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Manual Dexterity Abilities and Dual Tasking in Children With Developmental Coordination Disorder and Typically Developing Children
No full textToo hot to reason? Experimental heatwaves affect cognitive traits in male guppies
No full textHeatwaves, increasingly common and intense due to climate change, are increasing mortality rates and disrupting vital functions. Recent research has begun exploring their impact on cognition. Since cognition underlies key fitness-related behaviors, such as foraging, predator avoidance, and mate choice, understanding the cognitive costs of heatwaves is crucial. Here, we investigate whether heatwaves impact cognition using male guppies (Poecilia reticulata) as a vertebrate model. We focused on males due to their behavioral consistency in cognitive tests and because they were previously observed to alter sexual behavior after a heatwave. Males were exposed to a 5-d experimental heatwave (32 °C) or control treatment (26 °C). The chosen temperatures are ecologically relevant for the species, fall within their natural habitat's thermal range, and reflect extreme climatic events that are projected to become even more frequent and severe under future climate scenarios. Following treatment, all fish were tested at 26 °C for spatial memory and learning, mate choice, inhibitory control, and anti-predator responses. We also conducted histopathological evaluations of brain tissue to investigate potential central nervous system lesions. The results show that heatwave exposure declined maze solving efficiency, affected mate choice-related cognitive capacities, and led to suboptimal anti-predatory responses. No effects were observed on inhibitory control or habituation. Importantly, heatwave exposure induced morphological alterations in the central nervous system, potentially explaining the observed changes in cognitive performance. Our study provides a comprehensive evaluation of heatwave impacts on cognitive function, highlighting the need of investigating their subtle yet significant effects to fully understand how heatwaves influence fitness beyond survival
Intermediate Care Units in Europe and Italy: A Review of Structure, Outcomes, and Policy Implications for Internal Medicine
No full textBackground/Objectives: Intermediate Care Units (IMCUs) provide a level of care between general wards and Intensive Care Units (ICUs). While widely implemented across Europe, their use in the Italian internal medicine remains limited. To review the clinical effectiveness, organizational benefits, and policy relevance of IMCUs in Europe and assess opportunities and barriers to their implementation in the Italian hospital system. Methods: A narrative review of international and Italian literature from the origin of intermediate care models in 2025, with emphasis on patient outcomes, ICU utilization, cost-effectiveness, and governance models for IMCUs. Results: European studies consistently show that IMCUs improve patient flow, reduce ICU burden, and may reduce mortality among selected high-acuity patients. In Italy, respiratory and cardiac IMCUs have demonstrated similar benefits. However, general internal medicine IMCUs remain underdeveloped. The COVID-19 pandemic exposed structural gaps in the capacity for intermediate care. Recent legislative efforts (e.g., Decree-Law 34/2020) have aimed to expand sub-intensive care, but implementation is still heterogeneous. Conclusions: IMCUs are a cost-effective and clinically valuable strategy for managing non-ICU high-acuity patients. Structured integration of IMCUs into internal medicine in Italy could improve care quality and system efficiency. Clear triage protocols, adequate staffing, and strong organizational leadership are essential for success
Advanced-stage ALK-positive non-small-cell lung cancer (NSCLC) patients: Real-world treatment patterns and outcomes from the Italian biomarker ATLAS database
No full textBackground: Treatment of advanced ALK + NSCLC has improved with increasingly effective ALK tyrosine-kinase inhibitors (TKIs). We report real-world treatment patterns and outcomes from the Italian ATLAS registry. Methods: Clinical-pathological and treatment data were retrospectively and prospectively collected from 37 Italian centers. Results: 463 ALK + advanced NSCLC patients treated from 2019 to 2024 were included. 431 (93 %) patients received 1st line (1L) ALK TKIs, mostly alectinib (82.5 %). 1L treatment choice, reported in 142 cases, was driven by drug access as first (31 %) or subsequent lines (40.1 %) and by safety (21.8 %). Among 382 patients receiving 1L alectinib overall survival (OS) rate was 88.7 % and 73.3 % at 24 and 60 months, respectively. Median progression-free survival (mPFS) was 43.1 months (95 %CI: 29.5–57.0). Brain was a new site of progression in 11 (3.6 %) patients. Intracranial PFS rate was 73.1 % and 59.1 % at 24 and 36 months with a 64.7 % intracranial response rate. Grade ≥ 3 adverse events occurred in 41 (10.7 %) patients, mainly hepatic toxicity (13, 3.4 %) and asthenia (5, 1.3 %). At progression tissue and/or liquid biopsy were performed in 28 (23.5 %) and 20 (16.8 %) cases, respectively. Out of 80 patients receiving 2nd line therapy after alectinib, 67 (83.8 %) received lorlatinib achieving mPFS 7.5 (95 % CI: 6.2–8.8) and mOS 26.4 months (95 % CI: 19.1–33.7). 17 (15.5 %) patients died without second line therapy. Conclusions: Real-world data confirm the effectiveness and safety of alectinib, used as preferred upfront ALK-TKI. The recent 1L lorlatinib approval might change this scenario. Tissue/liquid biopsy at disease progression are underperformed in clinical practice
A Review of Technical Aspects and Challenges in Opportunistic Rainfall Estimation Using Satellite and Terrestrial Microwave Links: How wireless infrastructure can be used for rainfall monitoring
No full textThe idea of using terrestrial or satellite microwave links (SMLs) as opportunistic sensors (OSs) of rainfall is more than 15 years old, and the literature on the topic is vast. Many studies focused on rain detection and quantification from the data collected by the fronthauling and backhauling links of mobile networks, namely, commercial microwave links (CMLs). More recently, several researchers have also investigated the signals received by the ground terminals of TV-SAT or Internet of Things (IoT) satellite-based service subscribers, namely SMLs. CMLs and SMLs have different characteristics from those of conventional sensors (CSs) of rainfall; hence, they have the potential to complement measurements collected by rain gauges (RGs) or weather radars (WRs) as well as to provide unique data in the several areas of the globe where rainfall monitoring systems are scarce or completely missing. Unlike previous reviews on the topic, this work aims to survey the technical challenges involved by the usage of devices and data not designed for rainfall monitoring. In particular, we draw a state-of-the-art flowchart of OS data processing, we analyze the disturbances that affect the raw data, and we then present a comparative analysis of the major studies on the validation of OS rainfall estimates, based on a set of key performance indicators (KPIs). The similarities and differences of satellite and terrestrial links as rainfall sensors are highlighted. To conclude, we propose an author’s view on the future of rainfall measurements by CMLs and SMLs, which is closely tied to the evolution of wireless communication networks
2D and 3D anticancer activity of diiron bis-cyclopentadienyl complexes incorporating flurbiprofen and chlorambucil
No full textThe new diiron complex [Fe2Cp2(CO){Ph2P(4-C6H4CO2H)}(μ-CO){μ-CNMe(Cy)}]CF3SO3, [2]CF3SO3 (Cp = η5-C5H5, Cy = C6H11), was synthesized with a 92% yield from a tricarbonyl precursor and 4-(diphenylphosphanyl)benzoic acid. The carboxylic acid group in [2]+ was exploited for bio-conjugation with flurbiprofen and chlorambucil through esterification procedures, affording complexes [3-4]CF3SO3 (36-55% yields). Comprehensive characterization of the products was achieved using IR, multinuclear NMR spectroscopy and mass spectrometry. The log Pow values and the stability under physiologically relevant conditions were determined, revealing a considerable fraction of [3-4]+ still detectable in water/methanol solution after 72 hours and in DMEM culture medium/methanol solution after 24 hours. The antiproliferative activity was assessed in 2D across a panel of nine cancer cell lines, where [3,4]+ displayed IC50 values in the low-micromolar range and revealed the ability to overcome oxaliplatin resistance mechanisms. When tested in 3D cultures of human colon cancer and melanoma cells, [3,4]+ exhibited cytotoxic activity comparable to that of cisplatin. Targeted assays revealed that both [3]+ and [4]+ substantially preserved the COX inhibitory effect of flurbiprofen and the DNA damaging efficacy of chlorambucil, respectively
Universal Hole-Filling Strategies for Coprime Arrays
No full textCoprime arrays (CAs) are found to be captivating for striking a balance among the increased number of degrees of freedom (DOFs), reduced mutual coupling and applicable aperture. However, holes in the difference co-array (DCA) reduce the achievable number of DOFs, and further restrict the complete utilization of the aperture. In this paper, we propose novel universal hole-filling strategies to construct hole-free DCAs. We present universal configuration expressions for extant CAs and derive generalized symmetric relations between holes and inconsecutive lags in DCAs along with their explicit numbers. Based on the universal expressions and the symmetric relations, we propose universal hole-filling strategies by incorporating an additional sub-array outside the original CAs. These strategies that effectively accommodate existing CAs generate hole-free CAs with double-time number of DOFs compared with the original CAs. Finally, we provide numerical simulations to demonstrate that the modified CAs using the proposed strategies precede the original types in terms of DOFs, performance of direction-of-arrival (DOA) estimation and spatial resolution
Impact of Antibiotic Therapy in Patients with Cholangiocarcinoma Treated with Chemoimmunotherapy
No full textIntroduction: Patients with biliary tract cancers (BTCs) often require antibiotic therapy before starting systemic treatment that includes an immune checkpoint inhibitor. This study aimed to evaluate the prognostic impact of antibiotic therapy administered in the 15 days prior to the start of chemoimmunotherapy in patients with BTC. Methods: The study population included patients with metastatic or locally advanced BTC from Western and Eastern populations treated with first-line chemoimmunotherapy. The aim of the study was to evaluate the impact of antibiotic therapy in the 15 days prior to starting oncological treatment (AT population) compared to patients who did not receive antibiotic therapy (NAT). Univariate and multivariate analyses were used to evaluate predictive factors for overall survival (OS) and progression-free survival (PFS), while prognostic factors were analyzed by univariate and multivariate analysis using Cox regression model. Results: A total of 666 patients were enrolled in the study: 93 (14%) in AT cohort and 573 (86%) in NAT cohort. In the AT population, the incidence of cholangitis (p = 0.0017), alanine aminotransferase elevation (p = 0.0009), fever (p = 0.0021), decreased appetite (p = 0.0007), itching (p = 0.0081), and rash (p = 0.012) was significantly higher compared to the NAT. The median OS was 15.9 months (95% confidence interval [CI]: 13.8-18.3) in NAT cohort versus 10.1 months (95% CI: 7.9-12.4) in AT cohort (NAT vs. AT, hazard ratio [HR]: 0.43, 95% CI: 0.27-0.70, p = 0.0006), while median PFS was 8.5 months in NAT cohort versus 5.4 months in AT cohort (NAT vs. AT, HR: 0.49, 95% CI: 0.34-0.71, p = 0.0001). Multivariate analysis confirmed the prognostic role of antibiotic for OS and PFS. Finally, NAT cohort showed better overall response rate compared with AT cohort (31.4% vs. 20.4%, p = 0.03). Conclusions: The use of antibiotic therapy in the 15 days prior to starting chemoimmunotherapy is an independent unfavorable prognostic factor for survival in our cohort of patients with advanced BTC treated with cisplatin, gemcitabine and durvalumab