Archivio istituzionale della ricerca - Università dell'Insubria
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Association Between Isolated Postprandial Dyslipidemia And Erectile Dysfunction
No full textBackground: Postprandial lipid testing is increasingly recognized as a marker of vascular health. However, its relationship with erectile dysfunction (ED) remains largely unexplored. Isolated postprandial dyslipidemia (IPD), in particular, may evade detection using conventional fasting-based assessments, despite potential atherogenic effects. Objectives: To evaluate the association between IPD and erectile function, comparing the prevalence and severity of ED among men with IPD, combined dyslipidemia (CD), and those without dyslipidemia (WD). Materials and Methods: In this cross-sectional study, sexually active men aged ≥18 years underwent same-day fasting and postprandial lipid testing, as well as erectile function evaluation using the International Index of Erectile Function – Erectile Function domain (IIEF-EF) questionnaire. Dyslipidemia was defined according to the 2019 European Society of Cardiology/European Atherosclerosis Society criteria. Patients were categorized as WD (no dyslipidemia), IPD (postprandial abnormalities only), or CD (both fasting and postprandial abnormalities). Multivariable logistic regression was performed, adjusting for age, smoking status, BMI, and hypertension. The primary outcome was the prevalence of ED (IIEF-EF ≤25); secondary outcomes included ED severity and comparisons across lipid profile subgroups. Results: Among 351 men, ED prevalence was higher in the IPD (55.1%) and CD (57.0%) groups compared to WD (32.8%; p < 0.001). Median (IQR) IIEF-EF scores were 26 (25–28) in the WD group, 22 (20–23) in the IPD group, and 21 (19–23) in the CD group. The differences between WD and both IPD and CD exceeded the minimal clinically important difference (4 points) and were statistically significant (p < 0.001). Adjusted analyses confirmed increased odds of ED in IPD (odds ratio [OR] = 2.36; 95% confidence interval [CI]: 1.41–3.96) and CD (OR = 2.58; 95% CI: 1.43–4.65) versus WD. ED severity was also greater in the IPD and CD groups. No differences emerged between IPD and CD in any outcome. Among IPD subtypes, elevated postprandial triglycerides were most common, but no single lipid abnormality was independently associated with ED severity. Conclusion: IPD is associated with both the prevalence and severity of ED, paralleling the impact of chronic dyslipidemia. Postprandial lipid testing may reveal hidden metabolic risks relevant to sexual health and should be considered in the evaluation of ED
Evaluation of Relationship Between Neuromuscular Fatigue and Manual Dexterity in Physiotherapists: An Observational Study.
No full textDeterminants of adjuvant radiotherapy in early-stage cervical cancer: a retrospective analysis of the SUCCOR cohort
No full textOBJECTIVE: This study aimed to describe the patterns of adjuvant therapy use within the SUCCOR cohort, a large retrospective analysis comparing disease-free survival following minimally invasive versus open surgery in early-stage cervical cancer. Furthermore, to assess the factors associated with the indication for adjuvant radiotherapy after radical hysterectomy for International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IB (≤4cm) cervical cancer. METHODS: A retrospective analysis was performed using the SUCCOR study database. We investigated patients with FIGO 2009 stage IB1, node-negative cervical cancer at final pathology. Univariate and multi-variable logistic regression were performed to determine factors associated with the administration of adjuvant radiation therapy. RESULTS: The study included a total of 572 patients. Of these, 340 patients (59.4%) did not receive adjuvant radiotherapy, including 45 (13.2%) who met the Sedlis criteria. Conversely, among the 232 patients (40.6%) who received adjuvant radiotherapy, 132 (56.9%) did not meet Sedlis criteria. In the univariate logistic regression, factors associated with adjuvant radiotherapy included tumor size >2 cm (p< .001), lymphovascular space invasion (p < .001) and a tumor grade G3 (vs G1-G2, p .01). Furthermore, the probability of receiving adjuvant radiotherapy was higher for patients with deep stromal invasion (p < .001), and with intermediate stromal invasion (p < .001) in comparison to those with superficial stromal invasion. At multiple logistic regression, open approach (odds ratio [OR] 1.63, p =.01) and G3 tumor grade (OR 1.64, p= .01) were independently associated with the administration of adjuvant radiotherapy. In addition, the presence of Sedlis criteria was associated with a 4 times higher probability of having adjuvant radiotherapy (OR 4.44, p < .001). CONCLUSIONS: While the Sedlis criteria should guide post-operative radiotherapy administration, we observed a significant variation in post-operative adjuvant treatment among institutions involved in the SUCCOR study. A call for a standardized recommendation of adjuvant radiation therapy is needed
Measuring robustness in cyber-physical systems under sensor attacks
No full textThis paper contributes a formal framework for quantitative analysis of bounded sensor attacks on cyber–physical systems, using the formalism of differential dynamic logic. Given a precondition and postcondition of a system, we formalize two quantitative safety notions, quantitative forward and backward safety, which respectively express (1) how strong the strongest postcondition of the system is with respect to the specified postcondition, and (2) how strong the specified precondition is with respect to the weakest precondition of the system needed to ensure the specified postcondition holds. We introduce two notions, forward and backward robustness, to characterize the robustness of a system against sensor attacks as the loss of safety. To reason about robustness, we introduce two simulation distances, forward and backward simulation distances, which are defined based on the behavioral distances between the original system and the system with compromised sensors. Forward and backward distances, respectively, characterize upper bounds of the degree of forward and backward safety loss caused by the sensor attacks. We verify the two simulation distances by expressing them as modalities, i.e., formulas of differential dynamic logic, and develop an ad-hoc proof system to reason with such formulas. We showcase our formal notions and reasoning techniques on two non-trivial case studies: an autonomous vehicle that needs to avoid collision and a water tank system
Age-Related Variations in Clinical, Histological, and Genetic Characteristics in Multiple and Familial Melanomas: A Study of 333 Patients
Full text linkBackground/Objectives: Melanoma is an aggressive cutaneous malignancy with a rising incidence. While most cases are sporadic, 5–10% are hereditary, especially in patients with multiple or familial melanomas. The aim of this study is to explore the epidemiological, clinical, histological, and genetic features of this class of patients to identify risk factors for better management and surveillance. Methods: Between 2021 and 2024, patients with multiple melanomas or a familial history of melanoma were recruited. Collected data included demographic, clinic-pathologic features, and genetic analyses. Results: Patients >60 years had a higher prevalence of multiple melanomas (>50%, p = 0.0002), while familial melanoma was more common in those <40 years (54.3%). UV exposure increased with age, while sunscreen use decreased (p = 0.0004). Younger patients showed the highest nevi counts (mean: 139.6) and density (p < 0.0001). Dermatologists more frequently detected subsequent melanomas in older patients (>60 years) (p = 0.001). Genetic testing and melanoma subtypes showed no significant age-related differences. Conclusions: melanoma can develop at any age, and early detection through regular screening is crucial. Older patients (>60 years) have a higher prevalence of multiple melanomas, influenced by UV exposure and genetics. Indeed, in our cohort, a history of sun exposure, sunburns, and tanning bed use emerged as key risk factors, particularly among older individuals. Genetic testing showed a 4.3% rate of pathogenic/likely pathogenic variants, mainly in CDKN2A. Family history and nevus burden are significant risk factors, highlighting the need for targeted surveillance in high-risk populations
Infections Management in the Lung Transplant Setting in Italy: A Web-Survey
No full textIntroduction: Infections significantly impact morbidity and mortality in lung transplant (LuTx) recipients. This survey focused on documenting current practices regarding the prevention and management of infections in LuTx in Italy. Methods: A 52-question survey was administered online in the period from December 1, 2023, to January 31, 2024, assessing center characteristics, Tx team organization, microbiological investigations, infection prevention, and management. All Italian LuTx centers were invited to participate. Results: Nine out of 10 Italian LuTx centers answered. Most centers (6/9, 67%) performed LuTx only on adults. Chronic infection or colonization by Mycobacterium abscessus and Burkholderia cenocepacia is considered a contraindication to LuTx in five and two centers, respectively. For cytomegalovirus D+/R- patients, prophylaxis is used in six centers (67%), with a variable duration from 3 to 12 months. Two centers also use IgG. Three centers (33%) use a pre-emptive strategy. Four centers (45%) screen for Human herpesvirus 8 infection. Regarding antibiotic prophylaxis, most centers (6/9, 67%) utilise a dual regimen of anti-pseudomonal penicillin plus glycopeptide. The two most common durations of antibiotic prophylaxis were 72 h and 7 days, each reported by two centers (22%). Targeted prophylaxis against fungal infections is employed by a minority of centers (4/9, 44%). Inhaled amphotericin B is the most common antifungal, used as targeted prophylaxis (2/4, 50%) and universal prophylaxis (2/5, 40%). Almost all centers (8/9, 89%) involve the Tx infectious diseases specialist in the recipient management since the pre-listing period. Conclusion: There is considerable heterogeneity in infection management among Italian LuTx centers. Establishing a shared platform for data collection and outcome evaluation is essential to improve infection management. (Figure presented.)
Morbidity of multimodal treatments including endoscopic surgery for sinonasal malignancies: Results of an international collaborative study on 940 patients (MUSES)
Full text linkIntroduction: In the management of sinonasal malignancies treatment-induced morbidity and mortality is gaining relevance both for surgical approaches (endoscopic and open resection) and non-surgical therapies. The aim of this multicenter study is to assess complications associated with endoscopic surgery and non-surgical treatments (neoadjuvant and/or adjuvant) for malignant sinonasal tumors. Methods: All patients with nasoethmoidal malignancies treated with curative intent with endoscopic or endoscopic-assisted surgery at three referral centers with uniform management policies were included. Neo- and/or adjuvant (chemo)radiotherapy was administered according to histology and pathological report. Demographics, treatment characteristics, and complications related both to the surgical and non-surgical approaches were retrieved. The data were analyzed with univariate and multivariate statistics to assess independent predictors of complications. Results: Nine hundred and forty patients were included, 643 males (68%) and 297 females (32%). A total of 225 complications were identified in 187 patients (19.9%): cerebrospinal fluid (CSF) leak (3.5%), mucocele (2.3%), surgical site bleeding (2.0%), epiphora (2.0%), and radionecrosis (2.0%) were the most common. Treatment-related mortality was 0.4%. Variables independently associated with complications at multivariate analysis were principally dural resection (OR 1.92), cranioendoscopic or multiportal resection (OR 2.93), dural repair with multilayer technique with less than three layers (OR 2.17), and graft different from iliotibial tract (OR 3.29). Conclusion: Our study shows that modern endoscopic treatments and radiotherapy for sinonasal malignancies are associated with limited morbidity and treatment-related mortality. CSF leak and radionecrosis, although rare, remain the most frequent complications and should be further addressed by future research efforts
Bacterial Diversity of Marine Biofilm Communities in Terra Nova Bay (Antarctica) by Culture-Dependent and -Independent Approaches
Full text linkApplying both culture-independent and -dependent approaches, bacterial diversity of marine biofilm communities colonising polyvinyl chloride panels submerged in Terra Nova Bay (Ross Sea, Antarctica) was investigated. Panels were deployed in two sites subjected to a different degree of anthropogenic impact (Road Bay [RB] impacted site and Punta Stocchino [PTS] control site). Biofilm samples were collected after 3 or 12 months to evaluate both short-and long-term microbial colonisation.
Taxonomic composition of the microbial community was studied by 16S rRNA gene amplicon sequencing. Proteobacteria was the predominant phylum, followed by Bacteroidetes, Actinobacteria, Verrucomicrobia and Firmicutes. Impacted RB biofilms were found to contain a relevant fraction of potentially pathogenic bacterial genera, accounting for 27.49% of the whole community. A total of 86 psychrotolerant bacterial strains were isolated from the biofilm samples using culture-dependent techniques designed to enrich in Actinobacteria. These strains were assigned to three different phyla: Actinobacteria (54.65%), Firmicutes (32.56%) and Proteobacteria (12.79%). 2.73% of genera identified by metabarcoding were recovered also through cultivation, while 11 additional genera were uniquely yielded by cultivation. Functional screening of the isolates revealed their hydrolytic and oxidative enzyme activity patterns, giving new insights into the metabolic and biotechnological potential of microbial biofilm
communities in Terra Nova Bay seawater
Il piano per la fascicolatura. Questioni giuridiche, tecniche e applicative
No full textLe nuove Linee Guida sulla creazione, gestione e conservazione dei documenti digitali, approvate dall'Agenzia per l'Italia Digitale (AgID) e in vigore dal 1° gennaio 2022, pongono particolare enfasi non sui singoli documenti, bensì sulle unità e serie archivistiche fondamentali.
Per riprendere la terminologia di AgID, il focus della gestione e conservazione dei documenti si è spostato sulle "aggregazioni di documenti", ovvero serie e fascicoli, corredati di tutti gli strumenti di ricerca pertinenti.
All'interno delle pubbliche amministrazioni, tuttavia, la conformità può essere raggiunta solo a seguito della predisposizione della tabella dei procedimenti amministrativi (e delle relative materie e attività). È, infatti, fondamentale tenere presente che nell'ambito dell'azione amministrativa convergono quattro quadri normativi chiave: quello sulla trasparenza, intesa come accessibilità totale; quello sull'esercizio del diritto di accesso (al fascicolo, anziché ai singoli documenti); e, nell'ambito dell'amministrazione digitale, quello sul fascicolo digitale.
Questo studio, a seguito di un'analisi del quadro normativo vigente, si propone di chiarire le metodologie di redazione del Piano di Deposito (il nomen juris prescritto nelle Linee Guida) e del set di metadati associato. La logica di base, quindi, garantisce la continuità tra le fasi di creazione e conservazione dei documenti
Structural modelling and probabilistic seismic assessment of existing long-span precast industrial buildings
No full textPrecast concrete frame structures constitute a major construction technology of the industrial built heritage within the Italian territory. Most of these buildings were conceived according to obsolete seismic design criteria with lower hazard than currently recognised standards, whilst the most industrialised areas spread over the Italian territory were declared seismically active since less than 20 years. This paper focuses on seismic performance assessment of long-span flat-roof industrial buildings, representative of modern design technologies. Buildings located in areas with increasing seismic hazard over the Italian territory were designed following an archetype existing building based on standards in force after 1996. Seismic performance is investigated by modal response analysis, non-linear static pushover analysis, and non-linear time-history analysis with a multi-stripe approach. The flexibility of the horizontal diaphragm and the interaction of the resisting frame with the cladding system are addressed by exploring progressively advanced modelling strategies up to a detailed assembly comprising roof members, peripheral panels, and all related connections. Mechanical non-linearities regarding column elements, dowel beam-to-column and slab-to-beam connections, strap tie-back and bracket bearing panel-to-frame connections are modelled with lumped plasticity employing experimentally calibrated constitutive laws. Seismic risk is assessed by estimating via multi-stripe analysis failure rates encompassing performance levels from usability preventing damage to global collapse. The results are site-dependent, and the need for retrofit of these typical precast systems is deemed to be urgent for both buildings designed in areas of average and high seismicity