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Objective: It has recently been highlighted how a short healthy life-style program (LSP) can improve the functional outcomes of older people admitted to a Long-Term Care (LTC) facility. Although it is known that life-style medicine-based interventions can exert anti-aging effects through the modulation of oxidative stress and mitochondrial function, the mechanisms underlying the aforementioned effects have not been clarified, yet. For this reason, in this study, the outcomes were focused on the investigation of the possible mechanisms underlying the benefits of a short LSP in older people. This was achieved by examining circulating markers of oxidative stress and immunosenescence, such as Tymosin β (Tβ4), before and after LSP and the effects of plasma of older people undergone or not LSP on endothelial cells. Methods: Fifty-four older people were divided into two groups (n = 27 each): subjects undergoing LSP and subjects not undergoing LSP (control). The LSP consisted of a combination of caloric restriction, physical activity, and psychological intervention and lasted 3 months. Plasma samples were taken before (T0) and after LSP (T1) and were used to measure thiobarbituric acid reactive substances (TBARS), 8-hydroxy-2-deoxyguanosine (8OHdG), 8-Isoprostanes (IsoP), glutathione (GSH), superoxide dismutase (SOD) activity and Tβ4. In addition, plasma was used to stimulate human vascular endothelial cells (HUVEC), which were examined for cell viability, mitochondrial membrane potential, reactive oxygen species (ROS) and mitochondrial ROS (MitoROS) release. Results: At T1, in LSP group we did not detect the increase of plasma TBARS and IsoP, which was observed in control. Also, plasma levels of 8OHdG were lower in LSP group vs control. In addition, LSP group only showed an increase of plasma GSH and SOD activity. Moreover, plasma levels of Tβ4 were more preserved in LSP group. Finally, at T1, in HUVEC treated with plasma from LSP group only we found an increase of the mitochondrial membrane potential and a reduction of ROS and MitoROS release in comparison with T0. Conclusions: The results of this study showed that a short LSP in older persons exerts antiaging effects by modulating oxidative stress also at cellular levels. Implications of those findings could be related to both prognostic and therapeutic strategies, which could be pursued as antiaging methods.

IntroductionType 1 diabetes is an autoimmune disease with an significant genetic component, played mainly by the HLA class II genes. Although evidence on the role of HLA class I genes in developing type 1 diabetes and its onset have emerged, current HLA screening is limited to determining DR3 and DR4 haplotypes. This study aimed to investigate the role of HLA genes on type 1 diabetes risk and age of onset by extensive typing.MethodsThis study included 115 children and young adults with type 1 diabetes for whom typing of HLA-A, -B, -C, -DRB1, -DRB3/4/5, -DQA1, -DQB1, -DPA1 and -DPB1 genes was conducted using Next Generation Sequencing.ResultsWe observed that 13% of type 1 diabetes subjects had non-classical HLA haplotypes that predispose to diabetes. We also found that compared to type 1 diabetes subjects with classical HLA haplotypes, non-classical HLA subjects had a significantly higher frequency of HLA-B*39:06:02 (p-value=0.01) and HLA-C*07:02:01 (p-value=0.03) alleles, known to be involved in activating the immune response. Non-classical HLA subjects also presented peculiar clinical features compared to classical HLA subjects, such as multiple diabetic antibodies and the absence of other autoimmune diseases (i.e., coeliac disease and thyroiditis). We also observed that subjects with early onset had a higher frequency of DQ2/DQ8 genotype than late-onset individuals. Moreover, subjects with late-onset had a higher frequency of alleles HLA-B*27 (p-value=0.003), HLA-C*01:02:01 (p-value=0.027) and C*02:02:02 (p-value=0.01), known to be associated with increased protection against viral infections.DiscussionThis study reveals a broader involvement of the HLA locus in the development and onset of type 1 diabetes, providing insights into new possible disease prevention and management strategies.

Location awareness is vital in next generation (xG) wireless networks to enable different use cases, including location-based services (LBSs) and efficient network management. However, achieving the service level requirements specified by the 3rd Generation Partnership Project (3GPP) is challenging. This calls for new localization algorithms as well as for 3GPP-standardized scenarios to support their systematic development and testing. In this context, the availability of public datasets with 3GPP-compliant configurations is essential to advance the evolution of xG networks. This paper introduces xG-Loc, the first open dataset for localization algorithms and services fully compliant with 3GPP technical reports and specifications. xG-Loc includes received localization signals, measurements, and analytics for different network and signal configurations in indoor and outdoor scenarios with center frequencies from micro-waves in frequency range 1 (FR1) to millimeter-waves in frequency range 2 (FR2). Position estimates obtained via soft information-based localization and wireless channel quality indicators via blockage intelligence are also provided. The rich set of data provided by xG-Loc enables the characterization of localization algorithms and services under common 3GPP-standardized scenarios in xG networks.

(1) Background/Objectives: Nail psoriasis (NP) is a chronic and difficult-to-treat disease, which causes significant social stigma and impairs the patients’ quality of life. Moreover, nail psoriasis is a true therapeutic challenge for clinicians. The presence of nail psoriasis can be part of a severe form of psoriasis and can have predictive value for the development of psoriatic arthritis. Our real-world-evidence multicenter study aims to evaluate the efficacy of bimekizumab in nail psoriasis. (2) Methods: A retrospective analysis of a multicenter observational study included 834 patients affected by moderate-to-severe psoriasis, in 33 Dermatologic Units in Italy, treated with bimekizumab from December 2022 to September 2023. Clinimetric assessments were based on Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI), and Physician’s Global Assessment of Fingernail Psoriasis (PGA-F) for the severity of nail psoriasis at 0, 12, 24, and 36 weeks. (3) Results: Psoriatic nail involvement was present in 27.95% of patients. The percentage of patients who achieved a complete clearance of NP in terms of PGA-F 0 was 31.7%, 57%, and 88.5% at week 4, 16, and 36, respectively. PASI 100 was achieved by 32.03% of patients at week 4, by 61.8% at week 16, and by 78.92% of patients at week 36. The mean baseline PASI was 16.24. The mean DLQI values for the entire group of patients at baseline, at week 4, at week 16, and at week 36 were 14.62, 3.02, 0.83, and 0.5, respectively. (4) Conclusions: Therapies that promote the healing of both the skin and nails in a short time can also ensure a lower risk of subsequently developing arthritis which is disabling over time. Bimekizumab proved to be particularly effective to treat NP, with a fast response in terms of complete clearance, with over 88.5% of patients free from NP after 36 weeks. The findings of our real-world study showed that patients with moderate-to-severe PsO and concomitant NP had significantly faster and more substantial improvements in NP up to 36 weeks with respect to previous research findings. Considering the rapid healing of the nail, the dual inhibition of IL17 A and F might have a great value in re-establishing the dysregulation of keratin 17 at the nail level.

The second victim phenomenon (SVP) refers to workers negatively impacted by involvement in unanticipated adverse events or errors. While this phenomenon has been extensively studied in healthcare since its acknowledgment over 20 years ago, its presence and management in other high-risk industries have remained unclear. We conducted a scoping review aiming to map the SVP in non-healthcare industries, as well as to explore the available interventions or support programs addressed to help second victims (SVs). A total of 5818 unique records were identified and, after the screening process, 18 studies from eight sectors were included. All industries acknowledged the existence of the SVP, though many did not use a specific term for defining the SV. Similarities in psychological and emotional consequences were found across sectors. Support strategies varied, with the aviation sector implementing the most comprehensive programs. Self-care and peer support were the most reported interventions, while structured clinical support was not mentioned in any industry. Our review highlighted a lack of standardized terminology and industry-specific, evidence-based support interventions for the SVP outside of healthcare. Healthcare appears to be at the forefront of formally recognizing and addressing the SVP, despite traditionally learning from other high-reliability industries in safety practices. This presents opportunities for reciprocal learning and knowledge transfer between healthcare and other high-risk sectors.

Global warming poses a significant threat to our planet, with the food sector contributing up to 37% of total greenhouse gas emissions. This study aimed to assess the climate change impact and healthiness of menus in a long-term care facility in Italy. We analyzed two 28-day cyclical menus using the carbon footprint (CF) and the Modified EAT-Lancet Diet Score (MELDS) to evaluate adherence to the Planetary Health Diet (PHD). Monte Carlo simulations were employed to explore 20,000 daily menu permutations. Results showed that the mean GHGEs of spring/summer and autumn/winter daily menus were 2.64 and 2.82 kg of CO2eq, respectively, with 99% of menus exceeding the 2.03 kg of CO2eq benchmark. Only 22% of menus were adherent to the PHD, with MELDSs ranging from 12 to 29. A strong inverse association between the CF and adherence to the PHD was observed. These findings suggest significant potential for reducing the CFs of meals served in nursing homes while promoting adherence to a planetary diet, presenting an opportunity to set new standards in caregiving and environmental sustainability.

Recent evidence has highlighted the role of the gut–brain axis in the progression of autism spectrum disorder (ASD), with significant changes in the gut microbiome of individuals with this condition. This report investigates the effects of probiotics and human milk oligosaccharide (HMO) supplements on the gut microbiome, inflammatory cytokine profile, and clinical outcomes in an ASD adolescent with chronic gastrointestinal dysfunction and cognitive impairment. Following treatment, we observed a decrease in proinflammatory cytokines’ concentration alongside Sutterella relative abundance, a bacterium reported to be linked with gastrointestinal diseases. Also, we reported a notable increase in mood stability. The study aims to evaluate the use of gut microbiome-based therapy in selected ASD patients, highlighting its potential to improve related clinical symptoms.

Even though Family and Community Nurses (FCNs) were introduced into the Italian healthcare system in 2000, to date, there is a substantial knowledge gap regarding the implementation of these professional figures within the Primary Care (PC) system. This scoping review aims to provide a comprehensive picture of the role of FCNs in managing older adults and the elderly with chronic conditions within the Italian PC system. A search on Medline, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Embase, and Scopus was conducted including studies published until 7 April 2023. Among 141 potential articles, only 4 met our inclusion criteria. Each of these studies attributed their findings to the presence of FCNs. They reported a significant decrease in the prevalence of several behaviours among patients diagnosed with hypertension, a reduction in metabolic complications among frail patients receiving home enteral nutrition, a decline in hospital readmissions or emergency services utilization among patients >65 years of ages with at least one chronic disease, and, notably, a high level of effectiveness in detecting major cardiovascular events in patients with cardiac implantable electronic devices. Despite the effectiveness of interventions managed by FCNs, comprehensive information and research on the integration of this role within the PC setting are still lacking in the Italian healthcare system.

Abstract We present general results on generating AdS2 solutions to Type II supergravity from AdS3 solutions via U(1) and SL(2) T-dualities. We focus on a class of Type IIB solutions with small 𝒩 = 4 supersymmetry, that we show can be embedded into a more general class of solutions obtained by double analytical continuation from AdS3 geometries with small 𝒩 = (0, 4) supersymmetry constructed in the literature. We then start the analysis of the superconformal quantum mechanics dual to the 𝒩 = 4 backgrounds focusing on a subclass of AdS2 × S3 × 𝕋3 solutions foliated over a Riemann surface. We show that the associated supersymmetric quantum mechanics describes monopole bubbling in 4d 𝒩 = 2 supersymmetric gauge theories living in D3-D7 branes, as previously discussed in the literature. Therefore, we propose that our solutions provide a geometrical description via holography of monopole bubbling in 4d 𝒩 = 2 SCFTs. We check our proposal with the computation of the central charge.

Abstract Background After decades of use, methotrexate displays an established safety and efficacy profile in both in-hospital and outpatient settings. Despite its widespread use, there is surprisingly little clinical evidence to guide daily practice with methotrexate in dermatology. Objectives To provide guidance for clinicians in daily practice for areas in which there is limited guidance. Methods A Delphi consensus exercise on 23 statements was carried out on the use of methotrexate in dermatological routine settings. Results Consensus was reached on statements that cover six main areas: (1) pre-screening exams and monitoring of therapy; (2) dosing and administration in patients naïve to methotrexate; (3) optimal strategy for patients in remission; (4) use of folic acid; (5) safety; and (6) predictors of toxicity and efficacy. Specific recommendations are provided for all 23 statements. Conclusions In order to optimize methotrexate efficacy, it is essential to optimize treatment using appropriate dosages, carrying out a rapid drug-based step-up on a treat-to-target strategy and preferably using the subcutaneous formulation. To manage safety aspects appropriately, it is essential to evaluate patients’ risk factors and carry out proper monitoring during the course of treatment.

Among gynecological cancers, endometrial cancer is the most common in developed countries. Extracellular vesicles (EVs) are cell-derived membrane-surrounded vesicles that contain proteins involved in immune response and apoptosis. A deep proteomic approach can help to identify dysregulated extracellular matrix (ECM) proteins in EVs correlated to key pathways for tumor development. In this study, we used a proteomics approach correlating the two acquisitions—data-dependent acquisition (DDA) and data-independent acquisition (DIA)—on EVs from the conditioned medium of four cell lines identifying 428 ECM proteins. After protein quantification and statistical analysis, we found significant changes in the abundance (p < 0.05) of 67 proteins. Our bioinformatic analysis identified 26 pathways associated with the ECM. Western blotting analysis on 13 patients with type 1 and type 2 EC and 13 endometrial samples confirmed an altered abundance of MMP2. Our proteomics analysis identified the dysregulated ECM proteins involved in cancer growth. Our data can open the path to other studies for understanding the interaction among cancer cells and the rearrangement of the ECM.

LiDAR semantic segmentation is receiving increased attention due to its deployment in autonomous driving applications. As LiDARs come often with other sensors such as RGB cameras, multi-modal approaches for this task have been developed, which however suffer from the domain shift problem as other deep learning approaches. To address this, we propose a novel Unsupervised Domain Adaptation (UDA) technique for multi-modal LiDAR segmentation. Unlike previous works in this field, we leverage depth completion as an auxiliary task to align features extracted from 2D images across domains, and as a powerful data augmentation for LiDARs. We validate our method on three popular multi-modal UDA benchmarks and we achieve better performances than other competitors.

Quantum key distribution (QKD) can provide unconditional security to next-generation communication networks guaranteed by the laws of quantum physics. This article studies the secret key rate (SKR) of a continuous variable QKD (CV-QKD) system using multiple-input multiple-output (MIMO) transmission and operating at terahertz (THz) frequencies. Distinct from previous works, we consider a practical “restricted” eavesdropping scenario in which Eve can collect only a fraction of photons lost in the environment. We propose a system model for the MIMO THz CV-QKD system that accounts for restricted eavesdropping via a lossy wireless channel between Alice and Eve. We derive for this system new SKR expressions for both coherent-state-based and squeezed-state-based CV-QKD protocols. Our results show that previous analysis assuming unrestricted eavesdropping leads to overly pessimistic SKRs, and that in practice, the achievable SKR can be significantly increased under restricted eavesdropping. The increase in the SKR is quantified by the simplified SKR expansions derived in this article. Our results also reveal that squeezing is beneficial for improving the SKR only for unrestricted eavesdropping. However, in a practical setting with restricted eavesdropping, increased squeezing leads to a reduction in the SKR.

Mica is a naturally occurring 2D mineral that has been heavily studied in many diverse areas. Here authors present atomic force microscopy images to study the mica surface in ultra-high vacuum conditions; they unveil the distribution of its surface K+ ions and give insights into the distribution of subsurface Al3+ ions.

in_bo vol. 13 no. 17 focuses on one of its main themes of interest – the sacred – and investigates it according to the relationship between sacred architecture and design pedagogy in contemporary schools of architecture. Edited by Luigi Bartolomei and Andrea Conti, the issue draws a reflection from the sacred understood as the object of highest expression in architectural projects, to the intrinsic relationship between design pedagogy and sacred, intended as a complex of rituals that constitutes the educational practices in architecture. Authors’ contributions span from case studies of design studios to theoretical reflections, and analysis of educational and professional practices of architects and artists.

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According to many national legislations, biological agents represent an occupational hazard that must be managed in order to ensure safety at workplace. Bioaerosols have been associated to many pathological conditions but, despite many efforts, precise threshold limit values (TLV) are still undefined. We planned and conducted an environmental study concerning a typical restaurant that aimed to evaluate: (1) the occupational exposure to bacterial and fungal bioaerosol; (2) the efficacy of a photocatalytic air purifier device in mitigating such exposure. This observational study evaluated two dining rooms (Area 1 and Area 2) of a restaurant which can be considered typical during two consecutive weeks. Based on a national protocol, we monitored total bacterial and mycotic loads searching for two typologies of bacteria, psychrophilic bacteria (environmental contamination) along with mesophilic bacteria (human or animal origin source), and two types of fungi, mold and yeast. Baseline total bacterial load was 346.8 CFU/m3 for Area 1 and 412.9 CFU/m3 for Area 2. When the sanitizing device was operative, the total bacterial load decreased to 202.7 CFU/m3 (−41.50%—p value: 3 (−17.10%—p value: 0.06) for Area 2. Considering the fungal load, the mean baseline value was 189.7 CFU/m3 for Area 1 and 141.1 CFU/m3 for Area 2. When the device was kept on, the total fungal load was 108.0 CFU/m3 (−43.10%—p value: 0.055) for Area 1 and 205.0 CFU/m3 (+45.30%—p value: 0.268) for Area 2. Our findings supported the conclusion that, concerning the occupational risk derived from biological agents, a typical restaurant should be considered relatively safe. In order to mitigate or limit any possible increase of such risk, a photocatalytic device may be helpful, but not against the pollution caused by mold or yeasts. Our research also reaffirmed the need of further research assessing the kind of relationship between diseases and exposure levels, before considering the need of setting precise threshold limit values.

Verifica dei poteri is Franco Fortini’s most important collection of essays, as well as a pivotal book for the political, ideological and literary reflection carried out by the poet in the 1960s. Following the keywords of poetic «form» and literary «value», their meaning and the way they are declined from the oldest to the newest essay, this paper analyses the structure of the two editions of the book. Besides, comparing the essays to the contemporary poetic collections (Una volta per sempre, 1963; Questo muro, 1973), it aims to enlighten the formal and content link between Fortini’s poetry and his essay writing.

Non-traumatic hepatic hernia is defined as hepatic protrusion through acquired or congenital defects on diaphragm without prior trauma. This event is rare among adults and infrequently reported in literature. 52-year-old Caucasian woman with surgically treated breast cancer with suspected lung metastasis detected during a routine Multidetector Computed Tomography lung exam. Ultrasound and subsequently Magnetic Resonance Imaging (MRI) was performed which revealed an overdiaphragmatic mass in contiguity with liver parenchyma compatible with overdiaphragmatic hepatic hernia. Differential diagnosis should be made with diaphragmatic or pulmonary nodule. Correct diagnosis can avoid further diagnostic investigations or invasive procedures such as biopsy. Magnetic Resonance Imaging is a non-risky method and can clarify interpretative doubts. Currently there are still controversies about traumatic or idiopathic nature of this hernia.

Abstract Background Psoriasis is a chronic immune-mediated inflammatory skin disease which can also involve joints. It is often associated with burdensome comorbidities which negatively impact prognosis and quality of life (QoL). Biologic agents have been shown to be effective in controlling disease progression, but their use is associated with higher costs compared with traditional systemic treatments. The economic analysis of the CANOVA (EffeCtiveness of biologic treAtmeNts for plaque psOriasis in Italy: an obserVAtional longitudinal study of real-life clinical practice) study aims to assess the costs and cost-effectiveness of biologics in a real-world context in Italy. Methods The annualised overall direct costs of moderate-to-severe plaque psoriasis management, the annualised cost of biologic drugs and the cost per responder in the Italian National Health System perspective were assessed. More specifically, the cost per response and cost per sustained response of the most prescribed biologic therapies for the treatment of moderate-to-severe plaque psoriasis within the CANOVA study were assessed using the Psoriasis Area Severity Index (PASI) at several score levels (75, 90 and 100%). Results The most frequently used biologic therapies for plaque psoriasis were secukinumab, ustekinumab, adalimumab originator, and ixekizumab. Cost of biologics was the driver of expenditure, accounting for about 98% of total costs. Adalimumab originator was the biologic with the lowest cost per responder ratio (range: €7848 - €31,378), followed by secukinumab (range: €9015 - €33,419). Ustekinumab (range: €11,689 – €39,280) and ixekizumab (range: €11,092 – €34,289) ranked respectively third and fourth, in terms of cost-effectiveness ratio. As concerns the cost per sustained response analysis, secukinumab showed the lowest value observed (€21,375) over the other options, because of its high response rate (86% vs. 60–80%), which was achieved early in time. Conclusion Biologic therapy is a valuable asset for the treatment of moderate-to-severe plaque psoriasis. Concomitant assessment of treatment costs against the expected therapeutic response over time can provide physicians and payers additional insights which can complement the traditional risk-benefit profile assessment and drive treatment decisions.

The HNF1A transcription factor, implicated in the regulation of pancreatic beta cells, as well as in glucose and lipid metabolism, is responsible for type 3 maturity-onset diabetes of the young (MODY3). HNF1A is also involved in increased susceptibility to polygenic forms of diabetes, such as type 2 diabetes (T2D) and gestational diabetes (GD), while its possible role in type 1 diabetes (T1D) is not known. In this study, 277 children and adolescents with T1D and 140 healthy controls were recruited. The following SNPs in HNF1A gene were selected: rs1169286, rs1169288, rs7979478, and rs2259816. Through linear or logistic regression analysis, we analyzed their association with T1D susceptibility and related clinical traits, such as insulin dose-adjusted glycated hemoglobin A1c (IDAA1c) and glycated hemoglobin (HbA1c). We found that rs1169286 was associated with IDAA1c and HbA1c values (p-value = 0.0027 and p-value = 0.0075, respectively), while rs1169288 was associated with IDAA1c (p-value = 0.0081). No association between HNF1A SNPs and T1D development emerged. In conclusion, our findings suggest for the first time that HNF1A variants may be a risk factor for beta cell function and glycaemic control in T1D individuals.

Median arcuate ligament syndrome and superior mesenteric artery syndrome are well-known abdominal compression syndromes, the coexistence of which is rarely described in literature. In addition, due to the common pathogenesis, anterior nutcracker syndrome may occur simultaneously to superior mesenteric artery syndrome.To our knowledge, this is the first case reporting combination of these 3 syndromes detected with ultrasound, Computed Tomography and upper gastrointestinal fluoroscopic exam.A 69-year-old man came to our attention for rapid weight loss, postprandial epigastric pain and recurrent vomiting for at least 6 months. Doppler ultrasound showed both celiac artery and left renal vein stenosis with simultaneous left varicocele. Computed tomography showed a reduction of aortomesenteric space causing both left renal vein and duodenal stenosis, this latter confirmed by upper gastrointestinal fluoroscopic exam. The diagnosis of these three vascular compression syndromes (MALS, SMAS, and anterior NCS) has been formulated, based on clinical and imaging findings.We assumed that the postprandial crises caused by median arcuate ligament syndrome may induce a reduction of meals consumption and progressive weight loss which can be a cause of anterior nutcracker syndrome and superior mesenteric artery syndrome onset.Doppler ultrasound, in expert hands, allows to accurately diagnosing these syndromes which are often underestimated. Failure to recognize it and inadequate treatment could have serious consequences for patients' health.

Abstract Background Posterior nutcracker syndrome is defined by the compression of the left renal vein between the abdominal aorta and a lumbar vertebral body. It can be clinically manifest with intermittent hematuria, gonadal or spermatic reflux resulting in varicocele. Ultrasound is the first-line imaging which require more accurate study with contrast-enhanced computed tomography. Management can be conservative in younger patients with mild hematuria due to the high spontaneous remission rate and invasive with open surgical and endovascular interventions. We describe a very rare case with compression of the left renal vein due to an osteophyte of the spine. Case presentation A 62-year-old Caucasic male came to our radiology department for chronic hepatitis B virus (HBV)-related liver disease follow-up and mild scrotal pain. The ultrasound examination revealed a compression of the left retro-aortic renal vein in the aorto-vertebral space caused by an osteophyte. Duplex Doppler ultrasound revealed flow congestion in the left renal vein and renal failure; power Doppler ultrasound showed left varicocele. Conclusions Doppler ultrasound is the first-line imaging and allows the detection of all the typical signs of posterior nutcracker: left renal vein stenosis, flow congestion and renal failure. Nutcracker syndrome should be suspected in older patients with left varicocele associated with hematuria. Failure to diagnose and treat these patients could have serious consequences for their health.

Abstract Vascular compression syndromes are rare alterations that have in common the compression of an arterial and/or venous vessel by contiguous structures and can be congenital or acquired. The best known are the Thoracic Outlet Syndrome, Nutcracker Syndrome, May–Thurner Syndrome, and Dunbar Syndrome. The incidence of these pathologies is certainly underestimated due to the non-specific clinical signs and their frequent asymptomaticity. Being a first-level method, Ultrasound plays a very important role in identifying these alterations, almost always allowing a complete diagnostic classification. If in expert hands, this method can significantly contribute to the reduction of false negatives, especially in the asymptomatic population, where the finding of the aforementioned pathologies often happens randomly following routine checks. In this review, we briefly discuss the best known vascular changes, the corresponding ultrasound anatomy, and typical ultrasound patterns.

Professional education programs in environmental design disciplines aim to create ready-to-work designers to introduce in the world of practice. Studio courses are the places where students learn how to perform the professional tasks of design. Education in the studios has a practice-oriented focus, and students usually engage forms of experiential learning, focusing on the performance of final products rather than reflecting on the process. Forms of reflection on the design process do not seem to be part of the tradition of such courses. Students are not taught to do that, so this is also why they find difficult to convey what is in their mind when they are designing. The purpose of this talk is to start a discussion about the type of education instructors offer in design studio courses. In the text, I presents a qualitative research process where I have observed a course class in the Master program of Landscape Architecture at the Swedish University of Agricultural Sciences in Uppsala. Students’ voices captured during the final workshop in this course show how they reflect on their design process and how they perceive their design experience.

Over the last decades, different quadrivalent antimeningococcal vaccine formulations (diphteria toxoid conjugate, MenACWY-D; tetanus toxoid conjugate, MenACWY-TT; CRM197 protein conjugate, MenACWY-CRM) have been developed. However, their availability varies, both in terms of authorized formulations and of inclusion in vaccination schedules. Furthermore, several countries include only the monovalent meningococcal C (MenC) vaccine in their immunization programmes. Finally, there is currently no updated systematic review that directly compares the MenACWY formulations. Thus, we summarized the evidence on efficacy and safety through four parallel, independent systematic literature reviews with meta-analysis which included randomized controlled trials comparing the abovementioned vaccines. A total of 16 studies have been included. In terms of efficacy, MenACWY-TT outperformed MenACWY-D and MenACWY-CRM for A, W-135, and Y serogroups, while no significant difference was found for serogroup C. Furthermore, we did not find significant differences in efficacy between MenC and MenACWY-TT. Regarding the safety, we were able to perform a quantitative analysis only between MenACWY-TT and MenC, finding no significant differences. Similarly, among the different MenACWY formulations no relevant differences were identified. These findings suggest that MenACWY-TT could be preferable to other formulations to improve current vaccination programs and to better develop future immunization policies.

Secukinumab, a fully human monoclonal antibody, neutralizes interleukin-17A, a cornerstone cytokine driving the multiple manifestations of psoriasis. This post-hoc analysis of the SUPREME study was performed to determine the sustainability of response to secukinumab in terms of Psoriasis Area and Severity Index (PASI) 90 in patients with moderate-to-severe plaque psoriasis. Based on PASI 90 response at week 16, patients were stratified as PASI 90 responders (PASI90R, n = 337) or non-responders (PASI90NR, n = 72). At week 20, 94.2% (n = 295/313) achieved PASI 90/100 response in PASI90R, with response maintained through week 48 (89.6%, n = 189/211). An increased proportion of patients achieved PASI 90/100 response in PASI90NR (week 20: 29.9%, n = 20/67; week 48: 57.1%, n = 20/35). Overall, 64.4% patients achieved absolute PASI score = 0 at week 24 with response sustained to week 48 (66.9%). Secukinumab showed sustained and stable efficacy in maintaining PASI 90 response in patients with moderate-to-severe plaque psoriasis up to week 48.

Objective: We aimed to determine safety and feasibility of thulium laser transurethral vapoenucleation of prostate (ThuVEP) for treatment of obese patients affected by benign prostatic hyperplasia (BPH). Methods: We retrospectively analysed data of 452 patients with BPH who underwent ThuVEP from February 2012 to March 2016 in a single center. Patients were divided into three groups according to body mass index (BMI, kg/m2): Normal weight (18.5 ≤ BMI 0.05). There was no statistically significant difference among three groups as for hospital stay and days of catheterization (p > 0.05). Conclusion: Our results showed that ThuVEP was safe and feasible even in overweight patients with substantially enlarged prostate. Keywords: Laser, Thulium, Prostate, Overweight

This study evaluated whether secukinumab treatment for patients with moderate to severe plaque psoriasis correlates with improvements in symptoms of anxiety and depression. SUPREME was a 24-week, phase IIIb, multicentre, prospective study conducted across 50 centres in Italy with an extension period of up to 72 weeks. Assessments used were: Psoriasis Area Sever­ity Index (PASI), Hospital Anxiety and Depression Scale (HADS) – Anxiety (HADS-A), and HADS – Depression (HADS-D) scores and Dermatology Quality Life Index (DLQI). Compared with baseline, a significantly greater proportion of patients who reported moderate to severe clinical symptoms of anxiety or depression (HADS-A or HADS-D ≥ 11) were free of moderate to severe symptoms at weeks 16 and 48. The PASI and DLQI scores reduced over time with secukinumab treatment. Psoriasis treatment with secukinumab for 48 weeks resulted in significantly improved skin clearance and a parallel improvement in symptoms of anxiety and depression, assessed by HADS.

Background Inflammatory bowel diseases are associated with remodeling of neuronal circuitries within the enteric nervous system, occurring also at sites distant from the acute site of inflammation and underlying disturbed intestinal functions. Homeoproteins orthodenticle OTX1 and OTX2 are neuronal transcription factors participating to adaptation during inflammation and underlying tumor growth both in the central nervous system and in the periphery. In this study, we evaluated OTX1 and OTX2 expression in the rat small intestine and distal colon myenteric plexus after intrarectal dinitro-benzene sulfonic (DNBS) acid-induced colitis. Methods OTX1 and OTX2 distribution was immunohistochemically investigated in longitudinal muscle myenteric plexus (LMMP)-whole mount preparations. mRNAs and protein levels of both OTX1 and OTX2 were evaluated by qRT-PCR and Western blotting in LMMPs. Results DNBS-treatment induced major gross morphology and histological alterations in the distal colon, while the number of myenteric neurons was significantly reduced both in the small intestine and colon. mRNA levels of the inflammatory markers, TNFα, pro-IL1β, IL6, HIF1α and VEGFα and myeloperoxidase activity raised in both regions. In both small intestine and colon, an anti-OTX1 antibody labeled a small percentage of myenteric neurons, and prevalently enteric glial cells, as evidenced by co-staining with the glial marker S100β. OTX2 immunoreactivity was present only in myenteric neurons and was highly co-localized with neuronal nitric oxide synthase. Both in the small intestine and distal colon, the number of OTX1- and OTX2-immunoreactive myenteric neurons significantly increased after DNBS treatment. In these conditions, OTX1 immunostaining was highly superimposable with inducible nitric oxide synthase in both regions. OTX1 and OTX2 mRNA and protein levels significantly enhanced in LMMP preparations of both regions after DNBS treatment. Conclusions These data suggest that colitis up-regulates OTX1 and OTX2 in myenteric plexus both on site and distantly from the injury, potentially participating to inflammatory-related myenteric ganglia remodeling processes involving nitrergic transmission.

BACKGROUND:Knowledge regarding differences in care for psoriatic patients is limited. The aim of this study was to investigate factors influencing prescription of systemic treatments for patients with psoriasis with a special focus on socioeconomic factors. METHODS AND FINDINGS:This was a non-interventional, cross-sectional study, conducted in 18 Italian University and/or hospital centers with psoriasis-specialized units. Questionnaires evaluating demographic and socioeconomic characteristics were administered to participants. Overall, 1880 consecutive patients affected by mild-to-severe psoriasis were recruited. Univariate and multivariable logistic regression analyses of systemic therapy prescription, with a special focus on biologics, accounting for the above mentioned characteristics were performed. Our analysis showed that all analyzed patients' characteristics were significantly associated with biological therapy compared to non-biological systemic one. Particularly, women were less likely to receive biologics than men (OR = 0.66; 95% CI, 0.57-0.77). Elderly patients (≥65 years) and subjects with a BMI ≥30 had lower odds to receive biologics respect to adults (≥35-64 years) (OR = 0.33; 95% CI, 0.25-0.40), and subjects with BMI≥25

Introduction. Metastatic bone disease represents a systemic pathology that heavily affects the quality of life of oncologic patients causing pain and functional disability. Methodology. We present the case of a patient with a history of renal cell cancer presenting pathologic fractures of both humeri and proximal right radius. Results. After a careful multidisciplinary approach, an adjuvant anticancer therapy and a photodynamic bone stabilization procedure were performed with a minimally invasive technique aiming to minimize pain and local disease progression, while restoring functional autonomy and improving the patient’s quality of life. Electrochemotherapy was delivered on the lytic bone lesions with extraskeletal involvement of the proximal left humerus and the proximal right radius, and then polymeric bone stabilization was performed on both humeri. At two months of follow-up, the patient presented satisfactory functional scores (MSTS score: 12/30 bilaterally; DASH scores: 46.7/100 for the right side and 48.3/100 for the left one), and pain was well controlled with opioid analgesics. Radiographs showed good results in terms of ossification of lytic bone lesions and durability of polymeric stabilization. At four months of follow-up, the patient reported a stable clinical scenario. Six months after surgery, due to extremely poor prognosis after the progression of primary disease, the patient was referred to palliative care and died shortly thereafter. Conclusion. Over the last decade, the management of metastatic bone disease has changed. Low-toxicity and minimally invasive procedures such as electrochemotherapy and polymeric bone stabilization might be performed concomitantly in selected patients, as an alternative to radiation therapy and to more demanding surgical procedures such as plating and adjuvant cementing.

As reported in the recent image velocimetry literature, tracking the motion of sparse feature points floating on the river surface as done by the Optical Tracking Velocimetry (OTV) algorithm is a promising strategy to address surface flow monitoring. Moreover, the lightweight nature of OTV coupled with computational optimizations makes it suited even for its deployment in situ to perform measurements at the edge with cheap embedded devices without the need to perform offload processing. Despite these notable achievements, the actual practical deployment of OTV in remote environments would require cheap and self-powered systems enabling continuous measurements without the need for cumbersome and expensive infrastructures rarely found in situ. Purposely, in this paper, we propose an additional simplification to the OTV algorithm to reduce even further its computational requirements, and we analyze self-powered off-the-shelf setups for in situ deployment. We assess the performance of such set-ups from different perspectives to determine the optimal solution to design a cost-effective self-powered measurement node.

After metamorphosis, fire salamander is considered fully terrestrial, usually inhabiting wooded areas around aquatic habitats. It is often reported that only females go back to water for laying the larvae. The aim of this study is to assess if sites where males are active during the breeding seasons have specific features among microhabitat determinants and distance from the breeding sites. In the autumns of 2013 and 2014, we surveyed 26 transects and 72 plots around six isolated breeding sites in North-Western Italy. During rainy nights, we recorded males position and distance from breeding pools, while during daytime we characterized the environmental features of the plots. Males detection probability was relatively high (mean ± SE: 81.0 ± 4.3%). Several males (15% of the observations) were encountered inside breeding pools where females were laying larvae. Males occurrence was positively related to plots closer to breeding pools and higher leaf litter depth. Larger males were found closer to the breeding pools. This case study shows that the distribution of fire salamander males during the breeding season depends on the breeding sites.

OTX Homeobox genes are involved in embryonic morphogenesis and in the development of olfactory epithelium in adult. Mutations occurring in the OTX genes are reported to be associated to tumorigenisis in human. No reports correlate the expression of OTX genes and neoplasms of the nasal cavity. Thus, through immunohistochemical and Real-time PCR analysis we investigated OTX1 and OTX2 expression in the more frequent types of nasal and sinonasal tumours. Variable expression of both genes were found in normal sinonasal mucosa and in tumours. Interestingly, no expression of both OTX genes were detected in sinonasal intestinal-type adenocarcinomas; only OTX1 was found in non-intestinal-type adenocarcinomas and OTX2 was selectively expressed in olfactory neuroblastomas. In conclusion, OTX1 and OTX2 genes might have a role in the pathogenesis of different types of sinonasal neoplasms.

Wireless sensor networks (WSNs) enable new applications and require non-conventional paradigms for protocol design due to several constraints. Owing to the requirement for low device complexity together with low energy consumption (i.e., long network lifetime), a proper balance between communication and signal/data processing capabilities must be found. This motivates a huge effort in research activities, standardization process, and industrial investments on this field since the last decade. This survey paper aims at reporting an overview of WSNs technologies, main applications and standards, features in WSNs design, and evolutions. In particular, some peculiar applications, such as those based on environmental monitoring, are discussed and design strategies highlighted; a case study based on a real implementation is also reported. Trends and possible evolutions are traced. Emphasis is given to the IEEE 802.15.4 technology, which enables many applications of WSNs. Some example of performance characteristics of 802.15.4-based networks are shown and discussed as a function of the size of the WSN and the data type to be exchanged among nodes.

We address the problem of construction of space-time codes for cooperative communications in block fading channels. More precisely, we consider a pragmatic approach based on the concatenation of convolutional codes and BPSK/QPSK modulation to obtain cooperative codes for relay networks, for which we derive the pairwise error probability, an asymptotic bound for frame error probability, and a design criterion to optimize both diversity and coding gain. Based on this framework, we set up a code search procedure to obtain a set of good pragmatic space-time codes (P-STCs) with overlay construction, suitable for cooperative communication with a variable number of relays in quasistatic channel, which outperform in terms of coding gain other space-time codes (STCs) proposed in the literature. We also find that, despite the fact that the implementation of pragmatic space-time codes requires standard convolutional encoders and Viterbi decoders with suitable generators and branch metric, thus having low complexity, they perform quite well in block fading channels, including quasistatic channel, even with a low number of states and relays.

Positioning systems based on ultrawide bandwidth (UWB) technology have been considered recently especially for indoor environments due to the property of UWB signals to resolve multipath and penetrate obstacles. However, line-of-sight (LoS) blockage and excess propagation delay affect ranging measurements thus drastically reducing the positioning accuracy. In this paper, we first characterize and derive models for the range estimation error and the excess delay based on measured data from real-ranging devices. These models are used in various multilateration algorithms to determine the position of the target. From measurements in a real indoor scenario, we investigate how the localization accuracy is affected by the number of beacons and by the availability of priori information about the environment and network geometry. We also examine the case where multiple targets cooperate by measuring ranges not only from the beacons but also from each other. An iterative multilateration algorithm that incorporates information gathered through cooperation is then proposed with the purpose of improving the position estimation accuracy. Using numerical results, we demonstrate the impact of cooperation on the positioning accuracy.

This paper investigates the impact of several equalization techniques for multicarrier code division multiple access systems on the performance at both lower and upper layers (i.e., physical and TCP layers). Classical techniques such as maximal ratio combining, equal gain combining, orthogonality restoring combining, minimum mean square error, as well as a partial equalization (PE) are investigated in time- and frequency-correlated fading channels with various numbers of interferers. Their impact on the performance at upper level is then studied. The results are obtained through an integrated simulation platform carefully reproducing all main aspects affecting the quality of service perceived by the final user, allowing an investigation of the real gain produced by signal processing techniques at TCP level.