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Introduction: Caring for the dying can generate anxiety and emotional distress, particularly in nursing students, and perceived competence could play a crucial role in enabling nurses to perform their duties with greater confidence. Unfortunately, few studies describe the relationship between students’ nursing attitudes and perceived self-efficacy in palliative care (PC). To overcome this gap, this survey aimed to assess the attitudes towards dying patients and the perceived competence of nursing students in palliative care at different universities in the south of Italy. Methods: A cross-sectional study was conducted from September 2022 to March 2023 involving nursing students from the three major Sicilian universities (Italy). The study included a survey investigating socio-demographic characteristics, palliative care training, knowledge about pain management, and previous experience with dying. Moreover, the Professional Competence of the Core Curriculum in Palliative Care Nursing (CCPCN) questionnaire and the Frommelt Attitudes Toward Care of the Dying—B Italian version (FATCOD-B-I) assessed competencies and emotional attitudes. Results: A total of 1913 nursing students were recruited, of which 71.3% were females, and 53.9% were in the age range of 18 to 21 years. In the multivariable analysis, practical PC training was a substantial factor in enhancing competencies (Adj-OR 2.78 [95% CI = 2.12–3.65]). Male students had higher competence odds (Adj-OR 1.38 [95% CI = 1.14–1.66]), and perceived knowledge strongly correlated with self-assessed competence. Advancement in academic years also positively influenced competence self-assessment (Adj-OR 1.98 [95% CI = 1.75–2.24]). Regarding emotional attitudes, a per-quartile increase in competence score was found to improve the attitude score (Adj-OR 1.24 [95% CI = 1.13–1.35]). Conclusions: Nursing students gain valuable experience during clinical experience. PC training and perceived knowledge of PC significantly increase nurses’ competencies, and the latter seem to be strongly associated with attitudes. Thus, introducing palliative care education into nurses’ core curricula could be a way to reduce anxiety and emotional distress in young students.

The 16th century AD St. Barbara’s Church in Paternò, a town located at the SW foot of Mt. Etna volcano (Sicily, Italy), has since 2009 showed evident signs of structural instability and collapse. This is causing great concern among the local population and poses a growing hazard to the attendees to the masses. After precautionary closure of the church, we carried out geological, seismic, geophysical and geochemical surveys in order to shed light on the possible causes of the phenomenon. From the results of all surveys above, the presence of a hidden fault was hypothesized. The fault would prove to cross the west side of the church, parallel to its front portal, and continue both to the north and to the south of the edifice. It is part of a more complex system of faults that crosses the whole town of Paternò and is likely a result of the complex dynamics of Mt. Etna. This fault seems to also be a pathway for the upward flow of saline hydrothermal fluids, similar in composition to those emitted in nearby areas and whose corrosive action possibly contributed to the weakening of the rocks beneath the church. Temporal monitoring of several hydrological parameters (water temperature, water level and CO2 content) in some sites in and around the church allowed a better understanding both of the fault dynamics and of the extent of hydrothermal influence in the studied area.

This study explores burnout among nursing students in Bangalore, India, focusing on Exhaustion and Disengagement scores. A cross-sectional design was applied using the Oldenburg Burnout Inventory modified for nursing students, collecting data using a survey that was conducted between October and December 2023. The sample consisted of 237 female nursing students from the Bachelor of Science in Nursing program at Bangalore College of Nursing, South India. The study integrated the t-distributed Stochastic Neighbor Embedding (t-SNE) procedure for data simplification into three t-SNE components, used in a hierarchical clustering analysis, which identified distinct student profiles: “High-Intensity Study Group” and “Altruistic Aspirants”. While burnout scores were generally high, students with high study hours (“High-Intensity Study Group”) reported greater Exhaustion, with a mean score of 26.78 (SD = 5.26), compared to those in the “Altruistic Aspirants” group, who reported a mean score of 25.00 (SD = 4.48), demonstrating significant differences (p-value = 0.005). Conversely, those motivated by altruism (“Altruistic Aspirants”) showed higher Disengagement, with a mean score of 19.78 (SD = 5.08), in contrast to “High-Intensity Study Group”, which reported a lower mean of 17.84 (SD = 4.74) (p-value = 0.002). This segmentation suggests that burnout manifests differently depending on the students’ academic load and intrinsic motivations. This study underscores the need for targeted interventions that address specific factors characterizing the clusters and provide information for designing future research and interventions. This study was not registered.

This study critically examines the public’s perception of Florence Nightingale’s legacy through a critical discourse analysis (CDA) of digital media, specifically podcasts and YouTube. Nightingale, who is often remembered as “The Lady with the Lamp”, holds a complex identity within modern narratives that is celebrated for her pioneering contributions to nursing and public health, even if there are some disagreements about her, given the colonialist setting that may have shaped some of her opinions and decisions. This research employed CDA to analyze 25 podcasts and 18 YouTube videos, which were systematically included according to a priori inclusion criteria. The study synthesized how these media products portray Nightingale and, by extension, shape public discourse about the nursing profession. The findings reveal five thematic representations of Nightingale: as a legendary figure, a modern feminist, a dedicated statistician, a pioneer in public health, and a pivotal STEM contributor. These portrayals challenge traditional nursing stereotypes by emphasizing Nightingale’s role as a rigorous scientist and reformer, suggesting broader perceptions of nurses that encompass leadership, analytical skills, and strategic thinking. The study supports the hypothesis that digital narratives significantly influence the public’s understanding and appreciation of nursing, advocating for a more nuanced professional identity that integrates traditional caregiving roles with critical and analytical capabilities.

Background: Breast units (BUs) provide breast cancer (BC) care, including prevention, treatment, and genetic assessment. Genetic research has highlighted BRCA1/2 mutations as key hereditary BC risk factors. BRCA testing is crucial for personalized treatment and prevention strategies. However, the integration of BRCA testing in Italian BUs faces multiple challenges. This study, by Senonetwork Italia, aimed to evaluate genetic testing practices and identify obstacles within Italian BUs. Methods: Senonetwork Italia conducted a 16-question web-based survey involving 153 BUs. The survey assessed aspects of BRCA testing, including timing, urgency, counseling, patient selection, and multi-gene panels. Results: Of the 153 BUs, 109 (71.2%) responded. Testing before surgery was performed by 70.6% of centers, with urgent cases acknowledged by 87.2%. Most centers (56.0%) arranged urgent pre-test counseling within a week. BRCA mutation status influenced treatment decisions in 99.1% of cases. Multi-gene panels were used by 33.0% of centers for all genetic counseling cases, while 56.0% followed standard referral criteria. The main challenges included cost, reimbursement, and reporting timelines. Conclusions: This survey highlights significant variations in BRCA testing practices across Italian BUs and identifies key logistical and financial challenges. There is a need for standardized practices of genetic testing to ensure personalized and effective BC management in Italy.

In this study, we examine the cooperative effect between vitamins C and E that mitigates oxidative stress by using experimental and computational methods. We performed superoxide scavenging experiments on each vitamin individually and their combination using rotating ring–disk electrode voltammetry. The results indicate that vitamins E and C together produce more effective scavenging of superoxide as evaluated by a steeper slope in the efficiency graph, −7.2 × 104, compared to that of vitamin E alone, −1.8 × 103, or vitamin C alone, −1.3 × 104. Density Functional Theory calculations agree with our experimental results, and we describe a mechanism for the antioxidant action of individual vitamins E and C, plus the synergistic action when both vitamins interact. This process involves the restoration of vitamin E by vitamin C and includes π-π interactions between superoxide and scavengers. The overall result produces an increase in scavenging superoxide radicals when both vitamins act together.

Nursing retention is a major challenge globally. Ongoing workforce instability across countries underscores the need to understand the factors influencing turnover and nursing retention. Trust is a crucial element in managing workplace relationships between nurse managers and nurses. Existing studies have shown the direct impact of trust on employees’ intention to leave their job but have not explored the effects of potential mediators such as organizational commitment. The aim of this study was to examine the impact of trust in the leader on nurses’ intention to leave their job through the mediation of organizational commitment. A cross-sectional study was conducted in Italy. A convenience sample of 1853 nurses completed a self-report survey. The study tested a hypothesis-based mediation model using structural equation modeling, which showed good fit indices. The results indicated that trust in the leader had a significant impact on nurses’ intention to leave, and this relationship was partially mediated by organizational commitment. Nurses who trust their leader are more likely to demonstrate higher levels of organizational commitment, resulting in a lower intention to leave their job. Furthermore, organizational commitment and trust emerge as critical factors in reducing nurses’ intention to leave their current positions. Therefore, managers can reduce nurses’ intention to leave by building trustful relationships that enhance organizational commitment.This study was not registered.

Background: Arrhythmias in pregnancy are complex to manage due to the teratogenic effects of many antiarrhythmic drugs and the common use of ionizing radiation during catheter ablation procedures. Furthermore, pregnant women are extremely vulnerable and difficult to treat because of the progressive physical and hormonal changes that occur during the nine months of pregnancy. Case Presentation: In this case report, we describe a complex clinical case of a 34-year-old pregnant woman who was affected by an incessant right atrial tachycardia, with signs and symptoms of initial hemodynamic instability. This tachycardia was refractory to antiarrhythmic drugs, so a zero-fluoroscopy ablation was performed. The first procedure was complicated by cardiac tamponade, quickly resolved without further complications for the mother or the fetus. In the following days, a deep venous thrombosis occurred at the femoral venous access. After a few days, the patient underwent a second procedure that was successful and resulted in the restoration of a sinus rhythm. Conclusions: The management of this clinical case was complex both from a procedural and a clinical (cardiological and gynecological) point of view. Finally, the integration of the various skills led to an excellent result.

Despite the spread of novel-generation cochlear-implant (CI) magnetic systems, access to magnetic resonance imaging (MRI) for CI recipients is still limited due to safety concerns. The aim of this study is to assess and record the experiences of Hires Ultra 3D (Advanced Bionics) recipients who underwent an MRI examination. A multicentric European survey about this topic was conducted focusing on safety issues, and the results were compared with the current literature. We collected a total of 65 MRI scans performed in 9 otologic referral centers for a total of 47 Hires Ultra 3D recipients, including, for the first time, 2 children and 3 teenagers. Preventive measures were represented by scanning time and sedation for children. Head wrapping was used in eight cases, and six of the eight cases received local anesthesia, even if both measures were not needed. Only three patients complained of pain (3/65 examinations, 4.6%) due to the tight head bandage, and one of the three cases required MRI scan interruption. No other adverse events were reported. We believe that these results should encourage MRI execution in accordance with manufacturer recommendations for Ultra 3D recipients.

Symptom management remains challenging in cancer care. Emerging from nutritional science, nutritional metabolomics has seen exponential growth over recent years, aiming to discern the relationship between dietary habits and health consequences. This protocol aims to present the rationale and methodology for conducting a scoping review to summarize the extent of evidence on synbiotics utilization in cancer symptom management among adults. The scoping review will be undertaken in accordance with the Joanna Briggs Institute (JBI) principles and the research process guided by the PRISMA 2020 scoping reviews extension. The following electronic databases will be searched from the inception: PubMed, Cinahl, Web of Science and Scopus. The authors expect to map the literature regarding the clinical outcomes, including patient-report measures and patient-experience measures, on which the effects of probiotics were tested, and identify potential gaps. This protocol presents a rigorous methodological approach to map the literature on the clinical outcomes that the utilization of synbiotics might improve. This analysis will shape future researchers to examine the efficacy of probiotics on specific clinical outcomes in oncology care. Nurses are uniquely positioned to influence cancer symptom management through the selection and use of appropriate interventions in the field of nutritional supplements, along with nutritional counseling.

Early detection and comprehensive diagnostic approaches for breast cancer are essential for improving prognosis. When it comes to changes in the skin of the breast or the nipple–areola complex (NAC), particularly if they are unilateral, it is essential to be vigilant, as these changes could be an early sign of underlying malignancy or other pathologies. Primary breast malignancies, such as mammary Paget’s disease (MPD), can manifest as erythema, scaling, or ulceration of the NAC, while secondary cutaneous metastases from other breast carcinomas may present as nodules, erythematous plaques, or inflammatory reactions. Non-malignant inflammatory conditions, including eczema or mastitis, can also mimic these changes; histologic evaluation is the gold-standard diagnostic tool. The usefulness of conventional diagnostic techniques breast lesions has been confirmed, but in recent years, reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) have emerged as additional tools to diagnose cases characterized by cutaneous changes; they may, therefore, result in new perspectives on the non-invasive diagnosis of MPD. RCM is a non-invasive diagnostic technique that allows high-resolution images of the skin at microscopic level in real time, offering a promising approach to the non-invasive diagnosis of MPD, particularly when a lesion is not clinically evident and may mimic other benign or inflammatory conditions. We describe an atypical clinical presentation of mammary Paget’s disease diagnosed early by reflectance confocal microscopy evaluation and confirmed histologically.

The primary factors that can be modified in one’s lifestyle are the most influential determinants and significant preventable causes of various types of cancer. Exercise has demonstrated numerous advantages in preventing cancer and aiding in its treatment. However, the precise mechanisms behind these effects are still not fully understood. To contribute to our comprehension of exercise’s impact on cancer immunotherapy and provide recommendations for future research in exercise oncology, we will examine the roles and underlying mechanisms of exercise on immune cells. In addition to reducing the likelihood of developing cancer, exercise can also improve the effectiveness of certain approved anticancer treatments, such as targeted therapy, immunotherapy, and radiotherapy. Exercise is a pivotal modulator of the immune response, and thus, it can play an emerging important role in new immunotherapies. The mechanisms responsible for these effects involve the regulation of intra-tumoral angiogenesis, myokines, adipokines, their associated pathways, cancer metabolism, and anticancer immunity. Our review assesses the potential of physical exercise as an adjuvant/neoadjuvant tool, reducing the burden of cancer relapse, and analyzes emerging molecular mechanisms predicting favorable adjuvanticity effects.

Anomaly detection is crucial in large-scale industrial manufacturing as it helps to detect and localize defective parts. Pre-training feature extractors on large-scale datasets is a popular approach for this task. Stringent data security, privacy regulations, high costs, and long acquisition time hinder the development of large-scale datasets for training and benchmarking. Despite recent work focusing primarily on the development of new anomaly detection methods based on such extractors, not much attention has been paid to the importance of the data used for pre-training. This study compares representative models pre-trained with fractal images against those pre-trained with ImageNet, without subsequent task-specific fine-tuning. We evaluated the performance of eleven state-of-the-art methods on MVTecAD, MVTec LOCO AD, and VisA, well-known benchmark datasets inspired by real-world industrial inspection scenarios. Further, we propose a novel method to create a dataset by combining the dynamically generated fractal images creating a “Multi-Formula” dataset. Even though pre-training with ImageNet leads to better results, fractals can achieve close performance to ImageNet under proper parametrization. This opens up the possibility for a new research direction where feature extractors could be trained on synthetically generated abstract datasets mitigating the ever-increasing demand for data in machine learning while circumventing privacy and security concerns.

Gliomas are the most common primary brain tumors, representing approximately 28% of all central nervous system tumors. These tumors are characterized by rapid progression and show a median survival of approximately 18 months. The therapeutic options consist of surgical resection followed by radiotherapy and chemotherapy. Despite the multidisciplinary approach and the biomolecular role of targeted therapies, the median progression-free survival is approximately 6–8 months. The incomplete tumor compliance with treatment is due to several factors such as the presence of the blood–brain barrier, the numerous pathways involved in tumor transformation, and the presence of intra-tumoral mutations. Among these, the interaction between the mutations of genes involved in tumor bio-energetic metabolism and the functional response of the tumor has become the protagonist of numerous studies. In this scenario, the main role is played by mitochondria, cellular organelles delimited by a double membrane and containing their own DNA (mtDNA), which participates in numerous cellular processes such as the regulation of cellular metabolism, cellular proliferation, and apoptosis and is also the main source of cellular energy production. Therefore, it is understood that the mitochondrion, specifically its functional alteration, is a leading figure in tumor transformation, including brain tumors. The acquisition of mutations in the mitochondrial DNA of tumor cells and the subsequent identification of the so-called mitochondria-related genes (MRGs), both functional (mutation of Complex I) and structural (mutations of Complex III/IV), have been seen to play an important role in metabolic reprogramming with increased proliferation, resistance to apoptosis, and the progression of tumorigenesis. This demonstrates that these mitochondrial alterations could have a role not only in the intrinsic tumor biology but also in the extrinsic one associated with the therapeutic response. We aim to summarize the main mitochondrial dysfunction interactions present in gliomas and how they might impact prognosis.

Photogrammetry is a common tool for evaluating ecosystem-scale questions on coral reefs due to the ability to measure complex structures in situ. This technique is also increasingly being used at smaller scales to collect growth and morphometric data about individual coral fragments in manipulative experiments. However, there are substantial uncertainties in data quality and interpretation and limited reporting of the parameters useful for standardization across studies. There is a need to characterize the capabilities of photogrammetry as applied to coral fragments, to establish validation metrics for reporting, and to determine sources of variation in measurements to refine and improve methods. Here, we used fragments of two common reef-building corals (Montipora capitata and Porites compressa) and known size standards to evaluate accuracy and precision and present suggested validation metrics. We also used a tiered experimental design to evaluate sources of error in a photogrammetry workflow in a manipulative experiment using a purpose-built multi-camera workstation. We demonstrate extremely high accuracy (R2 > 0.999) in determining the surface area and volume of known objects, as well as very high precision (average CV < 0.01) in coral measurements during tests of reproducibility. These outcomes show the utility of fragment photogrammetry for experimental coral reef science and present suggested validation metrics and approaches that can help standardize data evaluation and interpretation in any application of photogrammetry to coral fragments.

The WFS1 gene was first identified in Wolfram Syndrome 1 (WS1), a rare autosomal recessive genetic disorder characterized by severe and progressive neurodegenerative changes. WFS1’s role in various cellular mechanisms, particularly in calcium homeostasis and the modulation of endoplasmic reticulum (ER) stress, suggests its potential involvement in the pathogenesis of Alzheimer’s disease (AD) and sleep disorders. Because it is involved in maintaining ER balance, calcium signaling, and stress responses, WFS1 plays a multifaceted role in neuronal health. Numerous studies have shown that the absence or improper expression of WFS1 disrupts these cellular processes, leading to neurodegeneration and making neurons more vulnerable. In AD, WFS1 dysfunction is thought to contribute to the accumulation of amyloid-β (Aβ) plaques and tau tangles, thereby accelerating disease progression. Additionally, WFS1 plays an essential role in sleep regulation by influencing neuronal excitability and neurotransmitter release, which may explain the sleep disturbances frequently observed in neurodegenerative diseases. Due to its involvement in the pathological mechanisms of AD and sleep disorders, WFS1 is regarded as a potential early diagnostic marker for these diseases. Further research is required to fully elucidate WFS1’s role in the cellular pathway, perhaps facilitating the development of new therapeutic strategies for Alzheimer’s disease and sleep disorders.

Fucoidans, known for their diverse biological properties such as anti-inflammatory, antiviral, antitumor, and immune stimulatory effects, have recently gained attention for their potential benefits in exercise endurance, muscle mass, and anti-fatigue. However, the mechanisms by which fucoidans enhance exercise performance are still unclear. To investigate these effects, we administered 400 mg/kg/day of fucoidan extract derived from Undaria pinnatifida to 64 C57BL/6J mice over 10 weeks. We evaluated changes in running activity, mitochondrial-related gene expression in skeletal muscle, and alterations in the intestinal microbiome. Our results showed that fucoidan supplementation significantly increased daily running distance and muscle mass by 25.5% and 10.4%, respectively, in mice on a standard chow diet, and with more modest effects observed in those on a high-fat diet (HFD). Additionally, fucoidan supplementation led to a significant increase in beneficial gut bacteria, including Bacteroides/Prevotella, Akkermansia muciniphila, and Lactobacillus, along with a notable reduction in the Firmicutes/Bacteroidetes ratio, indicating improved gut microbiome health. Mechanistically, fucoidan supplementation upregulated the mRNA expression of key genes related to mitochondrial biogenesis and oxidative capacity, such as COX4, MYH1, PGC-1α, PPAR-γ, and IGF1, in both standard chow and HFD-fed mice. Our findings suggest that fucoidan supplementation enhances exercise performance, improves muscle function, and positively modulates the gut microbiome in mice, regardless of diet. These effects may be attributed to fucoidans’ potential prebiotic role, promoting the abundance of beneficial gut bacteria and contributing to enhanced exercise performance, increased muscle strength, and improved recovery.

The integration of automated vehicle (AV) technology in public transportation systems offers promising opportunities to improve the flexibility and safety of the traffic environment. However, user acceptance remains a critical challenge in the field of human-machine interaction for the effective deployment of shared autonomous vehicles (SAVs). This study presents a design framework aimed at enhancing user acceptance through human-machine interface (HMI) design tailored to SAVs. The framework is developed in adherence to relevant interaction design principles, following a systematic approach encompassing three key steps: analysis, synthesis, and evaluation. It integrates user acceptance factors into the design process, providing a structured method for designers. The framework was iteratively refined through interviews with three international domain experts; a focus group discussion with 10 researchers and professionals specializing in automotive interaction designers; and a workshop with 30 students and designers. The results demonstrate the framework’s ability to guide the development of user-acceptable HMI solutions. The paper concludes by emphasizing the need for further exploration into how user acceptance factors evolve over time and how real-world testing can validate the framework’s effectiveness in promoting user acceptance and satisfaction.

Microbial colonization of plastic polymers in Antarctic environments is an under-investigated issue. While several studies are documenting the spread of plastic pollution in the Ross Sea, whether the formation of a plastisphere (namely the complex microbial assemblage colonizing plastics) may favor the spread of antibiotic-resistant bacteria (ARB) in this marine environment is unknown yet. A colonization experiment was performed in this ecosystem, aiming at exploring the potential role of plastic polymers as a reservoir of antibiotic resistance. To this end, the biofilm-producing activity and the antibiotic susceptibility profiles of bacterial strains isolated from biofilms colonizing submerged polyvinylchloride and polyethylene panels were screened. The colonization experiment was carried out at two different sites of the Ross Sea, namely Road Bay and Tethys Bay. Most of bacterial isolates were able to produce biofilm; several multidrug resistances were detected in the bacterial members of biofilms associated to PVC and PE (also named as the plastisphere), as well as in the bacterial strains isolated from the surrounding water. The lowest percentage of ARB was found in the PE-associated plastisphere from the not-impacted (control) Punta Stocchino station, whereas the highest one was detected in the PVC-associated plastisphere from the Tethys Bay station. However, no selective enrichment of ARB in relation to the study sites or to either type of plastic material was observed, suggesting that resistance to antibiotics was a generalized widespread phenomenon. Resistance against to all the three classes of antibiotics assayed in this study (i.e., cell wall antibiotics, nucleic acids, and protein synthesis inhibitors) was observed. The high percentage of bacterial isolates showing resistance in remote environments like Antarctic ones, suffering increasing anthropic pressure, points out an emerging threat with a potential pathogenic risk that needs further deepening studies.

Wheat landraces are locally adapted populations that are suitable for low-input agronomic management and constraining pedo-climatic conditions. The productivity of landraces under high-input and optimal conditions is usually lower than modern wheat varieties. The present study compared the response of Sicilian wheat landraces and modern varieties to organic management, including organic fertilization, and conventional management, including mineral fertilization and chemical weed control, under rainfed condition and supplementary irrigation in a field trial conducted on a xerofluvent soil in a semiarid Mediterranean climate. Modern varieties were on average more productive than landraces, although certain landraces achieved comparable yields, in particular under organic management. The increase in grain yield under conventional management in comparison with the organic management was higher for modern varieties than landraces. The loss of productivity in rainfed conditions was lower for landraces compared to modern varieties. The grain quality traits were similar between landraces and modern varieties and in both cases the conventional management led to an improvement of the traits. These findings highlight the resilience and adaptability of traditional wheat landraces to low-input agricultural systems and offer valuable insights into improving the sustainability and productivity of wheat production in Mediterranean environments.

Acetylsalicylic acid (ASA) represents a cornerstone of antiplatelet therapy for the treatment of atherosclerotic coronary artery disease (CAD). ASA is in fact indicated in case of an acute coronary syndrome or after a percutaneous coronary intervention with stent implantation. Aspirin hypersensitivity is frequently reported by patients, and this challenging situation requires a careful evaluation of the true nature of the presumed sensitivity and of its mechanisms, as well as to differentiate it from a more frequent (and more easily manageable) aspirin intolerance. Two main strategies are available to allow ASA administration for patients with CAD and suspected ASA hypersensitivity: a low-dose ASA challenge, aimed at assessing the tolerability of ASA at the antiplatelet dose of 100 mg, and desensitization, a therapeutic procedure which aims to induce tolerance to ASA. For those patients who cannot undergo ASA challenge and desensitization due to previous serious adverse reactions, or for those in whom desensitization was unsuccessful, a number of further alternative strategies are available, even if these have not been validated and approved by guidelines. The aim of this state-of-the-art review is therefore to summarize the established evidence regarding pathophysiology, clinical presentation, diagnosis, and management of aspirin hypersensitivity and to provide a practical guide for cardiologists (and clinicians) who have to face the not uncommon situation of a patient with concomitant coronary artery disease and aspirin hypersensitivity.

The by-products of the extraction of sea buckthorn (Hippophae rhamnoides L.) concentrated juice may represent a functional food ingredient for white chocolate production, as a rich source of bioactive compounds. The effects of six treatments derived from the factorial combination of two types of by-products (with oil or without oil) and three different concentrations (5%, 10%, and 15%), were assessed on rheological, quality, colour, antioxidant, and mineral properties of chocolate. The 15% addition of full powder led to the highest values of max firmness, total shear energy, shear energy, cohesiveness, gummosity, dry matter, and ABTS, compared to the untreated control, but the two highest concentrations of the oil-deprived powder resulted in the protein content increasing. The full powder addition always raised fat levels. Both the ‘L’ and ‘a’ colour component as well as total carotenoids, β-carotene, lycopene, and vitamin C increased with the rise of H. rhamnoides powder addition, compared to the untreated control. The opposite trend was shown by the ‘b’ colour component and pH, whereas polyphenols and antioxidant activity attained higher values with the oil-deprived powder. The content of potassium decreased upon the 15% addition of the Hippophae rhamnoides by-product powder, compared to the untreated control, whereas calcium and magnesium increased. The 15% H. rhamnoides full powder elicited the augmentation of phosphorus content in chocolate, compared to the untreated control, contrary to the effect of the oil-deprived powder on P and Zn. The employment of SBB by-products highlights the great potential for manufacturing innovative functional foods with high nutritional value, such as chocolate.

The intraoral scanner represents an important innovation in the world of dentistry, capable of transforming and digitizing conventional workflows and significantly improving communication with the patient, especially in pediatric age. The aim of this study is to investigate how digital dentistry, using the intraoral scanner, can interact in the communicative trinomial dentist–pediatric patient–parents and how this tool can be useful in communicating and understanding the received message. The value of the introduction of digital dentistry on communication schemes is evaluated by administering a questionnaire of 17 questions. A sample of 100 children aged between 6 and 12 years was studied. Of the sample of children/parents included in the study, 50 were re-examined 4 weeks after the first visit to re-administer the questionnaire. Internal consistency, assessed through Cronbach’s alpha, was adequate, being alpha equal to 0.728. Test–retest reliability was assessed with Cohen’s kappa index for dichotomous variables (percentage of agreement was >85.71%), and for the discrete variables it was assessed with the Intraclass Correlation Coefficient (ICC). The reliability was moderate (0.5 < ICC < 0.75) for Q4, Q9, Q11 and Q1; for the other answers, the reliability was poor (ICC < 0.5) and not statistically significant. The digital approach is confirmed not only as a powerful innovation from an engineering or clinical point of view, but also as a useful tool for a more effective communication in the approach to pediatric patients.

Due to the ecologically unfavorable state of the living world, any formal commitment made by the accommodation sector for the practical implementation of corporate social responsibility (CSR) strategies needs to be followed up by a credible plan, courageous action, and an attentive monitoring and reporting phase. Only in this way can high-end hotels in cities emerge as regenerative sustainability (RS) hubs and better amalgamate whole life-cycle thinking and economic performance in their day-to-day activities. This paper provides a detailed literature review of the ongoing transformation of the hospitality sector toward the RS paradigm, which is a concept that underpins Hortel’s business model. Hortel is then contextualized as the first example of an eco-innovative turnkey business-to-business (B2B) service for a high-end hotel with an annexed restaurant. Hortel implemented nature-based solutions adapted to the hospitality sector in order to contribute to local urban biodiversity and bring hotel clients closer to nature through biophilic tactics. Services like Hortel can support, with today’s resources and competences, hotels that are putting at the core of their business model planetary health and societal well-being. It also includes the description of the prototype built at Four Points by Sheraton Catania, the monitoring phase that lasted between 2016 and 2017, and other strategic business-related initiatives. This paper also contributes to the advancement of the literature discussing regenerative business models, which to date has been a largely unexplored aspect of hospitality.

Introduction: Asthma and bronchiectasis are often partners in a complex but uneven relationship with asthma receiving more attention. The aim of this study is to describe how bronchiectasis is investigated in some Severe Asthma (SA) Centers, scattered throughout the Italian territory. Materials and Methods: We enrolled 92 patients with SA and bronchiectasis from eight Italian SA Centers and recorded diagnostic approaches to investigate SA and bronchiectasis at the time of enrollment (T0), at the 6-month (T1), and at the 12-month (T2) follow-up visits. Results: A statistically significant heterogeneous diagnostic approach emerged across the centers under study. In fact, while, as expected, all involved centers made an in-depth investigation of SA, only a few of them provided a complete investigation of bronchiectasis in order to provide specific treatment. Discussion: This real-life multicenter study confirmed that patients with coexistent SA and bronchiectasis are mainly investigated for pheno-endotyping asthma but rarely for the complete assessment of bronchiectasis. We believe that the diagnostic flowchart of SA patients with suspicion or confirmed bronchiectasis needs to be clarified and implemented as the association of these conditions strongly influences the final outcome and management of these patients.

The effects of three medicinal plants in the feeds of juvenile Nile tilapia (Oreochromis niloticus) were investigated on growth, survival, immunity, and digestive histology at various inclusion levels: (A) Guiera senegalensis at 0, 1, 2, 4, and 8%; (B) Pluchea odorata at 0, 0.5, 1, 2, and 4%; (C) Piliostigma reticulatum at 0, 1, and 2%; and (D) a mixture of the three at 0, 1, and 2%. After 28 days of feeding, fish were infected with Aeromonas hydrophila for 12 days. The results showed that, except for G. senegalensis, the inclusion of the medicinal plants, alone or combined, enhanced the immune response. The diet with 4% P. odorata significantly increased plasma lysozyme and bactericidal activities without affecting feed conversion efficiency or growth. Despite improved immunity, none of the treatments enhanced post-infection survival rates. However, fish fed the 1% mixture showed healthier livers and intestines, with reduced cell swelling and normal lipid deposits, followed by the 2% mixture and the control. These results highlight the potential benefits of incorporating P. odorata and the plant mixture into the diets of Nile tilapia juveniles for enhancing their immune response against A. hydrophila.

The journal retracts the article, “Ceftriaxone and Melittin Synergistically Promote Wound Healing in Diabetic Rats” [...]

The aim of this contribution is to present a segmentation method for the identification of voluntary movements from inertial data acquired through a single inertial measurement unit placed on the subject’s wrist. Inertial data were recorded from 25 healthy subjects while performing 75 consecutive reach-to-grasp movements. The approach herein presented, called DynAMoS, is based on an adaptive thresholding step on the angular velocity norm, followed by a statistics-based post-processing on the movement duration distribution. Post-processing aims at reducing the number of erroneous transitions in the movement segmentation. We assessed the segmentation quality of this method using a stereophotogrammetric system as the gold standard. Two popular methods already presented in the literature were compared to DynAMoS in terms of the number of movements identified, onset and offset mean absolute errors, and movement duration. Moreover, we analyzed the sub-phase durations of the drinking movement to further characterize the task. The results show that the proposed method performs significantly better than the two state-of-the-art approaches (i.e., percentage of erroneous movements = 3%; onset and offset mean absolute error < 0.08 s), suggesting that DynAMoS could make more effective home monitoring applications for assessing the motion improvements of patients following domicile rehabilitation protocols.

This study focused on vaccine hesitancy and decision regret about the COVID-19 vaccine among nursing students (BScN and MScN) and Registered Nurses (RNs) in Italy. The primary aim was to describe decision regret and vaccine hesitancy among these groups and to understand what influences vaccine hesitancy. Data were collected through an e-survey conducted from March to June 2024. The Decision Regret Scale and the Adult Vaccine Hesitancy Scale were employed to assess regret and hesitancy levels, assessing trust, concerns, and compliance regarding vaccination. Among the participants, 8.64% were not vaccinated. The results indicated moderate to high levels of decision regret and diverse levels of trust, concerns, and compliance with COVID-19 vaccination. Structural equation modeling revealed that decision regret significantly predicted Trust (R2 = 31.3%) and Concerns (R2 = 26.9%), with lower regret associated with higher trust and lower concerns about vaccine safety. The number of COVID-19 vaccine boosters was a significant predictor of Trust and Concerns, with more boosters associated with higher trust and lower concerns. MScN students exhibited higher Compliance compared to RNs (R2 = 2.9%), highlighting the role of advanced education. These findings suggest that addressing decision regret and providing comprehensive vaccine information could enhance trust and compliance.

Background: Bacillus cereus is a widespread environmental Gram-positive bacterium which is especially common in soil and dust. It produces two types of toxins that cause vomiting and diarrhea. At present, foodborne outbreaks due to Bacillus cereus group bacteria (especially Bacillus cereus sensu stricto) are rising, representing a serious problem in the agri-food supply chain. Methods: In this work, we analyzed 118 strains belonging to the Bacillus cereus group, isolated from several food sources, for which in vitro and in silico antibiotic resistance assessments were performed. Results: Many strains showed intermediate susceptibility to clindamycin, erythromycin, and tetracycline, suggesting an evolving acquisition of resistance against these antibiotics. Moreover, one strain showed intermediate resistance to meropenem, an antibiotic currently used to treat infections caused by Bacillus cereus. In addition to the phenotypic antimicrobial resistance profile, all strains were screened for the presence/absence of antimicrobial genes via whole-genome sequencing. There was inconsistency between the in vitro and in silico analyses, such as in the case of vancomycin, for which different isolates harbored resistance genes but, phenotypically, the same strains were sensitive. Conclusions: This would suggest that antibiotic resistance is a complex phenomenon due to a variety of genetic, epigenetic, and biochemical mechanisms.

Indole alkaloids, a class of plant-derived nitrogen-containing compounds, have emerged as promising candidates for osteoporosis treatment. Their favorable biocompatibility profile demonstrated efficacy in preclinical models, and low reported toxicity make them attractive alternatives to existing therapies. This review focuses on the therapeutic potential of specific indole alkaloids, including vindoline, rutaecarpine, harmine, and its derivatives, in promoting bone health and managing osteoporosis.

Background: The incidence of various types of cancer, for example, papillary thyroid carcinoma (PTC), is on the rise. Since therapeutic success depends greatly on early diagnosis, reliable diagnostic biomarkers must be identified, and easy-to-apply tools for detecting them must urgently be standardized. Here, we contribute to solving this medical challenge by assessing miRNAs suspected of promoting carcinogenesis in extracellular vesicles (EVs) that can be routinely obtained via liquid biopsy. We profit from current progress in cancerology that provides innovations in liquid biopsy and EVs analysis, along with the identification of miRNAs and chaperone system (CS) components implicated in carcinogenesis. Methods: We measured in EVs obtained from circulating blood plasma from PTC patients the levels of three miRNAs implicated in thyroid cancer, hsa-miR-1-3p, hsa-miR-206, and hsa-miR-221-3p, and most likely involved in the regulation of two members of the CS, Hsp60 and CCT. EVs were isolated from the plasma of patients with PTC and controls with benign goiter (BG) and from the culture medium of a PTC cell line (MDAT32) and were appropriately characterized. Results: The levels of miRNAs determined by RT-qPCR were consistently higher in PTC patients and decreased down to control levels after thyroidectomy. Bioinformatics showed that the miRNAs target genes are associated with the molecular pathogenesis of PTC. Conclusions: Our exploratory study reaffirms the potential in clinics of the selected miRNAs in EVs as useful biomarkers of PTC easily accessible via liquid biopsy, which is minimally invasive and amenable to periodic repetition, an improvement compared to the established fine-needle aspirate biopsy.

The Mediterranean coasts are threatened by human activities that alter habitats structure and functionality, modifying vegetation and causing the loss of typical species. The definition of the conservation status of coastal habitats is essential to preserve these fragile environments through planned policies. This study aims to assess the conservation status of the habitats of community interest (sensu EEC Directive 43/92) through the analysis of biodiversity and correlating it with urbanisation. A total of 73 vegetation relevés were carried out, so allowing 13 revealing different habitats to be identified. The total plant species diversity per habitat was measured by means of the H-index, also used to assess naturalness (N), differently considering native, alien, and disturbance species. To correlate the N index with distance from urban centres, a statistical analysis was performed. The analysis showed the highest values of H+ were found in habitats 2240, 2110, 2260, and 2230, while lowest values were observed in habitats 2270* and 2240. The habitats 2270* and 2240, the closest to urban centres, have a lower naturalness score than habitats 1420, 2120, 2250*, and 2270*, where higher naturalness scores have been found and therefore lower levels of disturbance. The criteria and methods discussed in this study can be used in coastal management in order to identify the most sensitive habitats and implement an effective conservation strategy.

Background and Objectives: There are numerous techniques for the surgical treatment of Achilles tendon lesions described in the literature, and it is possible to distinguish repair techniques as either open surgery or percutaneous repair techniques. Both approaches have advantages and disadvantages. With this retrospective study, we aim to analyze the incidence of re-ruptures and other complications, return to sport and overall quality of life at a long-term follow-up in the treatment of acute ATRs, comparing the results of percutaneous repair with those of open repair. Materials and Methods: This is a retrospective study on a consecutive series of patients with complete tear of the AT who were managed through a surgical approach by the Operative Unit of Orthopaedics and Traumatology of Sant’Anna University Hospital (Ferrara, Emilia-Romagna, Italy) between April 2014 and December 2021. Patients were treated with a percutaneous or an open technique according to the surgeon’s preference without randomization. Results: We considered 155 patients who met the established inclusion criteria. Of these, 103 (66.45%) patients underwent percutaneous treatment with the Tenolig® system, and 52 (33.55%) underwent open surgery, with an average ATRS in the first group of 92.5 compared to an average ATRS value of 82 in patients treated with the open technique. Conclusions: In our experience, following overlapping rehabilitation protocols in all patients included, we observed that the Tenolig® repair system led to a better ATRS at long-term follow-up, with comparable complication rates to open surgery.

In the manufacture of ancient books, it was quite common to insert written scraps belonging to earlier library material into bookbindings. For scholars like codicologists and paleographers, it is extremely important to have the possibility of reading the text lying on such scraps without dismantling the book. In this regard, in this paper, we report on the detection of these texts by means of infrared (IR) pulsed thermography (PT), which, in recent years, has been specifically proven to be an effective tool for the investigation of Cultural Heritage. In particular, we present a quantitative analysis based, for the first time, on PT images obtained from books of historical relevance preserved at the Biblioteca Angelica in Rome. The analysis has been carried out by means of a theoretical model for the PT signal, which makes use of two image parameters, namely, the distortion and the contrast, related to the IR readability of the buried texts. As shown in this paper, the good agreement between the experimental data obtained in the historical books and the theoretical analysis proved that the capability of the adopted PT method could be fruitfully applied, in real case studies, to the detection of buried texts and to the quantitative characterization of the parameters affecting their thermal readability.

Recent agricultural research has prioritized the development of environmentally friendly management strategies to ensure food security, among which the application of biostimulants such as brown algae extracts, arbuscular mycorrhizal fungi (AMF), and their combination are included. The experimental protocol was based on the factorial combination of two planting times (4 May and 1 June) and seven biostimulant treatments (three brown algae species, Cystoseria tamariscifolia—C.t.; Fucus vesiculosus—F.v.; Padina pavonica—P.p.; arbuscular mycorrhizal fungi—AMF; C.t. + AMF; F.v. + AMF; P.p. + AMF) plus an untreated control. The earlier transplant resulted in a higher yield, due to the higher number of fruits per plant, and a higher plant fresh and dry biomass. The treatments with P.p. and F.v. extracts and the combination P.p. + AMF led to the highest yields (56.7 t ha−1), mainly due to the highest fruit number per plant. The earlier planting time led to higher values of dry residue, soluble solids, firmness, and colour component ‘a’. The highest values of fruit dry residue were recorded under the F.v. and P.p. extracts, and the combinations F.v. + AMF and P.p. + AMF, the highest soluble solid content with P.p. treatment, and firmness under P.p. + AMF. The highest levels of ‘L’ and ‘a’ fruit colour components were obtained under the P.p. extract treatment, of ‘b’ upon the application of P.p. and F.v. extract, and AMF + P.p. and AMF + F.v. The later planting time led to significantly higher values of the antioxidant parameters, as did the application of the P.p. extract and P.p. + AMF. CAT activity was more intense corresponding to the later tomato crop cycle, P.p. extract, and AMF + P.p. Overall, our study highlights the potential of biostimulants, particularly brown algae extracts and their combination with AMF, to improve tomato yield, antioxidant properties, and biochemical activities.

Fish oil, renowned for its high content of omega-3 fatty acids, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), has gained considerable attention for its potential health benefits. EPA and DHA exhibit anti-inflammatory effects by promoting the production of specialized pro-resolving mediators (SPMs), such as resolvins and protectins. Fish oil has been studied for its potential to reduce bronchial inflammation, a key feature of respiratory conditions like asthma and COPD. This study investigates the cellular mechanisms of fish oil in an in vitro model of lung inflammation using lipopolysaccharide (LPS) on a healthy human bronchial epithelium cell line. LPS exposure for 24 h reduced cell viability, elevated reactive oxygen species (ROS), depleted glutathione (GSH), and induced mitochondrial depolarization, indicating oxidative stress and inflammation. Fish oil administration significantly mitigated ROS production, prevented GSH depletion, and reduced mitochondrial depolarization. This was associated with the upregulation of the endogenous antioxidant system, evidenced by restored GSH levels and the increased gene expression of glutathione peroxidase (GPX), catalase (CAT), superoxide dismutase 1 (SOD1), and superoxide dismutase 2 (SOD2). Fish oil also suppressed IL-6 and IL-1β expression and increased anti-inflammatory cytokine IL-10 expression. Furthermore, fish oil upregulated the expression of pro-resolving mediator receptors, suggesting a role in inflammation resolution. These findings highlight the potential of fish oil supplementation as a preventive measure against pulmonary diseases characterized by unresolved inflammation such as lung inflammation.

Cyclic-nucleotide phosphodiesterases (PDEs) represent a superfamily of enzymes playing a pivotal role in cell signaling by controlling cAMP and cGMP levels in response to receptor activation. PDE activity and expression are linked to many diseases including inflammatory diseases. In light of their specific biochemical properties, PDE inhibition has attracted the interest of several researrs In this context, PDE4 inhibition induces anti-inflammatory effects. Piclamilast and rolipram, well-known PDE4 inhibitors, are endowed with common side effects. The selective phosphodiesterase 4B (PDE4B) inhibitors could be a promising approach to overcome these side effects. In the present study, six potential PDE4B inhibitors have been investigated. Through this study, we identified three PDE4B inhibitors in human macrophages activated by lipopolysaccharide. Interestingly, two of them reduced reactive oxygen species production in pro-inflammatory macrophages.

This study describes a high-performance second-generation Current Conveyor (CCII) operating at 0.35 V and achieving rail-to-rail operation at the Y terminal and class AB current drive at the X and Z terminals. The solution utilizes a low-voltage subthreshold bulk-driven CMOS OTA that was experimentally developed earlier, making systematic use of body terminals to improve small-signal and large-signal performance. The circuit has a high open-loop voltage gain and uses cascoded current mirror topologies, resulting in precise voltage and current transfer with bandwidths of 1.33 MHz and 2.13 MHz, respectively. The CCII offers a linear current drive up to 2.5 µA while consuming a total quiescent current of 2.86 µA (758 nA in the output branches), displaying one the highest figures of merit in terms of current utilization for sub 1 V solutions.

Information on the flyer deformation during laser impact welding (LIW) is an important aspect to consider when high reliability of the welded components is required. For this reason, accurate numerical models simulating thermal and mechanical aspects are needed. In the present work, the cross-section morphology during LIW of Ti/Brass joints at varying laser pulse energies is modeled by a 2D finite element (FE) model. A hydrodynamic plasma pressure model able to describe the evolution of the pressure load step by step, taking into account the progressive deformation of the flyer, was implemented. Hence, this paper proposes an alternative method to the conventional node concentrated forces or predefined velocity as flyer boundary conditions. The levels of the equivalent plastic strain (PEEQ), shear stress, and critical flyer velocity at the collision point were used as reference parameters to predict the success of the welding bond, distinguishing the welded area from the unwelded area. The model was validated by comparison with the experimental data, which showed the effectiveness of the proposed FE code in predicting the cross-section morphology of the welded materials. Moreover, practical industrial information such as variation in the flyer impact velocity, collision angle, and process temperatures was predicted by varying the process laser pulse energy according to the basic principle of the process.

Incorporating insect meals into poultry diets has emerged as a sustainable alternative to conventional feed sources, offering nutritional, welfare benefits, and environmental advantages. This study aims to monitor and compare volatile compounds emitted from raw poultry carcasses and subsequently from cooked chicken pieces from animals fed with different diets, including the utilization of insect-based feed ingredients. Alongside the use of traditional analytical techniques, like solid-phase microextraction combined with gas chromatography-mass spectrometry (SPME-GC-MS), to explore the changes in VOC emissions, we investigate the potential of S3+ technology. This small device, which uses an array of six metal oxide semiconductor gas sensors (MOXs), can differentiate poultry products based on their volatile profiles. By testing MOX sensors in this context, we can develop a portable, cheap, rapid, non-invasive, and non-destructive method for assessing food quality and safety. Indeed, understanding changes in volatile compounds is crucial to assessing control measures in poultry production along the entire supply chain, from the field to the fork. Linear discriminant analysis (LDA) was applied using MOX sensor readings as predictor variables and different gas classes as target variables, successfully discriminating the various samples based on their total volatile profiles. By optimizing feed composition and monitoring volatile compounds, poultry producers can enhance both the sustainability and safety of poultry production systems, contributing to a more efficient and environmentally friendly poultry industry.

Genomic surveillance based on sequencing the entire genetic code of SARS-CoV-2 involves monitoring and studying genetic changes and variations in disease-causing organisms such as viruses and bacteria. By tracing the virus, it is possible to prevent epidemic spread in the community, ensuring a ‘precision public health’ strategy. A peptide-based design was applied to provide an efficacious strategy that is able to counteract any emerging viral variant of concern dynamically and promptly to affect the outcomes of a pandemic at an early stage while waiting for the production of the anti-variant-specific vaccine, which require longer times. The inhibition of the interaction between the receptor-binding domain (RBD) of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and one of the cellular receptors (DPP4) that its receptors routinely bind to infect human cells is an intriguing therapeutic approach to prevent the virus from entering human cells. Among the other modalities developed for this purpose, peptides surely offer unique advantages, including ease of synthesis, serum stability, low immunogenicity and toxicity, and small production and distribution chain costs. Here, we obtained a potent new inhibitor based on the rearrangement of a previously identified peptide that has been rationally designed on a cell dipeptidyl peptidase 4 (DPP4) sequence, a ubiquitous membrane protein known to bind the RBD-SPIKE domain of the virus. This novel peptide (named DPP4-derived), conceived as an endogenous “drug”, is capable of targeting the latest tested variants with a high affinity, reducing the VSV* DG-Fluc pseudovirus Omicron’s infection capacity by up to 14%, as revealed by in vitro testing in human Calu-3 cells. Surface plasmon resonance (SPR) confirmed the binding affinity of the new DPP4-derived peptide with Omicron variant RBD.

This paper presents a practical method for analyzing drivers’ eye movements, providing a valuable tool for understanding their behavior during driving simulations. The method, which utilizes an image processing technique, addresses the challenges when the driver’s attention is on points without information about the image depth. The screen image changes or moves with the simulation. It allows us to identify the gaze position relative to the road, determining whether the glance is inside or outside. This is achieved by transforming RGB images (frames) collected by the eye-tracker video camera into a b/w image using the Canny filter. This filter can identify objects’ contours by evaluating the change in color of their surfaces. A window is then applied to these new images to extract information about the gaze position in the real world. Four drivers were used as a sample for the method’s testing. The findings demonstrate various driver variations and a disparity between driving in curved and rectilinear segments. The gaze is typically inside the road in curved sections, whereas in rectilinear sections, the gaze is frequently outside.

Hypereosinophilic syndrome (HES) encompasses a heterogeneous and complex group of different subtypes within the wider group of hypereosinophilic disorders. Despite increasing research interest, several unmet needs in terms of disease identification, pathobiology, phenotyping, and personalized treatment remain to be addressed. Also, the prospective burden of non-malignant HES and, more in general, HE disorders is currently unknown. On a practical note, shortening the diagnostic delay and the time to an appropriate treatment approach probably represents the most urgent issue, even in light of the great impact of HES on the quality of life of affected patients. The present document represents the first action that the Italian Society of Allergy, Asthma, and Clinical Immunology (SIAAIC) has finalized within a wider project aiming to establish a collaborative national network on HES (InHES—Italian Network on HES) for patients and physicians. The first step of the project could not but focus on defining a common language as well as sharing with all of the medical community an update on the most recent advances in the field. In fact, the existing literature has been carefully reviewed in order to critically integrate the different views on the topic and derive practical recommendations on disease identification and treatment approaches.

Breast cancer is the most common malignancy among women and is the second leading cause of cancer-related death for women. Depending on the tumor grade and stage, breast cancer is primarily treated with surgery and antineoplastic therapy. Direct or indirect side effects, emotional trauma, and unpredictable outcomes accompany these traditional therapies, calling for therapies that could improve the overall treatment and recovery experiences of patients. Hydrogels, biomimetic materials with 3D network structures, have shown great promise for augmenting breast cancer therapy. Hydrogel implants can be made with adipogenic and angiogenic properties for tissue integration. 3D organoids of malignant breast tumors grown in hydrogels retain the physical and genetic characteristics of the native tumors, allowing for post-surgery recapitulation of the diseased tissues for precision medicine assessment of the responsiveness of patient-specific cancers to antineoplastic treatment. Hydrogels can also be used as carrier matrices for delivering chemotherapeutics and immunotherapeutics or as post-surgery prosthetic scaffolds. The hydrogel delivery systems could achieve localized and controlled medication release targeting the tumor site, enhancing efficacy and minimizing the adverse effects of therapeutic agents delivered by traditional procedures. This review aims to summarize the most recent advancements in hydrogel utilization for breast cancer post-surgery tissue reconstruction, tumor modeling, and therapy and discuss their limitations in clinical translation.

The high biological activity of cultivated and wild purslane offers broad possibilities for utilizing this plant in medicine and human nutrition. To assess the prospects of obtaining new functional food products based on the wild form of P. oleracea L., foliar biofortification of this species with sodium selenate (VI) was carried out, and the changes in leaf and seed biochemical characteristics were investigated. Selenium significantly enhanced plant yield, photosynthetic pigments and the ascorbic acid content, and showed a tendency to seed productivity increase. The application of selenium augmented quinic acid content in leaves by 1.7 times but did not affect the oxalic acid content. Oxalic acid prevailed in wild purslane and quinic acid in cultivated purslane (cv. Makovey). Seed oil in Se-enriched purslane was characterized by a two-fold decrease in saturated fatty acids and squalene and 2.3-fold decrease in malonic dialdehyde content, along with a 1.4-fold increase in ascorbic acid. Selenium supplementation resulted in an increase in total lipids and mono- and di-unsaturated fatty acids and did not affect the concentration of ω-3 fatty acids and sterol accumulation. Among the identified sterols, only the minor ones (fucosterol, 7-stigmasterol and ∆7-avenosterol) showed a slight decrease upon Se supply. Compared to seeds of cv. Makovey, wild purslane seeds had higher levels of antioxidant activity by a factor of 2 and of polyphenols by a factor of 3.2 but did not differ significantly in oil fatty acid composition. The results indicate the importance of wild purslane leaves/seeds both fortified and not fortified with Se in human nutrition and medicine.

Sweet cherry grown under sustainable management produces highly valuable fruits, whose quality shows important biochemical and morphological changes during ripening. Research was carried out in Iasi (Romania), with the aim to assess the quality characteristics of the sweet cherry fruits of three cultivars (Van, Andreiaș, Margonia), grown in an inner or outer position inside the tree crown, at the pre-ripening or full ripeness phase. In 2022, the colour component a* showed higher values in cv. Van and Andreias red fruits and in an inner position, whereas the components L* and b* at the full ripeness phase were highest in cv. Margonia. The dry matter and total soluble solids contents increased from the pre-ripening to the full ripeness phase and were highest in cv. Van sweet cherry fruits; the DM of fruit from the outer part of crown was higher than that of fruit from the inner part at the pre-ripening phase. The content of phenolics was the highest in cv. Margonia fruits at the pre-ripening stage and in cv. Van at the full ripeness phase and higher in the inner tree crown zones. The cultivar Margonia generally showed the highest vitamin C content in both years and development phases. The yellow fruit cv. Margonia mostly showed the highest values of chlorophyll a and b. The fruit’s content of carotene, lycopene, and anthocyanins was generally the highest in the red fruits of cv. Andreias. The examined sweet cherry cultivars showed a high variability in fruit nutritional quality and proved to be a rich source of bioactive compounds with antioxidant potential.

Background: Diencephalic Syndrome is an atypical early manifestation of low-grade gliomas; so, it is important to detect it in patients that experience a failure to thrive despite adequate length growth and food intake. The purpose of this article is to focus attention on this rare but potentially dangerous cause of poor weight gain or stunting in childhood. Materials and Methods: We describe four patients with Diencephalic Syndrome and low-grade gliomas who were evaluated in our institution from January 2017 to December 2021. Case Description and Results: two patients presented with suspected malabsorption, and two presented with a suspected eating disorder. In all cases, neurological symptoms appeared late, explaining the reason for the diagnostic delay, which impacts negatively on prognosis and on quality of life. Currently, patients 1 and 2 have stable disease in second-line therapy, patient 3 has stable disease post end of second-line therapy, and patient 4 has stable disease in first-line therapy. Everyone is in psychophysical rehabilitation. Conclusions: A multidisciplinary evaluation is essential in order to make an early diagnosis and improve prognosis and quality of life.

Introduction: The COVID-19 pandemic has had a considerable impact on the psychological and psychopathological status of the population and health care workers in terms of insomnia, anxiety, depression, and post-traumatic stress disorder. The primary aim of this study was to describe and evaluate the impact of the pandemic on insomnia levels of a cohort of Italian nurses, particularly those involved in the care of COVID-19 patients. The secondary aim was to identify the interaction between insomnia and hardiness, anxiety, and sleep disturbances. Materials and Methods: A descriptive–exploratory study was conducted using an online survey during the first wave of the COVID-19 pandemic (March to July 2020). The questionnaire consisted of multiple-choice, open-ended, closed, and semi-closed questions. The psychometric tools administered were the Dispositional Resilience Scale (DRS-15), the State–Trait Anxiety Inventory (STAI-Y), and the Insomnia Severity Index (ISI). Results: a cohort of 1167 nurses fully completed the questionnaire (86.2% of total respondents). The insomnia scale survey showed an increase in post-pandemic scores compared to those before the pandemic, implying that insomnia levels increased after the first pandemic wave. Insomnia scores were directly correlated with anxiety levels (r = 0.571; p ≤ 0.05) and inversely correlated with hardiness levels (r = −0.324; p < 0.001). Multivariate analysis revealed the following protective factors: not having worked in COVID-19 wards, high levels of hardiness (commitment), and the presence of high pre-pandemic insomnia disorder. The main risk factor for insomnia reported in the analysis was a high anxiety score. Discussion and Conclusion: Anxiety represented the main risk factor for insomnia severity in our sample, while hardiness was confirmed as a protective factor. Thus, it is necessary to design further studies to identify additional risk factors for poor sleep quality and to develop educational courses and strategies aimed at enhancing rest and sleep quality, especially for frontline nurses.

Nurse managers play a vital role in healthcare organizations, wielding the ability to substantially enhance work environments, foster nurses’ autonomy, and bolster retention within workplaces. In this context, this study focuses on the Nurse Manager Actions scale, aiming to evaluate its items’ scalability as well as the scale’s validity and reliability among nurses and nurse managers operating within the Italian healthcare context. The study protocol was not registered. To ensure linguistic and cultural alignment, an iterative and collaborative translation process was undertaken. Subsequently, a multi-center cross-sectional design was adopted. Using a web-survey approach, data were collected among 683 nurses and 188 nurse managers between August 2022 and January 2023. The Nurse Manager Actions scale was found to be a valid and reliable instrument in Italian after a Mokken Scale Analysis. For nurses (HT= 0.630, Molenaar–Sijtsma rho = 0.890), the scale included 6 items, while 11 items were confirmed for nurse managers (HT= 0.620, Molenaar–Sijtsma rho = 0.830). Nurse Manager Actions scale scores were correlated with increased satisfaction and decreased intention to leave for both nurses and nurse managers. The employed validation process enhanced the scale validity for use in Italy and provided a model for other researchers to follow when assessing similar measures in different populations. Measuring and empowering nurse manager actions in work contexts is essential to improve the general well-being and retention of nurses, especially in the current nursing shortage.