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The increasing use of electromedical equipment in hospital care services necessitates effective management of complex devices often unsupported by existing control systems. This paper focuses on developing a pool of evaluation indices for the Clinical Engineering Department (CED) of the ASST Grande Ospedale Metropolitano Niguarda in Milano (Italy), aiming to enhance awareness of the economic value, assess operational units, and optimize maintenance processes. Leveraging business intelligence, this study identifies 18 key performance indicators (KPIs) across logistics, technical, and equipment management categories. An interactive dashboard, implemented using Power BI, facilitates dynamic analysis and visualization of these KPIs, providing insights into the maintenance efficiency and obsolescence of medical devices. It offers a comprehensive framework for ongoing monitoring and decision-making. The results showcase the potential of the developed KPIs and dashboard to enhance operational insights and guide improvements in the healthcare facility's maintenance processes. [ABSTRACT FROM AUTHOR]

The increases in both the elderly population and urbanization present new problems for planning new cities and managing old cities. To solve this challenge, innovative ideas/proposals that encourage walkability and reduce fossil energy motor transport are needed, in line with the actions advocated by Sustainable Development Goal #11 (SDG11), Sustainable Cities and Communities. Opening passages that cross blocks, creating connections between the streets, is the proposal discussed in this paper, as seen in cities like Paris, Prague, Milan, and Juíz de Fora, which have passages in their urban fabric. These can be implemented in a building's rehabilitation or when a new building replaces it. New architectural project designs should have several characteristics that promote walkability in the city, including passages and galleries. Although previous research has obtained promising results, extending the research to different urban fabrics and block sizes is needed. Using space syntax and data analysis, we simulated and quantitatively assessed the walkability of three neighborhoods in Lisbon, Portugal. The comparison of all simulations and the discussion of the results show that the passages improve walkability. It is also noticeable that there is higher walkability in orthogonal urban fabrics than in non-orthogonal fabrics. The results for block size are inconclusive. [ABSTRACT FROM AUTHOR]

The sedimentary cycle of Fengcheng Formation in Junggar Basin changes rapidly and is difficult to identify. The low classification accuracy of high-frequency fine-grained sedimentary cycles restricts the exploration of unconventional shale oil and gas. Full-interval coring of well Maye 1 provides a solid foundation for small-layer research. In this paper, the high-frequency sedimentary cycle of Milan kovitch in Fengcheng Formation is studied by means of spectral analysis and wavelet transform, and the shale sweet spot is identified. The long period of eccentricity of 405ka, short period of eccentricity of 100ka and long period of axis slope of 42736a can be used as semi-quantitative basis for the classification of the fourth, fifth and sixth sequences. The Fengcheng Formation can be divided into 2 quaternary sequence cycles, 9 quaternary sequence cycles and 16 quaternary sequence cycles. A long period of eccentricity of 405ka can identify large-scale lake recessional and recessional, and there is a maximum lake flooding surface in the middle of the second Fengcheng Formation, which corresponds to high abundance of organic matter and high hydrocarbon generation potential. The 100ka short period eccentricity can identify the sweet spot layer, and there are 8 sweet spots in the well Maye 1, which is consistent with the results of nuclear magnetic interpretation. The research results provide a semi-quantitative basis for the classification of high-frequency sedimentary cycles and the identification of sweet spots of Fengcheng Formation in Mahu Sag, Junggar Basin. [ABSTRACT FROM AUTHOR]

The emergence of antibiotic resistance poses a significant threat to public health worldwide, affecting various medical fields, including ophthalmology. Eye infections, ranging from conjunctivitis to more severe conditions like keratitis, are commonly treated with antibiotics. However, the misuse and overuse of these drugs have led to the development of resistant strains of bacteria, allowing traditional treatments ineffective. This paper aims to examine the current situation of antibiotic resistance in eye infections globally, with a specific focus on a large group of hospitals located in Milan (Italy) with considerable experience in cataract and cornea surgery as well as in retinopathy. The results of the study show the prevalence of Gram-positives in the tested samples and a low resistance of fluoroquinolones and glycopeptides. The results also highlight the need to implement sample collection methods for ocular infections, as the quantity of positive samples is rather low compared to the total number of samples. In conclusion, the study, although with limited data, shows that resistance to aminoglycosides and cephalosporins is a situation to be monitored. These data also show the critical need to improve and guide the biological sample collection modalities in order to make the diagnosis more reliable. [ABSTRACT FROM AUTHOR]

This paper suggests a "neoclassical" reading of Ernan McMullin's thought on science and theology. McMullin's Augustinian convictions on God and the God–world relation coincide with those of some prominent scholars from two renowned schools of neo-scholastic philosophy of the twentieth century in Louvain and Milan. The school of Milan, thanks to the work of some disciples of its leading figure, Amato Masnovo, developed a neoclassical version of neo-scholasticism, articulating a fundamental theory of knowledge, as well as an essential, rigorous path to God. We recall the main tenets of a neoclassical path to God, and we interpret this path as a possible contribution to the science–theology dialogue, in line with McMullin's Augustinism. A neoclassical approach to science and theology, with its rediscovery and reactualization of some ideas of classic philosophy in an interdisciplinary context, grounds the intelligibility of the universe and safeguards its mystery. [ABSTRACT FROM AUTHOR]

This study conducted an extensive literature review spanning from 1950 to 2023, exploring the methodologies in urban geomorphology and urban geoheritage assessment, and the possibility of applying Nature-Based Solutions (NbSs) in order to enhance geomorphological maps. The methodology proposed here is based on a two-step approach: (i) a bibliographic review and methodological investigation and (ii) methodological proposal in order to enhance the traditional geomorphological and geoheritage maps with NbS to reduce the geomorphological risk in urban areas. This paper aims to introduce a methodological framework and illustrated its practical application to provide researchers and practitioners with a clear understanding of its implementation in real-world scenarios. The proposed methodology was applied in the north and northeastern parts of Milan, Italy. The implementation of the proposed methodology demonstrated its effectiveness in urban contexts and its potential for further modification and extension to various urban environments in the future. [ABSTRACT FROM AUTHOR]

The genetic causes of epilepsies and developmental and epileptic encephalopathies (DEE) with onset in early childhood are increasingly recognized. Their outcomes vary from benign to severe disability. In this paper, we wished to retrospectively review the clinical, genetic, EEG, neuroimaging, and outcome data of patients experiencing the onset of epilepsy in the first three years of life, diagnosed and followed up in four Italian epilepsy centres (Epilepsy Centre of San Paolo University Hospital in Milan, Child Neurology and Psychiatry Unit of AUSL-IRCCS di Reggio Emilia, Pediatric Neurology Unit of Vittore Buzzi Children's Hospital, Milan, and Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia). We included 168 patients (104 with monogenic conditions, 45 with copy number variations (CNVs) or chromosomal abnormalities, and 19 with variants of unknown significance), who had been followed up for a mean of 14.75 years. We found a high occurrence of generalized seizures at onset, drug resistance, abnormal neurological examination, global developmental delay and intellectual disability, and behavioural and psychiatric comorbidities. We also documented differing presentations between monogenic issues versus CNVs and chromosomal conditions, as well as atypical/rare phenotypes. Genetic early-childhood-onset epilepsies and DEE show a very wide phenotypic and genotypic spectrum, with a high risk of complex neurological and neuropsychiatric phenotypes. [ABSTRACT FROM AUTHOR]

The application of artificial intelligence (AI) techniques may lead to significant improvements in different aspects of rail sector. Considering asset management and maintenance, AI can improve data analysis and asset status forecasting and decision-making processes, fostering predictive and prescriptive maintenance strategies. A prescriptive approach should be able to predict future scenarios as well as to suggest a course of actions. Nevertheless, the decision-making in rail asset management is often based on the classical asset-oriented approach, concentrating on the function of the asset itself as a main key performance indicator (KPI), whereas a user-oriented approach could lead to improved performance in terms of level of service. This paper is aimed at integrating the passengers' perspective in the decision-making process for asset management to mitigate the impact that service interruptions may have on the final users. A data-driven prioritisation framework is developed to prioritise maintenance interventions taking into account asset status and criticality. In particular, a three-step approach is proposed, which focuses on the analysis of passenger data to evaluate the failure impact on the service, the analysis of alarms and anomalies to evaluate the asset status, and the suggestion of maintenance interventions. The proposed approach is applied to the maintenance of the metro line M5 in the Italian city of Milan. Results show the usefulness of the proposed approach to support infrastructure managers and maintenance operators in making decisions regarding the priority of maintenance activities, reducing the risk of critical failures and service interruptions. [ABSTRACT FROM AUTHOR]

The urban heat island effect exacerbates the vulnerability of cities to climate change, emphasizing the need for sustainable urban planning driven by data evidence. In the last decade, the Local Climate Zone (LCZ) model emerged as a key tool for categorizing urban landscapes, aiding in the development of urban temperature mitigation strategies. In this work, the contribution of hyperspectral satellite imagery to LCZ mapping, leveraging the Italian Space Agency (ASI)'s PRISMA satellite, is investigated. Mapping performances are compared with traditional multispectral-based LCZ mapping using Sentinel-2 satellite imagery. The Random Forest algorithm is utilized for LCZ classification, with evaluation conducted through spectral separability analysis and accuracy assessment between PRISMA and Sentinel-2 derived LCZ maps as well as with the benchmark LCZ Generator mapping tool. An initial experiment on the effect of PRISMA image pan-sharpening on LCZ spectral separability is also presented. Results obtained for Milan (Northern Italy) demonstrate the potential of hyperspectral imagery in enhancing LCZ identification compared to multispectral data, with promising improvements in LCZ maps overall accuracy. Finally, air temperature patterns within each LCZ class are explored, qualitatively confirming the influence of urban morphology on thermal comfort. [ABSTRACT FROM AUTHOR]

Urbanisation is a main driver of land-use change, leading to rising in temperatures and fragmentation and reduction of green areas. Bees and wasps, which are important insect groups due to the ecosystem services they provide, may respond to this disturbance via changes in morphological traits which are functionally relevant. To date, studies focusing on this aspect only investigated few social bee species, and often gave contrasting results even at intra-generic level. Here, we studied how body size, wing loading, wing aspect ratio and wing fluctuating asymmetry vary in a social ground-nesting bee (Halictus scabiosae), a solitary hole-nesting bee (Osmia cornuta) and a social paper wasp (Polistes dominula) along an urbanisation gradient within Milan (Italy). By assessing the effects of temperature, green areas fragmentation and vegetation productivity on the above-listed functional traits, we found the three species to variably respond to increasing urbanisation, albeit the driving environmental parameters differed among species. More specifically, smaller individuals were sampled in warmer (for bees) and in less productive (for wasps) areas along the urbanisation gradient. Furthermore, greater wing aspect ratio values were recorded at warmer locations for H. scabiosae , lower wing loading was recorded at more fragmented sites for O. cornuta , and greater wing loading was recorded at locations with greater productivity for P. dominula. H. scabiosae and P. dominula showed greater wing fluctuating asymmetry at more fragmented sites. Although distinct species seemed sensitive to different driving factors, our results point toward a consistent response: smaller body but potentially improved flight performance in more urbanised environments. [ABSTRACT FROM AUTHOR]

Since pedestrians are impacted by solar radiation differently, urban designers must evaluate solar radiation exposure of pedestrian paths adopting an inclusive approach. This paper proposes a maximum threshold of direct solar radiation exposure for pedestrians based on activity, user profile and environmental conditions, defined as the difference between the energy consumption before feeling exhausted and the energy cost of walking. Two users of diverse walking abilities, a young adult and an elderly person with mobility impairment, were characterised by metabolic activity, walking speed and maximum energy capacity. Based on the theoretical framework, the energy budget of young adults to cope with thermal stress was set as three times higher than for the elderly. This framework was used to quantify the contribution of direct solar radiation to energy balance and then classify walkability during clear-sky summer hours; the term 'walkable' referred to environmental conditions allowing users to walk without feeling exhausted. The methodology was tested on an open area and an urban canyon in Milan; applicability by urban designers was key in developing a simplified way to evaluate shading needs. This approach could be applied to evaluate solar radiation exposure of pedestrian paths adopting diverse user experiences as an evaluation criterion. [ABSTRACT FROM AUTHOR]

This study challenges historical paradigms using a large-scale integrated bioarchaeological approach, focusing on the female experience over the last 2,000 years in Milan, Italy. Specifically, 492 skeletons from the osteological collection of Milan were used to elucidate female survivorship and mortality by integrating bioarchaeological and paleopathological data, paleoepidemiological analyses, and historical contextualization. Findings revealed changes in female longevity, with a notable increase from Roman to contemporary eras, albeit plateauing in the Middle Ages/modern period. Significant sex-specific differences in mortality risk and survivorship were observed: females had higher mortality risk and lower survivorship in the Roman (first-fifth century AD) and Modern (16th-18th century AD) eras, but this trend reversed in the contemporary period (19th-20th century AD). Cultural and social factors negatively impacted female mortality in Roman and modern Milan, while others buffered it during the Middle Ages (sixth-15th century AD). This study underscored the importance of bioarchaeological inquiries in reconstructing the past, providing answers that may challenge historical assumptions and shedding light on how the interplay of cultural, social, and biological factors shaped the female experience across millennia. [ABSTRACT FROM AUTHOR]

Background: The systemic inflammatory syndrome called "cytokine storm" has been described in COVID-19 pathogenesis, contributing to disease severity. The analysis of cytokine and chemokine levels in the blood of 21 SARS-CoV-2 positive patients throughout the phases of the pandemic has been studied to understand immune response dysregulation and identify potential disease biomarkers for new treatments. The present work reports the cytokine and chemokine levels in sera from a small cohort of individuals primarily infected with SARS-CoV-2 during the first wave of the COVID-19 pandemic in Milan (Italy). Results: Among the 27 cytokines and chemokines investigated, a significant higher expression of Interleukin-9 (IL-9), IP-10 (CXCL10), MCP-1 (CCL2) and RANTES (CCL-5) in infected patients compared to uninfected subjects was observed. When the change in cytokine/chemokine levels was monitored over time, from the hospitalization day to discharge, only IL-6 and IP-10 showed a significant decrease. Consistent with these findings, a significant negative correlation was observed between IP-10 and anti-Spike IgG antibodies in infected individuals. In contrast, IL-17 was positively correlated with the production of IgG against SARS-CoV-2. Conclusions: The cytokine storm and the modulation of cytokine levels by SARS-CoV-2 infection are hallmarks of COVID-19. The current global immunity profile largely stems from widespread vaccination campaigns and previous infection exposures. Consequently, the immunological features and dynamic cytokine profiles of non-vaccinated and primarily-infected subjects reported here provide novel insights into the inflammatory immune landscape in the context of SARS-CoV-2 infection, and offer valuable knowledge for addressing future viral infections and the development of novel treatments. [ABSTRACT FROM AUTHOR]

The increasing rate of urbanisation and extreme climatic events represent a constant threat for urban water resources management. In recent decades, Milan Metropolitan Area (Lombardy Region, Northern Italy) has been affected by a) frequent extreme rainfall events, responsible for the flooding of major surface water courses, and b) groundwater management problems, both from a quantitative (i.e. interaction with underground infrastructures) and qualitative point of view. Moreover, the increasing use of groundwater geothermal systems also requires further considerations. This work analyses the literature available in the area regarding surface floods, groundwater quantity, quality, and temperature. Finally, a discussion is provided to understand a) which approaches could promote an effective management of both surface water and groundwater resources b) which points of contact emerge between these two aspects of the urban water cycle, and c) which possible urban interventions could contribute to an integrated and functional management of water resources, also reducing some current issues. [ABSTRACT FROM AUTHOR]

Using the dispersive method we perform a two-loop analysis of the leading non-perturbative power correction to the change in jet transverse momentum pT, in the small R limit of a Cambridge-Aachen jet clustering algorithm. We frame the calculation in such a way so as to maintain connection with the universal "Milan factor" that corrects for the naive inclusive treatment of the leading hadronization corrections. We derive an enhancement factor that differs from the universal Milan factor computed for event-shape variables as well as the corresponding enhancement factor previously derived for the kt algorithm. Our calculation directly exploits the soft and triple-collinear limit of the QCD matrix element and phase space, which is relevant for capturing the coefficient of the leading 1/R power correction. As an additional check on our approach, we also independently confirm the known result for the kt algorithm. [ABSTRACT FROM AUTHOR]

Urban heat island (UHI) mitigation and adaptation are urgent needs in a built environment, which requires us to search for sustainable solutions to limit the urban heat island effect and improve the energy efficiency of building envelopes. Among these solutions, vertical green structures (VGSs) have recently attracted significant attention for their potential to mitigate adverse effects, especially in densely built areas. This study presents a comprehensive data analysis of the microclimate of a living wall in Milan, Italy. Our aim was to evaluate this VGS's performance in mitigating temperature increases caused by the UHI effect. In the literature, similar studies are limited to shorter monitoring periods (mostly in cooling seasons) and specific orientations (mostly facing south). However, the VGS presented in this case study here faces northwest and was continuously monitored for one calendar year. During this continuous in situ monitoring campaign, air temperature data from sensors either embedded in vegetation or exposed on a bare wall were collected and analysed over a whole calendar year, which is a novelty compared to the existing literature focused on VGSs due to the long duration. The findings indicate that the studied VGS has the ability to influence the outdoor microclimate depending on the season, the precipitation events, the wall exposure, the type of vegetation, and the vegetation's phenological attributes. The analysis showed that the VGS consistently maintained cooler temperatures than the bare wall, with mean temperature differences ranging from 2.8 °C in autumn to 0.8 °C in spring through the winter. The vegetation acted as a natural insulator by reducing the air temperature during the hot summer and in early autumn, corresponding to the growing period of the vegetation. Thus, VGSs show potential to mitigate the global warming effect. These findings provide valuable insights on vegetation's capability to act as a thermal regulator for sustainable urban planning and energy-efficient building design and retrofitting. [ABSTRACT FROM AUTHOR]

This research has investigated Italian consumers' preferences for and purchasing behaviors of strawberries utilizing the Best–Worst Scaling methodology (BWS). This approach enables the key factors that influence strawberry purchasing decisions to be identified and different choice groups to be characterized. To achieve this goal, a survey was conducted on a sample of 496 respondents living in the metropolitan area of Milan (North Italy). The declared preferences of the individuals for 12 strawberry characteristics, divided into intrinsic, extrinsic, and credence attributes, were first measured. A Latent Class Analysis (LCA) was then performed to identify different clusters of consumers according to the individuals' preferences. Subsequently, the heterogeneity of the clusters was tested, using the Chi-square test, and sociodemographic characteristics and purchasing habits were considered. The results suggest that the most important attribute in the choice of strawberries was appearance, highlighting the importance of preserving it throughout the supply chain, followed by one of the increasingly important aspects of diets, which is health benefits. The attribute considered the least important was the brand. This study demonstrates, from a holistic point of view, that sociodemographic characteristics, food habits, and perceptions of different strawberry attributes influence consumers' preferences and behaviors. Practical implications suggest a new prospective for communication marketing strategies for producers, creating a better brand identity and highlighting in their marketing all of the aspects that consumers would like to know about the fruits they choose as quality certifications. [ABSTRACT FROM AUTHOR]

Background: The current literature lacks studies which evaluate the failure of short stems in total hip arthroplasty (THA). Therefore, the present clinical investigation reported our experience with the failure of short stems in THA, evaluating the causes of failure, survivorship, and the clinical outcomes of revision arthroplasty. Methods: The present study was performed according to the STROBE guidelines. This study was conducted at the Department of Orthopaedic Surgery of the Humanitas Clinical Institute, Milan, Italy, between 2017 and 2022. All patients who underwent revision surgery of a previously implanted THA using a short stem were prospectively included in the present study. Surgeries were performed with patients in lateral position, using a minimally invasive posterolateral approach. The outcomes of interest were to report information on the type and survivorship of implants used for the revision surgery and evaluate the clinical outcomes and the rate of complications. The following patient-reported outcome measures (PROMs) used for the clinical assessment were the Western Ontario McMaster Osteo-Arthritis Index (WOMAC) and related subscales of pain, stiffness, and function, and the visual analogue scale (VAS). Results: Data from 45 patients were retrieved. Of them, 31% (14 of 45 patients) were women. The mean age was 63.7 ± 13.9 years. The mean length of the implant survivorship was 6.2 ± 5.7 years. In total, 58% (26 of 45 patients) underwent revision of all components, 36% (16 of 45 patients) revised only the stem, and 1% (3 of 45 patients) received a two-stage revision. The mean length of the follow-up was 4.4 ± 1.5 years. The cup was revised in 58% (26 of 45) of patients. At 4.4 ± 1.5 years of follow-up, the WOMAC score was 3.5 ± 1.3 and the VAS was 1.2 ± 1.3. In total, 9% (4 of 45) of patients experienced minor complications. One patient used a walking aid because of reduced function. One patient evidenced muscular hypotrophy. Two patients experienced hip dislocations. All two dislocations were managed conservatively with repositioning in the emergency room under fluoroscopy. No patient needed additional revision surgery or experienced further dislocations. Conclusions: Revision surgery is effective and safe when a short stem THA fails. At approximately four years of follow-up, all patients were highly satisfied with their clinical outcomes. Despite the relatively high number (9%), complications were of a minor entity and were successfully managed conservatively. [ABSTRACT FROM AUTHOR]

Introduction: Recent studies have highlighted the prognostic value of easily accessible inflammatory markers, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) for predicting severe outcomes in patients affected by Coronavirus disease 2019 (COVID-19). Our study validates NLR and PLR cut-off values from a prior cohort at IRCCS Policlinico San Matteo (OSM) of Pavia, Italy, across two new cohorts from different hospitals. This aims to enhance the generalizability of these prognostic indicators. Methods: In this retrospective cohort study, conducted at Milan's Ospedale Luigi Sacco (OLS) and IRCCS Ospedale Maggiore Policlinico (OMP) hospitals, we assess the predictive capacity of NLR and PLR for three main outcomes—non-invasive ventilation (NIV) or continuous positive airway pressure (CPAP) usage, invasive ventilation (IV), and death—in patients with COVID-19 at admission. For each outcome, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were computed separately for male and female cohorts. Distinct NLR and PLR cut-off values were used for men (7.00, 7.29, 7.00 for NLR; 239.22, 248.00, 250.39 for PLR) and women (6.36, 7.00, 6.28 for NLR; 233.00, 246.45, 241.54 for PLR), retrieved from the first cohort at OSM. Results: A total of 3599 patients were included in our study, 1842 from OLS and 1757 from OMP. OLS and OMP sensitivity values for both NLR and PLR (NLR: 24–67%, PLR: 40–64%) were inferior to specificity values (NLR: 64–76%, PLR: 55–72%). Additionally, PPVs generally remained lower (< 63%), while NPVs consistently surpassed 68% for PLR and 72% for NLR. Finally, both PLR and NLR exhibited consistently higher NPVs for more severe outcomes (> 82%) compared to NPVs for CPAP/NIV. Conclusions: Consistent findings across diverse patient populations validate the reliability and applicability of NLR and PLR cut-off values. High NPVs emphasize their role in identifying individuals less likely to experience severe outcomes. These markers not only aid in risk stratification but also guide resource allocation in emergencies or limited-resource situations. [ABSTRACT FROM AUTHOR]

The most frequent cause of periprosthetic infections (PJIs) is intraoperative contamination; hence, antibiotic prophylaxis plays a crucial role in prevention. Modifications to standard prophylaxis can be considered if there is a high incidence of microorganisms resistant to current protocols. To date, very few studies regarding microbial etiology have been published in Italy. In this single-center, retrospective study conducted at IRCCS Ospedale Galeazzi-Sant'Ambrogio in Milan, we analyzed hip, knee, and shoulder PJIs in patients undergoing first implantation between 1 January 17 and 31 December 2021. The primary aim was to derive a local microbiological case history. The secondary aim was to evaluate the adequacy of preoperative antibiotic prophylaxis in relation to the identified bacteria. A total of 57 PJIs and 65 pathogens were identified: 16 S. aureus, 15 S. epidermidis, and 10 other coagulase-negative staphylococci (CoNS), which accounted for 63% of the isolations. A total of 86.7% of S. epidermidis were methicillin-resistant (MRSE). In line with other case reports, we found a predominance of staphylococcal infections, with a lower percentage of MRSA than the Italian average, while we found a high percentage of MRSE. We estimated that 44.6% of the bacteria isolated were resistant to cefazolin, our standard prophylaxis. These PJIs could be prevented by using glycopeptide alone or in combination with cefazolin, but the literature reports conflicting results regarding the adequacy of such prophylaxis. In conclusion, our study showed that in our local hospital, our standard antibiotic prophylaxis is ineffective for almost half of the cases, highlighting the importance of defining specific antibiotic guidelines based on the local bacterial prevalence of each institution. [ABSTRACT FROM AUTHOR]

Simple Summary: In this study, we studied the potential health benefits of probiotic supplements in individuals with chronic diarrhea. Dysbiosis, resulting from factors like poor diet or stress, can lead to various systemic diseases. Probiotics are known for stabilizing gut microbiota and alleviating gastrointestinal issues, such as irritable bowel syndrome (IBS). We focused on the tryptophan pathway's role in regulating serotonin levels and its impact on host physiology and behavior. Nanovesicles isolated from subjects' plasma before and after 60 days of probiotics consumption showed enhanced levels of Tryptophan 2,3-dioxygenase 2 (TDO 2), suggesting a potential role in the gut–brain axis. In vitro experiments demonstrated the probiotics' cytoprotective effect against H2O2-induced stress, reducing heat shock protein 60 kDa levels and preserving intestinal integrity. Moreover, the probiotics increased TDO 2 and serotonin receptor expression. These results provide evidence for the role of nanovesicles in mediating the gut–brain axis and offer insights into potential therapeutic avenues for neurological disorders. Background: Dysbiosis, influenced by poor diet or stress, is associated with various systemic diseases. Probiotic supplements are recognized for stabilizing gut microbiota and alleviating gastrointestinal issues, like irritable bowel syndrome (IBS). This study focused on the tryptophan pathways, which are important for the regulation of serotonin levels, and on host physiology and behavior regulation. Methods: Nanovesicles were isolated from the plasma of subjects with chronic diarrhea, both before and after 60 days of consuming a probiotic mix (Acronelle®, Bromatech S.r.l., Milan, Italy). These nanovesicles were assessed for the presence of Tryptophan 2,3-dioxygenase 2 (TDO 2). Furthermore, the probiotics mix, in combination with H2O2, was used to treat HT29 cells to explore its cytoprotective and anti-stress effect. Results: In vivo, levels of TDO 2 in nanovesicles were enhanced in the blood after probiotic treatment, suggesting a role in the gut–brain axis. In the in vitro model, a typical H2O2-induced stress effect occurred, which the probiotics mix was able to recover, showing a cytoprotective effect. The probiotics mix treatment significantly reduced the heat shock protein 60 kDa levels and was able to preserve intestinal integrity and barrier function by restoring the expression and redistribution of tight junction proteins. Moreover, the probiotics mix increased the expression of TDO 2 and serotonin receptors. Conclusions: This study provides evidence for the gut–brain axis mediation by nanovesicles, influencing central nervous system function. [ABSTRACT FROM AUTHOR]

Increased temperature and fragmentation of green spaces in urban areas could drive variations in functional traits of insects. Such morphological shifts may occur for sensory systems, which were previously reported to be prone to change with habitat characteristics in non-urban contexts. Here, we measured traits related to the visual and antennal sensory systems in the bees Halictus scabiosae and Osmia cornuta and the wasp Polistes dominula along an urbanisation gradient within Milan (Italy). We hypothesised that fragmentation could filter for better visual properties, and that higher temperature could filter for fewer thermoreceptors and more olfactory hairs. While controlling for body size, results show subtle but appreciable responses to urbanisation in one or more traits in all species, though not always supporting our hypotheses. O. cornuta shows marginally higher ommatidia density and smaller ommatidia diameter (associated with better visual resolution) in more fragmented sites, as well as marginally fewer thermoreceptors in hotter sites, in agreement with our two predictions. On the other hand, H. scabiosae has marginally smaller antennae and P. dominula has smaller eyes at warmer locations, and the wasp also has smaller antennae and 9th flagellomeres in more fragmented areas. Perhaps higher temperatures accelerate development of sensory system at higher speed than the rest of body in these two species. Our results represent the first evidence of urbanisation effects on the visual and antennal sensory systems of bees and wasps and underline how such effects may involve a much broader bouquet of traits then previously observed. [ABSTRACT FROM AUTHOR]

Background: Non-surgical rhinoplasty is one of the best choices in mild cases of the saddle nose, and it represents a solution for the aesthetical amelioration of facial deformity; nevertheless, in most critical cases, surgical intervention is still required. This study reports the experience and results of a single facial plastic surgeon (M.G.) using a non-surgical technique for the correction of saddle noses in a large cohort of patients. Methods: This retrospective study assesses all patients injected from January 2017 through October 2023 in private clinics in Milan (Italy), London (UK), and Dubai (UAE). All patients were followed up for 12 months. The harvested adipose tissues were processed with different systems and with or without acoustic wave therapy (AWT). The extracted products have been characterized in terms of cellular yield and cell growth. Ninety-seven patients were injected with adipose-derived products or hyaluronic acid (HA). Patients were followed up for 12 months, and satisfaction data were analyzed. Results: The stem cells obtained from the patients who previously received AWT displayed a statistically higher cell growth ability in comparison with those of the cells derived from patients who did not receive AWT. The evolution of patient satisfaction during the time for each group of treatment was investigated, and cellular treatments show the best maintenance of patient satisfaction over time. Conclusions: Dermgraft and AWT approaches resulted in the highest patient satisfaction for the non-surgical correction of the saddle nose deformity. [ABSTRACT FROM AUTHOR]

Introduction: Differential diagnosis among subjects with Primary Progressive Aphasia (PPA) can be challenging. Structural MRI can support the clinical profile. Visual rating scales are a simple and reliable tool to assess brain atrophy in the clinical setting. The aims of the study were to establish to what extent the visual rating scales could be useful in the differential diagnosis of PPA, to compare the clinical diagnostic impressions derived from routine MRI interpretations with those obtained using the visual rating scale and to correlate results of the scales in a voxel-based morphometry (VBM) analysis. Method: Patients diagnosed with primary progressive aphasia (PPA) according to current criteria from two centers—Ospedale Maggiore Policlinico of Milan and Hospital Clínic de Barcelona—were included in the study. Two blinded clinicians evaluated the subjects MRIs for cortical atrophy and white matter hyperintensities using two protocols: routine readings and the visual rating scale. The diagnostic accuracy between patients and controls and within PPA subgroups were compared between the two protocols. Results: One hundred fifty Subjects were studied. All the scales showed a good to excellent intra and inter-rater agreement. The left anterior temporal scale could differentiate between semantic PPA and all other variants. The rater impression after the protocol can increase the accuracy just for the logopenic PPA. In the VBM analysis, the scores of visual rating scales correlate with the corresponding area of brain atrophy. Conclusion: The Left anterior temporal rating scale can distinguish semantic PPA from other variants. The rater impression after structured view improved the diagnostic accuracy of logopenic PPA compared to normal readings. The unstructured view of the MRI was reliable for identifying semantic PPA and controls. Neither the structured nor the unstructured view could identify the nonfluent and undetermined variants. [ABSTRACT FROM AUTHOR]

Background and Objective: The dynamic assessment of disease activity during the follow-up of patients with Crohn's disease (CD) remains a significant challenge. In this study, we aimed to identify the role of dynamic contrast-enhanced ultrasound (DCE-US) in the evaluation of activity of CD. Methods: In the retrospective study, patients diagnosed with CD in our hospital were included. All the diagnoses were confirmed by clinical symptoms and ileocolonoscopical results. All patients underwent intestinal ultrasound and contrast-enhanced ultrasound (CEUS) examinations within 1 week of the ileocolonoscopy examinations. Acuson Sequoia (Siemens Healthineers, Mountain View, CA, USA) and Resona R9 Elite (Mindray Medical Systems, China) with curved array and Line array transducers were used. The CEUS examination was performed with SonoVue (Bracco SpA, Milan, Italy). DCE-US analysis was performed by UltraOffice (version: 0.3-2010, Mindray Medical Systems, China) software. Two regions of interest (ROIs) were set in the anterior section of the infected bowel wall and its surrounding normal bowel wall 2 cm distant from the inflamed area. Time–intensity curves (TICs) were generated and quantitative perfusion parameters were obtained after curve fittings. The Simple Endoscopic Score for Crohn's disease (SES-CD) was regarded as the reference standard to evaluate the activity of CD. The receiver operating characteristic curve (ROC) analyses were used to determine the diagnostic efficiency of DCE-US quantitative parameters. Results: From March 2023 to November 2023, 52 CD patients were included. According to SES-CD score, all patients were divided into active group with the SES-CD score > 5 (n = 39) and inactive group SES-CD score < 5 (n = 13). Most of the active CD patients showed bowel wall thickness (BWT) > 4.2 mm (97.4%, 38/39) or mesenteric fat hypertrophy (MFH) on intestinal ultrasound (US) scan (69.2%, 27/39). Color Doppler signal of the bowel wall mostly showed spotty or short striped blood flow signal in active CD patients (56.4%, 22/39). According to CEUS enhancement patterns, most active CD patients showed a complete hyperenhancement of the entire intestinal wall (61.5%, 24/39). The TICs of active CD showed an earlier enhancement, higher peak intensity, and faster decline. Among all CEUS quantitative parameters, amplitude-derived parameters peak enhancement (PE), wash-in area under the curve (WiAUC), wash-in rate (WiR), wash-in perfusion index (WiPI), and wash-out rate (WoR) were significantly higher in active CD than in inactive CD (p < 0.05). The combined AUROC of intestinal ultrasound features and DCE-US quantitative perfusion parameters in the diagnosis of active CD was 0.987, with 97.4% sensitivity, 100% specificity, and 98.1% accuracy. Conclusions: DCE-US with quantitative perfusion parameters is a potential useful noninvasive imaging method to evaluate the activity of Crohn's disease. [ABSTRACT FROM AUTHOR]

Purpose: Besides the well-established efficacy in preventing severe COVID-19, the impact of early treatments, namely antivirals and monoclonal antibodies (mAbs), on the time length to negativization of SARS-CoV-2 nasal swabs is still unclear. The aim of this study was to compare the efficacy of different early treatments in reducing the SARS-CoV-2 viral shedding, identifying a single drug that might potentially lead to a more rapid negativization of SARS-CoV-2 nasal swab. Methods: This was a single-centre, retrospective, observational study conducted at Ospedale Luigi Sacco in Milan. Data of high-risk COVID-19 patients who received early treatments between 23 December 2021 and March 2023 were extracted. The comparison across treatments was conducted using the Kruskall-Wallis test for continuous variables. Dunn's test with Bonferroni adjustment was performed for post-hoc comparisons of days to negativization. Secondly, a negative binomial regression adjusted for age, sex, number of comorbidities, immunosuppression, and SARS-CoV-2 vaccination status was implemented. Results: Data from 428 patients receiving early treatments were collected. The majority were treated with Nirmatrelvir/Ritonavir and were affected by SARS-CoV-2 Omicron infection with BA.2 sublineage. The median length time to SARS-CoV-2 nasal swab negativization was 9 days [IQR 7–13 days]. We found that Nirmatrelvir/Ritonavir determined a significant decrease of the length time to SARS-CoV-2 nasal swab negativization compared to mAbs (p = 0.003), but not compared to Remdesivir (p = 0.147) and Molnupiravir (p = 0.156). Conclusion: Our findings highlight the importance of promptly treating high-risk COVID-19 patients with Nirmatrelvir/Ritonavir, as it also contributes to achieving a faster time to negative SARS-CoV-2 nasal swabs. [ABSTRACT FROM AUTHOR]

The geopolitical conflict between Russia and Ukraine has disrupted Europe's natural gas supplies, driving up gas prices and leading to a shift towards biomass for residential heating during colder months. This study assessed the consequent air quality and toxicological impacts in Milan, Italy, focusing on fine particulate matter (PM2.5, dp < 2.5 μm) emissions. PM2.5 samples were analyzed for their chemical composition and assessed for their oxidative potential using the dithiothreitol (DTT) assay across three periods reflecting residential heating deployment (RHD): pre-RHD, intra-RHD, and post-RHD periods. During the intra-RHD period, PM2.5 levels were significantly higher than those in other periods, with concentrations reaching 57.94 ± 7.57 μg/m3, indicating a deterioration in air quality. Moreover, levoglucosan was 9.2 times higher during the intra-RHD period compared to the pre-RHD period, correlating with elevated levels of elemental carbon (EC) and polycyclic aromatic hydrocarbons (PAHs). These findings were compared with previous local studies before the conflict, underscoring a significant rise in biomass-related emissions. DTT assay levels during the intra-RHD were 2.1 times higher than those observed during the same period in 2022, strongly correlating with biomass burning emissions. Our findings highlight the necessity for policies to mitigate the indirect health effects of increased biomass burning emissions due to the energy crisis triggered by the geopolitical conflict. [ABSTRACT FROM AUTHOR]

To meet the United Nations and European Union goals of reducing road crash fatalities and injuries, it is also relevant to address the negative externalities due to mega-events on the road network and the local communities, to assess the safety of the road network involved, and to implement appropriate measures for different road environments. Despite their relevance, the literature often overlooks social costs and risks associated with mega-events. This study presents an operating framework for rapidly assessing the safety of the Milano–Cortina 2026—"Via Olimpica" road—which will host a significant proportion of the traffic during the Winter Olympic Games in 2026. The framework proposes a simplified Road Infrastructure Safety Management (RISM) to address the unique challenges posed by the limited time available for screening and implementation by local authorities. The framework integrates four data sources and follows a seven-step procedure. It provides recommendations for improving road safety by identifying critical road sections and blackspots. Road authorities, practitioners, and public administrations may all benefit from the framework, as it makes it easier to prioritise safety improvements within time constraints. [ABSTRACT FROM AUTHOR]

Tracing the profile of pediatric Lyme borreliosis (LB) in Europe is difficult due to the interregional variation in its incidence and lack in notifications. Moreover, the identification of LB can be challenging. This study is an 18-year case series of 130 children and adolescents aged under 18 years referred to the Pediatric Infectious Diseases Unit at L. Sacco Hospital, Milan, with suspicion of LB, between January 2005 and July 2023. The routine serological workup consisted of a two-step process: an initial screening test followed by Western blot (WB). Forty-four (34%) patients were diagnosed with LB. The median age was six years, and 45% were females. Of the children with erythema migrans (EM), 33 (57%) were confirmed as having true EM, and, of these, 4 (12%) were atypical. Ten (23%) patients had early disseminated/late diseases, including facial nerve palsy (n = 3), early neuroborreliosis (n = 1), arthritis (n = 3), relapsing fever (n = 2), and borrelial lymphocytoma (n = 1). No asymptomatic infections were documented. Over seventy percent of confirmed LB cases (n = 31/44) recalled a history of tick bites; in this latter group, 19 (61%) were from the area of the Po River valley in Lombardy. Almost half of the children evaluated for LB complained of non-specific symptoms (fatigue, musculoskeletal pain, skin lesions/rash, and persistent headache), but these symptoms were observed in only two patients with confirmed LB. Most LB cases in our study were associated with EM; two-tier testing specificity was high, but we found frequent non-adherence to international recommendations with regard to the timing of serology, application of the two-step algorithm, and antibiotic over-prescription. Most children were initially assessed for a tick bite or a skin lesion suggestive of EM by a family pediatrician, highlighting the importance of improving awareness and knowledge around LB management at the primary healthcare level. Finally, the strengthening of LB surveillance at the national and European levels is necessary. [ABSTRACT FROM AUTHOR]

Deep learning models have gained prominence in human activity recognition using ambient sensors, particularly for telemonitoring older adults' daily activities in real-world scenarios. However, collecting large volumes of annotated sensor data presents a formidable challenge, given the time-consuming and costly nature of traditional manual annotation methods, especially for extensive projects. In response to this challenge, we propose a novel AttCLHAR model rooted in the self-supervised learning framework SimCLR and augmented with a self-attention mechanism. This model is designed for human activity recognition utilizing ambient sensor data, tailored explicitly for scenarios with limited or no annotations. AttCLHAR encompasses unsupervised pre-training and fine-tuning phases, sharing a common encoder module with two convolutional layers and a long short-term memory (LSTM) layer. The output is further connected to a self-attention layer, allowing the model to selectively focus on different input sequence segments. The incorporation of sharpness-aware minimization (SAM) aims to enhance model generalization by penalizing loss sharpness. The pre-training phase focuses on learning representative features from abundant unlabeled data, capturing both spatial and temporal dependencies in the sensor data. It facilitates the extraction of informative features for subsequent fine-tuning tasks. We extensively evaluated the AttCLHAR model using three CASAS smart home datasets (Aruba-1, Aruba-2, and Milan). We compared its performance against the SimCLR framework, SimCLR with SAM, and SimCLR with the self-attention layer. The experimental results demonstrate the superior performance of our approach, especially in semi-supervised and transfer learning scenarios. It outperforms existing models, marking a significant advancement in using self-supervised learning to extract valuable insights from unlabeled ambient sensor data in real-world environments. [ABSTRACT FROM AUTHOR]

This study explores the role of architectural composition and urban design in enhancing urban biodiversity, which is crucial for improving ecosystem services and overall urban sustainability. It addresses a gap in the literature by providing empirical evidence on how specific morphological characteristics in urban regeneration projects can support biodiversity, emphasizing the overlooked potential of architectural morphologies in urban greening strategies. Focusing on five recent urban regeneration projects in Milan, the study conducts a detailed analysis of built volumes and green areas. Quantitative measurements, such as green area compactness, perimeter edge continuity, and building front permeability, were combined with qualitative assessments to identify correlations between urban morphology and biodiversity potential. The analysis revealed three distinct urban morphologies--"Central Park," "Fluid Park," and "Garden Between Houses"--each offering unique conditions for accessibility and biodiversity development. These morphologies demonstrate varying capacities for conserving, promoting, and implementing urban biodiversity, depending on their interaction with the surrounding urban fabric. By establishing a clear correlation between urban morphology and biodiversity potential, this research highlights the critical role that architects and urban designers play in addressing the emerging challenge of enhancing urban biodiversity. It provides valuable insights for future urban regeneration projects aimed at fostering sustainable and biodiverse urban environments. [ABSTRACT FROM AUTHOR]

The "QuantitatEVs: multiscale analyses, from bulk to single vesicle" workshop aimed to discuss quantitative strategies and harmonized wet and computational approaches toward the comprehensive analysis of extracellular vesicles (EVs) from bulk to single vesicle analyses with a special focus on emerging technologies. The workshop covered the key issues in the quantitative analysis of different EV‐associated molecular components and EV biophysical features, which are considered the core of EV‐associated biomarker discovery and validation for their clinical translation. The in‐person‐only workshop was held in Trento, Italy, from January 31st to February 2nd, 2023, and continued in Milan on February 3rd with "Next Generation EVs," a satellite event dedicated to early career researchers (ECR). This report summarizes the main topics and outcomes of the workshop. [ABSTRACT FROM AUTHOR]

For the hypothetical reconstruction of architectural heritage, there are still no scientific standards of reference concerning their sharing and documentation. Recent international initiatives established the basis to address this problem; however, still, much work needs to be done in order to systematise good practices for the process of reconstruction and its dissemination. This contribution aims to take a step forward in the analysis and visualisation of uncertainty. Some authors have suggested various approaches to visualise uncertainty for single buildings; however, case studies at the urban scale are rarely investigated. This research proposes an improved source-based multi-feature approach aimed at analysing and visualising (through false-colour shading) the uncertainty of hypothetical 3D digital models of urban areas. The assessment of uncertainty is also quantified qualitatively by using newly defined formulas which calculate the average uncertainty weighted on the volume of the 3D model. This methodology aims to improve the objectiveness, unambiguity, transparency, reusability, and readability of hypothetical reconstructive 3D models, and its use is exemplified in the case study of the hypothetical reconstruction of Piazza delle Erbe in Verona, a project presented in the form of a docufilm at EXPO 2015 in Milan. [ABSTRACT FROM AUTHOR]