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Purpose: The Comprehensive assessment of Acceptance and Commitment Therapy (CompACT) is a 23-item questionnaire measuring psychological flexibility, a quality of life protective factor. An 18-item version was recently produced. We assessed validity and reliability of CompACT, and equivalence of paper and electronic (eCompACT) versions in people with multiple sclerosis (PwMS) in Italy, Germany and Spain. Methods: We used confirmatory factor analysis and assessed CompACT-23 and CompACT-18 measurement invariance between the three language versions. We assessed construct validity (Spearman's correlations) and internal consistency (Cronbach's alpha). Test–retest reliability (intraclass correlation coefficient, ICC) and equivalence of paper and eCompACT (ICC and linear regression model for repeated measures) were assessed in subsamples of PwMS. Results: A total of 725 PwMS completed the study. The three-factor structure of the CompACT-23 showed poor fit (RMSEA 0.07; CFI 0.82; SRMR 0.08), while the fit of the CompACT-18 was good (RMSEA 0.05; CFI 0.93; SRMR 0.05). Configural and partial metric invariance were confirmed, as well as partial scalar invariance (reached when five items were allowed to vary freely). The CompACT-18 showed good internal consistency (all alpha ≥ 0.78); and test–retest reliability (all ICCs ≥ 0.86). Equivalence between paper and eCompACT was excellent (all ICCs ≥ 0.86), with no mode, order, or interaction effects. Conclusion: Results support using the refined CompACT-18 as a three-factor measure of psychological flexibility in PwMS. Paper and eCompACT-18 versions are equivalent. CompACT-18 can be used cross-culturally, but sub-optimal scalar invariance suggests that direct comparison between the three language versions should be interpreted with caution. [ABSTRACT FROM AUTHOR]

Less than 2% of physicians complete a research training (PhD) after the residency with a declining trend in those pursuing a clinical scientist pathway in pediatrics. The exposure to research methodology during the clinical training may play a role in engaging the next generations of pediatric physician scientist. Herein, we describe the experience of the Padova Physician Scientist Research Training (PPSRT) of the pediatric residency program at the University of Padova. The PPSRT was addressed to residents attending PGY2 to PGY4 of the pediatric program and consisted of two cores: a general one including in person or virtual lectures about research methodology in pediatrics including design of a clinical trial, writing of a scientific paper and statistical methods, and a subspecialties core for the discussion of research challenges in each area and the scientific writing activities. The perceived barriers to a research training and an evaluation of the program were assessed by an anonymized questionnaire. Sixty-four out 150 residents registered for the research training with 62/64 completing the two cores. The major perceived barrier to research during clinical training was the absence of protected time (89%) followed by the lack of specific funds (37%). The group activities lead to the publication of 24 papers. Conclusion: This is the first experience in the Italian pediatric training of a dedicated research program within the frame of postgraduate medical education. Our report highlights the need for protected time to promote research interest and nurture a new generation of physician scientists. What is Known: • Training to medical research is not part of residency program. • The declining trend of physician scientists might be reverted by early exposure to research methodology and challenges during residency. What is New: • An early exposure to research training during pediatric residency increases the research engagement of pediatric residents. • The lack of protected time for research is perceived as the major barrier to research training during residency. [ABSTRACT FROM AUTHOR]

This paper explores the knowledge network structure of foreign research literature by applying the qualitative comparative analysis (QCA) method to the field of information science and library science (ISLS) from the perspective of the cocitation of social network actors such as authors, institutions, countries, and literature, and it further reveals the future application trends of this method. [Method/process] Based on 86 journals in the ISLS field that were downloaded from the Web of Science using the QCA method, the social network analysis (SNA) method and the visual analysis tool Gephi are used to analyse the author cooperation network, the research institution cooperation network, the national cooperation network, the cocitation network, the cutting-edge trends, etc., of journal papers. The analysis shows that the QCA method covers a wide range within the field of ISLS, but the research topics involved in this field are not concentrated, and the author cooperation network has scale-free characteristics. The application of the QCA method is still dominant in European and American countries, and China, the USA, and Italy all play key roles in the national cooperation network. Finally, the institutional cooperation network has certain small group attributes. [ABSTRACT FROM AUTHOR]

The paper analyzes the optimal lockdown policy using the SQAIRD model over a network with three population groups (young, adult, and old). We show that different lockdown policies may be justified by different socioeconomic structures (objective cost functions that are either convex or concave). We also show that a lockdown policy is always better than a laissez-faire policy, and a targeted policy specific to each group outperforms a uniform policy. In our benchmark example, we consider the case of Italy. Our simulations show that: (a) a lockdown policy is always better than the laissez-faire policy because it limits the costs generated by the pandemic in an uncontrolled situation; (b) a group-specific targeted lockout policy is more effective than a uniform policy to the extent that the groups differ. The latter is a less expensive targeted policy (as it optimally minimizes direct, indirect, and vaccination costs), and it is equally effective in controlling the pandemic. One finding of particular interest is that the optimal lockdown rate should be higher for the young and elderly than for adults. This is motivated by the fact that younger individuals are more likely to spread the virus in question asymptomatically. [ABSTRACT FROM AUTHOR]

Over the last two decades, involuntary part-time (IPT) employment has become a more and more pressing issue in Europe, especially in the southern countries, where IPT today constitutes most part-time employment. Using INAPP-PLUS data and different discrete choice model estimations, this paper aims to shed light on the factors that explain the IPT growth in Italy, focusing on what influences the IPT status at the individual, household and labour market levels. The main hypothesis is that what influences the IPT work derive from a combination of workers' individual, household, and job characteristics which may engender limited power during the bargaining process. The empirical results, based on gender-specific models, highlight that characteristics associated with the IPT status significantly changed over time, reporting a convergent path between the gender profiles of IPT employment. However, IPT employment for women still appears to be mainly originated from the gendered division of domestic and care tasks, while this phenomenon seems to be mainly driven by the labour demand side for men. [ABSTRACT FROM AUTHOR]

In the latest years the capacity and complexity of climate and environmental modeling has increased considerably. Therefore, tools and criteria for model performance evaluation are needed to ensure that different users can benefit from model selection. Among graphical tools, Taylor's diagram is widely used to provide evaluation and comparison of model performances, with particular emphasis on climate models. Taylor's diagram accounts for different statistical features of model outputs and observations, including correlation, variability and centered root mean square error. Not included is model bias, which is an essential feature for climate model evaluations, and it is usually calculated separately to complement the information embedded in Taylor's diagram. In this paper a new diagram is proposed, referred to as Aras' diagram, which allows for visual assessments of the correspondence between model outputs and reference data in terms of total error, correlation, as well as bias and variability ratios through an easy-to-interpret two-dimensional (2D) plot, allowing for proper weighting of different model features. The strengths of the new diagram are exemplified in a case study of performance evaluation of EURO-CORDEX historical experiment over Southern Italy using E-OBS as reference dataset, for three hydrological variables (i.e. daily precipitation, daily surface minimum temperature, and daily maximum surface temperature), and four popular climate indices (i.e. total annual precipitation, annual maxima of daily precipitation, annual minima of daily minimum temperatures, and annual maxima of daily maximum temperatures). The proposed diagram shows interesting properties, in addition to those already included in Taylor's diagram, which may help promoting climate model evaluations based on their accuracy in reproducing the climatological patterns observed in time and space. [ABSTRACT FROM AUTHOR]

When a lava flow enters a body of water, either a lake, sea, river or ocean, explosive interaction may arise. However, when it is an 'a'ā lava flow entering water, a more complex interaction occurs, that is very poorly described and documented in literature. In this paper, we analysed the 2–4 ka San Bartolo lava flow field emplaced on the north flank of Stromboli volcano, Italy. The lava flow field extends from ~ 650 m a.s.l. where the eruptive fissure is located, with two lava channels being apparent on the steep down to the coast. Along the coast the lava flow field expands to form a lava delta ~ 1 km wide characterised by 16 lava 'Flow' units. We performed a field survey to characterise the features of lava entering the sea and the associated formation of different components and magnetic measurements to infer the flow fabrics and emplacement process of the lava flow system. We measured the density, porosity and connectivity of several specimens to analyse the effect of lava-water interaction on the content in vesicles and their connectivity and conducted a macroscopic componentry analysis (clast count) at selected sites to infer the character of the eroded offshore segment of the lava flow field and its component flow units. The collected data allowed us to define the main components of a lava delta fed by 'a'ā lava flows, with its channels, littoral units, ramps, lava tubes, and inflated pāhoehoe flows controlled by the arterial 'a'ā flow fronts. The spatial organisation of these components allowed us to build a three-step descriptive model for 'a'ā entering a water. The initial stage corresponds to the entry of channel-fed 'a'ā lava flow into the sea which fragments to form metric blocks of 'a'ā lava. Continued lava supply to the foreshore causes flow units to stall while spreading over this substrate. Subsequent 'a'ā lava flow units ramp up behind the stalled flow front barrier. Lava tubes extending through the stalled flow barrier feed the seaward extension of a bench made of several pāhoehoe flow units. [ABSTRACT FROM AUTHOR]

The paper examines how individual motivations, the role of the supervisor and gender influence the early career path of doctorate holders. We investigate PhD graduates' occupational outcomes beyond academia in the framework of current literature on the oversupply of PhD holders and labor market constraints. Our analysis relies on two unique datasets. The first, at the national level, includes microdata from the Italian National Institute of Statistics regarding about 41,000 graduates who account for over 70% of the population of 6 cohorts surveyed for the period 2004–2014. The other dataset is from a single university, and resulted from an original survey of 760 PhD holders who earned their doctorates from the University of Turin in 2007–2017. We find that PhD holders' motivation towards science is associated with their subsequent employment in academia or in other research and non-research jobs. Sponsoring support in early career and the supervisor's propensity for basic research also play a role in the future academic career path. Gender differences in type of occupation, however, continue to persist even taking motivations and the supervisor's role into account. [ABSTRACT FROM AUTHOR]

In this paper the actual dynamic behavior of the civic Clock tower of Rotella, a little village in central Italy heavily damaged by the recent 2016 seismic sequence, is thoroughly investigated by means of a detailed numerical model built and calibrated using the experimental modal properties obtained through Ambient Vibration Tests. The goal is to update the uncertain parameters of two behavioral material models applied to the Finite Element Model (elastic moduli, mass densities, constraints, and boundary conditions) to minimize the discrepancy between experimental and numerical dynamic features. A sensitivity analysis was performed with the definition of a metamodel to reduce the computational strain and try to define the necessary parameters to use for the calibration process. Due to the high nonlinear dependency of the objective function of this optimization problem on the parameters, and the likely possibility to get trapped in local minima, a machine learning approach was meant. A fully automated Finite Element Model updating procedure based on genetic algorithms and global optimization is used, leading to tower uncertain parameters identification. The results allowed to create a reference numerical replica of the structure in its actual health state and to assess its dynamic performances allowing better control over their future evolution. [ABSTRACT FROM AUTHOR]

Landslide hazards have significant social, economic, and environmental impact. This work provides a critical review of the main existing literature using satellite data for mapping landslides. We created and examined an extensive bibliographic database from Web of Science (WoS) consisting in 291 outputs from > 1,000 authors who studied almost 700,000 landslides across all continents, for a total of 52 countries represented with China and Italy on top of the list with more authors. The outputs are equivalent to ~ 5% of the whole landslide-related production for the period 1996–2022, with a 600% increase in the number of papers after 2014 driven by the availability of Sentinel-1 and Sentinel-2 data. Analysis of the geographical location across the 66 different countries analysed shows that, within the total number of contributions, the satellite imagery was used to detect and map two main types of landslides: flows and slides. When specified in the manuscripts, the events have been triggered by rainfall (104 cases), earthquakes (32 cases), or both (17 cases). Slope instabilities in these areas were predominantly identified through manual detection (40%); but since 2020, the advent of artificial intelligence is suppressing all other techniques. Despite the undisputed progress of EO-based landslide mapping over the last 26 years, which makes it a consolidated tool for many landslide-related applications, challenges still remain for an effective and operational use of EO images for landslide detection and mapping, and we provide a perspective for future applications considering the existing and the planned SAR satellite missions. [ABSTRACT FROM AUTHOR]

The Electronic Personal Health Record (EPHR) provides an innovative service for citizens and professionals to manage health data, promoting patient-centred care. It enhances communication between patients and physicians and improves accessibility to documents for remote medical information management. The study aims to assess the prevalence of awareness and acceptance of the EPHR in northern Italy and define determinants and barriers to its implementation. In 2022, a region-wide cross-sectional study was carried out through a paper-based and online survey shared among adult citizens. Univariable and multivariable regression models analysed the association between the outcome variables (knowledge and attitudes toward the EPHR) and selected independent variables. Overall, 1634 people were surveyed, and two-thirds were aware of the EPHR. Among those unaware of the EPHR, a high prevalence of specific socio-demographic groups, such as foreign-born individuals and those with lower educational levels, was highlighted. Multivariable regression models showed a positive association between being aware of the EPHR and educational level, health literacy, and perceived poor health status, whereas age was negatively associated. A higher knowledge of the EPHR was associated with a higher attitude towards the EPHR. The current analysis confirms a lack of awareness regarding the existence of the EPHR, especially among certain disadvantaged demographic groups. This should serve as a driving force for a powerful campaign tailored to specific categories of citizens for enhancing knowledge and usage of the EPHR. Involving professionals in promoting this tool is crucial for helping patients and managing health data. [ABSTRACT FROM AUTHOR]

Promoting the shift from private cars to micromobility (e.g., bike, e-bike, scooter) can represent a valuable action to improve city sustainability and liveability. Micromobility can help to replace trips by individual private cars (e.g., daily short round trips) as well as to improve coverage and accessibility of transit services, and, subsequently, to reduce the traffic impacts (e.g., pollutant emissions). It can be seen as a potential solution to move people more efficiently in urban areas, as well as to push people towards a more active mobility behaviour, contributing to the well-being goals. In this context, the paper, rather than inferring the users' propensity to change their travel mode, proposes a methodology to identify car trips that can be considered the most compatible with micromobility. Estimation of the potential demand (e.g., the upper level of car trips that could be replaced by micromobility) is carried out by exploiting the opportunity offered by floating car data (FCD) for characterising car trips. Its goodness is therefore evaluated through an application to a real case study (i.e., the city of Trani, Apulia Region, Southern Italy), divided into seventy traffic zones, and where a FCD dataset of about 5,200 trips was available. The FCD allowed the car trips to be characterised (e.g., origin and destination, path features) instead of using the traditional surveys. The results indicate that a significant share of daily car trips can be substituted (i.e., the most compatible) by micromobility (31% of car round trips in the case study), with considerable potential environmental gains (traffic emission reduction; less than 21% of total emissions from private cars). Results can be of interest to local authorities in integrating micromobility in urban mobility planning and promoting new sustainable transport alternatives, as well as to transport companies for designing new appeal services. The developed methodology is parametric and uses easy-to-obtain data available worldwide; thus, it can be easily transferred to other city contexts. [ABSTRACT FROM AUTHOR]

Background: Insomnia is the most reported sleep disorder in industrialized countries, affecting, in the chronic form, around 10% of the European population. In Italy, such a percentage seems to be even higher. Although insomnia can be an independent disorder, it is frequently described as comorbid condition and may precipitate, exacerbate, or prolong a broad range of physical and mental disorders. Evaluating and targeting insomnia in the Italian clinical practice should be a priority. Methods: The present expert opinions and recommendations represent an update from 2020 and insights from Insomnia Expert Consensus Group, based on systematic reviews according to PRISMA on available options in Italy from January 2020 to March 2023. Results: We evaluated 28 papers among international guidelines, expert opinions, systematic reviews, and meta-analysis produced during the last 26 months. Conclusions: Our findings suggest that symptoms of insomnia must be assessed in the Italian clinical practice by evaluating nocturnal and daytime symptoms, comorbid conditions, and lifestyle. Cognitive behavioral therapy for insomnia should be the first option according to availability. The choice of the drug should be based on different factors including type of insomnia, age, comorbidities, and potential side effects. If the choice would be a Z-drug or a short-acting benzodiazepine (in subjects < 65 years old), the use should be in the short term (≤ 4 weeks). Indeed, eszopiclone, as a new option in Italy, may present a different profile and may be used for up to 6 months, also in the elderly. If the choice is melatonin, it should be used melatonin 2 mg prolonged release in adults ≥ 55 years for up to 13 weeks. A new dual orexin antagonist, daridorexant, is available in Italy; it has been shown to be effective in adults and elderly and it can be used for at least 3 months and up to 1 year. [ABSTRACT FROM AUTHOR]

The main purpose of this paper was to study the effect of spatial variability of soil hydraulic properties (HP) and vegetation parameters (VP) (e.g., leaf-area index, LAI, and crop coefficient, Kc) on modelling agro-hydrological processes and optimising irrigation volumes at large scale. Based on this analysis, the effect of partly overlooking the spatial variability of soil HP and/or VP inputs was verified on a 140 ha irrigation sector in "Sinistra Ofanto" irrigation system in Apulia Region, Southern Italy. Five soil profiles were excavated and the HP were measured in all the soil horizons. Additionally, measurements of soil HP were taken in the surface soil layer in ninety sites distributed over the whole irrigation sector. All the HP measurements were carried out using tension infiltrometer. Remote sensing applications were used to obtain LAI and Kc using European Space Agency's (ESA) Sentinel-2 images with 10 m resolutions. First, distributed (on ninety polygons with an average area of about 1.5 ha) optimal irrigation volumes and related deep percolation volumes at a depth of 80 cm, were computed using an agro-hydrological model and accounting for the actual observed variability of soil HP and VP inputs. The sector scale irrigation and deep percolation volumes were obtained by aggregating the distributed irrigation volumes. This was considered as the reference scenario (hereafter DVS—Detailed Variability Scenario). Then, reduced variability scenarios (hereafter RVS—Reduced Variability Scenario) were considered, where the information on the actual spatial variability of the soil HP and VP was gradually overlooked to find the minimum data set needed to still have sector scale irrigation volumes and related deep percolation volumes comparable to those obtained under the DVS. Results showed that overlooking VP (RVS-VP) variability did not significantly change the optimal irrigation volumes and the deep percolation fluxes. By contrast, neglecting the HP variability (RVS-HP) showed significant effects on both the irrigation and percolation volumes compared to the DVS. The main practical finding was that, at least for the area investigated in this study, hydraulic characterization of one soil profile in an area of approximately 30 ha provides sector scale irrigation volumes and percolation fluxes comparable to those obtained under the DVS, thus by accounting for all the observed local variability. [ABSTRACT FROM AUTHOR]

Although in Italy there is currently no effective law on physician-assisted suicide or euthanasia, Decision No. 242 issued by the Italian Constitutional Court on September 25, 2019 established that an individual who, under specific circumstances, has facilitated the implementation of an independent and freely-formed resolve to commit suicide by another individual is exempt from criminal liability. Following this ruling, some citizens have submitted requests for assisted suicide to the public health system, generating a situation of great uncertainty in the application processes. As a matter of fact, shared and defined procedures are lacking as Decision 242/2019 merely added some principles on which the legislature will have to base its future intervention. This paper analyses the advisory role that the Decision attributes to territorial ethics committees with the aim of stimulating discussions on their role in oversight mechanisms. The proposed conclusion is that the envisaged role does not appear consistent with the functions of these bodies and is ultimately substantially undefined and unjustified. [ABSTRACT FROM AUTHOR]

In this paper, the structural vibration control of short-period systems by a sliding model of a tuned liquid column damper (herein referred to as STLCD) is investigated from both theoretical and experimental points of view. The proposed STLCD is essentially composed of a U-tube container with liquid inside, which can slide on a linear guide rail and is connected to the structure by a spring-dashpot system. Unlike traditional fixed TLCDs, this type of arrangement allows the proposed STLCD to be tuned to short-period structural systems since the spring can be used for tuning while the dashpot provides additional damping. Details on the selection of the optimal design parameters of the STLCD are provided, and the validity of the introduced mathematical model is verified both in time and frequency domains through experimental tests conducted at the Laboratory of Experimental Dynamics at the University of Palermo, Italy. For the experimental tests, a scale model of an STLCD-controlled structure is considered, focusing on the reduction of the roof accelerations. Finally, for comparison purposes, the control performance of the proposed control strategy for the vibration suppression of stiff structures is evaluated by analyzing its structural responses in contrast with the corresponding uncontrolled structure under harmonic excitations. [ABSTRACT FROM AUTHOR]

Background: To assess the state of neurological scientific research in Italy in the time interval 2020–2023. Methods: Elsevier's modular integrated platform "SciVal" was used to analyze bibliometric research products starting from scientific production data uploaded onto Scopus. We considered the research area "Neurology" in the 01/01/2020–14/06/2023 time interval, and the following variables were extracted: number of published studies, number of citations, Field-Weighted Citation Impact, and percentage of international collaborations. The contribution of Italian scientists to the neurological research was compared to that of the other nations. Results: Research identified 90,633 scientific papers in the neurological area worldwide, with a total of 472,750 citations. The products assigned to Italian groups were 6670 (53,587 citations, Field-Weighted Citation Impact 1.68, 41% international collaborations). Conclusions: According to the present study, Italian neurological research 2020 to 2023 ranks fifth globally and third in Europe. [ABSTRACT FROM AUTHOR]

Introduction: A new national survey has been carried out by the Italian Centers for Cognitive Disorders and Dementias (CCDDs). The aim of this new national survey is to provide a comprehensive description of the characteristics, organizational aspects of the CCDDs, and experiences during the COVID-19 pandemic. Methods: A list of all national CCDDs was requested from the delegates of each Italian region. The online questionnaire is divided in two main sections: a profile section, containing information on location and accessibility, and a data collection form covering organization, services, treatments, activities, and any service interruptions caused by the COVID-19 outbreak. Results: In total, 511 out of 534 (96%) facilities completed the profile section, while 450 out of 534 (84%) CCDDs also completed the data collection form. Almost half of the CCDDs (55.1%) operated for 3 or fewer days a week. About one-third of the facilities had at least two professional figures among neurologists, geriatricians and psychiatrists. In 2020, only a third of facilities were open all the time, but in 2021, two-thirds of the facilities were open. Conclusion: This paper provides an update on the current status of CCDDs in Italy, which still shows considerable heterogeneity. The survey revealed a modest improvement in the functioning of CCDDs, although substantial efforts are still required to ensure the diagnosis and care of patients with dementia. [ABSTRACT FROM AUTHOR]

This paper presents a case study to support the hypothesis that religiosity and spirituality (R/S), as mood balancing factors, could facilitate the recovery process for patients suffering from bipolar disorder (BD) once they have been stabilized and are receiving appropriate support (e.g., in a residential rehabilitative center). After a succinct review of BD and R/S, the patient's medical history and rehabilitation pathway are described, with a particular focus on the role played by R/S. The authors found that in this case, once the patient was stabilized, R/S helped to consolidate her feelings of well-being, increasing her positive perception of social support services and ultimately her self-confidence. [ABSTRACT FROM AUTHOR]

Receiving information in the case of a positive or false-positive expanded newborn screening (ENBS) result for metabolic diseases is a stressful event. The availability of psychological support to families is crucial across the different communication steps and is recommended by different guidelines and position papers. However, more information is needed about the availability of psychological resources in the ENBS process. This national survey aimed to provide an overview of the availability of psychological resources for parents who received communication of positivity at the ENBS in the 23 Italian centers and how the support is provided to parents. An online survey was sent to the Heads of the ENBS centers asking about the availability of a clinical psychologist, their involvement in the ENBS process, and an estimation of parents receiving psychological support. More than 60% of the centers report having a clinical psychologist in the ENBS team; however, in more than 50% of cases, the psychologist does not participate in the consultation with parents (nor for the first consultation post-positivity or at confirmation of diagnosis). Furthermore, nearly 60% of the centers reported the experience of parental rejection of psychological sessions. Conclusion: There is a need for harmonization among the Italian ENBS centers concerning the availability of psychological resources and how these resources are provided to families. Parents' needs remained only partially fulfilled. What is Known: • Receiving communication of positivity at the ENBS can be highly stressful for parents and requires adequate psychological support. • The guidelines recommend psychological support for parents during the ENBS process. What is New: • Only 14/23 (60.9%) of Italian ENBS centers have a clinical psychologist within the team. • In half of the consultations with parents receiving communication of positivity, the clinical psychologist is never involved. [ABSTRACT FROM AUTHOR]

The research presented in this paper aims at providing a statistical model that is capable of estimating soil water content based on weather data. The model was tested using a long-time series of field experimental data from continuous monitoring at a test site in Oltrepò Pavese (northern Italy). An innovative statistical function was developed in order to predict the evolution of soil–water content from precipitation and air temperature. The data were analysed in a framework of robust statistics by using a combination of robust parametric and non-parametric models. Specifically, a statistical model, which includes the typical seasonal trend of field data, has been set up. The proposed model showed that relevant features present in the field of experimental data can be obtained and correctly described for predictive purposes. [ABSTRACT FROM AUTHOR]

Introduction: An innovative eye drops formulation containing 0.2% hyaluronic acid and a low concentration of hydrocortisone (0.001%; hereafter HALH) has been recently placed on the market (Idroflog®, Alfa Intes, Italy) to manage the dysregulated parainflammation in patients with dry eye disease (DED). In the present paper, the effectiveness of HALH on the signs and symptoms of DED was retrospectively evaluated and compared with that one obtained using standard tear substitutes (STS) by means of low- and high-tech (Keratograph®) assessments. Methods: This was a multicenter retrospective study carried out between February and April 2023, involving adult patients with DED diagnosis owing to post-cataract surgery, meibomian gland dysfunction, allergy, or glaucoma medications. The primary aim was to compare the changes induced by different therapies on Keratograph® parameters (noninvasive Keratograph tear breakup time [NIKBUT], tear meniscus height [TMH], eyelid meibography, conjunctival hyperemia, and conjunctivochalasis) or collected by traditional low-tech measures (tear breakup time [TBUT], Schirmer test, Efron score, and epithelial alterations) and the Ocular Surface Disease Index score. Results: Data from 155 patients were analyzed. The effectiveness of HALH and STS was reported by both high- and low-tech measures. NIKBUT-first showed a significant improvement in the HALH group versus the STS one at 15 days (6.4 ± 3.6 vs 5.4 ± 3.7 s, p = 0.02), whereas this difference was latent with low-tech TBUT until 45 days (6.8 ± 2.6 vs 5.6 ± 2.3 s, p = 0.03). Patients with DED occurring after cataract surgery reported an enhanced activity of HALH versus STS, particularly for NIKBUT-first, TMH, Schirmer test, and hyperemia stage. Conclusion: These findings highlighted the effectiveness of HALH in all DED subtypes, especially in patients with post-cataract surgery, as well as its superiority versus STS in terms of tear film stability improvement. We recommend longer observation (i.e., 3–6 months) to fully ascertain whether the early improvement detected by high-tech measures will be confirmed in subsequent time points even using low-tech tests. [ABSTRACT FROM AUTHOR]