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Introduction: Caring for the dying can generate anxiety and emotional distress, particularly in nursing students, and perceived competence could play a crucial role in enabling nurses to perform their duties with greater confidence. Unfortunately, few studies describe the relationship between students’ nursing attitudes and perceived self-efficacy in palliative care (PC). To overcome this gap, this survey aimed to assess the attitudes towards dying patients and the perceived competence of nursing students in palliative care at different universities in the south of Italy. Methods: A cross-sectional study was conducted from September 2022 to March 2023 involving nursing students from the three major Sicilian universities (Italy). The study included a survey investigating socio-demographic characteristics, palliative care training, knowledge about pain management, and previous experience with dying. Moreover, the Professional Competence of the Core Curriculum in Palliative Care Nursing (CCPCN) questionnaire and the Frommelt Attitudes Toward Care of the Dying—B Italian version (FATCOD-B-I) assessed competencies and emotional attitudes. Results: A total of 1913 nursing students were recruited, of which 71.3% were females, and 53.9% were in the age range of 18 to 21 years. In the multivariable analysis, practical PC training was a substantial factor in enhancing competencies (Adj-OR 2.78 [95% CI = 2.12–3.65]). Male students had higher competence odds (Adj-OR 1.38 [95% CI = 1.14–1.66]), and perceived knowledge strongly correlated with self-assessed competence. Advancement in academic years also positively influenced competence self-assessment (Adj-OR 1.98 [95% CI = 1.75–2.24]). Regarding emotional attitudes, a per-quartile increase in competence score was found to improve the attitude score (Adj-OR 1.24 [95% CI = 1.13–1.35]). Conclusions: Nursing students gain valuable experience during clinical experience. PC training and perceived knowledge of PC significantly increase nurses’ competencies, and the latter seem to be strongly associated with attitudes. Thus, introducing palliative care education into nurses’ core curricula could be a way to reduce anxiety and emotional distress in young students.

Philosophy, Ethics and Food Technologies: ethical and theoretical issues “Man is what he eats” So wrote Ludwig Feuerbach in an essay in 1862. Reflection on what we eat and the ethical issues raised by the consumption of food has constantly run through the history of Western thought, from Plato and Aristotle to the Old Testament, Luther’s exhortations, and Nietzsche with his dietary recommendations in Ecce homo. However, food ethics, in its current form, did not emerge as an independent field of study of applied ethics until the 1990s. Often, it is Ben Mepham’s 1996 text Food Ethics that is referred to as the starting point for a structured reflection on it. There are numerous topics under analysis in Food Ethics, and they concern both the production and distribution of food as well as its consumption. Browsing through the table of contents of Mepham’s text may give us an idea: world hunger and moral dilemmas; food aid and food distribution; sustainable food systems; the use of food of animal origin; the equation between food production, nutrition and health; food safety and ethical aspects; ethical analysis of food biotechnology; cultural aspects of food biotechnology; consumer freedom as an ethical practice in the food market; ethical issues in agri-food policies and food research. Almost thirty years after the publication of that volume, many of those issues are resurfacing. Advances in science and technology, however, are also handing us new possibilities to address them: cultured meat and fish, the use of 3D printers for food production, the introduction of new foods and new procedures to make them, the widespread use of AI in agribusiness, the new fields of nutrigenomics and nutraceutics. In fact, and broadening our gaze from ethical to theoretical reflection, the use of new technologies in the food sector is part of a broader process of technologisation of the world of life (and nature) that is present in various spheres. This process is culminating in the production of biohybrid organisms, in which the natural/biological and technological/artificial elements are difficult to separate. In other words, therefore, ‘in being what he eats’, through the use of various technologies, the human being is bidding farewell to dualistic and naive approaches that see a deep divide between technology and nature – thus laying the foundations for a new philosophical anthropology. Hence the profound need to understand, analyse and philosophically examine how the use of new technologies and new modes of food production and consumption are able to shape, hybridise and ultimately change the world around us. In this sense, this Dossier aims to explore the theoretical merits and preconditions behind the use of technologies in the creation of new forms of life and sustainable food practices. In this intersection of philosophy of technology, science and analysis of life-form structures, purely theoretical questions emerge: what notion of technology underpins food production in the 21st century? What concrete practices operate within the new food technologies and how do they relate to the techniques that have always characterised food production? How is it possible, de facto and de jure, to move from the use of foods considered natural to those derived from 3D printing? In other words, what notion of nature emerges from the use of new technologies in today’s food production and printing? In this dossier, we will examine, from a multi-focal perspective, both the ethical and the historical-philosophical aspects of food, in the belief that food choices attest to important characteristics of our modus essendi and our expectations of the future of humanity.

STAT6 (signal transducer and activator of transcription 6) is a transcription factor that plays a central role in the pathophysiology of allergic inflammation. We have identified 16 patients from 10 families spanning three continents with a profound phenotype of early-life onset allergic immune dysregulation, widespread treatment-resistant atopic dermatitis, hypereosinophilia with esosinophilic gastrointestinal disease, asthma, elevated serum IgE, IgE-mediated food allergies, and anaphylaxis. The cases were either sporadic (seven kindreds) or followed an autosomal dominant inheritance pattern (three kindreds). All patients carried monoallelic rare variants in STAT6 and functional studies established their gain-of-function (GOF) phenotype with sustained STAT6 phosphorylation, increased STAT6 target gene expression, and TH2 skewing. Precision treatment with the anti-IL-4Rα antibody, dupilumab, was highly effective improving both clinical manifestations and immunological biomarkers. This study identifies heterozygous GOF variants in STAT6 as a novel autosomal dominant allergic disorder. We anticipate that our discovery of multiple kindreds with germline STAT6 GOF variants will facilitate the recognition of more affected individuals and the full definition of this new primary atopic disorder.

Non-ventilator associated hospital-acquired pneumonia (nvHAP) is a common nosocomial infection, but little is known about the outcomes of patients with nvHAP and the risk factors for adverse outcomes. In this retrospective study conducted in a Swiss tertiary care centre, adverse outcomes like in-hospital mortality, intensive care unit (ICU) admission, and mechanical ventilation, both all-cause and nvHAP-associated, were investigated. Of 244 patients with nvHAP, 72 (30%) died, 35 (14%) deaths were attributed to nvHAP. While 36 (15%) patients acquired nvHAP on the ICU, another 173 patients were eligible for ICU-transferral, and 76 (43.9%) needed ICU-admission. Of all patients hospitalized on the ICU 58 (51.8%) needed intubation due to nvHAP. Multivariable logistic regression analysis identified lower body mass index (OR per unit increase: 0.90, 95%CI: 0.82–0.98) and lower haemoglobin on admission (OR per unit in g/l increase: 0.98, 95%CI: 0.97–1.00) as patient specific factors independently associated with nvHAP-associated mortality. Given the frequency of nvHAP adverse outcomes, hospitals should evaluate increasing nvHAP prevention efforts, especially for patients at high risk for nvHAP mortality. To what extent pneumonia prevention interventions do lower nvHAP mortality in these patients is still to be evaluated.

Background: Medical students are at high risk for mental disorders, and the COVID-19 pandemic might have exacerbated psychological distress. However, no data are available for the southern part of Italy. The SMS-ME (Sicilian Medical Students’ MEntal health) project aimed to estimate the prevalence of and predictors of depression, anxiety, stress, and suicidal ideation in a sample of Sicilian medical students. Methods: A web-based cross-sectional survey was carried out from September 2022 to December 2022. The study protocol investigated sociodemographic factors and clinical data including Depression, Anxiety, Stress Scale-21 (DASS-21), and a specific question addressing suicidal ideation frequency over the last six months. Multivariate regression models were assessed to examine the association between symptoms and relevant predictors and then regressed their residuals with suicidal thought frequency. Result: We collected 1,866 records (age=22.5, SD=3.4; 65.2 % females). One out of four students presented highly severe depression (25 %) and referred to the presence of some suicidal ideation in the six months preceding the interview (26.1 %). DASS-21 scores, especially depression (F(5, 1,828)=58.8, p = 6.59–57), increasingly predicted the frequency of suicidal thoughts when above the sample's mean. Limitations: The cross-sectional study design does not allow inferences on temporal relationships and the self-report strategy could be intrinsically biased by the person's feelings at the time of the interview. Conclusions: High prevalence of anxiety and depressive symptoms and suicidal thoughts were observed among Sicilian medical students. The DASS-21 was a good predictor for suicidal ideation that Universities could use as a simple tool to assess the need for psychological healthcare in this population.

Multiple myeloma (MM) is a dreadful disease, marked by the uncontrolled proliferation of clonal plasma cells (PCs) within the bone marrow (BM). MM is characterized by a highly heterogeneous clinical and molecular background, supported by severe genomic alterations. Important deregulation of long non-coding RNAs (lncRNAs) expression has been reported in MM patients, influencing progression and therapy resistance. NEAT1 is a lncRNA essential for nuclear paraspeckles and involved in gene expression regulation. We showed that NEAT1 supports MM proliferation making this lncRNA an attractive therapeutic candidate. Here, we used a combinatorial strategy integrating transcriptomic and computational approaches with functional high-throughput drug screening, to identify compounds that synergize with NEAT1 inhibition in restraining MM cells growth. AUKA inhibitors were identified as top-scoring drugs in these analyses. We showed that the combination of NEAT1 silencing and AURKA inhibitors in MM profoundly impairs microtubule organization and mitotic spindle assembly, finally leading to cell death. Analysis of the large publicly CoMMpass dataset showed that in MM patients AURKA expression is strongly associated with reduced progression-free (p < 0.0001) and overall survival probability (p < 0.0001) and patients displaying high expression levels of both NEAT1 and AURKA have a worse clinical outcome. Finally, using RNA-sequencing data from NEAT1 knockdown (KD) MM cells, we identified the AURKA allosteric regulator TPX2 as a new NEAT1 target in MM and as a mediator of the interplay between AURKA and NEAT1, therefore providing a possible explanation of the synergistic activity observed upon their combinatorial inhibition.

Abstract Background Mitochondrial alterations, often dependent on unbalanced mitochondrial dynamics, feature in the pathobiology of human cancers, including multiple myeloma (MM). Flavanones are natural flavonoids endowed with mitochondrial targeting activities. Herein, we investigated the capability of Hesperetin (Hes) and Naringenin (Nar), two aglycones of Hesperidin and Naringin flavanone glycosides, to selectively target Drp1, a pivotal regulator of mitochondrial dynamics, prompting anti-MM activity. Methods Molecular docking analyses were performed on the crystallographic structure of Dynamin-1-like protein (Drp1), using Hes and Nar molecular structures. Cell viability and apoptosis were assessed in MM cell lines, or in co-culture systems with primary bone marrow stromal cells, using Cell Titer Glo and Annexin V-7AAD staining, respectively; clonogenicity was determined using methylcellulose colony assays. Transcriptomic analyses were carried out using the Ion AmpliSeq™ platform; mRNA and protein expression levels were determined by quantitative RT-PCR and western blotting, respectively. Mitochondrial architecture was assessed by transmission electron microscopy. Real time measurement of oxygen consumption was performed by high resolution respirometry in living cells. In vivo anti-tumor activity was evaluated in NOD-SCID mice subcutaneously engrafted with MM cells. Results Hes and Nar were found to accommodate within the GTPase binding site of Drp1, and to inhibit Drp1 expression and activity, leading to hyperfused mitochondria with reduced OXPHOS. In vitro, Hes and Nar reduced MM clonogenicity and viability, even in the presence of patient-derived bone marrow stromal cells, triggering ER stress and apoptosis. Interestingly, Hes and Nar rewired MM cell metabolism through the down-regulation of master transcriptional activators (SREBF-1, c-MYC) of lipogenesis genes. An extract of Tacle, a Citrus variety rich in Hesperidin and Naringin, was capable to recapitulate the phenotypic and molecular perturbations of each flavanone, triggering anti-MM activity in vivo. Conclusion Hes and Nar inhibit proliferation, rewire the metabolism and induce apoptosis of MM cells via antagonism of the mitochondrial fission driver Drp1. These results provide a framework for the development of natural anti-MM therapeutics targeting aberrant mitochondrial dependencies.

In La Cena delle Ceneri Giordano Bruno wrote that “the moon is no more a heaven for us than we are a heaven for the moon”, anticipating, in some ways, what would later be called the principle of mediocrity or the Copernican principle: we are not privileged observers and the Earth is by no means a special place in the cosmos. For a long time this insight, supported by the belief that life is a widespread phenomenon in the Universe, drove speculation and thus the search for intelligent life forms on other celestial bodies. However, the first images of the Martian soil already gave a bleak picture, and the same happened a few years later with Venus, only in appearance similar to Earth, in fact a burning hell surrounded by an atmosphere of carbon dioxide. The belief that we are not in a privileged position, on a special planet, has given way to new interpretative hypotheses, on the basis of which life, a fortiori intelligent life, would be a rarer phenomenon than we might have expected. Recent advances in the field of astrobiology have made it possible to detect more than 5,000 exoplanets in our galaxy, and this undoubtedly opens up new exploration pathways for the search of extra-terrestrial life as well. Many questions arise: will we be able to recognise extraterrestrial life forms once we have them in front of us, or will they be so different as to be unrecognisable? Should such a discovery occur, will we have any direct duties towards alien ecosystems and exobiospheres? Who will decide what principles should guide future interactions and what criteria should be adopted? If, on the other hand, such contact never occurs, would our cosmic importance be magnified? Would our duties toward our common home be strengthened? And again: do we have a duty to protect our planet exclusively, or should the possibility of abandoning it to colonise new celestial bodies not be excluded? This Dossier aims to shed light on these and other questions, in the wake of a reflection that is now well-established. The philosophical reflection on astrophysics and astrobiology, in its various articulations, represents a field of investigation that for some years now has been trying to provide answers on the nature and impact of new scientific achievements, in ethical, socio-political and epistemological terms. At the same time, it also opens up new questions and new challenges that need to be explored in a spirit of interchange and fruitful collaboration.

This study aimed to evaluate the impact of using an AI model, specifically ChatGPT-3.5, in remote sensing (RS) applied to archaeological research. It assessed the model’s abilities in several aspects, in accordance with a multi-level analysis of its usefulness: providing answers to both general and specific questions related to archaeological research; identifying and referencing the sources of information it uses; recommending appropriate tools based on the user’s desired outcome; assisting users in performing basic functions and processes in RS for archaeology (RSA); assisting users in carrying out complex processes for advanced RSA; and integrating with the tools and libraries commonly used in RSA. ChatGPT-3.5 was selected due to its availability as a free resource. The research also aimed to analyse the user’s prior skills, competencies, and language proficiency required to effectively utilise the model for achieving their research goals. Additionally, the study involved generating JavaScript code for interacting with the free Google Earth Engine tool as part of its research objectives. Use of these free tools, it was possible to demonstrate the impact that ChatGPT-3.5 can have when embedded in an archaeological RS flowchart on different levels. In particular, it was shown to be useful both for the theoretical part and for the generation of simple and complex processes and elaborations.

Introduction Serogroups A, B, C, W, X, and Y of Neisseria meningitidis are responsible for almost all cases of invasive meningococcal disease. In Italy, vaccination against serogroup B is recommended at 3–13 months, C at 13–15 months, and A, C, Y and W in adolescents (12–18 years). Four quadrivalent meningococcal conjugate vaccines are available. This review describes the available data on a quadrivalent meningococcal tetanus toxoid-conjugate vaccine (MenACYW-TT; MenQuadfi®; Sanofi). Areas covered We identified articles on quadrivalent meningococcal conjugate vaccines indexed on PubMed since 2000. Of the 524 studies identified, 10 human studies investigating the immunogenicity and safety of MenACYW-TT in toddlers, children aged 2–9 years, and individuals 10–55 or ≥56 years are described in detail. Expert opinion In Italy, pediatric and public health groups recommend amending the current vaccination schedule to include a booster dose between 6 and 9 years and quadrivalent vaccine in young adults (≥19 years), targeting waning protection after childhood vaccination and the age cohort with the highest carrier prevalence (adolescents and young adults). MenACYW-TT is a suitable meningococcal vaccine for current and pending recommendations based on high seroprotection rates and a low incidence of adverse events in these age groups. Moreover, it does not require reconstitution.

The cutting operation significantly affects the shelf-life of fresh-cut produce due to the mechanical damage impacting molecular, physiological, and sensory responses, depending on tissue type and tool characteristics. The degree of sharpness (DoS), defined as the force required to cut a reference body, is crucial for this process. A methodology was developed to objectively evaluate cutting damage on fresh-cut ‘Golden Delicious’ apples using three knives at four DoS levels (30, 100, 140, and 190 N) to cut 96 apples into 288 slices. The study assessed color, visual acceptance score, electrolytic leakage, and nutritional quality over 14 days at 5 °C. A two-way ANOVA showed no significant correlation between DoS and nutritional quality. However, a* values and browning index significantly increased with DoS, with values rising from 39.4 and 2.7 at 30 N to 41.4 and 3.1, respectively, at 190 N. The best visual acceptance score (4.0) and shelf-life (14 days) were at 30 N, while the worst score (2.9) and shelf-life (5 days) were at 190 N. Positive correlations were found between DoS and both browning index and a* value, with coefficients r of 0.97 and 0.93, respectively, highlighting the importance of using sharp tools for optimal post-cutting quality.