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The Mediterranean Sea is known to be a hot spot for marine biodiversity, especially if considering the highly specialized Heterobranchia mollusks. In recent years, there has been increasing effort to fill some knowledge gaps existing on Mediterranean heterobranch diversity, but, to date, several potentially interesting habitats remain unexplored. In fact, most studies have been focused on sea slugs inhabiting coastal areas and lakes, but those living in extremely variable areas like Mediterranean rocky tide pools remain almost completely ignored even if it is reported worldwide that they can host a high sea slug diversity. In this context, the rocky tide pool system near the ‘Passetto’ urban beach (Ancona, Italy) in the North Adriatic Sea (Mediterranean Sea) represents a biodiversity hot spot, highlighting the importance of the conservation of this peculiar habitat. A preliminary quantitative survey on the associated Heterobranchia unveiled a thriving community residing in this limited and fragile habitat, and it inspired a more detailed investigation as performed in the present study. In order to reveal the presence of species that have gone unnoticed, an in-depth study was carried out between 2018 and 2022, which aimed to amplify the knowledge on this vulnerable environment and the fauna associated with this as yet poorly known habitat. Tide pooling activities corroborated by photographic analyses allowed the recording of 45 taxa in total and the addition of 25 species to the previously known list. Within those, (i) two species were potentially new to science, (ii) one was recorded in the Mediterranean Sea for the first time, (iii) two species were added to the Italian fauna, and (iv) one species constituted a new record for Sector 9 of the Italian Seas.

Endoluminal biliary radiofrequency ablation (RFA) has been proposed as a palliative treatment for patients with malignant biliary obstruction (MBO) in order to improve stent patency and survival. However, the existing data on patients with inoperable extrahepatic cholangiocarcinoma (eCCA) are conflicting. We performed a meta-analysis of randomized trials comparing RFA plus stenting versus stenting alone in patients with inoperable eCCA. We searched for trials published in the PubMed/MEDLINE, Scopus, and Cochrane databases up to November 2023. Data extraction was conducted from published studies, and a quality assessment was carried out in accordance with the guidelines recommended by the Cochrane Collaboration. Hazard ratios (HRs) with 95% CI were estimated from the trials. The primary endpoints of interest were overall survival and stent patency. Out of 275 results, 5 randomized trials and 370 patients were included. While overall survival was not different between the groups (HR 0.62; 95% CI 0.36–1.07; p = 0.09; I2 = 80%;), the subgroup analysis of studies employing plastic stents showed a trend toward better survival in the RFA-treated group (HR 0.42; 95% CI 0.22–0.80; p = 0.009; I2 = 72%). Stent patency was improved in patients receiving RFA (HR 0.64; 95% CI 0.45–0.90; p = 0.01; I2 = 23%). Adverse events were not different between the groups (OR 1.21; 95% CI 0.69–2.12; p = 0.50; I2 = 0%). Despite the promising results, high heterogeneity and potential biases in the included studies suggest the need for further high-quality randomized trials to explore the potential cumulative effects of RFA on CCA treatment outcomes.

Myeloproliferative neoplasms (MPNs) are the leading causes of unusual site thrombosis, affecting nearly 40% of individuals with conditions like Budd–Chiari syndrome or portal vein thrombosis. Diagnosing MPNs in these cases is challenging because common indicators, such as spleen enlargement and elevated blood cell counts, can be obscured by portal hypertension or bleeding issues. Recent advancements in diagnostic tools have enhanced the accuracy of MPN diagnosis and classification. While bone marrow biopsies remain significant diagnostic criteria, molecular markers now play a pivotal role in both diagnosis and prognosis assessment. Hence, it is essential to initiate the diagnostic process for splanchnic vein thrombosis with a JAK2 V617F mutation screening, but a comprehensive approach is necessary. A multidisciplinary strategy is vital to accurately determine the specific subtype of MPNs, recommend additional tests, and propose the most effective treatment plan. Establishing specialized care pathways for patients with splanchnic vein thrombosis and underlying MPNs is crucial to tailor management approaches that reduce the risk of hematological outcomes and hepatic complications.

Primary Biliary Cholangitis (PBC) is a chronic cholestatic liver disease with a heterogeneous presentation, symptomatology, disease progression, and response to therapy. The current risk stratification assessment, aimed at identifying patients with a higher risk of disease progression, encompasses an in-depth analysis of demographic data, clinical and laboratory findings, antibody profiles, and the evaluation of liver fibrosis using both invasive and noninvasive techniques. Treatment response scores after one year of therapy remain to date a major factor influencing the prognosis of PBC patients. While the initial therapeutic approach with ursodeoxycholic acid (UDCA) is universally applied, new second-line treatment options have recently emerged, with many others under investigation. Consequently, the prevailing one-size-fits-all approach is poised to be supplanted by tailored strategies, ensuring high-risk patients receive the most appropriate treatment regimen from diagnosis. This will require the development of a risk prediction model to assess, at the time of diagnosis, the course, outcome, and response to first and additional treatments of PBC patients. This manuscript provides a comprehensive overview of the current and emerging tools used for risk stratification in PBC and speculates on how these developments might shape the disease landscape in the near future.

Cholangiocarcinoma (CCA) is an aggressive neoplasia with an increasing incidence and mortality. It is characterized by a strong desmoplastic stroma surrounding cancer cells. Cancer-associated fibroblasts (CAFs) are the main cell type of CCA stroma and they have an important role in modulating cancer microenvironments. CAFs originate from multiple lines of cells and mainly consist of fibroblasts and alpha-smooth muscle actin (α-SMA) positive myofibroblast-like cells. The continuous cross-talking between CCA cells and desmoplastic stroma is permitted by CAF biochemical signals, which modulate a number of pathways. Stromal cell-derived factor-1 expression increases CAF recruitment to the tumor reactive stroma and influences apoptotic pathways. The Bcl-2 family protein enhances susceptibility to CAF apoptosis and PDGFRβ induces fibroblast migration and stimulates tumor lymphangiogenesis. Many factors related to CAFs may influence CCA prognosis. For instance, a better prognosis is associated with IL-33 expression and low stromal IL-6 (whose secretion is stimulated by microRNA). In contrast, a worst prognosis is given by the expression of PDGF-D, podoplanin, SDF-1, α-SMA high expression, and periostin. The maturity phenotype has a prognostic relevance too. New therapeutic strategies involving CAFs are currently under study. Promising results are obtained with anti-PlGF therapy, nintedanib (BIBF1120), navitoclax, IPI-926, resveratrol, and controlled hyperthermia.

We describe a THz spectrometer operating between 1.2 and 10.5 THz, consisting of band pass filters made by metasurfaces. The source is made of a 10 W small black body. The detector is a high sensitivity room temperature pyroelectric sensor. Various techniques that are used to prepare samples are described. The spectra obtained are compared with those measured with a Fourier Transformer Infrared Spectrometer on the same samples. Our instrument, which uses commercial technologies available at the present time, can constitute an economical alternative to very expensive spectrometers. It has already been successfully used, obtaining precise spectroscopic measurements on many inorganic powders.

This research concerns the issue of landscape risk due to the progressive spread of construction in rural areas through the creation of a “site-specific” analysis and evaluation model and its application to the context of the municipal area of Noto (Italy). The phenomenon of construction in rural areas was facilitated by the regulatory evolution of the Sicilian Region, which supported the construction of artifacts in agricultural areas to boost cultivation and production, but which, for the most part, was intended for seasonal residential use. In particular, the municipal territory of Noto is characterized by remarkable landscape values, including very low building density, large portions of the territory remaining almost uncontaminated, and the widespread presence of cultural and ethno-anthropological assets. Consequently, the demand for localization in rural areas, now also driven by the tendency to decongest dense urban areas in order to contain the effects of the pandemic, is a phenomenon that must be countered, on the one hand, and addressed and regulated on the other. The objective of this study is to provide the local administration with a planning tool to determine permissible interventions in various areas of the landscape context. This has guided the process of representing the phenomenon in quantitative and spatial terms, and of evaluating the territory targeted. A large set of data, coordinated in a hierarchical set of indices by means of a multidimensional valuation approach, allows us to provide an orderly and robust representation of the resilience of the landscape at risk from building pressure while considering multiple perspectives.

In order to estimate the seismic vulnerability of a densely populated urban area, it would in principle be necessary to evaluate the dynamic behaviour of individual and aggregate buildings. These detailed seismic analyses, however, are extremely cost-intensive and require great processing time and expertise judgment. The aim of the present study is to propose a new methodology able to combine information and tools coming from different scientific fields in order to reproduce the effects of a seismic input in urban areas with known geological features and to estimate the entity of the damages caused on existing buildings. In particular, we present a new software called ABES (Agent-Based Earthquake Simulator), based on a Self-Organized Criticality framework, which allows to evaluate the effects of a sequence of seismic events on a certain large urban area during a given interval of time. The integration of Geographic Information System (GIS) data sets, concerning both geological and urban information about the territory of Avola (Italy), allows performing a parametric study of these effects on a real context as a case study. The proposed new approach could be very useful in estimating the seismic vulnerability and defining planning strategies for seismic risk reduction in large urban areas