University of Udine
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Outcomes of intended temporary stomas in Crohn's disease (INTESTINE study): International, multicentre, retrospective study
Get PDFBackground Patients with ileocolic Crohn's disease often require surgery that can result in temporary stoma formation. Stomas are associated with a morbidity and can negatively impact quality of life. This study aimed to investigate the short-term (6-month) and mid-term (18-month) outcomes of intended temporary stomas in patients with Crohn's disease. Methods A trainee-led, international multicentre, retrospective study was conducted on all patients who underwent surgery for Crohn's disease in collaborating centres over 4 years (2017-2020). The primary outcome was the proportion of patients with Crohn's disease who underwent stoma reversal surgery by 6- and 18-month postoperative follow-up. Secondary outcomes included: the time interval between formation and reversal of stoma and predictors for non-reversal and stoma-related morbidity (postoperative complications, related readmissions and complications due to stoma reversal surgery). Results A total of 401 patients underwent stoma formation for Crohn's disease over the 4 years across the 44 collaborating centres. The temporary stomas had been reversed in 30.2% of patients at the 6-month and 56.9% at the 18-month follow-up. Reasons for non-reversal included ongoing medical treatment for Crohn's disease (respectively 6-month and 18-month: 37.6%, 39.3%), patient unfit for surgery (respectively 6-month and 18-month: 14.5%, 16.8%), patient preference (respectively 6-month and 18-month: 12.1%, 20.2%) and due to waiting lists (respectively 6-month and 18-month: 12.1%, 8.1%). Overall, 63.3% of patients had a temporary stoma reversed with a median time interval of 6 months. The stoma-related overall morbidity rate was 29.4%. Conclusions A large proportion of temporary stomas for Crohn's disease were not reversed at 6 and 18 months following initial surgery. Patients are exposed to the risk of non-reversal and risk of developing stoma complications for significantly longer intervals of time and, in some cases, indefinitely
Filosofia e diritto: il pensiero del nostro tempo Introduzione ad una raccolta di contributi presentati in occasione del XXV Congresso Mondiale di Filosofia (Roma, 1-8 agosto 2024)
Get PDFNel suo ultimo fascicolo (XVII, 1, 2025) la rivista TIGOR accoglie sette contributi presentati al XXV Congresso Mondiale di Filosofia (Roma, 1–8 agosto 2024). Il Congresso, dedicato al tema Philosophy across Boundaries, si è proposto come spazio fertile per il dialogo tra diverse tradizioni e settori della riflessione filosofica, stimolando anche la filosofia del diritto a interrogarsi su sé stessa, sulle sue funzioni e finalità. La raccolta di contributi pubblicati riflette la pluralità degli argomenti affrontati — tra cui giustizia, autorità, vulnerabilità ed intelligenza artificiale — e documenta l’apertura intellettuale della filosofia del diritto, intesa come ambito critico e civicamente impegnato, in continuità con la tradizione italiana e aperta al confronto internazionale
Obesity is associated with reduced sensitivity to stimulus rewarding value, but unaltered effects of fasting and contextual modulation during action prediction
Get PDFPrevious studies have shown that our perception of others’ actions is influenced by both the reward value of target objects and our internal motivational state. In the present study, we investigated how the energy content of the target object and the physiological state of hunger influence the prediction of food-oriented actions in people with a healthy weight or obesity. Thirty-one participants with normal-weight and 31 participants with obesity performed a social perception task in which, under a fasting or a satiety state, they had to predict the intention of actions directed to high- or low-energy food objects in the context of a breakfast table that could suggest congruent or incongruent actions compared to action kinematics. The results showed that action prediction performance was greater: 1) for high-compared to low-energy food objects in the group with healthy weight but not in the group with obesity, with lower sensitivity to the energy content of the target object in individuals with more weight; 2) under a fasting compared to a satiety state in both groups; 3) for actions embedded in congruent compared to incongruent contexts when directed to high- but not low-energy food objects, independently of group and hunger state. The findings document an altered sensitivity to the reward value of action stimuli in people with obesity, despite a conserved sensitivity to hunger and contextual modulation. This supports a reduced sensitivity to the reward value of food stimuli in people with obesity pointing at a dysfunctional reward system during action perception. Interestingly, being under a food deprivation state comparably boosted performance in both groups, providing evidence that fasting may sharpen senses independently from individual weight
Integrating BRCA testing into routine prostate cancer care: a multidisciplinary approach by SIUrO and other Italian Scientific Societies
Get PDFProstate cancer (PCa) ranks among the most prevalent malignancies in men, with notable associations to Hereditary Breast and Ovarian Cancer Syndrome (HBOC) and Lynch Syndrome, both linked to germline likely pathogenetic variant/pathogenetic variant (LPV/PV) in genes involved in DNA repair. Among these genes, BRCA2 in PCa patients is the most frequently altered. Despite progresses, challenges in BRCA carriers detection persist, with a quarter of PCa cases lacking family history. To address these challenges, a multidisciplinary expert panel from six Italian Scientific Societies, formulated a care pathway to integrate BRCA testing into routine clinical practice in different Italian geographical areas. The development process, promoted by the Italian Society of Uro-Oncology (SIUrO), involved three key stages. A preliminary meeting convened teams from different Italian regions to establish minimal requirements for a mini-counseling program (defined as a pre-test consultation carried out by clinicians responsible of patients’ management) and propose care pathway models. At the same time, a comprehensive survey was launched to highlight regional variations in BRCA testing and identify eventual obstacles to testing activities. A subsequent meeting synthesized care pathway proposals and formulated a unified framework, acknowledging regional legislative variations as enriching factors. Lastly, implementation of the unified framework was promoted by the project faculty and identified regional team leaders. Survey results revealed significant regional disparities in BRCA testing, reimbursement policies, and access to genetic counseling. The proposed mini-counseling program outlined essential steps for patient identification, information provision, and multidisciplinary review, aiming to streamline BRCA testing processes. Expert recommendations emphasized offering tumor genetic testing to metastatic PCa patients eligible for PARP-i treatment and outlined criteria for genetic counseling and germline testing. Key considerations included family history and tumor characteristics. In conclusion, the proposed care pathway represents a critical step towards integrating BRCA testing into routine PCa care, aiming to optimize patient management and familial risk assessment within the constraints of the Italian healthcare system
Red Blood Cells and Their Immunoregulatory Role
Get PDFThe physiological roles played by red blood cells (RBCs), i.e., oxygen transport to all cells and tissues, CO2 delivery to the lungs, control of pH in blood, and ions transport into and out of the cell membrane, have been investigated extensively over the past decades. The roles mature and immature RBCs play, while in the blood vessels, when they come in contact with other blood and endothelial cells, are only partially known. Here we will focus on the ability of RBC to modulate innate and adaptive immune responses when they interact with cells or molecules encountered during their flow in the vessels. We will outline the possible clinical impact on treatment of some diseases, such as autoimmune diseases, inflammatory pathologies, or tumors, where immunotherapy can be applied
Antecedents of collective psychological ownership in family firms. A multilevel configurational approach
Get PDFKnowledge about the antecedents of collective psychological ownership (CPO) in family firms is limited, despite its relevance for theory and practice. To address this gap, we adopted a multilevel configurational approach, encompassing organizational and individual attributes, to consider multiple possible combinations of the causal determinants of the perception of CPO over the organization. The empirical data comprise a sample of 162 individuals from 33 privately held family businesses in Belgium. More specifically, we conducted a fuzzy set qualitative comparative analysis (fsQCA), which was particularly appropriate given the aims of our study. By identifying distinctive configurational paths and three key mechanisms operating across such paths (socialization, identification and signaling), our results offer two important contributions. First, we contribute to the conceptual understanding of the antecedents of CPO in family firms, both for family and non-family members. Second, we expand the general literature on the paths leading to CPO by proposing an approach that combines individual attributes with organization-level features
Generational shifts: understanding the role of green self-identity, social norms and cohort differences in consumer intentions to purchase stigmatised recycled products
Get PDFPurpose – This study aims to investigate the moderating role of social norms and generational differences on the relationship between green selfidentity
and purchase intention towards a particular product category: recycled absorbent hygiene products.
Design/methodology/approach – An online survey was conducted, and structural equation modelling was used to examine the hypothesised
relationships based on data from 1,113 Italian consumers. In addition, a small qualitative study was carried out among Millennials to confirm and
further contextualise some of the observed effects.
Findings – This study finds a positive relationship between green self-identity and attitudes towards recycled absorbent hygiene products,
influencing purchase intention. Social norms moderate this relationship, with their effect varying across generational cohorts. Social norms
negatively influence the relationship between green self-identity and attitudes towards recycled products only for Generation Y. In contrast, for
Generation X and Generation Z, social norms do not significantly affect this relationship.
Research limitations/implications – This study’s cross-sectional design and non-probabilistic sampling may limit the generalizability of the results.
The findings related to a specific country: Italy. In addition, reliance on self-reported data may introduce some biases.
Practical implications – Marketers can attract eco-conscious consumers by aligning branding with sustainability values and emphasising ecofriendly
product offerings. Furthermore, businesses should actively work to challenge negative perceptions of recycled products, particularly those
related to quality or hygiene. Promoting positive social norms through targeted campaigns and collaborating with eco-conscious influencers can
reshape public perceptions and encourage more consistent eco-friendly purchasing behaviour.
Originality/value – To the best of the authors’ knowledge, this study is one of the first to explore the moderating role of social norms and
generational differences in shaping the relationship between green self-identity and consumers’ purchase intentions towards recycled products. By
highlighting how these factors interact, this research offers fresh insights into the literature on sustainable consumer behaviour, enhancing the
understanding of the complex influences that drive eco-friendly purchasing decisions
When infection hurts: golden rules for managing pediatric skin and soft tissue infections
Get PDFSkin and Soft Tissue Infections (SSTIs) are common in pediatric patients, accounting for nearly 25% of clinical visits. These infections can range from mild to life-threatening and include a severe subset known as Acute Bacterial Skin and Skin Structure Infections (ABSSSI). Prompt diagnosis and appropriate antibiotic use are crucial for optimizing patient outcomes while minimizing adverse effects and antimicrobial resistance. However, empirical treatment often becomes necessary due to the lack of culture specimens, making local epidemiology and clinical presentation key factors in treatment decisions. This expert opinion paper aims to outline the “golden rules” for the management of SSTIs in children, focusing on achieving microbiological clearance, clinical improvement, and effective control of symptoms, such as fever and pain, which significantly impact the child's well-being. These emphasize the principles of antimicrobial stewardship, recommending early diagnosis with appropriate laboratory tests, rational empiric therapy, and prompt switch to targeted therapy based on microbiological findings, as well as proper fever and pain management. The paper also highlights the importance of a multidisciplinary approach for complex cases, optimal dosing, and effective communication with patients' families to improve treatment compliance. Furthermore, antibiotic therapy should be selected to reduce hospital stay and facilitate home-based continuity of care, while follow-up and strengthening of the hospital-territory network are critical for continuity of care after discharge. These recommendations aim to optimize the management of pediatric SSTIs by ensuring comprehensive care from initial diagnosis to post-discharge follow-up, promoting the rational use of antibiotics, and ultimately improving clinical outcomes and quality of life for children and their families
Identifying and characterizing shared and ethnic background site-specific dietary patterns in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)
Get PDFBackground: A posteriori dietary patterns (DPs) are critical for capturing actual dietary behaviour. However, assessing their reproducibility across (sub)populations requires novel modelling approaches beyond descriptive statistics. Multi-study factor analysis derives DPs that are shared among all studies/subpopulations and those specific to a study or subpopulation of interest. Bayesian implementation of the multi-study factor analysis (BMSFA) is more flexible than frequentist as it imposes fewer assumptions and improves factor selection. Methods: We applied BMSFA to 24-h dietary recalls from the baseline visit (2008–2011) of the US Hispanic Community Health Study/Study of Latinos (n = 16,415). The analysis was conducted on 42 common nutrients to identify shared and subpopulation-specific DPs. Subpopulations were defined based on the cross-classification of ethnic background (Cuban, Dominican Republic, Mexican, Puerto Rican, Central and South American) and study site (Bronx, Chicago, Miami, San Diego) resulting in 12 Ethnic Background Site (EBS) categories. Regression analysis characterized DPs in terms of food groups, overall diet quality, socio-demographic/lifestyle factors, adjusting for survey design. Results: We identified four shared DPs across all EBS categories: Plant-based foods, Processed foods, Dairy products, and Seafood. Additionally, twelve EBS-specific DPs were identified—one for each EBS category. Most EBS-specific DPs were further grouped into overarching profiles: Animal vs. vegetable source, Animal source only, and Poultry vs. dairy products, to capture nuances within animal-based DPs. Puerto Rican background participants from Chicago expressed a strikingly different DP from all others (i.e., high on beta-carotene and low on starch/iron/thiamin). Higher overall diet quality was observed with increasing categories of Plant-based foods, Seafood, and the “Puerto Rican background – Chicago” EBS-specific DP, whereas increasing categories of Dairy products, Processed foods, and the remaining EBS-specific DPs were related to lower diet quality. Compared to non-US-born participants, US-born individuals had significantly higher adjusted mean scores in absolute value for most DPs. Specifically, they exhibited lower adherence to the Plant-based foods and Dairy products DPs but higher adherence to Processed foods, Seafood, and six EBS-specific DPs. Conclusions: The BMSFA successfully captured sources of dietary homogeneity and heterogeneity among US Hispanic/Latino adults across ethnic backgrounds and study sites. The study highlighted the crucial role of nativity on DPs