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Platelet lysate, derived from platelets, are valuable biological products rich in bioactive molecules. Their use promotes tissue healing and modulates inflammation. However, maintaining the stability and bioactivity of platelet lysate is challenging since they degrade rapidly at room temperature. This study focused on the possibility to confer enhanced stability to freeze-dried equine platelet lysate as an alternative to platelet-rich plasma (PRP). Platelet lysate (PL) was derived from PRP and freeze-dried either as such or using various adjuvants. Primary cell cultures of porcine Vascular Wall-Mesenchymal Stem Cells were treated with different PL formulations, and cell viability was assessed using an MTT assay. Overall, the addition of PL significantly improved cell viability as compared to controls without growth factor supplementation or with foetal bovine serum. Notably, the freeze-drying process maintained the effectiveness of the PL for at least a week. Furthermore, the study revealed that varying the horse as the source of PL could yield varying effects on cell viability. Detailed freeze-drying protocols were established, including freezing, primary drying and secondary drying phases, and the type of adjuvant. This study demonstrated the potential of freeze-dried equine PL as a viable alternative to PRP and highlighted the importance of precise freeze-drying protocols and adjuvants for standardization. Equine PL showed promise for medical treatment in horses, offering advantages such as extended shelf life, ease of handling, and reduced transportation costs, with the potential for broadened therapeutic usage.

Abstract Introduction Increasing effectiveness, efficiency, and reach of HIV case-finding strategies among priority populations is essential for epidemic control. Index testing is effective but presents potential risks, including stigma, violence, abandonment, and challenges such as fear of disclosure and reluctance to list contacts. We integrated the enhanced peer outreach approach (EPOA) social network strategy into index testing to increase case finding among Haitian migrants and individuals of Haitian descent in Dominican Republic. Methods The index-EPOA intervention implemented in two successive projects in the Dominican Republic offered index clients index-EPOA referral coupons to distribute to contacts. We analyzed retrospective client records from routine, aggregate program data. We compared overall case-finding rates pre-intervention (baseline October 2019–December 2020) and post-intervention (midline January 2021–March 2022; endline April 2022–June 2023), and case finding for index-EPOA versus standalone index. We calculated case-finding differences using the Student t-test. Results HS3/EHSEC tested 7,305 contacts of index clients, with 23% case finding. At baseline, 1,234 contacts were tested through standalone index, identifying 211 HIV-positive contacts with case finding at 17%. During the rollout of the intervention, the case-finding rate for standalone index testing remained similar to baseline (16%), while the rate for index-EPOA was 33%. Combined case finding for standalone index and index-EPOA increased to 22% at midline and 29% at endline, resulting in an overall case-finding rate of 25% during the intervention. The statistical analysis found overall case finding post-intervention (combined case-finding rate of 25% at midline + endline for standalone index and index-EPOA) significantly higher than at baseline (17% standalone index) (p

Polylactic acid (PLA) is a biodegradable polymer from renewable resources with mechanical properties comparable to traditional polymers, but with a higher cost. A solution to this issue is the production of bio-based composites to partially replace the PLA matrix with industrial wastes characterized by a zero-cost, e.g., linoleum, to also valorize them in a circular economy perspective. Linoleum heterogeneous nature deriving from the simultaneous presence of lignocellulosic and inorganic fillers and oil/rosin binders, made the evaluation of matrix/filler compatibilization strategies necessary. Two approaches were considered, one from the filler perspective with NaOH and silane treatments, and the other one from the matrix perspective by adding a chain extender (C.E.). The first approach marginally improved tensile stiffness (by 1.6 %) compared to neat PLA but caused a significant decrease of 32.8 % in strength. Considering this, the costs and disposal of the chemicals and the increased environmental impact of the process, this approach was discarded. One the contrary, the introduction of C.E. does not modify the manufacturing process and increases tensile stiffness and elongation at break of 7.2 % and 415.5 % compared to neat PLA with a tolerable reduction in strength, i.e., 16.6 %, thus being a suitable way to exploit linoleum as zero-cost filler.

IntroductionAdolescent girls and young women (AGYW) continue to experience a high incidence of HIV in southern and eastern Africa, even in the context of large-scale HIV prevention interventions. In Tanzania, AGYW account for the largest proportion of new infections and have a higher risk of HIV acquisition than males of comparable age.MethodsWe used routinely collected data from the PEPFAR/USAID-funded Sauti Project, a large combination HIV prevention program, to examine the relationship between transactional sex and sex with older partners among AGYW in Tanzania (2015–2020). Out-of-school AGYW 15–24 years completed a vulnerability index and were tested for HIV. We estimated weighted prevalence ratios (PR) and 95% confidence intervals (CI) for the associations of transactional sex (sex exchanged for money/services/gifts outside of sex work) and sex with older partners (≥5-years older, ≥10-years older) with prevalent HIV. Age cutoffs of 5 and 10 years were used to align partner age differences with age-disparate and intergenerational sex, respectively. We assessed potential synergism between exposures, and subgroup analyses explored associations among girls 15–19.ResultsSixty seven thousand three hundred fifty seven AGYW completed the vulnerability index and 14,873 had captured HIV testing records. Median age was 20 years (IQR 18–22). Transactional sex and age-disparate sex were common (35% and 28%, respectively); 13% of AGYW reported both behaviors. HIV prevalence was associated with both transactional sex (PR: 1.28; 95% CI 1.00–1.63) and age-disparate sex (PR:1.26, 95% CI 0.99–1.60). In common referent analysis, transactional sex remained strongly associated with HIV, even in the absence of age-disparate sex (PR 1.41; 95% CI 1.02–1.94).DiscussionEvidence of statistical synergism was not present, suggesting both transactional sex and age-disparate sex operate through similar pathways to increase HIV risk. Increased specificity within HIV prevention programs is needed to better meet the sexual and reproductive health needs of AGYW at high risk of HIV in Tanzania, including investment in tailored youth-friendly strategies for AGYW who have been marginalized from the current HIV response.

Abstract Purpose Besides the well-established efficacy in preventing severe COVID-19, the impact of early treatments, namely antivirals and monoclonal antibodies (mAbs), on the time length to negativization of SARS-CoV-2 nasal swabs is still unclear. The aim of this study was to compare the efficacy of different early treatments in reducing the SARS-CoV-2 viral shedding, identifying a single drug that might potentially lead to a more rapid negativization of SARS-CoV-2 nasal swab. Methods This was a single-centre, retrospective, observational study conducted at Ospedale Luigi Sacco in Milan. Data of high-risk COVID-19 patients who received early treatments between 23 December 2021 and March 2023 were extracted. The comparison across treatments was conducted using the Kruskall-Wallis test for continuous variables. Dunn’s test with Bonferroni adjustment was performed for post-hoc comparisons of days to negativization. Secondly, a negative binomial regression adjusted for age, sex, number of comorbidities, immunosuppression, and SARS-CoV-2 vaccination status was implemented. Results Data from 428 patients receiving early treatments were collected. The majority were treated with Nirmatrelvir/Ritonavir and were affected by SARS-CoV-2 Omicron infection with BA.2 sublineage. The median length time to SARS-CoV-2 nasal swab negativization was 9 days [IQR 7–13 days]. We found that Nirmatrelvir/Ritonavir determined a significant decrease of the length time to SARS-CoV-2 nasal swab negativization compared to mAbs (p = 0.003), but not compared to Remdesivir (p = 0.147) and Molnupiravir (p = 0.156). Conclusion Our findings highlight the importance of promptly treating high-risk COVID-19 patients with Nirmatrelvir/Ritonavir, as it also contributes to achieving a faster time to negative SARS-CoV-2 nasal swabs.

Abstract Hepatic encephalopathy is a neuropsychiatric complication of liver disease which is partly associated with elevated ammonemia. Urea hydrolysis by urease-producing bacteria in the colon is often mentioned as one of the main routes of ammonia production in the body, yet research on treatments targeting bacterial ureases in hepatic encephalopathy is limited. Herein we report a hydroxamate-based urease inhibitor, 2-octynohydroxamic acid, exhibiting improved in vitro potency compared to hydroxamic acids that were previously investigated for hepatic encephalopathy. 2-octynohydroxamic acid shows low cytotoxic and mutagenic potential within a micromolar concentration range as well as reduces ammonemia in rodent models of liver disease. Furthermore, 2-octynohydroxamic acid treatment decreases cerebellar glutamine, a product of ammonia metabolism, in male bile duct ligated rats. A prototype colonic formulation enables reduced systemic exposure to 2-octynohydroxamic acid in male dogs. Overall, this work suggests that urease inhibitors delivered to the colon by means of colonic formulations represent a prospective approach for the treatment of hepatic encephalopathy.

The demand for drone-based synthetic aperture radar (SAR) systems is growing, especially for applications in cases where satellites or airborne systems are not sufficiently flexible. However, the combination of a long operating range and high spatial resolution causes the atmosphere to pose challenges for these systems. In this article, we present our $K$-band drone system that has a long range sensibility through modification to a commercially available radar. In addition, a moving baseline configuration has been integrated to ensure accurate attitude data, especially the heading. The desired spatial resolution is achieved by our proposed autofocus algorithm based on image sharpness. It is designed to also work in challenging cases of nonlinear flight paths and can be integrated into a processing framework based on back-projection. Several experiments were conducted to demonstrate the drone system's capabilities. These included a comparison with an established airborne radar: MIRANDA35. The obtained results demonstrate the ability of the drone SAR system to map wide areas at high spatial resolution.

IntroductionIn 2016, UNAIDS set ambitious targets to reduce global HIV infections by 75% by 2020 and 90% by 2030, based on the 2.1 million new infections reported in 2010. However, by 2022, new HIV infections had only decreased by 38%, from 2.1 million in 2010 to 1.3 million in 2022, raising concerns about reaching the 2030 goal. Female sex workers (FSWs) in sub-Saharan Africa face a disproportionately high risk of HIV acquisition, contributing 5%–20% of all new infections in several countries in the region. This analysis investigates HIV seroconversion and associated factors among FSWs, offering insights into critical interventions for preventing HIV transmission in this population and advancing the goal of ending the HIV pandemic by 2030.MethodsWe conducted a retrospective cohort study involving 17,977 FSWs who initially tested HIV negative upon enrollment in the Sauti project between October 2016 and September 2018. HIV incidence rates were calculated by dividing the number of new HIV cases by observed person-time within the cohort. Cox regression analysis identified factors associated with seroconversion.ResultsThe study revealed an HIV incidence rate of 8.6 per 100 person-years among FSWs [95% confidence interval (CI): 8.1–9.1]. Factors independently associated with HIV seroconversion included age 35 years or older [adjusted hazard ratio (aHR): 2.53; 95% CI: 2.03–3.14], unprotected sex (aHR: 1.27; 95% CI: 1.13–1.42), STI symptoms (aHR: 1.99; 95% CI: 1.67–2.38), and alcohol consumption before sex (aHR: 1.20; 95% CI: 1.07–1.34).ConclusionTargeted interventions are vital in curbing HIV transmission among FSWs, with a focus on expanding access to primary HIV prevention services, particularly for older FSWs who face heightened risk. Tailored sexual health education programs are imperative to encourage consistent condom use and enable informed decision-making. Accessible and timely STI screening and treatment services are crucial to mitigate HIV transmission risk. Collaborative partnerships between healthcare providers, community organizations, and government agencies are essential in implementing these interventions among FSWs.

Background: Mpox virus (MPXV) has recently spread outside of sub-Saharan Africa. This large multicentre study was conducted in Lombardy, the most densely populated Italian region accounting for more than 40% of Italian cases. The present study aims to: i) evaluate the presence and the shedding duration of MPXV DNA in different body compartments correlating the MPXV viability with the time to onset of symptoms; ii) provide evidence of MPXV persistence in different body compartment as a source of infection and iii) characterize the MPXV evolution by whole genome sequencing (WGS) during the outbreak occurred in Italy. Material and methods: The study included 353 patients with a laboratory-confirmed diagnosis of MPXV infection screened in several clinical specimens in the period May 24th - September 1st, 2022. Viral isolation was attempted from different biological matrices and complete genome sequencing was performed for 61 MPXV strains. Results: MPXV DNA detection was more frequent in the skin (94.4%) with the longest median time of viral clearance (16 days). The actively-replicating virus in cell culture was obtained for 123/377 (32.6%) samples with a significant higher viral quantity on isolation positive samples (20 vs 31, p

Abstract Supercapacitors and transistors are two key devices for future electronics that must combine portability, high performance, easy scalability, etc. Graphene‐related materials (GRMs) are frequently chosen as active materials for these applications given their unique physical properties that are tunable via chemical functionalization. Up to date, among GRMs, only reduced graphene oxide (rGO) showed sufficient versatility and processability in mild media, rendering it suitable for integration in these two types of devices. Here, a sound alternative to rGO is provided, namely graphene acetic acid (GAA), whose physico‐chemical features offer specific advantages. In particular, the use of a GAA‐based cathode in a zinc hybrid supercapacitor (Zn‐HSC) delivers state‐of‐the‐art gravimetric capacitance of ≈400 F g−1 at a current density of 0.05 A g−1. Conversely, GAA‐based LGT, supported onto Si/SiO2, shows an ambipolar behavior in 0.1 m NaCl, featuring a clear p‐doping quantified by Dirac voltage higher than 100 mV. Such a device is successfully implemented in paper fluidics, thereby demonstrating the feasibility of real‐time monitoring.

Background and Aim: Seasonal changes, especially temperature and photoperiod, are well-known determining factors of swine reproductive capacity, but the underlying mechanisms remain unknown. This study aimed to investigate the effect of age and seasonal variations on boar seminal plasma steroids (dehydroepiandrosterone [DHEA], cortisol [CORT], and testosterone [TEST]) over 1 year. Materials and Methods: Four commercial hybrid adult boars (Large White × Duroc), aged between 12 and 44 months, were repeatedly evaluated at the Department of Veterinary Medical Sciences of the University of Bologna. Daily temperature and light hours relating to the collection date were considered for each observation within the four astronomical seasons: Winter, spring, summer, and autumn. Hormones were quantified using radioimmunoassay. The association between seasonal factors and hormone concentrations was evaluated using linear regression models. Univariate models were estimated for each hormone to assess the influence of the independent variables; two multivariate models were assessed to evaluate the effect of temperature and daylight hours, including boar and season factors. Results: Age significantly affected all analyzed hormones (CORT p < 0.0001; DHEA p < 0.0001; and TEST p < 0.0001). The highest average levels were found for each hormone during summertime, suggesting a positive correlation between steroid concentrations with temperature and light hours. Conclusion: The results of this study support the hypothesis that the increase in external temperature and light hours is somehow associated with higher levels of steroid concentrations in the seminal plasma of in-housed boars. These findings may help further investigate seasonal fluctuations in reproductive outcomes, which are well-known for porcine species.

Individuals with Down Syndrome exhibit deficits in muscle strength and cardiovascular adaptation, which limit athletic performance. We compared a maximum-intensity 50 m front crawl test between competitive male swimmers with Down Syndrome (SDS; n = 11; 26.5 ± 5.6 years; m ± SD) and a control group of swimmers (CNT; n = 11; 27.1 ± 4.0 years) with similar training routines (about 5 h/week). Wearable sternal sensors measured their heart rate and 3D accelerometry. The regularity index Sample Entropy (SampEn) was calculated using the X component of acceleration. The total times (SDS: 58.91 ± 13.68 s; CNT: 32.55 ± 3.70 s) and stroke counts (SDS: 66.1 ± 9.6; CNT: 51.4 ± 7.4) were significantly higher in the SDS group (p < 0.01). The heart rate was lower in the SDS group during immediate (SDS: 129 ± 15 bpm; CNT: 172 ± 11 bpm) and delayed recovery (30 s, SDS: 104 ± 23 bpm; CNT: 145 ± 21 bpm; 60 s, SDS: 79 ± 27 bpm; CNT: 114 ± 27 bpm) (p < 0.01 for all the comparisons). The SampEn of sternal acceleration showed no differences between the groups and between 0–25 m and 25–50 m. Body pitch correlated strongly with performance in the SDSs (R2 = 0.632, p < 0.01), but during the first 25 m only. The high-intensity front crawl performances differed between the SDS and CNT athletes in terms of time, biomechanics, and training adaptation, suggesting the need for tailored training to improve swimming efficiency in SDSs.

We present a challenging case of a patient admitted to an intensive care unit with influenza-associated pulmonary aspergillosis (IAPA). The clinical course was characterised by refractory fungal pneumonia and tracheobronchitis, suspected drug-induced liver injury due to triazole antifungals, and secondary bacterial infections with multidrug-resistant microorganisms, resulting in a fatal outcome despite the optimisation of antifungal treatment through therapeutic drug monitoring. This case underscores the complexity that clinicians face in managing critically ill patients with invasive fungal infections.

Paper-based or IT tools can be used in telerehabilitation mode to improve the skills of children with developmental dyslexia (DD), seeking to increase reading speed and reduce errors. Telerehabilitation is the provision of remote treatments in which the patient works autonomously in a familiar environment under the remote monitoring, through telecommunication means, of an expert operator. Through telerehabilitation, children with DD can receive treatments outside the specialist clinic, at home or school, via internet connections, and through advanced technological platforms. These procedures allow adequate communication with the family, intensity of treatment, self-adaptivity of exercises, and child engagement; these factors are crucial for a high intervention efficacy. Recent studies have supported the effectiveness of the telerehabilitation of reading in children with DD, with some studies reporting no differences in efficacy between remote and in-person methods. Nevertheless, many points remain to be clarified about the procedures and methods required by telerehabilitation, the variables linked to its effectiveness (e.g., the impact of the intensity of the training and the neuropsychological profile of the child), and the comparative validity of different tele-treatment paths. These aspects are discussed in the present paper.

Staphylococcus aureus bacteraemia (SAB) is a life-threatening bloodstream infection. Improved adherence to quality-of-care indicators (QCIs) can significantly enhance patient outcomes. This quasi-experimental study evaluated the impact of a bundle of interventions on QCI adherence in adult patients with SAB. Additionally, a molecular rapid diagnostic test (mRDT) for S. aureus and methicillin resistance was introduced during weekdays. We compared pre-intervention (January–December 2022) and post-intervention (May 2023–April 2024) data on QCI adherence and time to appropriate treatment. A total of 56 and 40 SAB episodes were included in the pre- and post-intervention periods, respectively. Full QCI adherence significantly increased from 28.6% to 67.5% in the post-intervention period (p < 0.001). The mRDT diagnosed SAB in eight cases (26.6%), but the time to achieve appropriate target therapy did not improve in the post-intervention period (54 h (IQR 30–74) vs. 72 h (IQR 51–83), p = 0.131). The thirty-day mortality rate was comparable between the two periods (17.9% vs. 12.5%, p = 0.476). This study demonstrates that a bundle of interventions can substantially improve adherence to SAB management QCIs.

IntroductionChildren of key population individuals (CPK) often face the same stigma and discrimination as their parents, limiting their access to HIV services. The Meeting Targets and Maintaining Epidemic Control project analyzed pediatric HIV testing data from project-supported sites to better understand risk among CKP and improve comprehensive prevention, testing, and treatment for KP families.MethodsWe conducted a retrospective analysis of routine program data collected October 1, 2021-September 30, 2022, in project-supported sites in Burundi, Côte d'Ivoire, Democratic Republic of Congo, Tanzania, and Togo. We compared HIV case finding (defined as the percentage of children diagnosed with HIV among those who were tested) and treatment initiation (defined as the percentage of children diagnosed with HIV who were initiated on antiretroviral therapy) data for children ResultsA total of 5,651 children were tested (n = 2,974 index testing; n = 2,677 non-index testing). Of those diagnosed with HIV, 33% (181/541) were CKP, with case finding 17% (181 positive/1,070 tested) among CKP and 8% among non-CKP (360 positive/4,581 tested). Almost half of CKP diagnosed were ages 1-4 years. Among the 2,974 (53%) reached through index testing, overall case finding was higher among CKP (17%; 178 positive/1,052 tested) than non-CKP (11%; 219 positive/1,922 tested). Treatment initiation was 97% among CKP and 94% among non-CKP.DiscussionCKP were identified primarily through index testing which, although considered a priority strategy to identify children at high risk, has not been widely used within KP family networks. Most CKP reached were children of female sex workers, but those of other KPs should also be prioritized.ConclusionsKP-focused programs have often excluded children, but the case-finding approaches in the project's KP programs were effective in reaching CKP. Comprehensive, family-centered KP programming is needed that includes family planning, prevention of vertical transmission, early infant diagnosis, and other maternal and child health services to reduce the impact of HIV on families and achieve an HIV-free generation.

Little is known about the effect of using an attentional focus instruction on motor performance in people with intellectual disabilities. Therefore, this study explored the effects of different attentional focus instructions on gross motor skill performances in individuals with Down syndrome. Seven community-dwelling participants (age 25.2±3.2 yrs, height 1.70±0.04 m, body mass 72.0±6.3 kg) voluntarily participated in the study. Motor performance on 5-meter running (5m sprint), vertical jump (countermovement jump with arm swing, CMJ), broad jump (standing broad jump, SBJ), forward medball throw (FMBT) or overhead medball backward throw (OMBT) and rising-up from a chair (five repetition sit-to-stand, 5STS) were recorded while performing internal-focus (IF) or external-focus (EF) instructions. EF induced significantly (p

The aim of this study was to assess the prevalence of inappropriate treatment among hospitalised patients affected by SARS-CoV-2 infection before hospital admission during the Omicron era. This single-centre, retrospective observational study included all the patients hospitalised because of SARS-CoV-2 infection during three periods characterised by the Italian prevalence of an Omicron variant of concern: (1) January–May 2022 (BA.1–BA.2), (2) June–October 2022 (BA.5), and (3) November 2022–March 2023 (BQ.1-XBB). Inappropriate treatment was defined as pre-hospitalisation exposure to antibiotics and/or steroids in the absence of a documented bacterial infection or the need for steroid treatment of an underlying medical condition. A total of 931 subjects were hospitalised: 394 in period 1, 334 in period 2, and 203 in period 3. Of the 157 patients undergoing inappropriate treatment (16.9%), 142 (15.3%) received antibiotics and 52 (5.6%) steroids. The proportion of inappropriately treated patients significantly decreased over time, from 23.1% in period 1 to 11.7% in period 2 and 13.3% in period 3 (p < 0.001), and there was a parallel decrease in antibiotic (p < 0.001) and steroid treatment (p < 0.013). Only 13 subjects (1.4%) received early pre-hospitalisation treatment for SARS-CoV-2. A significant proportion of hospitalised COVID-19 patients were exposed to inappropriate treatment before hospital admission.

Thromboprophylaxis/anticoagulation treatment is often required in hospitalized COVID-19 patients. We aimed to estimate the prevalence of major bleeding events in hospitalized COVID-19 patients. This was a retrospective observational study including all COVID-19 hospitalized patients ≥18 years of age at one reference center in northern Italy. The crude prevalence (between February 2020–2022) of major bleeding events was estimated as the number of major bleeding episodes divided by patients at risk. Uni- and multivariable Cox models were built to assess factors potentially associated with major bleeding events. Twenty-nine (0.98%) out of 2,945 COVID-19 patients experienced a major bleeding event [prevalence of 0.55% (95%CI 0.37–0.79)], of which five were fatal. Patients who experienced a major bleeding event were older [78 years (72–84 IQR) vs. 67 years (55–78 IQR), p-value < 0.001] and more frequently exposed to anti-aggregating therapy (44.8% vs. 20.0%, p-value 0.002) when compared to those who did not. In the multivariable Cox model, age [per 1 year more AHR 1.05 (CI95% 1.02–1.09)] was independently associated with an increased risk of major bleeding events. A strict monitoring of older hospitalized COVID-19 patients is warranted due to the risk of major bleeding events.

Lugones’s theory of oppression focuses on the need for the oppressed to cultivate a different logic of reality. The conditions that allow the emergence of a resistant consciousness rest on a pluralist ontology and on the idea of a multiple self-capable of traveling between «worlds». A key role in this theory is occupied by the space of limen. The limen constitutes a portal to liberation, but it does not guarantee its outcome. In fact, the political project of emancipation from the multiple oppressions requires the creation of coalitions. A goal that can only be achieved through complex communication, which abandons the liberal logic of transparency.

Background and aimsThe aim of the study was to evaluate the satisfaction of the use of telemedicine and telenursing in children and young adults with Type 1 Diabetes (T1D) using Advanced Hybrid Closed Loop systems (AHCL) with a focus on the role of connectivity, data download and the ease of technical steps in the set and sensor change procedures.MethodsAn online anonymous survey was administered to AHCL users. The questionnaire consisted of five Clusters: Cluster A-B-C included questions related to the general satisfaction in the use of telemedicine, Cluster D was focused on the role of data download and connectivity, Cluster E was related to satisfaction in telenursing and Cluster F to the perception of ease of execution of the technical steps like changing the infusion set and the sensor.ResultsWe collected 136 completed questionnaires. 83.8% of AHCL users were overall satisfied with the quality of the telemedicine service. 88.2% of patients downloaded AHCL data before visits and the overall quality of televisits (data sharing, connectivity, ease of use) was satisfactory for 85.3% of users. Telenursing support during set and sensor change procedures was considered effective by 98% of AHCL users. The sensor and insulin infusion set change procedure is perceived as different for the two systems: set change simpler for Medtronic (p = 0.011) users, while sensor change was simpler for Tandem users (p = 0.009).ConclusionTelemedicine and telenursing have an essential role in diabetology and are highly appreciated in AHCL users. The nurse support in the education of the use of AHCL systems is effective and must be implemented. Unfortunately, not all patients have the technological tools needed for downloading data at home and using telemedicine services; this represents an important challenge for the future of diabetology and for the equity in accessibility to care.

BackgroundNoonan syndrome (NS) is a genetic multisystem disorder characterised by variable clinical manifestations including dysmorphic facial features, short stature, congenital heart disease, renal anomalies, lymphatic malformations, chest deformities, cryptorchidism in males.MethodsIn this narrative review, we summarized the available data on puberty and gonadal function in NS subjects and the role of the RAS/mitogen-activated protein kinase (MAPK) signalling pathway in fertility. In addition, we have reported our personal experience on pubertal development and vertical transmission in NS.ConclusionsAccording to the literature and to our experience, NS patients seem to have a delay in puberty onset compared to the physiological timing reported in healthy children. Males with NS seem to be at risk of gonadal dysfunction secondary not only to cryptorchidism but also to other underlying developmental factors including the MAP/MAPK pathway and genetics. Long-term data on a large cohort of males and females with NS are needed to better understand the impact of delayed puberty on adult height, metabolic profile and well-being. The role of genetic counselling and fertility related-issues is crucial.

Pulmonary aspergillosis mainly affects elderly patients, patients with pulmonary complications, patients with hematological malignancies, organ transplant recipients, or critically ill patients. Co-morbidities may result in a high rate of polypharmacy and a high risk of potential drug–drug interaction (pDDI)-related antifungal azoles, which are perpetrators of several pharmacokinetic- and pharmacodynamic-driven pDDIs. Here, we report the results of the first 2-year study of an outpatient clinic focusing on the management of therapies in patients with pulmonary aspergillosis. All patients who underwent an outpatient visit from May 2021 to May 2023 were included in this retrospective analysis. A total of 34 patients who were given an azole as an antifungal treatment (53% voriconazole, 41% isavuconazole, and 6% itraconazole) were included. Overall, 172 pDDIs were identified and classified as red- (8%), orange- (74%), or yellow-flag (18%) combinations. We suggested handling polypharmacy in those patients using specific diagnostic and pharmacologic interventions. As expected, red-flag pDDIs involved mainly voriconazole as a perpetrator (71%). However, nearly 30% of red-flag pDDIs were not related to antifungal therapy. These findings highlight the importance of conducting an overall assessment of the pharmacologic burden and the key role played by a multidisciplinary team for the optimization of therapies in patients with pulmonary aspergillosis.

The study focuses on the antimicrobial activity of nanocellulose films (NFC) embedded with thyme, cinnamon, and oregano essential oils for active packaging application. The activity against model pathogenic bacteria was first tested to obtain each oil's minimum inhibitory concentration (MIC). The tests showed that the surface area of the films and the quantity of essential oil strongly influenced the antimicrobial effect. Then, the different active packaging systems were tested directly on packed raspberries to study their actual commercial packaging conditions. Through 12 days of storage at 1°C, it was observed that thyme and oregano essential oils were more effective in maintaining the firmness and reducing the weight loss of the fruits compared to cinnamon essential oil or the control; no significant effect was observed on the other quality parameters that were considered. The essential oils independently proved effective in preventing fungal growth. However, the combined impact of thyme+oregano (NAP_TO) demonstrated the best performance.

Solubility and diffusivity of Thyme, Cinnamon and Oregano essential oils in nanocellulose films, with different carboxymethylation degree, were investigated in view of potential use in active packaging applications.Solubility of liquid essential oils resulted to increase with the carboxymethylation degree for both Oregano and Thyme, while it was non-monotonous for Cinnamon. Thyme showed the higher solubility (about 20%wt) followed by Cinnamon and Oregano.The sorption kinetics of liquid essential oils was substantially Fickian. The diffusivity also increased with the increase of the carboxymethylation degree, going from 9.6 × 10−9 cm2⁄s, observed for oregano in pure nanocellulose, to 2.0 × 10−8 cm2⁄s, measured for Cinnamon in the most charged one.The release in vapor phase showed two different kinetics: a faster one dominating at short times and a slower one visible at long times. Fickian diffusion described the behaviour of most of the samples even if in some case data were better fitted by using exponential functions. In general, Diffusivities values ranged from 10−9 to 10−11 cm2⁄s for the fast process and from 10−11 to 10−13 cm2⁄s, for the slow one.Carboxymethylation degree also affected the release kinetics of antimicrobial essential oils, which therefore can be tuned by appropriate choice of the nanocellulose material.

Sex identification through coelioscopy is a minimally invasive surgical technique used to determine the sex of chelonians by directly visualizing their internal reproductive organs. An adequate anaesthesiologic plan is essential to guarantee patient immobilization and proper analgesia during the entire surgical procedure. In this study, we evaluated the effects of a combination of dexmedetomidine (0.05 mg/kg), midazolam (1 mg/kg), ketamine (8 mg/kg), and morphine (1 mg/kg) (DMKM) randomly delivered intramuscularly (IM) or subcutaneously (SC) in twenty-one Aldabra giant tortoise (Aldabrachelys gigantea) into the right antebrachium for celioscopic sex identification. Heart rate (HR), respiratory rate (RR), and body temperature (BT) were measured, along with the skeletal muscle tone of the thoracic and pelvic limbs, neck retraction reflex, palpebral reflex, and jaw tone every 15 min. The anaesthesiologic plan was considered to be adequate at the loss of the thoracic and pelvic limb retraction reflexes. After a 45 min interval, if the anaesthetic plan was deemed insufficient for the celioscopic procedure, a 5 mg/kg dose of propofol was administered intravenously into the subcarapacial venous plexus. At the end of the procedure, atipamezole (0.5 mg/kg) and flumazenil (0.05 mg/kg) were administered intramuscularly into the left antebrachium as reversal agents. Both HR and RR decreased from baseline to both 15 and 30 min. Due to the persistence of thoracic and pelvic limb retraction reflexes 45 min after DMKM administration, 6/11 (55%) cases in the SC group required the additional administration of propofol, in contrast to only 1/10 (10%) cases in the IM group (p = 0.05). The recovery times were comparable between the successfully induced animals in the IM and SC groups. In this study, the intramuscular administration of a DMKM combination quickly produced chemical restraint, suitable for celioscopic sex determination.

Abstract Background According to the guidelines, endobronchial ultrasound guided transbronchial needle aspiration (EBUS‐TBNA) is the technique of choice for the diagnosis of mediastinal involvement in lung cancer; it is also useful for other mediastinal malignancies and benign pathology. Nevertheless, there is still discussion about whether to perform it under general anesthesia or under conscious sedation. Methods We retrospectively analyzed the data of all patients who underwent EBUS‐TBNA under conscious sedation with up to 1 mg/kg of meperidine and up to 0.15 mg/kg of midazolam in the Interventional Pulmonology Unit of the Azienda USL‐IRCCS Santa Maria Nuova of Reggio Emilia during 2 consecutive years. Demographic data, indication for the procedure, duration, number of lymph node sampled, number of passes per station, diagnostic yield, drugs dosage, questionnaire score, and complications were collected. Results A total of 302 patients underwent EBUS‐TBNA, and 68% of the patients were males and the mean age was 65 ± 13 years old. The average duration of procedures was 24.4 minutes and the mean dosage of drugs was 4.32 ± 1.52 mg for midazolam and 50.86 ± 13.71 mg for meperidine. The mean number of lymph nodes sampled per patient was 1.75 ± 0.82, and each patient received an average of 4.71 ± 1.78 passes. A total of 90.7% of patients completed the procedures, 85% had adequate samples, and 94.4% of patients declared with Likert's questionnaire that they strongly agree to repeat the test if necessary. Conclusion EBUS‐TBNA performed under conscious sedation with meperidine and midazolam is feasible and well‐tolerated and has a similar diagnostic yield of that reported in literature.