Search

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

Recent technological advancements are transforming the architecture, engineering and construction (AEC) industry, focusing on digitalization and automation opportunities as drivers for improvement. In a realm as complex as building permitting, the drive for automation should be anchored in a comprehensive understanding of the process it seeks to transform. Furthermore, analyzing the process from a global perspective is essential for identifying opportunities for improvement. This article addresses the need for a systematic and robust approach to evaluate and compare building permit processes globally. Traditional approaches for process comparisons fail to capture the intricacies of a building permit process. Hence, in this paper, the authors propose and introduce the Process Analysis and Comparative Evaluation methodology, PACE-BP, which was tailored for building permit processes. The proposed method relies on a previously developed framework for process mapping which provides a comparable data set of building permit process maps in different countries. The comparative evaluation is then performed by assessing the maps based on predefined indicators, which are used to compile a representative vector for each process. The computational method for compiling the vectors and calculating the similarity measures between pairs of processes is described in detail. The application of PACE-BP for analyzing and comparing building permit processes in Germany, the US, Israel, and Italy is demonstrated in this paper. Our findings challenge the pursuit of a universal "best practice," emphasizing the need to balance priorities and stakeholder's objectives. The PACE-BP method is a powerful tool for policymakers and stakeholders, providing meaningful insight into existing processes and pinpointing drawbacks and limitations in current practices, while revealing opportunities for improvement. [ABSTRACT FROM AUTHOR]

The aim of this paper is to examine if and how the reclassification of platform workers from self-employment status to employment status can provide them with adequate social security protection. Little is known about how this transition would guarantee platform workers adequate social protection within the social protection scheme for employees. National social security schemes, in particular income replacement benefit schemes, often (still) depart from the standard employment relationship, leading to lower protection for atypical work forms. Platform workers combine several of the characteristics of atypical forms of work, such as low earnings, irregular working patterns and working. Integrating platform workers into employee social security schemes faces additional challenges due to the online nature of their work, algorithmic management, high levels of unpaid labor, and employer identification difficulties. This paper focuses on unemployment protection, as EU Member States struggle to provide adequate protection for workers with irregular work patterns and income fluctuations, in the case of (short term) income replacement benefits. By constructing nine ideal work patterns reflective of diverse nature of platform work and current practices among platform work, we analyse how different types of 'employed' platform workers may fare within the legislation of three EU countries (Belgium, Italy, and the Netherlands). This approach allows us to assess the applicability of unemployment protection to different working patterns among 'employed' platform workers, considering formal, effective, and adequate access to unemployment schemes as outlined in the Council Recommendation on access to social protection for workers and the self-employed (2019). [ABSTRACT FROM AUTHOR]

Although women's representation in STEM fields and occupations has increased, science and math continue to be stereotyped as male domains. This paper links psychological and sociological explanations for gendered disparities in STEM by examining the relationship between the local "micro-situational" female learning environment and the gender gap in academic self-concept in math and science. We applied hybrid models to TIMSS 2015 data comprised of a pseudo-panel of repeated measures for individual student and peer achievement, academic self-concept, utility value, and interest-enjoyment value in math/science (at age 14). We analyzed data from three countries, including a subsample of students who were taught by the same teacher in both math and science, thus eliminating unobserved teacher heterogeneity. Results indicate that female peer climate in the classroom is important for understanding how girls' self-concept in math/science is formed, even though it was unrelated to the gender gap. [ABSTRACT FROM AUTHOR]

The present paper aims to identify how economic evolutions related to health conditions during the Covid-19 pandemic. The research includes an analysis on the evolutions of the health and economic conditions during the Covid-19 health crisis and also on they way they are linked to each other. The investigation is conducted at country level and is exemplified on two European countries, namely Italy and Greece. The methodology employed was based on three types of analyses: descriptive, correlation and comparative analyses that used secondary data from international organizations. Results illustrate that the economic life was affected by the Covid-19 conditions (Covid-19 incidence and the associated restrictions), with inflation being the most affected in both countries. At the same time, international trade was affected differently in the two countries, with Italy being negatively and more intensively affected than Greece, for which the association was positive and rather weak. [ABSTRACT FROM AUTHOR]

This paper aims to present a comparative study of the civil society reaction to right-wing populism in power through social media, by looking at cases in Italy and the United Kingdom. The research question is how social movements are implementing a process of reactive political identity construction – i.e. political identification – and a political counter-strategy by opposing right-wing populism in power through their Facebook official accounts. It implements a mixed-method research design with in-depth semi-structured interviews and a two-step quantitative text analysis based on Topic Model and Dictionary Method. [ABSTRACT FROM AUTHOR]

Pairwise comparisons have been a long-standing technique for comparing alternatives/criteria and their role has been pivotal in the development of modern decision-making methods such as the Analytic Hierarchy/Network Process (AHP/ANP), the Best-Worst method (BWM), PROMETHEE and many others. Pairwise comparisons can be performed within several frameworks such as multiplicative, additive and fuzzy representations of preferences, which are particular instances of a more general framework based on Abelian linearly ordered groups. Though multiplicative, additive and fuzzy representations of preferences are widely used in practice, it is unknown whether decision makers are equally precise in the three aforementioned representations when they measure objective data. Therefore, the aim of this paper is to design, carry out and analyse an experiment with over 200 respondents (undergraduate university students) from two countries, Czechia and Italy, to compare precision of the respondents in all three representations. In the experiment, respondents pairwise compared (by approximation) the areas of four geometric figures and then, the imprecision of their assessments was measured by computing the distance with the exact pairwise comparisons. We grouped the respondents in such a way that each participant was allowed to deal with a unique type of representation. The outcomes of the experiment indicate that the multiplicative approach is the most precise. [ABSTRACT FROM AUTHOR]

Background: The ethnobotanical analysis of two bordering areas allows for the in-depth understanding of the dynamics of Local Ecological Knowledge, which mirrors the naturalistic, historical, and sociopolitical features of each area. As part of the Interreg Italy-Switzerland B-ICE&Heritage and GEMME projects, this work is an ethnobotanical comparative study of two neighboring Alpine territories: Valmalenco (Italy) and Valposchiavo (Switzerland). Methods: A total of 471 informants were interviewed on different fields of use (medicinal, food, veterinary, etc.). All data were organized in Excel™ spreadsheets. Informant Consensus Factor was calculated for the pathologies reported. Jaccard's similarity indices were calculated to compare the Valmalenco and Valposchiavo areas. Subsequently, another comparison between Valmalenco/Valposchiavo and Italian/Swiss Alpine neighboring areas was carried out. Results: The number of taxa for Valmalenco was 227 (77 families) and 226 in Valposchiavo (65). Out of the 10 most cited species, 7 were mentioned in both. Arnica montana L. was the most cited in Valmalenco, and Sambucus nigra L. in Valposchiavo. The 5 most cited families were the same. Regarding the medicinal and food fields, the similarity indices were fairly low (0.31 and 0.34 for the species; 0.22 and 0.31 for the uses). Concerning the comparison with Italian and Swiss Alps, similarity values were slightly higher with Italy (Valmalenco food species: 0.38 with Italy and 0.26 with Switzerland, medicinal: 0.26 IT and 0.14 SW; Valposchiavo food species: 0.36 with IT and 0.26 with SW, medicinal: 0.21 IT and 0.14 SW). Conclusion: Although Valmalenco and Valposchiavo partly share natural environment, language, history, and culture, they had low similarity indices. They both seemed to have more similarities with Italy than Switzerland, maintaining low values with the surrounding territories too. They showed a common core of Local Ecological Knowledge with several divergent branches possibly due to pivotal historical happenings, as well as more modern external influences. [ABSTRACT FROM AUTHOR]

In the DSM-5 Alternative Model of Personality Disorders (AMPD), psychopathy is marked by the presence of attention seeking, low anxiousness, and lack of social withdrawal, along with traits from the domains of Antagonism and Disinhibition. The triarchic model of psychopathy (TriPM) posits three biobehaviorally based traits underlying it: disinhibition, meanness, and boldness. The current study directly compared relations for measures of the two models with the broad dimensions of externalizing, internalizing, and positive adjustment. Participants (1,678 adults) were surveyed regarding maladaptive personality traits, clinical symptoms, and positive adjustment features. The TriPM model explained more variance than the AMPD in substance use, positive adjustment, and empathy, whereas the AMPD model explained more variance in internalizing symptoms. In addition, AMPD Antagonism and the Psychopathy Specifier diverged from TriPM Meanness and Boldness in their associations with some specific outcomes. Overall, our study provides evidence for complementarity of the two models in characterizing the multifaceted nature of psychopathy. [ABSTRACT FROM AUTHOR]

Introduction: The image of a nurse is a source of concern due to its impact on recruitment into the profession, political decisions about the profession, and how the image affects nursing practice. For these reasons, one of the long-term challenges is to assess and maintain a favorable public image that respects the utility and value of the nursing profession. Aim: This study aims to validate an instrument for assessing the image of the nurse as perceived by Italian citizens. Methods: A non-probabilistic sample of 564 people participated in the study between 2022 and 2023. Sociodemographic information of the Italian citizens was collected, and the instrument used to evaluate the perceived public image was the Nursing Attitudes Questionnaire (NAQ). The psychometric properties of the Italian version of the NAQ (NAQ-IV) were calculated using Cronbach's alpha, item–total correlations, skewness, and kurtosis. Factor analysis was performed using principal axis factoring and the varimax rotation method. Results: Factor analysis revealed a four-factor model explaining more than 60.52% of the variance, with the largest variance explained by the "Role and Professionalism" factor (34.08%). The internal consistency calculation showed a Cronbach's alpha of 0.89 for the scale and between 0.88 and 0.89 among the factors; all the items verified the item–total correlation and response variability criteria. Conclusions: The NAQ-IV could be a valid tool for assessing the perception of Italian citizens. However, further studies are recommended to evaluate the reliability of the instrument, especially in the evolving professional profile and social health welfare. [ABSTRACT FROM AUTHOR]

Introduction: Single-photon emission computed tomography (SPECT) and positron emission tomography (PET) are non-invasive nuclear medicine techniques that can identify areas of abnormal myocardial perfusion. We assessed the prevalence of cardiovascular risk factors in patients with suspected coronary artery disease (CAD) undergoing SPECT or PET stress myocardial perfusion imaging (MPI). Based on significant risk factors associated with an abnormal MPI, we developed a nomogram for each cohort as a pretest that would be helpful in decision-making for clinicians. Methods: A total of 6,854 patients with suspected CAD who underwent stress myocardial perfusion imaging by SPECT or PET/CT was studied. As part of the baseline examination, clinical teams collected information on traditional cardiovascular risk factors: age, gender, body mass index, angina, dyspnea, diabetes, hypertension, hyperlipidemia, family history of CAD, and smoking. Results: The prevalence of cardiovascular risk factors was different in the two cohorts of patients undergoing SPECT (n = 4,397) or PET (n = 2,457) myocardial perfusion imaging. A statistical significance was observed in both cohorts for age, gender, and diabetes. At multivariable analysis, only age and male gender were significant covariates in both cohorts. The risk of abnormal myocardial perfusion imaging related to age was greater in patients undergoing PET (odds ratio 4% vs. 1% per year). In contrast, male gender odds ratio was slightly higher for SPECT compared to PET (2.52 vs. 2.06). In the SPECT cohort, smoking increased the risk of abnormal perfusion of 24%. Among patients undergoing PET, diabetes and hypertension increased the risk of abnormal perfusion by 63% and 37%, respectively. For each cohort, we obtained a nomogram by significant risk factors at multivariable logistic regression. The area under the receiver operating characteristic curve associated with the nomogram was 0.67 for SPECT and 0.73 for the PET model. Conclusions: Patients with suspected CAD belonging to two different cohorts undergoing SPECT or PET stress myocardial perfusion imaging can have different cardiovascular risk factors associated with a higher risk of an abnormal MPI study. As crude variables, age, gender, and diabetes were significant for both cohorts. Net of the effect of other covariates, age and gender were the only risk factors in common between the two cohorts. Furthermore, smoking and type of stress test were significant for the SPECT cohort, where as diabetes and hypertension were significant for the PET cohort. Nomograms obtained by significant risk factors for the two cohorts can be used by clinicians to evaluate the risk of an abnormal study. [ABSTRACT FROM AUTHOR]

The purpose of this article is to investigate the common facilitators and barriers associated with the implementation of hospital-based health technology assessment (HB-HTA) across diverse hospital settings in seven countries. Through a two-round Delphi study, insights were gathered from a panel of 15 HTA specialists from France, Hungary, Italy, Kazakhstan, Poland, Switzerland, and Ukraine. Experts initially conducted a comprehensive review of the HB-HTA implementation in their respective countries, identifying the barriers and facilitators through descriptive analysis. Subsequently, panel experts ranked these identified barriers and facilitators on a seven-point Likert scale. A median agreement score ≥ 6 and interquartile range (IQR) ≤ 1 was accepted as reaching a consensus. Out of the 12 statements categorized as external and internal barriers and facilitators, the expert panel reached consensus on six statements (two barriers and four facilitators). The external barrier, which achieved consensus, was the lack of the formal recognition of the role of HB-HTA in national or regional legislations. The internal barrier reaching consensus was the limited availability of human resources dedicated to HB-HTA. This qualitative study indicates that HB-HTA still has progress to make before being formally accepted and integrated across most countries, although by building on the facilitating factors we identified there may be an opportunity for the implementation of internationally developed strategies to strengthen HB-HTA practices. [ABSTRACT FROM AUTHOR]

The EASY-NET network program (NET-2016-02364191)—effectiveness of audit and feedback (A&F) strategies to improve health practice and equity in various clinical and organizational settings), piloted a novel and more structured A&F strategy. This study compared the effectiveness of the novel strategy against the sole periodic dissemination of indicators in enhancing the appropriateness and timeliness of emergency health interventions for patients diagnosed with acute myocardial infarction (AMI) and ischemic stroke in the Lazio Region. The efficacy of the intervention was assessed through a prospective quasi-experimental design employing a pre- and post-intervention (2021–2022) comparison with a control group. Participating hospitals in the Lazio Region, where professional teams voluntarily engaged in the intervention, constituted the exposed group, while the control group exclusively engaged in routine reporting activities. Effectiveness analysis was conducted at the patient level, utilizing regional health information systems to compute process and outcome indicators. The effectiveness of the intervention was evaluated using difference-in-difference models, comparing pre- and post-intervention periods between exposed and control groups. Estimates were calculated in terms of the difference in percentage points (PP) between absolute risks. Sixteen facilities for the AMI pathway and thirteen for the stroke pathway participated in the intervention. The intervention yielded a reduction in the proportion of 30-day readmissions following hospitalization for ischemic stroke by 0.54 pp in the exposed patients demonstrating a significant difference of −3.80 pp (95% CI: −6.57; −1.03; 5453 patients, 63.7% cases) in the exposed group compared to controls. However, no statistically significant differences attributable to the implemented A&F intervention were observed in other indicators considered. These results represent the first evidence in Italy of the impact of A&F interventions in an emergency setting, utilizing aggregated data from hospitals involved in the Lazio Region's emergency network. [ABSTRACT FROM AUTHOR]

Background: Atypical Anorexia Nervosa (AAN) is a Feeding and Eating Disorder characterized by fear of gaining weight and body image disturbance, in the absence of significantly low body weight. AAN may present specific clinical and psychopathological features. Nonetheless, the literature lacks data concerning the nutritional characteristics and body composition of children and adolescents with AAN and their variation over time. Methods: Case series, including 17 children and adolescents with AAN. All the patients were assessed at the first evaluation (T0) with a standardized dietary assessment (24 h Dietary Recall, 24 hDR). Nutritional data were compared with European dietary reference values (DRVs). Body composition parameters (weight, fat mass, fat-free mass) and their changes over time at two (T1) and six (T2) months were collected as well, using a Bioelectrical impedance analysis (Wunder WBA300 with four poles and foot contact; impedance frequency 50 kHz 500 μA; impedance measurement range 200~1000 Ω/0.1 Ω). Results: The included individuals presented eating behaviors oriented towards significantly low daily energy intake (p < 0.001) compared with DRVs set by the European Food Safety Authority (EFSA) (with low carbohydrates and fats), and increased proteins (p < 0.001). A longer latency before observation (illness duration before observation) correlated with a negative change in weight. Body composition parameters were described, with no significant changes across the six-month outpatient assessment. Discussion: This is the first research to systematically assess the body composition and nutritional features of a group of individuals with AAN in the developmental age. Further research should assess the effect of targeted treatment interventions on body composition and nutritional features. [ABSTRACT FROM AUTHOR]

Previous research has highlighted the positive impact of greater health-related quality of life (Hr-QoL) and subjective well-being (SWB) on chronic diseases' severity and progression. There is a paucity of studies investigating the long-term trajectories of these variables among hypertensive patients. The present study aims to investigate the relationships between psychological variables (Type A and D personality, locus of control—LoC, self-esteem, and trait anxiety) with SWB and Hr-QoL in patients with hypertension and comorbid metabolic syndrome. A total of 185 volunteer patients (130 males, 70.3%; mean age 54 ± 10.93) were enrolled. Patients filled out measures of Hr-QoL and SWB, LoC, and self-esteem at three time points—Type A and D behaviors and anxiety measures only at baseline. Analyses were run through two-level hierarchical mixed models with repeated measures (Level 1) nested within participants (Level 2), controlling for sociodemographic and clinical confounders. Neither Hr-QoL nor SWB changed over time. Patients with greater self-esteem and internal LoC (and lower external LoC) increased their SWB and Hr-QoL up to 1-year follow-up. A greater Type A behavior and trait anxiety at baseline predicted a longitudinal increase in most of the dependent variables. Results suggest that it could be useful to tailor interventions targeting specific variables to increase Hr-QoL and SWB among hypertensive patients. [ABSTRACT FROM AUTHOR]

Background. Breast cancer with about 2.3 million diagnoses and 685,000 deaths globally is the most frequent malignancy in the female population. Continuous research has led to oncological and reconstructive advances in the management of breast cancer, thus improving outcomes and decreasing patient morbidity. Nowadays, the submuscular expander and prosthesis (E/P) implant-based breast reconstruction (IBR) accounts for 73% of all reconstructions. Despite its widely accepted efficacy, the technique is not free from complications and up to 28% of cases require revision surgery for mechanical complications such as capsular contracture, implant displacement/rotation, and implant rupture. With this study, the authors report their experience in the management of E/P IBR revision surgery through the technique of Selective Capsulotomies (SCs) and Partial Capsulectomy (PC). Methods. A retrospective study was conducted on patients who had previously undergone E/P IBR and presented for revision reconstruction between January 2013 and May 2023 at the Department of Plastic Surgery of the University of Siena, Italy. Reasons for revision included capsular contracture, implant displacement/rotation, and implant rupture. Revision reconstructions involved SC and PC with implant replacement. Fat grafting was also considered. The complication rate was evaluated by analysis of patients' medical records. Patients' satisfaction with the treatment was assessed through a specific questionnaire. Results. 32 patients underwent revision surgeries. No early complication occurred. Recurrence rate was assessed at 19% with average follow-up of 59 months (range: 13–114 months). The average time between revision surgery and recurrence was 3 years (range: 1–6 years). 23 patients answered the questionnaire and were overall satisfied with the treatments (8.29/10). Conclusions. SC possibly associated to PC is a valuable option for E/P IBR revision surgery with minimal complications, reduced surgical trauma, short operating time, and relatively low recurrence risk. In addition, treated patients are overall satisfied with the results over time. [ABSTRACT FROM AUTHOR]

Background: Tobacco consumption, incorrect nutrition and insufficient physical activity/sedentariness represent modifiable NCDs risk factors in Western countries. To evaluate recent lifestyle indicators in Italy, data from the national Health Examination Survey (HES), implemented in 2018–2019 within the CUORE Project, were assessed. Methods: Age–sex standardized results from random samples of Italian general population (35–74 years) were reported by sex, age-class, educational level and geographical area. From 2106 participants, 2090 were considered for smoking habit, 2016 for physical activity and 1578 for nutrition. Standardized questionnaires were used for smoking habit and physical activity, and the EPIC questionnaire for nutrition. Results: Total cigarette current smokers were 23% in men and 19% in women; sedentariness during leisure time was 34% in men and 45% in women and at work 45% and 47% in men and women, respectively. Prevalence of balanced eating behaviours for vegetables was 28% in men and 39% in women; and for fruits 50% and 52%, respectively; prevalence of correct lifestyle (not smoker, regular physical activity and following at least five correct eating behaviours) was 7% and 12% for men and women, respectively. Conclusions: In 2018–2019, levels of unhealthy lifestyles were found to be still epidemic and basically stable compared to 10 years earlier (slight smoking habit decrease, slight sedentariness increase and slight nutrition improvements); intersectoral strategies and monitoring need to be continued. [ABSTRACT FROM AUTHOR]

A healthy and balanced diet is crucial for children's well-being and aids in preventing diet-related illnesses. Furthermore, unhealthy dietary habits indirectly impact children's health, as the food industry stands as one of the primary drivers of climate change. Evidence shows the Mediterranean diet is sustainable for both children's and the planet's health. The aim of this cross-sectional study was to evaluate the eating habits of children aged between 6 months and 3 years, in the province of Modena and Reggio Emilia, in Italy, along with their adherence to the guidelines for a healthy diet, and examine the role of pediatricians in promoting knowledge about nutrition and sustainability. In our sample (218 children), most children exceeded the recommended meat and cheese intake, while consuming insufficient amounts of vegetables, fruit, and legumes. Vegetable and fruit consumption declined with the increase in age category while eating sweets, soft drinks, and processed food increased. Incorporating school meals' data into this analysis, we observed a modification in dietary compliance, characterized by an increase in meat and cheese consumption, alongside improvements in the intake of vegetables, fruits, fish, eggs, and legumes. This study suggests that supporting an integrated approach that combines social and educational initiatives is crucial. Future research should prioritize fostering sustainable eating habits within communities to facilitate dietary habits' transformation and encourage healthier lifestyles. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to investigate the potential occurrence of post-traumatic stress disorder (PTSD) symptoms, following exposure to traumatic events, in Italian midwives and their consequent influence on the quality of midwives' professional lives. In addition, data were collected on the major traumatic events described by midwives. Method: A cross-sectional study related the socio-demographic characteristics of 286 midwives with the scores obtained on two assessment scales, one for post-traumatic stress disorder (IES-R) and the other for quality of life (ProQOL V). The percentage of midwives who obtained a score higher than the predetermined threshold value in both questionnaires was noted, and the correlations that emerged were highlighted. Through this qualitative method, their significant work-related traumatic events were investigated to finally detect the prevalence percentage of each category. Results: The proportion of midwives scoring higher than 33 on the IES-R scale, indicating a higher likelihood of PTSD, was 48.6%. Freelancers or outpatient clinic midwives had lower mean IES scores (p = 0.049). A significant inverse correlation was observed between age and IES-R score and between the compassion satisfaction subscale and time since completing education (p = 0.028). A comparison between the IES-R and ProQOL scales showed a statistically significant correlation (p < 0.001), in particular, between the burnout (BO) (p < 0.001) and secondary traumatic stress (STS) (p < 0.001) subscales. The thematic categorization of traumatic events included mother/child death, mother/child medical complications, relational problems with patients or team members, and organizational problems/medical staff's inexperience. Conclusions: The emerging data may confirm the data in the literature, namely those showing that midwives are prone to developing work-related PTSD, particularly due to their exposure to traumatic events such as maternal and neonatal death. [ABSTRACT FROM AUTHOR]

Simple Summary: This study was conducted to compare two endoscopic procedures for managing malignant gastric outlet obstruction. The first and most commonly used procedure is enteral stenting, which is safe, easy, and widely available. The second procedure, endoscopic ultrasound-guided gastroenterostomy (EUS-GE), is more challenging, can result in severe adverse events, and requires specific skills. However, EUS-GE, which bypasses the tumor, could have some advantages in terms of the stent dysfunction rate. Our study found that stent dysfunction occurred more frequently after enteral stenting, while stent patency was longer after EUS-GE. However, the early clinical efficacy was comparable between the two procedures and was influenced by patients' performance status. This study suggests that the choice between these two techniques should be personalized based on several factors, including patients' prognosis and life expectancy, clinical success, and local expertise. Background: Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) using lumen apposing metal stent has emerged as a minimally invasive treatment for the management of malignant gastric outlet obstruction (mGOO). We aimed to compare EUS-GE with enteral stenting (ES) for the treatment of mGOO. Methods: Patients who underwent EUS-GE or ES for mGOO between June 2017 and June 2023 at two Italian centers were retrospectively identified. The primary outcome was stent dysfunction. Secondary outcomes included technical success, clinical failure, safety, and hospital length of stay. A propensity score-matching analysis was performed using multiple covariates. Results: Overall, 198 patients were included (66 EUS-GE and 132 ES). The stent dysfunction rate was 3.1% and 16.9% following EUS-GE and ES, respectively (p = 0.004). Using propensity score-matching, 45 patients were allocated to each group. The technical success rate was 100% for both groups. Stent dysfunction was higher in the ES group compared with the EUS-GE group (20% versus 4.4%, respectively; p = 0.022) without differences in clinical efficacy (p = 0.266) and safety (p = 0.085). A significantly shorter hospital stay was associated with EUS-GE compared with ES (7.5 ± 4.9 days vs. 12.5 ± 13.0 days, respectively; p = 0.018). Kaplan–Meier analyses confirmed a higher stent dysfunction-free survival rate after EUS-GE compared with ES (log-rank test; p = 0.05). Conclusion: EUS-GE offers lower rates of stent dysfunction, longer stent patency, and shorter hospital stay compared with ES. [ABSTRACT FROM AUTHOR]

The field of additive manufacturing, particularly 3D printing, has ushered in a significant transformation in the realm of joint arthritis treatment through prosthetic surgery. This innovative technology allows for the creation of bespoke prosthetic devices that are tailored to meet the specific needs of individual patients. These devices are constructed using high-performance materials, including titanium and cobalt-chrome alloys. Nevertheless, the routine physical activities of patients, such as walking, sitting, and running, can induce wear and tear on the materials comprising these prosthetic devices, subsequently diminishing their functionality and durability. In response to this challenge, this research has endeavored to leverage novel techniques. The primary focus of this study lies in the development of an algorithm designed to optimize hip replacement procedures via the mechanical design of the prosthesis. This optimization process exploits the capabilities of machine learning algorithms, multi-body dynamics, and finite element method (FEM) simulations. The paramount innovation in this methodology is the capacity to design a prosthetic system that intricately adapts to the distinctive characteristics of each patient (weight, height, gait cycle). The primary objective of this research is to enhance the performance and longevity of prosthetic devices by improving their fatigue strength. The evaluation of load distribution on the prosthetic device, facilitated by FEM simulations, anticipates a substantial augmentation in the useful life of the prosthetic system. This research holds promise as a notable advancement in prosthetic technology, offering a more efficacious treatment option for patients suffering from joint arthritis. The aim of this research is to make meaningful contributions to the enhancement of patient quality of life and the long-term performance of prosthetic devices. [ABSTRACT FROM AUTHOR]

Purpose: Achieving greater health and social care integration is a policy priority in many countries, but challenges remain. We focused on governance and accountability for integrated care and explored arrangements that shape more integrated delivery models or systems in Italy, the Netherlands and Scotland. We also examined how the COVID-19 pandemic affected existing governance arrangements. Design/methodology/approach: A case study approach involving document review and semi-structured interviews with 35 stakeholders in 10 study sites between February 2021 and April 2022. We used the Transparency, Accountability, Participation, Integrity and Capability (TAPIC) framework to guide our analytical enquiry. Findings: Study sites ranged from bottom-up voluntary agreements in the Netherlands to top-down mandated integration in Scotland. Interviews identified seven themes that were seen to have helped or hindered integration efforts locally. Participants described a disconnect between what national or regional governments aspire to achieve and their own efforts to implement this vision. This resulted in blurred, and sometimes contradictory, lines of accountability between the centre and local sites. Flexibility and time to allow for national policies to be adapted to local contexts, and engaged local leaders, were seen to be key to delivering the integration agenda. Health care, and in particular acute hospital care, was reported to dominate social care in terms of policies, resource allocation and national monitoring systems, thereby undermining better collaboration locally. The pandemic highlighted and exacerbated existing strengths and weaknesses but was not seen as a major disruptor to the overall vision for the health and social care system. Research limitations: We included a relatively small number of interviews per study site, limiting our ability to explore complexities within sites. Originality: This study highlights that governance is relatively neglected as a focus of attention in this context but addressing governance challenges is key for successful collaboration. [ABSTRACT FROM AUTHOR]

Background: The association between oral health of schoolchildren living in the North Sardinia area and socioeconomic deprivation was assessed to evaluate a potential spatial correlation. Methods: A total of 10,947 subjects were examined (5281 aged 3–5-years, and 5666 aged 6–11-years). The WHO dmft index score was calculated following clinical examination by calibrated examiners. The Sardinian Deprivation Index (IDMS) of the children's municipalities was also considered. Descriptive, bivariate and multinomial data analysis was conducted to assess the association between clinical data and socioeconomic deprivation. The presence of systematic spatial variation regarding caries experience (dmft) and deprivation status was investigated using a spatial autoregressive analysis. Results: Caries figures were statistically different in the two age groups (dmf > 0, 13.79% in the younger group vs. dmf > 0, 34.20% in the older one, p < 0.01). In a multinomial logistic regression model for caries experience, all the covariates were statistically significantly associated (p < 0.01) in comparison with the base outcome "caries-free". Linear regression analysis showed a dependence of dmft on IDMS (p < 0.01). Based on this equation, the dmft of the 39 municipalities that did not participate in the survey was estimated. IDMS was statistically significantly associated (p < 0.01) with caries prevalence in the spatial regression model. Conclusions: The deprivation index significantly increased the risk of caries for all categories of caries experience and prevalence compared to caries-free. The relationship between IDMS and caries data was also confirmed by spatial analysis. [ABSTRACT FROM AUTHOR]

Simple Summary: Synchronous oligometastatic non-small cell lung cancer (NSCLC) represents an intermediate state of metastatic disease with a limited number of metastases. It has been suggested that adding local radical treatment (LRT) in this setting may improve the survival outcomes, but there are no validated tools to better select those patients who are most likely to benefit from LRT. The presence of cachexia and sarcopenia at diagnosis seems to be linked to poorer outcomes in local or advanced NSCLC, but it is not clear if these factors can be used to guide the treatment decisions in oligometastatic NSCLC and to preclude a possible radical treatment in patients with baseline cachexia or sarcopenia. For this reason, we evaluated the impact of cachexia and sarcopenia on survival outcomes and toxicities in a group of patients with synchronous oligometastatic NSCLC on an intention-to-treat basis. Considering the different definitions of sarcopenia used among different studies, we used the Psoas Muscle Index (PMI) as a surrogate of sarcopenia. Progression-free survival was longer for patients without cachexia and sarcopenia compared to those with cachexia and/or sarcopenia. Among patients with advanced NSCLC, there is a group of patients with synchronous oligometastatic disease (sOMD), defined as a limited number of metastases detected at the time of diagnosis. As cachexia and sarcopenia are linked to poor survival, incorporating this information could assist clinicians in determining whether a radical treatment should be administered. In a retrospective multicenter study, including all patients with adequately staged (FDG-PET, brain imaging) sOMD according to the EORTC definition, we aimed to assess the relationship between cachexia and/or sarcopenia and survival. Of the 439 patients that were identified between 2015 and 2021, 234 met the criteria for inclusion and were included. The median age of the cohort was 67, 52.6% were male, and the median number of metastasis was 1. Forty-six (19.7%) patients had cachexia, thirty-four (14.5%) had sarcopenia and twenty-one (9.0%) had both. With a median follow-up of 49.7 months, median PFS and OS were 8.6 and 17.3 months, respectively. Moreover, a trend toward longer PFS was found in patients without cachexia and sarcopenia compared to those with cachexia and/or sarcopenia. In multivariate analysis, cachexia and sarcopenia were not associated with an inferior survival, irrespective of receiving radical treatment. High CRP was associated with inferior survival and could be a prognostic factor, helping the decision of clinicians in selecting patients who may benefit from the addition of LRT. However, despite the homogeneous definition of oligometastatic disease and the adequate staging, our subgroups were small. Therefore, further studies are needed to better understand our hypothesis and generating findings. [ABSTRACT FROM AUTHOR]