University of Udine
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Safety and Efficacy of Ianalumab in Patients With Sjögren's Disease: 52-Week Results From a Randomized, Placebo-Controlled, Phase 2b Dose-Ranging Study
No full textObjective: The objective of this study was to report 52-week safety and efficacy of ianalumab from phase 2b dose-finding study in patients with Sjögren's disease (SjD). Methods: Patients randomly received (1:1:1:1) ianalumab (5, 50, or 300 mg) or placebo subcutaneously every 4 weeks until week 24 (treatment period [TP]1). At week 24, patients on 300 mg were rerandomized to continue 300 mg or receive placebo until week 52 (TP2), patients on placebo were switched to ianalumab 150 mg, and patients on 5 and 50 mg directly entered posttreatment safety follow-up. Patients who discontinued treatment early or completed treatment entered safety follow-up (≥20 weeks). Results: During TP1, 190 patients were randomized (placebo = 49, 5 mg = 47, 50 mg = 47, 300 mg = 47). Of these 190 patients, 90 (47.4 %; 43 continued 300 mg and 47 received placebo) entered TP2, and 81 of 90 (90.0%) completed the study treatment. By week 52, efficacy was sustained in patients who continued 300 mg in TP2 (EULAR Sjögren's Syndrome Disease Activity Index, EULAR Sjögren's Syndrome Patient Reported Index, patient global assessment, and physician global assessment change from week 24: −1.45, −0.46, −4.69, and −6.86, respectively). Stimulated salivary flow rates and autoantibody levels numerically improved in the 300 mg group. Treatment-emergent adverse events were not dose-dependent, except for injection-site reactions. Cases of decreased neutrophil counts (Common Terminology Criteria for Adverse Events v4.03 grade 3 according to laboratory listings) were observed in three patients during the posttreatment follow-up, occurring at 3.5, 5.5, and 3 months, after the last ianalumab administration. None were associated with infection except one incidental finding of asymptomatic cytomegalovirus infection (IgM-positive). Conclusion: In patients with SjD, ianalumab 300 mg demonstrated sustained efficacy through week 52 and a favorable safety profile up to two years of follow-up
Parametric Study on Ru/CeO2 Ammonia Decomposition Catalysts for Hydrogen Production
Get PDFRu/CeO2 is a promising catalyst for H2 production from ammonia decomposition due to the chemical properties of cerium dioxide and its particular interaction with Ru. In this work, Ru/CeO2 catalysts prepared by mechanochemical synthesis are studied in comparison with conventional impregnated catalysts to investigate the relevant parameters for catalytic ammonia decomposition. Different Ru precursors are used on CeO2 supports with varying surface areas, leading to a portfolio of catalysts with different characteristics such as CeO2 crystallite size, surface basicity, defectiveness, metal-support interaction, reducibility, spillover effect, metal particle dispersion and dimension, and actual Ru loading. The combination of catalytic results and different characterization techniques allows for a better understanding of the importance of the different factors that affect ammonia decomposition on Ru/CeO2 catalysts, highlighting the role of particle size and Ru─H bond strength, whose relative relevance, in turn, is dependent on Ru precursor and synthesis method
The PERFORM Study: Artificial Intelligence Versus Human Residents in Cross-Sectional Obstetrics-Gynecology Scenarios Across Languages and Time Constraints
No full textObjective: To systematically evaluate the performance of artificial intelligence (AI) large language models (LLMs) compared with obstetrics-gynecology residents in clinical decision-making, examining diagnostic accuracy and error patterns across linguistic domains, time constraints, and experience levels. Patients and Methods: In this cross-sectional study, we evaluated 8 AI LLMs and 24 obstetrics-gynecology residents (Years 1-5) using 60 standardized clinical scenarios. Most AI LLMs and all residents were assessed in May 2024, whereas chat GPT-01-preview, chat-GPT4o, and Claude Sonnet 3.5 were evaluated in November 2024. The assessment framework incorporated English and Italian scenarios under both timed and untimed conditions, along with systematic error pattern analysis. The primary outcome was diagnostic accuracy; secondary end points included AI system stratification, resident progression, language impact, time pressure effects, and integration potential. Results: The AI LLMs reported superior overall accuracy (73.75%; 95% confidence interval [CI], 69.64%-77.49%) compared with residents (65.35%; 95% CI, 62.85%-67.76%; P<.001). High-performing AI systems (ChatGPT-01-preview, GPT4o, and Claude Sonnet 3.5) achieved consistently high cross-linguistic accuracy (88.33%) with minimal language impact (6.67%±0.00%). Resident performance declined significantly under time constraints (from 73.2% to 56.5% adjusted accuracy; Cohen's d=1.009; P<.001), whereas AI systems reported lesser deterioration. Error pattern analysis indicated a moderate correlation between AI and human reasoning (r=0.666; P<.001). Residents exhibited systematic progression from year 1 (44.7%) to year 5 (87.1%). Integration analysis found variable benefits across training levels, with maximum enhancement in early-career residents (+29.7%; P<.001). Conclusion: High-performing AI LLMs reported strong diagnostic accuracy and resilience under linguistic and temporal pressures. These findings suggest that AI-enhanced decision-making may offer particular benefits in obstetrics and gynecology training programs, especially for junior residents, by improving diagnostic consistency and potentially reducing cognitive load in time-sensitive clinical settings
mHealth Apps Available in Italy to Support Health Care Professionals in Antimicrobial Stewardship Implementation: Systematic Search in App Stores and Content Analysis
Get PDFBackground: Antimicrobial resistance (AMR) is a major challenge of the 21st century. Digital technologies are now an increasingly effective means of supporting optimal health care delivery and public health. Objective: The aim of this study was to explore the apps available to support health care professionals in the fight against AMR. Methods: A total of 4 independent researchers conducted a systematic search of the App Store and Google Play Store using the following keywords: "antimicrobial resistance," "antibiotic resistance," "antimicrobial stewardship," "antibiotic stewardship," "antibiotic guide," "antibiotic therapy," and "antimicrobial therapy." The same keywords were also searched in Italian. The apps whose contents were in languages other than Italian or English, or apps which were games, or had multimedia or paid content and advertising, or apps for only specific pathologies were not considered. A set of basic information was collected for all apps found. After downloading the apps, they were evaluated using an 86-item checklist containing expert-validated criteria aggregated in the domains of pathogens and etiological agents, diagnosis and therapy support, AMR, dashboard function, antimicrobial stewardship (AMS), notes and recordings, network, and technical characteristics of the app. Results: First, 115 apps were identified: 31 apps for Android and 84 apps for iOS. By applying the exclusion criteria, 31 apps were excluded (16 for Android and 15 for iOS) for the following reasons: not available in Italian or English (6 apps), not freely available (14 apps), required registration (5 apps), and games (6 apps). The remaining 84 eligible apps (15 for Android and 69 for iOS) were downloaded, installed, and further analyzed using the same criteria, excluding 57 apps (48 for iOS and 9 for Android) for the following reasons: required further registration (16 apps), language other than Italian or English (17 apps), pathology specific (5 apps), paid content (8 apps), specific to veterinarians (4 apps), recreational apps (2 apps), referred to only scientific articles (1 app), no longer available (1 app), and not health care objectives (3 apps). The remaining 27 apps (6 for Android and 21 for iOS) were selected for in-depth analysis. Of the 27 apps that met the inclusion criteria, most apps did not fulfill the desirable aspects and only 2 of them achieved a fulfillment score of 36%. The highest scores were achieved for support for diagnosis and therapy (37%) and technical characteristics of the app (23%). Lower scores were achieved for AMS (8%), pathogens and etiological agents (4%), notes and records (3%), network (2%), AMR (1%), and dashboard function (1%). Conclusions: None of the apps examined successfully provided the desired features and functions. To better engage of prescribers in the fight against AMR, the development of an app that meets the requirements is needed
Propolis Hydroalcoholic Extracts: Biochemical Characterization and Antifungal Efficacy
Get PDFThe present study investigated the antifungal potential of hydroalcoholic extracts of propolis against the causal agent of grey mould, Botrytis cinerea, by in vitro and in vivo assays. Five different propolis from different Italian regions were subjected to hydroalcoholic extraction using different ethanol concentrations and extraction methods. The preliminary bio-assay showed significant inhibitory effects on B. cinerea mycelial growth of propolis extracts obtained using 90% ethanol and subjected to sonication. The calculation of EC50 values, based on the demonstrated efficacy of non-volatile and volatile metabolites of propolis extracts, was useful to understand the main fraction involved in the antifungal activity of the samples and to perform the in vivo assay on grape and blueberry fruits. Three of the propolis extracts showed a high amount of genistein. Conversely, the other two propolis showed a fair amount of apigenin, caffeic acid, chrysin, ferulic acid, kaempferol, luteolin, p-coumaric acid and quercetin. From the volatile analysis of propolis, the main compounds detected were α-cadinol, α-eudesmol, calamenene, cadinol, benzyl acetate, benzyl benzoate and benzyl alcohol. The results suggest that propolis extracts have potential as an effective postharvest antifungal treatment, with varying degrees of efficacy depending on the extraction method and the type of propolis metabolites
Body composition determined with computed tomography at ICU admission as a potential long-term outcome assessment tool in critically ill patients: a post-hoc analysis of a prospective, observational study
No full textBackground: Body composition evaluated with computed tomography scan (CT) at intensive care unit (ICU) admission is a predictor of short-term mortality (six months). Little is known regarding long-term outcome. Our objective was to evaluate the potential predictor role of body composition at ICU admission evaluated with CT scan and long-term mortality (two years). Methods: Post-hoc analysis of a prospective observational study. Body composition evaluated at the level of the third lumbar vertebra (L3) was analyzed with dedicated software that automatically calculated the areas (cm2), determined the tissue composition by a Hounsfield unit (HU) and extracted fat component; all parameters were normalized to patient's height. Cox regression analysis was adopted to evaluate the association between statistically significant muscle parameters at univariate descriptive analysis and 2-years survival. Results: A total of fifty-one patients were evaluated for the analysis. Those who were alive at follow-up had a higher total muscle area compared to those who did not survive, 84.7 (68-99.4) versus 65.4 (59.2-84) cm2 per meter of height (P=0.025). However, no significant difference in fat area was found between survivors and non-survivors' group: the former had a fat area of 16.3 (10.9-23.4) cm2/m and the latter had 25.2 (14.8-31.5) cm2/m (P=0.166). Total muscle area was significantly associated with two-year mortality, showing a hazard ratio of 1.03 (1.01-1.06, P=0.023). Conclusions: Total muscle but not fat area evaluated at L3 at ICU admission is a prognostic marker of mortality at long-term follow-up in critically ill patients
Abuso dell’immagine del minore e onere della prova per il risarcimento del danno non patrimoniale
No full textIn tema di abuso di immagine di minore, il diritto al risarcimento del danno sorge quando vi sia un’illecita diffusione del ritratto di un minore per finalità pubblicitarie effettuata senza consenso di uno dei genitori esercente responsabilità genitoriale, laddove sia accertata una seria ed effettiva lesione alla riservatezza dell’immagine, come elemento essenziale dell’identità personale, che può subire una lesione a prescindere dal corredo delle immagini con le generalità del minore.
La tutela dell’immagine costituisce un interesse primario del fanciullo, senza che la mancanza di indicazioni relative al nome o alle generalità del minore o dei suoi genitori valgano ad escluderne il pregiudizio, poiché l'immagine della persona è tutelata in sé, quale elemento altamente caratterizzante l'individuo, che lo rende unico e originale, come tale riconoscibile.
Nel caso di specie, l’utilizzo delle fotografie del minore era avvenuto senza il necessario consenso del padre. La Corte d’appello aveva rigettato la richiesta risarcitoria dando rilievo alla mancata diffusione insieme alle foto del minore, inserite nel catalogo dei capi di abbigliamento e degli accessori offerti in vendita, del nome o delle generalità del bambino o dei suoi familiari. Come ha precisato opportunamente il Supremo Collegio, circostanze del genere non assumono invece alcuna incidenza ai fini dell'accertamento della produzione di un danno in conseguenza dell'abuso dell'immagine del minore, giacché l'immagine della persona è tutelata in sé, quale elemento altamente caratterizzante l'individuo, che lo rende unico e originale, come tale riconoscibile
Technologies of Façade Systems. Studies for the Proposal of a New Support System for Timber Claddings
No full textThe essay outlines the initial results of a research project developed within the DPIA (Polytechnic Department of Engineering and Architecture) of the University of Udine and ICEA (Department of Civil, Enviromental and Architectural Engineering) of the University of Padua. This research laid the foundations for the conception and subsequent experimentation of a new support system for façades timber finishes. Following a brief introduction highlighting the current potential and values of using wood in the context of contemporary construction, the new system for fixing timber elements is described. This includes a substructure that aligns double-framed configurations with vertical posts and horizontal beams into a single plane, using a single base element that can be customized in various dimensional ranges. This results in the formation of regular quadrilateral elements that can extend both horizontally and vertically, thanks to the variability offered by a telescopic movement. The lateral junction of multiple quadrilateral elements is achieved thanks to a cavity on the surface facing the cladding elements, near the corner joint between the two “arms” of a base element. The research is therefore ongoing and it is considering a possible redefinition of the base elements to allow the use of stainless steel open-section profiles, instead of aluminium as initially hypothesized. Laser cutting technologies are being considered for defining the necessary openings and holes