Search Results (16)

Background: Breast cancer is the most common female cancer in Italy. Despite better survival rates, significant disparities in access to diagnosis, treatment, and follow-up persist across regions. We propose an integrated, multidisciplinary care model—the Breast Immunology Network (BIN)—to address these challenges. Methods: The model was developed through a two-phase expert consultation with key opinion leaders and stakeholders, aligned with national and European oncology guidelines. No new patient data were collected; this is a qualitative analysis based on expert consensus and existing literature. The proposed model integrates a Hub-and-Spoke cancer network structure with fully functioning multidisciplinary teams (MDTs), standardized care pathways (PDTA), and digital tools to ensure continuity of care. Results: Experts identified critical gaps in Italy’s breast cancer care: limited access to specialized centers, inconsistent adherence to screening programs, and delays in treatment initiation. The proposed BIN model aims to bridge these gaps by enhancing collaboration across all care levels, incorporating immunotherapy where appropriate, and defining key performance indicators (KPIs) for continuous quality evaluation. For example, quantitative targets include achieving ≥65% nationwide mammography screening adherence and ensuring ≥90% of patients are treated in certified Breast Units. Conclusions: The Breast Immunology Network offers a strategic framework to improve equity, quality, and timeliness of breast cancer care in Italy. Importantly, unlike existing Hub–Spoke or CCCN models, the BIN formalizes governance tools, harmonized eligibility criteria, and a national registry for immunotherapy. By uniting Breast Units and community services under shared governance, and by integrating innovations such as immunotherapy and telemedicine, the BIN model could significantly improve clinical outcomes and ensure more equitable care for all patients. Its implementation may serve as a reference model for other health systems seeking to optimize oncology pathways through multidisciplinary integration and advanced treatments. Full article

Bio-based polydithioacetal nanocomposites were synthesized to address the critical need for materials that simultaneously achieve enhanced thermomechanical properties and excellent reprocessing capabilities. Using vanillin and cellulose nanocrystals (CNCs) as starting materials, linear polydithioacetals (PDTAs) were prepared via acid-catalyzed polycondensation of vanillin with various dithiols including 1,6-hexanedithiol, 1,10-decanedithiol, 3,6-dioxa-1,8-octanedithiol and 2,2′-thiodiethanethiol. These PDTAs were then crosslinked with a diepoxide (i.e., diglycidyl ether of bisphenol A, DGEBA) via the reaction of phenolic hydroxyl groups of PDTAs with epoxide groups of DGEBA. To create the nanocomposites, cellulose nanocrystals (CNCs) were surface-functionalized with thiol groups and then incorporated as the reinforcing nanofillers of the networks. The results of morphological observation showed that the fine dispersion of CNCs in the polymer matrix was attained. Owing to the incorporation of CNCs, the nanocomposites displayed improved thermomechanical properties. Compared to the network without CNCs, the nanocomposite containing 20 wt% CNCs exhibited an increase of more than tenfold in modulus and threefold in tensile strength. In addition, the nanocomposites exhibited excellent reprocessing properties, attributable to the dynamic exchange of dithioacetal bonds. This work presents a promising strategy for developing bio-based nanocomposites that have not only improved thermomechanical properties but also excellent reprocessing (or recycling) properties. Full article

In the hydrogen separation membrane, a dense TaTiNbZr amorphous layer was prepared between Pd and Ta to form a Pd/TaTiNbZr/Ta membrane system to prevent the reaction between Pd and Ta at high temperatures. The structural and chemical stability of the Pd/TaTiNbZr/Ta film system at high temperatures were investigated by annealing at 600 °C for 24 h. The high-temperature hydrogen permeation properties of the Pd/TaTiNbZr/Ta film systems were investigated by hydrogen permeation experiments at 600 °C after heat treatment for 6 h. The TaTiNbZr layer was significantly hydrogen-permeable. With the increase in the thickness of the barrier layer, the hydrogen permeability of Pd/TaTiNbZr/Ta decreased, but its hydrogen permeation flux was smaller than that of the highest value of Pd/Ta when it reached the steady state. The presence of the TaTiNbZr layer effectively blocks the interdiffusion between Pd and Ta to form TaPd₃, improving the sustained working ability of the Pd/TaTiNbZr/Ta membrane system. The results show that TaTiNbZr is a candidate material for the intermediate layer to improve the high-temperature stability of metal-composite hydrogen separation membranes. Full article

This paper discusses a methodology to improve the prevention processes of chronic diseases such as diabetes and strokes. The research motivation is to find a new methodological approach to design advanced Diagnostic and Therapeutic Care Pathways (PDTAs) based on the prediction of chronic disease using telemedicine technologies and machine learning (ML) data processing techniques. The aim is to decrease health risk and avoid hospitalizations through prevention. The proposed method defines a Process Mining Organization (PMO) model, managing risks using a PDTA structured to prevent chronic risk. Specifically, the data analysis is focused on stroke risk. First, we applied and compared the Random Forest (RF) and Gradient Boosted Trees (GBT) supervised algorithms to predict stroke risk, and then, the Fuzzy c-Means unsupervised algorithm to cluster information on the predicted results. The application of the proposed approach is able to increase the efficiency of healthcare human resources and drastically decrease care costs. Full article

New control measures are urgently required to control tuberculosis (TB), as the current vaccine, Bacille Calmette–Guérin (BCG), has had a limited impact on disease spread. The identification of virulence mechanisms of Mycobacterium tuberculosis is an important strategy in vaccine design, as it permits the development of strains attenuated for growth that may have vaccine potential. In this report, we determined the role of the PdtaS response regulator in M. tuberculosis virulence and defined the vaccine potential of a pdtaS-deficient strain. Deletion of pdtaS (Mtb^ΔpdtaS) resulted in reduced persistence of M. tuberculosis within mouse organs, which was equivalent to the persistence of the BCG vaccine in the lung and liver of infected mice. However, the generation of effector CD4⁺ and CD8⁺ T cells (CD44⁺CD62L^loKLRG1⁺) was similar between wild-type M. tuberculosis and Mtb^ΔpdtaS and greater than that elicited by BCG. Heightened immunity induced by Mtb^ΔpdtaS compared to BCG was also observed by analysis of antigen-specific IFN-γ-secreting T cell responses induced by vaccination. Mtb^ΔpdtaS displayed improved protection against aerosol M. tuberculosis compared to BCG, which was most apparent in the lung at 20 weeks post-infection. These results suggest that the deletion of the PdtaS response regulator warrants further appraisal as a tool to combat TB in humans. Full article

The influence of structure and technological parameters (STPs) on the metrological characteristics of hydrogen sensors based on MISFETs has been investigated. Compact electrophysical and electrical models connecting the drain current, the voltage between the drain and the source and the voltage between the gate and the substrate with the technological parameters of the n-channel MISFET as a sensitive element of the hydrogen sensor are proposed in a general form. Unlike the majority of works, in which the hydrogen sensitivity of only the threshold voltage of the MISFET is investigated, the proposed models allow us to simulate the hydrogen sensitivity of gate voltages or drain currents in weak and strong inversion modes, taking into account changes in the MIS structure charges. A quantitative assessment of the effect of STPs on MISFET performances (conversion function, hydrogen sensitivity, gas concentration measurement errors, sensitivity threshold and operating range) is given for a MISFET with a Pd-Ta₂O₅-SiO₂-Si structure. In the calculations, the parameters of the models obtained on the basis of the previous experimental results were used. It was shown how STPs and their technological variations, taking into account the electrical parameters, can affect the characteristics of MISFET-based hydrogen sensors. It is noted, in particular, that for MISFET with submicron two-layer gate insulators, the key influencing parameters are their type and thickness. Proposed approaches and compact refined models can be used to predict performances of MISFET-based gas analysis devices and micro-systems. Full article

The development of stable and durable hydrogen (H₂) separation technology is essential for the effective use of H₂ energy. Thus, the use of H₂ permeable membranes, made of palladium (Pd), has been extensively studied in the literature. However, Pd has considerable constraints in large-scale applications due to disadvantages such as very high cost and H₂ embrittlement. To address these shortcomings, copper (Cu) and Pd were deposited on Ta to fabricate a composite H₂ permeable membrane. To this end, first, Pd was deposited on a tantalum (Ta) support disk, yielding 7.4 × 10⁻⁸ mol_H2 m⁻¹ s⁻¹ Pa^−0.5 of permeability. Second, a Cu–Pd alloy on a Ta support was synthesized via stepwise electroless plating and plasma sputtering to improve the durability of the membrane. The use of Cu is cost-effective compared with Pd, and the appropriate composition of the PdCu alloy is advantageous for long-term H₂ permeation. Despite the lower H₂ permeation of the PdCu/Ta membrane (than the Pd/Ta membrane), about two-fold temporal stability is achieved using the PdCu/Ta composite. The degradation process of the Ta support-based H₂ permeable membrane is examined by SEM. Moreover, thermocatalytic H₂ dissociation mechanisms on Pd and PdCu were investigated and are discussed numerically via a density functional theory study. Full article

In line with priorities set by the Italian Ministry of Health and international literature, the “Crisalide project” provides specific care pathways aimed at young adults (YA) with severe mental disorders (SMD). As described in Materials and Methods, it consists of three lines of activity: transition to adult mental health services (TSMREE/CSM 17–19); Diagnostic, Therapeutic, and Assistance Pathways for Young Adults (PDTA-YA); high-intensity treatment center for young adults “Argolab2 Potential Space”. The aim of the study is to assess the results relating to the first three years of implementation of this clinical-organizational model (2018/2020) according to the process indicators identified by the ministry. Among the population aged 18–30 under treatment, results show increased prevalence (30%) and incidence (26%); 0% treatment conclusions due to the expiration of the conventional time limit; 0% involuntary hospitalizations (TSO); 0% STPIT hospitalizations; 0% repeated hospitalizations; 0% hospitalizations in the common mental disorders diagnostic group. Among the population of Argolab2 Potential Space, 45.4% have resumed studies; 40.9% have had a first work experience; 22.7% have obtained educational or training qualifications, and 18.2% live in independent houses. At a time when the academic literature underlines the terrible impact of the COVID-19 pandemic on this population, the present study confirms that specific treatment processes for young populations are a protective factor. Full article

A Fenton reaction and a corrosion inhibition strategy were designed for enhancing the polishing rate and achieving a corrosion-free Ge₁Sb₄Te₅ film surface during chemical-mechanical planarization (CMP) of three-dimensional (3D) cross-point phase-change random-access memory (PCRAM) cells and 3D cross-point synaptic arrays. The Fenton reaction was conducted with 1,3-propylenediamine tetraacetic acid, ferric ammonium salt (PDTA–Fe) and H₂O_2. The chemical oxidation degree of GeO₂, Sb₂O₃, and TeO₂ evidently increased with the PDTA–Fe concentration in the CMP slurry, such that the polishing rate of the Ge₁Sb₄Te₅ film surface linearly increased with the PDTA–Fe concentration. The addition of a corrosion inhibitor having protonated amine functional groups in the CMP slurry remarkably suppressed the corrosion degree of the Ge₁Sb₄Te₅ film surface after CMP; i.e., the corrosion current of the Ge₁Sb₄Te₅ film surface linearly decreased as the corrosion inhibitor concentration increased. Thus, the proposed Fenton reaction and corrosion inhibitor in the Ge₁Sb₄Te₅ film surface CMP slurry could achieve an almost recess-free Ge₁Sb₄Te₅ film surface of the confined-PCRAM cells, having an aspect ratio of 60-nm-height to 4-nm-diameter after CMP. Full article

Nowadays, chronic disease management is the primary challenge of the healthcare system. From 2015, in the Veneto region (Italy), patients with a diagnosis of type 2 diabetes mellitus (T2DM) have been included in the diagnostic-therapeutic pathway (PDTA) program, and their clinical condition has been continuously monitored. The aim of this retrospective study is to determine the effectiveness of PDTA intervention, alone or in combination with a specialized one, in subjects with diagnosis of T2DM. Clinical and behavioral characteristics were collected at baseline and after 1 year of follow-up. Two subgroups were considered: subjects enrolled in PDTA only and subjects enrolled in both the PDTA program and in the care plan proposed by the specialized medical center (CAD group). Longitudinal analysis showed a relevant positive effect of time on diastolic blood pressure, while CAD enrollment appears to be related to higher levels of glycated hemoglobin. When included together in the same model, interaction between time and CAD covariates results in completely nonsignificant effects. As long-term management of chronic disorders, such as T2DM, is often difficult due to disease characteristics and problems in healthcare organization, monitoring programs, such as PDTA, and specialized care programs, such as CAD, do not show a clinically relevant effect in the first year of follow-up. Therefore, they should be analyzed over a longer period. However, they should also carefully consider the need for adequate tools for data collection and sharing, in addition to the context of application, patient expectations and the need for a long-term educational program. Full article

Herein, the fabrication of a novel highly sensitive and fast hydrogen (H₂) gas sensor, based on the Ta₂O₅ Schottky diode, is described. First, Ta₂O₅ thin films are deposited on silicon carbide (SiC) and silicon (Si) substrates via a radio frequency (RF) sputtering method. Then, Pd and Ni are respectively deposited on the front and back of the device. The deposited Pd serves as a H₂ catalyst, while the Ni functions as an Ohmic contact. The devices are then tested under various concentrations of H₂ gas at operating temperatures of 300, 500, and 700 °C. The results indicate that the Pd/Ta₂O₅ Schottky diode on the SiC substrate exhibits larger concentration and temperature sensitivities than those of the device based on the Si substrate. In addition, the optimum operating temperature of the Pd/Ta₂O₅ Schottky diode for use in H₂ sensing is shown to be about 300 °C. At this optimum temperature, the dynamic responses of the sensors towards various concentrations of H₂ gas are then examined under a constant bias current of 1 mA. The results indicate a fast rise time of 7.1 s, and a decay of 18 s, for the sensor based on the SiC substrate. Full article

We present the generalized experimental results of performance degradation of hydrogen sensors based on metal-insulator-semiconductor field effect transistor (MISFET)with the structure Pd-Ta₂O₅-SiO₂-Si. The n-channel MISFET elements were fabricated on silicon single chips together with temperature sensors and heater-resistors by means of conventional -technology. Two hundred cycles of responses to different hydrogen concentrations were measured during eight weeks using special measuring and temperature stabilization circuitries with a feedback loop based on the chip’s thermo-sensor and heater. We show how the response parameters change during long-term tests of sensors under repeated hydrogen impacts. There were two stages of time-dependent response instability, the degradation of which depends on operating conditions, hydrogen concentrations, and time. To interpret results, we proposed the models, parameters of which were calculated using experimental data. These models can be used to predict performances of MISFET-based gas analysis devices for long-term operation. Full article

There are presented the generalized results of studies of performance degradation of hydrogen sensors based on MISFET with structure Pd-Ta₂O₅-SiO₂-Si. It was shown how responses’ parameters change during long-term tests of sensors under repeated hydrogen impacts. There were found two stages of time-dependence response’ instability, the degradation degree of which depends on operating conditions, hydrogen concentrations and time. To interpret results there were proposed the models, parameters of which were calculated using experimental data. These models can be used to predict performances of MISFET-based devices for long-time operation. Full article

Nanocarrier-based delivery systems are promising strategies for enhanced therapeutic efficacy and safety of toxic drugs. Photodynamic therapy (PDT)—a light-triggered chemical reaction that generates localized tissue damage for disease treatments—usually has side effects, and thus patients receiving photosensitizers should be kept away from direct light to avoid skin phototoxicity. In this study, a clinically therapeutic antibody cetuximab (C225) was conjugated to the surface of methoxy poly(ethylene glycol)-b-poly(lactide) (mPEG-b-PLA) micelles via thiol-maleimide coupling to allow tumor-targetable chlorin e6 (Ce6) delivery. Our results demonstrate that more C225-conjugated Ce6-loaded polymeric micelles (C225-Ce6/PM) were selectively taken up than Ce6/PM or IgG conjugated Ce6/PM by epidermal growth factor receptor (EGFR)-overexpressing A431 cells observed by confocal laser scanning microscopy (CLSM), thereby decreasing the IC₅₀ value of Ce6-mediated PDT from 0.42 to 0.173 μM. No significant differences were observed in cellular uptake study or IC₅₀ value between C225-Ce6/PM and Ce6/PM groups in lower EGFR expression HT-29 cells. For antitumor study, the tumor volumes in the C225-Ce6/PM-PDT group (percentage of tumor growth inhibition, TGI% = 84.8) were significantly smaller than those in the Ce6-PDT (TGI% = 38.4) and Ce6/PM-PDT groups (TGI% = 53.3) (p < 0.05) at day 21 through reduced cell proliferation in A431 xenografted mice. These results indicated that active EGFR targeting of photosensitizer-loaded micelles provides a possible way to resolve the dose-limiting toxicity of conventional photosensitizers and represents a potential delivery system for PDT in a clinical setting. Full article

The influence of the circuit’s electric modes on the radiation sensitivity of hydrogen sensors based on the metal-insulator-semiconductor field-effect transistor with structure Pd-Ta₂O₅-SiO₂-Si (MISFET) was investigated. There were measured the hydrogen responses of output voltages V of the MISFET-based circuits at different gate voltages before and after the electron irradiations. The voltages V as functions of hydrogen concentration C were determined for different ionizing doses D. Models of influence of the electric modes on the radiation sensitivity of sensors were based on experimental dependencies of V(C, D). The recommendations for the optimal choice of MISFET-based circuit’s electric modes were formulated. Full article