Archivio istituzionale della ricerca - Università dell'Insubria
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Amino Acid Infusion and Renal Protection: Beyond Hemodynamic Optimization in Cardiac Surgery
No full textReducing Barriers in the Procurement of Big Science. Evidence from the Virgo Experiment
No full textThis research investigates the Big Science Centres (BSCs)-suppliers relationship in the procurement of Large Research Infrastructures (LRIs) and in the overcoming of barriers that may occur during the collaboration. We investigate the BSCs-industry relationship aiming to understand how BSCs and their suppliers develop new forms of collaboration to foster innovation. We conducted a qualitative analysis of Virgo, the research infrastructure that detected the gravitational waves. Our results contribute to the literature on the BSCs-industry relationship by showing, i) that organizational and cultural distance creates barriers in the relation and ii) identifying practice and closeness as mechanisms for coping with barriers, creating synergies that reward and outweigh suppliers’ effort with access to novel sources of knowledge and innovation. The resulting collaboration generates value out of big science projects for small companies that would be otherwise excluded from such large investments in science and knowledge creation
Comparazione anatomica quantitativa degli approcci chirurgici microchirurgici transcranici, transcranici transorbitari, endoscopici transnasali ed endoscopici transorbitari all’orbita e sottosedi anatomiche circostanti.
No full textContesto: L’orbita e le regioni adiacenti della base cranica rappresentano alcune delle aree chirurgiche più complesse a causa della loro complessità anatomica e della concentrazione di strutture neurovascolari critiche. Sebbene le moderne tecniche microchirurgiche ed endoscopiche abbiano ampliato l’armamentario chirurgico, un confronto quantitativo completo degli approcci disponibili rimane limitato.
Obiettivi dello studio: Fornire un’analisi anatomica sistematica e quantitativa e un confronto statistico tra approcci microchirurgici transcranici (MTA), approcci endoscopici endonasali (EEA) e approcci endoscopici transorbitali (ETOA) diretti all’orbita e ai compartimenti circostanti.
Materiali e Metodi: Diciannove approcci chirurgici sono stati eseguiti bilateralmente su cinque preparati anatomici. Ogni campione è stato sottoposto a tomografia computerizzata ad alta risoluzione e i volumi chirurgici e le aree di esposizione sono stati quantificati utilizzando un sistema di neuronavigazione ottica con software dedicato (GTx-Eyes II, University Health Network, Toronto, Canada). Sono state analizzate in totale 26 strutture anatomiche appartenenti all’orbita, alla fossa cranica anteriore e media. Tutti gli approcci sono stati misurati sia in modalità crossing che non crossing, con tre acquisizioni ripetute per minimizzare l’errore. Le analisi statistiche sono state effettuate utilizzando modelli lineari misti con intercette casuali.
Risultati: Gli MTA hanno fornito le esposizioni più ampie ma hanno richiesto un’elevata invasività e retrazione cerebrale. Gli EEA hanno offerto un accesso diretto e voluminoso alle strutture orbitarie mediali e della linea mediana della base cranica. Gli ETOA hanno consentito un accesso minimamente invasivo alle regioni orbitarie laterali e superiori, bilanciando manovrabilità ed esposizione, e hanno dimostrato complementarità sia con gli MTA sia con gli EEA. La variabilità tra i campioni ha confermato l’importanza della valutazione quantitativa per tenere conto delle differenze anatomiche.
Conclusioni: Questo studio rappresenta il primo confronto quantitativo completo di 19 approcci all’orbita e alle regioni circostanti della base cranica, integrando analisi volumetriche e di esposizione su 26 strutture anatomiche. I risultati evidenziano i punti di forza e i limiti specifici di MTA, EEA ed ETOA, e confermano l’affidabilità della quantificazione basata sulla neuronavigazione come strumento solido a supporto della pianificazione chirurgica basata sull’evidenza.Background: The orbit and adjacent skull base regions represent some of the most challenging surgical areas because of their anatomical complexity and the concentration of critical neurovascular structures. Although modern microsurgical and endoscopic techniques have expanded the surgical armamentarium, a comprehensive quantitative comparison of available approaches remains limited.
Aims of the study: To provide a systematic, quantitative anatomical analysis and statistical comparison of microsurgical transcranial approaches (MTAs), endoscopic endonasal approaches (EEAs), and endoscopic transorbital approaches (ETOAs) directed to the orbit and surrounding compartments.
Materials & Methods: Nineteen surgical approaches were performed bilaterally on five adult cadaveric heads. Each specimen underwent high-resolution computed tomography scanning, and surgical volumes and exposure areas were quantified using an optical neuronavigation system with dedicated software (GTx-Eyes II, University Health Network, Toronto, Canada). A total of 26 anatomical structures belonging to the orbit, anterior and middle cranial fossae were analyzed. All approaches were measured in both crossing and non-crossing modalities, with three repeated acquisitions to minimize error. Statistical analyses were performed using mixed linear models with random intercepts.
Results: MTAs provided the largest exposures but required extensive invasiveness and brain retraction. EEAs offered a direct and voluminous route to medial orbital and midline skull base structures, particularly effective in crossing modality. ETOAs allowed minimally invasive access to lateral and superior orbital regions, balancing maneuverability with exposure, and demonstrated complementarity with both MTAs and EEAs. Variability across specimens confirmed the importance of quantitative evaluation in accounting for anatomical differences.
Conclusions: This study represents the first comprehensive quantitative comparison of 19 approaches to the orbit and surrounding skull base regions, integrating volumetric and exposure analyses across 26 anatomical structures. The findings highlight the specific strengths and limitations of MTAs, EEAs, and ETOAs, and confirm the reliability of neuronavigation-based quantification as a robust tool to support evidence-based surgical planning
Dual-Layer Spectral CT with Electron Density in Bone Marrow Edema Diagnosis: A Valid Alternative to MRI?
No full textBackground/Objectives: Although MRI with fat-suppression sequences is the gold standard for diagnosis of bone marrow edema (BME), Dual-Layer Spectral CT (DL-SCT) with electron density (ED) provides a viable alternative, particularly in situations where an MRI is not accessible. Using MRI as the reference standard, this study analyzed how DL-SCT with ED reconstructions may be a valid alternative in the detection of BME. Methods: This retrospective study included 28 patients with a suspected diagnosis of BME via MRI conducted between March and September 2024. Patients underwent DL-SCT using ED reconstructions obtained through IntelliSpace software v. 12.1. Images were evaluated by two experienced radiologists and one young radiologist in a blinded way, giving a grade from 0 to 3 to classify BME (0 absence; 1 mild; 2 moderate; 3 severe). To reduce the recall bias effect, the order of image evaluations was set differently for each reader. p-Values were considered significant when <0.05. Fleiss' Kappa was used to assess inter-rater reliability: agreement was considered poor for k < 0; slight for k 0.01-0.20; fair for 0.21-0.40; moderate for 0.41-0.60; substantial for 0.61-0.80; and almost perfect for 0.81-1.00. Results: All the readers detected the presence or absence of BME using DL-SCT. Inter-rater reliability for grade 0 resulted in 1 (p-value < 0.001); for grade 1: 0.21 (p-value < 0.001); for grade 2: 0.197 (p-value < 0.001); and for grade 3: 0.515 (p-value < 0.001). Conclusions: ED reconstructions allowed the identification of BME presence or absence in all analyzed cases, thus suggesting DL-SCT as a potentially effective method for its detection
Sulla costituzionalizzazione dell’ambiente ad opera della Legge cost. n. 1 del 2022: i riflessi sui servizi ecosistemici
No full textThe RCS-E is Predictive of Outcomes and Resource Allocation in a Large Neuromotor Rehabilitation Setting
No full textObjective: To assess the reliability of the Rehabilitation Complexity Scale - Extended (RCS-E) as a measure of rehabilitation complexity. Secondary outcomes include identifying which baseline data, including the RCS-E, are most predictive of rehabilitation stay effectiveness and exploring its role as a predictor of reimbursement for hospital admissions. Design: A retrospective observational study. Demographic and clinical variables were collected, including Length of Stay (LoS), modified Rankin Scale, modified Barthel Index (mBI), RCS-E, and reimbursement of stay. Setting: Study on inpatients admitted to the neuromotor Rehabilitation Units of the 16 Istituti Clinici Scientifici Maugeri IRCCS (November 2023 and June 2024). Participants: Of 5870 hospitalizations, 4091 (mean age 71.8 ±13 years; 42.2% male) met the inclusion criteria. The pre-post analysis was performed on 3792 patients (mean age 71.8 ±12.8 years; 41.6% male). Interventions: Rehabilitation program for neurological or orthopedic condition [median (1st - 3rd quartile) duration: 27 days (20-41)] MAIN OUTCOMES AND MEASURES: RCS-E scores on admission were categorised as follows: <8 (low complexity); 8-10 (medium complexity); >10 (high complexity). For each patient, we calculated the mBI derived parameters: mBI Gain, rehabilitation efficiency, and rehabilitation effectiveness. Results: A significant moderate Spearman correlation was found between RCS-E score and mBI (rho=-0.53, p<0.0001), LoS (rho=0.41, p<0.0001) and premorbid mRS (rho=0.23, p<0.0001). Rehabilitation efficiency and effectiveness were significantly lower in the high complexity group. Both RCS-E and mBI at admission significantly correlated with total reimbursement (both p<0.0001, rho=0.48 and rho=-0.43, respectively). Regression models indicated a predictive effect of RCS-E at admission on mBI at discharge. Conclusions: This study demonstrates the reliability and utility of RCS-E in assessing neurological and orthopedic rehabilitation complexity, predicting outcomes, and informing funding models
TERT translocation to mitochondria: Exploring its role in mitochondrial homeostasis
No full textTelomerase Reverse Transcriptase (TERT), in addition to its well-known role in telomere lengthening, also has non-canonical functions, including gene regulation and protection against apoptosis. Beyond its nuclear functions, it is now recognized for its presence inside mitochondria. However, the biological role of TERT in mitochondrial physiological activity, with its specific mechanism of action, still needs to be clarified. This work clearly demonstrates the presence of TERT inside the mitochondrion under physiological conditions, in different cellular contexts, both with endogenous and ectopic TERT expression, and regardless of the presence of telomerase RNA counterpart TERC. TERT was shown to bind mitochondrial DNA, influencing mitochondrial replication and transcription. Furthermore, electron microscopy analysis of morphology revealed TERT-induced fragmentation of the mitochondrial network. Collectively, our findings suggest that TERT may play a role in regulating mitochondrial biogenesis and dynamics, and influencing processes such as fission and mitophagy, essential for maintaining mitochondrial homeostasis and closely connected to cellular states
Limited Utility of Screening Electrocardiograms in Systemic Sclerosis: Data from the Canadian Scleroderma Research Group
No full textObjective: Recommendations have been made to use electrocardiograms (EKGs) to screen for cardiac disease in systemic sclerosis (SSc). The objective of this study was to compare the prevalence of EKG abnormalities in SSc and controls to help determine if the EKG should be used as a screening tool. Methods: EKGs from patients with SSc were compared with those from a random sample of age- and gender-matched controls. Two cardiologists read all EKGs using a standardized approach. The groups were compared using t-tests, chi-squared tests, and Fisher exact tests. Results: Patients with SSc (n = 833, mean ± SD disease duration 11.3 ± 9.3 years; 39.4% had diffuse cutaneous SSc) and controls (n = 832) were included. The prevalence of conduction and rhythm abnormalities were similar in the SSc and control groups. More patients with SSc than controls had possible right atrial enlargement (5% vs 0.1%, P < 0.001), right axis deviation (3.2% vs 0.4%, P < 0.001), left atrial enlargement (9.2% vs 1.6%, P < 0.001), poor/abnormal R progression (5.6% vs 2.2%, P < 0.001) and nonspecific T wave abnormalities (6.1% vs 3.4%, P = 0.008). Conclusion: Our findings suggest that conduction abnormalities are not more prevalent in those with SSc than in controls. Evidence of right heart stress on EKG in SSc may be secondary to pulmonary hypertension and left atrial enlargement, and poor R wave progression in precordial leads may indicate myocardial damage. Future studies are required to determine if these EKG abnormalities represent underlying structural heart disease, and, until that is proven, EKGs should not be considered a screening tool for cardiac abnormalities in SSc
La “Grammatica della lingua inglese” (1760-1873) di Giuseppe Baretti: oltre un secolo di vita editoriale tra norma e pratica comunicativa
No full textIl presente contributo esamina, nei limiti dello
spazio concesso, la "Grammatica della lingua inglese" (1760-1873) di Giuseppe Baretti da
una prospettiva metodologica di socio-pragmatica storica (Brinton
2023). L’obiettivo è duplice: da un lato delineare per sommi capi la
storia editoriale e l’evoluzione funzionale della "Grammatica", dalle
prime edizioni londinesi a quelle livornesi; dall’altro proporre una
prima analisi della sezione dei "Dialogues", in parte ripresi dal Baretti
da fonti anglo-francesi, come genere pedagogico e performativo,
in cui le scelte linguistiche veicolano valori sociali, traducendo la
norma in pratica comunicativa
Lp-Lq estimates for transition semigroups associated to dissipative stochastic systems
No full textIn a separable Hilbert space, we study supercontractivity and ultracontractivity properties for a transition semigroup associated with a stochastic partial differential equation. This is done in terms of exponential integrability of Lipschitz functions and some logarithmic Sobolev-type inequalities with respect to invariant measures. The abstract characterization results concerning the improvement of summability can be applied to transition semigroups associated to stochastic reaction-diffusion equations. (c) 2025 The Author(s). Published by Elsevier Masson SAS. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)