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Applications of Solid Platform and Federated Learning for Decentralized Health Data Management
No full textPer una cultura della governance collaborativa. Sussidiarietà e reti di cooperazione comunitaria nei sistemi territoriali di welfare
No full textIl contributo focalizza l’attenzione sulla governance collaborativa inquadrata all’interno del principio di sussidiarietà, inteso non solo come strumento giuridico, ma anche come orientamento etico-politico capace di promuovere una cultura condivisa e una riflessività diffusa tra attori pubblici, privati, del Terzo settore e della società civile non organizzata. Tale prospettiva permette di comprendere e spiegare come visioni condivise possano rigenerarsi in strategie, metodi e pratiche di intervento. L’obiettivo è ripensare il sistema di welfare in una chiave più integrata, partecipata e radicata nei territori, mettendo al centro l’individuo responsabile e in relazione costruttiva con la propria comunità
Rapidity dependence of antideuteron coalescence in pp collisions at s=13 TeV with ALICE
No full textThe production yields of antideuterons and antiprotons are measured in pp collisions at a center-of-mass energy of s=13 TeV, as a function of transverse momentum (pT) and rapidity (y), for the first time rapidity-differentially up to |y|=0.7. The measured spectra are used to study the pT and rapidity dependence of the coalescence parameter B2, which quantifies the coalescence probability of antideuterons. The pT and rapidity dependence of the obtained B2 is extrapolated for pT>1.7 GeV/c and |y|>0.7 using the phenomenological antideuteron production model implemented in PYTHIA 8.3 as well as a baryon coalescence afterburner model based on EPOS 3. Such measurements are of interest to the astrophysics community, since they can be used for the calculation of the flux of antinuclei from cosmic rays, in combination with coalescence models
Impact of first and further decompensation in patients with compensated ACLD due to MASLD
No full textBackground & Aims: First and further decompensation events mark key transitions in the natural history of cirrhosis and significantly influence mortality risk. We assessed the cumulative incidence of first and further (acute and non-acute) decompensation and evaluated their impact on liver-related death (LR-D) in patients with compensated advanced chronic liver disease (cACLD) due to metabolic dysfunction-associated steatotic liver disease (MASLD). Methods: We conducted an international, multicenter (17 centers), retrospective study involving 6,061 consecutive patients with cACLD due to MASLD, diagnosed either clinically (liver stiffness measurement >10 kPa) or histologically (F3–F4 fibrosis). Decompensation events were defined according to the Baveno VII criteria. Cumulative incidence functions and cause-specific Cox models (with baseline and time-dependent variables) were used to analyze competing risks. A multistate model was developed to better describe the clinical trajectory of cACLD due to MASLD. Results: The 5-year cumulative incidence of first decompensation was 3.5% (95% CI 3.0–4.1), which was associated with an 18.9-fold increase (95% CI 10.8–32.9) in the cause-specific hazard of LR-D. Among patients who experienced a first decompensation, the 5-year cumulative incidence of further decompensation was 43.9% (95% CI 37.2–50.2), further increasing the hazard of LR-D by 1.52-fold (95% CI 1.02–2.34). Ascites, followed by variceal bleeding, were the most common decompensation events. Hepatocellular carcinoma independently increased the cause-specific hazard of LR-D by 2.95-fold (95% CI 2.02–4.31) in the overall cohort and by 1.43-fold (95% CI 1.03–2.00) in patients who had experienced a first decompensation. Conclusions: First and subsequent decompensation events are major inflection points in the clinical progression of cACLD due to MASLD, increasing the cause-specific hazard of LR-D by 18.9- and an additional 1.52-fold, respectively. Hepatocellular carcinoma is an independent predictor of LR-D and further exacerbates mortality risk when present alongside decompensation. Impact and implications: In this large international multicenter cohort of 6,061 patients with compensated advanced chronic liver disease (cACLD) due to metabolic dysfunction-associated steatotic liver disease (MASLD), we examined the clinical impact of first and further decompensation events. At 5 years, the cumulative incidences of first and further decompensation were 3.5% and 43.9%, respectively, each significantly increasing the cause-specific hazard of liver-related death (18.9-fold and 1.52-fold). Ascites, more so than variceal bleeding, was the predominant and most impactful event. Both acute and non-acute decompensation similarly contributed to liver-related mortality. Additionally, hepatocellular carcinoma independently increased the hazard of liver-related death, even post-decompensation. Notably, extrahepatic deaths also represented a considerable burden, reflecting the high metabolic risk of MASLD. These findings highlight key prognostic inflection points in MASLD-related cACLD
Micro- and Nanoplastics and the Oral Cavity: Implications for Oral and Systemic Health, Dental Practice, and the Environment—A Narrative Review
No full textBackground: Micro- and nanoplastics (MNPs) have emerged as increasing environmental and public health concerns. Dentistry contributes to this exposure through polymer-based materials and personal oral care products. This review summarizes the current evidence on the sources, release mechanisms, physicochemical properties, and toxicological and biological effects of MNPs derived from dental sources and oral care products, as well as the synergistic effects of MNP oral exposure with environmental exposure. Methods: An electronic search was performed across the PubMed/MEDLINE, Scopus, and Web of Science databases to identify studies investigating the source, release mechanisms, physico/chemical properties, and toxicological/biological impact of MNPs related to dental materials, oral care products, and the synergic effects of MNPs oral and environmental exposure. Results: MNPs are released in the dental setting from resin-based composites, clear aligners, and prosthetic and impression materials through degradation, wear, and handling processes. Home-use products like toothpastes, toothbrushes, floss, and mouthwashes contribute to chronic oral exposure. Evidence from in vitro, in vivo, and human biomonitoring studies supports the biological activity and systemic distribution of MNPs. Despite this, clinical awareness remains limited, and regulatory oversight insufficient. Conclusions: Dentistry is both a source and vector of MNP exposure. Encouraging the use of safer, MNP-free materials, and raising awareness among dental professionals, may support more responsible and health-conscious practices. Further research and alignment with global policy strategies could help guide future innovation and risk mitigation in the dental field
