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Considering that people with Parkinson’s disease (PD) experience challenges in the control of both balance and eye movements, this study investigated the effects of saccadic eye movements on body sway in people with PD in two bases of support positions (side-by-side and tandem stances). Ten people with PD and 11 healthy individuals performed (a) fixation; (b) horizontal saccadic eye movements to the right and left; and (c) vertical saccadic eye movements up and down. The protocol for each postural task consisted of one block of six trials, making a total of 12 trials. Body sway and gaze parameters were measured during the trials. In both people with PD and healthy individuals, anterior–posterior body sway was significantly reduced in horizontal saccadic eye movements in contrast to fixation, regardless of the body position (side-by-side and tandem stances). Furthermore, vertical saccadic eye movements increased the area of sway in contrast to horizontal ones (and not to fixation) in people with PD. In addition, people with PD showed a higher number of fixations in all experimental conditions, without changes in the mean duration of fixations in both body positions. In conclusion, individuals with PD can improve body sway by coupling eye movements and postural sway when performing horizontal saccadic eye movements but not when performing vertical saccadic eye movements.

This narrative review addresses the integration of health education into school curricula in South Tyrol, an Italian province with significant cultural and linguistic diversity. This review’s objective is to analyze current health education initiatives and propose a strategic framework to enhance school-based health education, aiming to improve student well-being post-pandemic. The review synthesizes global examples and recent local studies, highlighting the importance of comprehensive teacher training, mindfulness-based interventions, culturally sensitive health education, and community engagement. The key findings indicate that current health education programs in South Tyrol are insufficient to meet immediate public health needs, such as low vaccine uptake and mental health challenges exacerbated by the COVID-19 pandemic. The proposed strategic framework seeks to align educational strategies with the diverse needs of South Tyrol’s student population, thereby improving health literacy and behavior and strengthening the region’s public health infrastructure.

In the wake of the COVID-19 pandemic, the surveillance and safety measures of indoor Cultural Heritage sites have become a paramount concern due to the unique challenges posed by their enclosed environments and high visitor volumes. This communication explores the integration of Artificial Intelligence (AI) in enhancing epidemiological surveillance and health safety protocols in these culturally significant spaces. AI technologies, including machine learning algorithms and Internet of Things (IoT) sensors, have shown promising potential in monitoring air quality, detecting pathogens, and managing crowd dynamics to mitigate the spread of infectious diseases. We review various applications of AI that have been employed to address both direct health risks and indirect impacts such as visitor experience and preservation practices. Additionally, this paper discusses the challenges and limitations of AI deployment, such as ethical considerations, privacy issues, and financial constraints. By harnessing AI, Cultural Heritage sites can not only improve their resilience against future pandemics but also ensure the safety and well-being of visitors and staff, thus preserving these treasured sites for future generations. This exploration into AI’s role in post-COVID surveillance at Cultural Heritage sites opens new frontiers in combining technology with traditional conservation and public health efforts, providing a blueprint for enhanced safety and operational efficiency in response to global health challenges.

Obesity is a complex disease with a multifactorial etiology and could be associated with psychiatric disorders, such as Binge Eating Disorder (BED), characterized by recurrent episodes of binge eating in the absence of compensatory behaviors. The present study aimed to analyze anthropometric and body composition changes over five years after bariatric surgery in patients diagnosed or not diagnosed with BED, depression, and anxiety in the preoperative period. One hundred and eighteen patients undergoing bariatric surgery were evaluated and divided into two groups according to the presence or absence of BED. The patients were submitted to anthropometric and body composition evaluation. We also analyzed BED diagnosis, depression, and anxiety according to the DSM-5 and validated questionnaires. The Kolmogorov–Smirnov, t-test, Fisher’s, and chi-square tests were used for statistical analysis. Over five years after bariatric surgery, only the BED group exhibited an increased weight and BMI (p < 0.05). In the preoperative period, patients with BED had severe depression (13,11%, p = 0.0079) and a higher frequency of moderate (22.95%, p < 0.01) or severe (14.75%, p < 0.01) anxiety. In conclusion, patients with BED had more intense symptoms of depression and anxiety in the preoperative period, and this disorder may persist in the postoperative period of bariatric surgery, contributing to weight gain and increased BMI.

Background: Palliative care (PC) focuses on relieving pain and difficult symptoms rather than treating disease or delaying its progress. Palliative care views death as a natural process and allows patients to live the last phase of their existence in the best possible way, encouraging them to express their opinions and wishes for a good death. Interventions are advocated to control symptoms and distress and promote wellbeing and social functioning. A multidisciplinary approach to support patients receiving palliative care is encouraged. Objective: The aims of this study were to investigate the facilitators and barriers to PC in people with kidney disease from a nursing perspective and to explore predictive factors associated with nurse-perceived facilitators and barriers to PC in people with kidney disease. Design: This study is a survey that adopted a questionnaire created in 2021 with Delphi methology, which included 73 statements divided into 37 facilitators and 36 barriers to PC in patients with kidney disease, to be scored using a Likert scale. Participants and Measurements: Participants were obtained through the membership database of the European Dialysis and Transplant Nurses Association/European Renal Care Association (EDTNA/ERCA) of 2020. Inclusion criteria included being registered as a nurse, an EDTNA/ERCA member and understanding of the English language. The questionnaire was sent via email. Results: Three profiles of respondents were found: the first group was characterized by the highest agreement percentages of facilitators and with an average value of 53.7% in barriers; the second was characterized by a lower endorsement of facilitators and similar agreement to the first group for barriers; the third group had a high probability (>80%) of items endorsing both barriers and facilitators. Predictive variables were significantly associated with “Years in nephrology” and “macro geographic area”. Conclusions: This study demonstrates variation in PC practice across Europe. Some professionals identified fewer barriers to PC and appeared more confident when dealing with difficult situations in a patient’s care pathway, while others identified more barriers as obstacles to the implementation of adequate treatment. The number of years of nephrology experience and the geographical area of origin predicted how nurses would respond. This study was not registered.

The rapid evolution of the urban landscape highlights the need to digitally document the state and historical transformations of heritage sites in densely urbanised areas through the combination of different geomatics survey approaches. Moreover, it is necessary to raise awareness of sites by developing strategies for their dissemination to a diverse audience through engaging, interactive, and accessible 3D web platforms. This work illustrates a methodology for the digital documentation and narration of a cultural heritage site through the implementation of a lightweight and replicable 3D navigation platform based on open-source technologies. Such a solution aims to be an easy-to-implement low-cost approach. The methodology is applied to the case study of the Farnese Castle in Piacenza (Italy), describing the data collection and documentation carried out with an in situ survey and illustrating how the resulting products were integrated into the web platform. The exploration functionalities of the platform and its potential for different types of audiences, from experts to users not familiar with 3D objects and geomatics products, were evaluated and documented on a ReadTheDocs website, allowing interested users to reproduce the project for other applications thanks to the template code available on GitHub.

Manganese (Mn) is one of the most abundant metals naturally present in the environment, but currently, it also represents an important factor of environmental contamination due to intense human activity. To investigate the nature of the presence of concentrations above the limits (CSC) established by Legislative Decree 152/06 for manganese in the groundwater underlying a non-hazardous solid waste plant, a study was carried out on the geochemical characteristics of the aquifers present in the study area. The study aimed to determine the natural background value (NBV) of Mn in the groundwater underlying the study area, according to the “Guidelines for Determining the Background Values of Soils and Groundwater” of ISPRA. Indeed, NBV assessment and site-specific considerations can help identify any specific sources of contamination in an area. In the study area, the chemical–physical and geochemical parameters of the water of 11 piezometers were analyzed. Subsequently, statistical tests were applied to detect an NBV identified as 192.3 µg/L, therefore much higher than the CSC, due to possible ongoing local phenomena linked to the geogenic conditions of the soil, which could determine high manganese values. In fact, in the study area, some lithologies favor establishing anaerobic environments and releasing manganese in the groundwater as hydroxides. Consequently, this process can lead to high manganese concentrations, even exceeding legal limits.

Limoncella of Mattinata, a rare and ancient Mediterranean citrus fruit, was investigated by sequence analysis of the ribosomal internal transcribed spacer regions, which assigns it as a variety of Citrus medica L. Morphological, chemical, and biomolecular approaches, including light and electron microscopy, HPLC-ESI-MS/MS, and antioxidant and anti-inflammatory assays, were used to characterize the flavedo and albedo parts, usually rich in bioactive compounds. The morphological findings showed albedo and flavedo cellular structures as “reservoirs” of nutritional components. Both albedo and flavedo hydroalcoholic extracts were rich in polyphenols, but they were different in compounds and quantity. The flavedo is rich in p-coumaric acid and rutin, whereas the albedo contains high levels of hesperidin and quercitrin. Antioxidant, anti-inflammatory, and genoprotective effects for albedo and flavedo were found. The results confirmed the health properties of flavedo and highlighted that albedo is also a rich source of antioxidants. Moreover, this study valorizes Limoncella of Mattinata’s nutritional properties, cueing its crops’ repopulation.

The use of starter cultures in the meat industry is common, even if the number of available commercial cultures is limited, inducing product standardisation and microbial diversity reduction. On the other hand, some artisanal products relying on spontaneous fermentation can represent a source of isolation of new interesting strains. In this work, four LAB strains derived from Mediterranean spontaneously fermented sausages were tested as new starter cultures for the industrial production of fermented sausages, in comparison to a commercial starter culture. The products obtained were analysed for physico-chemical parameters, microbiota, biogenic amines and aroma profile. A consumer test was also performed to evaluate product acceptability. The strains induced different acidification kinetics. LAB counts showed high persistence when Latilactobacillus curvatus HNS55 was used as the starter culture, while the addition of Companilactobacillus alimentarius CB22 resulted in a high concentration of enterococci (6 log CFU/g), 2 log higher than in other samples. Tyramine was detected at concentrations of 150–200 mg/kg, except for in the sample produced with Lactiplantibacillus plantarum BPF2 (60 mg/kg). Differences were observed in the aroma profile, with a high amount of 2-butanone found in the samples obtained with Comp. alimentarius CB22. These latter sausages also showed the lowest score in terms of acceptability. This study allowed us to select new LAB strains for fermented sausage starter cultures, increasing the product diversification.

Sustainable food practices are intrinsically linked to human nutrition in the preservation of the ecosystem. This study, therefore, evaluates the effectiveness, challenges, environmental impacts, and new food strategies related to plant and animal products, with a view to promoting more sustainable and healthy eating practices. The search stages were conducted using the following databases: PubMed, Science Direct, and SciElo. The studies selected included those published from 2018 to 2024 and government documents, available in English, Portuguese, and Spanish. The 34 articles analyzed in this study showed the environmental impacts related to the production of plant and animal proteins, highlighting the urgency of implementing changes in this sector. However, factors such as land use, carbon footprint, and water footprint show remarkable differences depending on the type of crop cultivated, agricultural practices adopted, and stages involved in the supply chain. As final considerations, the analysis suggests that achieving sustainability in food systems requires an integrate approach that combines the optimization of plant protein production with a reduction in environmental impacts and the development of technologies that that support the efficiency and resilience of the industry. Meeting the nutritional needs of the population in a sustainable way will only be possible through regional actions and a deep understanding of the challenges and opportunities.

(1) Background: The novel SARS-CoV-2 virus infects the endothelium. Vasculitis may lead to specific coronary artery wall lesions. Coronary computed tomography angiography (CTA) imaging findings have not been systematically reported. The aim of this study was to describe a case series using CTA. (2) Methods: Patients with recent RT-PCR confirmed SARS-CoV-2 infection referred for coronary CTA for clinical indications (e.g., chest pain, troponin+, and ECG abnormalities) were included. Coronary CTA findings, such as atypical coronary lesions suggestive of vasculitis, perivascular inflammation measured by using pericoronary fat attenuation (PCAT) index, coronary artery disease, and extracoronary findings were collected. (3) Results: Results for 12 patients (54.8 ± 22 years; four females) with SARS-CoV-2 infection within 60 days (four acute care and eight stable patients) are reported. Time to positive RT-PCR was a mean of 15.1 days (range, 0–51). In four acute patients with signs of myocardial injury, plaque rupture (n = 1), hyperenhancing myocardium/MINOCA (n = 1), MINOCA (n = 1), and pericarditis with acute heart failure (LVEF 20%) (n = 1) were found. All (100%) had pericardial effusion and signs of perivascular inflammation. Among eight stable patients, pericardial effusion or perivascular inflammation were found in only two (25%). Coronary artery disease was ruled out in five (62.5%) (4) Conclusions: Coronary CTA is a useful imaging modality in the diagnostic work up of patients with COVID-19 infection, and is able to describe coronary and other cardiac abnormalities.

Background/Objectives: Monoclonal antibodies (mAbs) have revolutionized multiple myeloma (MM) treatment. However, post-marketing data on their neuropsychiatric safety are limited. This study aimed to evaluate neuropsychiatric adverse events (AEs) related to mAbs used for MM through a retrospective pharmacovigilance analysis using the Food and Drug Administration (FDA) Adverse Events Reporting System (FAERS) database. Methods: Individual case safety reports (ICSRs) from 2015 to 2023 with at least one neuropsychiatric AE and one of the MM-approved mAbs as the suspected drug (i.e., daratumumab, elotuzumab, isatuximab, belantamab mafodotin, teclistamab, elranatamab, and talquentamab) were analyzed using descriptive and disproportionality approaches. Results: Unknown signals of disproportionate reporting (SDR) included the following: cerebral infarction for daratumumab (n = 45; reporting odds ratio (ROR) = 2.39, 95% confidence interval (CI) = 1.79–3.21; information component (IC) = 1.54, IC025–IC075 = 1.05–1.9), elotuzumab (25; 7.61, 5.13–11.28; 3.03, 2.37–3.51), and isatuximab (10; 2.56, 1.38–4.76; 1.67, 0.59–2.4); mental status changes for daratumumab (40; 2.66, 1.95–3.63; 1.67, 1.14–2.04) and belantamab mafodotin (10; 4.23, 2.28–7.88; 2.3, 1.22–3.03); an altered state of consciousness for daratumumab (32; 1.97, 1.39–2.78; 1.32, 0.73–1.74) and belantamab mafodotin (6; 2.35, 1.05–5.23; 1.6, 0.19–2.52); Guillain-Barre syndrome (GBS) for daratumumab (23; 6.42, 4.26–9.69; 2.81, 2.11–3.3), isatuximab (8; 10.72, 5.35–21.48; 3.57, 2.35–4.37), and elotuzumab (3; 4.74, 1.53–14.7; 2.59, 0.52–3.8); and orthostatic intolerance for daratumumab (10; 12.54, 6.71–23.43; 3.75, 2.67–4.48) and elotuzumab (4; 28.31, 10.58–75.73; 5, 3.24–6.08). Conclusions: Our analysis highlighted several previously unacknowledged SDRs for MM-approved mAbs. Given the complex and not entirely understood etiology of some neuropsychiatric AEs, including GBS, further investigations are necessary.

Background/Objectives: Seasonal influenza annually puts a significant burden on the pediatric population, especially the youngest, causing severe illness and death. Additionally, associated healthcare costs cause a significant financial strain on healthcare systems. While vaccination is the most effective prevention method, its cost-effectiveness for healthy children remains unassessed. Methods: Using the Pedianet database spanning from 2009 to 2019, we analyzed influenza cases among 6-month-olds to 14-year-olds in Italy. Data included influenza-related medical visits, prescriptions, exams, emergency visits, hospitalizations, and costs. Adverse events and quality-adjusted life years (QALYs) were considered from the existing literature. A static decision-tree model compared annual vaccination strategies, assessing probabilities for influenza or influenza-like illnesses by vaccination status. Incremental cost-effectiveness ratios (ICERs) were calculated, along with sensitivity analyses and cost-effectiveness acceptability curve generation. Results: Mean total influenza costs for vaccinated children averaged EUR 18.6 (range 0–3175.9, including EUR 15.79 for the influenza vaccination), whereas costs for unvaccinated children were consistently lower at around EUR 4.6 (range 0–3250.1). The average ICER for years where vaccine and virus strains are matched was EUR 29,831 per QALY, which is below the EUR 40,000 threshold set by the Italian National Health Services. The ICER values range from EUR 13,736 (2017/2018) to EUR 72,153 (2013/2014). Averted influenza costs averaged EUR 23 per case, with fluctuations over the years. In most observed years, influenza vaccination was cost-effective from the healthcare providers’ standpoint. The exception was 2009–2010, due to a mismatch between vaccine and virus strains. Conclusions: This study highlights the economic viability of influenza vaccination, especially when virus and vaccine strains align. It demonstrates the potential of vaccination programs in preserving children’s health and well-being while managing healthcare costs.

Introduction: The management of anemia in chronic kidney disease (CKD-An) presents significant challenges for nephrologists due to variable responsiveness to erythropoietin-stimulating agents (ESAs), hemoglobin (Hb) cycling, and multiple clinical factors affecting erythropoiesis. The Anemia Control Model (ACM) is a decision support system designed to personalize anemia treatment, which has shown improvements in achieving Hb targets, reducing ESA doses, and maintaining Hb stability. This study aimed to evaluate the association between ACM-guided anemia management with hospitalizations and survival in a large cohort of hemodialysis patients. Methods: This multi-center, retrospective cohort study evaluated adult hemodialysis patients within the European Fresenius Medical Care NephroCare network from 2014 to 2019. Patients treated according to ACM recommendations were compared to those from centers without ACM. Data on demographics, comorbidities, and dialysis treatment were used to compute a propensity score estimating the likelihood of receiving ACM-guided care. The primary endpoint was hospitalizations during follow-up; the secondary endpoint was survival. A 1:1 propensity score-matched design was used to minimize confounding bias. Results: A total of 20,209 eligible patients were considered (reference group: 17,101; ACM adherent group: 3108). Before matching, the mean age was 65.3 ± 14.5 years, with 59.2% men. Propensity score matching resulted in two groups of 1950 patients each. Matched ACM adherent and non-ACM patients showed negligible differences in baseline characteristics. Hospitalization rates were lower in the ACM group both before matching (71.3 vs. 82.6 per 100 person-years, p < 0.001) and after matching (74.3 vs. 86.7 per 100 person-years, p < 0.001). During follow-up, 385 patients died, showing no significant survival benefit for ACM-guided care (hazard ratio = 0.93; p = 0.51). Conclusions: ACM-guided anemia management was associated with a significant reduction in hospitalization risk among hemodialysis patients. These results further support the utility of ACM as a decision-support tool enhancing anemia management in clinical practice.

Fermented nut-based products, obtained after soaking and fermentation, are gaining increasing interest as animal food substitutes because of ethical, environmental and health reasons. In these products, Lactic Acid Bacteria (LAB) perform the fermentation, leading to matrix acidification and contributing to controlling spoilage and pathogenic microbiota. In this work, LAB strains isolated from an artisanal product and combined with a commercial strain were added as starter cultures during nut soaking to produce a cheese-like fermented plant-based product. Three different LAB consortia were used in challenge tests at laboratory scale against Listeria monocytogenes, Escherichia coli or Salmonella Enteritidis, inoculated in nuts at 5 log CFU/g, and monitored for pathogen survival and matrix acidification. The combination of Lactiplantibacillus plantarum 82 and Leuc. carnosum 4010 resulted in faster acidification (pH value < 4.4 after 18 h instead of 48 h) and the reduction of target pathogens; L. monocytogenes was already absent after seven days from production, and the counts of E. coli or S. Enteritidis were lower with respect to other samples. Thus, this microbial consortium was used for a pilot-scale production in which, beyond safety, the fermented plant-based product was also characterized for aroma profile and phenolic compounds, parameters that are known to be affected by LAB fermentation. The results showed an enhancement of the aroma profile, with an accumulation of molecules able to confer cheese-like notes (i.e., acetoin and diacetyl) and higher phenolic content, as well as the presence of compounds (i.e., phenyllactic acid and hydroxyphenyllactic acid) that could exert antimicrobial activity. This study allowed us to set up a guided fermentation for a cheese-like vegan product, guaranteeing safety and improving aromatic and functional features.

The present study used the adult earthworm Aporrectodea trapezoides as a bioindicator species to look into the possible dangers of ammonium sulfate (AS) fertilizer. Two complementary toxicity tests were conducted to determine the LC50values, growth rate inhibition, morphological alterations, and histopathological texture of worms. The lethality test included four increasing concentrations of AS fertilizer (ranging from 2500 to 7500 mg/kg of dry soil weight (d.w.)), while sub-lethal concentrations were based on 10%, 30%, 40%, and 50% of the 14-day median lethal concentration (LC50), with a control group included for both tests. The LC(50) values for AS fertilizer were significantly higher at 7 days (4831.13 mg/kg d.w.) than at 14 days (2698.67 mg/kg d.w.) of exposure. Notably, earthworms exhibited significant growth rate inhibition under exposure to various concentrations and time durations (14/28 exposure days). Morphological alterations such as clitellar swelling, bloody lesions, whole body coiling and constriction, body strangulation, and fragmentation were accentuated steadily, with higher concentrations. Histopathological manifestations included severe injuries to the circular and longitudinal muscular layers, vacuolation, muscle layer atrophy, degradation of the chloragogenous tissue in the intestine, collapsed digestive epithelium of the pharynx with weak reserve inclusion, and fibrosis of blood vessels. These effects were primarily influenced by increasing concentrations of fertilizer and time exposure. The study highlights the strong relationship between concentration and exposure time responses and underscores the potential of A. trapezoides earthworms as valuable biological control agents against acidic ammonium sulfate fertilizer. Importantly, this research contributes to the use of such biomarkers in evaluating soil toxicity and the biological control of environmental risk assessment associated with chemical fertilizers.

This study investigates the long-term trends (1992–2022) of nitrogen and phosphorus loadings exported by the River Po to the Adriatic Sea, to better analyse how changes in hydrology are affecting the timing and magnitude of river nutrient loads. We used 30 years of monitoring data in order to (a) identify the main temporal patterns and their interactions at a decadal, annual and seasonal scale, (b) estimate precipitation effects on load formation and evaluate whether and to which extent the hydrological regime affects nutrient export across the years and (c) analyse the nutrient export regime at a monthly scale and the main transport dynamic of N and P chemical species (hydrological vs. biogeochemical control). The long-term analysis shows a general decrease of both P and N loadings, but the trends are different between the elements and their chemical species, as well as undergoing different seasonal variations. We found a statistically significant relationships between precipitation and loads, which demonstrates that precipitation patterns drive the exported load at the intra- and interannual time scales considered in this study. Precipitation-induced load trends trigger seasonal changes in nutrient deliveries to the sea, peaking in spring and autumn. The nitrogen decrease is mainly concentrated in the summer dry period, while total phosphorus diminishes mainly in spring and autumn. This mismatch of N and P results in variable molar N:P ratios within the year. The effects of extreme drought and flood events, along with the progressive decrease in the snowmelt contribution to water fluxes, are expected to exacerbate the variability in the N and P loadings, which in turn is expected to perturbate the biodiversity, food webs and trophic state of the Northern Adriatic Sea.

Destinations seek to increase their competitiveness by offering memorable experiences that can stimulate repeat visitation and positive word of mouth. Travel experiences centered on agrifood systems (i.e., agrifood tourism) encompass a set of attributes (e.g., authenticity and interaction with locals) that tend to be memorable. However, the extent to which these attributes contribute to memorability warrants further investigation. Thus, this study identified common and distinct elements of memorability across agritourism, culinary tourism, and craft-beverage tourism compared to beach tourism (control group). We surveyed a panel (n = 1019) in 2023 using a hypothetical travel scenario with four experience options. A multivariate analysis of variance showed high levels of memorability across various attributes of the agrifood experiences (e.g., learning opportunities and hands-on participation), with few differences across them, as compared to beach tourism. This study advances the scholarly construct of agrifood tourism by incorporating memorability within its complex dynamics. The study results also provide insights that marketers and managers of destinations with a mix of agrifood experiences can use to improve destination competitiveness and memorability (e.g., increasing educational offerings and adding more participative activities).

Background: ALK tyrosine kinase inhibitors (TKIs) have revolutionized the treatment and largely improved the survival outcomes of patients with NSCLC harboring ALK rearrangements. Different ALK TKI compounds have demonstrated antitumor activity in these patients and are available in clinical practice. However, clinical expertise across countries varies according to local regulatory approval of different drugs, identifying multiple treatment scenarios to comply with international guidelines and clinical practice. Methods: A virtual webinar was held on July 2023 to discuss the state of the art and future perspectives in the treatment of ALK rearrangement in advanced NSCLC in Italy. The faculty hosting the webinar was composed of eight medical oncologists from different regions of Italy with clinical expertise in treating patients with lung cancer. Live-shared notes were used to produce a report to serve as the basis of a review manuscript on the topic. Results: Alectinib and brigatinib are the preferred front-line treatment options in Italy, pending approval of the front-line medicine lorlatinib, which would be considered among the choices. Due to a local regulatory limitation of second-line lorlatinib, which is not allowed after front-line brigatinib, alectinib is commonly the preferred front-line choice to follow a sequence of alectinib, followed by lorlatinib, followed by platinum plus pemetrexed chemotherapy. Age and performance status were not considered per se as clinical features influencing treatment choice. However, treatment compliance is deemed a relevant factor in decision making with regard to the number of pills to be administered. In general, given the availability of alternative choices, the spectrum of patients’ comorbidities and polypharmacotherapy interactions should be taken into account in treatment selection according to the toxicity profile of each compound. In addition, several issues were debated with regard to improving treatment outcomes, including testing, brain metastases, and management of an oligoprogressive disease. Conclusions: The treatment scenario of ALK-positive disease is dynamically evolving. Furthermore, not all FDA- and EMA-approved compounds are approved in Italy with the same indications. This influences therapeutic opportunities and increases the need for greater clinical expertise to help and guide treatment selection.

This comprehensive literature review explores the involvement of the gastrointestinal (GI) tract in sarcoidosis, a multisystem granulomatous disorder of unknown etiology. GI sarcoidosis presents a diagnostic and therapeutic challenge due to its rarity and nonspecific clinical manifestations, including overlap with other gastrointestinal diseases. We conducted a comprehensive screening of articles addressing the clinical features, diagnostic approaches, and treatment strategies for GI sarcoidosis. Our findings reveal that GI sarcoidosis can affect any part of the gastrointestinal tract, with the stomach and small intestine being the most involved. Clinical presentations range from asymptomatic cases to severe complications such as obstruction and perforation, with reflux being a common symptom. Diagnosis is often delayed due to the nonspecific nature of symptoms and the need for histopathological confirmation. Therapeutic approaches are poorly defined, typically involving corticosteroids as the mainstay of treatment. However, the long-term efficacy and safety of these treatments remain uncertain in this patient group, given the significant risks and complications associated with prolonged glucocorticoid therapy. There is a clear need to develop accurate diagnostic protocols to distinguish GI sarcoidosis from other conditions and to establish standardized therapeutic guidelines to optimize patient outcomes. Further research is essential to enhance our understanding and management of this complex condition.

Background: Coronary computed tomographic angiography (CCTA) is a non-invasive imaging technique that possesses the ability to provide detailed anatomical information about coronary arteries, avoiding unnecessary invasive procedures. Our aim was to assess the ability of CCTA to identify coronary artery disease compared to invasive coronary angiography (ICA) in a real-life setting. Methods: We examined 137 consecutive patients who underwent ICA after CCTA. The latter was conducted in various non-selected centers, and data regarding stenosis were taken from individual reports without further analysis. Results: A total of 60.5% of patients who underwent CCTA were found to have at least one critical stenosis, while the remaining 39.5% underwent ICA due to concurrent clinical or instrumental indications. Among these, 29.5% had angiographically critical pathology, 20.3% underwent a percutaneous coronary intervention (PCI), and 1.8% had coronary artery bypass grafting. Among the 83 patients with positive CCTA results, 34.9% had negative ICA findings. CCTA demonstrated low sensitivity (57.8%) and a positive predictive value of 42.6%. However, it retained high specificity (83.6%) and a negative predictive value of 90.4% for identifying critical stenosis. Among the 18.2% of patients who underwent CCTA without a specific indication, 60% had critical coronary lesions on their ICA and 86.6% of these subsequently underwent a PCI. Conclusions: CCTA performed in non-selective centers has a low concordance with ICA.

Nanoplastics (NPs) represent an escalating hazard to both humans and the ecosystem due to their pervasive presence. This review delves into (i) the widespread occurrence of NPs across the different environmental matrices, including food; (ii) routes and estimates for human exposure; (iii) the mechanisms of blood–brain barrier (BBB) crossing; and (iv) implications for human health, with a specific focus on molecular features associated with neurotoxicity and neurodegenerative processes. The impact of NPs on the central nervous system, their ability to cross the BBB and the underpinning mechanisms, the potential to initiate neurotoxicity by fostering β-amyloid aggregation, and their interactions with metallo-enzymes (such as superoxide dismutase) are elucidated. The analysis of transcriptomics and epigenomic results, including microRNA dysregulation, unveil how NPs could contribute to neurological disorders. The need for considering overlaps among diverse pathogenetic mechanisms when probing the effects of NPs is discussed. Additional urgent needs are the development of reliable in vitro models for neurotoxicity studies able to mimic the complexity of the nervous system and the exposure of such models to more environmentally relevant NPs. Finally, the development of extremely sensitive detection and analysis methodologies to quantify NPs in environmental and biological matrices is a pressing priority.

The estimation of carbon dioxide emissions in relation to the life cycle of road pavements is pivotal to quantify their sustainability at the design stage. This preliminary study assesses the carbon budgets concerning the production of aggregates and asphalt to build a new roadway stretch located close to Oslo (Norway), leveraging digital tools and environmental product declarations. First, the software Trimble Novapoint estimates the necessary quantity take-offs. Afterwards, the amounts of CO2 generated during the production of the construction materials are appraised for the four main industries operating nearby. The results based on the corresponding environmental product declarations indicate that the carbon budgets show very small discrepancies among the considered suppliers.

The nine-member CLC gene family of Cl− chloride-transporting membrane proteins is divided into plasma membrane-localized Cl− channels and endo-/lysosomal Cl−/H+ antiporters. Accessory proteins have been identified for ClC-K and ClC-2 channels and for the lysosomal ClC-7, but not the other CLCs. Here, we identified TMEM9 Domain Family Member B (TMEM9B), a single-span type I transmembrane protein of unknown function, to strongly interact with the neuronal endosomal ClC-3 and ClC-4 transporters. Co-expression of TMEM9B with ClC-3 or ClC-4 dramatically reduced transporter activity in Xenopus oocytes and transfected HEK cells. For ClC-3, TMEM9B also induced a slow component in the kinetics of the activation time course, suggesting direct interaction. Currents mediated by ClC-7 were hardly affected by TMEM9B, and ClC-1 currents were only slightly reduced, demonstrating specific interaction with ClC-3 and ClC-4. We obtained strong evidence for direct interaction by detecting significant Förster Resonance Energy Transfer (FRET), exploiting fluorescence lifetime microscopy-based (FLIM-FRET) techniques between TMEM9B and ClC-3 and ClC-4, but hardly any FRET with ClC-1 or ClC-7. The discovery of TMEM9B as a novel interaction partner of ClC-3 and ClC-4 might have important implications for the physiological role of these transporters in neuronal endosomal homeostasis and for a better understanding of the pathological mechanisms in CLCN3- and CLCN4-related pathological conditions.

Hereditary breast/ovarian cancer (HBOC) syndrome is caused by the inheritance of monoallelic germline BRCA1/2 gene mutations. If BRCA1/2 mutation carriers are identified before the disease develops, effective actions against HBOC can be taken, including intensive screening, risk-reducing mastectomy and salpingo-oophorectomy, and risk-reducing medications. The Italian National Prevention Plan mandates the creation of regional BRCA genetic testing programmes. So far, however, only informal data have been reported on their implementation. We have designed a study aimed at evaluating the results of a population-based programme for risk assessment and genetic counselling and testing for BRCA1/2-related HBOC that is underway in the Emilia-Romagna region (northern Italy). The programme—which is entirely free—includes basic screening with an estimate of the likelihood of carrying a BRCA1/2 mutation using a familial risk assessment tool, a closer examination of women with suspected risk increase, an assessment of the need for further genetic counselling and, if needed, genetic testing and risk-reducing interventions. In this paper, the design of the programme and the protocol of the study are presented. The study has an observational, historical cohort design. Eligible are the women found to be at an increased risk of HBOC (profile 3 women). The main objectives are (i) to determine the precision of the programme in measuring the level of risk of HBOC for profile 3 women; (ii) to determine the characteristics of profile 3 women and their association with the risk management strategy chosen; (iii) to compare the age at onset, histologic type, tumour stage, molecular subtype, and prognosis of breast/ovarian cancers observed in the cohort of profile 3 women with the features of sporadic cancers observed in the general female population; (iv) to determine the level and the determinants of adherence to recommendations; and (v) to determine the appropriateness and timing of risk-reducing surgery and medications. Investigating the quality and results of the programme is necessary because the best practices in risk assessment and genetic counselling and testing for BRCA1/2-related cancer and the challenges they encounter should be identified and shared. The study has the potential to provide sound empirical evidence for the factors affecting the effectiveness of this type of service.

The World Health Organization (WHO) recommends the introduction of a water safety plan (WSP) approach on drinking water, in all types of settings. This study represents the first WSP developed on the Neptune Fountain, in Bologna (Italy), based on an interdisciplinary approach, integrating hydraulic and microbiological features, in a Building Information Modeling (BIM). The aim was to develop a dynamic and digital platform to update and share the maintenance program, promoting collaboration among microbiologists, engineers, and municipal staff. Water samples were collected along fountain water distribution systems (WDS) from 2016 to 2021 to monitor water quality through the heterotrophic bacteria at 22 °C and 37 °C, as well as to conduct an Enterococci, Coliform bacteria, Escherichia coli, Pseudomonas aeruginosa, Clostridium perfringens, and Staphylococcus aureus assessment. Simultaneously, hydraulic measures were performed, and advanced geomatics techniques were used to detect the WDS structural components, with a focus on the water treatment system (WTS). The WTS consisted of 10 modules corresponding to specific treatments: descaling, carbon–sand filtration, reverse osmosis, and ultraviolet disinfection. Fecal indicators, heterotrophic bacteria, and P. aeruginosa exceeded the reference limits in most of the modules. Several disinfections and washing treatments, other than changing the maintenance procedure scheduling, were performed, improving the WTS and controlling the contamination. The developed microbiological results, hydraulic measurements, and maintenance procedures were integrated in the BIM model to optimize the data storage, updating procedures and the real-time data sharing. This approach improved the fountain management, operation, and material conservation, ultimately preserving the health of daily visitors.

Idiopathic pulmonary fibrosis (IPF) is a rare and progressive interstitial lung disease characterized by irreversible distortion of lung architecture and subsequent loss of pulmonary function. Pirfenidone is an antifibrotic agent associated with increased progression-free survival and overall survival rates, but it carries multiple side effects. The aim of the study was to examine the efficacy and safety profile of pirfenidone in a real-life context, with a focus on the concomitant use of antithrombotic and/or anticoagulant treatments. The clinical and functional data (forced vital capacity [FVC], forced expiratory volume in 1 s [FEV1], diffusing lung capacity for carbon monoxide [DLCO], and 6 min walking test distance [6MWD]) of all IPF patients treated with pirfenidone and referred to our two centers between 2019 and 2022 were retrospectively analyzed at baseline, 6 and 12 months after the start of treatment. A total of 55 IPF subjects undergoing pirfenidone treatment were included in the analysis (45.5% females, median [IQR] age at disease onset 68.0 [10.0] years, median [IQR] age at baseline 69.0 [10.8] years). Compared to baseline, at 12 months, FVC (86.0% vs. 80.0%; p = 0.023) and DLCO (44.0% vs. 40.0%; p = 0.002) were significantly reduced, while FEV1 (p = 0.304) and 6MWD (p = 0.276) remained stable; no significant change was recorded at 6 months. Most of the reported adverse events were mild or moderate. Gastrointestinal intolerance (9.1%) was the main cause of treatment discontinuation. A total of 5% of patients reported at least one minor bleeding event, although all episodes occurred in those receiving concomitant antithrombotic or anticoagulant. Overall, this real-life experience confirms the efficacy and safety profile of pirfenidone in the case of the concomitant use of antithrombotic and/or anticoagulant drugs.

Halyomorpha halys (Heteroptera: Pentatomidae) is an insect pest native to Asia that has spread over the last two decades to most of the North America, parts of South America, Europe and North Africa. Its impact is significant as it can feed on more than 300 host plants, rendering affected fruits and vegetable crops unsellable or of lower quality. Various chemical and biological methods have been used to control this pest, with varying degrees of success. The sterile insect technique (SIT) is a pest control method involving the sterilization of insects via ionizing radiation and their subsequent mass release into the field. In the present contribution, the spermiogenesis of H. halys was studied from an ultrastructural point of view in both irradiated and non-irradiated adult males. In both cases, we observed ultrastructural characteristics typical of hemipteran sperm cells: bridges connecting the mitochondrial derivatives and the axonemal microtubules, the absence of accessory bodies, and the presence of two or three crystalline inclusions within the mitochondrial derivatives, an acrosome composed of tightly packed tubules, and an atypical, plaque-shaped microtubular organizing center (MTOC) in the centriolar region. Moreover, in the same region, we seldom observed the presence of two centrioles in the spermatids, one of which disappeared at a later stage of maturation. This feature is a novelty for insect spermiogenesis. The cysts of irradiated adults were not all uniformly affected by the radiation. However, irradiated cysts sometimes exhibited a general disorganization of sperm arrangement, incomplete divisions of sperm cells resulting in multiple copies of the same organelle within the same cell, failure to reabsorb the cytoplasm, and the lack of axonemes. Finally, rod-shaped viruses or virus-like particles were observed in vasa deferentia independently of irradiation.

Background: Post-pandemic psychosomatic complaints in children and adolescents have been underreported. This study investigated psychosomatic complaints in children and adolescents in Northern Italy in 2023, with the aim of identifying changes in predictors and vulnerable subgroups. Methods: Cross-sectional data representative of scholars from a northern Italian province were analyzed using the Health Behavior in School-aged Children (HBSC) checklist. The sum scores, count data, and dichotomized data were examined, and predictor effects were expressed using a linear regression model for the sum scores. Results: Data from 4525 participants (aged 7–19 years, 50.5% girls) were analyzed. Psychosomatic symptoms remained unchanged after the pandemic. Significant gender differences were noted, especially in older age groups, with girls reporting more complaints. Factors such as children’s health, digital media use, and school problems significantly influence psychosomatic outcomes. While migration background negatively affected girls’ psychosomatic well-being, boys showed improvement through sports. Conclusion: The psychosomatic well-being of children and adolescents did not improve after the pandemic. These findings indicate the need for targeted interventions, improved health literacy, and ongoing monitoring to support the mental well-being of this vulnerable population. Reducing screen time remains a critical strategy for enhancing youth well-being.

Modern electric motors developed for the automotive industry have an ever higher power density with a relatively compact size. Among the various existing solutions to improve torque and power density, a reduction in the dimensions of the end-windings has been explored, aiming to decrease volume, weight, and losses. However, more compact end-windings often lead to complex shapes of the conductors, especially when preformed hairpin windings are considered. The rectangular cross-section of hairpin conductors makes them prone to deviating out of the bending plane during the forming process. This phenomenon, known as torsional–flexural instability, is influenced by the specific aspect ratio of the cross-section dimensions and the bending direction. This study focuses on understanding this instability phenomenon, aiming to identify a potential threshold of the cross-section aspect ratio. The instability makes it difficult to predict the final geometry, potentially compromising the compliance with the geometric tolerances. A finite element model is developed to analyse a single planar bend in a hairpin conductor. Various cross-section dimensions with different aspect ratios are simulated identifying those that experience instability. Moreover, an experimental campaign is conducted to confirm the occurrence of instability by testing the same single planar bending. The experimental data obtained are used to validate the finite element model for the tested dimensions. The aim is to provide designers with a useful tool to select hairpin geometries that are more suitable for the folding process, contributing to successful assembly and improving the overall design process of preformed hairpin conductors.

Twenty years ago, we started to apply quantum optics to the astronomical research carried out inside the Department of Physics and Astronomy and the INAF Astronomical Observatory in Padova, Italy. The initial activities were stimulated by the project of the European Southern Observatory (ESO) to build a 100 m diameter telescope, the Overwhelmingly Large (OWL) telescope. The enormous photon flux expected from such an aperture suggested that quantum optics concepts be utilized in order to obtain novel astrophysical results. Following initial successful attempts to utilize the orbital angular momentum of the light beam to enhance the visibility of faint companions to bright stars, the Padova team concentrated its efforts on very high time resolution, in order to measure and store the arrival time of celestial photons to better than one nanosecond. To obtain observational results, we built two photon counting photometers (AquEye and IquEye) to be used with our telescopes of the Asiago Observatory and with 4 m class telescopes such as the ESO New Technology Telescope (NTT) in Chile. This paper firstly describes these two instruments and then expounds the results obtained on pulsar light curves, lunar occultations and the first photon counting intensity interferometry measurements of the bright star Vega. Indeed, the correlation of photon arrival times on two or more apertures can lead to extremely high angular resolutions, as shown around 1970 by Hanbury Brown and Twiss. Prospects for quantum intensity interferometry with arrays of Cherenkov light telescopes will also be described.

Background: SARS-CoV-2 clinical manifestation and progression are variable and unpredictable, hence the importance of considering biomarkers in clinical practice that can be useful for both diagnosis and prognostic evaluation. This review aims to summarize, for intensive care physicians, the most recent state of knowledge regarding known COVID-19 in critical patients. We searched PubMed® using the Boolean operators and identified all results on the PubMed® database of all studies regarding COVID-19 biomarkers. We selected studies regarding endothelium, cytokines, bacterial infection, coagulation, and cardiovascular biomarkers. Methods: We divided the results into four essential paragraphs: “Cytokine storm”, “Endothelium dysfunction and coagulation biomarkers in COVID-19”, “Biomarker of sepsis”, and Cardiovascular lung and new perspectives. Results: The assessments of the severe COVID-19 prognosis should monitor, over time, IL-6, soluble Von Willebrand factor (VWF), P-selectin, sCD40L, thrombomodulin, VCAM-1, endothelin- Troponin, D-dimer, LDH, CRP, and procalcitonin. Metabolomic alterations and ACE2 receptors represent new perspectives. Discussion and Conclusions: Early identification of critically ill patients has been crucial in the first COVID-19 pandemic wave for the sustainability of the healthcare emergency system and clinical management. Only through the early identification of the most severe patients can they be provided with the most appropriate treatments.

Portland cement (PC) is a common material used in civil infrastructure engineering. Cement production emits roughly 2.2 billion tons of CO2 per year, contributing 8% of global emissions in 2016. This contributes to almost half of the calcination process, and together with thermal combustion, clinker generation could be responsible for 90% of the sector’s emissions. One effective technique for dealing with these industrial by-product wastes is to employ them to make cement replacements such as concrete and mortar, which can be used in a variety of applications. As a result, the purpose of this research is to review the current advancements, challenges, and future perspectives on the utilization of agro-industrial waste (AIW) produced around the world in cement-based products. Geopolymers (GPs), on the other hand, reduce carbon dioxide emissions and have the potential to be a complete or partial replacement for PC in the construction sector. The GP technology enables the use of AIW in combination with an alumina–silicate (A–S) phase with minimal environmental impact. GP-cement is mostly produced by activating alkali silicates or alkali sols with secondary raw materials such as calcined clays, fly ash (FA), zeolite, metakaolin, etc. Mixing various resource materials, including additives, A–S, and alkali sols, alkali concentrations, optimizing the curing temperature, the SiO2/Na2O ratio, microstructural behavior, and other factors, results in GP-cement with outstanding mechanical and durability characteristics. The review concludes that AIW-based geopolymer composites have shown promising results in terms of their mechanical properties, durability, and environmental sustainability, which makes them emerge as promising future building materials with applications in a wide range of industries.

COVID-19 has been a global health problem since 2020. There are different spectrums of manifestation of this disease, ranging from asymptomatic to extremely severe forms requiring admission to intensive care units and life-support therapies, mainly due to severe pneumonia. The progressive understanding of this disease has allowed researchers and clinicians to implement different therapeutic alternatives, depending on both the severity of clinical involvement and the causative molecular mechanism that has been progressively explored. In this review, we analysed the main therapeutic options available to date based on modulating the host inflammatory response to SARS-CoV-2 infection in patients with severe and critical illness. Although current guidelines are moving toward a personalised treatment approach titrated on the timing of presentation, disease severity, and laboratory parameters, future research is needed to identify additional biomarkers that can anticipate the disease course and guide targeted interventions on an individual basis.

Pirfenidone and Nintedanib are specific drugs used against idiopathic pulmonary fibrosis (IPF) that showed efficacy in non-IPF fibrosing interstitial lung diseases (ILD). Both drugs have side effects that affect patients in different ways and have different levels of severity, making treatment even more challenging for patients and clinicians. The present review aims to assess the effectiveness and potential complications of Pirfenidone and Nintedanib treatment regimens across various ILD diseases. A detailed search was performed in relevant articles published between 2018 and 2023 listed in PubMed, UpToDate, Google Scholar, and ResearchGate, supplemented with manual research. The following keywords were searched in the databases in all possible combinations: Nintedanib; Pirfenidone, interstitial lung disease, and idiopathic pulmonary fibrosis. The most widely accepted method for evaluating the progression of ILD is through the decline in forced vital capacity (FVC), as determined by respiratory function tests. Specifically, a decrease in FVC over a 6–12-month period correlates directly with increased mortality rates. Antifibrotic drugs Pirfenidone and Nintedanib have been extensively validated; however, some patients reported several side effects, predominantly gastrointestinal symptoms (such as diarrhea, dyspepsia, and vomiting), as well as photosensitivity and skin rashes, particularly associated with Pirfenidone. In cases where the side effects are extremely severe and are more threatening than the disease itself, the treatment has to be discontinued. However, further research is needed to optimize the use of antifibrotic agents in patients with PF-ILDs, which could slow disease progression and decrease all-cause mortality. Finally, other studies are requested to establish the treatments that can stop ILD progression.

We aimed to evaluate the intra-session relative and absolute reliability of obstacle-crossing parameters during overground walking in young adults, and to determine the number of trials required to ensure reliable assessment. We analysed data from 43 young male adults who were instructed to walk at a self-selected velocity on a pathway and to step over an obstacle (height = 15 cm; width = 80 cm, thickness = 2 cm) three times. Spatial–temporal gait parameters of the approaching and crossing phases (i.e., before and after the obstacle) and obstacle clearance parameters (i.e., vertical and horizontal distance between the foot and the obstacle during crossing) were computed using a three-dimensional motion analysis system. Intraclass correlation coefficients were used to compute the relative reliability, while standard error of measurement and minimal detectable change were used to assess the absolute reliability for all possible combinations between trials. Results showed that most spatial–temporal gait parameters and obstacle clearance parameters are reliable using the average of three trials. However, the mean of the second and third trials ensures the best relative and absolute reliabilities of most obstacle-crossing parameters. Further works are needed to generalize these results in more realistic conditions and in other populations.

The Setifian high-plains region, Northeast of Algeria, grapples with challenges in water resource management. As the water demand intensifies across a diverse range of sectors, assessing groundwater quality becomes indispensable. This article responds to the critical need for a thorough assessment of groundwater quality in the Wadi Boussellam sub-watershed. Employing a GIS-based method, we evaluate groundwater geochemistry by estimating the Water Quality Index (WQI), offering a comprehensive overview of water consumption. The analysis of groundwater samples reveals distinct facies, including calcic bicarbonate, calcic chloride, calcic sulfate, and magnesium sulfate, contributing to an enhanced understanding of the hydrochemical composition in the Setif region. Hydrochemical indices, specifically the WQI, Sodium Adsorption Ratio (SAR), and Na% are applied to assess groundwater suitability for various applications. The results indicate that most crops are generally suitable for irrigation, though they advise exercising caution with regard to human consumption. This study underscores the significance of regular monitoring to avert groundwater contamination and ensure sustainable use in the Setif region, providing insights that emphasize the ongoing necessity for efforts in water resource management and the preservation of this vital resource’s quality.

With sustainability dominating the industry, recycling the generated waste from different processes is becoming increasingly important. This study focuses on recycling waste generated during aluminum anodizing waste (AAW) in friction material formulations for automotive braking applications. However, before utilization, the waste needs to be pre-treated, which mainly involves drying. Hence, four different industrial drying methods were studied to dry the AAW, and the corresponding characteristics were observed by evaluating its residual humidity and crushability index. The waste powders were further characterized using FT-IR and SEM/EDXS to understand their constituents. The initial analysis showed that the waste subjected to the drying process P2 and P1 with the lowest final humidity fetched the most desirable results, with P1 having the simpler drying procedure. The AAW powders were added in a commercial friction material formulation at 6 and 12 wt.% and subjected to friction, wear, and non-exhaust particulate matter analysis. The worn surfaces were analyzed using SEM/EDXS evaluation to understand the extension and composition of the deposited secondary contact plateaus. It was seen that the 12 wt.% addition of waste processed using the P1 technique provided the most satisfactory friction, wear, and emission characteristics, along with expansive secondary contact plateaus with a good contribution of the waste in its formation. This study showed a good relationship between the processing method and a formulation’s tribological and emission characteristics, thereby paving the way for using this drying method for other waste requiring pre-treatment.

Studies on bioaerosol bacterial biodiversity have relevance in both ecological and health contexts, and molecular methods, such as 16S rRNA gene-based barcoded sequencing, provide efficient tools for the analysis of airborne bacterial communities. Standardized methods for sampling and analysis of bioaerosol DNA are lacking, thus hampering the comparison of results from studies implementing different devices and procedures. Three samplers that use gelatin filtration, swirling aerosol collection, and condensation growth tubes for collecting bioaerosol at an aeration tank of a wastewater treatment plant in Trieste (Italy) were used to determine the bacterial biodiversity. Wastewater samples were collected directly from the untreated sewage to obtain a true representation of the microbiological community present in the plant. Different samplers and collection media provide an indication of the different grades of biodiversity, with condensation growth tubes and DNA/RNA shieldTM capturing the richer bacterial genera. Overall, in terms of relative abundance, the air samples have a lower number of bacterial genera (64 OTUs) than the wastewater ones (75 OTUs). Using the metabarcoding approach to aerosol samples, we provide the first preliminary step toward the understanding of a significant diversity between different air sampling systems, enabling the scientific community to orient research towards the most informative sampling strategy.

Nuclear reactions are responsible for the chemical evolution of stars, galaxies and the Universe. Unfortunately, at temperatures of interest for nuclear astrophysics, the cross-sections of the thermonuclear reactions are in the pico- femto-barn range and thus measuring them in the laboratory is extremely challenging. In this framework, major steps forward were made with the advent of underground nuclear astrophysics, pioneered by the Laboratory for Underground Nuclear Astrophysics (LUNA). The cosmic background reduction by several orders of magnitude obtained at LUNA, however, needs to be combined with high-performance detectors and dedicated shieldings to obtain the required sensitivity. In the present paper, we report on the recent and future detector-shielding designs at LUNA.

Job satisfaction and willingness to stay are critical for workforce stability in a challenging healthcare environment. This study examined how relational coordination, a key factor in teamwork and communication, influences outcomes among healthcare professionals in a bilingual, culturally mixed region of Italy. This cross-sectional survey included general practitioners, hospital physicians, nurses, and administrators from the South Tyrol Health Service, using the ‘Relational Coordination Survey’ and additional measures of job satisfaction and willingness to stay. The analytical methods used included descriptive statistics, correlations, and regression analyses. This study applied path analysis, including mediation and moderation techniques, to investigate the roles of relational coordination and job satisfaction in influencing the willingness to stay. It employs Conditional Process Analysis with the PROCESS macro in SPSS, focusing on models for moderated mediation analysis. The results indicated a critical influence of relational coordination on both job satisfaction and willingness to stay among the 525 healthcare professionals. Job satisfaction varied by health district and years of service, with midcareer professionals being the least satisfied. The findings highlight the central role of relational coordination in job satisfaction and willingness to stay and confirm that low job satisfaction increases turnover intentions. Relational coordination directly enhanced job satisfaction and willingness to stay, while also serving as a mediating factor that amplifies the impact of job satisfaction on retention intentions. This study reinforces the need for strong teamwork and communication to stabilize the healthcare workforce. Targeted interventions aimed at improving relational coordination could significantly enhance job satisfaction and retention among healthcare professionals, particularly in culturally diverse settings such as South Tyrol.

Fires are a growing problem even in temperate climate areas, such as those in Central Italy, due to climate change leading to longer and longer periods of drought. Thus, knowing the fire susceptibility of an area is crucial for good planning and taking appropriate countermeasures. In this context, it was decided to use only causal factors of a geomorphological and environmental nature in order to obtain a fire susceptibility analysis that can also be applied to climatically under-sampled areas. Vector data of fires in Central Italy from 2005 to 2023 were collected, and the correct areal extent was calculated for each. At the same time, six factors were selected that could have an influence on fire development, such as ecological units, topographic wetness index (TWI), geology, slope, exposure, and altitude. The model was obtained by means of the weight of evidence statistical method, which takes into account past data by reinterpreting them in a future-oriented way on the basis of the identified factors and classes. The model was validated with a test sample and shows an area under the curve (AUC) value of 0.72 with a reliability that can be described as good considering the total absence of climatic factors that are known to play a major role in fire development. Furthermore, the identified causal factors were divided into classes, and these were carefully weighted in order to define their relative influence in the study area. Particularly Ecological Units with characteristic and well-defined contrast (C) values, which could lead to a more complete definition of forests that tend to increase fire susceptibility and those that tend to decrease it, allowing the latter to be exploited as a hazard mitigation agent.

Altruism plays an essential role in promoting vaccine uptake, an issue that came to the fore during the COVID-19 pandemic through discussions of herd immunity and altruistic motivations. In response, the primary objective of this cross-sectional survey was to explore how altruistic attitudes have evolved in the post-pandemic era and to assess their effectiveness in motivating vaccination behavior in different age groups. The study aimed to elucidate changes in altruistic motivations for vaccination and their implications for public health strategies. Using a representative sample of the adult population of South Tyrol, Italy, including 1388 participants, altruism was assessed in 2023 with the scales of the Elderly Care Research Center (ECRC) and the International Personality Item Pool (IPIP) subscale of the version 5F30F-R1. Its association with demographic variables, vaccination attitudes and personal beliefs in two age groups (18–69 years, 70+ years) was analyzed. The results reveal distinct predictors of altruism across these scales and age groups, suggesting a shift in altruistic attitudes towards vaccination when comparing data from a similar survey conducted in 2021 with the 2023 results. Consequently, the use of altruism scales for different age groups is warranted. This study highlights the need for further research in this field. It concludes that while promoting altruistic behavior to increase vaccine uptake appears to be effective primarily among the younger population, emphasizing personal safety is more appropriate for encouraging vaccination among older individuals.

Stress is an important risk factor for the onset of anxiety and depression. The ability to cope with stressful events varies among different subjects, probably depending on different genetic variants, sex and previous life experiences. The Val66Met variant of Brain-Derived Neurotrophic Factor (BDNF), which impairs the activity-dependent secretion of BDNF, has been associated with increased susceptibility to the development of various neuropsychiatric disorders. Adult male and female wild-type Val/Val (BDNFV/V) and heterozygous Val/Met (BDNFV/M) mice were exposed to two sessions of forced swimming stress (FSS) per day for two consecutive days. The mice were behaviorally tested 1 day (short-term effect) or 11 days (long-term effect) after the last stress session. Protein and mRNA levels were measured in the hippocampus 16 days after the end of stress exposure. Stressed mice showed a higher anxiety-like phenotype compared to non-stressed mice, regardless of the sex and genotype, when analyzed following the short period of stress. In the prolonged period, anxiety-like behavior persisted only in male BDNFV/M mice (p < 0.0001). Interestingly, recovery in male BDNFV/V mice was accompanied by an increase in pCREB (p < 0.001) and Bdnf4 (p < 0.01) transcript and a decrease in HDAC1 (p < 0.05) and Dnmt3a (p = 0.01) in the hippocampus. Overall, our results show that male and female BDNF Val66Met knock-in mice can recover from subchronic stress in different ways.

The Italian pig sector requires heavy pigs (raised for at least nine months and slaughtered at >160 kg). In order to avoid boar taint and lower the impact on welfare, immunocastration provides an alternative to surgical castration. This study investigated the effects of immunocastration compared to surgical castration on the chemical composition and fatty acid profile of loins (longissimus dorsi muscle) and adipose tissue in Italian heavy pigs raised for dry-cured ham. Twenty-four male pigs were subjected to surgical castration (n = 12) or immunocastration (n = 12). Carcass parameters were monitored at slaughter, and samples of longissimus dorsi muscle and subcutaneous fat were analysed. This study showed no significant differences in carcass characteristics and proximate composition of fresh meat. However, variations were observed in the fatty acid profiles of meat and adipose tissue between groups. Notably, saturated fatty acids, particularly stearic acid (18:0), were higher in the intramuscular fat (IMF) of the immunocastrated pigs compared to the surgically castrated pigs. Conversely, monounsaturated fatty acids, predominantly oleic acid (18:1n-9), were higher in the IMF from the surgically castrated pigs compared to the immunocastrated pigs. While immunocastration may offer benefits in terms of animal growth and carcass composition, it could lead to unfavourable lipid changes in fresh loin meat for Italian heavy pigs.

The highly virulent Toxoplasma gondii RH strain is maintained through successive passages in mice, but there is still a lack of studies that refine these procedures from a 3Rs perspective, where humanitarian ideals aim to minimize the stress, pain, or suffering of the animals used in the research without the loss of results. The aim of this study was to establish humane endpoints in Swiss Webster mice inoculated with the T. gondii RH strain. A total of 52 mice were infected with 5 × 106 tachyzoites/mL and monitored for periods of up to 5 days. The parameters body weight; hair condition; higher than normal body temperature; hypothermia; respiratory function; pain; soft stools or diarrhea; bloody diarrhea; tense, nervous, or in distress during handling; and ascites were recorded daily in score tables. The results showed that prominent piloerection, respiratory function, pain parameters, and ascites are important clinical signs to be used as a cut-off point for implementing euthanasia. The application of this refinement method helped to avoid animal suffering and pain without compromising the number of parasites recovered. We therefore suggest adopting these parameters in research protocols that require the maintenance of the T. gondii RH strain in murine models to avoid and reduce animal suffering.

Background: Chronic obstructive pulmonary disease (COPD) has higher rates among the general population, so early identification and prevention is the goal. The mechanisms of COPD development have not been completely established, although it has been demonstrated that endothelial dysfunction plays an important role. However, to date, the measurement of endothelial dysfunction is still invasive or not fully established. Nailfold video capillaroscopy (NVC) is a safe, non-invasive diagnostic tool that can be used to easily evaluate the microcirculation and can show any possible endothelial dysfunctions early on. The aim of this review is to evaluate if nailfold microcirculation abnormalities can reflect altered pulmonary vasculature and can predict the risk of cardiovascular comorbidities in COPD patients. Methods: A systematic literature search concerning COPD was performed in electronic databases (PUBMED, UpToDate, Google Scholar, ResearchGate), supplemented with manual research. We searched in these databases for articles published until March 2024. The following search words were searched in the databases in all possible combinations: chronic obstructive pulmonary disease (COPD), endothelial damage, vascular impairment, functional evaluation, capillaroscopy, video capillaroscopy, nailfold video capillaroscopy. Only manuscripts written in English were considered for this review. Papers were included only if they were able to define a relationship between COPD and endothelium dysfunction. Results: The search selected 10 articles, and among these, only three previous reviews were available. Retinal vessel imaging, flow-mediated dilation (FMD), and skin autofluorescence (AF) are reported as the most valuable methods for assessing endothelial dysfunction in COPD patients. Conclusions: It has been assumed that decreased nitric oxide (NO) levels leads to microvascular damage in COPD patients. This finding allows us to assume NVC’s potential effectiveness in COPD patients. However, this potential link is based on assumption; further investigations are needed to confirm this hypothesis.

In recent years, Italian Public Administrations (PAs) have swiftly adapted to flexible work arrangements due to the impact of COVID-19. The flexible work has led to addressing new challenges including the need to balance work demands with family commitments, a lack of social support, struggles with inadequate technology, and managing home interruptions that negatively affect home performance. Based on the job demands-resources (JD-R) model, the present study aims at examining the negative impact of home interruptions on smart working performance and the moderating role of two potential job resources: organizational support and perceived quality of the smart working. A convenience sample of 301 Italian public employees engaged in smart working completed an online questionnaire. Multivariate regression analysis results showed that organizational support plays a moderating role in reducing the negative effect of interruptions on home performance. However, the findings did not support a moderating role for the perceived quality of smart working. Overall, these findings highlight the critical role of social factors in buffering the negative effects of smart working, as compared to the quality of the technological arrangements. This information could be valuable for organizations looking to enhance the effectiveness of smart working by focusing on organizational support.

Background: The impact of non-vitamin K antagonist oral anticoagulants (NOACs) on platelet function is still unclear. We conducted a comprehensive ex vivo study aimed at assessing the effect of the four currently marketed NOACs on platelet function. Methods: We incubated blood samples from healthy donors with concentrations of NOACs (50, 150 and 250 ng/mL), in the range of those achieved in the plasma of patients during therapy. We evaluated generation of thrombin; light transmittance platelet aggregation (LTA) in response to adenosine diphosphate (ADP), thrombin receptor-activating peptide (TRAP), human γ-thrombin (THR) and tissue factor (TF); generation of thromboxane (TX)B2; and expression of protease-activated receptor (PAR)-1 and P-selectin on the platelet surface. Results: All NOACs concentration-dependently reduced thrombin generation compared with control. THR-induced LTA was suppressed by the addition of dabigatran at any concentration, while TF-induced LTA was reduced by factor-Xa inhibitors. ADP- and TRAP-induced LTA was not modified by NOACs. TXB2 generation was reduced by all NOACs, particularly at the highest concentrations. We found a concentration-dependent increase in PAR-1 expression after incubation with dabigatran, mainly at the highest concentrations, but not with FXa inhibitors; P-selectin expression was not changed by any drugs. Conclusions: Treatment with the NOACs is associated with measurable ex vivo changes in platelet function, arguing for antiplatelet effects beyond the well-known anticoagulant activities of these drugs. There are differences, however, among the NOACs, especially between dabigatran and the FXa inhibitors.

Daridorexant (dari), as the first dual orexin receptor antagonist (DORA) marketed in Europe, offers a novel therapeutic approach to insomnia. However, data regarding its real-world safety are scarce. Thus, this study was aimed at assessing its safety profile using a large-scale pharmacovigilance database. Dari-related adverse drug reaction (ADR) reports from the Food and Drug Administration Adverse Event Reporting System were scrutinized, and ADRs were selected using reporting odds ratio (ROR) as a measure of disproportionality. Frequencies of events related to dari were compared to all other drugs (reference group, RG1) and only to other DORAs (RG2). Only significant disproportionalities to both RGs were evaluated in-depth. A total of 845 dari-related reports were selected; nightmares (n = 146; dari vs. RG1: ROR = 113.74; 95%CI [95.13, 136]; dari vs. RG2: ROR = 2.35; 95 CI% [1.93, 2.85]), depression (n = 22; dari vs. RG1: 2.13; [1.39, 3.25]; dari vs. RG2: ROR = 2.31; 95 CI% [1.45, 3.67]), and hangover (n = 20; dari vs. RG1: ROR = 127.92; 95 CI% [81.98, 199.62]; and dari vs. RG2: 3.38; [2.04, 5.61]) were considered as safety signals. These data provide valuable insights into the real-world safety profile of daridorexant, supporting the existence of safety signals related to nightmares, depression, and hangovers.