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We show that U.S. banks do not engage in zombie lending to firms of deteriorating profitability, irrespective of capital levels and exposure to such firms. In contrast, unregulated financial intermediaries do, originating more and cheaper loans to these firms. We establish these results using supervisory data on firm-bank relationships, syndicated lending data for banks and nonbanks, and an empirical setting with quasirandom shocks to firm profitability. Although credit migrates from banks to nonbanks, zombie firms file for bankruptcy at an elevated rate, suggesting that nonbanks' zombie lending does not enhance the survival rate of distressed and unprofitable firms. JEL classification: G21, G32, G33 Key words: zombie lending, zombie firms, banks, nonbanks, 1 Introduction Zombie firms are unproductive businesses that survive on cheap credit despite generating insufficient profits to service their debt. These firms may have negative consequences for the real economy, [...]

Abstract Previous investigations have suggested a potential association between pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with telomere length (TL) in various tissues of pregnant women and newborns. Nonetheless, as association does not imply causation, our objective was to investigate the causal connections among pre-pregnancy BMI, GWG, and TL in amniotic fluid. The analysis included 136 mother-child pairs from the Mamma & Bambino cohort, and three causal graph models were developed to depict the interconnections between pre-pregnancy BMI, GWG, and TL. Causal graph analysis was conducted utilizing the do-operator to estimate the causal effect of GWG and the controlled direct effect of pregestational BMI. We revealed that transitioning from non-adequate to adequate GWG had a positive impact on the probability of having “long” TL (i.e., a value greater than the population median) in all three models. When considering the effect of pre-pregnancy BMI, the highest probability of “long” TL was observed in normal weight women with adequate GWG. In contrast, the effect of adequate GWG became minimal among overweight women. These results shed light on the potential causality between pre-pregnancy BMI, GWG, and TL in amniotic fluid, emphasizing the importance of appropriate weight management before and during pregnancy for optimal TL outcomes.

BackgroundThe use of wearable sensors is being explored as a challenging way to accurately identify smoking behaviors by measuring physiological and environmental factors in real-life settings. Although they hold potential benefits for aiding smoking cessation, no single wearable device currently achieves high accuracy in detecting smoking events. Furthermore, it is crucial to emphasize that this area of study is dynamic and requires ongoing updates. ObjectiveThis scoping review aims to map the scientific literature for identifying the main sensors developed or used for tobacco smoke detection, with a specific focus on wearable sensors, as well as describe their key features and categorize them by type. MethodsAccording to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) protocol, an electronic search was conducted on the PubMed, MEDLINE, and Web of Science databases, using the following keywords: (“biosensors” OR “biosensor” OR “sensors” OR “sensor” OR “wearable”) AND (“smoking” OR “smoke”). ResultsAmong a total of 37 studies included in this scoping review published between 2012 and March 2024, 16 described sensors based on wearable bands, 15 described multisensory systems, and 6 described other strategies to detect tobacco smoke exposure. Included studies provided details about the design or application of wearable sensors based on an elastic band to detect different aspects of tobacco smoke exposure (eg, arm, wrist, and finger movements, and lighting events). Some studies proposed a system composed of different sensor modalities (eg, Personal Automatic Cigarette Tracker [PACT], PACT 2.0, and AutoSense). ConclusionsOur scoping review has revealed both the obstacles and opportunities linked to wearable devices, offering valuable insights for future research initiatives. Tackling the recognized challenges and delving into potential avenues for enhancement could elevate wearable devices into even more effective tools for aiding smoking cessation. In this context, continuous research is essential to fine-tune and optimize these devices, guaranteeing their practicality and reliability in real-world applications.

Aim: The aim of this study was to systematically map the research conducted on health literacy skills in nursing students across all years of the bachelor's degree program, contributing to the advancement of knowledge in this crucial field. Background: Prior studies have highlighted the inadequacy and inconsistency of Health Literacy content in nursing curricula, emphasizing the pressing need for comprehensive research on effective methods and procedures to improve understanding of this subject. Review methods: Utilizing Arksey and O'Malley's framework, we conducted a scoping review. A systematic search was performed by four researchers across multiple electronic databases, including MEDLINE (via PubMed), the Education Resources Information Centre (ERIC), CINAHL, Scopus, Web of Science (WOS), and Google Scholar. The protocol was registered with the Open Science Framework (OSF) on April 20, 2023 (https://doi.org/10.17605/OSF.IO/CN8D7). Results: Inclusion criteria led to the selection of 30 studies. Various research areas emerged, such as the effectiveness of didactical strategies in promoting Health Literacy skills, the analysis of Health Literacy skill levels, Health Literacy skills as predictors of healthy behaviors, and nursing students' experiences in clinical settings regarding Health Literacy skills. The HL skills in nursing student was assessed with many different instruments. Conclusions: Further investigation and development of Health Literacy skills among nursing students are crucial. Analyzing patients' opinions on nursing students' performance during clinical placements and comparing nursing program curricula, including didactical strategies and Health Literacy skills assessment methods, can offer valuable insights into their impact on student learning outcomes. Implications for Nursing & Health Policy: This review emphasize the critical need for collaborative efforts between policymakers, educators, and healthcare professionals to enhance HL education in nursing programs and inform policies that promote the integration of HL skills into nursing practice. Patient and public involvement: Patient and Public Involvement and Engagement (PPIE) were not included in this project as it is a literature review and did not involve direct participation from patients or the public.

BackgroundCardiovascular diseases (CVDs) pose a significant global health challenge, necessitating innovative approaches for primary prevention. Personalized prevention, based on genetic risk scores (PRS) and digital technologies, holds promise in revolutionizing CVD preventive strategies. However, the clinical efficacy of these interventions requires further investigation. This study presents the protocol of the INNOPREV randomized controlled trial, aiming to evaluate the clinical efficacy of PRS and digital technologies in personalized cardiovascular disease prevention.MethodsThe INNOPREV trial is a four-arm RCT conducted in Italy. A total of 1,020 participants, aged 40–69 with high 10-year CVD risk based on SCORE 2 charts, will be randomly assigned to traditional CVD risk assessment, genetic testing (CVD PRS), digital intervention (app and smart band), or a combination of genetic testing and digital intervention. The primary objective is to evaluate the efficacy of providing CVD PRS information, measured at baseline, either alone or in combination with the use of an app and a smart band, on two endpoints: changes in lifestyle patterns, and modification in CVD risk profiles. Participants will undergo a comprehensive assessment and cardiovascular evaluation at baseline, with follow-up visits at one, five, and 12 months. Lifestyle changes and CVD risk profiles will be assessed at different time points beyond the initial assessment, using the Life's Essential 8 and SCORE 2, respectively. Blood samples will be collected at baseline and at study completion to evaluate changes in lipid profiles. The analysis will employ adjusted mixed-effect models for repeated measures to assess significant differences in the data collected over time. Additionally, potential moderators and mediators will be examined to understand the underlying mechanisms of behavior change.DiscussionAs the largest trial in this context, the INNOPREV trial will contribute to the advancement of personalized cardiovascular disease prevention, with the potential to positively impact public health and reduce the burden of CVDs on healthcare systems. By systematically examining the clinical efficacy of PRS and digital interventions, this trial aims to provide valuable evidence to guide future preventive strategies and enhance population health outcomes.

Available data highlights the significant impact of the COVID-19 pandemic on global vaccination trends. Despite this, comprehensive evaluations of these changes at the European level are still scarce. This study examines coverage for diphtheria, tetanus, and pertussis (DTP) and measles-containing vaccines (MCV) in the WHO European Region from 2000 to 2022. Vaccination coverage data, defined as the percentage of surviving infants who received the first and third doses of DTP (DTP1 and DTP3) and the first and second doses of MCV (MCV1 and MCV2), were extracted from UNICEF databases. Joinpoint regression analysis was employed to identify joinpoints in the time series and to estimate Annual Percent Changes (APCs) and Average Annual Percent Changes (AAPCs) over predefined timeframes. The coverages for DTP1 and MCV1 exhibit a similar trend, overall characterized by four joinpoints, one of which is in 2019. In contrast, the coverage for DTP3 does not show a significant temporal trend and lacks joinpoints, while the vaccination coverage for MCV2 shows a steadily increasing trend, with three identified joinpoints. A comparative analysis with the pre-pandemic period reveals a significant increase in the number of countries characterized by a decreasing trend during the pandemic period for all considered vaccination coverages, as indicated by the negative AAPC values. These results highlight the effect of the pandemic on childhood vaccination coverage. Compared to a mere descriptive analysis, the temporal analysis of trends using joinpoint regression provides significant opportunities to identify variations in vaccination coverages and pinpoint areas for intervention in future vaccination strategies.

ABSTRACT Symptoms of severe vein clearing, leaf rolling, and blistering were observed in cassava plants in southwestern Bahia State, Brazil. The plants were collected, vegetatively propagated, and kept in a greenhouse. Leaf samples tested positive for begomovirus infection by Polymerase chain reaction (PCR). Complete nucleotide sequences of DNA-A and DNA-B of isolate PSLDV-Man04 revealed 99.89 % and 96.2 % identity, respectively, with the bipartite begomovirus passionfruit severe leaf distortion virus (PSLDV) genome. This PSLDV isolate was experimentally transmitted to two and four of the five cassava plants and ten passion fruit plants, respectively, inoculated with Bemisia tabaci Middle East-Asia Minor 1 (MEAM1). This is the first report of the natural infection of cassava plants by the PSLDV begomovirus in Brazil.

Background: The six Platinum group metal elements (PGEs) comprising Ruthenium, Rhodium, Palladium, Platinum, Iridium and Osmium are grouped together in the periodic table. Human activities are mostly responsible for releasing PGEs into the environment. This systematic review focused on three PGEs with the greatest anthropogenic use, including in vehicle catalytic converters: Platinum (Pt), Palladium (Pd), and Rhodium (Rh). Consequently, these represent the greatest contributors to environmental pollution. The current review of in vivo toxicological studies (mammalian models) and in vitro cell exposure studies examined the potential harmful effects of these metalloids to mammalians, and their possible toxicity to human health. Methods: We applied Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology to conduct a comprehensive search and evaluation of records in the available literature published between 01/01/2009 and 01/15/2024 in four databases. PROSPERO code ID: CRD42024471558. Results concerning the health effects of PGEs were extracted from articles according to the inclusion and exclusion criteria. After screening the records for eligibility, 22 studies were included in the final analysis. Results: This systematic review revealed that airborne PGEs significantly increased the activation of pathologic pathways in several human organs and/or perturbed various metabolic pathways. In view of the known pro-inflammatory and organ-degenerative effects of PGEs, the paucity of studies on the effect of PGEs on the central nervous system and on possible correlations with neurodegenerative diseases were particularly evident. Conclusions: The clinical complexity and chronic nature of PGE-related pathologies indicate that targeted research is essential. In light of the increasing incidence of non-communicable diseases, particular attention should be paid to the design of epidemiological studies and to environmental monitoring services.

Abstract Background External auditory canal cholesteatoma (EACC) is a rare pathological condition representing 0.1% of all new otologic cases. Bilaterality manifests in 10% of EACC cases. Similar disease processes include keratosis obturans (KO) and benign necrotizing otitis externa (BNOE). Diagnostic differentiation may not always be unexacting but does however influence management and eventual outcome. This study aims to briefly review the literature, describe an unusual case of synchronous bilateral primary EACC, and simplify the diagnostic challenges surrounding this disease. Case presentation A 66-year-old man with no relevant family history, no concurrent or intercurrent illnesses, having undergone no relevant surgery, and had visited the Department of Otorhinolaryngology regarding right-sided otorrhoea and aural pruritis 9 years ago. At the time, he was diagnosed clinically with KO. Nine years later after having defaulted follow-up, he presented again with the same symptoms. Oto-microscopy now revealed excavation of the posterior canal wall, keratinous desquamation, and an intact tympanic membrane. Oto-endoscopy demonstrated extension posteriorly into the mastoid segment of the temporal bone. Computed tomography evinced a soft tissue attenuating mass within the excavated sub-adjacent bone, with extension into the mastoid air cell system. The contralateral ear had a smaller epithelial defect of the canal floor with underlying tympanic plate erosion. A closed mastoidectomy with the reconstruction of the posterior canal wall was performed on the right ear. The left ear was managed conservatively with micro-suctioning and aural toilette. Six months post-surgery, however, the reconstructed posterior canal wall underwent necrotic breakdown. The contralateral lesion gradually progressed into a Naim et al. (2005) Stage III EACC. Conclusion This case illustrates the diagnostic challenge presented by EACC and is unusual regarding its bilaterality. The importance of diagnostic differentiation, both in the management of this disease and in the prevention of its progression, is highlighted. The idea of oto-endoscopy as a routine clinical tool is introduced, and endoscopic images are compared to high-definition computed tomography scans of the affected temporal bones.

Abstract Age-associated B cells (ABC) accumulate with age and in individuals with different immunological disorders, including cancer patients treated with immune checkpoint blockade and those with inborn errors of immunity. Here, we investigate whether ABCs from different conditions are similar and how they impact the longitudinal level of the COVID-19 vaccine response. Single-cell RNA sequencing indicates that ABCs with distinct aetiologies have common transcriptional profiles and can be categorised according to their expression of immune genes, such as the autoimmune regulator (AIRE). Furthermore, higher baseline ABC frequency correlates with decreased levels of antigen-specific memory B cells and reduced neutralising capacity against SARS-CoV-2. ABCs express high levels of the inhibitory FcγRIIB receptor and are distinctive in their ability to bind immune complexes, which could contribute to diminish vaccine responses either directly, or indirectly via enhanced clearance of immune complexed-antigen. Expansion of ABCs may, therefore, serve as a biomarker identifying individuals at risk of suboptimal responses to vaccination.

Introduction The healthcare systems in Europe are changing rapidly due to the increased complexity of healthcare needs, specifically for the ageing population with chronic diseases. Nurses play a key role in providing care for patients with chronic diseases, encouraging patients to take care of their own health improving their Health Literacy (HL) too. Previous works have highlighted the paucity of HL content in nursing curricula, and the need to prioritise the development of HL skills in academic teaching and assessment methods. The aim of this study is to analyse HL skills nursing literature to further develop scientific knowledge in this area of research.Methods and analysis This scoping review will be conducted following Arksey and O’Malley’s framework. This study is based on the Joanna Briggs Institute manual. A systematic search will be performed by four researchers using the electronic databases of MEDLINE (via PubMed), the Education Resources Information Centre, the Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science and Google Scholar. We will include any paper that focuses on HL skills and undergraduate nursing students. We will select every primary study (quantitative, qualitative and mixed method design) published in peer-reviewed journals up until February 2023, in both Italian and English language, without any time limit.Ethics and dissemination This scoping review is part of a large project of the University of Catania which aims at developing higher educational standards for nursing student. This project will not involve patients/public and does not require ethical committee approval. This scoping review will be submitted to international peer-reviewed journals.Registration details The protocol was registered with the Open Science Framework on 20 April 2023 (https://osf.io/cn8d7).

ABSTRACT Zinnia sp. and hairy beggartick (Bidens pilosa) plants exhibiting symptoms of possible virus infection were found in the municipality of Santa Bárbara d’Oeste, São Paulo State, Brazil. Flexuous filamentous particles and cytoplasmatic inclusions typical of potyvirus infection were observed by transmission electron microscopy, respectively, in leaf extracts and cells of symptomatic leaves. Infection of both plants with bidens mottle virus (BiMoV) was confirmed by RT-PCR using potyvirus universal primers, followed by nucleotide sequencing of the amplicons. The nearly complete genome sequence of the Brazilian isolate, named BiMoV-BR, is 9700 nucleotides long and shares 95.6 % identity with the corresponding nucleotide sequence of a BiMoV isolate from the United States. BiMoV-BR was mechanically transmitted and caused systemic infection on plants of Zinnia sp., hairy beggarstick, sunflower (Helianthus annuus), and lettuce (Lactuca sativa). Myzus persicae transmitted the virus to Zinnia sp. plants with efficacy of 8 % and 42 %, using one and ten aphids per plant, respectively. This is the first detection of BiMoV in Brazil. Further studies are necessary to evaluate the distribution of this potyvirus in the country.

The integration of various geophysical methodologies is considered a fundamental tool for accurately reconstructing the extent and shape of a groundwater body and for estimating the physical parameters that characterize it. This is often essential for the management of water resources in areas affected by geological and environmental hazards. This work aims to reconstruct the pattern and extent of two groundwater bodies, located in the coastal sectors of the North-Eastern Sicily, through the integrated analysis and interpretation of several geoelectrical, seismic and geological data. These are the Sant’Agata-Capo D’Orlando (SCGWB) and the Barcelona-Milazzo (BMGWB) Groundwater Bodies, located at the two ends of the northern sector of the Peloritani geological complex. These two studied coastal plains represent densely populated and industrialized areas, in which the quantity and quality of the groundwater bodies are under constant threat. At first, the resistivity models of the two groundwater bodies were realized through the inversion of a dataset of Vertical Electrical Soundings (VES), constrained by stratigraphic well logs data and other geophysical data. The 3D resistivity models obtained by spatially interpolating 1D inverse VES models have allowed for an initial recognition of the distribution of groundwater, as well as a rough geological framework of the subsoil. Subsequently, these models were implemented by integrating results from active and passive seismic data to determine the seismic P and S wave velocities of the main lithotypes. Simultaneous acquisition and interpretation of seismic and electrical tomographies along identical profiles allowed to determine the specific values of seismic velocity, electrical resistivity and chargeability of the alluvial sediments, and to use these values to constrain the HVSR inversion. All this allowed us to recognize the areal extension and thickness of the various lithotypes in the two investigated areas and, finally, to define the depth and the morphology of the base of the groundwater bodies and the thickness of the filling deposits.

Background: Natural language processing, such as ChatGPT, demonstrates growing potential across numerous research scenarios, also raising interest in its applications in public health and epidemiology. Here, we applied a bibliometric analysis for a systematic assessment of the current literature related to the applications of ChatGPT in epidemiology and public health. Methods: A bibliometric analysis was conducted on the Biblioshiny web-app, by collecting original articles indexed in the Scopus database between 2010 and 2023. Results: On a total of 3431 original medical articles, “Article” and “Conference paper”, mostly constituting the total of retrieved documents, highlighting that the term “ChatGPT” becomes an interesting topic from 2023. The annual publications escalated from 39 in 2010 to 719 in 2023, with an average annual growth rate of 25.1%. In terms of country production over time, the USA led with the highest overall production from 2010 to 2023. Concerning citations, the most frequently cited countries were the USA, UK, and China. Interestingly, Harvard Medical School emerges as the leading contributor, accounting for 18% of all articles among the top ten affiliations. Conclusions: Our study provides an overall examination of the existing research interest in ChatGPT’s applications for public health by outlining pivotal themes and uncovering emerging trends.

Background: Maternal–child health suggests the critical impact of maternal nutrition during the pre-conception and gestational periods, with some genetic variants also playing a significant role. Our systematic review provides an overview of epidemiological studies exploring the interactions between genetic variants, maternal dietary habits, and neonatal and/or maternal pregnancy outcomes. Methods: From its inception until June 2023, we conducted a comprehensive literature search on PubMed, Embase, and Web of Science databases. Results: On a total of 29 epidemiological studies, 11 studies were conducted to explore the interplay between genetic variants and dietary factors, focusing on the risks associated with gestational diabetes mellitus, hypertensive disorders of pregnancy, recurrent spontaneous abortion, recurrent pregnancy loss, iron deficiency anemia, and gestational weight gain. Concerning neonatal outcomes, six studies investigated the interplay between genetic variants, dietary factors, and anthropometric measures, while eight studies delved into abnormal embryonic development, two studies focused on preterm birth, and two studies explored other neonatal outcomes. Conclusions: Deeply understanding gene–diet interactions could be useful in developing highly personalized approaches to maternal and child nutrition, as well as in exploring the potential implications in disease prevention and the promotion of the long-term well-being of both mothers and their offspring.

BackgroundThe inappropriate use of antibiotics in clinical and non-clinical settings contributes to the increasing prevalence of multidrug-resistant microorganisms. Contemporary endeavours are focused on exploring novel technological methodologies, striving to create cost-effective and valuable alternatives for detecting microorganisms, antimicrobial resistance genes (ARGs), and/or antibiotics across diverse matrices. Within this context, there exists an increasingly pressing demand to consolidate insights into potential biosensors and their implications for public health in the battle against antimicrobial resistance (AMR).MethodsA scoping review was carried out to map the research conducted on biosensors for the detection of microorganisms, ARGs and/or antibiotics in clinical and environmental samples. The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist was used. Articles published from 1999 to November 2022 and indexed in the following databases were included: MEDLINE, EMBASE, Web of Science, BIOSIS Citation index, Derwent Innovations index, and KCI-Korean Journal.ResultsThe 48 studies included in the scoping review described the development and/or validation of biosensors for the detection of microorganisms, ARGs and/or antibiotics. At its current stage, the detection of microorganisms and/or ARGs has focused primarily on the development and validation of biosensors in clinical and bacterial samples. By contrast, the detection of antibiotics has focused primarily on the development and validation of biosensors in environmental samples. Asides from target and samples, the intrinsic characteristics of biosensors described in the scoping review were heterogenous. Nonetheless, the number of studies assessing the efficacy and validation of the aforementioned biosensor remained limited, and there was also a lack of comparative analyses against conventional molecular techniques.ConclusionPromoting high-quality research is essential to facilitate the integration of biosensors as innovative technologies within the realm of public health challenges, such as antimicrobial resistance AMR. Adopting a One-Health approach, it becomes imperative to delve deeper into these promising and feasible technologies, exploring their potential across diverse sample sets and matrices.

Preview: /Review: Brian S. Dixon, Dewey and Design: A Pragmatist Perspective for Design Research (Cham: Springer, 2020), 200 pages./ Brian S. Dixon’s book Dewey and Design provides, as the book’s subtitle declaims, a pragmatist perspective for design research. Design research is an academic field that specifically deals with the design process. Its domain-specific knowledge led to the establishment of design as an independent discipline of study in the second half of the last century. According to Dixon’s description, design research consists of three major areas of investigation: the design process, the artifacts that result from this process, and the relation of these artifacts with the end-user. Dixon exposes the fruitlessness of drawing a clear dividing line, and argues that design research would be better off as a continuous, not necessarily linear, process involving “practically” all three. Concurrently, the author emphasizes the practical aspect of this continuity; on the one hand as a stark contrast to the idea of ​​purely theoretical research, on the other, from a pragmatist viewpoint, intending the knowledge of the world as full of the practical consequences of acting within it. Specifically, the pragmatist slant of Dixon’s proposal is that of John Dewey, centered on the ideas of “an experience,” “inquiry,” and “imagination”; notions aiming at providing “a robust epistemological narrative” for design research. The choice of this perspective necessarily leads Dixon to deal with problems such as the ontology of the specifically creative act of designers, distinct from the artistic one, the communicative potential of industrial artifacts, and their ethical import.