universitaria Policlinico Bari, Bari, Italy; 5IRCCS G.B. Bietti Foundation, Rome, Italy; 6Eye Clinic, Department of Biomedical and Clinical Sciences, Luigi Sacco Hospital, University of Milan, Milan, ItalyCorrespondence: Enrico Peiretti, Head of the Retina Unit, Eye Clinic, University of Cagliari, Via Ospedale 48, Cagliari, 09100, Italy, Email enripei@hotmail.comPurpose: Limited data is available on treatment satisfaction with the management of wet age-related macular degeneration (wAMD) among patients in Italy. In this cross-sectional real-world study, treatment satisfaction with anti-vascular endothelial growth factor (anti-VEGFs) was assessed in patients with wAMD in Italy.Patients and Methods: This was a non-interventional, cross-sectional survey involving patients with wAMD receiving anti-VEGFs. The survey was administered through a virtual assistant via phone. Patients’ treatment satisfaction was assessed using a newly developed Novartis Tailored Treatment Satisfaction Questionnaire (NVS TTSQ) and the validated Macular Disease Treatment Satisfaction Questionnaire (MacTSQ).Results: Overall, 154 evaluable patients were enrolled in 5 centers across Italy. The mean (SD) age of the patients was 76.8 years (7.01). Overall treatment satisfaction score assessed by NVS TTSQ was 40.50 (7.11), with a mean of 9.97 (1.84) on the information domain and 22.98 (4.57) on the unmet need domain. Patients were satisfied with diagnosis communication (4.99 [1.30]), information provided on treatment administration (4.58 [1.49], range 0– 6), the waiting room (4.40 [1.43]), and management of visits and injections at the center (5.14 [1.12]), general management of maculopathy at the center (5.22 [1.01]). Patients were not satisfied with their independence in terms of disease management (2.56 [2.45]); they would like additional information about the disease (5.38 [1.03]) and to discuss the injection procedures (4.02 [1.94]) with already-treated patients. The overall treatment satisfaction score on MacTSQ scale was 55.84 (10.13).Conclusion: Patients with wAMD are satisfied with the overall management of their disease in Italy. However, patients would like to have more information on prognosis and management of the disease.Keywords: anti-VEGF, patient-reported outcomes, real-world study, treatment satisfaction, treatment satisfaction questionnaire, wAMD

Environmental noise directive requires Member States to produce and periodically update strategic noise maps for agglomerates in order to evaluate citizens’ noise exposure before the action plan. Its ultimate purpose is to mitigate the highest or most harmful noise levels. Available tools do not provide a point-to-point indication of the predominant sources to be addressed by intervention on the sources by individual owners. Recently, noise source predominance maps were developed to show the predominant source at each point of the calculation grid of the strategic noise map by means of polygons and colors. Intensity noise source predominance maps were also developed to add the visualization of noise exposure levels by coloring the polygons according to a color scale. This work investigates their applicability in agglomerates and defines an additional indicator with the purpose of connecting the high levels of citizen exposure to its predominant source. The new approach provides an aid to administrations in identifying areas where singular noise mitigations would be truly effective in improving the citizen’s quality of life by ensuring a noticeable decrease in total noise while reducing exposure to the specific source.

Abstract Background Mass media are a new and important source of information for any natural disaster, mass emergency, pandemic, economic or political event, or extreme weather event affecting one or more communities in a country. Several techniques have been developed for data mining in social media for many natural events, but few of them have been applied to the automatic extraction of landslide events. In this study, Twitter has been investigated to detect data about landslide events in Italian-language. The main aim is to obtain an automatic text classification on the basis of information about natural hazards. The text classification for landslide events in Italian-language has still not been applied to detect this type of natural hazard. Results Over 13,000 data were extracted within Twitter considering five keywords referring to landslide events. The dataset was classified manually, providing a solid base for applying deep learning. The combination of BERT + CNN has been chosen for text classification and two different pre-processing approaches and bert-model have been applied. BERT-multicase + CNN without preprocessing archived the highest values of accuracy, equal to 96% and AUC of 0.96. Conclusions Two advantages resulted from this studio: the Italian-language classified dataset for landslide events fills that present gap of analysing natural events using Twitter. BERT + CNN was trained to detect this information and proved to be an excellent classifier for the Italian language for landslide events.

Summary: Despite extensive global research into genetic predisposition for severe COVID-19, knowledge on the role of rare host genetic variants and their relation to other risk factors remains limited. Here, 52 genes with prior etiological evidence were sequenced in 1,772 severe COVID-19 cases and 5,347 population-based controls from Spain/Italy. Rare deleterious TLR7 variants were present in 2.4% of young (

Artemisinin-based treatments (ACTs) are the first therapy currently used to treat malaria produced by Plasmodium falciparum. However, in recent years, increasing evidence shows that some strains of P. falciparum are less susceptible to ACT in the Southeast Asian region. A data reanalysis of several omics approaches currently available about parasites of P. falciparum that have some degree of resistance to ACT was carried out. The data used were from transcriptomics and metabolomics studies. One mitochondrial carrier of the parasite possibly involved in the mechanisms of tolerance to oxidative stress was modeled and subjected to molecular dockings with citrate and oxoglutarate. An increase in glutathione production was detected, changing the direction of the flux of metabolites in the tricarboxylic acid cycle and boosting the glucose consumed. The models of the mitochondrial carrier, called PfCOCP, show that it may be important in transporting citrate and oxoglutarate from the mitochondrial matrix to the cytosol. If so, it may allow the parasite to tolerate the oxidative stress produced by artemisinin. This in-silico analysis shows that P. falciparum may tolerate artemisinin’s oxidative stress through metabolic changes not reported before, showing the need for further experimental research on the many metabolic aspects linked to this phenotype.

Long-term care insurance (LTCI) plays a crucial role in providing substantial aid in non-self-sufficient situations and complementing existing state protection mechanisms. With an aging population and increasing demand for healthcare services LTC policies have become indispensable. While individual LTCI policies face adoption challenges, group insurances offer a more streamlined alternative. However, realizing the full potential of these insurances necessitates targeted legislative intervention to improve accessibility and ensure sustainability. This article explores the evolution of LTCI policies in Italy, offering an overview of the current landscape and highlighting the socio-economic and medico-legal factors shaping the present scenario. By providing this analysis, we seek to offer insights into the dynamic evolution of LTCI policies and the crucial role of legislative measures in enhancing their effectiveness and accessibility.

The practice of transporting a patient affected by a Highly Transmissible Disease (HTD) with a high risk of fatal evolution using biocontainment isolators requires careful planning and preparation. To date, there is only limited literature regarding aeromedical transport, most of which is military-derived, and it does not address patient transfer by road vehicles. To standardize these practices, or at least some of their most critical aspects, we tried to schematize a few of the improvements each author implemented during their practices as a scaffold, which could eventually be based on operative protocols. In particular, we focused on the series of actions that needed to be performed and planned to guarantee the safety of both the patient and operators during the entire duration of the operations.

Antecedentes: El síndrome postimplantación (SPI) es una complicación aguda que puede surgir tras colocar endoprótesis para reparación de aneurismas aórticos abdominales (AAA). Su incidencia oscila entre 11.2-60%. Objetivo: Describir frecuencia de PIS y su asociación con factores de riesgo en pacientes sometidos a reparación endovascular (EVAR) de AAA. Método: Estudio observacional, analítico y ambispectivo. Se analizaron los registros clínicos de pacientes con AAA sometidos a EVAR; teniendo seguimiento a corto plazo (72 horas) y mediano plazo (un mes). Resultados: Se incluyeron 50 pacientes, 43 varones y 7 mujeres (edad media 74 ± 8 años). El 97.9% presentó aneurismas fusiformes (diámetro medio 66.2 ± 17.5 mm). Se empleó dacrón en 54.2% (n = 26/50) y politetrafluoroetileno en el resto de las prótesis. Siete casos (14.6%) presentaron PIS durante las primeras 24 horas. Dos pacientes fallecieron (sin desarrollar SPI). Se observó asociación entre dislipidemia y el desarrollo de PIS (odds ratio [OR]: 9.500; IC95%: 1.416-63.724; p = 0.033). Conclusión: La frecuencia de SPI fue similar a otras series y en el presente estudio encontramos que la dislipidemia incrementa el riesgo de SPI (OR: 9.5).

Antecedentes: La termografía es una herramienta para la obtención de imágenes por medio de la captación de diferentes temperaturas que emite un cuerpo. Los patrones termográficos son el resultado de la obtención de imágenes de los diferentes rangos de temperatura. Objetivo: Analizar patrones termográficos en el diagnóstico y seguimiento de la enfermedad venosa crónica. Método: Se realizó un estudio observacional, descriptivo, longitudinal y prospectivo de 98 pacientes con enfermedad venosa crónica con registro de termografía. Resultados: La temperatura inicial promedio fue: 31.6 oC en C1, 33.2 oC en C2, 32.7 oC en C3, 32.4 oC en C4A, 32.1 oC en C4B, 32.9 oC en C4C, 32.6 oC en C5 y 34.2 oC en C6. Los pacientes con tratamiento conservador clasificados como CEAP C1 registraron un descenso de temperatura entre 0.3 y 0.5 oC a las cuatro semanas, los pacientes con tratamiento quirúrgico registraron un descenso entre 0.8 y 1 oC en 24 horas y cuatro semanas posteriores un descenso entre 1.4 y 1.6 oC. Los pacientes tratados con EVLA registraron un descenso entre 0.8 y 1.4 oC en 24 horas y cuatro semanas posterior un descenso entre 1.8 y 2.6 oC. Conclusión: En los pacientes en quienes se registró un descenso de temperatura entre 31 y 32.6 oC, esto se asoció con mejoría de la sintomatología a las cuatro semanas.

Streptococcus pneumoniae constituye un problema mundial de salud pública, es causante de una gran variedad de síndromes infecciosos, los más graves se incluyen dentro del grupo denominado enfermedad neumocócica invasiva (ENI), que incluyen bacteriemias, meningitis, pleuritis, artritis, peritonitis y pericarditis. Paciente de sexo masculino de 54 años de edad, con un cuadro clínico caracterizado por fiebre, vómito, letargia, alteraciones del habla, alteración del estado de alerta y postración. Se realiza punción lumbar, obteniendo líquido cefalorraquídeo; en la tinción de Gram se observaron cocos grampositivos en racimos, el análisis en el equipo Vitek 2 obtuvo el resultado confirmado de S. pneumoniae.

Abstract Landslides are the most frequent and diffuse natural hazards in Italy causing the greatest number of fatalities and damage to urban areas. The integration of natural hazard information and social media data could improve warning systems to enhance the awareness of disaster managers and citizens about emergency events. The news about landslide events in newspapers or crowdsourcing platforms allows fast observation, surveying and classification. Currently, few studies have been produced on the combination of social media data and traditional sensors. This gap indicates that it is unclear how their integration can effectively provide emergency managers with appropriate knowledge. In this work, rainfall, human lives, and earmarked fund data sources were correlated to “landslide news”. Analysis was applied to obtain information about temporal (2010–2019) and spatial (regional and warning hydrological zone scale) distribution. The temporal distribution of the data shows a continuous increase from 2015 until 2019 for both landslide and rainfall events. The number of people involved and the amount of earmarked funds do not exhibit any clear trend. The spatial distribution displays good correlation between “landslide news”, traditional sensors (e.g., pluviometers) and possible effects in term of fatalities. In addition, the cost of soil protection, in monetary terms, indicates the effects of events.

Pure and copper-doped Zirconium oxide nanoparticles were synthesized using a co-precipitation process and investigated the effect of doping on photocatalytic and anti-microbial activities. The prepared samples are pure tetragonal phase, as shown by the X-ray diffraction pattern, and the crystallite size decreases as the dopant concentration increases. Higher dopant concentrations resulted in needle-shaped morphology, as seen in the SEM image. The presence of Zr, Cu, and O in the sample is confirmed by EDS analysis. According to UV-VIS analysis, when the Cu content is increased, a more significant wavelength absorption band edge is formed, and the band gap reduces with the increase in dopant concentration. All samples have magnetic hysteresis loops with diamagnetic background effects, according to VSM tests. A prominent and influential peak at 485nm in the PL spectra suggests that ZrO2 nanoparticles emit blue light. The produced nanoparticles were utilized as a photocatalyst to degrade Methylene Blue (MB) dye, and the results indicate that a high dopant concentration (0.08wt percent) outperforms pure and other dopant concentrations. Copper-doped ZrO2 has moderate anti-bacterial and anti-fungal activities.

Purpose – This paper attempts to rejuvenate waqf in the health sector by identifying and elaborating on its issues and challenges. The government budget for this sector is significant; thus, the present paper aims to provide a nongovernment budget to lessen the government's burden Design/methodology/approach – This qualitative study uses structured in-depth interviews with 12 respondents to generate valuable insights and thoughts in order to frame recommendations. Findings – The findings highlight the key themes: human resources, finance, collaboration and coordination, legal issues, basic healthcare insufficiency, data and digitalization, accountability and sustainability and infrastructure. The following are the proposed solutions: capacity building program (CBP), hybrid waqf scheme, big data connectivity, specific legal framework, refocusing and reallocating of resources for the health sector during and after the pandemic Research limitations/implications – This study focuses on Indonesia and Malaysia as the authors believe that these two countries have a lot of practice in the field. Further studies may focus on other countries, such as Pakistan. Practical implications – This paper proposes potential ways to embrace government policy consideration, optimize the elaboration among productive waqf with other kinds, improve governance of and coordination among waqf institutions and increase the awareness to improve significant development. Social implications – By considering this paper's recommendations, waqf stakeholders in the healthcare system can improve the social benefits for poor and needy patients. Originality/value – This study presents the latest strategic analysis of waqf, which is important for the government policy in developing waqf.

Antecedentes: La safenectomía de vena safena menor y varicectomía son una opción de manejo viable para las várices. En Colombia, existen pocos estudios que hagan seguimiento a largo plazo. Se evaluó el resultado a largo plazo, síntomas y recurrencias de safenectomía de safena menor. Objetivo: Determinar las características sociodemográficas, clínicas y ecográficas posteriores a safenectomía de safena menor a mediano y largo plazo. Método: Estudio prospectivo, seguimiento de 3 a 5 años en pacientes sometidos a safenectomía de vena safena menor y varicectomía, intervenidos entre 2016 y 2018 en Colombia. Resultados: Se revisaron 46 pacientes. 17.4% persistía con síntomas asociados a enfermedad venosa, 84.7% tenía un estadio clínico CEAP C1-C2. El estudio Doppler encontró safena menor insuficiente recidivada en 32% de los casos, 50% presentaba tributarias insuficientes dependientes de safena menor. Conclusiones: Se encontró una proporción de recurrencias similar a otros estudios en el seguimiento a largo plazo, y similar a los procedimientos endovasculares (30% y 65% respectivamente).

Abstract Background Differences exist among doctors in examination performance, clinical and academic career progression, and prevalence of performance assessment by professional regulatory bodies. Some of these differences have been reported in relation to individual characteristics. The purpose of this study is to establish whether any specific individual characteristics are associated with performance in selection for entry into specialty training in Intensive Care in the United Kingdom. Methods We evaluated data of 509 candidates from the national recruitment rounds of 2018/19 and 2019/20. The outcome evaluated was “success at interview". Variables reaching statistical significance at univariate logistic regression analysis were fed in the multivariable analysis to identify independent predictors of success, with additional exploratory analyses performed, where indicated. Results The candidates’ median age was 31.5 (interquartile range, IQR 30–33.7) years, 324 (63.7%) were male, 256 (50.3%) not married/in civil partnership, 6 (1.2%) pregnant. The majority (316, 62.1%) were White British, 99 (19.5%) of Asian background, other ethnicities represented less than 20% of the sample. Of the 509 candidates, 155 (30.5%) were Atheist, 140 (27.5%) Christian; most were heterosexual (440, 86.4%); 432 (84.9%) reported no disability, while 4 (0.8%) had a minor and 1 (0.2%) had a major disability; 432 (84.9%) candidates held a UK medical degree; 77 (15.1%) a non-UK degree. At univariate logistic regression analysis (LRA) multiple factors were found to be associated with a lower likelihood of success, the strongest being an international medical graduate (IMG, holding a non-UK medical degree); others were increasing age, male gender, being married, Asian or mixed ethnicity, specific religious beliefs (Buddhism, Islam and Hinduism). After feeding all factors significant at univariate analysis, the only two retained as independent predictors at multivariable regression were Asian ethnicity and holding a non-UK degree. Asian UK graduates success rate was 92.7%, comparable to the national average of 92.3%, the Asian IMGs success rate was significantly lower, at 45.5%. Conclusions As the imbalances seen within the candidates of Asian background are explained by considering the country of primary medical training, the variations in performance is likely to reflect differences in training systems and understanding of the UK NHS.

Objetivo: Reportar la organización y desempeño de la primera red organizada de atención al ictus en México, ResISSSTE Cerebro. Materiales y métodos: Después de la aprobación de los comités de investigación se registraron prospectivamente las variables de la atención a pacientes con sospecha de infarto cerebral de menos de 24 horas de evolución que se presentaron en los hospitales de la primera red de ictus en México ResISSSTE Cerebro (dos hospitales preparados para ictus, cinco hospitales primarios y un centro integral de ictus) del 1 de enero de 2019 al 28 de febrero de 2021. Resultados: Logramos trombólisis endovenosa en el 39% de los pacientes con ictus isquémico y tiempo desde el inicio de los síntomas a la trombólisis (OTN) de 167 minutos (RIC: 116-216 minutos). Conclusiones: México históricamente ha mostrado bajo acceso a terapias de reperfusión en pacientes con infarto cerebral posiblemente debido a que muchos acuden tardíamente a recibir atención. En 2019 la frecuencia de trombólisis IV en cuatro grandes centros médicos urbanos fue del 7.6%, solo 17.4% llegaron a un hospital en menos de 4.5 horas; los centros que participaron dicho estudio no formaban parte de una red. Este es el primer estudio que presenta resultados de una red establecida de ictus en México. La red ResISSSTE Cerebro no recibió ningún recurso adicional a los disponibles en nuestra institución, se basa en capacitación y vinculación de hospitales con diferentes capacidades logrando una tasa de trombólisis IV del 39%. Es un modelo fácilmente transportable a países de bajos y medianos ingresos.

Antecedentes: La insuficiencia venosa es un padecimiento frecuente que puede ser tratado mediante técnicas endovasculares, incluyendo la ablación endovenosa con láser. Objetivo: Evaluar las posibles complicaciones a corto plazo derivadas de la ablación endovenosa con láser para tratamiento de insuficiencia venosa en safena mayor y menor. Métodos: Se incluyeron 158 miembros inferiores con diagnóstico clínico y por ultrasonido Doppler de insuficiencia venosa superficial. Fueron sometidos a ablación endovenosa con láser 1470 nm y fibra radial (400 y 600 nm) de forma ambulatoria y el seguimiento postoperatorio se llevó a cabo entre 15-30 días posterior al tratamiento. Resultados: 32 sujetos (20%) presentaron complicaciones menores, las cuales fueron síndrome doloroso (10.7%), parestesia (6.3%), seroma (1.2%), hematoma (0.6%), equimosis sintomática (0.6%) y tromboflebitis superficial (1.2%). No se registraron complicaciones graves. Conclusiones: Nuestros resultados coinciden con lo reportado comúnmente en la literatura, sin registrar complicaciones graves, por lo que consideramos que la ablación endovenosa con láser es un procedimiento seguro.

The global pandemic, previously only a health crisis, has been slowly causing the economic crisis. The government policy to lockdown and apply social distancing affected the social and economic lives of the countries. The policy affected businesses and led companies to lay off their employees. Many households were suffering economically because of this pandemic. This research aims to identify the changes in household financial behaviour during the covid-19 pandemic. This research is vital as it is the first to explore household financial behaviour during a pandemic which uses a quantitative method of an online survey with 635 participants in Indonesia. Participants’ perceptions on their behaviour during the most challenging time of covid-19 (mid-2020) were compared to their current behaviour and the differences were analysed thoroughly. The results show that spending and insurance behaviour did not change during the pandemic, but the saving and investment behaviour increased significantly during the pandemic. Pandemic warns people that they need investment and savings to survive in an emergency. As the pandemic is still ongoing and there were different government policies between the first and fourth waves, the impact on the economy and households needs to be examined in a more extended period.

Landslide susceptibility assessment using machine learning models is a popular and consolidated approach worldwide. The main constraint of susceptibility maps is that they are not adequate for temporal assessments: they are generated from static predisposing factors, allowing only a spatial prediction of landslides. Recently, some methodologies have been proposed to provide spatiotemporal landslides prediction starting from machine learning algorithms (e.g., combining susceptibility maps with rainfall thresholds), but the attempt to obtain a dynamic landslide probability map directly by applying machine learning models is still in the preliminary phase. This work provides a contribution to fix this gap, combining in a Random Forest (RF) algorithm a static indicator of the spatial probability of landslide occurrence (i.e., a classical susceptibility index) and a number of dynamic variables (i.e., seasonality and the rainfall amount cumulated over different reference periods). The RF implementation used in this work allows the calculation of the Out-of-Bag Error and depicts Partial Dependence Plots, two indices that were used to quantify the variables’ importance and to comprehend if the model outcomes are consistent with the triggering mechanism observed in the case of study (Metropolitan City of Florence, Italy). The goal of this research is not to set up a landslide probability map, but to 1) understand how to populate training and test datasets with observations sampled over space and time, 2) assess which rainfall variables are statistically more relevant for the identification of the time and location of landslides, and 3) test the dynamic application of RF in a forecasting model for the spatiotemporal prediction of landslides. The proposed dynamic methodology shows encouraging results, consistent with the actual knowledge of the physical mechanism of the triggering of shallow landslides (mainly influenced by short and intense rainfalls) and identifies some benchmark configurations that represents a promising starting point for future regional-scale applications of machine learning models to dynamic landslide probability assessment and early warning.

Las urgencias oncológicas son comunes en la medicina de urgencias, pero no es habitual verlas en salas que no atiendan a una población oncológica robusta. Las cuatro urgencias oncológicas más comunes son la fiebre neutropénica, el síndrome de lisis tumoral, el síndrome de hiperviscosidad y la hipercalcemia maligna. Esta última es un síndrome clínico potencialmente mortal, uno de los desequilibrios hidroelectrolíticos menos comunes, cuya presencia es de gran importancia clínica pues se ha asociado a un incremento del riesgo de muerte. La hipercalcemia ha sido documentada en una proporción significativamente menor y su presencia está relacionada con una enfermedad maligna en el 72% de los casos. Algunos autores la asocian hasta en el 90% de los casos, por lo que el diagnóstico diferencial de cualquier hipercalcemia incluye la búsqueda de una neoplasia, y refiriendonos a estas hay un determinante, como lo es el mieloma múltiple, en el que la asociación es bien establecida e incluso es una manifestación clínica mayor dentro del abordaje diagnóstico.

Introduction and objectives: Cardiac amyloidosis (CA) is not a rare cause of heart failure (HF). In Spain, more than 60% of HF patients admitted to hospitals are treated in Internal Medicine Services. REGAMIC is a registry designed by the HF Working Group of the Spanish Society of Internal Medicine to improve the suspicion criteria and the selection of patients in whom CA must be ruled out. The main objective is to evaluate the differential characteristics between two groups of HF patients with suspicion of CA: confirmed vs ruled out cases. The secondary objectives are to evaluate the data on which investigators have based the suspicion of CA, and to identify prognostic differences between both groups. Methods: A multicenter, observational, prospective, cohort study of at least 600 patients, with a 2-year follow-up. Inclusion criteria: patients of Internal Medicine Services, aged ≥ 18 years, with HF and left ventricular hypertrophy (septum or posterior wall ≥ 12 mm), with suspicion of CA. Clinical, electrocardiographic, echocardiographic, and follow-up data will be compared between both groups of patients. Results and discussion: If the recommendations of the 2021 European Society of Cardiology Consensus on CA are followed, a large number of patients should be studied to rule out CA. REGAMIC can improve the selection of patients in whom CA will be ruled out and make the study more cost-effective. Conclusions: Our registry aims to improve the knowledge about differential characteristics between HF patients with clinical suspicion of CA and may increase knowledge of the natural history of the disease.

Healthcare in the third millennium is largely delivered through systems involving the use of the technological devices and services, foremost among them telemedicine. For the adequate delivery of digital medicine services, however, it is necessary for users to be digitally literate, that is, able to consciously make use of technology. In order to understand how relevant digital literacy is in determining the effectiveness of e-Health services, we performed a traditional literature review on 3 major databases by combining the terms “Digital Literacy” and “Computer Literacy” with the terms “Telemedicine” and “Telehealth”. Starting from an initial library of 1,077 papers, we selected 38 articles. At the outcome of the search, we found that digital literacy is a pivotal element in conditioning the effectiveness of telemedicine and digital medicine services in general, however, with some limitations.

Rainfall induced landslide is one of the main geological hazard in Italy and in the world. Each year it causes fatalities, casualties and economic and social losses on large populated areas. Accurate short-term predictions of landslides can be extremely important and useful, in order to both provide local authorities with efficient prediction/early warning and increase the resilience to manage emergencies. There is an extensive literature addressing the problem of computing landslide susceptibility maps (which is a classification problem exploiting a large range of static features) and only few on actual short terms predictions (spatial and temporal). The short-term prediction models are still empirical and obtain unsatisfactory results, also in the identification of the predictors. The new aspects addressed in this paper are: (i) a short-term prediction model (1 day in advance) of landslide based on machine learning, (ii) real time features as good predictors. The introduction of explainable artificial intelligence techniques allowed to understand global and local feature relevance. In order to find the best prediction model, some machine learning solutions have been implemented and assessed. The obtained models overcome the ones available in literature. The validation has been performed in the context of the Metropolitan City of Florence, data from 2013 to 2019. The method based on XGBoost achieved best results, demonstrating that it is the most reliable and robust against false alarms. Finally, we applied explainable artificial intelligence techniques locally and globally to derive a deep understanding of the predictive model’s outputs and features’ relevance, and relationships. The analysis allowed us to identify the best feature for short term predictions and their impact in local cases and global prediction model. Solutions have been implemented on Snap4City.org infrastructure.

Landslides are a worldwide natural hazard that cause more damage and casualties than other hazards. Therefore, social and economic losses can be reduced through a landslide quantitative risk assessment (QRA). In the last two decades, many attempts of quantitative analysis on various scales have been performed; nevertheless, the major difficulty of QRA lies in how precise and reliable the assessment should have to be useful. For this reason, in this paper, we analyzed different freely available datasets and some products of previous research to assess the soundness of the outcomes performed by a recent QRA of slow-moving landslides in the Arno River basin (Central Italy). The validation process was carried out by comparing the abovementioned datasets and two components of the selected QRA (hazard and risk). The obtained results showed a robust correlation between most of the testing dataset and risk components, highlighting the accuracy of the selected QRA.

Objectives Hospital-acquired pressure injuries (PIs) are a source of morbidity and mortality, and many are potentially preventable.Design This study prospectively evaluated the prevalence and the associated factors of PIs in adult critical care patients admitted to intensive care units (ICU) in the UK.Setting This service evaluation was part of a larger, international, single-day point prevalence study of PIs in adult ICU patients. Training was provided to healthcare givers using an electronic platform to ensure standardised recognition and staging of PIs across all sites.Participants The characteristics of the ICUs were recorded before the survey; deidentified patient data were collected using a case report form and uploaded onto a secure online platform.Primary and secondary outcome measures Factors associated with ICU-acquired PIs in the UK were analysed descriptively and using mixed multiple logistic regression analysis.Results Data from 1312 adult patients admitted to 94 UK ICUs were collected. The proportion of individuals with at least one PI was 16% (211 out of 1312 patients), of whom 8.8% (n=115/1312) acquired one or more PIs in the ICU and 7.3% (n=96/1312) prior to ICU admission. The total number of PIs was 311, of which 148 (47.6%) were acquired in the ICU. The location of majority of these PIs was the sacral area, followed by the heels. Braden score and prior length of ICU stay were associated with PI development.Conclusions The prevalence and the stage of severity of PIs were generally low in adult critically ill patients admitted to participating UK ICUs during the study period. However, PIs are a problem in an important minority of patients. Lower Braden score and longer length of ICU stay were associated with the development of injuries; most ICUs assess risk using tools which do not account for this.Trial registration number NCT03270345.

Three-dimensional bioprinting is a rapidly evolving technology that holds the promise of addressing the increasing demand for organs, tissues, and personalized medicine. By employing computer-aided design and manufacturing processes, 3D bioprinting allows for the precise deposition of living cells, biomaterials, and biochemicals to create functional human tissues and organs. The potential applications of this technology are vast, including drug testing and development, disease modeling, regenerative medicine, and ultimately, organ transplantation. However, as with any groundbreaking technology, 3D bioprinting presents several ethical, legal, and regulatory concerns that warrant careful consideration. As the technology progresses towards clinical applications, it is essential to address these challenges and establish appropriate frameworks to guide the responsible development of 3D bioprinting. This article, utilizing the Arksey and O’Malley scoping review model, is designed to scrutinize the bioethical implications, legal and regulatory challenges, and medico-legal issues that are intertwined with this rapidly evolving technology.

Background and objective Renewed interest in robot-assisted cardiac procedures has been demonstrated by several studies. However, concerns have been raised about the need for a long and complex learning curve. In addition, the COVID-19 pandemic in 2020 might have affected the learning curve of these procedures. In this study, we investigated the impact of COVID-19 on the learning curve of robotic-assisted mitral valve surgery (RAMVS). The aim was to understand whether or not the benefits of RAMVS are compromised by its learning curve. Materials and Methods Between May 2019 and March 2023, 149 patients underwent RAMVS using the Da Vinci® X Surgical System at the Humanitas Gavazzeni Hospital, Bergamo, Italy. The selection of patients enrolled in the study was not influenced by case complexity. Regression models were used to formalize the learning curves, where preoperative data along with date of surgery and presence of COVID-19 were treated as the input covariates, while intraoperative and postoperative data were analyzed as output variables. Results The age of patients was 59.1 ± 13.3 years, and 70.5% were male. In total, 38.2% of the patients were operated on during the COVID-19 pandemic. The statistical analysis showed the positive impact of the learning curve on the trend of postoperative parameters, progressively reducing times and other key indicators. Focusing on the COVID-19 pandemic, statistical analysis did not recognize an impact on postoperative outcomes, although it became clear that variables not directly related to the intervention, especially ICU hours, were strongly influenced by hospital logistics during COVID-19. Conclusions Understanding the learning curve of robotic surgical procedures is essential to ensure their effectiveness and benefits. The learning curve involves not only surgeons but also other health care providers, and establishing a stable team in the early stage, as in our case, is important to shorten the duration. In fact, an exogenous factor such as the COVID-19 pandemic did not affect the robotic program despite the fact that the pandemic occurred early in the program.

Hematological markers that can be rapidly analyzed and regularly monitored during a patient’s stay on ICU, and that can identify bacterial causes of sepsis are being extensively sought. The significance of platelets in early immunological responses provides justification for assessing their usefulness in the identification of bacteremia amongst sepsis patients. In this preliminary study, the full blood count, including the platelet count by impedance (PLT-I), Immature Platelet Fraction (IPF%) and absolute immature platelet count (AIPC), were analyzed in eighty-two sepsis patients daily over the first 5 days stay on ICU. C-Reactive Protein (CRP), procalcitonin (PCT), and lactate were also analyzed daily. Blood cultures confirmed or excluded the presence of bacteremia. PCT provided the earliest indicator of bacteremia, with significant differences between the two cohorts on day 1. The change in IPF% and AIPC from day 1 to day 2 (Δ IPF% and Δ AIPC) provided the most accurate indication; A combination of Δ IPF% and day 2 PCT, provided a positive predictive value and negative predictive value of 100% and 96.10%, respectively. These data provide strong justification for larger multi-center validation studies to confirm the usefulness of these platelet indices during the assessment of sepsis on the ICU.

La úlcera de Marjolin se define como una neoplasia desarrollada en el seno de una herida que ha sido crónicamente traumatizada. Presentamos el caso de una úlcera venosa crónica con degeneración maligna y realizamos una breve revisión de la literatura. Se trata de una paciente de género femenino, de 50 años de edad, con enfermedad venosa crónica diagnosticada desde los 20 años. Se le realizó ablación farmacológica de vena safena mayor bilateral; dos décadas mas tarde desarrolló una úlcera varicosa en cara medial de pierna derecha presentando recidiva a pesar de tratamiento durante 10 años. Esta úlcera aumentó de tamaño y presentó sangrado, por lo que se decide realizar biopsias. El reporte histopatológico reveló degeneración neoplásica maligna con extensión a planos profundos y adenopatías inguinales. Se realizó amputación supracondílea del miembro pélvico derecho con linfadenectomía inguinal. En conclusión, la úlcera de Marjolin secundaria a una úlcera varicosa puede tener mayor morbilidad debido a su localización, ya que predomina en las extremidades y generalmente es identificada en estadios avanzados, pudiendo conducir a desenlaces sombríos.

Digitization of health records is still struggling to take hold in the Italian healthcare context, where medical records are still largely kept manually on paper. Besides being anachronistic, this practice is particularly critical if applied to the drug chart. Poor handwriting and transcription errors can generate medication errors and thus represent a potential source of adverse events. In the present study, we attempt to test the hypothesis that the application of a computerized medical record model may represent a useful tool for managing clinical risk and medical expenditure. We shall do so through the analysis of the preliminary results of the application of such a model in two private hospitals in Northern Italy. The results, although preliminary, are encouraging. Among the benefits of digitizing drug records, we recorded a greater accuracy and adequacy of prescriptions, a reduction in the overall workload for nurses (no longer required to manually transcribe the list of drugs from one chart to another), as well as an optimization of the management of drug stocks by hospital pharmacies. The results in terms of clinical risk reduction will be monitored through a prospective cohort study that will take place in the coming months.

Multifunctional Zirconia Nanorods performing photocatalysis, anti-bacterial and anti-fungal activities are presented in this article. Tetragonal Zirconia is synthesized by simple co-precipitation method. The synthesized Zirconia is characterized by various characterization methods such as XRD, SEM, EDX, UV-Vis, PL, VSM and TG/DTA analysis. Exploration of powder XRD pattern indicates tetragonal phase. SEM image illustrates rod-shaped morphology. UV-Vis spectra reveal that the synthesized catalyst has wide band gap of about 4.6eV. The emission peaks in the PL spectra reveal the presence of oxygen vacancies in the sample. Room Temperature Ferromagnetism (RTFM) is confirmed from VSM measurements. The performance of Zirconia nanorods in various applications such as photocatalysis, anti-bacterial and anti-fungal activities has been analyzed. t-ZrO2 photo catalyst degrades methylene blue dye with 80% removal efficiency in 180 minutes under UV light irradiation. t-ZrO2 obtained 28mm inhibition zone against Staphaureus for anti-bacterial assessment while Amikacin has 15mm inhibition and obtained 25mm inhibition zone against Candida Albicans for anti-fungal assessment while Nystatin has 20mm inhibition. t-ZrO2 shows superior inhibiting effect against both gram positive and gram negative bacterial pathogens. Owing to its high surface area it exhibits greatest inhibiting effect against fungal strain.

Hoarding disorder (HD) is a recently recognized psychiatric condition, now classified under the category of obsessive-compulsive and related disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). It leads to an unwarranted attachment to material possessions, such that the individual is unable to separate themselves from them. There is still a lack of awareness of the critical sociological implications of this disorder, which is too often considered a purely health-related issue. This article endeavors to frame hoarding disorder from a unique socio-criminological and legal perspective, proposing an alternative approach to HD that considers it not only as a mental disorder, but also as a genuine societal issue. We also explore potential avenues for protection, considering both the well-being of individuals with this mental disorder and the communities in which individuals suffering from HD reside. This paper presents a fresh perspective on HD, aiming to delineate its impact and significance as an affliction affecting both individuals and society at large.

Josep Darbà,1 Meritxell Ascanio,2 Jörgen Syk,3– 5 Kjell Alving4 1Department of Economics, Universitat de Barcelona, Barcelona, Spain; 2BCN Health Economics & Outcomes Research, S.L., Barcelona, Spain; 3Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; 4Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden; 5Academic Primary Health Care Centre, Stockholm, SwedenCorrespondence: Josep DarbàDepartment of Economics, Universitat de Barcelona, Diagonal 696, Barcelona, 08034, SpainTel +34 934020110Fax +34 934039082Email darba@ub.eduObjective: To determine the economic impact of the fraction of exhaled nitric oxide (FeNO) in asthma diagnosis and management in primary care in Sweden.Methods: An economic model has been developed to determine the economic impact of the fraction of exhaled nitric oxide (FeNO) in asthma diagnosis and management in primary care in Sweden. The model includes the use and cost of commonly used tests, the associated outcomes and diagnostic accuracy. We compared FeNO with spirometry and reversibility testing, methacholine challenge test, allergy testing, and blood eosinophil count. One-way sensitivity analyses were performed to confirm the robustness of results.Results: Adding FeNO measurement in asthma diagnosis resulted in cost savings of SEK 672 per patient by the fourth year. The use of FeNO testing in asthma management proved to be a dominant strategy when compared with each other test except methacholine challenge test. Sensitivity analyses confirmed the robustness of the results.Conclusion: Introducing FeNO testing in clinical practice for the diagnosis and management of asthma in primary care in Sweden is less costly than standard methods while providing similar health benefits.Keywords: asthma, management, diagnosis, FeNO, exhaled nitric oxide, health economy

Primary renal extra-skeletal Ewing sarcoma is a rare neoplasm, often metastatic at diagnosis, and with a poor outcome. A multimodal approach is often the treatment of choice in this aggressive neoplasm. We present a case of primary renal extra-skeletal sarcoma in a 45-year-old woman who underwent tumor resection without clear margins. After no response to the first cycle of chemotherapy, we documented an early onset of local recurrence. The patient refused any other treatment and died four months after surgery.

The purpose of this paper is to examine the effect of monetary incentives on unattractive task. Pre-test and post-test were conducted to examine the effect of monetary incentives on unattractive task. The data generated from University Student in Indonesia. Total 53 participant follow two stages of the experiment to do the assignment. The first stage to examine individual performance in the assignment without incentives and the second stage is the treatment group. One group with financial incentives while another group without financial incentives. The T-Test was examining to evaluate the difference between pre-test and post test result. The result shows that monetary incentives could not change people perceived of unattractive task become attractive and could not increase individual performance in unattractive task. But people that perceived the assignment as attractive, they improve the performance when there are monetary incentives. This research found that money could not shift people perception on task attractiveness.

Abstract Introduction This is the report of the first official survey from the Italian Society of Pediatric Surgery (ISPS) to appraise the distribution and organization of bedside surgery in the neonatal intensive care units (NICU) in Italy. Methods A questionnaire requesting general data, staff data and workload data of the centers was developed and sent by means of an online cloud-based software instrument to all Italian pediatric surgery Units. Results The survey was answered by 34 (65%) out of 52 centers. NICU bedside surgery is reported in 81.8% of the pediatric surgery centers. A lower prevalence of bedside surgical practice in the NICU was reported for Southern Italy and the islands than for Northern Italy and Central Italy (Southern

Summary: Background: Dexamethasone was the first intervention proven to reduce mortality in patients with COVID-19 being treated in hospital. We aimed to evaluate the adoption of corticosteroids in the treatment of COVID-19 in the UK after the RECOVERY trial publication on June 16, 2020, and to identify discrepancies in care. Methods: We did an audit of clinical implementation of corticosteroids in a prospective, observational, cohort study in 237 UK acute care hospitals between March 16, 2020, and April 14, 2021, restricted to patients aged 18 years or older with proven or high likelihood of COVID-19, who received supplementary oxygen. The primary outcome was administration of dexamethasone, prednisolone, hydrocortisone, or methylprednisolone. This study is registered with ISRCTN, ISRCTN66726260. Findings: Between June 17, 2020, and April 14, 2021, 47 795 (75·2%) of 63 525 of patients on supplementary oxygen received corticosteroids, higher among patients requiring critical care than in those who received ward care (11 185 [86·6%] of 12 909 vs 36 415 [72·4%] of 50 278). Patients 50 years or older were significantly less likely to receive corticosteroids than those younger than 50 years (adjusted odds ratio 0·79 [95% CI 0·70–0·89], p=0·0001, for 70–79 years; 0·52 [0·46–0·58], p80 years), independent of patient demographics and illness severity. 84 (54·2%) of 155 pregnant women received corticosteroids. Rates of corticosteroid administration increased from 27·5% in the week before June 16, 2020, to 75–80% in January, 2021. Interpretation: Implementation of corticosteroids into clinical practice in the UK for patients with COVID-19 has been successful, but not universal. Patients older than 70 years, independent of illness severity, chronic neurological disease, and dementia, were less likely to receive corticosteroids than those who were younger, as were pregnant women. This could reflect appropriate clinical decision making, but the possibility of inequitable access to life-saving care should be considered. Funding: UK National Institute for Health Research and UK Medical Research Council.

Performing a reliable stability analysis of a landslide slope requires a good understanding of the internal geometries and an accurate characterisation of the geotechnical parameters of the identified strata. Geotechnical models are commonly based on geomorphological data combined with direct and intrusive geotechnical investigations. However, the existence of numerous empirical correlations between seismic parameters (e.g., S-wave velocity) and geotechnical parameters in the literature has made it possible to investigate areas that are difficult to reach with direct instrumentation. These correlations are often overlooked even though they enable a reduction in investigation costs and time. By means of geophysical tests, it is in fact possible to estimate the N-SPT value and derive the friction angle from results obtained from environmental seismic noise measurements. Despite the empirical character and a certain level of uncertainty derived from the estimation of geotechnical parameters, these are particularly useful in the preliminary stages of an emergency, when straight data are not available and on all those soils where other direct in situ tests are not reliable. These correlations were successfully applied to the Theilly landslide (Western Alps, Italy), where the geotechnical model was obtained by integrating the results of a multi-parameter geophysical survey (H/V seismic noise and ground-penetrating radar) with stratigraphic and geomorphological observations, digital terrain model and field survey data. The analysis of the triggering conditions of the landslide was conducted by means of hydrological–geotechnical modelling, evaluating the behaviour of the slope under different rainfall scenarios and considering (or not) the stabilisation interventions present on the slope. The results of the filtration analyses for all events showed a top-down saturation mechanism, which led to the formation of a saturated face with a maximum thickness of 5 m. Stability analyses conducted for the same events showed the development of a shallow landslide in the first few metres of saturated soil. The modelling results are compatible with the actual evolution of the phenomenon and allow us to understand the triggering mechanism, providing models to support future interventions.

On 13 January 2012, the Italian vessel Costa Concordia wrecked on the shore of Giglio Island, about 15 km off the coast of southern Tuscany (Italy), causing the loss of 32 lives. It is considered one of the worst disasters in maritime history. Salvage operations started immediately after the wreck with the coordination of the Italian National Civil Protection Department and the technological support of several Research Centers, which were activated for the management of the consequent emergency phase. A multi-parametric and multiplatform monitoring system was promptly implemented, involving several advanced remote sensing techniques, among which was Infrared Thermography (IRT). In this framework, IRT monitoring was performed during a 35-day period (25 January–1 March 2012), using a terrestrial, hand-held thermal camera. Six different thermal images were acquired daily from the island’s coastline in three different positions, both in daylight and night times. The aim was to detect thermal anomalies connected to possible deformations of the vessel and oil spills. Between 3–4 February, IRT successfully revealed on oil spill drifting from the stern of the wreck towards the island harbor. Furthermore, the wreck’s thermal dilatation was also analyzed during a 24-day close-range monitoring, providing interesting insights for the interpretation of the deformation monitoring results. This paper presents the outcomes of these innovative and experimental monitoring activities, with the aim of testing the potential of IRT as a versatile and operative tool to be used in maritime and environmental disaster response.

Introduction: The recent report issued by the MHRA indicating an association of Sodium glucose linked transporter type 2 (SGLT2) Inhibitors with the contraction of Fournier's Gangrene (FG), has been drawn with insufficient supporting evidence and without an adequately powered study to make any meaningful assertions or recommendations. We aimed to look specifically at the currently available dataset used to link SGLT2 Inhibitors to FG and highlight what conclusions or inferences can meaningfully be made, in particular the power of any study that would be required to make sensible conclusions.Methods: World literature review of SGLT2 Inhibitors and FG was performed. With a subsequent 10-year review of cases of FG seen in a regional burns and plastics centre. Data was collected retrospectively from the coding department at Whiston Hospital for all patients with necrotising fasciitis. An electronic document management system was used to identify patients with FG specifically as well as their diabetes state and medication history.Results: Seventy-eight patients were admitted with FG, of whom 32 had diabetes mellitus (DM). Of those with DM none was taking an SGLT2 Inhibitor, 17 patients were taking metformin, a further nine patients were taking a second line medication and 14 required insulin injections.Discussions: DM is a known major risk factor for FG, which is clearly observed in our patient cohort. The risk of patients with DM developing FG is irrespective of the medication patients are taking. The current articles and reports published have little ground to claim an association between SGLT2 Inhibitors and FG and are missing the crucial message that needs to be conveyed to the public: that DM is a major risk factor for FG and patients suffering with diabetes need to be extra vigilant.

Objectives The steroid hormone vitamin D has roles in immunomodulation and bone health. Insufficiency is associated with susceptibility to respiratory infections. We report 25-hydroxy vitamin D (25(OH)D) measurements in hospitalised people with COVID-19 and influenza A and in survivors of critical illness to test the hypotheses that vitamin D insufficiency scales with illness severity and persists in survivors.Design Cross-sectional study.Setting and participants Plasma was obtained from 295 hospitalised people with COVID-19 (International Severe Acute Respiratory and emerging Infections Consortium (ISARIC)/WHO Clinical Characterization Protocol for Severe Emerging Infections UK study), 93 with influenza A (Mechanisms of Severe Acute Influenza Consortium (MOSAIC) study, during the 2009–2010 H1N1 pandemic) and 139 survivors of non-selected critical illness (prior to the COVID-19 pandemic). Total 25(OH)D was measured by liquid chromatography-tandem mass spectrometry. Free 25(OH)D was measured by ELISA in COVID-19 samples.Outcome measures Receipt of invasive mechanical ventilation (IMV) and in-hospital mortality.Results Vitamin D insufficiency (total 25(OH)D 25–50 nmol/L) and deficiency (

This paper focuses on the potential of the plantbased production in Sumbanga, a region located in Banyumas, Indonesia. A lot of villagers in Sumbang are plant growers, making Sumbang a place with great potential for plant-based production. However, villagers do not take advantage of this reality and the study higlights the main problem encountered: villagers are not aware of the potential their rural area has. The research uses action research methodology, which combines doing research, taking action and making the necessary changes after profound critical reflection on the consequences of the envisaged measures. This paper examines the potential of the area and analyses the findings of the focus group discussions with several parties (rural authorities, rural public figures, managers of the village owned companies etc.) with a view to devising the action strategy for implementing the digital marketing policy. Following the introduction of the digital marketing strategies the research also focuses on the impact social media may have on the sales of rural products.

The purpose of this paper is to explain the benefits of the educational programme for micro-investment in Indonesian rural areas. Rural communities that tend to have a low income need financial education so that people can understand the concept of investment and benefit from it. Investment at the micro level is accessible for people who have minimal investment funds. Furthermore, this paper will provide steps and benefits for micro-investment education. Finally, this research will deal with the financial side of micro-investment in agriculture. Further empirical findings are presented to demonstrate the effectiveness of this programme.

The aim of the Indonesian government in the economic field is to advance public welfare. The Program Nasional Pemberdayaan Masyarkat Mandiri (PNPM-M) or Community Empowerment National Program which covered 2007 - 2014, succeeded in reducing poverty in rural and urban areas, but still left problems unsolved including leaving revolving funds in the hands of the community, a high level of community dependence on loan funds scrolling, more than 50% of beneficiaries utilizing revolving loan funds for consumption. In an effort to realize prosperity, efforts should be made to divert the use of loan funds from consumption to productive activities. The socio-economic limitations of the poor are obstacles to productive economic activities. Social capital which is local wisdom in the community include trusts, rules (norms), and networks (networking) and can be used as a means to increase the independence and welfare of the community. The analysis used the ZMET model and obtained the construct connector to increase the economic productivity of the poor, namely: getting to know each other, helping each other, cooperating, or obeying the rules. Willingness to learn, cohesiveness, consistency, correct information or continuous activities come as natural consequences.

This research aims to identify and measure the effectiveness of business ethics courses on student Moral Reasoning. In-depth interview and a pilot test were conducted to examine the understandability of the experimental instrument. Quasi-experimental methods were conducted on students who join a business ethics course. One hundred twenty-two participants were valid from the manipulation check of pre-test and post-test. Paired T-Test was used to test the score between pre-test and post-test. Moral reasoning was measured using a defining issue test (DIT) to categorise High and Low Moral Reasoning on Participants. The result shows no difference in moral reasoning score between pre-test and post-test on a student who joins the business ethics course. This study finds that student moral reasoning does not improve by joining a business ethics course at university. These results imply that we should evaluate and re-examine the business ethics course syllabus for future research.

The population structure of Crematogaster subdentata Mayr, 1877 in the primary (native) (Uzbekistan) and secondary ranges (Crimea, Rostov-on-Don) is analyzed. The data obtained indicate an uncommon behavior for invasive ants – the formation of supercolonies in the primary range (the size of the foraging area is about 600 m2) in the urban territory. Nesting in houses and in trunks of old trees occurs both in the zone of invasion and in the primary range. The data of the distribution of the second invasive species in the same regions – Lasius neglectus Van Loon et al., 1990 are provided. Comparison of the population structure (ratio of the mono- and polycalic colonies, presence of the supercolonies and their sizes), parameters of the colonies (average number of the nests and forage trees per colony) showed the ad- vantage of Crematogaster subdentata over Lasius neglectus, which is gradually crowded out by the first species in the places of contact.

The COVID-19 pandemic has shocked the world causing more victims than the latest global epidemics such as Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) in 2003, and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in 2012. Italy has been one of the most affected countries, and it had to deal with an already weak economic condition and cuts to public health services due to budgetary requirements from the last decade—something that made the situation even more dramatic. Deaths have exceeded 600.000 worldwide. During the emergency, regulatory measures were taken to counter the situation. This study highlights the main anti-COVID-19 government measures to support doctors and healthcare professionals, and it analyzes how to respond to the many requests complaining about neglectful healthcare professionals during the spread of the infection. For all those healthcare workers who died on duty, a compensation plan is assumed through a solidarity fund. The same solution cannot be granted to all patients, given the difficulty in assessing the responsibility of the doctor not only during an emergency but with insufficient instruments to cope with it as well.