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This paper explores the development of scholarship examining invasive alien species and their impacts from an environmental justice perspective. As the scope of the environmental justice field grows to encompass considerations of ecological integrity, invasive alien species should be part and parcel of this discourse, because they have the potential to harm human health directly and interfere with ecosystem services upon which vulnerable groups sometimes rely. Further, invasive alien species might cause environmental justice issues at the international level, as developing countries are likely at greater risk from their impacts. We propose that research should investigate the distribution of direct impacts from invasive alien species, as well as those via changes of ecosystem functioning and services, across different socioeconomic populations. We highlight the need for a holistic approach to understanding these impacts that includes environmental justice concerns and recommend the development of a framework that would enable consideration of cultural, ecological, economic, and social issues involved in the management of invasive alien species.

Immunoproteasomes are a special class of proteasomes, which can be induced with IFN-γ in an inflammatory environment. In recent years, it became evident that certain immune cell types constitutively express high levels of immunoproteasomes. However, information regarding the basal expression of proteolytically active immunoproteasome subunits in different types of immune cells is still rare. Hence, we quantified standard proteasome subunits (β1c, β2c, β5c) and immunoproteasome subunits (LMP2, MECL-1, LMP7) in the major murine (CD4 + T cells, CD8 + T cells, CD19 + B cells, CD11c + dendritic cells, CD49d + natural killer cells, Ly-6G + neutrophils) and human immune cell (CD4 + T cells, CD8 + T cells, CD19 + B cells, CD1c + CD141 + myeloid dendritic cells, CD56 + natural killer cells, granulocytes) subsets. The different human immune cell types were isolated from peripheral blood and the murine immune cell subsets from spleen. We found that proteasomes of most immune cell subsets mainly consist of immunoproteasome subunits. Our data will serve as a reference and guideline for immunoproteasome expression and imply a special role of immunoproteasomes in immune cells., (© 2024 The Authors. European Journal of Immunology published by Wiley‐VCH GmbH.)

Competing Interests: Conflict of interest: AM, CB, MAR and FSM have no conflict of interest. EA, LM, FS are employees of AMGEN.

Peritoneal dialysis is an efficient renal replacement therapy for uremic patients but is currently under-prescribed. This is partly due to the unfavorable effects on peritoneal morphology and function (bioincompatibility) of current glucose-based solutions. Use of standard solutions can cause several peritoneal alterations including inflammation, mesothelial to mesenchymal transition, and neo-angiogenesis. The final step is fibrosis, which reduces the peritoneal filtration capacity and can lead to ultrafiltration failure and transfer of the patient to hemodialysis. Bioincompatibility can be local (peritoneum) but also systemic, due to the excessive absorption of glucose from the dialysate. Several strategies have been adopted to improve the biocompatibility of peritoneal dialysis solutions, based on the alleged causal factors. Some new solutions available on the market contain low glucose degradation products and neutral pH, others contain icodextrin or aminoacids. Clinical benefits have been associated with the use of these solutions, which however have some limitations and a debated biocompatibility profile. More recent strategies include the use of cytoprotective agents or osmo-metabolic agents in the dialysate. In this article, we review the different approaches currently under development to improve the biocompatibility of peritoneal dialysis solution and hence the clinical outcome and the viability of the technique., (Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.)

Introduction: Bullying in health care setting has a globally prevalence between 1% and 87% and it's in constant increase described by "WHO" as: "Bullying is a major public health problem". It is defined as a repeated ill-treatment, harmful for the health of one or more individuals by one or more people. There are different types of behaviours and they vary from verbal abuse, offensive conduct, humiliating and intimidating attitudes. Those attitudes won't help you doing your job. Different are the outcomes that those actions have on victims: anxiety, sleep disturbances, generalized pain and reduced attention. The objective of the study was to investigate the presence of the phenomenon within the Ticino (Swiss Canton) on healthcare contexts and to explain its experiences., Methods: A qualitative study was conducted on a sample of healthcare professionals who are active in the Ticino (Switzerland) healthcare context through 18 semi-structured interviews and their thematic analysis., Results: The results that emerged shows how the problem is also relevant in Ticino`s healthcare contexts, sometimes with different modalities and outcomes, moreover, experiencing these situations during one's working career leads to re-proposing such behaviours, as it is considered a rite of passage. What emerges in a predominant way is the lack of programs or structures aimed to prevent and support the victim and the perpetrator.

On June 7, 2021, the US Food and Drug Administration (FDA) approved aducanumab, a monoclonal amyloid targeting β-amyloid, for the treatment for Alzheimer's disease (AD). This decision was achieved through the Accelerated Approval Pathway and was essentially motivated by the evidence that aducanumab reduces brain amyloid plaques. This news is causing a heated debate in the scientific community. On the one hand, aducanumab is the first drug to be approved for the treatment of the disease since 2003 and is the first drug to act on the alleged pathophysiological mechanisms of AD. At the same time, the evidence of clinical benefit coming from two phase 3 clinical trials is contradictory and still inconclusive. The aim of the present editorial is to provide some points to consider that can help understand the peculiarities and implications of this approval and feed the scientific debate underway.

Introduction: Patients' needs and the change of health professionals' roles have led researchers to reflect about the involvement of nurses in care processes development, as well as health policies. Studies confirm how advanced nursing training promotes quality of care and reduces the costs of healthcare. The introduction of the Advanced Practice Nurses (APNs) could potentially be an added value also in the Swiss healthcare context, where this figure is positioning. The study aims to investigate how APNs can participate in building health policy projects., Method: This is a qualitative study. Four focus groups were conducted on nurses with managerial and clinical roles. A content analysis approach with three review phases was applied., Results: The identified macro-themes are: APN: Advanced training provides the skills needed to exercise the role. However, it emerges that the recognition of nurses in the field of health policies originates from a cultural change. Interprofessional collaboration: Multidisciplinary work allows overall patient care. However, requests for advice from the APN is still marginal. Health policy: The emerged needs are: defining a target population, educating the population and encouraging organizations to obtain quality certifications. Proposals for improvement: adequate training and the involvement of specialized figures are required for suitable care., Conclusions: APNs have potential impact upon health policy discussions. The authors recommend investing on education and cultural change, in order to maximize the active involvement in discussions supporting progress in nursing practice.

Introduction: In February 2020 the first case of COVID-19 arrived in Canton Ticino. Since then, many things have changed at great speed, especially in health organizations, and these changes have had a strong impact on the nursing profession. The objective of this research was: to investigate the experiences of nurses at different organizational levels who were confronted with the COVID pandemic in the first month in which it occurred., Methods: Narrative Research. The data collection was carried out involving a group of 20 nurses working in different contexts and roles in Canton Ticino. The collected narrations were analyzed through a thematic analysis of their content using Nvivo 12®., Results: The thematic analysis of the narrations made it possible to define 26 themes and 6 macro-themes: Pandemic, What changes, Communication, Emotions/experiences, Role and image, Interprofessional collaboration. The results of this research make it possible to understand how a heterogeneous group of nurses experienced the particular period of pandemic in Canton Ticino and which reflections were derived from it. Some of the aspects highlighted can be compared with what is present in the international literature on the subject in order to find common ways of action for the nursing leadership, in the different Countries, facing the need to organize, manage and support nursing professionals in this and future pandemic situations., Conclusions: The results of this research can be used both at an organisational and educational level and can be the starting point for future research.

Introduction: In Italy, the nursing doctoral programs were established in 2006, and after ten years we though it would be important to understand how nursing research in Italy has developed thanks to its four doctoral schools of nursing. Our research question was: How have the Italian doctoral schools of nursing contributed to the development of nursing research in the last ten years?, Methods: A national descriptive observational was conducted to collect all the publications made by the four nursing doctoral schools in Florence, Genoa, L'Aquila, and Rome between 2006 and 2015. For the enrolment of the participants, an online survey was sent to the e-mail address of each student provided by the reference University. The publications collected through the CVs of the current and former doctoral students were then checked against Web Science. The publication trends were analysed considering the type of journal, the Impact Factor (IF), and the topics., Results: A total of 478 papers published between 2006-2015 were retrieved, of which 226 (47.59%) were published in Italian journals and 250 (52,41%) on international journals. The great majority of the papers (59,21%) were published in 30 journals, of which 15 had an Impact Factor (range 0.236 - 3.755). The main topics were clinical care, research methods, education, management, ethics, and policies., Conclusions: Between 2006 and 2015, Italy has produced nursing knowledge and scientific data that can be used to improve the quality of care and facilitate discussions with health policy decision-makers in order to better address the incumbent heath challenges of the near future.

Purpose: To identify orientations in Italian nursing research regarding nursing practice, highlighting strengths, needs for improvement, as well as suggestions and recommendations for promoting the future development of nursing knowledge., Method: An extensive review of the literature was conducted (scoping review) by consulting the following databases: PubMed, CINAHL, PsycINFO, Biosis and Scopus, for the time interval between January 2006 and July 2016., Results: Out of a total of 5635 publications, 35 were identified as relevant to the research question. These highlighted the changes implemented by nurses in Italy through their professional actions according to the best available evidence, especially since 2011/2012. Many publications relate to the implementation of new technical procedures or educational systems for patients, but there is a lack of studies that examine the effectiveness of nursing care and its effects on patients. Many studies do not belong within a program of research or larger projects, and virtually none involve participation in international research teams. With regard to the clinical environments in which the studies were conducted, the majority involved hospitals and the focus was mainly on patients in an acute phase of an illness. Few studies have investigated persons with chronic illnesses, the elderly or have been conducted in long-term care settings such as nursing homes. Another finding identified in this review is the prevalence of quantitative studies, with descriptive study designs, the use of questionnaires that were often created ad hoc, and the recruitment of samples from 'convenience' populations. These findings highlight the need to further review orientations in the Italian nursing research literature, focusing attention on emerging clinical priorities. This should be done through a process that balances the needs of nurses and with those the patients., Conclusions: Italian nursing researchers tend to focus their investigations on technical and educational topics. Theoretical or philosophical frameworks are almost completely missing in the literature, highlighting the need for more work in this area. In most cases, Italian researchers do not seem to follow research tracks based on research priorities, highlighting the need to review practice settings to identify areas that need to be developed, explored or consolidated. For Italian nurses, research is an area that is still under development and consolidation, but with strong potential for the future.

The eighth edition of TNM classification of malignant tumours has been published by the Union for International Cancer Control in January 2017. As for the previous editions - from the third on - it has been translated into Italian and recently published in our Country. This article explains the main changes from the previous edition: new classifications, some major revisions of cancer staging rules, the introduction of a grid of prognostic factors for each neoplasia and the addition of two chapters. These two chapters are about the essential TNM and the paediatric tumours, and have been developed in order to facilitate the use of data by Cancer Registries.

Introduction: Cutaneous melanoma is a significant cause of mortality, and since the skin is easily accessible for inspection, it is amenable to interventions of education and promotion of early diagnosis through the use of telemedicine systems., Methods: Clicca il neo is a programme for the early diagnosis of skin cancer employing tools of teledermatology with a store-and-forward modality. The system uses a web form for data collection and upload of skin photographs taken by users. The target geographic area in which the pilot phase of the project was conduced has been the province of Bergamo (1,100,000 inhabitants according to data from ISTAT 2011) with an incidence of melanoma of approximately 14 cases per 100,000 inhabitants per year. Two main result indicators were adopted: 1) the proportion of assessable images over the total (expected threshold more than 75%); 2) the identification during the study period of at least one melanoma., Results: Between July 1, 2015 and December 31, 2015, a total of 302 images of skin lesions were sent to the system -Clicca il neo, by people resident in the province of Bergamo. Of the images sent, 256 (84.7%) were of sufficient quality for evaluation, and of these, 11 (4.3%) were considered as images of highly suspicious lesions, 4 (1.6%) of a suspected squamous cell carcinoma and 6 (2.3%) of a suspected melanoma. Two of the 4 suspected squamous cell carcinomas and 3 of the 6 suspected melanomas received a diagnostic confirmation after surgical excision and histological examination. Remarkably, the excised melanomas were in 2 cases thin melanomas (thickness less than 1 mm) and, in 1 case, a melanoma in situ., Discussion: This pilot project demonstrates the technical feasibility and potential utility of a teledermatology system to promote early detection of skin cancers. Several aspects remain to define including accessibility, reliability, and preventive effectiveness in reducing melanoma mortality and morbidity by early diagnosis.

Vertebroplasty was first introduced in the United States at the 1988 annual meeting of the Radiological Society of North America (RSNA). Until now, vertebroplasty is little known and only few radiologists perform this procedure but interest in and enthusiasm for vertebroplasty are growing at a surprising rate. The literature on this matter clearly shows how effective this procedure is. This technique allows significant results in pain relief and in bone strengthening. It also provides increased stability in pathological vertebral bodies. This is why we would like to share our knowledge on this procedure that we have closely examined and tested. The main goal of this paper, besides illustrating the technical aspects of vertebroplasty, is to provide anyone intending to approach this procedure with some practical tips on how to handle the technical problems that may arise when performing the procedure.

IL-1 and TNF-alpha are potent inducers of matrix metalloproteinases (MMP), eicosanoids, nitric oxide oxydase (iNOS), receptor activator of NF-kB ligand (RANKL), products involved in the destruction of the extracellular matrix, the cartilage and in bone resorption. IL-1, particularly important at the local level, is more potent than TNF-alpha in stimulating MMP and specifically in impeding cartilage repair. However, IL-1 and TNF-alpha strongly synergize in multiple biological functions. Blockade of IL-1 by IL-1 receptor antagonist (IL-1Ra, sIL-1RII) in combination with the soluble IL-1 accessory protein (IL-1R AcP) result in a long-term beneficial effect in chronic inflammatory diseases. The association with anti-TNF-alpha therapy may also represent a logical approach, considering the number of patients that do not respond to either compound alone.

The essay II, 37 De la ressemblance des enfants aux pères, written by Montaigne between 1579 and the first months of 1580, is a merciless critique of doctors, doctoring and medicine in general. This Essay, as much as a large number of other texts, of archival records, of iconographic materials produced during the Early Modern period, testifies a wide spread skeptical attitude toward medicine across Europe. This is an important aspect of Early Modern culture. Despite its relevance it has been often neglected by medical historians. This paper aims to show how a literary text can contribute to the understanding of the rise of some aspects of these critical attitudes towards medicine and medics. In Montaigne's text, these attitudes appear to be generated by his personal experiences of suffering and disillusion deeply entangled with a long tradition of philosophical skepticism to which some of his favorite readings belong. Both these elements seem to have also contributed to bring Montaigne in 1580 to the definition of the poetic project of the Essays as a self-portrait: a project in which the bodily presence of the author, with his humors, passions and sufferings, is self-consciously part of the writing process and of the intellectual enterprise.

Background: In a multicentre clinical study was evaluated the efficacy and safety of a mouthwash containing diclofenac 0.074% in patients undergone to oral or periodontal surgery., Methods: Multicentre clinical open study. The patients rinsed for 1 min twice a day with diclofenac mouthwash for 7 days. After the baseline measurements of all parameters, spontaneous pain and burning were evaluated daily, while redness and oedema after 3 and 7 days of treatment. Seventy-nine patients (48 F, 31 M), mean aged 42.5 years+/-13.1 SD, with pain intensity at the end of anaesthesia effect equivalent to 54.8 mm+/-15.1 SD of a visual analogue scale were evaluated for efficacy., Results: Spontaneous pain was significantly reduced by diclofenac mouthwash, versus baseline, in the first day of treatment. After a week of treatment, intensity was reduced more than 88% (p<0.01). Burning, redness and oedema too evidenced a similar behaviour, with absence of the sign respectively superior to 87%, 72% and 91 % (p<0.01). The physician's and patient's final judgement overlapped, recording a resolution/improvement in 94.1% of cases, particularly improvement in 77.2% for the physician and in 70.9% for the patients. Palatability was judged pleasant/acceptable in all cases., Conclusions: Diclofenac mouthwash is endowed by very good efficacy and safety in the treatment of inflammatory condition of the buccal cavity following oral or periodontal surgery.

The "Magnum wire" is a stiff shaft, blunt tip wire constructed for recanalization of total coronary occlusions. Smaller series have demonstrated superior qualities if compared to conventional wires. The purpose of this study was to analyze its efficacy in total and nontotal lesions in a large number of consecutive procedures. A database analysis identified the use of the Magnum wire in 569 procedures from October 1992 to February 1995, which accounted for 26% of all angioplasties during the time period at our Institution. There were 347 total occlusions and 222 nontotal occlusions. Technical success was achieved in 69% of total occlusions and 90% of subtotal occlusions. Procedural success was recorded in 58 and 75%, respectively. Stents were implanted in 29 patients with total occlusion (8%) and 19 patients with nontotal lesions (9%). Acute occlusion of the treated lesion occurred in 4.5% of patients with nontotal lesion and 1.5% of the patients with total occlusion. In conclusion, the Magnum wire is an efficient tool for angioplasty of total occlusions and severe nonocclusive stenoses. In light of the complexity of the attempted lesions, achieved success rates were remarkable.

Pharmacokinetic analysis of experimental data is usually carried out through two different approaches: non compartmental model or standard compartmental models. Benefits and restrictions of these two approaches are here discussed, with attention to the studies of clinical pharmacokinetics and, particularly, to those of bioavailability and bioequivalence. In fact, different opinions about the most appropriate model to be used with these studies were encountered. Besides, the paper deals with European and American guidelines, data from a check of the literature published during 1995 on two international journals of clinical pharmacology and results of non-compartmental and non-linear fitting analyses on plasma concentrations obtained with an oral administration of a delayed dosage form in humans.

SDZ PSC 833 is a novel compound able to reverse the resistance to chemotherapy of cancer cells with the multidrug resistance (MDR) phenotype by inhibiting the 170 kd P-glyco-protein (P-gp). In vitro studies show that SDZ PSC 833 directly interacts with, but is not transported by P-gp, although the exact mechanism of action has not yet been defined. In cells with the MDR phenotype, intracellular concentration of various P-gp-transported anticancer drugs is restored to the same level as in sensitive cells by SDZ PSC 833 concentrations of 0.8 microM to 3.0 microM. In vivo SDZ PSC 833 was highly active in potentiating the anti-tumour activity of all tested anticancer drugs (ACs) in both sensitive and MDR tumours. Sensitivity of non-MDR tumours was increased by SDZ PSC 833 through pharmacokinetic interactions, that result in enhanced area-under-the-curve (AUC) of P-gp-transported ACs. However, an increased AC bioavailability is not sufficient to explain the therapeutic benefit of SDZ PSC 833 co-treatment in MDR tumour-bearing mice: in these animals, no survival increase could be achieved with the AC alone by simply increasing the cytotoxin dosage up to doses that were severely toxic for the non-tumour-bearing mice. In a series of phase I/II studies, the recommended doses of SDZ PSC 833 were established at: 10 mg/kg/day i.v. as a 24-hour continuous infusion after a 2 mg/kg loading dose as a 2-hour infusion; 20 mg/kg orally divided four times daily in solid tumours or 16 mg/kg orally divided four times daily in multiple myeloma. The dose limiting toxicity of SDZ PSC 833 is ataxia, which appears to be reversible and dose-related. Moreover, a predictable change in pharmacokinetic parameters of concomitantly administered P-gp-transported AC(s) which usually necessitate a 30-60% reduction from the standard dose of the AC in order to maintain the same time-exposure and dose-related toxicity of the cytotoxic drug alone. The results of experiments both in vitro and in vivo suggested that adequate blood levels (i.e. > or = 1.0 microM) of SDZ PSC 833 must be reached before and maintained during the administration of concomitant AC(s), in order to maximally reverse MDR. At the recommended doses, blood concentrations exceeding 1000 ng/mL (1.0 microM) can be achieved after both i.v. and oral administration. Indeed, SDZ PSC 833 concentrations that fully reverse MDR in vitro are achievable in vivo, plasma samples from patients treated with SDZ PSC 833 restored the sensitivity of MDR human sarcoma cells to paclitaxel, etoposide and doxorubicin. Clinical studies completed so far aimed first to determine the dose of both SDZ PSC 833 and the concomitant AC(s) to be used in ongoing pivotal trials. These studies accrued advanced stage cancer patients, however, tumour responses have been observed in both solid and hematological tumours. The in vitro finding that treatment with SDZ PSC 833 may suppress the activation of the MDR1 gene and prevent the emergence of resistant cancer cell clones with the MDR phenotype might support the use of this MDR modulator in earlier stages of disease.

62 patients with infected hip joints whose treatment was started between January 1980 and December 1986 were analysed retrospectively in December 1992 with a mean observation period of 7.2 years (range 1-13). The treatments employed were debridement with lavage drainage in 6 cases, one-stage replacement of the prosthesis on 47 occasions and two-stage replacement in 27 cases. On 5 occasions the prosthesis was removed and a Girdlestone procedure was undertaken. In the 47 one-stage replacements primary intervention was successful in 57% (n = 27), in the two-stage replacements in 74% (n = 20). In 42 cemented shafts there was primary healing in 34, i.e. 81%, compared with 13 (65%) in the 20 non-cemented shafts. Successful healing was finally achieved in all 62 infected hips.

Because they show fairly good short- and mid-term results frozen, morselized homologous bone grafts have become very popular in acetabular reconstruction after failed total hip arthroplasty. Graft integration proceeds uneventfully. However, very little is known about its longevity. From 1980 to 1984 we performed 121 acetabular revisions in cases with contained bone defects utilizing homologous bone graft and a cementless non-coated or hydroxyapatite coated HDPE cup. At the end of 1991 (7 to 11 years after the operation), 43 patients (35%) were available for review. 41 patients (34% had died, 19 patients (16%) were lost to follow-up. In 18 patients (15%), the cups had been revised because of aseptic loosening. The Harris Hip Score showed 50% good to excellent results. Cups inserted after grafting of cystic defects showed almost no migration. However when cavity defects were filled with large bone grafts (n = 23), slow continuous cup migration and progressive graft resorption over time was observed. Due to this continuous resorption, we conclude, that morselized bone grafts do not guarantee an ever lasting inert interface. Once the non-coated HDPE cup is in contact with the autogenous host bed, bone osteolysis occurs and loosening proceeds. Cementless porous coated cups with morselized allografts alone may be used in acetabular revision only when cystic defects are present. The surface of the cup has to be brought into contact with a well vascularized autochthonous pelvic bone in order to achieve stable fixation. Segmental and massive cavity defects can only be reconstructed with morselized allografts when protected from loading by supporting rings.(ABSTRACT TRUNCATED AT 250 WORDS)

Resection arthroplasty should nowadays be considered as obsolete for the following reasons: the removal of the implant and adequate antibiotic therapy can clear the infection. From this point of view the reimplantation of an endoprosthesis is possible. "Deficient bone stock" is not a contraindication to the reimplantation since there are surgical means available to replace bone stock. The results of revision arthroplasty (reimplantation) are incomparably better today that they were years ago (cement-free technique, bone replacement, supports of the acetabulum, special revision prostheses etc.

Thirty-two patients with therapy-resistant low-back pain and justified indication for fusion were divided into two groups: 16 patients were treated with anterior fusion of the lumbosacral spine, with insertion of tricortical bone grafts of the iliac crest, and 16 patients with insertion of a fibular peg. Additional dorsal fusion of the same segments was performed. Comparison of the two techniques of circumferential fusion of the lumbosacral joint reveals comparable clinical results. A marked difference in roentgenographical criteria such as disk height, retrolisthesis, and anterior osteophytes in the adjacent segment between the two techniques was noted at the time of follow-up evaluation after 89 months and motivated the authors to abandon the fibular-peg technique.