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Role of liposomal amphotericin B in intensive care unit: an expert opinion paper
No full textIntroduction: Invasive fungal infections (IFI) are frequent in patients admitted to the intensive care unit (ICU). The use of first-line antifungals like triazoles or echinocandins may be limited by the global spread of multi-drug resistance species, drug–drug interactions, low organ penetration, and some safety concerns in case of multi-organ failure. Liposomal amphotericin B (L-AmB) is a polyene drug with a broad activity against mold and yeast and an acceptable safety profile. To outline the role of L-AmB in the treatment of IFI in critically ill patients, a panel of experts was invited to draw up an expert opinion paper on the appropriate place in therapy of L-AmB in different clinical scenarios of patients admitted to ICU. Methods: A multidisciplinary group of 16 specialists in infectious disease, microbiology, pharmacology, and intensive care elaborated an expert opinion document through a multi-step approach: (1) the scientific panel defined the items and wrote the statements on the management of IFI in ICU, (2) a survey was submitted to an external panel to express agreement or disagreement on the statements, and (3) the panel reviewed the survey and implemented the final document. Results: The final document included 35 statements that focused on epidemiology and microbiological rationale of the use of systemic L-AmB in critically ill patients and its potential role in specific clinical scenarios in the ICU. Conclusion: Systemic L-AmB may represent an appropriate therapeutic choice for IFI in ICU patients with different underlying conditions, especially when the use of first-line agents is undermined. This expert opinion paper may provide a useful guide for clinicians
Gender inequities in speaker representation and academic recognition: A cross-sectional observational study
No full textAim: This study evaluates gender disparities in speaker representation at the Italian Society of Orthodontists (SIDO) congresses (2020–2024) and the International Orthodontic Congress (IOC) 2020, focusing on gender distribution and academic impact, measured by the h-index. Materials and Methods: The SIDO congress programs (2020–2024) and IOC 2020 were analyzed to count male and female invited speakers. The h-index for each speaker was retrieved from the Scopus database to assess academic productivity. Statistical tests, including the Shapiro-Wilk test, independent samples t-test, and Kruskal-Wallis test, were used to analyze gender-based differences in representation and h-index values. Results: Data from the SIDO congresses showed a persistent gender imbalance in both representation and academic recognition. In 2020, only 6 out of 29 speakers were female, with their average h-index (7.33) significantly lower than that of male speakers (13.13). Female representation increased to 31 % in 2024, but their average h-index (8.95) still lagged behind males (11.13). At the IOC 2020, female speakers represented 24 % but had a higher average h-index (22.62) than males (20.91). Conclusions: This study highlights significant gender disparities in both speaker representation and academic recognition in orthodontics. Despite increased female participation at SIDO congresses, their academic impact remains lower than that of their male counterparts. These findings emphasize the need for initiatives promoting gender equality, such as mentorship programs and inclusive policies, to empower women and reduce the gender gap in academic and professional settings
Tecniche riproduttive di inizio vita e le sfide bioetiche del diritto di famiglia islamico
No full textIn recent decades, medical science has offered ever more advanced assisted reproductive techniques that can provide access to parenthood for people who would otherwise be excluded. The rapid development of such techniques has (also) raised 'new' questions in the field of religious rights, not least Islamic ones.
This research will begin with some preliminary reflections on the role of procreation within the Islamic family, to understand its relevance within the broader framework of religious precepts. It also provides a summary description of the so-called traditional remedies provided by Islamic family law in cases of infertility or sterility. The overall rationale governing such remedies has enabled Islamic doctrine to define certain functional principles that have become paradigms for the legitimacy of medically assisted reproductive techniques. Finally, the analysis considers the possibility that the various reproductive techniques may fall within the cases provided for by Islamic law, devoting some final reflections to post-mortem procreation, which is currently the subject of extensive (not only religious) debate
A Holistic Investigation of Arabidopsis Proteomes Altered in Chloroplast Biogenesis and Retrograde Signalling Identifies PsbO as a Key Regulator of Chloroplast Quality Control
No full text: Communication between the diverse compartments of plant cells relies on an intricate network of molecular interactions that orchestrate organellar development and adaptation to environmental conditions. Plastid-to-nucleus signalling pathways play a key role in relaying information from developing, mature, and damaged or disintegrating chloroplasts to the nucleus, which serves to coordinate gene expression between the two genomes. To shed light on these mechanisms, we performed a comprehensive analysis of the response of the Arabidopsis thaliana proteomes to perturbation of chloroplast biogenesis by the antibiotic lincomycin (Lin) in the absence of GENOMES UNCOUPLED 1 (GUN1), a key player in plastid-to-nucleus signalling. The topological analysis of protein-protein interactions (PPIs) and co-expression networks enabled the identification of protein hubs in each genotype and condition tested, and highlighted whole-cell adaptive responses to the disruption of chloroplast biogenesis. Our findings reveal a novel role for PsbO, a subunit of the oxygen-evolving complex (OEC), which behaves as an atypical photosynthetic protein upon inhibition of plastid protein synthesis. Notably, and unlike all other subunits of the thylakoid electron transport chain, PsbO accumulates in non-photosynthetic plastids, and is crucial for the breakdown of damaged chloroplasts
The circular economy and the role of technology in the fashion industry: a comparison of empirical evidence
Get PDFThe present article analyses the theme of circularity in the fashion industry, with
particular attention to the role of technology in favoring the adoption of circular economic
models. The article explores the role of technology in supporting the circular economy in
the fashion industry, focusing on the implementation of circular business models by three
companies: SHEIN, Ralph Lauren, and Cotopaxi. The aim is to investigate the challenges
and opportunities associated with the adoption of circular economy practices in an industry
known for its environmental impact. The research highlights how technology, particularly
software such as Materia MX, can facilitate streamlined supply chains, reduced waste, and
optimized resource efficiency, thus, overcoming obstacles such as high investment costs and
supply chain complexities. The case studies demonstrate how each company has integrated
circular practices, such as recycling, reusing materials, and improving transparency through
technologies such as AI, blockchain, and IoT, to promote sustainability. Thus, the study
emphasizes the importance of technological innovation in enabling a more sustainable and
circular future for the fashion industry while addressing challenges related to consumer
awareness, regulatory pressures, and infrastructure. The results suggest that technology is
a key factor in the fashion industry’s transition to a circular economy, offering a competitive
advantage and facilitating the achievement of environmental objectives
Lower albumin levels are associated with 1-year mortality in older patients hospitalized for acute heart failure: THE ALBIMED-HF study
No full textHypoalbuminemia (i.e., albumin levels <= 3.5 g/dL) is a negative prognostic marker in several conditions, including acute heart failure (AHF). Hypoalbuminemia is common in patients hospitalized in Internal Medicine (IM) divisions. However, its role in predicting long-term mortality in AHF patients hospitalized in this setting is not clear. In THE ALBIMED-HF study, all patients hospitalized for AHF in the First Division of Internal Medicine at Ospedale di Circolo and Fondazione Macchi (ASST Sette Laghi, Varese, Italy) between January 1st and December 31st 2022 were retrospectively included. Clinical information was retrieved from patient electronic medical records. Four hundred and ninety-eight patients were considered for the present study (median age 85 [78-89] years). Median Charlson Comorbidity Index was 6 [5-7]. Heart failure (HF) with preserved ejection fraction was found in 40.6% of patients (N = 202/498). Median albumin levels were 3.2 [2.8-3.5] g/dL and hypoalbuminemia was recorded in 76.5% of patients (N = 381/498). At 12 months, 221 out of 498 patients (44.4%) died, and mortality was significantly higher in patients with hypoalbuminemia than in those without (N = 185/381 [48.6%] vs. N = 36/117 [30.8%], p < 0.001). Patients who died within 12 months were older, suffered more frequently from chronic kidney disease and active cancer, and exhibited higher C-reactive protein levels. At the multivariable analysis, hypoalbuminemia was independently associated with 12-month all-cause mortality (HR 2.41, 95% confidence interval 1.20-4.83). Hypoalbuminemia was independently associated with 12-month all-cause mortality in older patients with multiple comorbidities hospitalized for AHF in an IM division
Perceptions and attitudes toward sexual norms: key insights from the International Society of Sexual Medicine Young Researchers Committee survey
No full textBackground: Sexuality is a complex aspect of human life, and the perception of sexual normality may vary across genders, religious beliefs, and other aspects. Aim: To report preliminary findings of a pilot survey on sexual attitudes, behaviors, and individual perception of sexual normality in a contemporary cross-cultural scenario. Methods: A 48-item survey was developed by the Young Researchers Committee (YRC) on behalf of the International Society for Sexual Medicine (ISSM) to collect data on cross-cultural perceptions and attitudes toward sexual norms. The survey consisted of questions related to sexual attraction, behavior, identity, orientation, and subjective perception of sexual normality. Data were collected via five translated versions across five countries (Italy, United States, Brazil, Spain, and Japan) and analyzed to investigate how cultural norms, personal experiences, and social expectations shape individuals' views on sexual normality. Outcomes: The primary outcome was to assess gender-based differences in sexual behaviors, satisfaction, religious beliefs' impact, pornography use, and anatomical perceptions. Results: This pilot study included 3423 respondents [63.5% female, 36.2% male; median (IQR) age 39 (30.00, 50.00) years]. Of all, active sexual life was reported by 83.3% participants, with 58.8% expressing satisfaction with their sex life. Heterosexual orientation was predominant (90%), with significant differences in distribution between genders in terms of sexual orientation (P <. 001). Religious influence on sexual activity was reported by 18.6% of respondents, more commonly among females (20.2% vs 15.8%, P <. 001). Median ages of first sexual intercourse and pornography exposure were 18 (16.00, 19.00) and 14 (12.00, 16.00) years, respectively, with females reporting older ages for both experiences (P <. 001). Regarding perceptions of normality, most respondents (55.6%) believed first sexual intercourse typically occurs between 16 and 19 years. The perception of normal erect penile length differed between genders, with men more likely to report greater values (>16.1 cm: 13.1% vs 6.2%, P <. 01). Gender differences were also observed in orgasm frequency, with fewer females reporting orgasm during >80% of sexual encounters (38.2% vs 66.5%, P <. 001). Clinical Implications: Our findings shape the development of sexual education, fostering inclusivity, equity, and sexual health for overall satisfaction. Strengths and Limitations: Possible biases associated with different modalities throughout data collections and with different linguistic and cultural weights given the cross-sectional nature of the pilot survey. Conclusion: Current preliminary findings from the pilot survey developed by the ISSM YRC start shedding lights on perceptions and attitudes toward sexual norms, and gender differences in sexual behaviors and satisfaction
JN.1 variants circulating in Italy from October 2023 to April 2024: genetic diversity and immune recognition
No full textBackground: The continuous emergence of SARS-CoV-2 variants and subvariants poses significant public health challenges. The latest designated subvariant JN.1, with all its descendants, shows more than 30 mutations in the spike gene. JN.1 has raised concerns due to its genomic diversity and its potential to enhance transmissibility and immune evasion. This study aims to analyse the molecular characteristics of JN.1-related lineages (JN.1*) identified in Italy from October 2023 to April 2024 and to evaluate the neutralization activity against JN.1 of a subsample of sera from individuals vaccinated with XBB.1.5 mRNA. Methods: The genomic diversity of the spike gene of 794 JN.1* strain was evaluated and phylogenetic analysis was conducted to compare the distance to XBB.1.5. Moreover, serum neutralization assays were performed on a subsample of 19 healthcare workers (HCWs) vaccinated with the monovalent XBB.1.5 mRNA booster to assess neutralizing capacity against JN.1. Results: Sequence analysis displayed high spike variability between JN.1* and phylogenetic investigation confirmed a substantial differentiation between JN.1* and XBB.1.5 spike regions with 29 shared mutations, of which 17 were located within the RBD region. Pre-booster neutralization activity against JN.1 was observed in 42% of HCWs sera, increasing significantly post-booster, with all HCWs showing neutralization capacity three months after vaccination. A significant correlation was found between anti-trimeric Spike IgG levels and neutralizing titers against JN.1. Conclusions: The study highlights the variability of JN.1* in Italy. Results on a subsample of sera from HCWs vaccinated with XBB.1.5 mRNA booster vaccine suggested enhanced neutralization activity against JN.1
Bertrand Russell’s Commitment against Atomic Warfare
No full textBertrand Russell (chapter 1): he was an intellectual who, like very
few others in history, was able to advocate for peace, demonstrating the fallacy
of the reasons that drive men to war. From 1914 until his death in 1970,
he never stopped fighting against violence, which he viewed as both useless
and the enemy of civilization and reason (in which he placed immense hope).
Russell wrote short, incisive essays capable of convincing the common man,
intellectuals, and political leaders alike. His stance in the face of the potential
for nuclear holocaust was neither that of a politician (who calculates the
real possibilities of action) nor that of a realist political scientist (who aims
to describe the situation objectively); it was that of an engaged philosopher,
a man who uses the best ideas available to explain how to pursue good (or
avoid evil). In short, Russell’s goal was to oppose the madness of his time
with the awareness of a great intellectual and to develop a philosophy capable
of shouldering the responsibility of such a challenge
The complexity of pharmaceutical expenditures across U.S. states
No full textUnderstanding the complexity of pharmaceutical expenditures across U.S. states is critical for designing efficient healthcare policies and ensuring equitable drug access. This study applies network-based economic complexity methods to analyze state-level Medicaid drug spending, leveraging Medicaid State Drug Utilization Data (SDUD) from 2018 to 2024. Using Revealed Comparative Advantage (RCA) and the Method of Reflections, we quantify the sophistication of pharmaceutical consumption and identify structural inefficiencies in drug reimbursement policies. Our findings reveal substantial heterogeneity in pharmaceutical complexity across states, with highly diversified markets in states like California and Texas, while others, such as Wyoming and West Virginia, exhibit lower complexity due to restrictive formulary policies and healthcare infrastructure limitations. A 15% decline in network density over the study period suggests consolidation in reimbursement practices, influenced by regulatory interventions and cost-containment strategies. Additionally, Medicaid expansion states show a 20% increase in prescription utilization, particularly for antiviral and mental health medications. Null model comparisons highlight systematic deviations from expected expenditure patterns, with states like Arkansas and Nebraska showing lower-than-expected pharmaceutical embeddedness, whereas Massachusetts and California appear more integrated than network models predict. These findings suggest that state-specific policies, provider behavior, and market dynamics significantly shape pharmaceutical expenditures beyond structural network constraints, as well as they offer significant implications for policymakers and healthcare providers seeking to balance cost efficiency with equitable medication distribution