University of Udine
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Neurological immune-related adverse events of immune checkpoint inhibitors: clinical and hematological risk factors
No full textBackground: Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment, but can induce neurological immune-related adverse events (n-irAEs). Objective: We aimed at evaluating the occurrence and characteristics of n-irAEs in cancer patients treated with ICIs and identifying biomarkers predictive of such complications in a single-center case–control study in the USA. Methods: We retrospectively reviewed the electronic health records for all patients treated with ICIs at the University of Cincinnati in 2011–2023. Demographic and clinical data were gathered for patients who experienced at least one n-irAE. Logistic regression was conducted to assess the associated factors for n-irAEs. Results: Twenty-eight (1.5%)/1817 patients who received ICI developed n-irAEs. Compared to those who did not, n-irAEs patients were older (median age, 75 vs 68 years; p < 0.001), male (75%, vs 56% p = 0.04), more likely to have used more than one ICI drug (36% vs 15%, p = 0.015), and had higher absolute eosinophil count before the first infusion (159 [75–251] vs 94 [37–194] cells/uL, p = 0.039). The most common cancer site was melanoma among cases (43%) and lungs in controls (31%, p < 0.001; non-small cell lung cancer, 73%). Neuropathy (34.4%) and encephalitis (18.8%) were the most common n-irAEs. Three subjects died of n-irAEs complications. Sixteen/28 cases (57%) improved at follow-up after ICIs discontinuation. The median time to n-irAEs after ICI administration was 68 (30–473) days. Conclusion: N-irAEs are rare, serious, and potentially reversible complications of ICIs, occurring in the early treatment phase. Older age, male sex, multiple ICI therapies, and higher absolute eosinophil count before first infusion are associated with n-irAEs
Staying Despite the Intention to Leave: Insights from Frontline Nurses and Nurse Managers from a Qualitative Descriptive Study
No full textBackground/Objectives: The global nursing workforce shortage has heightened concerns
about burnout, workload, and nurse retention, with an increasing intention to leave the
profession and the unit, especially in the post-pandemic context. Although intention to
leave has been widely studied, limited attention has been paid to nurses who continue to
provide high-quality care and persist despite expressing a desire to leave. This study
aimed to explore the reasons for persistence among nurses who intend to leave the
organization and the profession. Methods: A descriptive qualitative study was conducted
involving frontline nurses and nurse managers working in a large university healthcare
trust in Northern Italy. Data were collected through three focus groups, using a semistructured
interview, until data saturation was achieved. Data were analyzed using
inductive content analysis. Findings were reported in accordance with COnsolidated
criteria for REporting Qualitative research guidelines. Results: Thirty-two participants
were included. Overall, two main themes emerged: ‘Reasons that are inside of me’ and
‘Reasons that are outside of me but influence my decisions to stay’, with eight and six subthemes
respectively. Internal reasons included professional passion, commitment, autonomy,
perceived usefulness, and supportive collegial relationships. External reasons included
organizational flexibility, opportunities for internal mobility and professional
development, responsiveness to nurses’ expectations, and, in some cases, limited external
employment alternatives. Conclusions: Persistence represents a distinct and
underexplored dimension within the intention-to-leave continuum. While internal
reasons reflect deeply rooted professional identity, external organizational reasons are
modifiable and play a critical role in promoting retention. Organizational strategies
aligned with nurses’ values, expectations, and professional development needs may
enhance workforce stability and inform more targeted retention interventions
Re: Lucia L. Rijstenberg, Hridya Harikumara, Esther I. Verhoef, et al. Identification of Intraductal-to-Invasive Spatial Transitions in Prostate Cancer: Proposal for a New Unifying Model on Intraductal Carcinogenesis. Histopathology 2025;86:1091–100
No full textMoulded objects. Sheets of Italian paper and their watermarks from the fifteenth to the twentieth-first centuries
No full textSintesi della storia della carta
Le gare di Virgilio
No full textIl contributo analizza le gare che Virgilio narra nel libro 5 dell'Eneide, mettendone in particolare risalto i rapporti con i valori morali e ideologici espressi nel poema
Development of a synbiotic snack for gut–brain axis health
No full textSnacks are ideal vehicles to intervene in the diet of consumers as they are becoming a staple in the modern diet. This study aimed to develop a synbiotic snack capable of delivering both prebiotics and live probiotics with a potential positive impact on supporting the gut–brain axis system by incorporating chickpea and red lentil flour as a source of protein and fibre, specialty fibres as sugar and fat/saturated fat substitutes, and dark chocolate enriched with a probiotic formulation (SLAB51®) with proven neuroprotective properties in a mouse model. Compared with a conventional wheat snack, the developed snacks presented not only better nutritional composition (high in proteins, fibres, and unsaturated fatty acids and low in sugars and total/saturated fats) but were also characterised by high prebiotic potential towards the SLAB51® multi-strain probiotic formulation, low glycaemic index, and the ability to induce slightly increased satiety. The developed snacks had a good shelf life with minimal chocolate blooming and high probiotic viability after six months of storage at both 25 °C and 4 °C (41.7% and 88.0% survival, respectively). Positive consumer response was observed among the senior population (>65 years old), with moderate acceptability and high willingness to buy in the senior population upon disclosure of pulse ingredients and potential health benefits. This research provides comprehensive scientific evidence for developing nutritional and healthy food products with a potential synbiotic effect tailored to an ageing population, without neglecting the pleasure of treating yourself to a good chocolate-coated cookie
Spinal Cord Transcutaneous Stimulation Priming Largely Enhances Lower Limb Performance during a Simulated Power Training Session in Young Active Males
No full textPURPOSE: To investigate the potential efficacy of spinal cord transcutaneous stimulation (scTS) priming to enhance lower limb neuromuscular performance during a subsequent power training session. METHODS: Eleven young active males (age: 21.3 ± 1.6 yr) participated in this randomized crossover, sham-controlled study. The priming protocol consisted of the application of scTS or sham stimulation (Sham) at rest and during warm-up for approximately 25 min. Force, velocity, and power, as well as electromyography (EMG) of lower limbs generated during unilateral half squats on a Smith machine, were assessed over two separate experimental sessions (scTS or Sham) for: 1) four power training sets, each including six unilateral repetitions with 2) the last (fourth) set continuing to failure. RESULTS: Peak and mean power generated during the four power training sets preceded by scTS priming were significantly higher (11%, P < 0.001 and 14%, P = 0.008, respectively) than those generated in the Sham session. Similar trends were also shown by velocity, force, and total impulse of force. Exploratory EMG analysis revealed that scTS priming favored an overall improved activation of the vastus lateralis during the concentric phase. Higher peak and mean power outputs (13%, P = 0.006, and 24%, P = 0.014, respectively), associated with higher EMG amplitude of vastus lateralis, were promoted by scTS priming also for the last set to failure, which resulted in a similar number of repetitions between the scTS (32 ± 17) and Sham priming (32 ± 19) sessions. CONCLUSIONS: scTS priming enhanced neuromuscular outcomes during a simulated lower limb power training session. Further studies should implement scTS priming throughout a longitudinal power training intervention and assess its potential to enhance training-induced neuromuscular adaptations
Empowerment of Newly Graduated Nurses in Six European Countries 1 Year Post-Graduation: Cross-Sectional Study and Psychometric Evaluation
No full textIntroduction: Global nursing shortage emphasizes empowering newly graduated nurses (NGNs) to enhance retention and satisfaction. While empowerment is widely studied, little is known about NGNs' empowerment 1 year post-graduation. This study describes it and evaluates the Essential Elements of Nurse Empowerment (EENE ©Kuokkanen 2003) instrument. Methods: In total, 239 NGNs from six European countries responded to this cross-sectional study using the EENE in 2019-2020. Data were analyzed statistically. Results: Most NGNs reported moderate empowerment. NGNs planning to stay in their workplace and profession reported higher empowerment. Exploratory factor analysis supported a four-factor structure, and the Cronbach's alpha for the instrument was 0.88. Discussion: Empowering NGNs is crucial for improving job satisfaction and retention. Inclusive practices and validated, culturally adaptable instruments like the EENE support equitable workforce development and culturally adaptable care. "Culturally adaptable" means retaining conceptual meaning across languages and contexts; translation revealed cultural nuances in how empowerment is understood and expressed
Boosting microbial dextran production through moderate-intensity pulsed electric field (MI-PEF) treatments
No full textSecond attempt to discontinue TKI after molecular relapse in patients with chronic myeloid leukemia: A real-life Italian multicenter study
No full textBackground: Approximately half of patients with chronic myeloid leukemia (CML) who attempted tyrosine kinase inhibitor (TKI) discontinuation for the first time experienced molecular relapse and restarted TKIs. Although several studies have already investigated first treatment-free remission (TFR) attempts (TFR1), few previously published articles have focused on the plausibility and predictors of second TFR (TFR2). Methods: To evaluate the feasibility and likelihood of TFR2 success in real-life, 90 patients with CML regularly followed in 23 Italian hematological centers were analyzed; these patients reattempted TKI discontinuation after a first failed attempt. Results: Forty-five (50.0%) patients lost major molecular response after a median of 4.0 months off therapy, whereas 45 (50.0%) remained treatment-free for a median of 18.8 months. In univariate analysis, there was no association between TFR2 and the following variables: age, gender, Sokal risk score, BCR::ABL1 transcript type, prior interferon exposure, type and number of previous TKIs, resistance to any prior TKIs, and TKI switching after TFR1. In contrast, factors identified as associated with TFR2 success included a lower ELTS risk score, a longer time from TFR1 to molecular relapse (≥3 months), as well as a longer TKI treatment and deep molecular response (DMR) duration (≥4 years) before TFR2. Conclusions: While confirming the critical prognostic role of ELTS risk and TKI treatment and DMR duration even before TFR2, this real-life study provides further information to support the safety of a second effort to discontinue TKIs in patients with CML, as a failed first attempt does not appear to preclude a second successful one