Search Results (100)

Background/Objectives: Healthcare workers (HCWs) were the most exposed job category to SARS-CoV-2, due to patient care, HCW-to-HCW transmission, and community exposure. However, the relative relevance of each source is still debated. To address this issue, this study investigated the dynamics of the professional and extra-professional determinants of infection across the pandemic among a large, multicenter cohort of HCWs. Methods: The study included 5576 HCWs from four Italian University Hospitals within a European Project, called ORCHESTRA. Socio-demographic and clinical data were collected retrospectively via online surveys from March 2020 to September 2022. Factors associated with SARS-CoV-2 infection during different pandemic periods were evaluated by a multinomial logistic regression model. Results were expressed as Relative Risk Ratios (RRR). Results: The cumulative incidence was 46.2%. The highest incidence period was the Omicron phase (OVP) (69.7%). The extra-professional source was the most reported (34.3%), followed by the occupational (26.8%). However, in almost 40%, the source was undetected. The RRR for occupational exposures was 0.39 (95% CI 0.25–0.61) during the Pre-Omicron variant Period (POP) and even lower (0.22, 95% CI 0.16–0.29) in the OVP, as compared to extra-professional exposures, using the Pre-Vaccination Period (PVP) as reference. Conclusions: The dominant source of infection among HCWs changed over time. While occupational contacts were more frequent during PVP, it significantly waned over the subsequent pandemic phases. Implementing procedures and guidelines to prevent infection, even outside the workplace during pandemics, would reduce the spread of infection among HCWs and patients. Full article

Modern scientific research increasingly views olive leaf extract (OLE) not merely as a simple supplement, but as a sophisticated chemical orchestra where a wide array of phytochemicals works in natural harmony to provide therapeutic benefits. While olive oil is the most famous product of the Olea europaea tree, it is important to emphasize that the leaves are actually a far richer and more concentrated reservoir of bioactive molecules, often containing phenolic levels several times higher than those found in the fruit or oil. This whole plant extract often proves more biologically effective than isolated compounds because its components target multiple cellular pathways simultaneously. Many beneficial effects have been ascribed to OLE including anti-inflammatory, anti-oxidant, anti-microbial, anti-viral, neuroprotective, and anti-tumoral effects. In this review, we focused on the latter activity, especially in the field of pediatric tumors such as acute leukemias and neuroblastoma. This issue was discussed starting from the definition of OLE and its components describing the main biological activities, passing through the OLE roles on the immune system, moving on to the anti-cancer functions, and ending with future perspectives. Full article

The shift toward more electric aircraft has intensified thermal management challenges due to increased heat load from electrical actuators, power electronics and energy storage systems concentrated within confined fuselage bays. A Conventional Environmental Control System (ECS) alone is not sufficient to dissipate such high localized heat loads. This creates the need for innovative heat dissipation and heat reuse strategies. This paper presents two thermal management concepts evaluated at the Fraunhofer Flight Test Facility. The first, developed in the ORCHESTRA project, integrates a bilge skin heat exchanger with modified ventilation to dissipate elevated heat loads. The second, under investigation in the TheMa4HERA project, focuses on reusing avionics heat to warm the FWD cargo hold, thereby reducing ECS power demand. Both concepts depend on convective heat exchange, characterized using Fraunhofer’s Convective Heat Transfer Meter (CHM) to determine key heat transfer coefficients. In parallel, an aircraft-level thermal model was developed, validated against experimental data and subsequently used for virtual demonstration of a ground test scenario. Full article

This article presents an autoethnographic narrative account of curating and performing two pieces for solo piano and string orchestra—Climate Concerto by Brian Field and Eclogue by Gerald Finzi—to advocate for climate action. It discusses the selection of a concert venue that could be “thickly lived”, offering layers of cultural, historical and aesthetic resonance, and a concert date that could generate “interaction chains”, where engagement in one event motivates engagement in others. The article reflects on the multiple forms of loss brought about by the climate emergency, exploring Field’s musical portrayal of environmental loss and Finzi’s evocation of a harmonious human-nature relationship, which highlights a way of being-in-the-world that has been lost. In response to pervasive pessimism and dystopian narratives in climate communication, the discussion foregrounds hope as a powerful motivator for positive action, showing how the narrative scope of Field’s large-scale forms and the aesthetic beauty of Finzi’s music can elicit felt hope. The article also advocates for gentle musical activism for climate action, emphasising music’s capacity to cultivate relational sensitivity, ethical responsiveness, and collective responsibility toward each other and the world—even amid ecological crisis, social fragmentation, and uncertainty. Full article

This study investigated the narratives of teachers of children and youth orchestras regarding their identity as educators. A qualitative phenomenological approach was employed to compare the experiences of teachers from two orchestral programs in Mexico within two different contexts. One group of teachers from each program participated. Each group consisted of nine orchestra teachers who had at least two years of experience in their respective programs. Additionally, a coordinator from each program was interviewed. The study aimed to understand the subjective representations of what it means to be a teacher in interaction with each educational music context. Fieldwork was conducted between August 2021 and August 2022. Empirical data were obtained through autobiographical multimethodology, which allowed for data triangulation across participants’ narratives. Interpretative analysis was conducted in accordance with Kelchtermans’ conceptual framework of teachers’ self-understanding, which encompasses five components: self-image, self-esteem, task perception, job motivation, and future perspective. The findings reveal differences between the two studied contexts, mainly regarding their opportunities for teacher training and professional development. Similarities were also found between the narratives of the teachers from both programs, finding that task perception and job motivation are associated with the socio-emotional support they provide to students. Teacher narratives highlight training needs and working conditions that require attention to enhance the development of similar programs. Full article

Acoustically, Baroque theatres have prove remarkably appropriate for opera, and, in the past, little distinction was drawn in design between drama and opera use, except for the inclusion of an orchestra pit, because both music and words were audible and balanced, reverberation times being shorter than in concert halls but longer than in speech auditoria. In a drama configuration, scenery is set in the fly tower on stage, while for opera pieces, in most cases, the orchestra pit platform raises to the main floor level of the stalls to set additional seats rows. Considering the characteristics of the Opera di Roma (IT), the case study, the main physical parameters that contribute to the sound quality are evaluated and compared in relation to the pit position level, in order to understand the possible merits of the covering seats on the pit surface for drama representations and, more generally, for speech activities. Eight different configurations are compared and, to evaluate the acoustic parameters’ sensitivity, the JND (just noticeable difference) is analyzed. The parameters’ trend is described. Full article

Crescendo is a music-based social and emotional learning (SEL) programme designed for primary/elementary school children living in disadvantaged communities. It is a community-led, orchestra-delivered, and evidence-informed initiative aimed at improving children’s musical and SEL outcomes through sustained engagement. Children growing up in socioeconomically disadvantaged areas often experience challenges with SEL and limited access to orchestral music education. However, emerging research suggests a relationship between music participation and SEL development. This study evaluated the initial impact of Crescendo on 559 children aged 5–6 in their first year of participation (Year 1 of 7). A quasi-experimental, rolling cohort design compared pupils in four participating Crescendo schools with pupils in four matched control schools not receiving the programme. Outcome measures included music skills (beat, pitch, and reaction to music) and SEL (behavioural self-regulation). The findings indicated significant positive effects of the programme across all outcome domains, with moderate effects observed in self-regulation (Cohen’s d = 0.29) and reaction to music (Cohen’s d = 0.21) compared to control schools. These results suggest that collaboration between orchestral musicians and educators can positively influence young children’s musical and SEL development in resource-constrained settings. The findings also underscore the importance of clearly defined programme models to support replication and scalability. Full article

Background: Persistent low-grade inflammation has been proposed as part of the biological mechanisms underlying post-COVID condition (PCC), which can result in laboratory tests abnormalities. However, the accuracy of routine laboratory tests for the diagnosis and follow-up of PCC is still under discussion. Methods: Patients with SARS-CoV-2 infection enrolled in the prospective, multinational ORCHESTRA cohort study, which included both European and non-European countries, were followed up for 18 months after acute infection. Blood test results were collected at acute infection and at 6, 12, and 18 months. A multivariable analysis was performed to estimate the relationship between the alterations of biochemical markers and the presence of four distinct PCC phenotypes, identified previously through a principal component analysis—respiratory (RESc), chronic pain (CPc), chronic fatigue (CFc), and neurosensorial (NSc)—during follow-up. Furthermore, this study investigated the correlation between biochemical parameters measured during the acute phase and the subsequent development of PCC. Finally, the relationship between the severity of the acute infection and biochemical abnormalities observed during follow-up was assessed. Results: The cohort included 4587 patients, 58% male, with a mean age of 58.7 (±15.5) years. A robust multivariable analysis demonstrated that, compared to controls, patients with PCC, and in particular those in the RESc cluster, presented higher mean C-reactive protein (CRP) levels at the 12- and 18-month follow-up (p-value = 0.01). In each follow-up, CRP values in patients with PCC and RESc were above 3 mg/L, corresponding to those observed in low-grade inflammation (3–10 mg/L). The severity of COVID-19 acute infection was associated with increased levels of CRP, ferritin and LDH during follow-up (p < 0.001). Biochemistry abnormalities detected during the early stages of acute COVID-19 did not correlate with an increased risk of developing PCC and its phenotypes. Conclusions: In patients with the RESc PCC phenotype, identified through a principal component analysis, blood test abnormalities consistent with prolonged and sustained low-grade inflammation can be detected up to 18 months after acute infection, supporting its role in the pathogenesis of PCC. Based on these results, trials on anti-inflammatory drugs, together with symptom-tailored interventions for patients with RESc, should be planned to prove their effectiveness in managing PCC and improving patient outcomes. Full article

The pituitary gland is considered the conductor of the hormonal orchestra, and despite its small dimensions, numerous tumoral lesions can arise within it. Over the past decade, substantial changes have been made regarding the nomenclature, which are summarized in the 5th Edition of the World Health Organization Classification of Endocrine and Neuroendocrine Tumors. Furthermore, significant breakthroughs in biomolecular mechanisms have been uncovered, which have formed the basis for the new classification. The management of these lesions varies according to several factors such as tumoral dimensions, hormonal activity, symptomatology, and radiological findings. At the same time, the therapeutic goal is represented by normalization of hormonal hypersecretion if present, control of tumoral growth and/or relief of mass effect symptoms, and preservation or restoration of the pituitary function. The current narrative review aims to explore the link between biomolecular aspects, the extent of resectability, and the postoperative outcome. Full article

The arts sector—museums, theaters, and orchestras—in the United States and Europe faces increasing financial and operational challenges, from declining attendance to reduced public and private funding. While these organizations have historically pursued their goals independently, their future may depend on fostering collaboration across these traditionally siloed institutions. By pooling resources, expertise, and, most importantly, audiences, cross-disciplinary partnerships can amplify the impact of cultural institutions while addressing shared challenges. For instance, museums and performing arts organizations could collaborate on immersive experiences that integrate visual and performing arts, attracting a broader and more diverse audience base. Similarly, joint programming and shared digital platforms could reduce overhead costs and expand outreach. These partnerships also enable the arts to present a unified case for public and philanthropic support, leading to greater collective societal impact. Drawing on successful examples of cross-sector collaboration, this paper explores practical strategies for fostering synergies among arts institutions. By working together, the arts can not only enhance their resilience in a challenging environment but also redefine how cultural experiences are created and consumed, ensuring their relevance and vibrancy for future generations. Full article

Humanity currently faces a state of crisis, as it navigates the challenges of a quickly evolving world. The increasing number of conflicts and wars has had serious repercussions on human life, contributing to the displacement of populations and a growing influx of refugees. The high number of children and young people among this group requires urgent action to meet their needs for education, health, and a secure upbringing. Music education provides one platform for unique expression and identity for these age groups. In 2022, nearly a hundred young musicians from Afghanistan were welcomed into the cities of Braga and Guimarães in Portugal. They work to defend their culture through orchestral activity which has achieved international reach, thanks to the work of the Afghanistan National Institute of Music (ANIM). This article examines how music connects Afghan refugee youth with host communities. It focuses on the role of musical practice in fostering integration within schools and the broader urban context. Using a qualitative approach, based on ethnographic observation of this orchestra’s rehearsals, this article explores the concept of affordances. Ethnographic observation was conducted throughout school activities, music workshops, and informal interactions during break periods. Field notes focused on participants’ non-verbal expressions, musical engagement, and interactions with both peers and educators. These observations were used to contextualise the interviews and triangulate the data. This theoretical–analytical approach shows that, for these youngsters, music plays a mediating role regarding social actions and experiences, shaping new subjectivities and their externalisations. It is a technology of the self, of (re)adaptation, resistance, and identity re-emergence. The main argument is that ANIM’s music in action is a communication tool that, like migratory processes, reconfigures the identities of its protagonists. Music has been demonstrated to function as a catalyst for connection, predominantly within the context of ensemble and orchestra rehearsals, serving as a shared language. Full article

Digestion was once viewed as a host-driven process, dependent on salivary, gastric, pancreatic, and intestinal enzymes to break down macronutrients. However, new insights into the gut microbiota have redefined this view, highlighting digestion as a cooperative effort between host and microbial enzymes. Host enzymes initiate nutrient breakdown, while microbial enzymes, especially in the colon, extend this process by fermenting resistant polysaccharides, modifying bile acids, and transforming phytochemicals and xenobiotics into bioactive compounds. These microbial actions produce metabolites like short-chain fatty acids, which influence gut barrier function, immune regulation, and metabolism. I propose two frameworks to describe this interaction: the “duet,” emphasizing sequential enzymatic cooperation, and the “orchestra,” reflecting a spatially and temporally coordinated system with host–microbiota feedback. Disruption of this symbiosis, through antibiotics, inflammation, diet, or aging, leads to dysbiosis, impaired digestion, and contributes to metabolic, neurologic, cardiovascular, and inflammatory diseases. Recognizing digestion as a dynamic, integrated system opens new paths for therapies and nutrition. These include enzyme-targeted prebiotics, probiotics, postbiotics, and personalized diets. Embracing this systems-level perspective enables innovative diagnostics and treatments, aiming to restore enzymatic balance and improve digestive and systemic health. Full article

Background/Objectives: Compared to in the general pregnant population, pregnancy in women with type 1 diabetes (T1D) is still associated with an increased number of perinatal complications affecting both the fetus and the mother. The Great Orchestra of Christmas Charity Foundation (GOCCF) program enables the use of continuous subcutaneous insulin infusion (CSII) enhanced by a hypo-stop function and real-time continuous glucose monitoring (rtCGM) during the preconception or early pregnancy period in patients with T1D. This observational study aimed to analyze the association between pregnancy planning and pregnancy outcomes in patients who qualified for the GOCCF program. Methods: Ninety-eight women with T1D, aged 21–41 years, who began using the CSII + rtCGM system at the planning/early pregnancy stage or at a later stage in the case of an unplanned pregnancy, were eligible for this study. We analyzed glucose control, the insulin requirements, the pregestational BMI, the maternal weight gain, the occurrence of preterm births, congenital malformations and the birthweight of newborns. Results: Women who planned their pregnancies had significantly better glycemic control before and throughout the entire pregnancy, and a significantly higher proportion of them achieved a TIR (time in range) > 70% (58.7% vs. 28.9%, p = 0.014) and TAR (time above range) < 25% (65.2% vs. 24.4%, p < 0.001). Their glucose variability at the end of the pregnancy was significantly lower (29.4 ± 5.5 vs. 31.9 ± 5.1, p = 0.030). They also gave birth later, at a mean of 37.8 ± 0.9 weeks compared to 36.9 ± 1.8 weeks in the non-planned group (p = 0.039). Preterm birth occurred in five women (10.4%) who planned their pregnancies and in fifteen women (30%) who did not, with p = 0.031. Conclusions: Pregnancy planning in women with type 1 diabetes (T1D) is associated with better glucose control before conception and throughout the entire pregnancy, resulting in better pregnancy outcomes. Full article

Background/Objectives: This retrospective multicenter study, conducted within the ORCHESTRA Project, investigated SARS-CoV-2 reinfections among 5777 healthcare workers (HCWs) from four University Hospitals (Modena, Verona, Padova and Trieste) in northern Italy, aiming to assess the risk of reinfection and its determinants, comparing the clinical characteristics of reinfections with those of first infections, and examining the impact of preventive measures and vaccination strategies. Methods: HCWs completed an online questionnaire between June and August 2022. The survey collected demographic, occupational, and clinical data, including information on first infections and reinfections. Statistical analyses were performed using SPSS 28.0, through bivariate and multivariate approaches. Results: Response rates were 41.8% for Modena, 39.5% for Verona, 17.9% for Padova, and 17.4% for Trieste. Among the respondents, 4.8% (n = 276) experienced 2 infections and 0.5% (n = 27) reported 3 infections, out of a total of 330 reinfection cases. Additionally, 43.0% (n = 2787) reported only one infection, while 51.5% were never infected. Reinfection rates increased across five study phases (based on the epidemiological context), likely due to the emergence of new SARS-CoV-2 variants. A booster vaccine dose significantly reduced reinfection risk. Higher reinfection risk was found among HCWs aged ≤30 years, those with chronic respiratory diseases, and those working in COVID-19 wards, particularly nurses and allied health professionals. Reinfections were associated with a lower frequency of symptoms both during the period of swab positivity and after a negative swab, as well as with a shorter duration of swab positivity. No significant differences in symptom duration were found between first infections and reinfections. Conclusions: Despite its limitations, the online questionnaire proved a useful tool. Natural infection and vaccination reduced both reinfection risk and symptom severity. Prior infections should be considered in planning vaccination schedules and prioritizing HCWs. Full article

Background The prevalence of obesity is increasing all over the world, resulting in a global health emergency. The impact of obesity on the risk of SARS-CoV-2 infection and symptom severity, especially among high-risk working populations such as health workers, deserves further studies. Methods A multicentric retrospective cohort study was conducted among health workers at four Italian University Hospitals belonging to the ORCHESTRA Project. Data were collected through an online survey, investigating sociodemographic and clinical data, until September 2022. Results The questionnaire was filled out by 5777 health workers. The median age was 46 years old (I–III quartile 20–72) and 75.5% were females. Data on BMI was available for 5470 participants. Overweight and obese subjects amounted to 23.4% and 9.8%, respectively. Naïve health workers were the majority (57.4%). Overweight and obese subjects were at a higher risk of infection only before vaccination with respect to normoweight subjects (RRR = 1.28 (IC 95% 1.01–1.62, p = 0.039) and 1.36 (1.00–1.86, p = 0.047), respectively). Major acute and post-acute COVID-19 symptoms were more common among obese subjects, as compared to those with a normal weight (35.2% vs. 23.5%, and 14.2% vs. 9.3%). BMI did not reduce antibody levels after vaccination. On the contrary, overweight and obese health workers had a significantly higher RGM after the third dose (1.12 and 1.48, respectively; normal weight as reference). Conclusions Overweight and obese subjects are at a higher risk of SARS-CoV-2 infection. However, SARS-CoV-2 vaccination fosters a high antibody response even in these individuals. Vaccination against SARS-CoV-2 should be prioritized in subjects with a high BMI, especially in highly exposed workers, such as health workers. Full article