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Abstract Introduction Diabetes mellitus (DM) is associated with severe forms of COVID-19 but little is known about the diabetes—related phenotype considering pre-admission, on-admission and data covering the entire hospitalization period. Methods We analyzed COVID-19 inpatients (n = 3327) aged 61.2(48.2–71.4) years attended from March to September 2020 in a public hospital. Results DM group (n = 1218) differed from Non-DM group (n = 2109) by higher age, body mass index (BMI), systolic blood pressure and lower O2 saturation on admission. Gender, ethnicity and COVID-19-related symptoms were similar. Glucose and several markers of inflammation, tissue injury and organ dysfunction were higher among patients with diabetes: troponin, lactate dehydrogenase, creatine phosphokinase (CPK), C-reactive protein (CRP), lactate, brain natriuretic peptide, urea, creatinine, sodium, potassium but lower albumin levels. Hospital (12 × 11 days) and intensive care unit permanence (10 × 9 days) were similar but DM group needed more vasoactive, anticoagulant and anti-platelet drugs, oxygen therapy, endotracheal intubation and dialysis. Lethality was higher in patients with diabetes (39.3% × 30.7%) and increased with glucose levels and age, in male sex and with BMI

Wood is one of the main materials used in buildings and furniture worldwide. After a disaster, indeed, a considerable amount of timber waste is produced. Wood waste is generally downcycled—i.e., recycled into low-quality products, incinerated for energy production—or, worse, landfilled, but in a post-disaster situation, it not only represents a quantitative issue and an environmental hazard but also acquires a cultural, social, economic and emotional value, thus requiring more effective ways to be managed. The Katrina Furniture Project, led by Sergio Palleroni in 2006 for the regions hit by hurricanes Katrina and Rita, provides a valuable precedent. Through pilot initiatives in New Orleans, furniture design emerged as a resilient practice within the reconstruction process. Affected people were involved for six weeks in a collaborative design workshop, enabling the generation of income, the acquisition of professional skills and, moreover, the rebuilding of a sense of community through collective work and the intrinsic gathering value of the crafted objects. The research develops a desk analysis and an on-field survey to reflect on the social, cultural, economic and environmental impacts of this case study and on the role of furniture design for resilient wood waste upcycling. Finally, the paper discusses the “legacy” of such practices from a digital perspective, analyzing limitations and opportunities within current research in design and manufacturing.

BackgroundSocial robots are becoming increasingly important as companions in our daily lives. Consequently, humans expect to interact with them using the same mental models applied to human-human interactions, including the use of cospeech gestures. Research efforts have been devoted to understanding users’ needs and developing robot’s behavioral models that can perceive the user state and properly plan a reaction. Despite the efforts made, some challenges regarding the effect of robot embodiment and behavior in the perception of emotions remain open. ObjectiveThe aim of this study is dual. First, it aims to assess the role of the robot’s cospeech gestures and embodiment in the user’s perceived emotions in terms of valence (stimulus pleasantness), arousal (intensity of evoked emotion), and dominance (degree of control exerted by the stimulus). Second, it aims to evaluate the robot’s accuracy in identifying positive, negative, and neutral emotions displayed by interacting humans using 3 supervised machine learning algorithms: support vector machine, random forest, and K-nearest neighbor. MethodsPepper robot was used to elicit the 3 emotions in humans using a set of 60 images retrieved from a standardized database. In particular, 2 experimental conditions for emotion elicitation were performed with Pepper robot: with a static behavior or with a robot that expresses coherent (COH) cospeech behavior. Furthermore, to evaluate the role of the robot embodiment, the third elicitation was performed by asking the participant to interact with a PC, where a graphical interface showed the same images. Each participant was requested to undergo only 1 of the 3 experimental conditions. ResultsA total of 60 participants were recruited for this study, 20 for each experimental condition for a total of 3600 interactions. The results showed significant differences (P

Social robots represent a valid opportunity to manage the diagnosis, treatment, care, and support of older people with dementia. The aim of this study is to validate the Mini-Mental State Examination (MMSE) test administered by the Pepper robot equipped with systems to detect psychophysical and emotional states in older patients. Our main result is that the Pepper robot is capable of administering the MMSE and that cognitive status is not a determinant in the effective use of a social robot. People with mild cognitive impairment appreciate the robot, as it interacts with them. Acceptability does not relate strictly to the user experience, but the willingness to interact with the robot is an important variable for engagement. We demonstrate the feasibility of a novel approach that, in the future, could lead to more natural human–machine interaction when delivering cognitive tests with the aid of a social robot and a Computational Psychophysiology Module (CPM).

Assistive devices could promote independent living and support the active and healthy aging of an older population; however, several factors can badly influence the long-term use of new technologies. In this context, this paper presents a two-step methodology called “pre-validation” that aims to identify the factors that can bias the use of new services, thus minimizing the risk of an unsuccessful longer trial. The proposed pre-validation methodology is composed of two main phases that aim to assess the usability and the reliability of the technology assessed in a laboratory environment and the usability, acceptability, user experience, and reliability of the technology in real environments. The tested services include the socialization scenario, in which older adults are better connected to the community via technological solutions (i.e., socialization applications), and the monitoring scenario, which allows for the introduction of timely interventions (technologies involved include environmental monitoring sensors, a telepresence robot, wearable sensors, and a personalized dashboard). The obtained results underline an acceptable usability level (average System Usability Scale score > 65) for the tested technologies (i.e., socialization applications and a telepresence robot). Phase Two also underlines the good acceptability, user experience, and usability of the tested services. The statistical analysis underlines a correlation between the stress related to the use of technology, digital skills, and intention of use, among other factors. Qualitative feedback also remarks on a correlation between older adults with low digital skills and an anxiety about using technology. Positive correlation indexes were highlighted between the trust and usability scores. Eventually, future long-term trials with assistive technology should rely on motivated caregivers, be founded on a strong recruitment process, and should reassure older adults—especially the ones with low digital literacy—about the use of technology by proposing personalized training and mentoring, if necessary, to increase the trust.

The paper investigates the cultural and technical transformations in architectural design produced by digital technologies, considering ‘data’ as a strategic asset for the definition of new connections between the physical environment, virtuality and digitalization in order to improve the decision-making processes underpinning design choices. The article explores the case of the urban regeneration of the Corradini ex-industrial area in Naples, offering an experimental application of rule-based compliance protocols within a high informative uncertainty context. The application of BIM-based procedures in the early design process stage becomes an opportunity to develop a multi-scenario approach, which employs Code and Model Checking systems as ‘heuristic’ tools to support decisions and enhancing risk management in complex projects.

Introduction. Telepresence provides clinicians the ability to monitor patients as well to communicate with all the members of the healthcare staff. Covid-19 Units cope with high complexity in providing care and an integration amount the care team and the patients’ relatives should be carried out to obtained successful outcomes and preventing complication. Virtual rounding (VR) has been successfully applied to cope with this task in the last 2000 years in medical units. Covid-19 patients due to safety rules may be prone to isolation and lack of communication with their family. Purpose. The aim of our study was to evaluate the effect of structured virtual round protocol in a geriatric Covid-19 unit on anxiety and depression for the patients and their relatives. Methodology. All the patients admitted to the geriatric Covid-19 unit from 1 February 2021 to 30 April were studied. Inclusion criteria to the study were the followings: no severe cognitive impairment (MMSE =>24) or neuro sensorial deficits; informed consent to participate to the study. Forty-nine 49 (75% of patients) met the inclusion criteria. All the subject who were found to be eligible to the study underwent a VR standard protocol of care. VR was consisted with: 1) a video call with a tablet device conducted by a psychologist that established a cooperative communication between the health care staff (nurses and MD, their relatives) at the bed sides; 2) a video call with the patient’s relatives in which it was clearly explained the standard care and the role of each healthcare member was also included. Anxiety and depression levels were assessed for the patients at baseline after the end of the protocol by the Hospital Anxiety and Depression Scale (HADS). Patients’ relatives were investigated for depression at baseline and after the end of the protocol by the Beck Depression Inventory- Primary Care (BDI-PC). The Beck Depression Inventory for primary care has seven items with each item rated on a 4-point scale (0–3). It is scored by summing ratings for each item (range 0–21). Items are symptoms of sadness, pessimism, past failure, loss of pleasure, self-dislike, self-criticalness, and suicidal thoughts and wishes. The Hospital Anxiety and Depression Scale (HADS) is a self- assessment scale found to be a reliable instrument for detecting states of depression and anxiety. The anxiety and depressive sub-scales are also valid measures of severity of the emotional disorder. The questionnaire comprises seven questions for anxiety and seven questions for depression, and takes 2–5min to complete. For both scales, scores less than 7 indicate non- cases, 8-10 mild, 11-14 moderate, 15-21 severe. JMP software by SAS (v.16) was used for the statistical analysis. Results. The present study included forty-nine 49 patients (67% male), mean age of 69.9 ±14.7 years with one relative for each patient. The average mean of the hospitalization for each patients was 17.6 ± 5.7 days The mean VR duration time was 60±5.5 minutes. VR showed a significant decrease in both Anxiety and depression for patients: (HADS Depression baseline 10.6 ±3.1 vs 6.9 ±2.7 end p

As a consequence of the COVID-19 emergency, frail citizens felt isolated because of social isolation, suspended and/or strongly reduced home assistance, and limited access to hospitals. In this sense, assistive technology could play a pivotal role in empowering frail older adults reducing their isolation, as well as in reinforcing the work of formal caregivers and professionals. In this context, the goal of this paper is to present four pilot studies—conducted from March 2020 to April 2021—to promptly react to COVID-19 by providing assistive technology solutions, aiming to (1) guarantee high-quality service to older adults in-home or in residential facility contexts, (2) promote social inclusion, and (3) reduce the virus transmission. In particular, four services, namely, telepresence service, remote monitoring service, virtual visit, and environmental disinfection, were designed, implemented, and tested in real environments involving 85 end-users to assess the user experience and/or preliminary assess the technical feasibility. The results underlined that all the proposed services were generally accepted by older adults and professionals. Additionally, the results remarked that the use of telepresence robots in private homes and residential facilities increased enjoyment reducing anxiety, whereas the monitoring service supported the clinicians in monitoring the discharged COVID-19 patients. It is also worth mentioning that two new services/products were developed to disinfect the environment and to allow virtual visits within the framework of a hospital information system. The virtual visits service offered the opportunity to expand the portfolio of hospital services. The main barriers were found in education, technology interoperability, and ethical/legal/privacy compliance. It is also worth mentioning the key role played by an appropriate design and customer needs analysis since not all assistive devices were designed for older persons.

Background/objectives: Amyotrophic lateral sclerosis (ALS) is a devastating and still untreatable motor neuron disease. The causes of ALS are unknown, but nutritional factors may impact the rate of disease progression. We aimed to ascertain the influence of coffee and tea consumption on ALS progression rate.Subjects/methods: In this multicenter cross-sectional study, we recruited 241 patients, 96 females, and 145 males; the mean age at onset was 59.9 ± 11.8 years. According to El Escorial criteria, 74 were definite ALS, 77 probable, 55 possible, and 35 suspected; 187 patients had spinal onset and 54 bulbar. Patients were categorized into three groups, according to their ΔFS (derived from ALS Functional Rating Scale-Revised score and disease duration from onset): slow (81), intermediate (80), and fast progressors (80).Results: Current coffee consumers were 179 (74.3%), 34 (14.1%) were non-consumers, and 22 (9.1%) were former consumers, whereas six (2.5%) consumed decaffeinated coffee only. The log-ΔFS was weakly correlated with the duration of coffee consumption (p = 0.034), but not with the number of cup-years, or the intensity of coffee consumption (cups/day). Current tea consumers were 101 (41.9%), 6 (2.5%) were former consumers, and 134 (55.6%) were non-consumers. Among current and former consumers, 27 (25.2%) consumed only green tea, 51 (47.7%) only black tea, and 29 (27.1%) both. The log-ΔFS was weakly correlated only with the consumption duration of black tea (p = 0.028) but not with the number of cup-years.Conclusions: Our study does not support the hypothesis that coffee or tea consumption is associated with the ALS progression rate.

Background: Emotion recognition skills are predicted to be fundamental features in social robots. Since facial detection and recognition algorithms are compute-intensive operations, it needs to identify methods that can parallelize the algorithmic operations for large-scale information exchange in real time. The study aims were to identify if traditional machine learning algorithms could be used to assess every user emotions separately, to relate emotion recognizing in two robotic modalities: static or motion robot, and to evaluate the acceptability and usability of assistive robot from an end-user point of view. Methods: Twenty-seven hospital employees (M = 12; F = 15) were recruited to perform the experiment showing 60 positive, negative, or neutral images selected in the International Affective Picture System (IAPS) database. The experiment was performed with the Pepper robot. Concerning experimental phase with Pepper in active mode, a concordant mimicry was programmed based on types of images (positive, negative, and neutral). During the experimentation, the images were shown by a tablet on robot chest and a web interface lasting 7 s for each slide. For each image, the participants were asked to perform a subjective assessment of the perceived emotional experience using the Self-Assessment Manikin (SAM). After participants used robotic solution, Almere model questionnaire (AMQ) and system usability scale (SUS) were administered to assess acceptability, usability, and functionality of robotic solution. Analysis wasperformed on video recordings. The evaluation of three types of attitude (positive, negative, andneutral) wasperformed through two classification algorithms of machine learning: k-nearest neighbors (KNN) and random forest (RF). Results: According to the analysis of emotions performed on the recorded videos, RF algorithm performance wasbetter in terms of accuracy (mean ± sd = 0.98 ± 0.01) and execution time (mean ± sd = 5.73 ± 0.86 s) than KNN algorithm. By RF algorithm, all neutral, positive and negative attitudes had an equal and high precision (mean = 0.98) and F-measure (mean = 0.98). Most of the participants confirmed a high level of usability and acceptability of the robotic solution. Conclusions: RF algorithm performance was better in terms of accuracy and execution time than KNN algorithm. The robot was not a disturbing factor in the arousal of emotions.

Background: Amyotrophic lateral sclerosis (ALS) is a devastating and untreatable motor neuron disease, with a 3–5-year survival from diagnosis. Possible prognostic serum biomarkers include albumin, C-reactive protein, ferritin, creatinine, uric acid, hemoglobin, potassium, sodium, calcium, glucose, and the neutrophil-to-lymphocyte ratio (NLR), a marker of subclinical inflammation. Objective: To ascertain the influence of NLR on ALS progression rate and survival. Methods: Cross-sectional multicenter study including 146 consecutive incident and prevalent patients (88 males), aged >18 years, diagnosed according to the El Escorial criteria. The exclusion criteria were: (1) patients with tracheostomy or receiving mechanical ventilation; (2) patients with percutaneous endoscopic gastrostomy; and (3) patients who did not sign the informed consent. The rate of disease progression (ΔFS score) represents the monthly decline of the ALSFRS-R score, and was computed as (48 − total ALSFRS-R at recruitment)/symptom duration in months. Patients were followed up to tracheotomy, death, or the end of the follow-up, whichever occurred first. To validate our findings, we used data retrieved from the Pooled Resource Open-Access ALS Clinical Trials (PRO-ACT) Database. Results: The median disease duration was 15 (range = 2–30) months. The mean ALSFRS-R score at recruitment was 35.8 ± 8.0 (range: 10–48), and the median ΔFS was 0.66 (range: 0–5.33). Age at onset, at diagnosis, and at recruitment were significantly lower in the lowest NLR tertile. NLR values positively correlated with ΔFS values (r = 0.28): the regression slope of NLR (log-values) was 0.60 (p < 0.001) before and 0.49 (p = 0.006) after adjustment for age at recruitment. The ΔFS score progressively increased from the lowest to the highest NLR tertile: 0.35 (IQR: 0.18–0.93), 0.62 (IQR: 0.25–1.09), and 0.86 (IQR: 0.53–1.92). Patients were followed for a median of 2 years. The mortality rate passed from 15.9 events per 100 person-years in patients belonging to the lowest NLR tertile to 52.8 in those in the highest tertile. The optimal cut-off value which best classified patients with the lowest and the highest mortality rate was set at the NLR value of 2.315. Indeed, the mortality rate of patients with an NLR value above such cut-off was twice the mortality rate of patients with a value below the cut-off (age adjusted hazard ratio (HR): 2.16, 95% confidence interval (CI): 1.32–3.53). In the PRO-ACT validation sample, patients with an NLR value above the cut-off consistently had a higher mortality rate than those with a value below the cut-off (age adjusted HR: 1.17, 95%CI: 1.01–1.35). Conclusions: NLR could be a candidate easy, fast, and low-cost marker of disease progression and survival in ALS. It may be associated with low-grade inflammation either as a direct mirror of the pathological process of disease progression, or as a consequence of neuronal death (reverse causation). However, prospective studies are needed to understand whether NLR changes during the course of the disease, before using it to monitor disease progression in ALS.

The operational/management phase is the one most affected by an ineffective organization of information, which occurred in the previous phases. The activity of this applied research had the objective of verifying the possibility of reducing the problems that arise between the executive phase and the Management phase, through the improvement of the interaction between the different protagonists in the exchange, sharing and updating of informational datasets. The work focused on the case study of the Apple Developer Academy in Naples, the first school in Europe for the development of digital mobile applications, with respect to which the management strategies were simulated starting from the development of an Informational Modeling functional to the operational phase of the spaces.

Background/Aims: Life on Earth is constantly exposed to electromagnetic fields (EMFs) and the effects induced by EMFs on biological systems have been extensively studied producing different and sometimes contradictory results. Extremely low-frequency electromagnetic fields (ELF-EMFs) have shown to play a role in regulating cell proliferation and differentiation, although how EMFs influence these processes remains unclear. Human acute promyelocytic leukemia (APL) cells are characterized by the arrest of differentiation at the promyelocytic stage due to epigenetic perturbations induced by PML/RARα fusion protein (Promyelocytic Leukemia protein - PML/Retinoic Acid Receptor alpha - RARα). Therapeutic administration of all-trans retinoic acid (ATRA) re-establishes the leukemogenic mechanism re-inducing the normal differentiation processes. Methods: We studied the effects of ELF-EMFs (50 Hz, 2 mT) on the ATRA-mediated granulocytic differentiation process of APL NB4 cells (a cell line established from the bone marrow of a patient affected by the acute promyelocytic leukemia) by monitoring cellular proliferation and morphology, nitrob lue tetrazolium (NBT) reduction and the expression of differentiation surface markers. Finally, we investigated mechanisms focusing on reactive oxygen species (ROS) generation and related molecular pathways. Results: ELF-EMF exposure decreases cellular proliferation potential and helps ATRA-treated NB4 cells to mature. Furthermore, the analysis of ROS production and the consequent extracellular signal regulated kinases (ERK1/2) phosphorylation suggest that a changed intracellular oxidative balance may influence the biological effects of ELF-EMFs. Conclusions: These results indicate that the exposure to ELF-EMF promotes ATRA-induced granulocytic differentiation of APL cells.

Background: The Pilots for Healthy and Active Ageing (PHArA-ON) project aimsto ensure reality smart and active living for Europe’s ageing population by creating a set of integrated and highly customizable interoperable open platforms with advanced services, devices, and technologies and tools. The aim of the present study was to determine the needs and preferences of older people and their caregivers for improving healthy and active aging and guiding the technological development of thePHArA-ON system. Methods: A pre-structured interview was administered to older adults, informal caregivers and professional caregivers (including social operators) taking part in the piloting sessions. Results: Interviews were carried out in Umana Persone Social Enterprise R&D Network (UP) in Tuscany, and Ospedale Casa SollievodellaSofferenza (CSS) in Apulia. A total of 22 older adults, 22 informal caregivers, 13 professional caregivers and 4 social operators were recruited. A prioritization analysis of services, according to the stakeholder’s needs, has determined two fundamental need categories: Heath Management (i.e., stimulation and monitoring), and Socialisation (i.e., promoting social inclusion). Conclusions: The main scientific contributions to this study are the following: to design and evaluate technology in the context of healthy and active ageing, to acquire relevant knowledge on user needs to develop technologies that can handle the real life situations of older people, obtain useful insights about the attitude and availability of end-users in using technologies in clinical practice, and to provide important guidelines to improve the PHArA-ON system. Specific experimentation stages were also carried out to understand which kind of technology is more acceptable, and to obtain feedback regarding the development priority related to the impact of the proposed services. Research through fruitful and continuous interaction with the different subjects involved in the development process of the system, as well as with stakeholders, enabled the implementation of a platform which could be further and easily integrated and improved.

This paper aims to investigate the possibilities offered by the design and production paradigms of Industry 4.0 in the Architecture, Engineering & Construction industry, through the coordination between systems for the integrated management of the design process (Building Information Modeling) and rapid prototyping tools (Computer-Aided Manufacturing). Is hereby proposed an interpretation of the meaning that an industrial transformation of the AEC industry takes over for the Architectural design, simulating a methodology in a BIM environment for the design of residential buildings in Cold-Formed Steel with drywall envelopes, exploiting the potential of digital manufacturing and computational design advanced tools.

Background—Amyotrophic lateral sclerosis (ALS) is a devastating and untreatable motor neuron disease; smoking and alcohol drinking may impact its progression rate. Objective—To ascertain the influence of smoking and alcohol consumption on ALS progression rates. Methods—Cross-sectional multicenter study, including 241 consecutive patients (145 males); mean age at onset was 59.9 ± 11.8 years. Cigarette smoking and alcohol consumption data were collected at recruitment through a validated questionnaire. Patients were categorized into three groups according to ΔFS (derived from the ALS Functional Rating Scale-Revised and disease duration from onset): slow (n = 81), intermediate (80), and fast progressors (80). Results—Current smokers accounted for 44 (18.3%) of the participants, former smokers accounted for 10 (4.1%), and non-smokers accounted for 187 (77.6%). The age of ALS onset was lower in current smokers than non-smokers, and the ΔFS was slightly, although not significantly, higher for smokers of >14 cigarettes/day. Current alcohol drinkers accounted for 147 (61.0%) of the participants, former drinkers accounted for 5 (2.1%), and non-drinkers accounted for 89 (36.9%). The log(ΔFS) was weakly correlated only with the duration of alcohol consumption (p = 0.028), but not with the mean number of drinks/day or the drink-years. Conclusions: This cross-sectional multicenter study suggested a possible minor role for smoking in worsening disease progression. A possible interaction with alcohol drinking was suggested.

The aim of this paper is to identify the potential for integration, within BIM approach, the multi-criteria evaluation methods to improve the effectiveness of the award process of tendering, by defining an alternative method to more traditional procedures. To reach this aim four public procurement have been analyzed for the construction of educational facilities in the Metropolitan City of Naples. It was later represented the procedure of one of the four contracts previously analyzed, through the synergy of building information modeling and PROMETHEE method. The study has identified interesting results in relation to the objectives of speeding up the phase of evaluation and preparation of the final ranking, as well as of the transparency of this phase.

Osteoporosis is a metabolic skeletal disease characterized by an imbalance between osteoclast-mediated bone resorption and osteoblast-mediated bone formation. We examined the beneficial effect of shock waves (SW) alone or in combination with raloxifene (RAL) on bone loss in ovariectomized rats (OVX). Sixteen weeks after surgery, OVX were treated for five weeks with SW at the antero-lateral side of the right hind leg, one session weekly, at 3 Hz (EFD of 0.33 mJ/mm2), or with RAL (5 mg/kg/die, per os) or with SW+RAL. Sera, femurs, tibiae and vertebrae were sampled for following biochemical and histological analysis. SW, alone or combined with RAL, prevented femur weight reduction and the deterioration of trabecular microarchitecture both in femur and vertebrae. All treatments increased Speed of Sound (SoS) values, improving bone mineral density, altered by OVX. Serum parameters involved in bone remodeling (alkaline phosphatase, receptor activator of nuclear factor kappa-B ligand, osteoprotegerin) and osteoblast proliferation (PTH), altered by ovariectomy, were restored by SW and RAL alone or in combination. In tibiae, SW+RAL significantly reduced cathepsin k and TNF-α levels, indicating the inhibition of osteoclast activity, while all treatments significantly increased runt-related transcription factor 2 and bone morphogenetic-2 expression, suggesting an increase in osteoblastogenic activity. Finally, in bone marrow from tibiae, SW or RAL reduced PPARγ and adiponectin transcription, indicating a shift of mesenchymal cells toward osteoblastogenesis, without showing a synergistic effect. Our data indicate SW therapy, alone and in combination with raloxifene, as an innovative strategy to limit the hypoestrogenic bone loss, restoring the balance between bone formation and resorption.

Background: atrial fibrillation (AF) is the most common form of alteration in cardiac rhythm and associated with more severe episodes of stroke. Treatment with oral anticoagulants vitamin K antagonists (VKA) such as warfarin, is nowadays the therapy of choice for stroke prevention in patients with AF, but dabigatran etexilate (DE) 150 mg twice daily was more clinically effective than warfarin in reducing the risk of stroke or systemic embolism, ischaemic stroke and vascular mortality whereas DE 110 mg twice daily was non-inferior to warfarin. Aim: to assess the affordability of the use of DE for the Italian NHS, in patients with non-valvular AF (NVAF) through a budget impact analysis (BIA). Methods: the BIA in a timeframe of 5 years was divided into 3 scenarios (1: current management of patients with NVAF; 2: all patients with NVAF treated with VKA; 3: all patients with NVAF treated with DE). The population considered is the one with indication for anticoagulation. Analysis is from the NHS perspective: therefore, indirect costs are excluded. Results: the underuse of oral anticoagulation, associated with the difficulty in keeping the patients treated with VKA within an acceptable therapeutic range, results in an enormous social and human cost, represented by a total of more than 63,000 strokes cumulated in the 5-year period considered. The cumulative cost for the scenario 1 over the 5-year period is over € 2.3 billion. In the scenario 2 the number of strokes avoided per year increases by -5,219 compared to no treatment (-2,368 compared to scenario 1), although the number of events remains high (about 10,000 events/year). In the 5-year observation period the scenario 2 would result in a reduction in the total number of strokes (-12,323 events vs. scenario 1), and savings for the NHS of around 95 million Euros compared to scenario 1. In the Scenario 3 there is a reduction of more than 38,600 of the total cumulative number of strokes vs. the scenario 1 and over 26,200 vs. scenario 2, and savings for the NHS at the fifth year of observation of circa 174 million Euros vs. scenario 1 and 123 million Euros vs. scenario 2. Conclusion: DE in Italy is economically sustainable, as it allows savings for the NHS in the management of patients with NVAF from the second year vs. no treatment and vs. treatment with VKA

The ADH (alcohol dehydrogenase) system is one of the earliest known models of molecular evolution, and is still the most studied in Drosophila. Herein, we studied this model in the genus Anastrepha (Diptera, Tephritidae). Due to the remarkable advantages it presents, it is possible to cross species with different Adh genotypes and with different phenotype traits related to ethanol tolerance. The two species studied here each have a different number of Adh gene copies, whereby crosses generate polymorphisms in gene number and in composition of the genetic background. We measured certain traits related to ethanol metabolism and tolerance. ADH specific enzyme activity presented gene by environment interactions, and the larval protein content showed an additive pattern of inheritance, whilst ADH enzyme activity per larva presented a complex behavior that may be explained by epistatic effects. Regression models suggest that there are heritable factors acting on ethanol tolerance, which may be related to enzymatic activity of the ADHs and to larval mass, although a pronounced environmental effect on ethanol tolerance was also observed. By using these data, we speculated on the mechanisms of ethanol tolerance and its inheritance as well as of associated traits.

This paper reflects on the results of the recent technical policy for energy requalification in Italy, focusing on both the European objectives of decarbonisation, circularity and industrialisation of the sector, and the size and characteristics of demand. Starting from the comparison between the two main models of efficiency of the public and private building stock, based respectively on the Minimum Environmental Criteria and the Superbonus, the study examines the effectiveness and limitations of the measures for private construction, which constitutes the majority share of the entire Italian building stock. The study identifies the Energiesprong model as a possible way to improve the management and quality of energy requalification interventions capable of expanding their effectiveness beyond the environmental point of view. [ABSTRACT FROM AUTHOR]

This paper develops a decisionmaking methodology for urban regeneration projects based on the use of datadriven procedures and technologies for the conversion of former industrial areas to residential use. The proposed approach is aimed at the elaboration of an information management protocol for the generation of design scenarios, starting from the assessment of the regulatory and technical compatibility of the possible transformations with the existing constraints. This paper describes the application of the methodology to several buildings in the ex-Corradini complex in Naples to be used for different types of residential functions, in a framework of high uncertainty and complexity, also due to the inaccessibility and abandonment of the site [ABSTRACT FROM AUTHOR]

Morphological traits and coadapted gene complexes for them in Drosophila mercatorum are discussed based on a study that focused on detection of single-locus and two-loci effects on the traits. Results indicate epistatsis to be an important contributor to genetic architecture.