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This article examines the life, theological career, exegetical development, and posthumous biographies of Johannes Oecolampadius as illustrative examples of the fact that the Swiss Reformation, with all its religious movements, was far from a uniform concept in terms of its origins, purposes, and methodologies. The article explains through Oecolampadius’s example an approach to reform that was ‘in progress’, traversing the nexuses of disparate methods and exegetical priorities. Oecolampadius’s experience occupied a position at the intersection between the authority of Patristics and the principle of sola scriptura, exemplifying a balance between the past and the present of Christian tradition. The path that led Oecolampadius to become a Protestant Reformer is characterised by a gradual transition, not abrupt, not radical. His example demonstrates the methodological and ideological diversity of the Reformation, which can be observed through the prism of a single life and its intellectual periods. His conversion offers insight into how these varied approaches shaped personal engagements with Scripture, and challenges the notion of an immediate or singular evangelical ‘calling’ or ‘conviction’. This article examines a specific phase within the broader and varied trajectory of the Swiss Reformation by analysing the transformation of Oecolampadius from a biblical scholar to a preacher, and eventually to a Reformer. This case study illustrates how disparate methodologies, whether rooted in humanism or Patristics, contributed to gradual and personal evolution, ultimately giving rise to distinctive individual stances on reform. This article presents a synthesis of three distinct perspectives on the question. The first part approaches the question through the lens of church history and intellectual history; the second one utilises the history of exegesis and New Testament scholarship; and the third draws upon the perspectives of Protestant historiography, from the standpoint of social history and the history of biographies in Early Modern times.

Obiettivo La frequenza di segnalazione di atti violenti in ambito sanitario rappresenta il principale parametro per la Valutazione del Rischio (VdR) di subire aggressioni fisiche e/o verbali a danno degli operatori sanitari. Questo studio ha voluto indagare il fenomeno delle aggressioni in sanità, identificando una metodologia di valutazione multidimensionale per stimare e classificare il rischio anche in assenza di segnalazioni spontanee, operando quindi in fase di prevenzione. Materiali e metodi Inizialmente è stata condotta una revisione della letteratura già esistente per identificare i Fattori di Rischio (FdR) e le Misure di Prevenzione e Protezione (MPP); successivamente sono stati analizzati tali dati che hanno portato all’elaborazione di un algoritmo. Quest’ultimo è stato poi somministrato durante le VdR ad un totale di 32 unità operative appartenenti all’Azienda ULSS 4 "Veneto Orientale". Risultati l’attuazione di MPP ha abbassato il rischio espositivo iniziale in 22 delle 32 sedi valutate (68,7%). Le strutture a maggior rischio risultano essere quelle che applicano minori MPP in presenza di elevati FdR. Pronto Soccorso (PS), Servizio per le Dipendenze (SerD) e reparti di Medicina, considerati a maggior rischio dalla letteratura [5] [6] [15] [16], sono invece le unità operative che meglio conoscono il fenomeno e adottano di conseguenza maggiori MPP per contenerlo. La dimensione “paziente” è quella che pesa di più sulla determinazione dell’indice di rischio IR (35%). Discussione L’utilizzo di un algoritmo che mette in relazione FdR e MPP permette di identificare la composizione del rischio aggressioni in termini quantitativi e qualitativi. In questo modo la VdR risulta più completa, in quanto le sedi non sono valutate solamente attraverso i FdR [13] [14], ma anche pesando le MPP attuate per fronteggiare il fenomeno. Questo costituisce una novità nel campo della prevenzione. Conclusioni L'approccio utilizzato ha permesso di affermare che il rischio di aggressioni è multidimensionale ed è generato dalla complessa interazione di più fattori raggruppati nelle diverse dimensioni. Conoscere il rischio aiuta a prevenirlo e l’attuazione di idonee MPP, pur in presenza di elevati FdR, ne abbassa le potenzialità di danno.

Gastrojejunostomy is the principal method of palliation for unresectable malignant gastric outlet obstructions (GOO). Gastrojejunostomy was traditionally performed as a surgical procedure with an open approach butrecently, notable progress in the development of minimally invasive procedures such as laparoscopic gastrojejunostomies have emerged. Additionally, advancements in endoscopic techniques, including endoscopic stenting (ES) and endoscopic ultrasound-guided gastroenterostomy (EUS-GE), are becoming more prominent. ES involves the placement of self-expandable metal stents (SEMS) to restore luminal patency. ES is commonly the first choice for patients deemed unfit for surgery or at high surgical risk. However, although ES leads to rapid improvement of symptoms, it carries limitations like higher stent dysfunction rates and the need for frequent re-interventions. Recently, EUS-GE has emerged as a potential alternative, combining the minimally invasive nature of the endoscopic approach with the long-lasting effects of a gastrojejunostomy. Having reviewed the advantages and disadvantages of these different techniques, this article aims to provide a comprehensive review regarding the management of unresectable malignant GOO.

In this work, the mechanical behaviour of cancellous bone tissues used for the manufacturing of commercial heterologous bone grafts was investigated both at small and at large strains. Three different tissues were examined. They were obtained from equine bones after a specific proprietary enzymatic-based treatment aimed at achieving perfect biocompatibility while preserving the collagenous part. Two tissues had the mineral content of the bones of origin (femur, humerus), whereas the third was markedly demineralized (femur). The response at small strains and at failure was studied by means of monotonic compression tests in quasi-static conditions. Stiffness and strength turned out to be governed by the apparent density of the tissue, with specimen size and geometry, and tissue macro-structural characteristics, only playing a secondary role. A ductile- and a brittle-like failure was exhibited by the demineralized tissue and the non-demineralized ones, respectively. The large deformation behaviour was studied by means of cyclic compression tests, which clearly highlighted the occurrence of plasticity (for strains higher than ≈1.9%), and allowed to study the strain accumulation processes, at the macromechanical level. More in-depth microstructural analyses were carried out on the demineralized tissue. Flexural tests were also performed.

This review article provides a comprehensive overview of the evolving techniques in image-enhanced endoscopy (IEE) for the characterization of colorectal polyps, and the potential of artificial intelligence (AI) in revolutionizing the diagnostic accuracy of endoscopy. We discuss the historical use of dye-spray and virtual chromoendoscopy for the characterization of colorectal polyps, which are now being replaced with more advanced technologies. Specifically, we focus on the application of AI to create a “virtual biopsy” for the detection and characterization of colorectal polyps, with potential for replacing histopathological diagnosis. The incorporation of AI has the potential to provide an evolutionary learning system that aids in the diagnosis and management of patients with the best possible outcomes. A detailed analysis of the literature supporting AI-assisted diagnostic techniques for the detection and characterization of colorectal polyps, with a particular emphasis on AI’s characterization mechanism, is provided. The benefits of AI over traditional IEE techniques, including the reduction in human error in diagnosis, and its potential to provide an accurate diagnosis with similar accuracy to the gold standard are presented. However, the need for large-scale testing of AI in clinical practice and the importance of integrating patient data into the diagnostic process are acknowledged. In conclusion, the constant evolution of IEE technology and the potential for AI to revolutionize the field of endoscopy in the future are presented.

Endoscopic retrograde cholangiopancreatography (ERCP) is considered the preferred method for managing biliary obstructions. However, the prevalence of surgically modified anatomies often poses challenges, making the standard side-viewing duodenoscope unable to reach the papilla in most cases. The increasing instances of surgically altered anatomies (SAAs) result from higher rates of bariatric procedures and surgical interventions for pancreatic malignancies. Conventional ERCP with a side-viewing endoscope remains effective when there is continuity between the stomach and duodenum. Nonetheless, percutaneous transhepatic biliary drainage (PTBD) or surgery has historically been used as an alternative for biliary drainage in malignant or benign conditions. The evolving landscape has seen various endoscopic approaches tailored to anatomical variations. Innovative methodologies such as cap-assisted forward-viewing endoscopy and enteroscopy have enabled the performance of ERCP. Despite their utilization, procedural complexities, prolonged durations, and accessibility challenges have emerged. As a result, there is a growing interest in novel enteroscopy and endoscopic ultrasound (EUS) techniques to ensure the overall success of endoscopic biliary drainage. Notably, EUS has revolutionized this domain, particularly through several techniques detailed in the review. The rendezvous approach has been pivotal in this field. The antegrade approach, involving biliary tree puncturing, allows for the validation and treatment of strictures in an antegrade fashion. The EUS-transmural approach involves connecting a tract of the biliary system with the GI tract lumen. Moreover, the EUS-directed transgastric ERCP (EDGE) procedure, combining EUS and ERCP, presents a promising solution after gastric bypass. These advancements hold promise for expanding the horizons of comprehensive and successful biliary drainage interventions, laying the groundwork for further advancements in endoscopic procedures.

Concerning energy improvement of existing façades, a favourable system involves prefabricated multilayer panels, made of internal insulation core and outer textile reinforced concrete layers. It is a convincing alternative to external thermal insulation composite systems (ETICS) and ventilated façades, and it meets all the requirements for façade systems. The main advantage is the possibility to apply the panel using a crane, without any scaffolding. The paper considers two solutions: the former uses expanded polystyrene (EPS) as insulating material; the latter substitutes EPS with an innovative green insulation material made of inorganic diatomite. The paper aims at comparing the solutions in terms of mechanical properties of the components and behaviour of the composite sandwich at lab-scale level. Numerical models, previously calibrated, will be instrumental for the discussion.

Ampullary neoplastic lesions (ANLs) represent a rare cancer, accounting for about 0.6–0.8% of all gastrointestinal malignancies, and about 6–17% of periampullary tumors. They can be sporadic or occur in the setting of a hereditary predisposition syndrome, mainly familial adenomatous polyposis (FAP). Usually, noninvasive ANLs are asymptomatic and detected accidentally during esophagogastroduodenoscopy (EGD). When symptomatic, ANLs can manifest differently with jaundice, pain, pancreatitis, cholangitis, and melaena. Endoscopy with a side-viewing duodenoscopy, endoscopic ultrasound (EUS), and magnetic resonance cholangiopancreatography (MRCP) play a crucial role in the ANL evaluation, providing an accurate assessment of the size, location, and characteristics of the lesions, including the staging of the depth of tumor invasion into the surrounding tissues and the involvement of local lymph nodes. Endoscopic papillectomy (EP) has been recognized as an effective treatment for ANLs in selected patients, providing an alternative to traditional surgical methods. Originally, EP was recommended for benign lesions and patients unfit for surgery. However, advancements in endoscopic techniques have broadened its indications to comprise early ampullary carcinoma, giant laterally spreading lesions, and ANLs with intraductal extension. In this paper, we review the existing evidence on endoscopic diagnosis and treatment of ampullary neoplastic lesions.

This narrative review provides an overview of the application of endoscopic ultrasound-guided biliary drainage (EUS-BD), including EUS-guided gallbladder drainage (EUS-GBD), for the treatment of malignant biliary obstruction. EUS-BD has demonstrated excellent technical and clinical success rates, with lower rates of adverse events when compared with percutaneous trans-hepatic biliary drainage (PTBD). EUS-BD is currently the preferred alternative technique for biliary drainage (BD) in patients with distal malignant biliary obstruction (DMBO) after failed endoscopic retrograde cholangiopancreatography (ERCP). Particularly, this review will focus on EUS-BD performed with the use of lumen apposing metal stent (LAMS). The introduction of these innovative devices, followed by the advent of electrocautery-enhanced LAMS (EC-LAMS), gave the procedure a great technical implementation and a widespread application.

Alkali-resistant (AR) glass textiles are used as the main reinforcement in several composite applications due to their good performance-to-cost ratio. A huge variety of textiles are already present in the market; they differ on various parameters, such as, for example, the filaments’ diameters, the geometry, the type of weaving, or the nature of the impregnation coating. To orient manufacturers towards the production of efficient textiles, the most important aspect is the balance between cost and performance. In this paper, a series of different fabrics designed for textile-reinforced cementitious composites were considered. Performance was assessed by means of uniaxial tensile tests and the results are presented in terms of load vs. displacement. Then, the selected AR-glass textiles were compared in terms of fabric efficiency, targeting the effect of each parameter on the textile capacity. The research here presented is part of a comprehensive campaign aimed at the optimization of glass-fabric-reinforced cementitious composites for structural retrofitting. To better discuss the different solutions tested, at the end, only considering a small number of the investigated textiles, an efficiency evaluation was carried out at the cementitious composite level.

Background: Endoscopic Ultrasound (EUS) is widely used for the diagnosis of bilio-pancreatic and gastrointestinal (GI) tract diseases, for the evaluation of subepithelial lesions, and for sampling of lymph nodes and solid masses located next to the GI tract. The role of Artificial Intelligence in healthcare in growing. This review aimed to provide an overview of the current state of AI in EUS from imaging to pathological diagnosis and training. Methods: AI algorithms can assist in lesion detection and characterization in EUS by analyzing EUS images and identifying suspicious areas that may require further clinical evaluation or biopsy sampling. Deep learning techniques, such as convolutional neural networks (CNNs), have shown great potential for tumor identification and subepithelial lesion (SEL) evaluation by extracting important features from EUS images and using them to classify or segment the images. Results: AI models with new features can increase the accuracy of diagnoses, provide faster diagnoses, identify subtle differences in disease presentation that may be missed by human eyes, and provide more information and insights into disease pathology. Conclusions: The integration of AI in EUS images and biopsies has the potential to improve the diagnostic accuracy, leading to better patient outcomes and to a reduction in repeated procedures in case of non-diagnostic biopsies.

Over the last two decades, endoscopic eradication therapy has been established as the therapeutic strategy of choice for patients with Barrett’s oesophagus-related dysplasia and early oesophageal adenocarcinoma. With a multimodal approach, ablative therapies have been highly effective in achieving remarkable eradication rates of metaplastic epithelium with an acceptable adverse event rate. Among ablative techniques, radiofrequency ablation is currently considered as the first-line option as its efficacy and safety are strongly supported by relevant data. Nevertheless, radiofrequency ablation is costly, and not universally available, or applicable to every situation. Moreover, primary failure and recurrence rates are not negligible. In the last few years, cryotherapy techniques and hybrid argon plasma coagulation have been increasingly assessed as potential novel ablative therapies. Preliminary data have been promising and suggest that they may even have a role as first-line options, alternatively to radiofrequency ablation. The aim of this review is to provide a practical guide for the ablation of Barrett’s oesophagus, with emphasis on the different ablative options.

Deep brain stimulation (DBS) is used for the treatment of movement disorders, including Parkinson’s disease, dystonia, and essential tremor, and has shown clinical benefits in other brain disorders. A natural path for the improvement of this technique is to continuously observe the stimulation effects on patient symptoms and neurophysiological markers. This requires the evolution of conventional deep brain stimulators to bidirectional interfaces, able to record, process, store, and wirelessly communicate neural signals in a robust and reliable fashion. Here, we present the architecture, design, and first use of an implantable stimulation and sensing interface (AlphaDBSR System) characterized by artifact-free recording and distributed data management protocols. Its application in three patients with Parkinson’s disease (clinical trial n. NCT04681534) is shown as a proof of functioning of a clinically viable implanted brain-computer interface (BCI) for adaptive DBS. Reliable artifact free-recordings, and chronic long-term data and neural signal management are in place.

Background and Objectives: Acute cholecystitis is a frequent cause of admission to the emergency department, especially in old and frail patients. Percutaneous drainage (PT-GBD) and endosonographic guided drainage (EUS-GBD) could be an alternative option for relieving symptoms or act as a definitive treatment instead of a laparoscopic or open cholecystectomy (LC, OC). The aim of the present study was to compare different treatment groups. Materials and Methods: This is a five-year monocentric retrospective study including patients ≥65 years old who underwent an urgent operative procedure. A descriptive analysis was conducted comparing all treatment groups. A propensity score was estimated based on the ACS score, incorporated into a predictive model, and tested by recursive partitioning analysis. Results: 163 patients were included: 106 underwent a cholecystectomy (81 laparoscopic (LC) and 25 Open (OC)), 33 a PT-GBD and 21 EUS-GBD. The sample was categorized into three prognostic groups according to the adverse event occurrence rate. All patients treated with EUS-GBD or LC resulted in the low risk group, and the adverse event rate (AE) was 10/96 (10.4%). The AE was 4/28 (14.2%) and 21/36 (58.3%) in the middle- and high-risk groups respectively (p < 0.001). These groups included all the patients who underwent an OC or a PT-GBD. The PT-GBD group had a lower clinical success rate (55.5%) and higher RR (16,6%) when compared with other groups. Conclusions: Surgery still represents the gold standard for AC treatment. Nevertheless, EUS-GBD is a good alternative to PT-GBD in terms of clinical success, RR and AEs in all kinds of patients.

Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) is the gold standard procedure for malignant jaundice palliation; however, it can be challenging when a duodenal self-expandable metal stent (SEMS) is already in place. Patients and methods The primary aim of our study was to evaluate the technical feasibility of the placement of a lumen apposing metal stent (LAMS) through the mesh (TTM) of duodenal stents. The secondary aims were to evaluate clinical outcomes and adverse events (AEs) related to the procedures. Results Data from 23 patients (11 F and 12 M; mean age: 69.5 ± 11 years old) were collected. In 17 patients (73.9 %) TTM LAMS placement was performed as first intention, while in six patients (26.1 %) it was performed after a failed ERCP. Thirteen patients (56.5 %) underwent the procedure due to advanced pancreatic head neoplasia. One technical failure was experienced (4.3 %). The TTM LAMS placement led to a significant decrease in the serum levels of bilirubin, ALP, GGT, WBC and CRP. No cases of duodenal SEMS occlusion occurred and no other AEs were observed during the follow-up. Conclusions Concomitant malignant duodenal and biliary obstruction is a challenging condition. Palliation of jaundice using TTM LAMS in patients already treated with duodenal stent is associated to promising technical and clinical outcomes.

Climate change, nutrition, poverty and medical drugs are widely discussed and pressing issues in science, policy and society. Despite these issues being of great importance for the quality of our lives it remains unclear how well people understand them. Specifically, do particular demographic and socioeconomic factors explain variation in public understanding of these four concepts? To what extent are people's changes in understanding associated with changes in their behaviour? Do people judge scientific practices relying on the more descriptive concepts of climate change and effective medical drugs to be more objective (less controversial) than practices relying on the more value-laden concepts of poverty and healthy nutrition? To address these questions, an experimental survey and regression analyses are conducted using data collected from about one thousand participants across different continents. The study finds that public understanding of science is generally low. A smaller proportion of people were able to correctly identify the common explanation accepted internationally among the scientific community for climate change and effectiveness of medical drugs (42% and 43% of participants in the study, respectively) than for poverty and healthy nutrition (61% and 65% of participants, respectively). Older age and political non-conservativeness were the strongest predictors of correctly understanding these four concepts. Greater levels of education and political non-conservativeness were in turn the strongest predictors of people's reported changes in their behaviour based on their improved understanding of these concepts. Because climate change is among the least understood scientific concepts but is arguably the greatest challenge of our time, better efforts are needed to improve how media, awareness campaigns and education systems mediate information on the topic in order to tackle the large knowledge deficits that constrain behavioural change.

Different xenogeneic inorganic bone substitutes are currently used as bone grafting materials in oral and maxillo-facial surgery. The aim of the present study was to determine the physicochemical properties and the in vivo performance of an anorganic equine bone (AEB) substitute. AEB is manufactured by applying a process involving heating at >300 °C with the aim of removing all the antigens and the organic components. AEB was structurally characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD), X-ray fluorescence (XRF), and Fourier-transformed infrared (FT-IR) spectroscopy and compared to the anorganic bovine bone (ABB). In order to provide a preliminary evaluation of the in vivo performance of AEB, 18 bone defects were prepared and grafted with AEB (nine sites), or ABB (nine sites) used as a control, in nine Yucatan Minipigs. De novo bone formation, residual bone substitute, as well as local inflammatory and tissue effects were histologically evaluated at 30 and 90 days after implantation. The structural characterization showed that the surface morphology, particle size, chemical composition, and crystalline structure of AEB were similar to cancellous human bone. The histological examination of AEB showed a comparable pattern of newly formed bone and residual biomaterial to that of ABB. Overall, the structural data and pre-clinical evidence reported in the present study suggests that AEB can be effectively used as bone grafting material in oral surgery procedures.

Experimental philosophy (x-phi) is a young field of research in the intersection of philosophy and psychology. It aims to make progress on philosophical questions by using experimental methods traditionally associated with the psychological and behavioral sciences, such as null hypothesis significance testing (NHST). Motivated by recent discussions about a methodological crisis in the behavioral sciences, questions have been raised about the methodological standards of x-phi. Here, we focus on one aspect of this question, namely the rate of inconsistencies in statistical reporting. Previous research has examined the extent to which published articles in psychology and other behavioral sciences present statistical inconsistencies in reporting the results of NHST. In this study, we used the R package statcheck to detect statistical inconsistencies in x-phi, and compared rates of inconsistencies in psychology and philosophy. We found that rates of inconsistencies in x-phi are lower than in the psychological and behavioral sciences. From the point of view of statistical reporting consistency, x-phi seems to do no worse, and perhaps even better, than psychological science.

Explanation is a central concept in human psychology. Drawing upon philosophical theories of explanation, psychologists have recently begun to examine the relationship between explanation, probability and causality. Our study advances this growing literature at the intersection of psychology and philosophy of science by systematically investigating how judgments of explanatory power are affected by (i) the prior credibility of an explanatory hypothesis, (ii) the causal framing of the hypothesis, (iii) the perceived generalizability of the explanation, and (iv) the relation of statistical relevance between hypothesis and evidence. Collectively, the results of our five experiments support the hypothesis that the prior credibility of a causal explanation plays a central role in explanatory reasoning: first, because of the presence of strong main effects on judgments of explanatory power, and second, because of the gate-keeping role it has for other factors. Highly credible explanations are not susceptible to causal framing effects, but they are sensitive to the effects of normatively relevant factors: the generalizability of an explanation, and its statistical relevance for the evidence. These results advance current literature in the philosophy and psychology of explanation in three ways. First, they yield a more nuanced understanding of the determinants of judgments of explanatory power, and the interaction between these factors. Second, they show the close relationship between prior beliefs and explanatory power. Third, they elucidate the nature of abductive reasoning.

Textile reinforced concrete (TRC) is a promising high-performance material that has been employed with success in new constructions, as well as a strengthening layer of existing structural components. In this work, we document the optimisation procedure of textile-based composites for new construction and for the seismic retrofitting of under-reinforced concrete elements and masonry buildings. The study, aimed at maximising the material performances avoiding waste of economic resources, was addressed by means of a series of uniaxial tensile tests conducted on a wide set of alkali-resistant (AR) glass fabrics and TRCs. The samples differed in terms of cement-based matrices, embedded textiles and addition of dispersed microfibers. The results highlight the effects of fabric characteristics and introduction of short fibres on the mechanical behaviour, proposing novel comparison parameters based upon the load bearing capacity and the deformation response of the composites. The application of simplified analytical models borrowed from the literature finally revealed the limitations of the available predictive approaches, suggesting future lines of investigation.

In the last few years click chemistry reactions, and in particular coppercatalyzed cycloadditions, have been used intensively for the preparation of new bioconjugate molecules and materials applicable to biomedical and pharmaceutical areas. This review will be focused on conjugates of the tripeptide Arg-Gly-Asp formed by means of click chemistry reactions. This sequence is a well known binding motif for specific transmembrane proteins and is involved in cellular adhesion to the extracellular matrix, allowing the selective recognition of the biomolecule or polymer in which it is incorporated.