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Abstract We aimed to determine how a bout of resistance or aerobic exercise impacts physiological responses and performance during firefighting occupational tasks. Thirty-two non-firefighters completed two baseline assessments and three trials: resistance exercise (RE), aerobic exercise (AE), or a rested control (CON). Trials were followed by an occupational task assessment (OTA; four rounds of 10 deadlifts (38.6–61.4 kg) and 0.24-km 40lb-sandbag carry) in an environmental chamber (35 °C/50% humidity) while wearing standard municipal firefighter gear. Time to complete by condition was not statistically different (CON: 18.9 ± 4.4, AE: 20.0 ± 3.6, RE: 20.2 ± 5.0 min; p = 0.16). During the OTA average heart rate (CON: 149 ± 16, AE: 166 ± 12, RE: 160 ± 13 bpm; p

Abstract This study contributes to understanding semi-automated ergonomic risk assessments in industrial manufacturing environments, proposing a practical tool for enhancing worker safety and operational efficiency. In the Industry 5.0 era, the human-centric approach in manufacturing is crucial, especially considering the aging workforce and the dynamic nature of the entire modern industrial sector, today integrating digital technology, automation, and sustainable practices to enhance productivity and environmental responsibility. This approach aims to adapt work conditions to individual capabilities, addressing the high incidence of work-related musculoskeletal disorders (MSDs). The traditional, subjective methods of ergonomic assessment are inadequate for dynamic settings, highlighting the need for affordable, automatic tools for continuous monitoring of workers’ postures to evaluate ergonomic risks effectively during tasks. To enable this perspective, 2D RGB Motion Capture (MoCap) systems based on computer vision currently seem the technologies of choice, given their low intrusiveness, cost, and implementation effort. However, the reliability and applicability of these systems in the dynamic and varied manufacturing environment remain uncertain. This research benchmarks various literature proposed MoCap tools and examines the viability of MoCap systems for ergonomic risk assessments in Industry 5.0 by exploiting one of the benchmarked semi-automated, low-cost and non-intrusive 2D RGB MoCap system, capable of continuously monitoring and analysing workers’ postures. By conducting experiments across varied manufacturing environments, this research evaluates the system’s effectiveness in assessing ergonomic risks and its adaptability to different production lines. Results reveal that the accuracy of risk assessments varies by specific environmental conditions and workstation setups. Although these systems are not yet optimized for expert-level risk certification, they offer significant potential for enhancing workplace safety and efficiency by providing continuous posture monitoring. Future improvements could explore advanced computational techniques like machine learning to refine ergonomic assessments further.

In this systematic literature review, reports of international students, faculty members, and researchers indicate that international students have difficulty with the reading, writing, listening, and speaking demands of their English-mediated academic contexts, and that many host-institutions are not equipped to effectively accommodate their linguistic needs. A significant number of the studies reviewed also report that the difference between international students' previous educational experiences and typical Western classroom practices, dynamics, and expectations can be sources of confusion and anxiety. Additionally, salient trends indicate that linguistic and cultural difficulties may persist throughout the entire course of study, that some instructors hold deficit views of international students, and that international and domestic students have limited interactions. Host-institutions that fail to adequately meet the unique needs of this population have a moral obligation to take each of these issues into consideration if they are going to continue to take international students' tuition dollars.

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Capitalizing on the widespread adoption of smartphones among farmers and the application of artificial intelligence in computer vision, a variety of mobile applications have recently emerged in the agricultural domain. This paper introduces GranoScan, a freely available mobile app accessible on major online platforms, specifically designed for the real-time detection and identification of over 80 threats affecting wheat in the Mediterranean region. Developed through a co-design methodology involving direct collaboration with Italian farmers, this participatory approach resulted in an app featuring: (i) a graphical interface optimized for diverse in-field lighting conditions, (ii) a user-friendly interface allowing swift selection from a predefined menu, (iii) operability even in low or no connectivity, (iv) a straightforward operational guide, and (v) the ability to specify an area of interest in the photo for targeted threat identification. Underpinning GranoScan is a deep learning architecture named efficient minimal adaptive ensembling that was used to obtain accurate and robust artificial intelligence models. The method is based on an ensembling strategy that uses as core models two instances of the EfficientNet-b0 architecture, selected through the weighted F1-score. In this phase a very good precision is reached with peaks of 100% for pests, as well as in leaf damage and root disease tasks, and in some classes of spike and stem disease tasks. For weeds in the post-germination phase, the precision values range between 80% and 100%, while 100% is reached in all the classes for pre-flowering weeds, except one. Regarding recognition accuracy towards end-users in-field photos, GranoScan achieved good performances, with a mean accuracy of 77% and 95% for leaf diseases and for spike, stem and root diseases, respectively. Pests gained an accuracy of up to 94%, while for weeds the app shows a great ability (100% accuracy) in recognizing whether the target weed is a dicot or monocot and 60% accuracy for distinguishing species in both the post-germination and pre-flowering stage. Our precision and accuracy results conform to or outperform those of other studies deploying artificial intelligence models on mobile devices, confirming that GranoScan is a valuable tool also in challenging outdoor conditions.

Abstract Rectal core temperature monitoring can help fire services mitigate heat injury but can be invasive and impractical. EQ02 + LifeMonitor provides a non-invasive estimation of core temperature. Therefore, the primary purpose of this study was to determine the validity of the EQ02 + LifeMonitor compared to the gold standard rectal thermometer core temperature assessment, as well as the potential influence of turnout gear on the estimated and physiological strain experienced during these activities. Thirteen participants completed simulated firefighting tasks with and without turnout gear, involving four rounds of a 5-min walk on a treadmill at 2.8 mph/2.5% grade and 20 deadlifts over 5 min in an environmental chamber set to 40.6 °C; 50% humidity. During each trial participants wore both an EQ02 + LifeMonitor and DataTherm II rectal thermometer. The results from the devices were statistically equivalent (p 0.372]. These results suggest the EQ02 + LifeMonitor may be a viable, non-invasive alternative for assessing core temperature compared to rectal temperature monitoring, especially during rigorous, intermittent activities. Turnout gear does however increase heart rate, cumulative core temperature, and perceived exertion. Additionally, the validity of the estimated core temperature is not impacted by the use turnout gear. This is likely due to significant changes in heart rate, which allowed the heart-rate derived estimate of core temperature to remain consistent with changes in DataTherm II rectal temperatures.

Objective: The aim of this observational retrospective study was to report quality of life (QoL) in patients with postoperative facial nerve (FN) palsy after vestibular schwannoma (VS) surgery, investigating clinical factors related to functional outcomes. Methods: Forty-eight consecutive patients (M:F 25:23; median age: 52.5 years) with facial palsy following surgery for sporadic VS were considered retrospectively. FN palsy was graded by using the Sunnybrook facial grading system (SBFGS), while postoperative QoL and subjective functional aspects were assessed by using the Penn Acoustic Neuroma Quality of Life (PANQOL) Scale, the Synkinesis Assessment Questionnaire, and questions on eating and drinking. Results: A significant correlation emerged between all Sunnybrook scores and median PANQOL domain regarding facial function. Increasing overall SBFGS scores were associated with reduced risk of slow chewing on the affected side (p = 0.004), lack of masticatory strength (p = 0.025), masticatory fatigue (p < 0.001), accumulation of food in the oral vestibule (p < 0.001), difficulty in drinking from a glass (p = 0.019), and fluid spillage while drinking (p = 0.016). Conclusions: This study suggests that the clinical evaluation of patients with FN palsy after VS surgery should be integrated with patient reports about functional outcomes and perceived QoL to help clinicians guide rehabilitation choices.

One of the most fundamental strategies in mathematics instruction is practice problems because teachers know that practicing a skill improves performance. At the same time, teachers also know that just because students can correctly answer practice problems does not mean they fully understand the concept or how to apply a formula--especially not in the long term. Because students understand a key concept in seventh grade does not guarantee they will understand or remember the same concept in eighth grade. So the question is this: How can math teachers ensure that students are learning math and improving their skills, both in the short term and the long term? As described in the book "Powerful Teaching: Unleash the Science of Learning," research by cognitive scientists demonstrates that interleaving, or the simple strategy of mixing up concepts to be learned, can increase (and even double) math learning. The authors describe how to implement this strategy quickly and effectively in the classroom.

Aim: Coronavirus disease 2019 (COVID-19) became pandemic on 11th March 2020 and it deeply stressed the healthcare system. Cancer patients represent a vulnerable population, so many recommendations have been approved to ensure optimal management. Clinical research was notably impacted by COVID too. This review aims to analyze the challenges occurred during a pandemic for the management of enrolled patients (enrollment, use of telemedicine visits, study procedures) and for the clinical trials system (from feasibility to selection visit, site initiation visit, monitorings, use of e-signature, deviations and discontinuations). Methods: The studies included in the present review were selected from PubMed/Google Scholar/ScienceDirect databases. Results: During the first phase of pandemic many clinical trials were suspended in accrual and, as the pandemic progressed, recommendations were established to guarantee the safety and the continuity of care of enrolled patients. In addition, lot of new strategies was found during the pandemic to reduce the negative consequences on clinical trial performance and to guarantee new opportunities of care in the respect of good clinical practice (GCP) in a bad scenario. Conclusions: Among all modifiers, investigators would prefer to maintain the positive ones such as pragmatic and simplified trial designs and protocols, reducing in-person visits when not necessary and to minimizing sponsor and contract research organizations (CROs) visits.

Veronica Agostinelli,1 Lucia Musacchio,2 Floriana Camarda,2 Vanda Salutari,2 Maria Vittoria Carbone,2 Viola Ghizzoni,2 Camilla Nero,2 Caterina Ricci,2 Maria Teresa Perri,2 Elena Giudice,3 Sara Lardino,3 Rossana Berardi,1 Giovanni Scambia,2,3 Domenica Lorusso2,3 1Oncologic Clinic, Università Politecnica delle Marche, Ancona, Italy; 2Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; 3Institute of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Rome, ItalyCorrespondence: Vanda Salutari, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli, 8, Roma, 00168, Italy, Tel +39-06-3015-3234, Email vanda.salutari@policlinicogemelli.itAbstract: Cervical cancer is the fourth most common type of cancer in women worldwide. It is associated with a high death rate, despite the fact that it is a nearly 100% preventable disease because of very effective primary and secondary preventive strategies. Advanced and recurrent disease is uncurable with a high relapse risk and the second-line therapies are limited with modest response rates and short durability. Investigating alternative mechanisms of action is crucial because of the high request for effective new therapies. Tisotumab vedotin (TV) is the first antibody-drug conjugated to target a cell surface-expressed tissue factor, and preliminary data in patients with metastatic and recurrent cervical cancer have been promising. In addition, the trials showed a favorable tolerability profile, with limited incidence of grade 3 or worse adverse events. According to the data of ENGOT-cx6/GOG-3023/innovaTV 204, the US Food and Drug Administration granted expedited approval of TV on September 20, 2021, for women with recurrent or metastatic cervical cancer. Actually, two other trials testing TV alone or in combination with other agents are ongoing. ENGOT-cx8/GOG-3024/innovaTV 205 is a Phase Ib/II trial of TV in combination with platinum or bevacizumab or pembrolizumab, in patients with recurrent or metastatic cervical cancer who have not received prior systemic therapy or who have progressed after no more than two prior systemic therapies. ENGOT-cx12/GOG-3057/InnovaTV 301 is a Phase 3 trial of TV vs investigator’s choice chemotherapy in patients with advanced or recurrent cervical cancer who had received no more than 2 prior chemotherapy lines. The outcomes of these two trials will potentially confirm and reinforce the use of TV as a new standard of care in advanced or recurrent cervical cancer.Keywords: cervical cancer, gynecological cancer, antibody–drug conjugate, tissue factor

Leiomyomas are smooth muscle-derived benign neoplasms that can affect all organs, most frequently in the uterus. Fumarate hydratase gene (FH) mutation is characterised by an autosomal dominant disease with increased occurrence of renal tumours, but also by cutaneous (CLs) and uterine leiomyomas (ULs). So far, an increased occurrence of skin tumours in non-mutated patients with ULs has not been verified. To this aim, a case-group of women who were FH non-mutated patients surgically treated for ULs (n = 34) was compared with a control-group (n = 37) of consecutive age-matched healthy women. The occurrence of skin neoplasms, including CLs and dermatofibromas (DFs), was evaluated. Moreover, the microscopic features of FH non-mutated skin tumours were compared with those of an age-matched population group (n = 70) who presented, in their clinical history, only one type of skin tumour and no ULs. Immunohistochemical and in vitro studies analysed TGFβ and vitamin D receptor expression. FH non-mutated patients with ULs displayed a higher occurrence of CLs and DFs (p < 0.03 and p < 0.001), but not of other types of skin tumours. Immunohistochemistry revealed a lower vitamin D receptor (VDR) expression in CLs and DFs from the ULs group compared with those from the population group (p < 0.01), but a similar distribution of TGFβ-receptors and SMAD3. In vitro studies documented that TGFβ-1 treatment and vitamin D3 have opposite effects on α-SMA, TGFβR2 and VDR expression on dermal fibroblast and leiomyoma cell cultures. This unreported increased occurrence of CLs and DFs in FH non-mutated patients with symptomatic ULs with vitamin D deficiency suggests a potential pathogenetic role of vitamin D bioavailability also for CLs and DFs.

Standardized treatment options are lacking for patients with unresectable or multifocal follicular dendritic cell sarcoma (FDCS) and disease-related mortality is as high as 20%. Applying whole-genome sequencing (WGS) in one case and whole-exome sequencing (WES) in additional twelve cases, this study adds information on the molecular landscape of FDCS, expanding knowledge on pathobiological mechanisms and identifying novel markers of potential theragnostic significance. Massive parallel sequencing showed high frequency of mutations on oncosuppressor genes, particularly in RB1, CARS and BRCA2 and unveiled alterations on homologous recombination DNA damage repair-related genes in 70% (9/13) of cases. This indicates that patients with high-stage FDCS may be eligible for poly ADP ribose polymerase inhibition protocols. Low tumor mutational burden was confirmed in this study despite common PDL1 expression in FDCS arguing on the efficacy of immune checkpoint inhibitors. CDKN2A deletion, detected by WGS and confirmed by fluorescence in situ hybridization in 41% of cases (9/22) indicates that impairment of cell cycle regulation may sustain oncogenesis in FDCS. Absence of mutations in the RAS/RAF/MAPK pathway and lack of clonal hematopoiesis-related mutations in FDCS sanction its differences from dendritic cell-derived neoplasms of hematopoietic derivation. WGS and WES in FDCS provides additional information on the molecular landscape of this rare tumor, proposing novel candidate genes for innovative therapeutical approaches to improve survival of patients with multifocal disease.

We compiled a sampling of the treatment techniques of intensity-modulated total body irradiation, total marrow irradiation and total marrow and lymphoid irradiation utilized by several centers across North America and Europe. This manuscript does not serve as a consensus guideline, but rather is meant to serve as a convenient reference for centers that are considering starting an intensity-modulated program.

Abstract Background Coronavirus disease 2019 (COVID‐19) has spread to all countries since December 2019, triggering a pandemic within weeks of the initial outbreak. Doctors were presented with the challenge of having to reimagine the traditional hospital organisation in order to effectively manage patients. Patients and Methods During the months of the COVID‐19 pandemic our Institution was assisted by a call‐center (CC) that triaged cancer patients planned for follow‐up in our outpatient clinics: C1 (for female cancers), C2 (for gastrointestinal, urogenital, and thoracic tumours), and D1 (for melanoma and for patients with tumours in over 5 years follow up). Data refers to the period between 15 April and 3 July 2020. Results A total of 1054 patients have been included in our study and 1005 (95%) of the contacts were successful. The analysis showed a majority of female patients (74%) and patients affected by breast cancer (56%). Among the options provided 646 patients (92.4%) opted for online consultancy. Conclusion This study has shown that cancer patients valued technology‐mediated follow‐up visits mainly during the beginning of the pandemic because patients themselves were afraid to come to the hospital. Although telemedicine has intrinsic limitations, it is important for providing assistance and preventing cancer patients from feeling isolated during an emergency.

Richter’s Transformation is a treatment-resistant and fatal progression from Chronic Lymphocytic Leukemia (CLL) to an aggressive lymphoma. Here, the authors show that PRMT5 is upregulated months prior to and after transformation, PRMT5 overexpression in a CLL mouse model leads to increased risk of transformation, and that targeted PRMT5 inhibition prolongs survival and delays disease development.

The CCR4 receptor is a pivotal target in cutaneous T-cell lymphoma (CTCL) therapy due to its role in impairing immune responses against malignant T-cells and expression profiles. Monoclonal antibodies like mogamulizumab effectively bind to CCR4, reducing tumour burden and enhancing patient outcomes by inhibiting the receptor’s interaction with ligands, thereby hindering malignant T-cell migration and survival. Combining CCR4 antibodies with chemotherapy, radiation, and other drugs is being explored for synergistic effects. Additionally, small-molecular inhibitors, old pharmacological agents interacting with CCR4, and CAR-T therapies are under investigation. Challenges include drug resistance, off-target effects, and patient selection, addressed through ongoing trials refining protocols and identifying biomarkers. Despite advancements, real-life data for most of the emerging treatments are needed to temper expectations. In conclusion, CCR4-targeted therapies show promise for CTCL management, but challenges persist. Continued research aims to optimise treatments, enhance outcomes, and transform CTCL management. This review aims to elucidate the biological rationale and the several agents under various stages of development and clinical evaluation with the actual known data.

Concert halls have led to increasingly complex spaces that cannot be thought of as static ‘containers’ anymore. This complexity makes them viable to be launched towards industry 4.0 and to be considered a function of the activities that they can provide during their life cycle. They are characterized by dynamic objects that contain sophisticated sub-systems and add to the capability to influence both environmental variables and user behavior. This article explains an adaptive concert hall at an early stage, in which a network of sensors that gather real-time data on environmental factors such as temperature, air humidity and air velocity are considered, focusing on their direct and indirect intercorrelations with the acoustic quantities to optimize the room acoustic response. The proposed methodology is controlled by a digital twin (DT) based on building information modeling (BIM), integrated with sensors, actuators, and acoustic measurements and algorithms. By analyzing the data, algorithms identify patterns, and an autonomous fine-tune setting is achieved, including the novelty for which a natural variable acoustic field becomes possible during a musical execution without the use of any electroacoustic system support. The hall becomes a natural active instrument to be included in the composer’s score. A case study is presented.

Cutaneous T cell lymphomas (CTCLs), encompassing mycosis fungoides (MF) and Sézary syndrome (SS), present a complex landscape influenced by cytokines and cellular responses. In this work, the intricate relationship between these inflammatory proteins and disease pathogenesis is examined, focusing on what is known at the clinical and therapeutic levels regarding the most well-known inflammatory mediators. An in-depth look is given to their possible alterations caused by novel immunomodulatory drugs and how they may alter disease progression. From this narrative review of the actual scientific landscape, Interferon-gamma (IFN-γ) emerges as a central player, demonstrating a dual role in both promoting and inhibiting cancer immunity, but the work navigates through all the major interleukins known in inflammatory environments. Immunotherapeutic perspectives are elucidated, highlighting the crucial role of the cutaneous microenvironment in shaping dysfunctional cell trafficking, antitumor immunity, and angiogenesis in MF, showcasing advancements in understanding and targeting the immune phenotype in CTCL. In summary, this manuscript aims to comprehensively explore the multifaceted aspects of CTCL, from the immunopathogenesis and cytokine dynamics centred around TNF-α and IFN-γ to evolving therapeutic modalities. Including all the major known and studied cytokines in this analysis broadens our understanding of the intricate interplay influencing CTCL, paving the way for improved management of this complex lymphoma.

Machine learning (ML) algorithms are now part of everyday life, as many technological devices use these algorithms. The spectrum of uses is wide, but it is evident that ML represents a revolution that may change almost every human activity. However, as for all innovations, it comes with challenges. One of the most critical of these challenges is providing users with an understanding of how models’ output is related to input data. This is called “interpretability”, and it is focused on explaining what feature influences a model’s output. Some algorithms have a simple and easy-to-understand relationship between input and output, while other models are “black boxes” that return an output without giving the user information as to what influenced it. The lack of this knowledge creates a truthfulness issue when the output is inspected by a human, especially when the operator is not a data scientist. The Building and Construction sector is starting to face this innovation, and its scientific community is working to define best practices and models. This work is intended for developing a deep analysis to determine how interpretable ML models could be among the most promising future technologies for the energy management in built environments.