Search Results (169)

Background: Art therapy is increasingly recognized as a valuable complementary intervention for individuals with eating disorders (EDs), who frequently experience comorbid anxiety and difficulties with emotional regulation. However, few studies have examined its short-term effects on state and trait anxiety within structured clinical settings. Methods: This pilot study involved 19 adolescent females (mean age 17.7 ± 2.1 years) diagnosed with anorexia nervosa (AN) or bulimia nervosa (BN) and admitted to the Mariconda Regional Residence for Eating Disorders (ASL Salerno, Italy) in residential or semi-residential treatment. Participants completed a structured six-week cycle of weekly textile-based art therapy sessions, designed to promote emotional expression and body reconnection. State and trait anxiety levels were assessed pre- and post-session using the State-Trait Anxiety Inventory (STAI). Repeated-measures ANOVA was used to analyze state anxiety changes; a linear mixed-effects model was applied to trait anxiety. Results: State anxiety significantly decreased immediately after sessions (p = 0.002). A significant main effect of session (p = 0.01) and a time × session interaction (p = 0.025) indicated variability across sessions. Trait anxiety showed a non-significant trend toward reduction (p = 0.11); however, reductions were significant at sessions 4 (p = 0.015), 5 (p < 0.001), and 6 (p = 0.005). Conclusions: Art therapy may offer immediate reductions in state anxiety and may contribute to a longer-term reduction in trait anxiety with 4–6 sessions. These findings support integrating creative interventions within multidisciplinary ED treatment programs. Future research with larger samples and control groups is needed to confirm and expand upon these preliminary results. Full article

Navigational aids play a vital role in enhancing the mobility and independence of blind and visually impaired (VI) individuals. However, existing solutions often present challenges related to discomfort, complexity, and limited ability to provide detailed environmental awareness. To address these limitations, we introduce SnapStick, an innovative assistive technology designed to improve spatial perception and navigation. SnapStick integrates a Bluetooth-enabled smart cane, bone-conduction headphones, and a smartphone application powered by the Florence-2 Vision Language Model (VLM) to deliver real-time object recognition, text reading, bus route detection, and detailed scene descriptions. To assess the system’s effectiveness and user experience, eleven blind participants evaluated SnapStick, and usability was measured using the System Usability Scale (SUS). In addition to the 94% accuracy, the device received an SUS score of 84.7%, indicating high user satisfaction, ease of use, and comfort. Participants reported that SnapStick significantly improved their ability to navigate, recognize objects, identify text, and detect landmarks with greater confidence. The system’s ability to provide accurate and accessible auditory feedback proved essential for real-world applications, making it a practical and user-friendly solution. These findings highlight SnapStick’s potential to serve as an effective assistive device for blind individuals, enhancing autonomy, safety, and navigation capabilities in daily life. Future work will explore further refinements to optimize user experience and adaptability across different environments. Full article

Background/Objectives. With a rapid palatal expander (RPE) is reported to be effective in increasing the volume of nasal cavities, with a restoration of physiological nasal airflow. The purpose of this retrospective clinical study was to evaluate, using Cone Beam Computed Tomography (CBCT), the volumetric changes and airflow velocity changes in the nasal cavities, retro-palatal and retro-glossal airways, resulting from the use of RPE with dental anchorage (group A), also comparing these data with patients non treated with RPE (group B). Methods. Sixteen subjects (aged 9.34 years) with transverse maxillary deficiency and unilateral posterior crossbite were treated with RPE with dental anchorage. Additionally, 8 patients (aged 11.11 years) with juvenile idiopathic arthritis, who did not undergo any orthodontic treatment, were selected as a control group. Expansion was performed until overcorrection was achieved, and the device was left in place for 6 months as fixed retention, followed by another 6 months of night-time removable retention. From the retrospective evaluation, all patients presented two CBCT scans at baseline (T0) and 1-year follow-up (T1). The 3D-Slicer software was used for each CBCT to measure the nasal (VN), retropalatal (VRP), and retroglossal (VRG) volumes, while an iterative Excel spreadsheet allowed for a pilot approximated modeling and calculation of airway flow-related data. Results. Regarding mean age, a statistically significant difference (p = 0.01 *) was found between groups, suggesting that group B is closer to the pubertal growth peak. Analysis between T0 and T1 revealed: (i) a statistically significant increase for volumes VN, VRP and VRG in group A; (ii) a statistically significant increase for VN in group B; (iii) a statistically significant decrease for all variables related to airflow velocity in both groups. Furthermore, comparison between group A and B, regarding variations between T0 and T1, found a statistically significant difference only for VN. Conclusions. Within the limitations of this pilot evaluation, the treatment with RPE revealed promising outcomes for retro-palatal, retro-glossal and nasal volumes, together with clinical changes in airflow velocities. Full article

In specialized orchards, approximately 6–10 tons/hectare of cactus pear pruning waste and 60 million tons of spent coffee grounds are estimated to be produced each year worldwide. Composting is a process that produces stable organic matter useful in agriculture. The aim of this work was to explore the potential of Opuntia ficus-indica (OFI) cladodes and spent coffee ground (SCG) mixtures for compost production and to assess their benefits for agricultural applications. Three composting campaigns were carried out using rotating composters. Feedstock for these campaigns was formulated with different ratios of OFI and SCGs, and the compost obtained were characterized by their chemical and physical proprieties. To assess these composts, basil was grown in plots using growing substrate as a blank and comparing it with substrate mixed with 10% of each compost. All plants sprouted and grew up. While no significant differences were detected in polyphenol content among the grown plants, the yields with compost at OFI–SCG (3.3:1) were differentiated for longer shoots and there was greater biomass compared to the control. Compost obtained from cladode mixed with spent coffee grounds proved to be a good soil improver with the characteristics of being able to ameliorate soil fertility and plant growth. Full article

Brugada syndrome (BrS) is a cardiac disease associated with characteristic ECG abnormalities and a heightened risk of sudden cardiac death, especially in young individuals with structurally normal hearts. The primary aim of this study was to highlight, for the first time, the potential of using droplet digital PCR (ddPCR), a highly sensitive method, to detect C-type natriuretic peptide (CNP) and its receptors, NPR-B and NPR-C, expression in BrS. Whole-blood samples from 12 subjects with type 1 BrS and 12 controls were analyzed. CNP expression was detectable and lower in BrS patients than in the controls, although not significantly. NPR-B and NPR-C expression was significantly reduced in the same patients (p ≤ 0.05). Strong correlations were observed between CNP and NPR-B (p = 0.01) and NPR-C (p < 0.0001), as well as between NPR-B and NPR-C (p = 0.0002). Body weight correlated with CNP (p = 0.02), NPR-B (p = 0.03), and NPR-C (p = 0.02); meanwhile, NPR-B expression was related to height (p = 0.05). This study is the first to analyze CNP expression and its specific receptors using ddPCR technology, showing for the first time their presence and activation in individuals with BrS. Although further research is needed to clarify CNP-related mechanisms, these findings offer a valuable starting point for exploring its role in BrS. Full article

Background: Urinary steroid profiling plays a key role in the diagnosis of inherited and acquired endocrine disorders. Despite the proven diagnostic value of gas chromatography–mass spectrometry (GC-MS), standardized and clinically validated protocols for extended steroid panels remain limited. Methods: We developed and validated a GC-MS method for the quantification of 32 urinary steroid metabolites, including androgens, estrogens, progestins, glucocorticoids, and mineralocorticoids. Sample preparation involved solid-phase extraction, enzymatic hydrolysis, and dual derivatization, followed by chromatographic separation and mass detection under full scan mode. Validation followed ICH M10 guidelines. Results: The method demonstrated high selectivity, accuracy (within ±15%), and precision (CV% < 15%) across three QC levels. Limits of Quantification were estimated using the Hubaux–Vos approach and were suitable for detecting both physiological and pathological steroid concentrations. Robustness and matrix effect tests confirmed the method’s reliability and reproducibility. Conclusions: This GC-MS protocol enables comprehensive urinary steroid profiling and calculation of diagnostic ratios for inborn errors of steroid metabolism and endocrine disorders. The method is suitable for clinical application and future integration into personalized medicine workflows. Full article

Background: Tooth whitening is a widely sought-after cosmetic procedure, with various at-home and professional treatments available. This study compares the whitening efficacy of an activated charcoal toothpaste and a 6% hydrogen peroxide whitening pen under controlled in vitro conditions. Methods: Twenty freshly extracted human teeth were stained with a coffee solution and divided into two groups. Group A underwent daily applications of activated charcoal toothpaste for 30 days, while Group B received a single 5 min application of a 6% hydrogen peroxide whitening pen. Tooth color was assessed using the VITA Classical A1-D4 Shade Guide at baseline, mid-treatment, and post-treatment for Group A and at baseline and immediately after treatment for Group B. Results: The activated charcoal toothpaste exhibited a gradual whitening effect, with the most significant improvements occurring within the first two weeks (p < 0.01), after which the whitening effect plateaued. In contrast, the hydrogen peroxide whitening pen produced immediate and substantial whitening (p < 0.001). Statistical analysis using the Wilcoxon signed-rank test and Mann–Whitney U test confirmed the superior efficacy of the hydrogen peroxide treatment. Conclusions: The hydrogen peroxide whitening pen was significantly more effective in achieving rapid and substantial whitening compared to the activated charcoal toothpaste, which provided gradual but limited improvements. Further clinical studies are needed to evaluate the long-term color stability. Full article

Sodium-glucose cotransporter 2 (SGLT2) inhibitors, initially developed for glycaemic control in type 2 diabetes, have demonstrated substantial renal and cardiovascular protective effects across various chronic kidney diseases (CKD), including glomerulonephritis. Beyond their established haemodynamic and metabolic benefits, recent evidence points to additional mechanisms of action potentially relevant to immune-mediated kidney diseases, such as the modulation of inflammation, immunometabolism, and oxidative stress. Randomised clinical trials (DAPA-CKD and EMPA-KIDNEY) and real-world observational studies consistently show that SGLT2 inhibitors reduce proteinuria and slow estimated glomerular filtration rate (eGFR) decline in patients with glomerulonephritis, including IgA nephropathy and focal segmental glomerulosclerosis. These benefits may extend to patients with stable immunosuppression. Further data are needed in this subgroup. Importantly, SGLT2 inhibitors display a favourable safety profile, even among those with immunosuppressed status. Again, further evidence is awaited in this respect. Despite these promising findings, unanswered questions remain regarding their efficacy in nephrotic syndrome, early-stage disease, and in comparison or combination with other supportive therapies. Overall, the evolving evidence supports the inclusion of SGLT2 inhibitors as a key component of supportive therapy in glomerulonephritis, with potential benefits extending beyond proteinuria reduction. Full article

Biofilm plays a crucial role in the pathogenesis and chronicity of urinary tract infections (UTIs). The present work aimed to evaluate the anti-biofilm effects of Formulation (DIF17BRO^® plus NAC) in combination with ciprofloxacin (CPX) on Escherichia coli strains. The antimicrobial activity of ciprofloxacin was evaluated by minimum inhibitory concentration (MIC) determination, and the antibiofilm effects of ciprofloxacin alone and combined with Formulation were evaluated on E. coli ATCC700926, E. coli ATCC10536, E. coli PNT, and E. coli PCA mature biofilms in terms of CFU/mL and biomass quantifications. Moreover, the potential protective effects of Formulation plus ciprofloxacin was tested in a Galleria mellonella in vivo infection assay. Our results underlined the increased microbial reduction in the mature biofilm in the presence of the combination Formulation and CPX, even at a lower concentration of CPX. Formulation increased the percentage of biofilm biomass reduction, inducing a disruption of the biofilm structure itself. Our present findings confirm that MIC CPX combined with Formulation also induced an antimicrobial effect in the G. mellonella assay. Formulation facilitated the perturbation of the biofilm polymeric matrix, enhancing the antibiotic penetration and its antimicrobial action on bacteria, underlining Formulation’s role as an enhancer of ciprofloxacin antibacterial action. Full article

Background: antimicrobial resistance represents a critical issue leading to delayed wound healing; hence, it is necessary to develop novel strategies to address this phenomenon. Objectives: this study aimed to explore the antimicrobial/anti-virulence action of Methylglyoxal-MGO alone or combined with novel technologies such as Light-Emitting Diodes-LED and Complex Magnetic Fields-CMFs against resistant clinical strains isolated from chronic wounds. Methods: characterized planktonic Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans isolates were used. Antimicrobial activity was evaluated by measuring optical density, Colony Forming Units-CFU, and synergy between MGO/LED or CMFs. Cellular membrane permeability by propidium iodide fluorescence and fluidity by Laurdan generalized polarization measurements were performed. P. aeruginosa motility was tested using the soft agar method. A docking study was performed to evaluate the possible interaction between MGO and urease in P. aeruginosa. Results: single/combined treatments showed significant antimicrobial activity. Major CFU reduction was detected after CMFs/MGO+CMFs application on C. albicans. Treatments exhibited significant changes in membrane permeability and fluidity. The treatments decreased P. aeruginosa motility with a major reduction after LED application. Docking analysis showed that MGO could bind with P. aeruginosa urease leading to defective folding and functional alterations. Conclusions: the results suggest that these treatments could represent promising and green therapeutic solutions against resistant isolates from chronic wounds. Full article

Background: Anterior disc displacement without reduction (ADDwoR) of the temporomandibular joint (TMJ) often leads to persistent pain and reduced quality of life (QoL). Conservative treatments frequently fail to provide adequate symptom relief. Objective: To assess the short-term (≥6 months) effectiveness of functional arthroplasty in reducing pain and improving QoL in patients with ADDwoR unresponsive to conservative therapies. Methods: A retrospective cohort study was conducted on 105 patients (median age 38 years, 80% female) treated at Santa Maria Hospital from January 2018 to December 2021. All patients had unilateral painful ADDwoR confirmed via MRI and underwent functional arthroplasty. Primary outcomes included pain reduction (VAS) and QoL improvements (QoL-TMJ questionnaire). Covariates such as age, gender, and baseline mood disturbances were analyzed for associations with surgical outcomes. Statistical analyses included the Wilcoxon rank test, Friedman’s ANOVA, and Spearman’s rank correlation. Results: Postoperative VAS scores significantly decreased (8.0 pre-op vs. 2.0 post-op, p < 0.001). QoL-TMJ scores improved significantly in pain (p < 0.001), activity (p < 0.05), mood (p < 0.001), and anxiety (p < 0.01), but no significant changes were observed in chewing and speaking functions. Improvements in QoL correlated strongly with pain reduction. Gender and age did not influence the outcomes, though females reported higher baseline mood disturbances. Conclusions: Functional arthroplasty effectively reduces pain and improves QoL in patients with ADDwoR, regardless of age or gender. However, limited improvement in chewing and speaking abilities highlights the need for targeted interventions. Future studies should assess the long-term outcomes to confirm the sustained benefits of this procedure. Full article

Objective: To evaluate the impact of a prosthetic and native aorta proximal landing zone (PLZ) for hybrid thoracic aorta repair with a stent graft deployed in the Zone 0 ascending aorta. Methods: Retrospective analysis of 100 patients who underwent Zone 0 hybrid thoracic aorta repair between 2005 and 2022, at a single institution. Fifty-eight (58%) had a Dacron PLZ (ascending aorta replacement with debranching), and forty-two (42%) had a native ascending aorta PLZ (off-pump aortic arch debranching). All the surviving patients had at least one radiological follow-up. Results: Patients with a native aorta PLZ were older (p = 0.01) and had higher rates of pulmonary disease (p = 0.01) and chronic kidney disease (p = 0.01) and a higher Logistic EUROscore (p = 0.02). In-hospital mortality was similar between the two groups (2.3% vs. 1.7%; p = 0.68). Retrograde aortic dissection was observed in four (9.2%) of the native PLZ group. The mean follow-up was 37 ± 22 months in the Dacron PLZ group and 42 ± 20 months in the native PLZ group (p = 0.05). At 1,3, and 5 years, freedom from Type Ia endoleak was significantly higher in patients with a Dacron PLZ: 100% vs. 96 ± 0.3%, 100% vs. 85 ± 1%, and 100% vs. 66 ± 1.3% (p = 0.03). Despite this, the 1-, 3-, and 5-year survival was similar between groups: 100% vs. 96 ± 0.4%, 90 ± 1% vs. 89 ± 0.6%, and 66 ± 1% vs. 64 ± 2%. (p = 0.96). Conclusions: Endograft deployment in a prosthetic ascending aorta is a safe and durable option for aortic repair. A Dacron PLZ is associated with a lower rate of Type Ia endoleak and can prevent retrograde aortic dissection when compared with native aorta. Full article

Contrast-enhanced mammography (CEM) combines morphological and functional imaging, enhancing breast cancer (BC) diagnosis. This study investigates the relationship between CEM morphodynamic features and histopathological characteristics of BC. In this prospective study, 50 female patients (mean age: 57.2 ± 13.7 years) with BI-RADS 4–5 lesions underwent CEM followed by surgical excision between December 2022 and May 2024. Low-energy and recombined CEM images were analyzed for breast composition, lesion characteristics, and enhancement patterns, while histopathological evaluation included tumor size, histotype, grade, lymphovascular invasion, and immunophenotype. Spearman rank correlation and multivariable regression analysis were used to evaluate the relationship between CEM findings and histopathological characteristics. Tumor size on CEM strongly correlated with histopathological tumor size (ρ = 0.788, p < 0.001) and was associated with high-grade lesions (p = 0.017). Non-circumscribed margins were linked to a Luminal-B subtype (p = 0.001), while high lesion conspicuity was associated with Luminal-B and triple-negative BC (p = 0.001) and correlated with larger tumors (ρ = 0.517, p < 0.001). Background parenchymal enhancement was negatively correlated with age (ρ = −0.286, p = 0.049). CEM provides critical insights into BC, demonstrating significant relationship between imaging features and histopathological characteristics. These findings highlight CEM’s potential as a reliable tool for tumor size estimation, subtype characterization, and prognostic assessment, suggesting its role as an alternative to MRI, particularly for patients with contraindications. Full article

Background/Objectives: Hereditary transthyretin-mediated amyloidosis (ATTRv) is a rare disease characterized by the deposition of amyloid in the heart and peripheral nerves, particularly affecting small fibers. This study aims to evaluate autonomic cardiac involvement in ATTRv. Methods: Twelve patients with ATTRv and twelve sex- and age-matched healthy subjects underwent ¹²³I-mIBG scintigraphy to evaluate the early and late heart-to-mediastinum ratio (eH/M and lH/M), ^99mTc-HDP bone scan scintigraphy, and neurophysiological assessments. Data were analyzed in relation to functional cardiac and neurologic scales (NYHA and FAP scales). Results: Patients with ATTRv exhibited significant cardiac denervation, as demonstrated by the reduction in early and late H/M ratios compared to the control group (eH/M: 1.48 ± 0.08 vs. 1.89 ± 0.05, p < 0.001; lH/M: 1.39 ± 0.08 vs. 2.01 ± 0.05, p < 0.001). Values of eH/M and lH/M < 1.6 effectively differentiated patients with ATTRv from the healthy controls. Cardiac denervation correlated with interventricular septal thickness and the Perugini score but was not related to neurophysiological assessments or NYHA and FAP scales. Conclusions: Ultimately, ¹²³I-mIBG scintigraphy is an effective tool for assessing cardiac denervation in patients with ATTRv. Full article

Background: Most of the communication training programs developed over the past two decades were monodisciplinary, relied on traditional teaching methods, and targeted the hospital context. Objectives: The aim of this study is to assess the impact of a short, interdisciplinary, experiential-based communication program (Teach-to-Communicate program) targeted at nursing home (NH) personnel with regard to short-term, staff-related outcomes. Methods: This study is part of a larger quality improvement project based on a pre–post single-arm intervention design. We focused on a 6 h residential program involving 30 participants with different scopes of practice working in an NH. Traditional and experiential learning methods were used, including lectures, small group discussions, brainstorming sessions, videos on successful and failed communication, role play, and storytelling based on real cases. The primary outcome was the acquired knowledge of communication strategies and protocols (pre- and post-test quiz). Secondary outcomes were self-reported knowledge, preparedness, confidence, and satisfaction with training (5-point Likert questions). Results: A statistically significant improvement in acquired knowledge with a large size effect (0.7, p < 0.001) was observed. Self-reported preparedness and confidence ameliorated for all measured communication skills and topics, with the highest effect size registered for self-reported preparedness and confidence in engaging in difficult communication (both 0.7, p < 0.001). Participants were highly satisfied with the training, and particularly with the use of video cases (mean 4.6, SD 0.6) and the relevance to clinical practice (mean 4.7, SD 0.5). Conclusions: The Teach-to-Communicate program holds promise for improving knowledge and self-confidence regarding difficult communication among NH staff, and highlights the utility of video cases in communication skills training. Full article