University of Udine
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Redefining infection management in implant-based breast reconstruction: Insights and innovations from an 11-year retrospective analysis
No full textBackground: Infections associated with implant-based breast reconstructive surgery are challenging for both patients and surgeons, often implying high recurrence rate, long treatments (both medical and surgical management), multiple invasive procedures, and delay of the end-result and, in some cases, even reconstruction failure. Early diagnosis is crucial but not always easy to achieve. Various treatment options are available and have been described in literature, with no clear winning strategy. Recent improvements in microbiological and therapeutic tools have led the authors to question what would be considered the best plan for reconstruction salvage approach. Methods: All patients who underwent implant-based breast reconstruction between 2012 and 2023 were enrolled. Clinical records regarding infections and treatment were retrospectively analyzed. Results: Among a total of 506 patients, 26 (5.14%) developed implant-associated infections. Discussing the results, we realized that previous protocol was old-fashioned and required improvements. Through a multidisciplinary approach, a new prevention and treatment algorithm was derived. First, microbiological screening through nasal and rectal swab allows for proper decontamination prior to intervention. However, the keystone improvement consists in the use of molecular biology analysis, thus minimizing diagnosis timing and allowing targeted antibiotic therapy shortly after the removal of the infected implant. In addition, a fundamental role is played using instillation negative pressure wound therapy as a temporary spacer to ensure the maintenance of the periprosthetic pocket. Conclusions: By following these precise steps in case of implant-associated infection, treatment can be optimized to reduce both therapy and hospitalization time, allowing the patient to achieve a reconstruction in a relatively short period. Level of evidence: I
Gas sensor for 4-ethylguaiacol detection based on tyrosinase enzymatic activity in a deep eutectic solvent
Get PDFThe use of environmentally friendly, cost-effective and biodegradable deep eutectic solvents (DESs) as nonaqueous solvents and electrolytes offers a promising avenue for enhancing enzymatic sensors and extending their applicability to the gas phase. In this study, an assembly is presented that includes a paper crown modified with tyrosinase enzyme, soaked in a DES and positioned on a disposable screen-printed carbon electrode. The paper crown contacts the outer edge of the carbon disk working electrode, as well as the peripheral counter and reference electrodes. This assembly yields a portable and disposable electrochemical platform, effortlessly immobilising DESs onto a porous and economical supporting material like paper. Moreover, the entire configuration resulted in a sensitive, rapidly responsive, membrane-free gas sensor whose response time depended exclusively on the enzymatic reaction. The electroanalytical capabilities of this setup were evaluated through voltammetric and amperometric determinations of phenols in synthetic and real wine samples. The proposed gas enzymatic sensor demonstrated excellent analytical performance for detecting phenolic compounds, offering fast measurement times, simple operation, high sensitivity, wide linear range and good repeatability
Oral anticoagulation versus no anticoagulation for stroke prevention in patients with intracranial haemorrhage and atrial fibrillation: An updated meta-analysis of randomised controlled trials
No full textBackground: Oral anticoagulation (OAC) effectively reduces stroke risk in patients with atrial fibrillation (AF), but its use after intracranial haemorrhage (ICH) remains controversial due to bleeding concerns. This study aimed to update the evidence on the efficacy and safety of OAC in patients with AF with a history of ICH. Methods: A systematic review and meta-analysis were conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines. We searched PubMed, Scopus and EMBASE for randomised controlled trials (RCTs) comparing OAC versus avoiding anticoagulation in patients with AF post-ICH. The primary outcomes were ischaemic stroke and recurrent ICH. Secondary outcomes included all-cause mortality, cardiovascular mortality, major adverse cardiovascular events (MACE), major haemorrhage and a composite endpoint of clinical benefit' (first incident ischaemic stroke and first incident recurrent ICH). Pooled risk ratios (RRs) with 95% CIs were calculated using a random-effects model. Results: Four RCTs with 653 participants were included. Anticoagulation was associated with a reduced risk of ischaemic stroke (RR 0.23, 95% CI 0.06 to 0.91) and increased risk of recurrent ICH (RR 3.60, 95% CI 1.40 to 9.30). No significant differences were observed in all-cause mortality (RR 0.93, 95% CI 0.59 to 1.46), cardiovascular death (RR 1.01, 95% CI 0.32 to 3.18) and for net clinical benefit (RR 0.72, 95% CI 0.42 to 1.24). Anticoagulation was associated with a significant increased risk of any major haemorrhage (RR 2.49, 95% CI 1.29 to 4.81) and reduced MACE (RR 0.64, 95% CI 0.44 to 0.94). Conclusions: OAC in patients with AF and prior ICH was associated with a reduced risk of ischaemic stroke and an increased risk of recurrent ICH. PROSPERO registration number: CRD42025637606
Randomized clinical trial on the effects of early cognitive interventions for children with acquired brain injury
Get PDFPediatric acquired brain injuries (ABIs) may cause significant cognitive deficits. Early rehabilitation is recommended, but there is no solid evidence on the best intervention formats. This randomized clinical trial investigated the efficacy of two multidomain cognitive interventions for children aged 5:0–17:11. A personalized intervention was compared with an intervention providing a fixed-dose cognitive stimulation. 40 children were randomized into the 2 study arms and received 12-week rehabilitation (3 45-minute daily sessions for 5 days per week). 34 children completed the intervention and were assessed at baseline (T0) and post-intervention (T1). Visual sustained attention and other cognitive measures of attention, memory, visual-spatial/visual-constructional abilities and executive functions were primary and secondary outcomes, respectively. Primary and 14 of the 16 secondary outcomes showed an improvement at T1 with a medium-to-very-large effect, but training effects could not be disentangled from spontaneous recovery. No differences were found between interventions, likely because of the prolonged multidomain stimulation provided by both of them, which might have been helpful in improving the widespread cognitive deficits of children in both groups. Therefore, while for the chronic phase the guidelines recommend a personalized approach, in the early phase of recovery a standardized intervention may also be effective
Swift-BAT GUANO Follow-up of Gravitational-wave Triggers in the Third LIGO–Virgo–KAGRA Observing Run
Get PDFWe present results from a search for X-ray/gamma-ray counterparts of gravitational-wave (GW) candidates from the third observing run (O3) of the LIGO–Virgo–KAGRA network using the Swift Burst Alert Telescope (Swift-BAT). The search includes 636 GW candidates received with low latency, 86 of which have been confirmed by the offline analysis and included in the third cumulative Gravitational-Wave Transient Catalogs (GWTC-3). Targeted searches were carried out on the entire GW sample using the maximum-likelihood Non-imaging Transient Reconstruction and Temporal Search pipeline on the BAT data made available via the GUANO infrastructure. We do not detect any significant electromagnetic emission that is temporally and spatially coincident with any of the GW candidates. We report flux upper limits in the 15–350 keV band as a function of sky position for all the catalog candidates. For GW candidates where the Swift-BAT false alarm rate is less than 10−3 Hz, we compute the GW–BAT joint false alarm rate. Finally, the derived Swift-BAT upper limits are used to infer constraints on the putative electromagnetic emission associated with binary black hole mergers
Data2Concept2Text: An Explainable Multilingual Framework for Data Analysis Narration
Get PDFThis paper presents a complete explainable system that interprets a set of data, abstracts the underlying features and describes them in a natural language of choice. The system relies on two crucial stages: (i) identifying emerging properties from data and transforming them into abstract concepts, and (ii) converting these concepts into natural language. Despite the impressive natural language generation capabilities demonstrated by Large Language Models, their statistical nature and the intricacy of their internal mechanism still force us to employ these techniques as black boxes, forgoing trustworthiness. Developing an explainable pipeline for data interpretation would allow facilitating its use in safety-critical environments like processing medical information and allowing non-experts and visually impaired people to access narrated information. To this end, we believe that the fields of knowledge representation and automated reasoning research could present a valid alternative. Expanding on prior research that tackled the first stage (i), we focus on the second stage, named Concept2Text. Being explainable, data translation is easily modeled through logic-based rules, once again emphasizing the role of declarative programming in achieving AI explainability. This paper explores a Prolog/CLP-based rewriting system to interpret concepts-articulated in terms of classes and relations, plus common knowledge-derived from a generic ontology, generating natural language text. Its main features include hierarchical tree rewritings, modular multilingual generation, support for equivalent variants across semantic, grammar, and lexical levels, and a transparent rule-based system. We outline the architecture and demonstrate its flexibility through some examples capable of generating numerous diverse and equivalent rewritings based on the input concept
Recensione a Simone Malavolti, Nazionalismi e “pulizia etnica” in Bosnia-Erzegovina: Prijedor (1990-1995), Pacini, Ospedaletto (Pisa) 2024
No full textRecensione a Simone Malavolti, Nazionalismi e “pulizia etnica” in Bosnia-Erzegovina: Prijedor (1990-1995), Pacini, Ospedaletto (Pisa) 2024, pp. 279
The role of grey water footprint in urban wastewater management: from pollution to reuse
No full textThe grey water footprint (WFgrey), defined as the volume of freshwater required to dilute pollutants below ambient water quality standards, has gained increasing relevance as a qualitative indicator of wastewater impact on receiving water bodies (RWB). This study evaluates the WFgrey using real data from a municipal wastewater treatment plant (WWTP) and its associated RWB over an eight-year period (2016–2023). A wide range of pollutants were considered, including organic compounds, solids, nutrients, and heavy metals. The analysis considered three scenarios: (a) untreated wastewater discharge, (b) treated effluent discharge, and (c) treated wastewater reuse for agricultural purposes. Results indicate that the WWTP significantly reduces pollutant loads, with scenario (b) showing an average 8-fold decrease in WFgrey compared to scenario
(a). Ammonium (in scenario (a)) and phosphorus (in scenario (b)) emerged as the primary contributors to WFgrey, highlighting the limited phosphorus removal due to the absence of dedicated chemical or biological treatments. Lead was found to be the most impactful heavy metal in several instances, underlining the importance of monitoring low-concentrated contaminants. Ammonium and total nitrogen showed the highest removal efficiency, whereas phosphorus removal was relatively inefficient, reinforcing the need for future plant upgrades. Furthermore, the reuse scenario (c) demonstrated the potential of nutrientrich treated effluent for irrigation, particularly during dry summer months, offering dual benefits of pollution reduction and resource recovery. Overall, WFgrey proved to be a robust and accessible indicator for evaluating WWTP performance,
identifying critical pollutants, guiding plant optimization, and supporting sustainable discharge and reuse strategies. Future developments should expand monitoring to emerging contaminants such as pharmaceuticals, pesticides, microplastics, and additional heavy metals to ensure comprehensive environmental protection