Search Results (135)

Background: Hand–arm vibration syndrome (HAVS) is a well-recognized occupational condition resulting from prolonged exposure to hand-transmitted vibration (HTV), characterized by vascular, neurological, and musculoskeletal impairments. While vibration exposure is a known risk factor for HAVS, less is understood about the role of personal risk factors and, particularly regarding neurosensory dysfunction. This study aimed to examine the association between vibrotactile (VPT) and thermotactile perception thresholds (TPT) and individual risk factors and comorbidities in HTV-exposed workers. Methods: A total of 235 male HTV workers were evaluated between 1995 and 2005 at the University of Trieste’s Occupational Medicine Unit. Personal, occupational, and health-related data were collected, and sensory function was assessed in both hands. VPTs at 31.5 and 125 Hz and TPTs (for warm and cold) were measured on fingers innervated by the median and ulnar nerves. Results: Multivariable regression analysis revealed that impaired VPTs were significantly associated with age, higher daily vibration exposure (expressed as 8 h energy-equivalent A(8) values), BMI ≥ 25, smoking, vascular/metabolic disorders, and neurosensory symptoms. In contrast, TPTs showed weaker and less consistent associations, with some links to smoking and alcohol use. Conclusions: These findings suggest that, in addition to vibration exposure, individual factors such as aging, overweight, smoking, and underlying health conditions significantly contribute to neurosensory impairment and may exacerbate neurosensory dysfunction in a context of HAVS. The results underscore the importance of including personal health risk factors in both clinical assessment and preventive strategies for HAVS and may inform future research on its pathogenesis. Full article

Vestibular atelectasis (VA) is a rare clinical entity characterized by a collapse of the endolymphatic space resulting in vestibular loss with the possible onset of positional and/or sound/pressure-induced vertigo. It could be idiopathic or secondary to other inner-ear diseases including Meniere’s disease (MD). A collapse of the membranous labyrinth involving the semicircular canals (SCs) and the utricle represents its distinctive histopathological feature. While specific radiological patterns consistent with VA have been described on contrast-enhanced MRI with delayed acquisitions, an impairment of the blood–labyrinthine barrier (BLB) could be detected in several disorders leading to vestibular loss. We conducted a narrative review of the literature on VA focusing on the putative pathomechanisms accounting for positional and sound/pressure-induced nystagmus despite unilateral vestibular loss (UVL) in this condition, providing two novel cases of VA. Both patients presented with a clinical picture consistent with unilateral MD that rapidly turned into progressive UVL and positional and/or sound/pressure-induced vertigo. In both cases, the posterior SC was initially impaired at the video-head impulse test (vHIT) and both cervical and ocular VEMPs were initially reduced. Progressively, they developed unsteadiness with paretic spontaneous nystagmus, an impairment also for the lateral and anterior SCs, caloric hypo/areflexia and VEMPs areflexia. They both exhibited ipsilesional nystagmus to sound/pressure stimuli and in one case a persistent geotropic direction-changing positional nystagmus consistent with a “light cupula” mechanism involving the lateral SC of the affected side. A collapse of the membranous labyrinthine walls resulting in contact between the vestibular sensors and the stapes footplate could explain the onset of nystagmus to loud sounds and/or pressure changes despite no responses to high- and low-frequency inputs as detected by caloric irrigations, vHIT and VEMPs. On the other hand, the onset of positional nystagmus despite UVL could be explained with the theory of the “floating labyrinth”. Both patients received contrast-enhanced brain MRI with delayed acquisition exhibiting increased contrast uptake in the pars superior of the labyrinth, suggesting an impairment of the BLB likely resulting in secondary VA. A small intralabyrinthine schwannoma was detected in one case. VA should always be considered in case of positional and/or sound/pressure-induced vertigo despite UVL. Full article

This study investigates the potential of strontium isotopes as a geographical tracer for Vignola cherries. Despite several studies having employed this indicator to trace the origin of food products, the mechanisms underlying the fractionation and translocation of strontium from soil to edible parts remain poorly understood. In this study, the ⁹¹Zr/⁹⁰Zr ratio was used as a normalization pair to correct measurements of ⁸⁷Sr/⁸⁶Sr and ⁸⁸Sr/⁸⁶Sr (δ⁸⁸Sr). Soil, cherry branches, and fruit samples were collected from various producers and locations. Isotopic analyses were carried out using a double-focusing multi-collector–inductively coupled plasma/mass spectrometer (MC-ICP/MS). External correction was applied using the ⁹¹Zr/⁹⁰Zr ratio, assuming both equal and different fractionation factors for Sr and Zr isotopes. Results from both correction models showed improved accuracy by accounting for fluctuations in instrumental mass bias. Regarding the translocation of strontium, the data indicate an increase in ⁸⁸Sr of approximately 0.2‰ from soil to plant tissue. This trend was consistent across all sampled locations. Full article

Understanding the in situ stress state and mechanical properties of rock masses is essential for ensuring the stability and safety of quarrying operations. This study aims to estimate the natural stress state of rock using the CSIRO HI (Hollow Inclusion) triaxial overcoring method; we also conducted numerical modelling by applying the Distinct Element Method (DEM) for stability assessments in quarry environments. The investigation provided comprehensive insights into the geomechanical properties of the rock mass and the stability of quarry fronts. Precise measurements and analyses of in situ stress contributed to a detailed understanding of stress distribution within the rock. Additionally, biaxial compression tests further characterized the mechanical behavior of the rock, which was essential for accurate modelling and simulation. Numerical modelling using DEM facilitated an in-depth stability analysis, allowing evaluation of potential failure mechanisms and proposal of effective mitigation strategies. The 3D numerical model was calibrated using in situ measurements from CSIRO HI data and was employed to simulate future excavations. DEM modelling was particularly crucial because of the fractured nature of the rock mass, which necessitated thorough stability verification in excavation design simulations. This research advances the scientific understanding of stress distribution and mechanical behavior in jointed rock masses, ultimately contributing to the development of safer and more efficient quarrying practices. Full article

Feline lower urinary tract disease (FLUTD) is a frequent diagnosis in cats, with bacterial causes constituting a minor percentage of cases. This observational study aimed to assess the diagnostic and therapeutic approaches to FLUTD among Italian veterinarians and explore variations in different workplaces. Data were collected via an anonymous survey completed by 317 veterinarians from small clinics (SC), large clinics (LC), and veterinary hospitals (VH). Results revealed that approximately half of respondents relied on clinical signs and urinalysis for diagnosis, while fewer incorporated abdominal ultrasound. Urine culture and sensitivity (UCS) testing was infrequently performed, primarily due to financial and logistical constraints, with higher compliance in VH practitioners. Antimicrobials were widely employed, with enhanced penicillins being the most prescribed class. The frequent empirical use of quinolones raises concern regarding gaps in antimicrobial stewardship. Despite some adherence to the ISCAID guidelines, discrepancies in diagnostic rigor, antimicrobial selection, and treatment duration were observed. Larger facilities demonstrated greater alignment with evidence-based practices, emphasizing the need for widespread education on appropriate antimicrobial use. This study underscores the importance of integrating guideline-based diagnostics and stewardship in managing feline urinary tract diseases. Full article

Objective: The objective was to evaluate the impact of perioperative immunonutrition (IN) on postoperative complications in patients undergoing radical cystectomy (RC) for bladder cancer (BC). Methods: A prospective case series of 19 patients treated with perioperative IN between October 2022 and July 2023 was conducted. Patients received preoperative IN based on nutritional risk and postoperative IN with gradual recovery of normal feeding. The inclusion criteria encompassed clinically node-negative patients without metastatic disease. The outcomes were assessed using Clavien–Dindo classification and included infectious complications, wound healing disorders, ileus, anemia, genitourinary issues, recovery time, and compliance with the nutritional regimen. Results: Sixteen patients (84.2%) experienced complications. Most were low-grade (CD 1–2), with no CD > 3a. Wound disorders affected 10.5% and anemia requiring transfusion occurred in 47.4% of patients, infectious complications were reported in 26.3%, and ileus in 36.8%. The median time to first flatus was 2 days (IQR 2–3), while resumption of oral feeding occurred after 4 days (IQR 2–5), like mobilization (IQR 2–5). The median hospital stay was 14 days (IQR 11–18). Compliance with IN was 78.9%, with gastrointestinal intolerance being the primary cause of discontinuation. Conclusions: Patients with RC undergoing perioperative IN showed low rates of high-grade complications and promising results in bowel function recovery and infection rates. Further randomized controlled trials are required to validate these results. Full article

Urban biodiversity is essential for enhancing liveability for both humans and wildlife by providing a range of ecosystem services. Therefore, it is crucial to raise awareness among citizens, particularly schoolchildren, about the significance of biodiversity in urban environments. To this end, an Open-Air Laboratory was established in an urban park of an Italian Mediterranean city (Livorno), where natural vegetation flourishes. This initiative engaged schoolchildren in experimental campaigns to collect ecophysiological data on local wild woody species. Specifically, the students were tasked with identifying various wild woody species and, under the guidance of researchers, recording specific leaf ecophysiological traits, such as leaf mass per area, leaf pigments, and chlorophyll fluorescence. The results, which highlighted seasonal variations in leaf ecophysiological traits and interspecific differences, were analysed in relation to the environmental conditions documented by the schoolchildren. This analysis revealed distinct plant strategies for coping with winter and summer stressful periods. The methodology employed in this project, which involved schoolchildren in research activities, not only fostered environmental awareness among young participants but also serves as a pilot model for public engagement in scientific research. Full article

This study investigates the content of some metals and metalloids in the flowers of three Aesculus cultivars (AHP, Aesculus hippocastanum pure species, with white flowers; AHH, Aesculus hippocastanum hybrid species, with pink flowers; and AXC, Aesculus × carnea, with red flowers) over a four-year period (2016–2019) using inductively coupled plasma optical emission spectrometry (ICP OES) and principal component analysis (PCA). The research focuses on assessing macro- and micro-elemental compositions, identifying variations in mineral uptake, and exploring potential correlations with soil composition. Results highlight significant differences in elemental profiles among the three species, despite similar total ash content. Potassium and phosphorus emerged as dominant macroelements, with AXC showing lower magnesium levels compared to AHP and AHH. Particularly intriguing was the detection of antimony in all cultivars, raising questions about its role and bioaccumulation pathways in floral tissues. Iron and aluminum concentrations varied significantly across species, indicating species-specific metal transport mechanisms. Nickel content showed temporal fluctuations, potentially influenced by climatic conditions and soil properties. PCA revealed distinct clustering patterns, linking elemental concentrations to specific species and years. This comprehensive analysis enhances understanding of metal absorption and distribution in ornamental plants, providing insights into their metabolic processes and potential implications for environmental monitoring and phytoremediation strategies. Full article

This study presents findings on the metal and metalloid composition of red horse-chestnut (Aesculus × carnea, AXC) seeds, determined by the ICP OES technique. Samples were collected from five AXC plants located in Modena (Italy) over four consecutive years (2016–2019). The seeds underwent proximate analysis, which included measurements of moisture content, proteins, lipids, carbohydrates, ash, and elemental composition. The analysis revealed consistent values for these parameters throughout the study period. The metal content of the AXC seeds can be categorized into two groups: (i) major components, with concentrations ranging from 1 to <1500 mg/100 g dry basis (d.b.), where K was identified as the most abundant element, and (ii) minor constituents, with concentrations between 1 and <1000 μg/100 g d.b., with Li, Mo, and Ti at the lower concentration limit. Comparative analyses were performed using literature data on AHP and AHH seeds, which, like AXC, belong to the Sapindaceae family and were collected from the same area and period. A hydroalcoholic extract of AXC seeds was prepared annually and characterized, with results compared to a commercial product (AXC_herb). AXC extracts had approximately 30% higher analyte concentrations than AXC_herb, while AXC seeds showed 20–30% higher metal and metalloid levels than AHP and AHH. Full article

Urban afforestation is increasingly regarded as a key strategy for fostering biodiversity to restore and enhance the ecosystem services needed to counteract the effects of climate change in built-up areas. In Italy, several experimental afforestation projects have been launched as part of the National Recovery and Resilience Plan (NRRP), focusing on cities or metropolitan areas such as Milan, Rome, Pistoia and Campobasso. These projects follow a multidisciplinary approach, integrating botanists, foresters, urban planners, landscape architects and remote sensing specialists. The goal is to address the challenging complexity of urban forest restoration through reforestation and afforestation actions. Key innovations include the integration of transdisciplinary methodologies (landscape analysis, landscape design, forest and plant ecology) with the application of advanced remote sensing technologies and participatory community engagement frameworks to address ecological and social challenges. Experimental plots have been set up across various urban areas, testing a range of planting schemes to maximise climate change resilience and ensure long-term ecological sustainability. Emphasis has been placed on selecting drought-tolerant and thermophilic species that are better adapted to widespread warming and local urban heat islands. ‘Biodiversity strips’ with perennial flowers for insects, shrubs with berries for birds and nests for wild bees and vertebrates have been set up to enhance biodiversity in new afforestation areas. Advanced monitoring tools, such as Light Detection and Ranging (LiDAR) and multi-sensor drones, have been employed alongside field observations to assess forest growth, species survival, structural complexity and biodiversity enhancement over time. Historical analyses of landscape patterns and ecological connectivity over the past 200 years, along with evaluations of afforestation projects from the last 70 years, have provided critical insights into the successes and challenges of previous interventions, serving as a guide for future efforts. By focusing on ecological connectivity, the integration of afforested areas into the urban matrix, and citizen engagement, the current project aims to align urban forestry efforts with sustainable development goals. This comprehensive project framework addresses environmental restoration and the social and aesthetic impacts on local communities, contributing to the overall resilience and well-being of urban and peri-urban ecosystems. Full article

Background: Congenital coronary artery anomalies (CAAs) are a significant cause of sudden cardiac death and a key factor in determining athletes’ eligibility for competitive sports. Their prevalence varies with diagnostic modalities and may present as asymptomatic or with life-threatening ischemic or arrhythmic events. This case series highlights the diverse manifestations of CAAs and the clinical approaches used to determine sports eligibility. Cases description: Five competitive athletes with different CAAs are presented. These cases include anomalous coronary origins, intramyocardial bridges, and coronary fistulas. Diagnostic tools, including coronary CT angiography (CCTA), cardiac magnetic resonance imaging (CMR), and stress tests, were essential in evaluating these anomalies and determining treatment strategies. In some cases, such as intramyocardial bridges, surgical intervention was necessary, while others required conservative management or exclusion from competitive sports. Conclusions: CAAs require individualized care based on risk stratification through advanced imaging techniques and functional assessment. Surgical interventions are reserved for high-risk anomalies, while others may be managed conservatively. Early detection and tailored management are crucial for ensuring athletes’ safety, and ongoing research is needed to optimize long-term outcomes. Full article

Background/Objectives: HER2-positive breast cancer (HER2⁺BC) is an aggressive subtype, with neoadjuvant treatment (NAT) aiming to achieve a pathological complete response (pCR) to improve long-term outcomes. Trastuzumab emtansine (T-DM1) has been established as the standard of care in the adjuvant setting for HER2⁺BC patients who do not obtain pCR. The ATD study aimed to evaluate the real-world tolerability of T-DM1 in this setting. The secondary objective was to assess the effectiveness. Methods: This was a multicenter, retrospective study across 24 Italian oncology centers, including 410 patients with HER2⁺BC treated with adjuvant T-DM1 following a lack of pCR after NAT. Patient characteristics, NAT regimens, and surgical outcomes were recorded. Tolerability was assessed by documenting adverse events (AEs) according to the CTCAE (v5.0). Preliminary effectiveness was evaluated in terms of relapse-free survival (RFS) and overall survival (OS). Results: Overall, 228 patients (55.6%) experienced at least one AE related to T-DM1, with 4.9% experiencing grade 3 or higher AEs. The most common AEs were hepatotoxicity (18.5%) and thrombocytopenia (17.6%). T-DM1 was discontinued in 10.0% of patients due to toxicity. After a median follow-up of 25 months, 31 relapse events (7.6%) and 22 deaths (5.4%) were reported. The preliminary incidence of RFS and OS events was similar between patients who completed the T-DM1 course and those who discontinued it early. Conclusions: T-DM1 demonstrated a manageable safety profile, and the adverse events were consistent with those reported in randomized trials. The data are not yet sufficient to allow for a formal analysis of RFS and OS, and long-term follow-up is required. Full article

This study examines the effects of the thermal pre-treatment of hemp hurds on the physical, mechanical, and thermal properties of hempcrete, evaluating its potential as a sustainable building material. Hemp hurds were pre-treated at various temperatures (120–280 °C) and characterized by proximate analysis, CHNS elemental analysis, and thermogravimetric analysis (TGA). The resulting hempcrete samples were analyzed for density, water absorption, compressive strength, and thermal conductivity. Three different hempcrete formulations, with varying lime:hemp proportions, were analyzed. The findings indicate that higher pre-treatment temperatures lead to reduced density and water absorption across all formulations. Formulations containing a higher hemp hurd content had lower densities but higher water absorption values. Compressive strength increased consistently with the pre-treatment temperature, suggesting that higher temperatures enhance matrix bonding and structural rigidity, and with the lime content. However, thermal conductivity also rose with pre-treatment, with only the composition containing the highest hemp hurd content maintaining the optimal insulation threshold (0.1 W/mK). This suggests a trade-off between compressive strength and insulation performance, influenced by the balance of hemp hurd and lime content. These findings underscore the potential of thermal pre-treatment to tailor hempcrete properties, promoting its application as a durable, moisture-resistant material for sustainable building, though the optimization of hurd–lime ratios remains essential. Full article

Purpose: Single-agent immune checkpoint inhibitor (IO) therapy is the standard for non-oncogene-addicted advanced non-small cell lung cancer (aNSCLC) with PD-L1 tumor proportion score ≥ 50%. Smoking-induced harm generates high tumor mutation burden (H-TMB) in smoking patients (S-pts), while never-smoking patients (NS-pts) typically have low TMB (L-TMB) and are unresponsive to IO. However, the molecular characterization of NS-pts with H-TMB remains unclear. Experimental design: Clinical data of 142 aNSCLC patients with PD-L1 ≥ 50% treated with first line pembrolizumab were retrospectively collected. Next-generation sequencing was performed using the FoundationOne^®CDx assay to correlate genomic alterations with clinical characteristics and response outcomes. Detected mutations were classified into eleven main pathways and enrichment analysis identified patient subgroups based on mutated pathways. Additionally, a patient similarity network was constructed to analyze molecular characterization. Results were validated using data from 853 aNSCLC patients in POPLAR and OAK trials. Results: Among the patients, S-pts had higher TMB than NS-pts. Interestingly, 11 (8%) NS-pts exhibited H-TMB and were enriched in β-catenin/Wnt and DDR pathway mutations. DDR pathway mutations were confirmed to be enriched in NS-pts with H-TMB using data from POPLAR and OAK trials. In the real-world cohort, the NS/H-TMB subgroup with DDR pathway mutations demonstrated improved IO outcome. Patient similarity network analysis confirmed the clustering of NS/H-TMB patients with DDR mutations and their association with improved overall survival in both the real-world cohort and the trials. Conclusions: The DDR signature has a potential role as an additional generator of H-TMB in NS-pts. This subgroup of IO-responsive NS-pts may have better prognosis. Our findings suggest that DDR-based mutational profiling may help identify NS-pts who could benefit from IO therapy. Full article

Mast cells are immune system cells with the most disparate functions, but are also among the least understood. Mast cells are implicated in several known pathological processes, tissue homeostasis, and wound repair. However, they owe their notoriety to allergic diseases, of which they represent the effector cell par excellence. In both allergic and not upper airway pathologies, mast cells play a key role. Exploring the mechanisms through which these cells carry out their physiological and pathological function may help us give a new perspective on existing therapies and identify new ones. A focus will be placed on non-allergic rhinitis, a poorly recognized and often neglected condition with complex management, where the role of the mast cell is crucial in the pathogenetic, clinical, and prognostic aspects. Full article