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The present report investigates the impact of a Telemedicine Service (TMS) on the management of Idiopathic Pulmonary Fibrosis (IPF) during coronavirus disease of 2019 (COVID-19) outbreak in Italy. The TMS comprised 3 phone numbers, active 12 h per day, and an email address, monitored every 4 h by trained physicians; chat- and videoconference-services were also offered. At the end of the study period, our staff contacted all patients, to get information about the final outcome (i.e. composite hospitalisations/all causes of death). Outcomes were compared with a cohort of patients who attended our unit in the same period of the previous year (when no TMS was available). 189 patients participated in the present study. From 11th March to 4th May 2020, 61% of patients made at least one TMS access, mostly by emails (53%), followed by phone calls (33%). With regard to the primary outcome, TMS patients experienced a significant lower rate of events of the 182 patients of the no-TMS cohort (p < 0.001). Specifically, a significant difference was observed for IPF hospitalisation (p < 0.001) whereas no differences were observed with regard to deaths (p = 0.64). TMS permits patients to be followed up even during COVID-19 lockdown, with an encouraging impact on outcomes.

Alfonso Papa,1 Maria Teresa Di Dato,1 Giuliano Lo Bianco,1– 3 Giuseppe Gazzerro,1 Anna Maria Salzano,1 Emilio Di Costanzo,1 Dario Tammaro,1 Michael E Schatman,4,5 Giustino Varrassi6 1Pain Department AO “Ospedali dei Colli”, Monaldi Hospital, Naples, Italy; 2Department of Biomedical and Biotechnological Sciences (BIOMETEC), University of Catania, Catania, Italy; 3Anesthesiology and Pain Department, Fondazione Istituto G. Giglio, Cefalù, Italy; 4Department of Anesthesiology, Perioperative Care, and Pain Medicine, NYU School of Medicine, New York, NY, USA; 5School of Social Work, North Carolina State University, Raleigh, NC, USA; 6Paolo Procacci Foundation, Rome, ItalyCorrespondence: Giuliano Lo Bianco Tel +393289682219Email giulianolobianco@gmail.comObjective: Osteoarthritis (OA) is the most common cause of chronic knee pain, often a debilitating condition that can cause a significant reduction in functional capacity. Radiofrequency is a form of neuromodulation that modulates pain signal transmission and has become progressively more common as a treatment for knee pain. This retrospective study aims to evaluate the efficacy of intraarticular radiofrequency in patients with chronic knee OA pain.Materials and Methods: In this retrospective study, we included 129 patients undergoing intraarticular pulsed radiofrequency using the Poisson curve for energy distribution (Sluijter-Teixeira Poisson radiofrequency) (STP) from March 2018 to November 2019. Knee osteoarthritis severity was assessed prior to the procedure using the Lequesne Index, classifying patients into six groups based on level of severity. Pain intensity was assessed through a 10-cm visual analog scale (VAS), and level of patient satisfaction was assessed through a questionnaire.Results: In the sample, pain reduction as measured by VAS compared to baseline prior to the procedure was statistically significant immediately following the procedure, at 30 days and at 90 days (p< 0.001); this difference was less significant at 180 days (p< 0.005). Efficacy in patients with moderate to severe disability was considerably greater than in patients with very severe to extremely severe disability. 57.36% reported that they were very satisfied, 29.46% satisfied, 9.3% neither satisfied nor dissatisfied, 2.33% dissatisfied, and 1.55% very dissatisfied.Conclusion: Our results suggest that STP radiofrequency may be a safe and effective procedure for knee OA, able to signi&filig;cantly reduce VAS scores at 1 month and 3 months compared to baseline. Based on our results, a key factor to consider when treating knee OA with STP radiofrequency is that it is more effective among patients with a lower level of disability. Due to the retrospective observational study design, prospective longitudinal investigation is required to further support the recommendation of STP radiofrequency for knee OA.Keywords: pulsed radiofrequency treatment, knee joint, osteoarthritis, knee, chronic pain

Retroperitoneal fibrosis is a connective disease of the auto-inflammatory/auto-immune type of the retroperitoneum with unknown etiology and pathological mechanism. The manifestations of the pathology can be local or systemic. Amongst the local symptoms, the dull and constant pain in the hips, back or abdomen is the most frequent.

The prevalence of chronic pain is between 33% to 64% and is due to cancer pain, but it has also been observed in non-cancer patients. Chronic pain is associated with lower quality of life and higher psychological distress and depressive/anxiety disorders in patients without a history of disorder.

Cancer-related pain represents one of the most common complaints of cancer patients especially for those with advanced-stage of disease and/or bone metastases. More effective therapeutic strategies are needed not only to improve the survival of cancer patients but also to relieve cancer-related pain. In the last decade, immune checkpoint inhibitor (ICI)-based immunotherapy targeting programmed cell death-1 (PD-1) and its ligand 1 (PD-L1) has revolutionized cancer care. Beyond its anticancer role, PD-1/PD-L1 axis pathway is involved in many other physiological processes. PD-L1 expression is found in both malignant tissues and normal tissues including the dorsal root ganglion, and spinal cord. Through its interaction with PD-1, PD-L1 can modulate neuron excitability, leading to the suppression of inflammatory, neuropathic, and bone cancer pain. Therefore, since the intricate relationship between immunotherapy and pain should be largely dissected, this comprehensive review explores the complex relationship between PD-1/PD-L1-based immunotherapy and cancer-related pain. It delves into the potential mechanisms through which PD-1/PD-L1 immunotherapy might modulate pain pathways, including neuroinflammation, neuromodulation, opioid mechanisms, and bone processes. Understanding these mechanisms is crucial for developing future research directions in order to optimize pain management strategies in cancer patients. Finally, this article discusses the role of artificial intelligence (AI) in advancing research and clinical practice in this context. AI-based strategies, such as analyzing large datasets and creating predictive models, can identify patterns and correlations between PD-1/PD-L1 immunotherapy and pain. These tools can assist healthcare providers in tailoring treatment plans and pain management strategies to individual patients, ultimately improving outcomes and quality of life for those undergoing PD-1/PD-L1-based immunotherapy.

The aim of the present study was to determine the effect of including green forage in the diet of Italian Mediterranean dairy buffaloes on the ruminal microbiota, CAZymes profile, functional biomolecules and total antioxidant activity in bulk milk. Sixteen buffaloes were randomly assigned according to lactation number and daily milk production to two homogeneous groups, and for 60 days received each: Group 1, a standard total mixed ration (TMR) or group 2, TMR + ryegrass green forage (30% of diet). The diets of the two groups were iso-nitrogenous and iso-energetic and differed only in the proportion of green forage. Buffaloes that received TMR + green feed had a higher (p

Buffalo is a rustic animal; it can adapt and survive in various environments with different topography, climate and vegetation, and has a greater longevity than cattle. The high resistance to parasites, as well as the ability to improve the efficiency of feed consumption in case of forage shortage, means that even in marshy territories, where any other type of livestock or agricultural activity is impossible, buffalo farming can develop an economy. This review aims to present the key research topics, the evolution and geographic distribution of literature on buffalo welfare, and to underscore potentiality and existing knowledge gaps. A comprehensive search on the Scopus bibliometric database was carried out using various welfare-related keywords such as: ‘buffalo welfare’, ‘buffalo calf welfare’ and ‘buffalo heifers’ welfare’. The research identified 308 papers published in English from January 1992 to December 2023 that, after filtering, became 148 eligible records. Descriptive statistics revealed a significant exponential increase in studies on buffalo welfare since 2020, particularly in Italy, followed by Brazil. Text mining and topic analysis revealed that the most frequently mentioned terms were ‘milk’, ‘water’, ‘behaviour’, ‘farm’ and ‘stun’, confirming the role and the importance of this species in dairy production. Nine identified topics span diverse subject areas such as ‘slaughter process’, ‘dairy production’, ‘general welfare’, ‘housing system’, ‘heat stress’, ‘reproduction performance’, ‘health status’ ‘breeding management’, and ‘stress evaluation’. Although academia shows an increasing interest in buffalo behaviour and welfare, continued research is necessary to fully comprehend how to ensure the welfare of this important species.

Purpose: Non-obstructive azoospermia (NOA) represents the persistent absence of sperm in ejaculate without obstruction, stemming from diverse disease processes. This survey explores global practices in NOA diagnosis, comparing them with guidelines and offering expert recommendations. Materials and Methods:Materials and Methods: A 56-item questionnaire survey on NOA diagnosis and management was conducted globally from July to September 2022. This paper focuses on part 1, evaluating NOA diagnosis. Data from 367 participants across 49 coun-tries were analyzed descriptively, with a Delphi process used for expert recommendations. Results:Results: Of 336 eligible responses, most participants were experienced attending physicians (70.93%). To diagnose azoosper-mia definitively, 81.7% requested two semen samples. Commonly ordered hormone tests included serum follicle-stimulating hormone (FSH) (97.0%), total testosterone (92.9%), and luteinizing hormone (86.9%). Genetic testing was requested by 66.6%, with karyotype analysis (86.2%) and Y chromosome microdeletions (88.3%) prevalent. Diagnostic testicular biopsy, distinguishing obstructive azoospermia (OA) from NOA, was not performed by 45.1%, while 34.6% did it selectively. Differ-entiation relied on physical examination (76.1%), serum hormone profiles (69.6%), and semen tests (68.1%). Expectations of finding sperm surgically were higher in men with normal FSH, larger testes, and a history of sperm in ejaculate. Conclusions:Conclusions: This expert survey, encompassing 367 participants from 49 countries, unveils congruence with recommended guidelines in NOA diagnosis. However, noteworthy disparities in practices suggest a need for evidence-based, international consensus guidelines to standardize NOA evaluation, addressing existing gaps in professional recommendations.

Intra-abdominal adhesions are the most frequently occurring postoperative complication following abdomino-pelvic surgery. Abdominal and pelvic surgery can lead to peritoneal adhesion formation causing infertility, chronic pelvic pain, and intestinal obstruction. Laparoscopy today is considered the gold standard of care in the treatment of several abdominal pathologies as well as in a wide range of vascular diseases. Laparoscopy has several advantages in comparison to open surgery. These include rapid recovery times, shorter hospitalisation, reduced postoperative pain, as well as cosmetic benefits. The technological improvements in this particular surgical field along with the development of modern techniques and the acquisition of specific laparoscopic skills have allowed for its wider utilization in operations with fully intracorporeal anastomoses. Postoperative adhesions are caused by aberrant peritoneal healing and are the leading cause of postoperative bowel obstruction. The use of anti-adherence barriers is currently being advocated for their prevention. The outcome of the investigation showed adhesion formation inhibition without direct detrimental effects on anastomotic healing. Poor anasto-motic healing can provoke adhesions even in the presence of anti-adhesion barriers. This review gives a short overview on the current evidence on the pathophysiology and prevention of peritoneal adhesions.

Context: Blockchain-based information ecosystems (BBIEs) are a type of information ecosystem in which blockchain technology is used to provide a trust mechanism among parties and to manage shared business logic, breaking the traditional scheme of information ecosystems dominated by a leading company and leveraging the decentralization of data management, information flow, and business logic.Objective: In this paper, we'd like to propose an architecture and the technical aspects concerning creating a BBIE, underlining the supplied advantages and the logic decomposition among the business and storage components.Method: The requirements are derived from the current needs of the collaborative business and the data collected by surveying practitioners. To meet these needs, we followed the Grounded Theory research approach. We validate our architectural schema against a case study on managing a wine supply chain involving different companies and supervision authorities.Results: The proposed solution integrates blockchain-based applications with the existing information system as a module of the ecosystem, leveraging on the low costs, scalability, and high-level security because of the restricted access to the network.Conclusion: We must go a long way in deepening and refining the possibilities offered by technology in supporting innovative multi-organizational business models. BBIEs can contribute substantially to paving the way in such a direction.

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Salinity stress represents a key factor for global agriculture. Plants can respond to salinity stress by adapting their physiology in different ways with the aim of limiting reductions in growth and development. Importantly, moisture retention capacity, permeability and nutrient availability of substrates represent critical variables for plants as they may further influence the effect of osmotic stress. Here, a multidisciplinary approach was applied to evaluate the role of two different substrates, peat and perlite, on 2-year-old potted cuttings of Olea europaea (cultivar Arbequina) under different salinity stress conditions (0, 100 and 200 mM NaCl). Biometric and physiological data indicate that plants potted in perlite (AP) generally present lower growth and photosynthetic rates when compared with peat (AS) in combination with salinity stress. Ion measurements indicate a rise in Na+ accumulation with increasing stress severity, which alters the ion ratio in both substrates. In addition, differences occurred in polyphenol contents, with a general increase in quinic acid and rutin contents in AS and AP samples, respectively. Metabolomic and biometric data were also coupled with metabarcoding analysis, which indicates that the moderate salinity treatment (100 mM NaCl, T100) reshaped the endophytic community of plants grown on both substrates. Taken together, the data suggest that the strategy used by a glycophytic species such as the olive tree to cope with salinity stress seems to be highly related to availability of water and nutrients. The lack of both may be simulated by perlite, enhancing the effect of salinity stress response in woody plants. Lastly, applying the beneficial endophytic bacterial taxa identified here could represent a step forward in increasing plant defence and nutrient uptake and reducing inputs for modern and more sustainable agriculture.

To accurately model the consequences of accidental dust explosions, numerical simulations of the flame propagation process are required. A key parameter in these models is the burning velocity ( ?? ?? ), which represents the consumption rate of the reactants by the flame front. Experiments are therefore needed to determine the burning velocity, and the influence of turbulence on this velocity; as well as to validate these models of flame propagation. In this article, aluminum flame propagation inside a vertical duct with obstacles is studied. The aim of the obstacles is first to increase the turbulence just in front of the flame front, in order to quantify its influence on the burning velocity. The second objective of the implementation of the obstacles is to obtain experimental data in a more complex geometry in order to validate the models. During these experiments, the flame propagation is recorded and the unburned flow velocity is measured using the TR-PIV (Time-Resolved Particle Image Velocimetry) technique. This innovative measurement of the unburned flow velocity is important not only for the accurate determination of the burning velocity, but also to validate these numerical simulations. An increase in the propagation velocity and the burning velocity is observed as the flame propagates toward the obstacles.

The increasing global demand for cleaner energy sources implies the use of H2 which poses significant safety issues. One of the major safety issues in H2 management is the storage, based on extreme condition technology (high pressure and/or very low temperatures). Alternatively, instead of H2, ammonia may be used since storage of NH3 is much simpler from a technological point of view. From a safety point, the comparison between the risk of H2 storage and NH3 storage has still to be understood. The energy (H2) sector worldwide is a dynamic and complex system, relying on the mutual interactions between different factors like safety, risk, sustainability, political and social decisions, and economic impact. The understanding and management of global behaviour can be obtained by taking into account all the interactions among these factors. In order to deal with such complex systems, system thinking, and system dynamics approaches could be developed and used. The present work aims to develop an integrated Systems Thinking approach for assessing and managing the safety of storage systems with a particular focus on the comparison between hydrogen and ammonia. The developed models integrate the complex interdependencies considering material properties, environmental conditions, and storage infrastructure. Systems Thinking is used for mapping the intricate network of interdependencies, considering storage vessel design, regulatory frameworks, and emergency response plans. Therefore, by adopting this holistic perspective, potential vulnerabilities and leverage points of the system are identified which lead to improving the overall safety of gas storage systems. Additionally, this research explores the dynamic behaviour of safe storage under different scenarios, including temperature fluctuations, pressure changes, and potential leaks. The development of System Dynamics-based models offers valuable insights for policymakers, industry stakeholders, and researchers alike. The integration of a Systems Thinking approach allows for a better understanding of the complex interactions involved in the safe storage of these technologies for informed decision-making and advancements in gas storage technologies.

The chemical industry often handles, stores, and processes molecules like hydroxylamine (HA) and hydrogen peroxide (HP), which can easily undergo thermal decomposition reactions. Hence, the ideal perspective is to have simple quantitative criteria to use during the equipment design phase, accommodating the possibility of exothermic degradations of substances to enhance process safety and avoid thermal runaways. To this aim, the Frank-Kamenetskii theory of self-heating (FKT) can be involved in determining the critical size of a storage vessel to guarantee the intrinsic safe storage of chemically hazardous materials. Eventually, the proposed design strategy will be implemented to design storage equipment for two commercial aqueous solutions of HA and HP, respectively. In this way, it will be possible to compare the inherent thermal hazard linked to the storage of these mixtures, evaluating the threshold vessel size above which the self-heating phenomenon of the materials becomes no longer controllable. The HA and HP mixtures can be used alone or together in chemical processes as oxidants or precursors for producing hydroxyl radicals. Under comparable conditions free of impurities and organic contamination, the results show that the system made of 50 %w hydrogen peroxide is more stable than hydroxylamine. This is reflected in a larger characteristic size of the storage vessel able to handle appropriately self-heating phenomena potentially leading to runaway.

Flammable liquids typically adopted in chemical and industrial processes can be subjected to intense heat radiation due to nearby hot surfaces or fires. A second cascading event is then likely because the flash point can be easily reached and the surrounding environment can provide sufficient energy for ignition. Nevertheless, the flaming condition is not necessarily reached instantaneously if no direct (e.g., spark) ignition is present. Hence, a time to flaming, i.e., in the absence of an ignition source, is extremely relevant for the active and passive fire protection of flammable liquid, as the minimum time for intervention can be defined before developing a pool fire and for the correct evaluation of domino effects, in analogy with gas fires. In addition, a complete characterization of liquid behaviour under radiant heating is essential to guarantee safe operations, prevention measures, robust databases and optimized design. Therefore, this work reports the results for three liquid solvent representative classes of substances: i) hexane, ii) ethyl acetate, and iii) ethanol. A bench scale facility was adopted for the characterization of mass and energy aspects involving a pool fire of the investigated substances. Among the others, the ignitability and the intensity of the generated pool fires were evaluated experimentally in terms of mass burning rate, heat release rate, and combustion efficiency. Different boundary conditions were tested to identify the optimized set of conditions for a robust evaluation of the safety aspects of liquid. Results showed the most relevant trends in terms of ignitability of liquid species and combustion intensity during the pseudo-steady state regime of a pool fire. In addition, indications on the boundary conditions to be considered for a robust and consistent dataset were provided in this work.