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Background: Low-dose computed tomography-based lung cancer screening (LCS) has demonstrated efficacy in reducing lung cancer mortality. However, concerns about overdiagnosis and overtreatment hinder global LCS implementation. Methods: Here, we report the unique case of a slow-growing 1 cm pure ground-glass opacity (GGO) of the lung, known for 15 years, which unexpectedly developed into a 5 cm mixed GGO within 1 year, with an increased solid component and FDG-PET uptake. Results: The patient, asymptomatic, underwent right upper lobectomy and lymphadenectomy, even complicated with postoperative chylothorax, later revealing to be affected by only an unchanged adenocarcinoma in situ (AIS). Conclusions: This case serves as a reminder of the potential behavior of pre-invasive lesions, which can mimic invasive neoplasia and may lead to overtreatment, and underscores the challenge of distinguishing indolent lesions from potentially aggressive malignancies in LCS, highlighting the need for the ongoing refinement of LCS protocols to mitigate this risk.

Resumo Objetivo apresentar o percurso metodológico da tessitura analítica de mídia e refletir sobre sua implementação na perspectiva da arquegenealogia foucaultiana em estudo sobre o sofrimento de enfermeiras na pandemia de COVID-19 no Brasil. Método trata-se de estudo teórico-metodológico, no qual foram utilizados alguns conceitos de análise de mídia, além de teorizações foucaultianas da arqueogenealogia e análise de discurso. Apresentamos a sequência metodológica da pesquisa, abrangendo a seleção dos veículos jornalísticos utilizados, coleta de dados, seleção da materialidade a ser trabalhada e posterior etapa de análises. Resultados os dados coletados foram sistematizados, criando a tessitura analítica de mídia, composta de três etapas: leitura integral das reportagens selecionadas e aplicabilidade das regras dos operadores discursivos da mídia impressa; leitura integral e captura dos excertos – nas manchetes - e das redes discursivas - nas reportagens; e categorização dos resultados e elaboração de categorias analíticas a partir de fios condutores sociais e culturais. Esses elementos processuais são livremente inspirados nos operadores discursivos da mídia impressa, da análise de discurso foucaultiana e da análise de conteúdo de Minayo. Conclusões e implicações para a prática a análise de mídia e sua tessitura podem representar uma possibilidade potente de análise de dados em pesquisas na enfermagem, fornecendo ferramentas conceituais e estratégicas para novos olhares e reflexões na contemporaneidade da área da saúde.

Background: anatomic lung segmentectomies allow accurate resection of pulmonary lesions, maximizing healthy tissue preservation, and reducing unnecessary loss of lung function. In this setting, accurate preoperative planning is crucial. We present our early experience, detailing the successful use of 3D-CT models in tailoring therapeutic strategies for three patients undergoing complex anatomical lung resections due to neoplastic diseases. Case Presentation: (1) 60-year-old male patient with significant pulmonary functional impairment underwent successful right lower lobe bi-segmentectomy (S7–S8) for carcinoid, stage IA1. (2) 65-year-old female patient with previous left lung resection and functional impairment underwent uneventful right upper lobe bi-segmentectomy (S1–S2) for double lung adenocarcinoma, stage IIb. (3) 67-year-old male with previous ipsilateral lung resection underwent left lower lobe segmentectomy (S8) for metastatic colic adenocarcinoma without any complications. Conclusion: 3D-CT imaging, particularly through VPTM platform, enhances the safety and precision of complex lung segmentectomy, providing a valuable surgical map for improved outcomes.

Introduction: Aim of the study was the molecular characterization of 21 ceftazidime/avibactam resistant (CZA-R) Klebsiella pneumoniae strains, collected in the period October 2021–March 2022 from an Intensive Care COVID Unit in a Northern Italian Hospital. Methods: After growth on selective/chromogenic culture media and susceptibility tests assessment, resistance genes content was ascertained for all the isolates by the HybriSpot 12 multiplexing, PCR and Whole-Genome Sequencing (WGS). Clonality was assessed by PFGE and MLST according to the Pasteur scheme. A SNPs-based phylogenetic tree was obtained comparing representative isolates and global genomes. The blaKPC gene horizontal transmission was evaluated by conjugation experiments. blaKPC-166 was cloned in a pCR2.1 vector and transformed in chemically competent TOP10 cells. Results: Sixteen inpatients resulted positive for colonization and/or infection by KPC-producing K. pneumoniae (KPC-Kp) strains. The 21 CZA-R KPC-Kp isolates obtained showed MDR phenotype; susceptibility to meropenem was always retained. All the CZA-R KPC-Kp presented a novel blaKPC variant, named blaKPC-166, showing a single nucleotide substitution (T811C) compared to the blaKPC-94; but related to blaKPC-2. Two different pulsotypes were detected: A in 18/21 and B in 1/21 cases, two strains from the same patient being untypable by PFGE. Interestingly, the outbreak was sustained by the high-risk clone ST307, although the ST22, ST6342, ST6418 and ST6811 have also been identified and associated to KPC-166. Worryingly, blaKPC-166 could be transferred horizontally and, after cloning, it conferred resistance to CZA. Discussion: This novel variant confers CZA–resistance and carbapenems susceptibility restoration. As KPC-166 was found expressed by multiple Kp clones, greater efforts should be made to prevent the further dissemination of such strains in Italian clinical settings.

Il contributo si propone di indagare il rapporto fra ‘rappresentazione’ e ‘simulazione’ in relazione alle classificazioni dei marginalia d’autore, in particolare attraverso la presentazione e il commento della mia tassonomia delle postille autografe di Umberto Eco, rinvenute all’interno delle sue collezioni librarie moderne. Nella parte iniziale svolgerò alcune considerazioni preliminari circa i modelli di rappresentazione dizionariali e enciclopedici e alla loro applicazione alla classificazione dei marginalia. Nella sezione centrale procederò quindi a esporre e commentare le quattro sezioni della mappa delle postille echiane, mettendone in rilievo gli aspetti originali e proponendo, laddove necessario, degli esempi concreti. Da ultimo, proporrò una riflessione finale in merito alla bontà delle scelte di modellizzazione adottate e all’efficacia del modello enciclopedico echiano.

Fosfomycin (FOS) is an effective antibiotic against multidrug-resistant Enterobacterales, but its effectiveness is reducing. Little is known on the current prevalence of FosA enzymes in low-risk pathogens, such as Citrobacter freundii. The aim of the study was the molecular characterization of a carbapenemase- and FosA-producing C. freundii collected in Italy. AK867, collected in 2023, showed an XDR profile, retaining susceptibility only to colistin. AK867 showed a FOS MIC >128 mg/L by ADM. Based on WGS, AK867 belonged to ST116 and owned a wide resistome, including fosA3, blaKPC-2, and blaVIM-1. fosA3 was carried by a conjugative pKPC-CAV1312 plasmid of 320,480 bp, on a novel composite transposon (12,907 bp). FosA3 transposon shared similarities with other fosA3-harboring pKPC-CAV1312 plasmids among Citrobacter spp. We report the first case of FosA3 production in clinical carbapenemase-producing C. freundii ST116. The incidence of FosA3 enzymes is increasing among Enterobacterales, affecting even low-virulence pathogens, as C. freundii.

Mutual interactions between the diaphragm and lung transplantation (LTx) are known to exist. Before LTx, many factors can exert notable impact on the diaphragmatic function, such as the underlying respiratory disease, the comorbidities, and the chronic treatments of the patient. In the post-LTx setting, even the surgical procedure itself can cause a stressful trauma to the diaphragm, potentially leading to morphological and functional alterations. Conversely, the diaphragm can significantly influence various aspects of the LTx process, ranging from graft-to-chest cavity size matching to the long-term postoperative respiratory performance of the recipient. Despite this, there are still no standard criteria for evaluating, defining, and managing diaphragmatic dysfunction in the context of LTx to date. This deficiency hampers the accurate assessment of those factors which affect the diaphragm and its reciprocal influence on LTx outcomes. The objective of this narrative review is to delve into the complex role the diaphragm plays in the different stages of LTx and into the modifications of this muscle following surgery.

Commercial Brazilian wheat flour was subjected to extrusion, oven, and microwave treatments. The solubility, monomeric and polymeric proteins, and the glutenin and gliadin profiles of the gluten were analyzed. In addition, in vitro digestibility and response against potential celiac disease immune-stimulatory epitopes were investigated. All treatments resulted in low solubility of the polymeric and monomeric proteins. The amounts of insoluble proteins increased from 5.6% in control flour to approximately 10% for all (treatments), whereas soluble proteins decreased from 6.5% to less than 0.5% post treatment. In addition, the treatments affected glutenin and gliadin profiles. The amount of α/β-gliadin extracted decreased after all treatments, while that of γ-gliadin was unaffected. Finally, the potential celiac disease immune stimulatory epitopes decreased in oven and microwave treatment using the G12 ELISA, but no change was observed using the R5 antibody. However, the alteration of the gluten structure and complexity was not sufficient to render a product safe for consumption for individuals with celiac disease; the number of potential celiac disease immune-stimulatory epitopes remained high.

Abstract Cognitive control is a core feature of several mental disorders. A recent account poses that health problems may derive from proactive forms of cognitive control that maintain stress representation over time. The working hypothesis of the present study is that psychological distress is caused by the tendency to select a particular maladaptive self-regulation strategy over time, namely perseverative thinking, rather than by transient stimulus–response patterns. To test this hypothesis, we asked 84 women to carry out a battery of standardized questionnaires regarding their tendency to undertake perseverative thinking and their level of psychological distress, followed by cognitive tasks measuring the tendency to use proactive versus reactive control modality and disinhibition. Through a series of mediation analyses, we demonstrate that the tendency to use proactive control correlates with psychological distress and that this relation is mediated by perseverative thinking. Moreover, we show that the relation between low inhibitory control and psychological stress is more strongly mediated by perseverative thinking than impulsiveness, a classical construct that focuses on more transient reactions to stimuli. The present results underline the importance of considering psychological distress as the consequence of a maladaptive way of applying control over time, rather than the result of a general deficit in cognitive control abilities.

The paper first analyzes the complexity of the notion of the archival document, in its fundamental definition and its updates prompted by the shift to the digital dimension. It then sets out to consider – from a digital hermeneutic point of view – the notion of ‘document’ from the perspective of the information object and therefore of the intentional object. Finally, the paper discusses the ways in which the archive is a technological enhancement for the interrogability and ‘consultability’ of knowledge.

La biblioteca escolar en Italia se define, de acuerdo con las directrices elaboradas por IFLA (Federación Internacional de Asociaciones e Instituciones Bibliotecarias), como un entorno educativo donde se fomenta la práctica de la lectura en todas sus formas, incluso si la noción de una “biblioteca escolar” sugiere una lectura orientada a un propósito. Motivado por el concepto de “patrimonio histórico-educativo”, que distingue la esencia misma del SIPSE, se realizó un censo del patrimonio bibliográfico existente en las bibliotecas escolares de todos los niveles en toda Italia, a partir de colecciones locales específicas y significativas. La contribución tiene como objetivo presentar el trabajo realizado y los resultados obtenidos hasta el momento.