Search Results (622)

Assessing the increased impacts/risks of urban heatwaves generated by stressors such as a pandemic period, such as the one experienced during the COVID-19 pandemic, is complicated by the lack of comprehensive information that allows for an analytical determination of the alteration produced on climate risks/impacts. The assessment of the increased impacts/risks of urban heatwaves generated by stressors such as those due to the presence of a pandemic is complicated by the lack of comprehensive information that allows for the functional determination of the increased impacts/risks due to such stressors. On the other hand, it is essential for decision makers to understand the complex interactions between climate risks and the environmental and socioeconomic conditions generated by pandemics in an urban context, where specific restrictions on citizens’ livability are in place to protect their health. This study aims to address this need by proposing a fuzzy multi-criteria decision-making framework in a GIS environment that intuitively allows experts to assess the increase in heatwave risk factors for the population generated by pandemics. This assessment is accomplished by varying the values in the pairwise comparison matrices of the criteria that contribute to the construction of physical and socioeconomic vulnerability, exposure, and the hazard scenario. The framework was tested to assess heatwave impacts/risks on the population in the study area, which includes the municipalities of the metropolitan city of Naples, Italy, an urban area with high residential density where numerous summer heatwaves have been recorded over the last decade. The findings indicate a rise in impact/risks during pandemic times, particularly in municipalities with the greatest resident population density, situated close to Naples. Full article

In this work, different implementation strategies for a Time-Domain (TD) focusing procedure applied to airborne Synthetic Aperture Radar (SAR) raw data are presented, with the key objective of quantitatively assessing their computing time. In particular, two methodological approaches are proposed: a pixel-wise strategy, which processes each image pixel independently, and a matrix-wise strategy, which handles data blocks collectively. Both strategies are further extended to parallel execution frameworks to exploit multi-threading and multi-node capabilities. The presented analysis is conducted within the context of the airborne SAR infrastructure developed at the Institute for Electromagnetic Sensing of the Environment (IREA) of the National Research Council (CNR) in Naples, Italy. This infrastructure integrates an airborne SAR sensor and a high-performance Information Technology (IT) platform well-tailored to the parallel processing of huge amounts of data. Experimental results indicate an advantage of the pixel-wise strategy over the matrix-wise counterpart in terms of computing time. Furthermore, the adoption of parallel processing techniques yields substantial speedups, highlighting its relevance for time-critical SAR applications. These findings are particularly relevant in operational scenarios that demand a rapid data turnaround, such as near-real-time airborne monitoring in emergency response contexts. Full article

Background/Objectives: The hypothalamic-pituitary-testis axis is known to be dysregulated in patients with hematological malignancies. However, data on the association between the type of hematological malignancies and semen quality are discordant. In the era of personalized medicine, identifying disease-specific patterns of reproductive impairment is crucial to optimize fertility preservation strategies. While patients with leukemia often show a clear deterioration in semen quality, studies on Hodgkin and non-Hodgkin lymphomas have shown that spermatogenesis is not always compromised. Indeed, some patients may present normospermia before treatment. This study aimed to assess semen parameters in males affected by hematological malignancies compared with a non-cancer population and to explore implications for individualized fertility preservation counseling. Methods: We performed a retrospective monocentric study including all patients affected by hematological malignancies who underwent fertility preservation at the Maternal and Child Department, Gynecology and Obstetrics, Oncofertility Unit, Federico II of Naples, from January 2017 through December 2024. In total, 247 patients with hematological malignancies and 63 non-cancer males undergoing in vitro fertilization for female tubal factor, selected as a control group, were included in the analysis. Sperm parameters (semen volume, sperm concentration, motility, and morphology) were first compared between the hematological malignancy group and the control group, and then among hematological malignancies classified as Hodgkin lymphoma (HL), non-Hodgkin lymphoma (NHL), and leukemia (L). Results: Overall, according to World Health Organization (WHO, 2021) criteria, semen parameters of patients with hematological malignancies were at the 25th percentile, except for motility, which was below the 5th percentile. Significant differences were observed in sperm concentration/mL, total sperm number, and percentage of total sperm motility between the hematological malignancy group and the control group (p = 0.0004; p = 0.0003; p < 0.0001). Based on disease classification, 158 patients had Hodgkin lymphoma, 54 had non-Hodgkin lymphoma, and 35 had leukemia. Significant differences in concentration/mL and total sperm number were found between the Hodgkin lymphoma group and the control group (p = 0.003; p = 0.001). The percentage of total sperm motility was significantly decreased in all subtypes of hematological malignancies compared with controls, especially in the leukemia group (HL p = 0.001; NHL p = 0.004; L p < 0.001). Conclusions: These findings highlight significant impairment of semen quality, particularly motility, reinforcing the role of personalized medicine in tailoring fertility preservation strategies according to malignancy subtype and baseline reproductive risk. Full article

The randomness and volatility of wind power pose significant challenges for short-term forecasting, requiring the model to capture both temporal dynamics and the spatial correlations among turbines. To address this issue, this paper proposes a Spatio-Temporal Adaptive Graph Convolutional Recurrent Network (STAGCRN). The proposed method dynamically constructs and updates the spatial relationship graph through node adaptive parameter learning (NAPL) and a data adaptive graph generation (DAGG) module, enabling more accurate modeling of spatio-temporal dependencies in wind power data. In addition, a spatio-temporal self-attention mechanism is introduced to enhance the model’s ability to capture both short-term fluctuations and long-term temporal patterns. By stacking multiple spatio-temporal adaptive graph convolutional recurrent layers, the model is capable of extracting complex nonlinear characteristics in wind power sequences. Experimental results based on real wind farm data demonstrate that the proposed method achieves significantly improved prediction accuracy and robustness compared with existing approaches in short-term wind power forecasting tasks. Full article

Marine sponges are recognized as reservoirs of diverse microorganisms that produce bioactive natural compounds. In this study, we conducted a metataxonomic analysis of Geodia cydonium specimens collected from four sites in Italy: Secca delle Fumose (Gulf of Naples, Tyrrhenian Sea), Mar Piccolo of Taranto and an Integrated Multi-Trophic Aquaculture (IMTA) system in Mar Grande of Taranto (both located in the Ionian Sea), and Polignano a Mare (Adriatic Sea). Our results revealed a highly diverse microbial community within the sponges, encompassing 24 bacterial phyla. Among these, Chloroflexota was the most abundant phylum, accounting for an average of 30.2% of the total community across all samples. In addition, the majority of the microbiota was composed of Actinomycetota, Proteobacteria, Acidobacteriota, Poribacteriota, Gemmatimonadota, and Dadabacteria. The sponge sample from Polignano a Mare exhibited the richest and most diverse bacterial community. This observation was supported by phylogenetic analysis, which identified seven bacterial genera, Albidovulum, Filomicrobium, Microtrix, Gaiellales, D90 (Gammaproteobacteria class), and Blastopirellula, exclusive to this site. Several of these taxa are known for their potential biotechnological applications, underlining the significance of site-specific microbial diversity in G. cydonium. Full article

Background: Systemic inflammation and nutritional status have emerged as promising prognostic indicators across various malignancies; however, their clinical relevance in advanced laryngeal cancer remains underexplored. This study aimed to evaluate the prognostic significance of inflammation- and nutrition-based indices on the overall survival (OS) and progression-free survival (PFS) in patients with locally advanced or metastatic laryngeal cancer. Methods: A total of 147 patients treated at Pamukkale University between 2013 and 2022 were retrospectively analyzed. Baseline hematologic and biochemical parameters were used to calculate the Naples Prognostic Score (NPS), the Controlling Nutritional Status (CONUT) score, the Systemic Immune–Inflammation Index (SII), the Systemic Inflammation Response Index (SIRI), the C-reactive Protein/Albumin Ratio (CAR), and the Prognostic Nutritional Index (PNI). Survival outcomes were estimated using the Kaplan–Meier method, and independent prognostic factors were identified by Cox regression analyses. Results: The median OS and PFS were 55.5 and 48.8 months, respectively. In univariate analyses, high NPS, CONUT, SIRI, SII, and CAR values were significantly associated with inferior OS and PFS (p < 0.05). Multivariate analyses identified advanced stage, disease progression during chemotherapy, and high NPS as independent predictors of both the OS and PFS, whereas surgery conferred a survival advantage. Conclusions: Inflammation- and nutrition-based indices, particularly NPS, are strong prognostic markers for survival in patients with advanced laryngeal cancer. Routine integration of these parameters may enhance individualized risk stratification and guide treatment decisions in clinical practice. Full article

The end-of-life phase of a building, which includes demolition and waste disposal, represents a crucial aspect of sustainable construction. In Europe, construction and demolition (C&D) waste accounts for approximately 40% of the total waste generated in the EU, making its management a global challenge. The EU Construction & Demolition Waste Management Protocol (2024) emphasizes the importance of evaluating, before proceeding with the demolition of a building, whether renovation could be a more efficient solution, considering economic, environmental, and technical aspects. From an economic perspective, demolition costs vary depending on several factors, including project size, structural complexity, techniques employed (conventional or non-conventional), materials to be removed, and local regulations. In addition to the direct costs of the intervention, it is essential to consider indirect impacts, such as the management of construction and demolition (C&D) waste, the removal of hazardous substances, and potential environmental damage to be mitigated. This study analyzes a case located in Italy, in the municipality of Caivano (Metropolitan City of Naples, in Campania region), concerning a building that required energy efficiency improvements and seismic upgrades. The decision to demolish and rebuild proved to be economically more advantageous than renovation, while also allowing a 35% increase in volume, enabling the creation of a greater number of housing units. Through the analysis of this real case study, the aim is to highlight how investments in demolition, if properly planned, designed, assessed, and managed, can effectively contribute to building redevelopment, supporting the transition towards a sustainable construction model in line with the principles of the circular economy. Full article

Objective: The Italian Drug Agency (AIFA) Determination n. 589 of 2015 (Note 79) establishes that the use of bisphosphonates or denosumab is necessary for the primary prevention of bone fractures in postmenopausal patients with early breast cancer (EBC) undergoing adjuvant endocrine therapy (ET). Since adherence to the 2015 AIFA recommendation was still very low in 2019, a new bone health management model was identified to improve adherence to this recommendation. Methods: The aim of this project (Predict & Prevent) was to increase the percentage of patients with early breast cancer (EBC) with hormone receptor-positive (HR+) tumors treated. The project identified a new bone health model of management including the following: training of breast multidisciplinary teams and bone health specialists; presentation and implementation of this model in cancer centers; evaluation, at baseline and 12 months after the implementation of the project, of two key performance indicators (KPIs): rate of HR+ EBC patients assessed for bone health within 30 days from the start of adjuvant ET (KPI-1) and rate of HR+ breast cancer patients receiving bisphosphonates or denosumab within 90 days from the start of adjuvant ET (KPI-2). The primary endpoints of this study were the assessment of the rates of the two key performance indicators (KPIs) 12 months after the start of the project (T3) in comparison with the rates recorded at time 0 (T0) in each participating cancer center and the bone fracture rates at 5 years. In this first analysis, we reported the rates of two KPIs 12 months after the start of the new model (T3) and the comparison with the rates recorded at time 0 (T0) in each participating cancer center, to assess whether these percentages had increased after the implementation of the new organizational model. The rates of bone fractures will be evaluated after five years from implementation of this project in every cancer center. Results: From 2020 to 2022, 10 Italian cancer centers were involved in this project. As of September 2023, 9 cancer centers reported rates relative to two KPIs assessed in each hospital. In 6 hospitals (Negrar, Brescia, Bergamo, Aviano, Turin, Rome), the rates relative to KPI-1 and to KPI-2 increased progressively from time T0 (at baseline) to time T3 (after 12 months from the start of the project), due to training of multidisciplinary teams and implementation of a new bone health management model. In the other three cancer centers (Ancona, Genoa, Naples), where the rate of evaluation of bone health (KPI-1) and the indication for bisphosphonates/denosumab (KPI-2) in HR+ EBC patients were already high at time T0, the rates remained high even after 12 months from the start of this project. Conclusions: After 12 months from the implementation of this new organizational model of bone health management, an increase in the rate of postmenopausal HR+ EBC patients on adjuvant ET assessed for bone health and the rate of patients treated with bisphosphonate/denosumab were reported in six out of nine cancer centers. In the other three cancer centers, where the rates were high at baseline, the rates also remained high after 12 months from the new model implementation. This new model should be adopted in all cancer centers to allow adequate management of bone health in all postmenopausal HR+ EBC patients undergoing adjuvant ET, with the ultimate goal of reducing the rate of bone fractures in these patients in subsequent years. Full article

Background/Objectives: Chronic kidney disease (CKD) represents a major global public health challenge. Diet plays a central role in CKD management, with guidelines emphasizing individualized intake of energy, macronutrients, and micronutrients in combination with medical treatment. In recent years, increasing attention has been directed toward diet quality and the degree of food processing, particularly the consumption of ultra-processed foods (UPFs), which have been linked to adverse metabolic and renal outcomes. However, limited data are available on the real-life dietary patterns of individuals with CKD who have not yet received structured nutritional counseling. This study aims to describe the dietary habits of adults with CKD compared to healthy controls, in order to better understand nutritional challenges and identify potential targets for dietary intervention in CKD management. Methods: 73 subjects (46.6% M) were enrolled; they attended the Outpatients Clinic of the I.P. “Diet Therapy in transplantation, renal failure and chronic pathology”, University of Naples Federico II. Subjects were divided into two groups based on the presence/absence of CKD, established on the basis of a glomerular filtration rate (eGFR) < 60 mL/min/1.73 m². Each participant was evaluated for biochemical parameters, anthropometric measurements, body composition, and dietary assessment. Results: CKD group showed a lower caloric intake compared to Control Group. In particular, lipid intake was significantly higher in Control Group whereas carbohydrates intake was higher in CKD Group. No difference was found between the two groups regarding daily protein intake. Dietary sodium and salt intake was found to be lower in CKD Group compared to Control Group and the latter showed a lower omega-6/omega-3 ratio. Interestingly, the consumption of UPF was higher in Control Group compared to CKD Group. Conclusions: This study offers a snapshot of the dietary habits of a cohort from Southern Italy CKD stage 3–5 patients, showing that even in the absence of specific nutritional guidance, individuals were able to implement small lifestyle changes such as UPF and salt intake reduction. However, critical nutritional imbalances in CKD patients show the limits of self-managed diets, highlighting the need for structured nutritional support. Full article

Background: Human papillomavirus (HPV) plays a crucial role in the pathogenesis of oropharyngeal squamous cell carcinomas (OPSCC). Accurate HPV status classification is essential for therapeutic stratification. While p16 immunohistochemistry (IHC) is the clinical surrogate marker, it has limited specificity. Methods: In this study, we implemented a weakly supervised deep learning approach using the Clustering-constrained Attention Multiple-Instance Learning (CLAM) framework to directly predict HPV status from hematoxylin and eosin (H&E)-stained whole-slide images (WSIs) of OPSCC. A total of 123 WSIs from two cohorts (The Cancer Genome Atlas (TCGA) cohort and OPSCC cohort from the University of Naples Federico II (OPSCC-UNINA)) were used. Results: Attention heatmaps revealed that the model predominantly focused on tumor-rich regions. Errors were primarily observed in slides with conflicting p16/in situ hybridization (ISH) status or suboptimal quality. Morphological analysis of high-attention patches confirmed that cellular features extracted from correctly classified slides align with HPV status, with a Random Forest classifier achieving 83% accuracy at the cell level. Conclusions: This work supports the feasibility of deep learning-based HPV prediction from routine H&E slides, with potential clinical implications for streamlined, cost-effective diagnostics. Full article

Background/Objectives: Phenylketonuria (PKU) is an inherited metabolic disorder requiring early and lifelong dietary management through a low-phenylalanine (Phe) diet supplemented with Phe-free protein substitutes (PS). Recently developed slow-release PS formulations aim to mimic natural protein absorption, enhancing metabolic stability and tolerability. The PREMP study (effect of Protein RElease on the Microbiota composition and function in Phenylketonuric subjects) assessed the effects of a slow-release, Phe-free PS on gut microbiota composition and metabolic parameters in patients with PKU. Methods: Patients aged ≥6 years with PKU were enrolled from two Italian centers (Milan and Naples). Participants replaced ≥50% of their usual protein equivalent (P.Eq.) intake from Phe-free PS with a slow-release PS for 4 months. Clinical, biochemical, and nutritional assessments were performed at baseline and post-intervention. Gut microbiota composition was analyzed by 16S rRNA gene sequencing, and fecal fatty acids were quantified by gas chromatography–mass spectrometry. Results: Thirteen patients (median age 17 years) completed the intervention, replacing on average 78% of their usual P.Eq. intake with the slow-release formulation. Plasma phenylalanine and tyrosine levels remained stable, while fasting insulin (p = 0.0185) and HOMA-IR (p = 0.0099) significantly decreased, indicating improved insulin sensitivity. Anthropometric and dietary parameters showed no significant changes. Gut microbiota diversity remained stable, with modest increases in microbial richness and beneficial genera such as Bacteroides, Bifidobacterium, and Gemmiger, while Hafnia, Anaerostipes and Romboutsia decreased. Fecal butyrate and other fatty acids showed slight, non-significant increases. Conclusions: The slow-release PS was safe, well-tolerated, and improved insulin sensitivity without affecting amino acid or nutritional status. Microbial changes suggest potential benefits for gut health, warranting confirmation in larger, long-term studies. Full article

Background/Objectives: Distal biceps tendon rupture is a disabling injury that compromises elbow flexion and forearm supination strength, particularly in high-performance athletes. Although several fixation techniques have been proposed, no single method has proven optimal in combining mechanical stability, anatomical restoration, and early functional recovery. This study aimed to evaluate the efficacy, safety, and reproducibility of a hybrid dual-fixation technique combining a Tightrope^® cortical button (Arthrex, Naples, FL, USA) with a PEEK interference screw for anatomic reinsertion of the distal biceps tendon in athletic individuals. Methods: A prospective observational study was conducted on 13 high-performance athletes who underwent distal biceps tendon repair using the hybrid Tightrope–PEEK construct between March 2024 and September 2025. Functional recovery, muscle strength, esthetic contour, and patient satisfaction were evaluated using the Visual Analog Scale (VAS), Mayo Elbow Performance Score (MEPS), Quick Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH), and a 5-point Likert scale over a 12-month follow-up. Descriptive statistical analysis was performed using IBM SPSS Statistics, version 29.0. Results: All patients achieved secure fixation with no intraoperative or postoperative complications, loss of reduction, or hardware failure. Early controlled mobilization began within the first postoperative week. At 6 months, flexion and supination strength were fully restored, and at 12 months, all patients achieved full range of motion and optimal functional scores (mean MEPS 100; QuickDASH 0). No “Popeye” deformities or contour irregularities were observed, and mean patient satisfaction was 5/5. Conclusions: The hybrid Tightrope–PEEK dual-fixation technique provides excellent mechanical stability, allowing early mobilization and rapid functional recovery with minimal complications. Its reproducibility and cosmetic advantages suggest that it represents a safe and effective option for distal biceps tendon reinsertion in high-demand athletes. Full article

Background: The distal biceps brachii tendon inserts proximally and posteriorly on the bicipital tuberosity of the radius and it is a forearm supinator but also contributes to flexion of the elbow. Chronic distal biceps tendon ruptures are relatively rare, often complicated by tendon and muscle retraction, and, therefore, their primary repair is difficult or impossible. The gold standard treatment of these chronic lesions is its anatomic reinsertion at the radial tuberosity after tendon reconstruction, using autograft or allograft tissue, but there is no agreement about the most appropriate surgical technique. Untreated injuries usually result in elbow joint deficits and decreased muscular strength. We report the preliminary results in a group of patients treated with a tripled autologous semitendinosus graft. Methods: In the present retrospective study, we report the results in a series of 13 patients surgically treated using tripled autologous semitendinosus graft, fixed to the residual distal biceps tendon, starting from the myotendinous junction, and using tension-slide technique (Biceps Button—Arthrex, Inc, Naples, FL 34108, USA) in association with an interference screw. Eleven males and two females, with a mean age of 46, participated in the study. Results: At mean follow-up check-in of 35 months, clinical results were assessed using the DASH score and MEPS, with a mean value of 11 points and 87 points, respectively. Tensiomyography was also performed to evaluate muscular strength. Six patients had excellent results and seven had good results. No patient had either a tendon re-rupture, or a peripheral neurological deficit, or symptomatic heterotopic ossifications. Seven patients had a mild deficit in elbow motion and six patients had a mild deficit in forearm prono-supination. Upon tensiomyography evaluation, five patients showed a mild deficit in flexion and supination strength. All patients returned to their previous daily and sporting activities. Conclusions: According to our results, in patients affected by chronic distal biceps tendon rupture, surgical treatment performed using tripled autologous semitendinosus autograft secured to the radial tuberosity using the tension-slide technique and interference screw is associated with satisfactory outcomes. Full article

Background: eHealth literacy (eHL) is the ability to seek, find, understand, and apply digital health information. Adolescents often overestimate their eHL skills, potentially leading to poor health decisions and posing a public health concern. Objectives: This study aimed to examine the knowledge, attitudes, and behaviors toward eHL and seeking health information online among a sample of Italian adolescents aged 10–19 to identify the sociodemographic characteristics and other variables that are associated with the outcomes of interest. Methods: A cross-sectional study was conducted using a structured questionnaire, including the eHealth Literacy Scale (eHEALS). Results: A total of 793 Italian adolescents from seven public schools in Naples, southern Italy, participated in the survey. Among the participants, 58.6% had an eHEALS score below 27. A higher eHL was associated with being male, perceiving the Internet as useful for health decisions, the use of electronic devices for seeking health information, consulting institutional/scientific sources, having a mother with lower education, and having parents without underlying chronic conditions. Additionally, a higher eHL, male sex, younger age, and Internet use for seeking health information in the last three months were linked to perceiving the Internet as a helpful tool for health decision making. Conclusions: Overall, Italian adolescents reported suboptimal eHL with sex, attitudes, and parental factors playing significant roles. Targeted educational interventions are needed to enhance eHL in this specific age group. Full article

This research proposes a method based on the greatest and shortest eigen fuzzy sets of fuzzy relations to evaluate the effectiveness of policies and strategies implemented in urban settlements aimed at increasing the livability and well-being of citizens. This assessment is performed by extracting population census data collected at the beginning and end of the analyzed period and grouping them by subzone, that is, for each of the urban areas into which the urban settlement is divided. The greatest eigen fuzzy set (GEFS) and the smallest eigen fuzzy set (SEFS) are determined symmetrically as min-max and max-min solutions of fuzzy relations; they are calculated to estimate the average impact of urban strategies on generating symptoms of growth in citizen well-being during the investigated period. The method is implemented on a GIS (Geographic Information System) platform and was tested to assess the effectiveness of local policies applied between 2011 and 2021 on the growth of employment rates and educational attainment in the city of Naples (Italy), partitioned by neighborhood. Our model, unlike other fuzzy-based models for evaluating the effectiveness of actions and strategies to improve the quality of life in urban settlements, does not allow for subjective interpretations based on the knowledge or experience of different stakeholders, but relies solely on measurements over time of characteristics collected during census activities. Furthermore, it is integrated into a GIS-based platform, providing additional capabilities for identifying the urban areas where the impact of local strategies and policies has been most significant and those most critical. The test results show that the proposed framework can be a valuable tool for supporting decision makers in evaluating the effectiveness of local actions and policies aimed at improving the livability and well-being of citizens. Full article