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Abstract Introduction Photobiomodulation (PBM) has become a promising approach for slowing the progression of early and intermediate dry age-related macular degeneration (dAMD) to advanced AMD. This technique uses light to penetrate tissues and activate molecules that influence biochemical reactions and cellular metabolism. This preliminary analysis is aimed at assessing the safety, tolerability, and short-term effectiveness of the EYE-LIGHT®PBM treatment device in patients with dAMD. Methods The EYE-LIGHT® device employs two wavelengths, 590 nm (yellow) and 630 nm (red), in both continuous and pulsed modes. Patients over 50 years of age with a diagnosis of dAMD in any AREDS (Age-Related Eye Disease Study) category were randomly assigned to either the treatment group or the sham group. The treatment plan consisted of an initial cycle of two sessions per week for 4 weeks. Safety, tolerability, and compliance outcomes, along with functional and anatomical outcomes, were assessed at the end of the fourth month. Results This preliminary analysis included data from 76 patients (152 eyes). All patients were fully compliant with treatment sessions, and only one fifth of patients treated with PBM reported mild ocular adverse events, highlighting exceptional results in terms of tolerability and adherence. Changes in best-corrected visual acuity (BCVA) from baseline to month 4 differed significantly between the sham and PBM-treated groups, favoring the latter, with a higher proportion achieving a gain of five or more letters post-treatment (8.9% vs. 20.3%, respectively; p = 0.043). No significant differences in central subfield thickness (CST) were observed between the two groups over the 4-month period. The study also found a statistically significant disparity in mean drusen volume changes from baseline to month 4 between the groups in favor of patients treated with PBM (p = 0.013). Conclusion These preliminary results indicate that PBM treatment using the EYE-LIGHT® system is safe and well tolerated among patients with dAMD. Furthermore, both functional and anatomical data support the treatment’s short-term efficacy. Trial Registration ClinicalTrials.gov identifier NCT06046118.

ABSTRACTInfectious diseases pose a significant burden on the general population, particularly older adults who are more susceptible to severe complications. Immunization plays a crucial role in preventing infections and securing a healthier aging, but actual vaccination rates among older adults and frail individuals (OAFs) remains far from recommended targets. This study aims to collect and share good practices implemented in several Italian local health districts during the SARS-CoV-2 pandemic to ease routine immunization for OAFs. A 28-items questionnaire has been developed to collect information on organization aspect of immunization services and local good practices implemented before and during the SARS-CoV-2 pandemic. Twelve Public Health managers representative of 9 Italian Regions were further interviewed between January and March 2021. Despite literature suggests several effective interventions to increase vaccine demand, improve vaccine access, and enhance healthcare providers’ performance, our survey highlighted substantial heterogeneity in their implementation at local level. Seven good local practices have been identified and described: mass vaccination centers; vaccination mobile units; drive-through vaccination; co-administration; tailored pathways; cooperation among providers involved in vaccination; digitization. Our survey pointed out valuable strategies for enhancing routine immunization for OAFs. Providers should combine effective interventions adequate to their specific context and share good practices.

Abstract Objective In gout, monosodium urate crystals are taken up by macrophages, triggering the activation of the NLRP3 inflammasome and the maturation of IL-1β. This study aimed to investigate the role of integrin CD11b in inflammasome activation in macrophages stimulated by MSU. Methods BMDM from WT and CD11b KO mice were stimulated in vitro with MSU crystals. Cellular supernatants were collected to assess the expression of the inflammatory cytokines by enzyme-linked immunosorbent assay and western blot methods. The role of integrin CD11b in MSU-induced gouty arthritis in vivo was investigated by intra-articular injection of MSU crystals. Real-time extracellular acidification rate and oxygen consumption rate of BMDMs were measured by Seahorse Extracellular Flux Analyzer. Results We demonstrate that CD11b-deficient mice developed exacerbated gouty arthritis with increased recruitment of leukocytes in the joint and higher IL-1β levels in the sera. In macrophages, genetic deletion of CD11b induced a shift of macrophage metabolism from oxidative phosphorylation to glycolysis, thus decreasing the overall generation of intracellular ATP. Upon MSU stimulation, CD11b-deficient macrophages showed an exacerbated secretion of IL-1β. Treating wild-type macrophages with a CD11b agonist, LA1, inhibited MSU-induced release of IL-1β in vitro and attenuated the severity of experimental gouty arthritis. Importantly, LA1, was also effective in human cells as it inhibited MSU-induced release of IL-1β by peripheral blood mononuclear cells from healthy donors. Conclusion Our data identified the CD11b integrin as a principal cell membrane receptor that modulates NLRP3 inflammasome activation by MSU crystal in macrophages, which could be a potential therapeutic target to treat gouty arthritis in human patients.

IntroductionWhile pharmacists-led interventions in hypertension have proven effective in high-income countries, their implementation and impact in low- and middle-income countries (LMIC) remain limited. This study assessed the implementation and outcomes of the hypertension program FarmaTeCuida (FTC), which integrated community pharmacies into the public primary care level using information and communication technologies. The study took place during the pandemic in General Pueyrredón, Buenos Aires, Argentina, so modifications to the implementation strategy and expected outcomes were also analyzed.MethodsA mixed-methods study was conducted using the non-adoption, abandonment, scaling-up, dissemination, and sustainability (NASSS) conceptual model. Qualitative in-depth interviews were conducted with key stakeholders using snowball sampling until thematic saturation was achieved. The quantitative approach employed a quasi-experimental, prospective, longitudinal design in a cohort of hypertensive patients enrolled in the FTC program since October 2020 to March 2022. Adoption, access, adherence to follow-up, and blood pressure levels were assessed. Clinical outcomes were compared to a cohort of hypertensive patients attending primary health care centers (PHCCs) in 2021 but not enrolled in the FTC program. Routine data from this cohort was obtained from the municipal health information system (HIS).ResultsOut of 33 PHCCs, 23 adopted the FTC program, but only four collaborated with community pharmacies. A total of 440 patients were recruited, with 399 (91%) enrolled at PHCCs. Hypertension was detected in 63% (279/440) of cases at the first visit (113 were possible hypertensive patients; 26 new hypertensive patients and 140 already diagnosed). During follow-up, FTC identified 52 new hypertensive patients (12% out of 440). Reduction of systolic blood pressure (SBP) was observed in patients enrolled in both the FTC program and the comparison group over 60 days. In the multivariate analysis that included all hypertensive patient (FTC and HIS) we found strong evidence that for each month of follow up, SBP was reduced by 1.12 mmHg; however, we did not find any significant effect of the FTC program on SBP trend (interaction FTC*months has a p-value = 0.23). The pandemic was identified as the main reason for the program's underperformance; in addition we identified barriers related to technology, patient suitability, implementation team characteristics, and organizational factors.DiscussionOur study, grounded in the NASSS model, highlights the profound complexity of introducing innovative strategies in low- and middle-income settings. Despite substantial challenges posed by the pandemic, these obstacles provided valuable insights, identified areas for improvement, and informed strategies essential for reshaping the care paradigm for conditions like hypertension in resource-constrained environments.

Training in the Occupational Safety and Health (OSH) sector is crucial for minimizing workplace hazards and ensuring employee well-being. Virtual Reality (VR) emerges as a training tool that can enhance learning outcomes and simulate hazardous scenarios safely. However, several aspects must be taken into consideration when implementing VR-based training solutions. The paper investigates how to effectively design, develop, integrate, and validate a VR OSH training tool. To this aim, a comprehensive guideline of 9 key elements articulated in 29 items is proposed. Every element and item is retrieved from analyzing the existing literature on the topic using a systematic approach. The result is a comprehensive guide to consider all these aspects from the outset of design, in a cohesive, complete, and tailored manner. This formalization is intended to facilitate the advancement of research and implementation of these solutions, which to date have been largely confined to prototypes or lack real practical application.

IntroductionThe quiet ego indicates a more compassionate conception of self-identity that integrates others into the self by lowering the intensity of the ego and enhancing the awareness of the present moment. The Quiet Ego Scale (QES) is a 14-item self-report measure of quiet ego, and it is composed of the following four psychological domains: detached awareness, inclusive identity, perspective taking, and growth. The present study aimed to test the psychometric properties of the Quiet Ego Scale within the Italian cultural context (iQES).MethodsA total of 160 Italian university students aged between 20 and 42 years, with a mean age of 22.85 years (SD = 3.41), completed the measures of the iQES and of other psychological dimensions. The psychometrics properties of iQES were assessed based on its internal consistency, test-retest reliability, and construct validity through comparisons with other correlated psychological measures.ResultsAnalyses confirmed the psychometrics properties of iQES. As in previous studies, the quiet ego was positively associated with the indicators of resilience (p < 0.01), happiness (p < 0.05), self-esteem (p < 0.01), and psychological wellbeing (p < 0.01).DiscussionThe study discussed the possible uses of the iQES in the field of mental health, specifically focusing on improving adherence to psychological therapies and enhancing psychological and social well-being. The results indicated strong psychometric properties of the iQES in measuring the quiet ego construct. Our findings enrich the literature on the validity of the iQES and highlight the multidimensional nature of the quiet ego construct.

A long-standing link exists between avant-garde and scientific cinema. In the 1920s, in fact, the former contributed to the construction of the latter: on the one hand, by its systematic inclusion in film clubs’ and film societies’ screening programs; on the other hand, by catalyzing the theoretical debate on the medium specificity because of the specific techniques it develops. Through the texts by philosophers, film makers and theorists of the time (Walter Benjamin, Germaine Dulac, Jean Epstein, Émile Vuillermoz, László Moholy-Nagy among others), this essay examines the role of microscope films in the construction of 1920s film theory, discussing several tropes and key concepts such as pure cinema, cinégraphie integrale, rhythm theory and optical “unconscious”.

Aim: Children with otitis media (OM) experience long waiting times to access Australia's public hospitals due to limited capacity. The aim of this article is to utilize an Ear, Nose, and Throat (ENT) telehealth service (the Ear Portal) to examine whether delayed access to specialist care is associated with poorer behavioral outcomes for children with OM. Methods: Participants in the study included 45 children who were referred to ENT specialists due to recurrent and persistent OM. Children were triaged as semiurgent with a target time-to-assessment of 90 days or nonurgent with a target time-to-assessment of 365 days. The behavioral outcomes of children were assessed using the parent report Strengths and Difficulties Questionnaire (SDQ). Descriptive statistics and adjusted multiple linear regression models were used to compare children who received access to the service within the time-to-assessment target of their triage category (?on-boundary?; n?=?17) and outside the time-to-assessment target (?off-boundary?; n?=?28). Spearman correlation analysis was used to explore the relationship between the internalizing, externalizing, and total SDQ scores as a function of waiting times in days. Results: Borderline or abnormal SDQ scores ranged from 24.4% to 42.2% across the study participants. The regression analysis showed a statistically significant association between the off-boundary group and higher scores (i.e., poorer) on the peer, emotional, conduct, internalizing, and total problems subscales. Further, lengthy waiting times were significantly correlated with higher internalizing problems. These findings indicate that longer waiting times may lead to poorer behavioral outcomes for children with OM. Clinical Trial Registration: (ACTRN1269000039189p). Conclusion: Children with recurrent and persistent OM referred to ENT outpatient care were found to have significantly more behavioral difficulties if their waiting times exceeded the recommended timeframes for their triaged referrals. Additionally, they experienced more internalizing problems that correlated with longer waiting times. This highlights the calls for alterations in current clinical practice given the lengthy waiting times in Australia's public hospitals.

ObjectiveDespite the overall success of responsive neurostimulation (RNS) therapy for drug-resistant focal epilepsy, clinical outcomes in individuals vary significantly and are hard to predict. Biomarkers that indicate the clinical efficacy of RNS-ideally before device implantation-are critically needed, but challenges include the intrinsic heterogeneity of the RNS patient population and variability in clinical management across epilepsy centers. The aim of this study is to use a multicenter dataset to evaluate a candidate biomarker from intracranial electroencephalographic (iEEG) recordings that predicts clinical outcome with subsequent RNS therapy.MethodsWe assembled a federated dataset of iEEG recordings, collected prior to RNS implantation, from a retrospective cohort of 30 patients across three major epilepsy centers. Using ictal iEEG recordings, each center independently calculated network synchronizability, a candidate biomarker indicating the susceptibility of epileptic brain networks to RNS therapy.ResultsIctal measures of synchronizability in the high-γ band (95-105 Hz) significantly distinguish between good and poor RNS responders after at least 3 years of therapy under the current RNS therapy guidelines (area under the curve = .83). Additionally, ictal high-γ synchronizability is inversely associated with the degree of therapeutic response.SignificanceThis study provides a proof-of-concept roadmap for collaborative biomarker evaluation in federated data, where practical considerations impede full data sharing across centers. Our results suggest that network synchronizability can help predict therapeutic response to RNS therapy. With further validation, this biomarker could facilitate patient selection and help avert a costly, invasive intervention in patients who are unlikely to benefit.

Brief biography and scientific achievements of Yuri Georgiiovych Zdesenko in relation with his 80-th anniversary.

The Mediterranean fruit fly (medfly), Ceratitis capitata, is considered one of the most destructive fruit pests worldwide. Female medflies prefer to lay eggs in ripening, ripe, or overripe fruits. In deciduous orchards of temperate regions, fruitlets (juvenile fruits) of early cultivars could represent the earliest spring resource with a potential host function for medflies. However, little is known about the medfly female’s ability to ovipositing and complete breeding in fruitlets. To clarify the possible role of fruitlets, the suitability of key-host fruitlets for the oviposition of medflies and the further development of immature stages were examined in laboratory conditions and an attempt was made to assess the degree of infection of fruitlets collected in the field. Additionally, the development of the overwintering medfly population and the putative use of fruitlets as a resource for early population growth were simulated using the PESTonFARM model optimized to reflect specific features of medfly biology and behavior. Our laboratory data demonstrate that nectarine and pear fruitlets can support the full development of medfly offspring. However, no medfly pupae were obtained from a sample of 14,000 fruitlets collected at the farm. The simulation showed that the sample number needed to detect with at least 95% certainty rare cases of medfly pupae or adults emerging from infected fruitlets is several tens of thousands, which is several times more than the actual number of fruitlets used in our study. Our research suggests that the fruitlets of some cultivated fruit species can potentially constitute a viable food resource for the development of the earliest generation of spring medflies, with implications for medfly Integrated Pest Management (IPM).

Pediatric acute-onset neuropsychiatric syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS), represent an overlapping group of disorders which is characterized by acute-onset obsessive compulsive disorders, eating restriction, tics, cognitive and behavioral deterioration which typically follows a relapsing-remitting course but some patients have a primary or secondary persistent progress. This condition is likely caused by heterogeneous inflammatory mechanisms (autoantibodies, complement activation, pro-inflammatory cytokine production) involving the basal ganglia as evidenced by imaging studies (patients vs. controls), sleep studies that found movements and/or atonia during REM sleep, and neurological soft signs that go along with basal ganglia dysfunction. The condition causes significant psychiatric and behavioral symptoms, caregiver burden and sleep abnormalities. Autoantibodies resulting from molecular mimicry of infectious agents (namely group A Streptococcus) and neuronal autoantigens that map to the basal ganglia play also a subtle role. This narrative review aims to describe the key immunological features documented thus far and that likely play a role in the pathogenesis and clinical manifestations of this disorder.

An experiment to search for 2ε-, εβ+- and 2β+-decays of 106Cd, using a 215 g cadmium tungstate scintillation crystal enriched at 66 % by 106Cd (106CdWO4) is carried out at the Gran Sasso underground laboratory (Italy). Events in the 106CdWO4 detector are recorded in (anti)coincidences with two large-volume CdWO4 scintillation counters. The design of the detector system, calibration and background measurements, methods, and results of data analysis to determine key detector characteristics are described. The experimental data are compared with Monte Carlo simulation results, and a background model is constructed. The radioactive contamination of the setup components is studied. The sensitivity of the experiment approaches the level of theoretical predictions for the 2νεβ+-decay channel, while for other possible 2β-decay channels it is already on the level of lim T1/2 ∼ 1021-1022 years.

Abstract Objective Epilepsy surgery is an effective treatment for drug‐resistant patients. However, how different surgical approaches affect long‐term brain structure remains poorly characterized. Here, we present a semiautomated method for quantifying structural changes after epilepsy surgery and compare the remote structural effects of two approaches, anterior temporal lobectomy (ATL), and selective amygdalohippocampectomy (SAH). Methods We studied 36 temporal lobe epilepsy patients who underwent resective surgery (ATL = 22, SAH = 14). All patients received same‐scanner MR imaging preoperatively and postoperatively (mean 2 years). To analyze postoperative structural changes, we segmented the resection zone and modified the Advanced Normalization Tools (ANTs) longitudinal cortical pipeline to account for resections. We compared global and regional annualized cortical thinning between surgical treatments. Results Across procedures, there was significant cortical thinning in the ipsilateral insula, fusiform, pericalcarine, and several temporal lobe regions outside the resection zone as well as the contralateral hippocampus. Additionally, increased postoperative cortical thickness was seen in the supramarginal gyrus. Patients treated with ATL exhibited greater annualized cortical thinning compared with SAH cases (ATL: −0.08 ± 0.11 mm per year, SAH: −0.01 ± 0.02 mm per year, t = 2.99, P = 0.006). There were focal postoperative differences between the two treatment groups in the ipsilateral insula (P = 0.039, corrected). Annualized cortical thinning rates correlated with preoperative cortical thickness (r = 0.60, P

Abstract Introduction This study aimed to investigate the prevalence of cystoid macular edema after pars plana vitrectomy for the treatment of pseudophakic rhegmatogenous retinal detachment and identify possible related risk factors. Methods A retrospective monocentric study was conducted within a cohort of pseudophakic patients undergoing vitrectomy for rhegmatogenous retinal detachment between January 2019 and December 2022. Demographic data, initial and intraoperative characteristics of rhegmatogenous retinal detachment, and postoperative data were analyzed. Cystoid macular edema was defined on optical coherence tomography exclusively. Results A total of 164 eyes of 164 patients were included for analysis. The mean age of the patients at surgery was 65.7 ± 12.0 years. The mean best-corrected visual acuity was 2.1 ± 1.0 logMAR preoperatively and 1.0 ± 0.7 logMAR postoperatively. The mean follow-up was 13.4 ± 7.7 months. The prevalence of cystoid macular edema was 17.1% [9.8–26.4]. In multivariate analysis, severe proliferative vitreoretinopathy (relative risk 3.6 [1.3–9.7]) and laser retinopexy (relative risk 8.4 [1.1–64.7]) were independently and significantly associated with cystoid macular edema. Conclusion The prevalence of cystoid macular edema in pseudophakic rhegmatogenous retinal detachment after pars plana vitrectomy was 17.1%. Severe proliferative vitreoretinopathy stage and the use of endolaser retinopexy were independent risk factors for development of cystoid macular edema.

Abstract Background Ageing is accompanied by a progressive loss of skeletal muscle mass and strength, potentially determining the insurgence of sarcopenia. Evidence suggests that motoneuron and neuromuscular junction (NMJ) degeneration contribute to sarcopenia pathogenesis. Seeking for strategies able to slow down sarcopenia insurgence and progression, we investigated whether a 2‐year mixed‐model training involving aerobic, strength and balance exercises would be effective for improving or preserving motoneuronal health and NMJ stability, together with muscle mass, strength and functionality in an old, sarcopenic population. Methods Forty‐five sarcopenic elderly (34 females; 11 males) with low dual‐energy X‐ray absorptiometry (DXA) lean mass and Short Physical Performance Battery (SPPB) score

Background: Endomyocardial biopsy (EMB) is considered the gold standard for monitoring allograft rejection after heart transplantation. EMB is an invasive procedure that may be performed via a trans-jugular or a trans-femoral approach with a complication rate reported as less than 6%. The aim of this study was to evaluate the complication rate after EMBs in heart recipients and to compare the results of EMBs performed via a trans-jugular or a trans-femoral approach. Methods: Medical records of heart recipients undergoing EMBs between January 2012 and December 2022 were retrospectively reviewed. EMB-related complications were classified as major (death, pericardial effusion, hemopericardium, cardiac tamponade requiring a pericardiocentesis or an urgent cardiac surgery, ventricular arrythmias, permanent atrio-ventricular block requiring permanent pacing, hemothorax, pneumothorax and retroperitoneal bleeding) and minor (de novo tricuspid regurgitation, arrhythmias, coronary artery fistula, vascular access site complications). Results: A total of 1698 EMBs were performed during the study period at our institution in 212 heart recipients. There were 927 (55%) EMBs performed through a trans-jugular approach (TJ group) and 771 (45%) EMBs performed through a trans-femoral approach (TF group). A total of 60 (3.5%) complications were recorded, including nine (0.5%) major complications (six cardiac tamponades, two pneumothorax and one retroperitoneal bleeding) and 51 (3%) minor complications (seven coronary fistulae, five de novo tricuspid regurgitation, four supraventricular arrythmias and thirty-five vascular access site complications). No difference was found in total (38 [4%] vs. 22 [3%]; p = 0.16) and major (6 [1%} vs. 3 [0.4%]; p = 0.65) complications (32 [3%] vs. 19 [2%]; p = 0.23) between the TJ group and the TF group. No difference was found in male sex, age at time of EMB and time from HT between complicated and not complicated EMBs. Conclusions: EMBs represent a safe procedure with a low risk of complications. In our experience, EMBs performed via a trans-jugular approach are as safe as the trans-femoral approach.

Abstract The prompt identification of frailty in primary care is the first step to offer personalized care to older individuals. We aimed to detect and quantify frailty among primary care older patients, by developing and validating a primary care frailty index (PC-FI) based on routinely collected health records and providing sex-specific frailty charts. The PC-FI was developed using data from 308,280 primary care patients ≥ 60 years old part of the Health Search Database (HSD) in Italy (baseline 2013–2019) and validated in the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K; baseline 2001–2004), a well-characterized population-based cohort including 3363 individuals ≥ 60 years old. Potential health deficits part of the PC-FI were identified through ICD-9, ATC, and exemption codes and selected through an optimization algorithm (i.e., genetic algorithm), using all-cause mortality as the main outcome for the PC-FI development. The PC-FI association at 1, 3 and 5 years, and discriminative ability for mortality and hospitalization were tested in Cox models. The convergent validity with frailty-related measures was verified in SNAC-K. The following cut-offs were used to define absent, mild, moderate and severe frailty:

Frailty is a clinically measurable state of vulnerability to developing increased dependency and/or mortality when exposed to a stressor. Chronic diseases, aggressive treatments, antibiotic overuse, microbiota changes, immune senescence, and increased use of medical devices and implants (i.e., central lines and catheters) expose modern patients to healthcare-associated infections (HAIs), multidrug-resistant bacteria, and new and unusual opportunistic pathogens. Older adults are among the main victims of HAIs and are associated with high costs, disability, morbidity, and mortality. Ralstonia pickettii is an emerging opportunistic pathogen that causes rare nosocomial infections in frail individuals. Herein, we present a case of bloodstream infection caused by R. pickettii in an 88-year-old woman with a relatively mild course. In addition to describing this unusual finding, this report discusses the problem of HAIs in older adults. Older age, comorbidities, and hospital admissions were among the main risk factors for HAIs. Adherence to guidelines, training, auditing, and surveillance is crucial for reducing the burden of HAIs in acute settings. Furthermore, avoiding incongruous hospitalizations would have positive implications both for preventing HAIs and improving patient quality of life.

This article examines the circulation of the first scientific films at the turn of the XXth century, primarily in the French context, when one could witness their sporadic diffusion in entertainment venues and a growing enthusiasm surrounding the reception of the first popular science series. Following the unearthing of some traces of scientific films in the cinéma forain, this article focuses on the reception of scientific series by Charles Urban, which were screened at the London Alhambra Theatre in 1903, and of the first micro-cinematographic films (1908) by Jean Comandon. Thus, the article provides a brief review of scientific films’ positioning within the screening programming practices of the 1910s, revealing that, in those years, scientific films continued to be perceived as “highly attractive” spectacles. In conclusion, by analyzing these films’ resonance in the press, the article will identify several tropes of estrangement. These tropes borrowed from the tradition of the magic lanterns’ scientific projections, which will reappear shortly thereafter – carrying new meanings – within the theories of the medium specificity in the 1920s, when scientific films were integrated within avant-garde screening practices.