Search Results (245)

Equestrian sports play a significant economic role in the horse industry. In recent years, numerous equine viruses have emerged, among which are equine Pegiviruses and the re-emerging Equine coronavirus (ECoV). These viruses are distributed globally and primarily cause subclinical infections with unknown morbidity, even if ECoV can occasionally induce febrile and diarrheic episodes. To broaden the data on the Italian equine population, a study was conducted to assess their prevalence in two distinct horse populations belonging to the Carabinieri Corps (CC) and the Italian Army (IA) of the Italian Armed Forces (IAF). Samples consisted of blood serum and rectal swabs of 436 horses collected within the national surveillance program for equine infectious anemia and gastrointestinal parasite monitoring and analyzed for Pegivirus (caballi and equi) and ECoV by Real-Time RT PCR. The prevalence detected were 6.56% and 3.53%, respectively, for Pegivirus caballi and equi for the IA, while for the CC, they were 10.13% and 0.84%. Only one sample tested positive for ECoV belonging to a horse of the CC. Phylogenetic analyses were carried out on the PCR-positive samples that were sequenced using Sanger protocols. Understanding the epidemiology of these viruses is essential for evaluating the implementation of effective prevention strategies. Full article

Chiroptera includes over 1400 bat species, with at least 35 of these present in Italy. Due to their role as Lyssavirus reservoirs, bats found dead, with and without signs suggestive of this infection, are routinely submitted to the laboratory network of the Istituti Zooprofilattici Sperimentali in the framework of the rabies national passive and active surveillance program. Carcasses and biological samples collected from January to December 2021 in Latium and Tuscany, regions of our jurisdiction, were further screened for the presence of Coronaviruses (CoVs) and Herpesviruses using pan-family virus PCR tests, and relative PCR products were Sanger sequenced. Genetic characterization through sequencing detected AlphaCoVs in Miniopterus schreibersii and Beta- and Gammaherpesviruses in Tadarida teniotis. Samples were also submitted to bat genetic species identification. Full article

The colour evolution of malvidin-3-O-glucoside (Mv-3-O-glc) elicited by caffeic acid (CAF), (+)-catechin (CA), or syringic acid (SI) was spectrophotometrically monitored in model wine solution, modulating the malvidin-to-polyphenol molar ratio (1:1 to 1:20) and the pH (2.8–3.8). The spectral features provided the thermodynamic parameters Gibbs free energy (ΔG⁰) and equilibrium constant (K_eq), showing that the copigmentation extent is maximized at pH 3.6 and a higher molar ratio (1:20), and that copigments have different efficiency. In a long-term evolution (12 months), transient complexes evolved into different colour characteristics. Spectrophotometry and colorimetry (chroma C*, hue H*, and lightness L*) revealed the formation of stable pigments with peculiar orange-reddish colour when CAF was present; however, in the case of CA, an accentuated yellow tone was observed. SI showed minimum impact in the long-term evolution of Mv-3-O-glc. This study expands knowledge on oenological copigmentation, further exploring its potential implication in the colour of aged red wines. Full article

There is a confirmed and ongoing need to encourage adherence to healthy dietary patterns in the general population in western societies, given their recognized positive impact in preventing non-communicable diseases (NCDs). A potentially very effective solution is the use of digital tools such as apps and web apps, which can reach a large number of people quickly. Still, to be effective, it is necessary to better understand how participant engagement in these interventions works, to identify the motivations that may lead them to drop out, and to evaluate the effectiveness of these interventions. In our study, an innovative web app designed to encourage adherence to the Mediterranean diet (EATMED) was tested in an intervention study, evaluating adherence to the Mediterranean diet before and after the use of the web app in a cohort of people, compared to a control group, using the MEDI-lite questionnaire. The Health and Taste Attitude Scale questionnaire was also administered to all participants to assess interest in healthy foods and diets, as well as attitudes toward food. The study showed that the score of the Food as Reward subscale of the HTAS had a significant effect on dropout from the intervention study, and that the use of the app among participants who remained resulted in a two-point increase in adherence to the Mediterranean diet, according to the MEDI-lite questionnaire. These results indicate the effectiveness of the EATMED tool and provide useful insights into how to understand and mitigate dropout in digital nutrition interventions. Full article

Spinal cord injury (SCI) represents a complex pathological event, which requires continuous and highly specialized territorial interventions. The literature highlights disadvantages faced by people with SCI in accessing local services. This study aimed to investigate the concept of territorial continuity for SCI, reconstructing patients and healthcare professionals’ perspectives, to identify facilitators, barriers and opportunities. Methods: a Focus Group (FG) qualitative study was conducted at Piacenza Ausl; four FGs were carried out; a research team member moderated FGs using thematic guides, while an observer was responsible for noting non-verbal aspects. Meetings lasted between 90 and 120 min and were audio-recorded. Transcript analysis involved the identification of units of meaning, which were grouped into general themes. Results: Final analysis highlighted 435 verbatim, grouped into 21 initial themes, that converged into 5 emerging themes: “SCI continuity as multidisciplinary teamwork”; “The need for rehabilitation as a driver of territorial continuity”; “Reinventing everyday life after SCI”; “Barriers and facilitators”; and “The future of territorial care”. Discussion: Patients and healthcare professionals highlighted the absence of a defined treatment path and the lack of reference points, thus generating disorientation and need for information. Among the proposals, telemedicine, empowering the case manager’s role, promoting specific training courses and rethinking community hospitals were supported. Full article

Ex situ machine perfusion has emerged as a pivotal technique for organ preservation and pre-transplant viability assessment, where the real-time monitoring of mitochondrial biomarkers—flavin mononucleotide (FMN) and nicotinamide adenine dinucleotide (NADH)—could significantly mitigate ischemia-reperfusion injury risks. This study develops a non-invasive optical method combining fluorescence and UV-visible spectrophotometry to quantify FMN and NADH in hypothermic oxygenated perfusion media. Calibration curves revealed linear responses for both biomarkers in absorption and fluorescence (FMN: λ_ex = 445 nm, λ_em = 530–540 nm; NADH: λ_ex = 340 nm, λ_em = 465 nm) at concentrations < 100 μg mL⁻¹. However, NADH exhibited nonlinear fluorescence above 100 μg mL⁻¹, requiring shifted excitation to 365 nm for reliable detection. Spectroscopic analysis further demonstrated how perfusion solution composition alters FMN/NADH fluorescence properties, with consistent reproducibility across media. The method’s robustness was validated through comparative studies in clinically relevant solutions, proposing a strategy for precise biomarker quantification without invasive sampling. These findings establish a foundation for real-time, optical biosensor development to enhance organ perfusion monitoring. By bridging spectroscopic principles with clinical needs, this work advances translational sensor technologies for transplant medicine, offering a template for future device integration. Full article

Pancreatic cystic lesions (PCLs) are increasingly identified via computerized tomography (CT) and magnetic resonance (MR), with a prevalence of 2–45%. Distinguishing mucinous PCLs (M-PCLs), which include intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms (MCNs) that can progress to pancreatic ductal adenocarcinoma, from non-mucinous PCLs (NM-PCLs) is essential. Carcinoembryonic antigen (CEA) remains widely used but often demonstrates limited sensitivity and specificity. In contrast, endoscopic ultrasound-guided measurement of intracystic glucose more accurately differentiates PCL subtypes, as tumor-related metabolic changes lower cyst fluid glucose in mucinous lesions. Numerous prospective and retrospective studies suggest a glucose cut-off between 30 and 50 mg/dL, yielding a sensitivity of 88–95% and specificity of 76–91%, frequently outperforming CEA. Additional benefits include immediate point-of-care assessment via standard glucometers and minimal interference from blood contamination. DNA-based biomarkers, including KRAS and GNAS mutations, enhance specificity (up to 99%) but exhibit moderate sensitivity (61–71%) and necessitate specialized, expensive platforms. Molecular analyses can be crucial in high-risk lesions, yet their uptake is constrained by technical challenges. In practice, combining glucose assessment with targeted molecular assays refines risk stratification and informs the choice between surgical resection or active surveillance. Future investigations should establish standardized glucose thresholds, improve the cost-effectiveness of genetic testing, and integrate advanced biomarkers into routine protocols. Ultimately, these strategies aim to optimize patient management, limit unnecessary interventions for benign lesions, and ensure timely therapy for lesions at risk of malignant transformation. Full article

Introduction: Cystic fibrosis (CF) is a chronic genetic disease affecting the respiratory and digestive systems. Multidisciplinary care is vital for managing CF’s complex complications. This study investigates the potential role of a Case Manager (CM) in improving care coordination and patient outcomes at the CF Unit of Careggi University Hospital. Methods: A survey among 34 CF Unit healthcare professionals assessed the perceptions of integrating a CM. The survey included demographic questions and 12 Likert scale items on the CM’s role in care continuity, team collaboration, and treatment adherence. Responses were collected anonymously and analyzed using descriptive statistics. Results: The response rate was 100%, with strong support for the CM role, averaging 4.5/5 across Likert scales. Respondents highlighted the CM’s value in coordinating care, managing time-sensitive tasks, and improving communication with external care providers. Telemedicine was positively rated, particularly for reducing hospital visits and supporting the remote monitoring of CF patients treated. Discussion: Findings indicate that integrating a CM could enhance multidisciplinary CF care by improving communication and treatment adherence. Challenges, including team readiness and training, were noted. Future studies will focus on patient satisfaction and clinical outcomes following the integration of CM, with special attention to the role of telemedicine in CF care. Full article

Background and Objective. The significance of microRNAs (miRNAs) in relation to neoplastic diseases; such as renal carcinoma carcinoma (RCC); has been brought to light by recent studies. Analyzing the main urinary miRNAs implicated in RCC and their potential diagnostic use was the goal of this systematic review of the literature. Methods. This systematic review was performed following the PROSPERO protocol CRD42024550716. Our literature search strategies were deciding which database to include (Pubmed; EMBASE and Clinicaltrial.gov) and composing strings with words related to urinary miRNA in patients with RCC. Key findings and limitations. After screening; 10 papers were included from the 593 records that the systematic review found. No miRNA was investigated in more than one paper by different authors. The miR-210 and let-7 family were the most investigated and resulted upregulated in RCC cases compared to controls. Five papers reported different expression of miRNAs in urine samples before and after surgery: miR-15a; miR-34a-5p; miR-200a-3p; miR-205-5p; miR-210; miR-210-3p; miR-365a-3p and let-7d-5p levels decreased after nephrectomy. Meta-analysis was not performed since the included studies were heterogeneous; in terms of studied miRNA; of the normalizer used during stabilization phase; and histologic type of RCC (clear cell RCC; papillary RCC; unspecified RCC). Conclusions. Considering the variability and heterogeneity of the obtained results; as well as the vastness of the topic; expanding research in this field appears highly promising. To support further advancements; it would be useful to establish a database that consolidates international findings. Full article

Introduction: Total skin irradiation (TSI) is a radiotherapy technique used to treat cutaneous lymphomas, such as mycosis fungoides. A key aspect of the success of the treatment is the correct positioning of the patient, which ensures a homogeneous distribution of radiation over the skin surface, minimizing exposure to the surrounding healthy tissues. Materials and Methods: Following the preferred reporting items for systematic review and meta-analysis (PRISMA) extension for scoping reviews and the Arksey and O’Malley framework, electronic searches of EMBASE, PubMed, SCOPUS, and the Web of Science were conducted to identify original studies detailing positioning techniques for TSI in clinical practice. Results: A total of 44 studies were included, reporting a range of positioning techniques used in TSI. The selected articles were divided into four categories: Stanford, rotational, tomotherapy, and mixed (including studies comparing two or more of the previously mentioned techniques). Articles concerning the Stanford technique were predominant (n = 33; 75.0%), followed by those addressing the rotational technique (n = 5; 11.4%), tomotherapy (n = 3; 6.8%), and mixed (n = 3; 6.8%). Studies on the Stanford technique described both the original method and its modifications, including variations such as the lying position, and analyzed its strengths and limitations. Research on the rotational method examined different device configurations and implementation strategies to optimize dose distribution and treatment efficiency. Mixed articles compared the Stanford and rotational techniques, highlighting their similar dose uniformity while examining differences in treatment efficiency and practical implementation. Conclusions: Despite its widespread use, the Stanford technique is associated with challenges that have led to the exploration of alternative positioning strategies. The rotational technique addresses some of these limitations, while tomotherapy offers advanced immobilization but raises toxicity concerns. Future research should focus on optimizing the balance between efficacy, safety, and practicality of treatment in clinical settings. Full article

The integration of artificial intelligence in interventional radiology is an emerging field with transformative potential, aiming to make a great contribution to the health domain. This overview of reviews seeks to identify prevailing themes, opportunities, challenges, and recommendations related to the process of integration. Utilizing a standardized checklist and quality control procedures, this review examines recent advancements in, and future implications of, this domain. In total, 27 review studies were selected through the systematic process. Based on the overview, the integration of artificial intelligence (AI) in interventional radiology (IR) presents significant opportunities to enhance precision, efficiency, and personalization of procedures. AI automates tasks like catheter manipulation and needle placement, improving accuracy and reducing variability. It also integrates multiple imaging modalities, optimizing treatment planning and outcomes. AI aids intra-procedural guidance with advanced needle tracking and real-time image fusion. Robotics and automation in IR are advancing, though full autonomy in AI-guided systems has not been achieved. Despite these advancements, the integration of AI in IR is complex, involving imaging systems, robotics, and other technologies. This complexity requires a comprehensive certification and integration process. The role of regulatory bodies, scientific societies, and clinicians is essential to address these challenges. Standardized guidelines, clinician education, and careful AI assessment are necessary for safe integration. The future of AI in IR depends on developing standardized guidelines for medical devices and AI applications. Collaboration between certifying bodies, scientific societies, and legislative entities, as seen in the EU AI Act, will be crucial to tackling AI-specific challenges. Focusing on transparency, data governance, human oversight, and post-market monitoring will ensure AI integration in IR proceeds with safeguards, benefiting patient outcomes and advancing the field. Full article

Background: In recent years, research has highlighted the importance of microRNAs (miRNAs) in the context of oncological diseases, including renal cell carcinoma (RCC). The aim of this systematic review of the literature was to analyze the main serum miRNAs involved in RCC and their potential diagnostic power. Methods: This systematic review was performed following the PROSPERO protocol CRD42024550709. Literature search strategies were developed composing strings with text words related to serum miRNA in RCC for PubMed, EMBASE and Clinicaltrial.gov. The studies enrolling adult populations with RCC and healthy controls measuring circulating miRNAs were included. Results: We found 500 records, and 26 papers were included after screening. Four studies found that miR-210, the most investigated miRNA, was overexpressed in RCC patients compared to controls, while one reported no statistical difference. The expression of some miRNAs was consistently lower in cases compared to healthy controls, such as miR-1-3p and miR-129-5p, while others (miR-221, miR-222, miR-224-5p and miR-1233) were consistently upregulated. Conclusions: Circulating miRNAs represent a promising avenue for the non-invasive diagnosis of RCC. Future research should focus on standardization, validation in larger cohorts and the development of multi-marker diagnostic panels to address these current limitations and pave the way for miRNA-based diagnostics in RCC. Full article

Background/Objectives: Meropenem is a broad-spectrum antibiotic essential for treating resistant Gram-negative infections in pediatric patients. Current dosing recommendations may not consistently achieve optimal pharmacokinetic (PK) targets, especially in critically ill children. Methods: We conducted a retrospective cohort study at IRCCS Istituto Giannina Gaslini, analyzing 97 plasma levels from 86 pediatric patients (<18 years) hospitalized between January 2020 and December 2023 in the neonatal and pediatric intensive care unit. Patients receiving meropenem for proven or suspected infections were included. Demographic, clinical, and PK parameters were assessed, with a focus on trough concentrations (C_trough). Results: The median age was 25 months, with neonates representing 15.5% of cases. The median C_trough was 2.8 mg/L and was significantly higher in neonates (8.9 mg/L) compared to older patients (2.2 mg/L, p < 0.001). Only 27.8% of patients achieved the target C_trough of >8 mg/L, with estimated glomerular filtration rate (eGFR) being the primary factor influencing these levels. Patients with C_trough > 8 mg/L had a significantly lower eGFR (61 mL/min/1.73 m²) compared to those below this threshold (131 mL/min/1.73 m², p = 0.001). Conclusions: The current meropenem dosing regimen may not reliably meet PK targets in critically ill pediatric patients, particularly those with augmented renal clearance or when treating pathogens with increased meropenem MIC. Our findings suggest that increased dosages and prolonged infusion times may be necessary to optimize therapeutic efficacy against resistant Gram-negative bacteria in this vulnerable population. Further studies are needed to refine dosing strategies and improve patient outcomes. Full article

The mechanical properties of rubber-like materials, such as their high flexibility and durability, make them widely applicable across different industrial fields, from aerospace to healthcare and, most notably, the automotive sector. In operative conditions, these materials experience large deformations and repeated loadings, which may result in inelastic and dissipative phenomena. The aim of this study is to investigate the mechanical properties of two thermoplastic elastomeric materials manufactured with the Fused Filament Fabrication (FFF) technique: unfilled thermoplastic polyurethane (TPU) and TPU reinforced with carbon nanotubes (CNTs). Several experimental tests were performed to assess the response of both materials under monotonic and cyclic loadings. The addition of CNTs led to improved stiffness and strength without compromising elasticity. Under repeated loadings, both materials were characterized by the Mullins and viscous effects. However, the presence of CNTs was found to slightly amplify these inelastic phenomena. The integration of additive manufacturing technologies, combined with the use of innovative fillers, can offer design and performance optimization to all those components that strongly rely on elastomers. Full article

Pancreatic neuroendocrine neoplasms (pNENs) represent approximately 2% of all solid pancreatic tumors. The incidence of pNENs has been increasing in the last decade. The clinical manifestations of pNENs range from hormone secretion syndromes in functioning neoplasms (F-pNENs) to local infiltration or distant metastases in late-stage diagnoses or incidental findings in small non-functioning neoplasms (NF-pNENs). While surgery is the gold-standard treatment for larger and more aggressive tumors, small and low-grade tumors (G1) may be followed-up due to the indolent course of disease. Recently, endoscopic ultrasound (EUS)-guided ablative techniques, such as ethanol injection (EUS-EI) and radiofrequency ablation (EUS-RFA), have emerged as promising options for loco-regional ablations in selected cases. Despite promising safety profile and efficacy, high-quality evidence is needed to support their widespread adoption. This article reviews the current state of EUS-guided locoregional therapies, patient selection criteria, procedural details, and associated risks. Full article