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WINFOCUS worldwide survey on central venous catheter insertion and position confirmation practices (CVC-ICON study)
No full textBackground: Central venous catheters (CVC) are essential in medicine for monitoring, drug and fluid administration, and renal replacement therapy. Complications such as arrhythmias, endothelial damage, thrombosis, or hemothorax might arise from incorrect positioning. Despite evidence showing their reduction using ultrasound to guide insertion and correct tip positioning, and greater accuracy for tip position assessment vs. chest-X-ray (CXR), ultrasound adoption greatly varies worldwide. This study, conducted by the World Interactive Network Focused On Critical Ultrasound (WINFOCUS) aimed to assess global practices in CVC insertion and tip position confirmation. Methods: A web-based survey was conducted (April–September 2023) among WINFOCUS members/affiliates across five continents. It assessed clinical backgrounds, CVC insertion and tip position check methods, and reasons for not using ultrasound. Developed by WINFOCUS Research sub-committee, the survey was emailed, with two reminders. Data were analyzed using SPSS 27.0. Results: A total of 1,227 respondents (5.1% response rate) participated, mainly from Europe (33.5%), Asia (28.3%), and the Americas (30.9%), with 95.4% being physicians. Over half (51.3%) had over six years of experience and placed over 200 CVC, mostly using ultrasound guidance (70% of cases). The internal jugular vein (IJV) was the preferred insertion site (74%). Ultrasound was used for pre-insertion assessment (55%) and vessel puncture (57%) but less for guidewire confirmation (44%). CXR remained the primary method for tip position assessment (52%), while only 12% relied solely on bedside ultrasound. Barriers to exclusive ultrasound use included institutional guidelines (33.9%) and medico-legal concerns (13.8%). Conclusions: Despite evidence favoring ultrasound for CVC insertion and tip position confirmation, its use remains inconsistent, with CXR still widely used. This survey underscores the need for standardized protocols and training to enhance US adoption, improve patient safety, and reduce CXR reliance
A Robust and Portable All-Digital TRNG Circuit for Extending the Instruction Set Architecture of RISC-V Processors
No full textAll-digital True Random Number Generators (TRNGs) play a crucial role in enhancing hardware security by providing native entropy sources directly within the processor pipeline. Their integration into open architectures such as RISC-V enables the extension of the Instruction Set Architecture (ISA) with secure, hardware-level random number generation capabilities essential for cryptographic operations. This work presents the design and validation of an all-digital True Random Number Generator (TRNG) for seamless integration with RISC-V processors via a custom interface. The proposed circuit has been developed using SystemVerilog and leverages Fibonacci Galois Ring Oscillators (FiGaROs), which use jitter and metastability as entropy sources to ensure high quality randomness. The TRNG has been integrated with the VECtor processor (VEC) core of the European Processor ACcelerator (EPAC) chip through a custom Control and Status Register (CSR) interface, enabling its use as a secure entropy source within the RISC-V instruction set architecture for cryptographic applications. The validation campaign is based on the typical main statistical suites of reference organizations in the field of security and cryptography and demonstrates that our solution offers both high-security standards and independence from both the implementation technology and the operating frequency chosen for the TRNG circuit, reporting an entropy per bit (in terms of Shannon entropy) of 0.9999 in all test cases, while always passing the pass-fail criteria for randomness. In addition, our circuit offers the highest entropy rate for both Field Programmable Gate Array (FPGA) and Application Specific Integrated Circuit (ASIC) solutions, as well as an efficiency in terms of entropy rate per resource consumption that is approximately 96 to 257 times that of the other solutions in the case of ASIC implementation
Evaluation of Soccer Use Performance of Tall Fescue as a Permanent Stand Turfgrass for Soccer Fields in Mediterranean Climates
No full textHigh-quality playing surfaces enhance player experience and safety while serving as an appealing setting for spectators. Natural turfgrass provides optimal conditions at the beginning of the playing season but faces challenges under increasing field usage. Turfgrasses with high wear tolerance and quick recovery capacity are crucial for maintaining surface quality under intensive wear. Bermudagrass is the most used species in warm climates but needs winter overseeding in the transition zone. In Mediterranean climates, tall fescue (Schedonorus arundinaceus (Schreb.) Dumort, formerly Festuca arundinacea) has emerged as a promising species due to its tolerance to heat, drought, and salinity, alongside traits like deep rooting, shade adaptation, and wear resistance. The trial was conducted at the CeRTES experimental station in Rottaia, Pisa, Italy. Twenty-seven tall fescue cultivars and three cultivars of perennial ryegrass (Lolium perenne L.) were hand-seeded on 3 November 2022, at a rate of 43 g m−2. The experimental design consisted of plots measuring 4.5 m2 arranged in a randomized complete block design with three replications. The objective of the study is to evaluate the performance of twenty-seven cultivars of tall fescue with the aim of using the species in soccer fields with a permanent stand approach, with no need to manage spring and fall transitions. The field study encompasses determinations referring to the establishment stage, the maintenance at low cutting height stage (20 mm) and the subsequent stage of soccer use under different seasonal conditions (autumn, winter, and spring). Results showed that certain fescue cultivars, notably ‘Essential’, ‘Eyecandy’, and ‘FAG3/19-20208B’, exhibited quick establishment and adaptation to low cutting height (20 mm), and performed similarly to the reference ryegrasses ‘Gianna’ and ‘Mercitwo’ in terms of wear tolerance and recovery capacity across the three seasons. Moreover, most of the tested tall fescue cultivars performed well at a 20 mm mowing height, maintaining satisfactory quality and density. Among these, ‘Eyecandy’ and ‘Foxhound’ displayed finer leaf textures, comparable to those of the reference ryegrass
Musical heritage historical entity linking
No full textLinking named entities occurring in text to their corresponding entity in a Knowledge Base (KB) is challenging, especially when dealing with historical texts. In this work, we introduce Musical Heritage named Entities Recognition, Classification and Linking (mhercl), a novel benchmark consisting of manually annotated sentences extrapolated from historical periodicals of the music domain. mhercl contains named entities under-represented or absent in the most famous KBs. We experiment with several State-of-the-Art models on the Entity Linking (EL) task and show that mhercl is a challenging dataset for all of them. We propose a novel unsupervised EL model and a method to extend supervised entity linkers by using Knowledge Graphs (KGs) to tackle the main difficulties posed by historical documents. Our experiments reveal that relying on unsupervised techniques and improving models with logical constraints based on KGs and heuristics to predict NIL entities (entities not represented in the KB of reference) results in better EL performance on historical documents
Ligand‐Dependent DNA Binding and Cytotoxicity of Palladium(II) Complexes
No full textIn the search for alternatives to platinum anticancer drugs, palladium complexes have attracted considerable interest. In this frame, six square planar palladium(II) complexes with the general formula [PdAB2] were prepared, where the ligand A is (1R,2R)-diaminocyclohexane (DACH) or 1,10-phenanthroline (Phen), and the ligand B is chlorine, iodine, or pyridine. The biological properties of the investigated compounds were systematically evaluated to identify trends linked to ligand variations. The complexes were synthesized following established experimental procedures and characterized by elemental analysis and NMR spectroscopy. DNA interactions were investigated through melting experiments and the ethidium bromide (EB) displacement assay. The obtained data suggested covalent adduct formation as the preferential binding mode for the DACH-containing complexes, whereas intercalation was predominant for the phenanthroline-based complexes. Notably, at least one compound appears to interact with DNA through both modes. Cytotoxic activity was evaluated against three human ovarian cancer cell lines (A2780, A2780R, and SKOV3) as well as a healthy control cell line (HSkM, human skeletal myoblasts). Significant cytotoxic activity was observed for the Phen-containing complexes, with compound 3 also showing a good selectivity index. Conversely, DACH-containing complexes were found to be non-cytotoxic
Statistical Model Checking for the Analysis of Attacks in Connected Autonomous Vehicles
No full textThis paper proposes an approach for the analysis of the effects of attacks in connected autonomous vehicles by simulated attack injection and statistical model checking technique. The vehicles, together with the co-ordination algorithm among vehicles and the attacks are formalized using hybrid automata in UPPAAL framework. Then, the statistical model checker, UPPAAL-SMC, allows to study the resilience of the system to attacks across a range of circumstances and uncertainties. The approach is applied to a platoon of vehicles, and properties of the system under attack in case of various driver patterns of the platoon's leader and parameters of a data alteration attack are analyzed
Valorisation of the under-sieve fraction of mixed municipal solid waste by hydrothermal carbonization
No full textHydrothermal carbonization (HTC) was investigated as an innovative route to valorise a waste stream from mechanical biological treatment of mixed municipal solid waste, namely the under-sieve fraction (USF), a high-moisture stream typically landfilled. This study explores HTC as an alternative to USF disposal, leveraging its ability to process wet organic feedstocks into value-added products. The main product of HTC, a carbonaceous solid called hydrochar, shows interesting potentials in various applications as a solid biofuel, soil amendment, and adsorbent material. Using Design of Experiments (DoE) and Response Surface Methodology (RSM), optimal HTC operating conditions (temperature, residence time, and solid load) were identified to maximise process yields. Experimental results demonstrated hydrochar yields up to 76 %, carbon yields up to 96 %, and energy yields up to 94 %. Maximum yields were achieved under mild conditions (190 °C, 60 min), indicating reduced process energy requirements. Hydrochar suitability as a soil amendment was also assessed, highlighting its potential as a soil improver or growing medium. These findings confirm HTC as a promising alternative for managing USF, offering environmental and resource recovery benefits compared to traditional landfill disposal
Real‐life effectiveness and safety of baricitinib in patients with severe alopecia areata: A 24‐week Italian study
No full textBackground: Alopecia areata is an autoimmune condition characterized by rapid hair loss in the scalp, eyebrows and eyelashes, for which treatments are limited. Baricitinib, an oral inhibitor of Janus kinases 1 and 2, has been recently approved to treat alopecia areata. Materials and Methods: We conducted a retrospective study involving 23 medical centres across Italy, enrolling patients affected by severe alopecia areata (SALT >50), for more than 6 months. Clinical and trichoscopic assessment was performed at each visit and impact on quality of life, anxiety and depression were evaluated using the Skindex-16 and the Hospital Anxiety and Depression Scale (HADS), respectively. Results: A total of 118 patients were enrolled, with a mean age of 39 years and a mean SALT >95. The mean value of the SALT score decreased from an average of 96.6 (±8.23 sd) to 48 (±35.2 sd) after 24 weeks of treatment and 42.3% of patients achieved a SALT 30, 31.3% a SALT 20 and 20.3% a SALT 10 by Week 24. Trichoscopic signs showed fewer yellow dots and black dots significantly earlier than hair regrowth. Adverse events during the treatment period (mild laboratory test abnormalities) were reported in 12.7% patients. No drop-out were registered. Conclusions: Data on the effectiveness and safety of baricitinib are promising and support the use of this drug in severe forms of AA, also in the early stages. We also suggest performing trichoscopy in order to reveal early response to therapy
Experts’ consensus on the management and treatment of individuals with X-linked hypophosphatemia across lifespan
No full textPurpose: X-linked hypophosphatemia (XLH) is a rare hereditary skeletal disorder that may be very disabling and significantly impacting the quality of life throughout the lifespan. The aim of this document was to inform stakeholders about the lifelong impact, management, and treatment of individuals with XLH, especially focusing on the new therapeutic approach with burosumab. Methods: From October 2023 to April 2024, a multidisciplinary working group of Italian experts on bone and mineral metabolism convened periodic online meetings. Statements were formulated identifying the most relevant studies, including randomized controlled trials, international guidelines based on GRADE criteria, and systematic reviews, and the experts’ opinions. Results: The panel of experts provided "consensus statements" on the clinical management of individuals with XLH across lifespan. Five main issues were identified: (1) clinical and biochemical diagnosis of individuals with XLH and monitoring of the progression of the disease; (2) effects of conventional treatment with phosphate supplements and active vitamin D metabolites; (3) effects of the treatment with burosumab; (4) multidisciplinary approach and management of individuals with XLH; (5) consensus statement for transition from pediatric to adult care in individuals with XLH. Conclusion: Individuals with XLH often experience unmet needs throughout life; a multidisciplinary approach involving different specialists, is recommended. The new treatment with burosumab can provide an effective and safety therapeutic option in reducing the burden of the disease in both children and adults. Therefore, awareness about the XLH disease should be increased among stakeholders. The criteria and reimbursement policies of burosumab should be revised