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This study aims to compare the effects of some chemical agents on the removal of calcareous encrustations, which are characterized by the presence of both calcium and silicon. The experimentation was conducted during the conservation treatments of Cerriglio’s nymphaeum (Massa Lubrense, Naples, Italy). Tests were carried out in the laboratory on specimens and in situ to define the most efficient choice between several chelant agents, in the recovery of calcium and silicon, using ICP/OES and spectrocolorimetric and microscopic analyses.

A multi-analytical approach was employed for the first time to study the stone materials, wall paintings and related degradation forms in the Cathedral of Gerace (Reggio Calabria, southern Italy). With an area of around 1898 square meters, the Gerace Cathedral is the largest in Calabria: its construction dates back to the Norman era (between 1085 and 1120), and currently displays distinct features of Greek and Latin architectural orders. Despite having undergone numerous restorations, the church perfectly preserves its original buildings materials. Following an extensive site inspection campaign, supported by the experts dealing with building restoration, several areas were selected for analyses. Both in situ investigations and laboratory tests were carried out on micro-fragments using Non-Destructive and Micro-Destructive Techniques (NDTs and MDTs). The first step involved an inspection through InfraRed Thermography (IRT) in order to map the internal walls of the Cathedral and identify zones with potential degradation phenomena. Subsequently, a more in-depth study was designed based on the thermographic results, and laboratory tests were carried out on micro-fragments and powders to characterize the different kinds of materials (i.e., stones, mortars, plasters and pigments) and decay agents (i.e., salts and efflorescences). Thirty-one samples were subjected to a complementary analytical approach which included Polarizing Optical Microscopy (POM), Ion Chromatography (IC), X-Ray Powder Diffraction (XRPD) and Scanning Electron Microscopy (SEM) coupled with microanalysis (EDS). The results allowed us to preliminarily characterize the different materials from which the Cathedral was built, determine its state of conservation and provide a better knowledge of the entire building, revealing details not visible to the naked eye which are important for future conservation interventions. As for the state of conservation, the integrated use of various techniques enabled the detection of rising damp generally correlated with the occurrence of water infiltration and migration phenomena which appear to affect a large part of the building, causing noticeable damage (i.e., loss of surface material, micro-cracks, white salt efflorescence, etc.). The characterization of the materials carried out on mortars, plasters, and pigments also confirmed the local origin of the raw materials. However, the provenance of the studied marbles and crystalline limestones, could not be established and, therefore, further in-depth studies are required.

Modern society and industrial development rely heavily on the availability of freshwater and minerals. Seawater reverse osmosis (SWRO) has been widely adopted for freshwater supply, although many questions have arisen about its environmental sustainability owing to the disposal of hypersaline rejected solutions (brine). This scenario has accelerated significant developments towards the hybridization of SWRO with membrane distillation–crystallization (MD-MCr), which can extract water and minerals from spent brine. Nevertheless, the substantial specific energy consumption associated with MD-MCr remains a significant limitation. In this work, energy harvesting was secured from renewables by hotspots embodied in the membranes, implementing the revolutionary approach of brine mining via photothermal membrane crystallization (PhMCr). This method employs self-heating nanostructured interfaces under solar radiation to enhance water evaporation, creating a carefully controlled supersaturated environment responsible for the extraction of minerals. Photothermal mixed matrix photothermal membranes (MMMs) were developed by incorporating graphene oxide (GO) or carbon black (CB) into polyvinylidene fluoride (PVDF) solubilized in an eco-friendly solvent (i.e., triethyl phosphate (TEP)). MMMs were prepared using non-solvent-induced phase separation (NIPS). The effect of GO or GB on the morphology of MMMs and the photothermal behavior was examined. Light-to-heat conversion was used in PhMCr experiments to facilitate the evaporation of water from the SWRO brine to supersaturation, leading to sodium chloride (NaCl) nucleation and crystallization. Overall, the results indicate exciting perspectives of PhMCr in brine valorization for a sustainable desalination industry.

This study investigates the potential of fatty acid methyl esters (FAME) as environmentally sustainable alternatives to traditional solvents for the removal of low-polarity materials commonly found in cultural heritage artefacts. Recognizing the environmental and health concerns associated with conventional solvents, this research focuses on FAME to remove low/non-polarity or non-polar substances used in cultural heritage preservation. Laboratory samples coated with low molecular synthetic resins (LMW) such as Regalrez 1094 and microcrystalline wax were treated with FAME applied in gel to prevent solvent–substrate interactions. Photographic documentation under UV-vis light, optical microscope observations, and spectrocolorimetric analysis were used for assessing surface “cleanness”, while FTIR-ATR spectroscopy was used to detect possible residue from treatment. Moreover, SEM analysis was used for a better understanding of the results. The best results were obtained using FAME base on methyl stearate according to Hansen-RED.

Lithium-ion batteries (LIBs) are fundamental for the energetic transition necessary to contrast climate change. The characteristics of cathode active materials (CAMs) strongly influence the cell performance, so improved CAMs need to be developed. Currently, Li(Ni0.8Mn0.1Co0.1)O2 (NMC811) is state-of-the-art among the cathodic active materials. The aim of this work is the optimization of the procedure to produce NMC811: two different syntheses were investigated, the co-precipitation and the self-combustion methods. For a better understanding of the synthesis conditions, three different types of atmospheres were tested during the calcination phase: air (partially oxidizing), oxygen (totally oxidizing), and nitrogen (non-oxidizing). The synthesized oxides were characterized by X-ray Powder Diffraction (XRPD), Scanning Electron Microscopy (SEM), Energy Dispersive X-ray (EDX), Inductively Coupled Plasma (ICP), and Particle Size Distribution (PSD). The most promising materials were tested in a half-cell set up to verify the electrochemical performances. The procedure followed during this study is depicted in the graphical abstract. The oxidizing atmospheric conditions turned out to be the most appropriate to produce NMC811 with good electrochemical properties.

Aim: The aim of the present study was to analyze retrospectively the results of patients who underwent early-staged, i.e., within 24–48 h, carotid artery stenting (e-s CAS) before coronary artery bypass grafting (CABG). Methods: Between December 2014 and December 2022, 1046 consecutive patients underwent CABG; 31 of these patients (3%) were subjected to e-s CAS prior to CABG (e-s CAS + CABG group). Preoperative and intraoperative variables and early and mid-term results of the e-s CAS + CABG group were compared with those of patients who underwent isolated CABG (CABG group). Results: As compared with the CABG group, the e-s CAS + CABG group showed a worse clinical risk profile due to higher Euroscore-2 values and incidence of obstructive pulmonary disease and bilateral carotid artery and peripheral artery diseases (p < 0.05, for all comparisons). The combined end point of operative mortality, periprocedural myocardial infarction, and stroke was 3.2% (0%/0%/3.2%) in the e-s CAS + CABG group vs. 5.9% (2.2%/2.8%/0.9%) in the CABG group (p > 0.5, for all measurements). At 5 years, actuarial survival was 74% ± 16% in the e-s CAS + CABG group vs. 93% ± 4.0% in the CABG group, freedom from cardiac death was 100% vs. 98% ± 1.0% (p = 0.6), and freedom from MACCEs was 85% ± 15% vs. 97% ± 2.5% (p > 0.1, for all comparisons). Independent predictors of all-causes death were advanced age at the operation (p < 0.0001), a lower value for left ventricular ejection fraction (p = 0.05), and a high Euroscore-2 (p = 0.04). Conclusions: CABG preceded by e-s CAS appears to be associated with satisfactory early outcomes while limiting the risk of myocardial infarction to a very short time interval between the two procedures. Freedom from late all-causes death, cardiac death, and MACCEs were comparable and equally satisfactory, underscoring the positive protective effects of CAS and CABG on the carotid and coronary territories over time.

A large constellation of hitherto unexplained symptoms including inability to burp, gurgling noises from the chest and lower neck, abdominal bloating, flatulence, painful hiccups and emetophobia was defined as Retrograde Cricopharyngeus Dysfunction (R-CPD) in 2019. First choice treatment of R-CPD involves injection of botulinum toxin into the cricopharyngeus muscle under local or general anesthesia. This treatment has been found to be effective in the vast majority of subjects, with limited adverse events and prolonged therapeutic effects. Notwithstanding, R-CPD is still a poorly understood and underestimated disease, and a specific therapeutic dosage range of botulinum toxin (BT) has not been yet established. In this report, we describe the first case of R-CPD diagnosed in Italy, successfully treated with unilateral, anesthesia-free injection of 10 units of onabotulinum toxin into the cricopharyngeus muscle, representing the lowest dose reported to date.

Lithium–titanium–sulfur cathodes have gained attention because of their unique properties and have been studied for their application in lithium-ion batteries. They offer different advantages such as lower cost, higher safety, and higher energy density with respect to commonly adopted transition metal oxides. Moreover, this family of compounds is free from critical raw materials such as cobalt and nickel. For cathode materials, a crucial aspect is evaluating the evolution and behavior of the structure and properties during the cycling process, which means simulating the system under lithium extraction and insertion. Structural optimization, electronic band structures, density of states, and Raman spectra were simulated, looking for fingerprints and peculiar aspects related to the delithiation and overlithiation process. Lithium transport properties were also investigated through the nudged elastic band methodology. This allowed us to evaluate the diffusion coefficient of lithium, which is a crucial parameter for cathode performance evaluation.

This article concerns the diagnostic campaign aimed at analyzing the mural painting representing the iconographic theme of the Deesis of the Church of St. Maria Annunziata, Motta San Giovanni, in the province of Reggio Calabria. In 1951, a flood caused the collapse of the building and the consequent breaking of the apse into two parts. The present study focused on the left side of the apse, hosting the figures of Christ and Mary, in order to plan the best conservation intervention strategy. For this purpose, non-invasive investigations and laboratory analytical methods were conducted in order to characterize the constituent materials and to identify the forms of alteration and degradation present on the surface of the painting. In particular, Raman spectroscopy, optical microscopy, scanning electron microscopy coupled to the chemical analysis by an EDS probe, Fourier-transform infrared spectroscopy and ion chromatography were employed. The results highlighted the presence of a single layer of plaster made with a lime-based binder. The chromatic palette of the painting is characterized by ochres and carbon black mixed with lime to obtain the different shades. Finally, the definition of the nature of the deposits and of the overlaid materials was fundamental in order to identify the best products and methods to restore the readability of the work.

Ovarian cancer (OC) is the eighth most common cancer among the female population and the most lethal of all the female reproductive system malignancies. Poly (ADP-ribose) polymerase inhibitors (PARPis) have reshaped the treatment scenario of metastatic OC in the maintenance setting post platinum-based chemotherapy. Niraparib is the first Food and Drug Administration (FDA)- and European Medical Agency (EMA)-approved PARPi as maintenance therapy for platinum-sensitive OC, regardless of BReast CAncer gene (BRCA) status, in first-line patients, with a recent restriction to germline BRCA mutations in second-line patients. In this review, we comprehensively summarized the pharmacological properties of niraparib, alongside the efficacy and safety data of the main trials leading to the current approvals, and discussed the future development of this agent.

Ovarian cancer (OC) is women’s eighth most common cancer, bearing the highest mortality rates of all female reproductive system malignancies. Poly (ADP-ribose) polymerase inhibitors (PARPis) have reshaped the treatment scenario of metastatic OC as a maintenance post platinum-based chemotherapy. Olaparib is the first PARPi developed for this disease. Results from Study 42, Study 19, SOLO2, OPINION, SOLO1, and PAOLA-1 clinical trials, led to the FDA and EMA approval of olaparib for the maintenance treatment of women with high-grade epithelial ovarian, fallopian tube, or primary peritoneal cancer without platinum progression: in the platinum-sensitive recurrent OC; in the newly diagnosed setting in case Breast Cancer (BRCA) mutations and, in combination with bevacizumab, in case of BRCA mutation or deficiency of homologous recombination genes. In this review, we synthetized olaparib’s pharmacokinetic and pharmacodynamic properties and its use in special populations. We summarized the efficacy and safety of the studies leading to the current approvals and discussed the future developments of this agent.

Objective: Acute renal in-stent thrombosis is common, especially after complex endovascular treatments, or in case of risk factors such as Covid-19 infection. Irreversible renal damage occurred when the renal artery was occluded for more than 3 hours. In this case, we present a case of renal function recovery after thromboaspiration of a renal stent thrombosis for more than 72 hours. Case presentation: A 88-year-old man who tested positive for COVID-19 presented to the emergency room with dyspnea and anuria. He referred a previous complex endovascular intervention with the triple chimney technique (ChEVAR). More than 72 hours passed between the onset of symptoms to the diagnosis of acute renal intra-stent thrombosis. He underwent urgent thromboaspiration with neurovascular devices returning to his baseline renal function. Conclusion: Despite the prolonged ischemia, renal revascularization with thromboaspiration restored renal function and rescued the remaining renal parenchyma.

Introduction: some studies have shown that fasting blood glucose values between 100 and 109 mg/dL are associated with high rates of prediabetes when the classification criteria are HbA1c values. The Argentine Diabetes Society still maintains 110 mg/dL as the value from which a patient is classified as having impaired fasting blood glucose; the frequency of individuals possibly incorrectly classified, according to this criterion, is not yet known in any Argentine population. Objectives: to establish the frequency in a population without a diagnosis of diabetes mellitus with fasting blood glucose levels between 100 and 109 mg/dL in which prediabetes occurs according to HbA1c, to correlate both variables and to quantify the probability that this predicts with respect to others with fasting blood glucose levels

This paper is concerned with a morphological-stylistic and archaeometric study of two small pottery statues, confiscated by the Cosenza Carabinieri Unit for the Protection of Cultural Heritage and Anti-Counterfeiting (Calabria, Italy). The research aimed to establish the authenticity of the artworks and to verify a possible origin from the same workshop manufacturing, by providing indications about the textural features and raw materials used for their production. For these purposes, the analytical approach involved the use of minero-petrographic and physical analysis, as follows: petrographic analysis (OM), X-ray diffraction (XRD) and thermoluminescence tests (TL). The preliminary observation, which highlights differences in the stylistic features of the two statuettes as well as in the color, morphology and distribution of the white-greyish patina, is further confirmed by the TL investigations. The TL test revealed an ancient production only for one of the analyzed finds and the investigations on the raw materials allowed to relate this to a possible local historical-artistic context. The second statuette, on the other hand, is attributable to a modern production as confirmed by TL measurement.

Background Atherosclerosis vulnerability regression has been evidenced mostly in randomized clinical trials with intensive lipid‐lowering therapy. We aimed to demonstrate vulnerability regression in real life, with a comprehensive quantitative method, in patients with asymptomatic mild to moderate carotid atherosclerosis on a secondary prevention program. Methods and Results We conducted a single‐center prospective observational study (MAGNETIC [Magnetic Resonance Imaging as a Gold Standard for Noninvasive Evaluation of Atherosclerotic Involvement of Carotid Arteries]): 260 patients enrolled at a cardiac rehabilitation center were followed for 3 years with serial magnetic resonance imaging. Per section cutoffs (95th/5th percentiles) were derived from a sample of 20 consecutive magnetic resonance imaging scans: (1) lipid‐rich necrotic core: 26% of vessel wall area; (2) intraplaque hemorrhage: 12% of vessel wall area; and (3) fibrous cap: (a) minimum thickness: 0.06 mm, (b) mean thickness: 0.4 mm, (c) projection length: 11 mm. Patients with baseline magnetic resonance imaging of adequate quality (n=247) were classified as high (n=63, 26%), intermediate (n=65, 26%), or low risk (n=119, 48%), if vulnerability criteria were fulfilled in ≥2 contiguous sections, in 1 or multiple noncontiguous sections, or in any section, respectively. Among high‐risk patients, a conversion to any lower‐risk status was found in 11 (17%; P=0.614) at 6 months, in 16 (25%; P=0.197) at 1 year, and in 19 (30%; P=0.009) at 3 years. Among patients showing any degree of carotid plaque vulnerability, 21 (16%; P=0.014) were diagnosed at low risk at 3 years. Conclusions This study demonstrates with a quantitative approach that vulnerability regression is common in real life. A secondary prevention program can promote vulnerability regression in asymptomatic patients in the mid to long term.

This study reports the analytical approach towards nine coins found in wreck A of Fontanamare for understanding the complex corrosion processes that take place in underwater conditions. Optical microscopy (OM) combined with micro-Raman (µ-Raman) spectroscopy, X-ray diffractometry (XRD), and scanning electron microscopy with energy-dispersive X-ray spectroscopy (SEM and EDS) were used to analyze the nature and the microstructure of the corrosion patina in comparison with the non-degraded state of coins. Three main types of corrosion patina based on copper, lead chloride, and carbonate were identified: black, white, and green, and the obtained results demonstrate the complex corrosion processes that take place in underwater conditions. To better understand the role played by different chemical and physical parameters in the corrosion of bronze artefacts in an underwater environment, this study attempts to understand the nature of the patinas on the coins in relation to the specific structural and environmental parameter variation.

The archaeometric study of the frescoes by the painter Saturnino Gatti (1463–1518) in the apse of the Church of San Panfilo in Villagrande di Tornimparte (L’Aquila) was the subject of the II National Research Project [...]

The introduction of rotavirus A (RVA) vaccines has considerably reduced the RVA-associated mortality among children under 5 years of age worldwide. The ability of RVA to reassort gives rise to different combinations of surface proteins G (glycoprotein, VP7) and P (protease sensitive, VP4) RVA types infecting children. During the epidemiological surveillance of RVA in the Northwest Amazon region, an unusual rotavirus genotype G6P[8] was detected in feces of a 2-year-old child with acute gastroenteritis (AGE) that had been vaccinated with one dose of Rotarix® (RV1). The G6P[8] sample had a DS-1-like constellation with a Wa-like VP3 gene mono-reassortment similar to equine-like G3P[8] that has been frequently detected in Brazil previously. The results presented here reinforce the evolutionary dynamics of RVA and the importance of constant molecular surveillance.

Air pollution can have a significant impact on stone materials used in monuments, buildings, and sculptures. Sulfur and nitrogen oxides are particularly harmful pollutants, especially in carbonate stones. These oxides, reacting with moisture in the air, result in the formation of acids able to erode the stone surface and gradually compromise its structural integrity. The acids can also combine with airborne particulate matter, heavy metals, and salts, leading to the development of black crusts. These not only have detrimental effects on the stone’s integrity but also affect the original appearance of the surfaces, threatening the conservation of important monuments and buildings. This review discusses the characteristics of black crusts and their relation to the environment and stone materials.

Na tradição intelectual brasileira, vários autores se questionaram sobre certa dificuldade perene no país em relação ao enfrentamento da sua própria história. Buscando, por vezes, evadir-se dela ou superar essa história a partir da ficção de um outro a ser alcançado, esse tema ganhou particular atenção quando, no modernismo, Oswald de Andrade abordou essa dificuldade e viu no gesto antropofágico uma potente imagem para reinventar nossa relação com a história e com o que nos seria próprio e outro. No artigo, propomos revisitar o gesto antropofágico em sua relação com a história e desdobrá-lo juntamente a uma perspectiva mais recente, aquela de Ailton Krenak, quando este propõe, por intermédio de um entendimento da história enquanto força existencial, refazer o encontro entre a sociedade moderna brasileira e a experiência de comunidades tradicionais.

This research concerns a stylistic and archaeometric study of an ancient marble female bust recently discovered by the Trapani Lombardo family of Reggio Calabria (Southern Italy) and delivered to the Superintendency of Archaeology, Fine Arts, and Landscape for the metropolitan city of Reggio Calabria and Vibo Valentia (SABAP). Based on the first technical, stylistic, and iconographic observations made by the competent bodies, it is a half-length portrait bust from the Roman era, which precisely had the function of faithfully reproducing the physiognomy of the depicted subject. The research aimed to establish the authenticity of the artwork and the origin of the raw material, providing indications about the textural and compositional features and of the alteration products as well as identifying traces of any previous restoration interventions. For these purposes, after a preliminary assessment of the state of conservation of the bust using visual inspections supported by a handheld digital microscope, different analytical techniques, including polarized optical microscopy (OM), scanning electron microscopy coupled with energy dispersive spectrometry (SEM-EDX), carbon and oxygen stable isotope ratio determinations (δ13C and δ18O), X-ray diffraction (XRD), and Fourier transform infrared spectroscopy (FT-IR), were used. The results highlighted the originality of the artifact, thus remarking on the importance of the precious archaeological find to be included in the cataloging of tangible assets in the panorama of Italian cultural heritage.

Plant diseases and pests significantly influence food production and the productivity and economic profitability of agricultural crops. This has led to great interest in developing technological solutions to enable timely and accurate detection. This systematic review aimed to find studies on the automation of processes to detect, identify and classify diseases and pests in agricultural crops. The goal is to characterize the class of algorithms, models and their characteristics and understand the efficiency of the various approaches and their applicability. The literature search was conducted in two citation databases. The initial search returned 278 studies and, after removing duplicates and applying the inclusion and exclusion criteria, 48 articles were included in the review. As a result, seven research questions were answered that allowed a characterization of the most studied crops, diseases and pests, the datasets used, the algorithms, their inputs and the levels of accuracy that have been achieved in automatic identification and classification of diseases and pests. Some trends that have been most noticed are also highlighted.

Although many authors have observed a degradation in greening cover alongside an increase in the built-up areas, resulting in a deterioration of the essential environmental services for the well-being of ecosystems and society, few studies have measured how greening developed in its full spatiotemporal configuration with urban development using innovative remote sensing (RS) technologies. Focusing on this issue, the authors propose an innovative methodology for the analysis of the urban and greening changes over time by integrating deep learning (DL) technologies to classify and segment the built-up area and the vegetation cover from satellite and aerial images and geographic information system (GIS) techniques. The core of the methodology is a trained and validated U-Net model, which was tested on an urban area in the municipality of Matera (Italy), analyzing the urban and greening changes from 2000 to 2020. The results demonstrate a very good level of accuracy of the U-Net model, a remarkable increment in the built-up area density (8.28%) and a decline in the vegetation cover density (5.13%). The obtained results demonstrate how the proposed method can be used to rapidly and accurately identify useful information about urban and greening spatiotemporal development using innovative RS technologies supporting sustainable development processes.

Underwater cultural heritage (UCH) is a crucial asset for our knowledge of human history and traditions [...]

This research aims at identifying main risk factors on rural areas, investigating characteristics both of the stressor and of the system, providing ordinary planning with tools that are useful in a preventive perspective and not only in emergency conditions. Local vulnerability assessment is a key tool able to provide a framework for prioritizing choices and actions in different strategies and policies. In literature, many studies focus on the assessment of local vulnerability, but there are few directly site-specific methods concerning climate change as stressor in rural areas, although they are particularly vulnerable contexts to climate change. Vulnerability of rural areas is principally linked to their significant dependence on agriculture sector and to specific socio-economic dynamics, often responsible of inequalities within communities. Starting from these assumptions, authors define a methodology to quantitatively assess, in rural areas, the level of vulnerability to climate change based on climatic and context analysis at the municipality scale. The methodology is based on numerical and statistical computation operations on a set of indicators of climate exposure, sensitivity and adaptive capacity in order to provide an aggregate Vulnerability Index. The paper presents the results of the application to the Calabrian territorial context of the Grecanica Area (Italy).

BackgroundPisa syndrome (PS) is a frequent postural complication of Parkinson's disease (PD). PS poorly responds to anti-parkinsonian drugs and the improvement achieved with neurorehabilitation tends to fade in 6 months or less. Transcranial direct current stimulation (t-DCS) is a non-invasive neuromodulation technique that showed promising results in improving specific symptoms in different movement disorders.ObjectivesThis study aimed to evaluate the role of bi-hemispheric t-DCS as an add-on to a standardized hospital rehabilitation program in the management of PS in PD.MethodsThis study included 28 patients with PD and PS (21 men, aged 72.9 ± 5.1 years) who underwent a 4-week intensive neurorehabilitation treatment and were randomized to receive: i) t-DCS (t-DCS group, n = 13) for 5 daily sessions (20 min−2 mA) with bi-hemispheric stimulation over the primary motor cortex (M1), or ii) sham stimulation (sham group, n = 15) with the same duration and cadence. At baseline (T0), end of rehabilitation (T1), and 6 months later (T2) patients were evaluated with both trunk kinematic analysis and clinical scales, including UPDRS-III, Functional Independence Measure (FIM), and Numerical Rating Scale for lumbar pain.ResultsWhen compared to the sham group, the t-DCS group achieved a more pronounced improvement in several variables: overall posture (p = 0.014), lateral trunk inclination (p = 0.013) during upright standing position, total range of motion of the trunk (p = 0.012), FIM score (p = 0.048), and lumbar pain intensity (p = 0.017).ConclusionsOur data support the use of neuromodulation with t-DCS as an add-on to neurorehabilitation for the treatment of patients affected by PS in PD.

BackgroundEndometrial cancer (EC) represents the sixth most common female tumor. In the advanced setting, the prognosis is dismal with limited treatment options. Platinum-based chemotherapy represents the actual standard of care in first-line chemotherapy, but no standard second-line chemotherapy is approved, with less than 1/4 of patients responding to second-line chemotherapy. In the last 10 years, immune checkpoint inhibitors (ICIs) have changed the treatment landscape of many solid tumors.MethodsThe review was conducted according to the PRISMA guidelines. We searched EMBASE, MEDLINE, Cochrane Database, and conference abstracts from international societies, up to November 2021. Clinical trials employing ICIs in advanced EC, written in English, were included. Reviews, letters, and commentaries were excluded. The overall response rate (ORR), progression-free survival (PFS), overall survival (OS), and safety (number and grade of treatment-related adverse events [TRAEs]) were evaluated.Results15 studies, for a total of 1,627 patients, were included: 14 non-randomized phase I/II trials and 1 randomized phase III trial. Anti-PD1 (pembrolizumab, nivolumab, dostarlimab) and anti-PD-L1 agents (avelumab, atezolizumab, durvalumab) were administered as single agents; pembrolizumab and nivolumab were combined with the tyrosine-kinase inhibitors (TKI) lenvatinib and cabozantinib, respectively; and durvalumab was associated with anti-CTLA4 tremelimumab. 4 studies selected only MSI patients. Single agents determined an ORR from 26.7% to 58% among MSI patients, from 3% to 26.7% among MSS patients. DCR ranged from 53.5% to 88.9% in MSI, 31.4% to 35.2% in MSS patients. The combination of TKI and ICIs determined 32% to 63.6% of ORR in all-comers, 32%–36.2% in MSS patients. 54.2% to 76% of patients developed TRAEs. The combination of ICIs and TKI achieved a higher toxicity rate than single agents (≥G3 TRAEs 88.9%).ConclusionICIs represent an effective option for pretreated advanced EC patients with a tolerable profile. Given the encouraging results in MSI patients, every woman diagnosed with EC should be investigated for MS status. In MSS women, the combination of ICIs and TKI is more effective than monotherapy, notwithstanding safety concerns. PD-L1 cannot predict ICI response, whereas other biomarkers such as MSI and tumor mutational burden seem more accurate. Ongoing randomized trials will further clarify the role of these therapeutic options.Systematic Review RegistrationPROSPERO, CRD42021293538.

Over the centuries, humans have developed different systems to protect surfaces from the influence of environmental factors. Protective paints are the most used ones. They have undergone considerable development over the years, especially at the turn of the 19th and 20th centuries. Indeed, between the two centuries, new binders and pigments have been introduced in the constituent materials of paints. The years in which these compounds have been introduced and spread in the paint market allow them to be defined as markers for the dating of paints and painted artifacts. The present work is focused on the study of the paints of two vehicles of the Frankfurt Museum of Communication, i.e., a carriage and a cart, that was designed for the German Postal and Telecommunications Service roughly between 1880 and 1920. The characterization of the paints was performed through in situ non-invasive techniques, i.e., portable optical microscopy and multispectral imaging, and laboratory non-destructive techniques, i.e., FT-IR ATR spectroscopy and SEM-EDS. The analytical investigation and the comparison with the data reported in the literature allowed us to determine the historicity of the paints, which are all dated before the 1950s.

In the present study, a diagnostic approach was used to analyze the wall painting in the apse of the Sotterra church at Paola, in the province of Cosenza, Italy. The Sotterra church is nowadays located 6 m under the ground level. The presbytery area houses valuable pictorial evidence attributable to different phases. The oldest painting, visible in the apse area, dates back to the 11th–12th centuries, and it represents the subject of the present study, while the later decorations are placed in a chronological range from the 14th to the 15th centuries. Due to the peculiar environmental conditions, the conservation of subterranean sites represents a debated issue and must be properly investigated. For this reason, in this research, noninvasive analysis and laboratory-based methods were planned to obtain information about both the composition of original materials and the mechanisms and causes of alterations affecting the wall painting in the apse. Simultaneously, an environmental monitoring campaign of the indoor climate for the duration of nine months was conducted. The results highlighted the use of natural mineral pigments such as ochres and earths. The analysis of the painting stratigraphy revealed that the mural painting consists of two plaster layers characterized by lime-based binder. Moreover, the presence of a high amount of calcium sulfate has been discovered; this latter result, combined with the monitoring of the microclimate, allowed for the establishment of the crystallization and the condensation risks which occur on the investigated surfaces.

Background: Cervical cancer (CC) constitutes the fourth most common tumor among the female population. Therapeutic approaches to advanced CC are limited, with dismal results in terms of survival, mainly after progression to platinum-based regimens. Immune checkpoint inhibitors (ICIs) are remodeling the therapeutic scenario of many solid tumors. The role of ICIs in CC should be addressed. Therefore, we systematically reviewed the latest clinical trials employing ICIs in advanced CC to assess which ICIs have been employed and how ICIs might meet the need for new therapeutic options in terms of efficacy and safety. Methods: The review was conducted following the PRISMA guidelines. The following efficacy outcomes were specifically collected: overall response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS); for safety: type, number, and grade of adverse events (AEs). Results: A total of 17 studies were analyzed. Anti-PD1 (pembrolizumab, nivolumab, cemiplimab, balstilimab, and tislelizumab), anti-PD-L1 (atezolizumab), and anti-CTLA-4 (ipilimumab, zalifrelimab) agents were employed both as single agents or combinations. Overall ORR ranged from 0% to 65.9%. ORR ranged from 5.9% to 69.6% in PD-L1-positive patients and from 0% to 50% in PD-L1-negative patients. DCR was 30.6–94.1%. mPFS ranged from 2 to 10.4 months. mOS ranged from 8 months to not reached. PD-L1 status did not impact survival. A total of 33.9% to 100% of patients experienced AEs. Conclusion: Immunotherapy represents an appealing strategy for patients with advanced CC, as 2 out of 3 patients seem to respond to ICIs. PD-L1 status might be an indicator of response without impacting survival.

Regeneration of disused sites represents a significant opportunity. The scientific interest in their redevelopment possibilities has grown considerably in recent years. Despite this, a shared definition of disused sites which goes beyond that of brownfields and allows recognition the size of the problem on a transnational scale is still lacking. This study provides an overview of the main definitions provided by scientific literature and on this basis, it proposes a parametric definition of functionally disused areas. Subsequently, a GIS-based operational tool able to map functionally disused areas through a progressive screening of the local territory is introduced. The proposed methodology is tested on two Italian municipalities. It is the first step of a research aimed at defining a wider process able to assess the possibility of converting disused areas into multifunctional or monofunctional “smart” districts. They could be, indeed, characterized by a mixed use – contributing to soil consumption reduction – or by a single use – “social infrastructures” – linked to the needs that emerged as result of Covid 19 pandemic. This assessment process, hence, could support urban planning both at ordinary and emergency phase, allowing to identify in very short time areas where temporary facilities could be installed.

Background and Objective To preserve cardiovascular health in persons with spinal cord injury (SCI), it is important to promote physical activity programs adapted to them. Home-based exercise programs allow patients to perform clinician-prescribed physical activity without going to a hospital. However, they make it difficult for the clinician to guide and monitor the patient. To face this issue, this paper proposes a novel smartphone-based mobile application (Fisiofriend), and evaluates its feasibility with a pilot study in a real clinical intervention. Methods Fourteen SCI male subjects were involved in a 6-weeks home-based intervention, based on upper limbs exercises: 7 subjects (APP group) used Fisiofriend, and 7 subjects used traditional pictorial instructions on paper (PAPER group). At the beginning (t1) and end (t2) of the study period, we measured: (i) biceps and triceps brachii strength and endurance parameters with an isokinetic dynamometer (Biodex System 4), (ii) O2 maximal consumption with a crank ergometer stress test (VO2000, Medgraphics). Moreover, we collected subjective data about subjects’ perception of the support (app or paper) in the home-based program. Results Physiological results were encouraging for both groups. Questionnaire data suggests a possible advantage of the app in terms of pleasantness, engagement and perception of positive effects. Practical clinical experience with the subjects and their informal reports highlighted which features of the app could be of particular benefit in real interventions, as we discuss in the paper. Conclusions The study showed the feasibility of using a mobile app in home-based exercise programs involving SCI patients. We discuss implications of introducing such kind of apps into clinical practice.

Different from skeletal muscle, the heart autonomously generates rhythmic contraction independently from neuronal inputs. However, speed and strength of the heartbeats are continuously modulated by environmental, physical or emotional inputs, delivered by cardiac innervating sympathetic neurons, which tune cardiomyocyte (CM) function, through activation of β-adrenoceptors (β-ARs). Given the centrality of such mechanism in heart regulation, β-AR signaling has been subject of intense research, which has reconciled the molecular details of the transduction pathway and the fine architecture of cAMP signaling in subcellular nanodomains, with its final effects on CM function. The importance of mechanisms keeping the elements of β-AR/cAMP signaling in good order emerges in pathology, when the loss of proper organization of the transduction pathway leads to detuned β-AR/cAMP signaling, with detrimental consequences on CM function. Despite the compelling advancements in decoding cardiac β-AR/cAMP signaling, most discoveries on the subject were obtained in isolated cells, somehow neglecting that complexity may encompass the means in which receptors are activated in the intact heart. Here, we outline a set of data indicating that, in the context of the whole myocardium, the heart orchestra (CMs) is directed by a closely interacting and continuously attentive conductor, represented by SNs. After a roundup of literature on CM cAMP regulation, we focus on the unexpected complexity and roles of cardiac sympathetic innervation, and present the recently discovered Neuro-Cardiac Junction, as the election site of “SN-CM” interaction. We further discuss how neuro-cardiac communication is based on the combination of extra- and intra-cellular signaling micro/nano-domains, implicating neuronal neurotransmitter exocytosis, β-ARs and elements of cAMP homeostasis in CMs, and speculate on how their dysregulation may reflect on dysfunctional neurogenic control of the heart in pathology.