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Purpose This paper aims to recall the attention on a key challenge for customer relationship management related to the role of human agents in the management of the “switch point” for ensuring the effectiveness and efficiency in a customer-machine conversation. Design/methodology/approach This study contributes to the discussion about the firms’ approach to artificial intelligence (AI) in frontline interactions under the conceptual umbrella provided by knowledge management studies. Findings This paper provides a theoretical model for clarifying the role of human intelligence (HI) in AI-based frontline interactions by highlighting the relevance of the actors’ subjectivity in the dynamics and perceptions of customer-machine conversations. Originality/value An AI-HI complementarity matrix is proposed in spite of the still dominant replacement view.

This survey aimed to understand how far the Italian infectious diseases (ID) specialists are confident in the "Undetectable = Untransmittable" (U = U) message and translate this concept into clinical practice. An anonymous survey was distributed by e-mail to 286 clinicians to collect their opinions regarding six situations potentially at risk of HIV transmission between virologically suppressed patients and seronegative individuals who possibly require postexposure prophylaxis (PEP). Overall, 51% of ID specialists deemed zero risk of HIV transmission through condomless sex for undetectable patients. This answer was more frequent among HIV specialists (30% vs. 21%, p = .01) and clinicians working in teaching hospitals (35% vs. 16%, p = .03). Remarkably, 61% of participants would advise taking PEP for the HIV-negative partner in case of sexual intercourse with a seropositive person with a recent blip occurrence or absence of an HIV RNA test performed within the last 6 months (63%). Seventy-three percent of respondents deemed it essential to know patients' history of adherence to interpreting an HIV RNA test, regardless of its timing. When applying the U = U concept to daily clinical decisions, we observed an overall cautious attitude among physicians. Concerns mainly regarded the timing of the last HIV RNA test to the exposure event, especially in the absence of details on the patient's adherence. Wider diffusion and application of the U = U message are needed.

Despite the availability of vaccines and antivirals and the biological evolution of SARS-CoV-2, the rate of hospitalizations and deaths from COVID-19 remains high in Italy. It is crucial to understand whether and how the clinical characteristics of patients hospitalized for COVID-19 have changed over 2021–2022 and which risk factors are currently associated with adverse outcomes to develop targeted interventions. In this study, we present and compare the characteristics and outcomes of 310 patients with COVID-19 who were hospitalized between 1 August and 9 December 2021, when the Delta SARS-CoV-2 variant was prevalent (Group A), and between 3 January and 30 June 2022, when the Omicron variant was predominant (Group B). Using Survival Analysis, we estimated the cumulative 28-day hazard ratio (H.R.) of Intensive Care Unit (ICU) admission/death of patients in Group B vs. A. We built uni- and multivariate Cox regression models for the overall population and each group to identify risk factors for ICU admission/death among patient features. We found that Group B had a comparable risk of ICU admission/death (HR 1.60, 95% Confidence Interval, C.I. 1.00–2.58, p = 0.05) but a higher prevalence of elderly and co-morbid subjects than Group A. Non-invasive ventilation requirement was associated with adverse outcomes in both Group A (HR 21.03, 95% C.I. 5.34–82.80, p < 0.001) and Group B (HR 4.53, 95% C.I. 2.39–8.59, p < 0.001), as well as in the overall population (HR 3.88, 95% C.I. 2.49–6.06, p < 0.001). During the Omicron wave, elderly and co-morbid subjects had the highest risk of hospitalization and poor outcomes.

Via the analysis of a set of parking and journey information for vehicles traveling to the parking site at the University of Brescia (Italy), we evaluated the possibility of managing the electric recharging of these vehicles, which are hypothesized to be electric. The paper investigates charging optimization techniques that can limit the charge power peaks and distribute the energy demand throughout the day. A cost assessment for an auxiliary system consisting of a photovoltaic energy source (PV) and battery stationary storage (BSS) is also carried out. Optimal power management at the station with PV and BSS is introduced, and the performance of two feedback controllers based on the optimized results is compared with that of a real-time management algorithm in the presence of randomness in charging requests and insolation. The results show that the BSS degradation cost plays a primary role in determining the strategy to adopt to minimize the operating expenditure of a charging station.

Baricitinib, a reversible Janus-associated kinase-inhibitor, is approved for treating COVID-19, combined with Dexamethasone and, eventually, with Remdesivir (RDV). This retrospective cohort study assesses the real-life advantages and limits of Baricitinib in the current pandemic scenario. Data of all patients consecutively hospitalized with moderate/severe COVID-19 between 1 October 2021 and 31 March 2022 were retrospectively collected and described according to the treatment received (Baricitinib, Baricitinib + RDV, none). We performed survival analyses to estimate the 21-day probability of Intensive Care Unit (ICU) admission, death, and composite. We built multivariate Cox regression models to identify ICU admission/death predictors among patients’ features. Of 111 subjects, 28 received Baricitinib, 21 received Baricitinib + RDV, and 62 could not be treated due to pre-existing conditions. Treated patients had a comparable risk of death (HR 0.50, 95% C.I. 0.20–1.26, p = 0.14) but remarkably lower risk of 21-day ICU admission (H.R., 0.10, 95% C.I., 0.01–0.86, p = 0.03), regardless of the type of treatment received. At multivariable analysis, older age was the only predictor of ICU admission/death (HR 1.14, 95% C.I. 1.03–1.26, p ≤ 0.01).Although effective, the high prevalence of elderly, co-morbid patients limits Baricitinib use in the current pandemic setting.

According to the ESMO and ASCO clinical guidelines, the main role of liquid biopsy in EGFR+ advanced NSCLC patients is represented by T790M detection after erlotinib/gefitinib/afatinib progression. However, the general international expert consensus regards osimertinib as the preferred upfront treatment in this setting; therefore, this role has been scaled back in recent years. As of today, liquid biopsy has no ASCO or ESMO recommendation following first-line osimertinib; in the same vein, no targeted therapy has received ASCO or ESMO recommendation following post upfront Osimertinib progression. However, this standard could change in the near future. Therefore, adopting a clinical point of view, this paper aims to provide a comprehensive review on the previous, the current and the possible future role of liquid biopsy in the framework of the diagnostic–therapeutic algorithm of EGFR+ advanced NSCLC.

International audience

Marina Talamonti,1 Filomena Russo,2 Giovanna Malara,3,4 Katharina Hansel,5 Manuela Papini,6 Angelo Cattaneo,7 Aurora Parodi,8 Andrea Chiricozzi,9,10 Piergiorgio Malagoli,11 Federico Bardazzi,12 Valeria Brazzelli,13 Paolo Dapavo,14 Paolo Gisondi,15 Cristina Zane,16 Concetta Potenza,17 Franca Cantoresi,18 Maria Concetta Fargnoli,19 Sara Trevisini,20 Pina Brianti,21 Leonardo Pescitelli,22 Giovanni Gigante,23 Marta Bartezaghi,23 Luisa Caputo,23 Elisabetta Aloisi,23 Antonio Costanzo24,25 On behalf of the SUPREME Study Group1Dermatology, University of Rome Tor Vergata, Rome, Italy; 2Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy; 3Dermatology Unit, Hospital “Bianchi Melacrino Morelli”, Reggio, Calabria, Italy; 4Department of Dermatology, Papardo Hospital, Messina, Italy; 5Section of Dermatology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy; 6Dermatologic Clinic of Terni, Department of Medicine and Surgery, University of Perugia, Perugia, Italy; 7U.O. Dermatologia, Fondazione IRCCS Ca’ Granda - Ospedale Maggiore Policlinico, Milano, Italy; 8Di.S.Sal. Section of Dermatology, Ospedale Policlinico San Martino, University of Genova, Genova GE, 16132, Italy; 9UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy; 10Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy; 11Psocare Unit, I.R.C.C.S Policlinico San Donato, Milano, Italy; 12Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; 13Dermatology, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy; 14Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Torino, Torino, Italy; 15Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy; 16Dermatology Department, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy; 17Dermatology Unit “Daniele Innocenzi”, Department of Medico-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome – Polo Pontino, Latina, Italy; 18Dermatology Unit, Department of Medicine, University of Roma, Roma, Italy; 19Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy; 20Department of Dermatology, University of Trieste, Trieste, Italy; 21Dermatology and Cosmetology Unit - San Raffaele Hospital, Milan, Italy; 22Department of Health Sciences, Dermatology Clinic, University of Firenze, Firenze, Italy; 23Novartis Farma SpA, Origgio, Italy; 24Unit of Dermatology, IRCCS Humanitas Research Hospital, Milano, Italy; 25Department of Biomedical Sciences, Humanitas University, Milano, ItalyCorrespondence: Marina Talamonti, Dermatology-Department of Systems Medicine, University of Rome Tor Vergata, PTV – Policlinico Tor Vergata, V.le Oxford 81, Rome, 00133, Italy, Tel +39 0620902743, Fax +39 0620902742, Email talamonti.marina@gmail.comPurpose: Secukinumab is a fully human monoclonal antibody that inhibits interleukin (IL)-17A approved for the treatment of moderate to severe plaque psoriasis in adults and children. We compared the efficacy and safety of secukinumab in patients aged < 65 years (adult patients) versus patients aged ≥ 65 years (elderly patients) in a post-hoc analysis of the SUPREME study.Patients and Methods: Patients with moderate to severe plaque psoriasis received subcutaneous secukinumab 300 mg per week for the first 5 weeks, then 300 mg per month. We compared the following outcomes in patients aged ≥ 65 years vs < 65 years: baseline characteristics; PASI50/75/90/100 response rates (improvements ≥ 50%/75%/90%/100% in Psoriasis Area and Severity Index (PASI) from baseline); changes in Dermatology Life Quality Index (DLQI); Hospital Anxiety and Depression Scale (HAD-A, HAD-D) score changes; treatment-emergent adverse events (TEAEs).Results: Secukinumab was slightly less effective in elderly patients than in adult patients (response rates at week 16: PASI90, 69.4% vs 80.9%, p = 0.4528; PASI100, 44.4% vs 56.7%, p = 0.8973). Elderly and adult patients showed a similar time course of changes in absolute PASI scores. Patients aged ≥ 65 years had a statistically significantly lower improvement in quality of life (mean DLQI reduction) than patients aged < 65 years at week 16 [− 5.4 (± 4.3) vs − 8.8 (± 6.9), p = 0.0065] and at week 24 [− 5.3 (± 4.4) vs − 9.2 (± 7.1), p = 0.0038]. Secukinumab treatment resulted in comparable mean reductions in anxiety and depression scores in both cohorts at 24 weeks [HAD-A, − 1.3 (± 3.3) vs − 2.1 (± 3.8), p = 0.9004; HAD-D, − 1.0 (± 3.3) vs − 1.5 (± 3.1), p = 0.4598]. The frequency of TEAEs in the two cohorts was similar (16.7% vs 14.6%, p = 0.7391).Conclusion: Secukinumab is a valid option for the management of moderate to severe psoriasis in elderly patients.Keywords: psoriasis, biologics, interleukin-17A, secukinumab, elderly

Background: The senior leadership course at the University of Pennsylvania School of Nursing includes both didactic and clinical components. The didactic portion delves into leadership topics and during clinical rotations the students witness nurses and patients navigate through complicated and emotional patient care experiences. Method: Structured, active, in-class learning (SAIL) activities in a classroom were used to connect didactic content with clinical scenarios. Different specialty-related clinical scenarios were presented to the students, and they were allocated a certain amount of time for discussion in small groups before sharing their outcomes with the whole group (think-pair-share). Results: Student evaluations showed that the percentage of students who rated each session as excellent increased each semester and feedback remained overwhelmingly positive; the consistently identified area for improvement is the timing and we plan to lengthen the sessions to address that. Conclusion: Our team discovered that by shifting most of our simulation scenarios to SAIL, we provided the students with ample opportunities to speak in a dialectically rich environment about clinical scenarios while maintaining the interrelation between theory and practice. [ J Nurs Educ . 2023;62(4):257–262.]

Using molecular data and representative species coverage, we confirmed the monophyly of Cirsium sect. Eriolepis and, therefore, we propose to treat it as a separate genus (Lophiolepis). Besides, based on molecular and morphological evidence we segregate Cirsium italicum into the separate genus Epitrachys, sister to a large clade including Carduus, Cirsium s.l. and several allied genera. The name of a new hybrid genus (Lophiocirsium) is also published. Overall, 129 new combinations in Lophiolepis one in Epitrachys and one in Lophiocirsium are proposed.

Partial tears of the distal biceps tendon can be difficult to diagnose based on clinical examination and magnetic resonance imaging (MRI).Patients from a single surgeon's practice from 2000 to 2018 with a partial distal biceps tendon tear were retrospectively reviewed to determine the utility of the distal biceps palpation-rotation test in the detection of partial tears. This test is performed by palpating the bicipital tuberosity at the lateral forearm while ranging the forearm from supination to pronation with the arm adducted at the patient's side and the elbow flexed to 90°. A positive test elicits tenderness at the tuberosity with the arm in pronation but not in supination. Examination findings were correlated with MRI reports confirming a partial tear. Twelve cadaveric arms were dissected to determine overall pronosupination range of motion, the degree of pronation at which the bicipital tuberosity is maximally palpable, and anatomic measurements of the bicipital tuberosity to guide the optimal technique when carrying out the maneuver.Ninety-nine patients were diagnosed with a partial distal biceps tendon, of whom 34 had available MRI reports and complete physical examination documentation. Thirty-three of 34 patients (97%) had partial tears on MRI. The hook test was negative in all cases. All patients had tenderness with resisted supination. In those with MRI-confirmed partial tears, the palpation-rotation test was positive in all patients (100% sensitivity). The bicipital tuberosity was maximally palpated at the dorsolateral forearm at a mean 20° of pronation, and the proximal and distal boundaries of the radial tuberosity were 2.5 cm and 5.3 cm, on average, distal to the radial head, respectively.A positive palpation-rotation test was seen in 33 of 33 patients (100% sensitivity), as correlated with MRI. The combination of an intact distal biceps tendon within the antecubital fossa, tenderness on resisted supination, and a positive palpation-rotation test are highly suggestive of a partial distal biceps tendon tear.

Mobile applications (hereafter, apps) collect a plethora of information regarding the user behavior and his device through third-party analytics libraries. However, the collection and usage of such data raised several privacy concerns, mainly because the end-user - i.e., the actual owner of the data - is out of the loop in this collection process. Also, the existing privacy-enhanced solutions that emerged in the last years follow an "all or nothing" approach, leaving the user the sole option to accept or completely deny the access to privacy-related data. This work has the two-fold objective of assessing the privacy implications on the usage of analytics libraries in mobile apps and proposing a data anonymization methodology that enables a trade-off between the utility and privacy of the collected data and gives the user complete control over the sharing process. To achieve that, we present an empirical privacy assessment on the analytics libraries contained in the 4500 most-used Android apps of the Google Play Store between November 2020 and January 2021. Then, we propose an empowered anonymization methodology, based on MobHide, that gives the end-user complete control over the collection and anonymization process. Finally, we empirically demonstrate the applicability and effectiveness of such anonymization methodology thanks to HideDroid, a fully-fledged anonymization app for the Android ecosystem.

This study aims to evaluate the possible occurrence during seismic shaking of interaction effects between the shallow subsoil and the overlying buildings of the Villa d’Agri town (Southern Italy). From the geological and building heritage points of view, the investigated area represents a typical town along the Apennines chain and therefore the obtained results could be easily exported to similar urban areas. A total of 239 single-station seismic ambient noise measurements were thus performed, 154 on the urban soils and 85 within buildings. Both subsets of measurements were planned to cover the main outcropping lithologies and building typologies. By means of the Horizontal-to-Vertical Noise Spectral Ratio technique, isofrequency and isoamplitude maps have been reconstructed for the whole area. The results evaluated on the 65 tested buildings allowed to infer the empirical relationship between the first vibrational period, T(s), and their height, H(m). Using this relationship and available information on the height of each building, the first vibrational frequency was estimated for 659 buildings belonging to the urban area of Villa d'Agri. Finally, in order to assess the possible occurrence of the double resonance phenomenon, we compared the main frequency of each building with that interpolated for the underlying foundation soil. The results show that the probability of being affected by the double resonance effect is very high only for a couple of buildings, high for about 16% of the buildings, moderate for the 23% and practically null for most buildings (60%).

Many U.S. parents share a household with an adult child in later life. However, the reasons parents and adult children coreside may vary over time and across family race/ethnicity, shaping relationships with parents' mental health. Using the Health and Retirement Study, this study investigates the determinants and mental health correlates of coresidence with adult children from 1998 to 2018 among White, Black, and Hispanic parents under age 65 and aged 65+. Findings show that the predictors of coresidence shifted with increasing odds that parents lived with an adult child, and several varied by parents' age group and race/ethnicity. Compared with White parents, Black and Hispanic parents were more likely to live with adult children, especially at older ages, and to indicate that they helped their children with household finances or functional limitations. Living with adult children was associated with higher depressive symptoms among White parents, and mental health was negatively related to living with adult children who were not working or were helping parents with functional limitations. The findings highlight increasing diversity among adult child–coresident parents and underscore persistent differences in the predictors and meaning of coresidence with adult children across race/ethnicity.

BACKGROUND: Police officers are exposed to specific occupational tasks, which require lifting, trunk flexion and rotation, carrying weight, and frequent standing periods, which may be associated with an increased risk of experiencing low back pain (LBP). OBJECTIVE: To describe the prevalence and intensity of chronic LBP (CLBP) in Brazilian Federal Highway Police officers (FHPO) from the Rio Grande do Sul state and evaluate its associated factors. METHODS: A total of 208 FHPOs participated in this study. The participants answered an electronic questionnaire containing sociodemographic, behavioral, and occupational questions, and CLBP history. Data analysis comprises descriptive statistics and Poisson regression models. RESULTS: Most of the FHPO were male, aged 41 or more, lived with a partner and were physically active. Sixty-seven percent of FHPO had CLBP, and the median pain intensity was 3.0 (IQR = 0– 5). Participants who lived with a partner were less likely to report CLBP (PR = 0.80; 95% CI = 0.64; 0.99). On the other hand, those who worked as FHPO for more than 11 years were more likely to report CLPB (PR = 1.32; 95% CI = 1.06; 1.63), and high pain intensity (β= 0.95; 95% CI = 0.19; 1.71). CONCLUSIONS: The high CLBP prevalence among FHPO from Rio Grande do Sul state indicates a need to highlight the importance for police organizations to promote CLBP prevention and implement workplace management programs.

Aetiological understanding and screening methods for congenital heart disease (CHD) are limited. Maternal metabolomic assessment offers potential to identify risk factors and biomarkers.We performed a systematic review (PROSPERO CRD42022308452) investigating the association between fetal/childhood CHD and endogenous maternal metabolites. Ovid-MEDLINE, Ovid-EMBASE and Cochrane Library were searched between inception and 06/09/2022. Case control studies were included analysing maternal blood or urine metabolites in pregnancy or postpartum where there was fetal/childhood CHD. Risk of bias assessment utilised the SIGN methodology checklist and narrative synthesis was performed.134 records were screened with eight eligible studies (n=3,242 pregnancies, n=842 CHD-affected offspring). Five studies performed untargeted metabolomic analysis in pregnancy. Metabolites distinguishing case and control groups spanned lipid, glucose, and amino-acid pathways, with the development of sensitive risk prediction models. No single metabolite consistently distinguished cases and controls across studies. Three studies performed targeted analysis postnatally with altered lipid and amino acid metabolites and raised homocysteine and markers of oxidative stress identified in cases. Included studies reported small sample sizes, analysing different biosamples at variable time points using differing techniques.At present, there is not enough evidence to confidently associate maternal metabolomic profiles with offspring CHD risk. However, several identified pathways warrant further investigation. This article is protected by copyright. All rights reserved.

A partire dall’analisi della giurisprudenza costituzionale in materia di detenzione, nell’articolo si propone una teoria costituzionale dei diritti irrinunciabili della persona privata della libertà personale. Questa viene elaborata a partire dalla critica alla tradizionale teoria liberale dell'insindacabilità del governo amministrativo del carcere e alla più recente teoria del primato della rieducazione. Entrambe risultano incompatibili con il principio del primato della persona sancito dallo stato costituzionale di diritto. A partire dall’articolato reasoning della Corte, viene proposta una teoria utilitaristica dei diritti dei detenuti basata sul principio della minima sofferenza necessaria e su quello della giurisdizionalizzazione del carcere. The article presents a constitutional theory of the inalienable rights of the person deprived of personal liberty, based on the constitutional jurisprudence on detention. The theory is elaborated from the critique of the traditional liberal theory of the unquestionability of the administrative government of the prison and of the more recent theory of the primacy of re-education. Both are considered incompatible with the principles of the constitutional rule of law based on the respect of fundamental human rights. Starting from the articulated reasoning of the Court, the article proposes a utilitarian theory of the rights of prisoners based on the principles of the minimum necessary suffering and of the jurisdictionalization of the prison.

Derrida’s notion of unconditional hospitality appears to be an invitation to disaster. He seems to say that we should always and everywhere welcome the other into our own, into our home or our land, “without condition,” no questions asked, even if they mean to do us harm. But surely we have the right to insist that the other is welcome only under the condition of having no ill intentions. So it seems, contra Derrida, that hospitality only makes sense if it is conditional while unconditional hospitality is inviting trouble. So the question for us today is this, How can the notion of unconditional hospitality – or forgiveness – be maintained in the face of such perfectly obviously objections? A cautionary note: Derrida takes up the question of hospitality from the point of view of the refugee, the displaced, the exile, the immigrant, in short, of those who are in need of our hospitality. He was not discussing the right to self-defense when we come under attack by the other, when the other poses a clear and present threat. So we are raising this question in a different context and we will need to draw out the implications of what he is saying for our own purposes today.

Purpose Hospital facilities and social life, along with the global economy, have been severely challenged by COVID-19 since the World Health Organization (WHO) declared it a pandemic in March 2020. Since then, countless ordinary citizens, as well as healthcare workers, have contracted the virus by just coming into contact with infected surfaces. In order to minimise the risk of getting infected by contact with such surfaces, our study aims to design, prototype, and test a new device able to connect users, such as common citizens, doctors or paramedics, with either common-use interfaces (e.g., lift and snack machine keyboards, traffic light push-buttons) or medical-use interfaces (e.g., any medical equipment keypad) Method To this purpose, the device was designed with the help of Unified Modelling Language (UML) schemes, and was informed by a risk analysis, that highlighted some of its essential requirements and specifications. Consequently, the chosen constructive solution of the robotic system, i.e., a robotic-arm structure, was designed and manufactured using computer-aided design and 3D printing. Result The final prototype included a properly programmed micro-controller, linked via Bluetooth to a multi-platform mobile phone app, which represents the user interface. The system was then successfully tested on different physical keypads and touch screens. Better performance of the system can be foreseen by introducing improvements in the industrial production phase. Conclusion This first prototype paves the way for further research in this area, allowing for better management and preparedness of next pandemic emergencies.

The bladder is a rare site for breast cancer metastases, and only occasional reports are present in the literature. Most cases coexist with synchronous metastases elsewhere, but isolated cases of a single metastatic localization in the urinary bladder have been reported. The most common symptoms of a metastatic localization of breast cancer to the urinary bladder are hematuria and voiding dysfunction. Herein we present three cases of urinary bladder metastasis from breast carcinoma, all presenting with gross hematuria as the only symptom. After a review of the relevant literature, we discuss the clinical and histological characteristics unique to our cases, highlighting potential clinical and pathological diagnostic pitfalls and differential diagnoses.

A 33-year-old bisexual man presented to the Department of Infectious Diseases with a 9-day history of non-itching, painless, pustular, and vesicular lesions that were scattered and a high fever.

Osteosarcoma is a bone cancer characterized by the production of osteoid tissue and immature bone from mesenchymal cells. Osteosarcoma mainly affects long bones (femur is most frequently site) and occur in children and young adults with greater incidence. Here, we investigated the role accomplished by polydatin, a natural antioxidative compound, in promoting osteogenic differentiation alone or after radiation therapy on osteosarcoma cells. In vitro, polydatin significantly induced cell cycle arrest in S-phase and enhanced bone alkaline phosphatase activity. Moreover, the differentiation process was paralleled by the activation of Wnt-β-catenin pathway. In combination with radiotherapy, the pretreatment with polydatin promoted a radiosensitizing effect on osteosarcoma cancer cells as demonstrated by the upregulation of osteogenic markers and reduced clonogenic survival of tumor cells. Additionally, we analyzed, by mass spectrometry, the secretion of sphingolipid, ceramides, and their metabolites in osteosarcoma cells treated with polydatin. Overall, our results demonstrate that polydatin, through the secretion of sphingolipids and ceramide, induced osteogenic differentiation, alone and in the presence of ionizing therapy. Future investigations are needed to validate the use of polydatin in clinical practice as a potentiating agent of radiotherapy-induced anticancer effects.

The COVID-19 Pandemic, which began in March 2020, and its associated surges, had an immense impact on our medical staff and their ability to perform their daily duties. The COVID-19 Pandemic necessitated hospital modifications, including the expansion of the Emergency Department, ICU, and Isolation units. The overwhelmed staff and overburdened ER and ICU required adjustments to deal with the Inpatient impasse. For example, temporary patient care rooms needed to be set up for the overflow of patients. The tsunami of the Pandemic almost overwhelmed our hospital. With the challenges presented to our hospital during the Pandemic, we needed a fresh perspective to our multi-disciplinary approach. Thus, we fathomed that the use and cost-effectiveness of both Dalbavancin, a long-acting lipoglycopeptide antibiotic combined with the diagnostic Moleculight Imaging Device would be a sound decision. We hypothesized that with the use of this cost-effective antibiotic in conjunction with the use of the Moleculight Imaging Device, with its fluorescent imaging, we could detect the presence of bacteria and assist our wound treatment and decision-making. A shift in patients from the Emergency Room/Inpatient Department to the Outpatient Department/Wound Care Center was made possible with the use of these two novel products.

The increasing globalisation, the multiculturality of workplaces and the current challenges for organisations generated the need for researchers to support them to manage the workforce. Although the relevance of employee voice for these themes, a lack of shared understanding about this topic results in fragmented literature across and within research fields that limits theoretical advancement and deep comprehension of the phenomenon. Our first aim is to offer a literature review of employee voice by combining systematic and bibliometric methods; the second aim is to understand voice's main issues and implications by considering different research streams. The results present an integrated framework of the leading intellectual knowledge and reveal the main research focuses on voice in domestic contexts. The discussion underlines the cultural issue and context as critical elements for future research by proposing avenues for scholars and some implications for organisations to benefit from the contributions of their members.