Archivio istituzionale della ricerca - Università dell'Insubria
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Crystal fabrication techniques for enhanced performance in planar channeling
No full textBent crystals have emerged as innovative tools for manipulating high-energy particle beams, offering unparalleled precision in beam steering for accelerator physics. However, the practical application of these devices is hindered by nuclear dechanneling, limiting channeling efficiency to approximately 80%. The GALORE project addresses this limitation by introducing a novel bent crystal design featuring a microtrench structure. Acting as a crystalline lens, the microtrench minimizes nuclear interactions, thereby significantly enhancing channeling efficiency. This paper details the fabrication process for these advanced bent crystals, utilizing high-purity silicon wafers and state-of-the-art micromachining techniques. A silicon nitride thin film induces controlled curvature, while Deep Reactive Ion Etching (DRIE) is employed to create the microtrench with sub-micron precision. Characterization studies confirm the structural integrity and channeling potential of the microstructures. These results represent a significant milestone in the development of bent crystals capable of achieving near-ideal channeling efficiency—a breakthrough in crystal-assisted particle beam technology. This advancement holds the potential to revolutionize collimation systems, enhance fixed-target experiments, and shape the design of next-generation accelerators
Long-Term Effectiveness of Bimekizumab in Plaque Psoriasis: Two-Year Drug Survival from a Real-Life Multicenter Italian Study
No full textBackground: Bimekizumab, a monoclonal antibody targeting both IL-17A and IL-17F, has shown strong efficacy in moderate-to-severe plaque psoriasis. However, long-term real-world data on its effectiveness and treatment persistence remain limited. Objective: Evaluate the 2-year drug survival of bimekizumab in a real-life setting across multiple Italian dermatology centers. Methods: This multicenter, retrospective, observational study included adult patients with moderate-to-severe plaque psoriasis who initiated bimekizumab between May 2022 and November 2024. Drug survival was assessed using Kaplan-Meier analysis. Univariable and multivariable Cox regression models were used to identify predictors of treatment persistence. Results: Eight hundred twenty-six patients were included (66.6% male; mean age 52.3 ± 14.9 years). At baseline, the mean PASI score was 15.5 ± 8.9, which decreased to 1.4 ± 3.3 at the last follow-up. Estimated drug survival rates at 12, 18, and 24 months were 89.1%, 85.0%, and 82.4%, respectively. One hundred twenty-nine patients discontinued treatment, primarily due to adverse events (n=68) and ineffectiveness (n=31). In both univariable and multivariable analyses, male sex was significantly associated with a lower risk of discontinuation (HR 0.65, p = 0.002; HR 0.67, p = 0.008, respectively). Other factors, including BMI >30 kg/m2, presence of psoriatic arthritis, baseline PASI >15, and prior biologic exposure, were not significantly associated with treatment discontinuation. Conclusion: This real-world study demonstrates a long-term effectiveness and high drug survival of bimekizumab up to 24 months, across diverse patient profiles, regardless of BMI, disease severity, prior biologic exposure, or presence of psoriatic arthritis
Prospect of kitchen wastes for biomaterials and biogas production in a biorefinery approach
Full text linkA biorefinery approach to obtain biodegradable biomaterials from hospital kitchen wastes (HKW) was proposed before the anaerobic biogas production. Two mixtures corresponding to mixed pre and postconsumption HKW from different diets were used. The lunch+snack (L + S) mixture was rich in proteins (49.8 +/- 2.1 %) whereas that from dinner+breakfast (D + B) was rich in carbohydrates (60.3 +/- 1.9 %). A two-stage hydrothermal processing was proposed for solubilizing first starch (yield 9.8 +/- 0.5 %) and then protein. The recovered starch mixed with the waste solids from the hydrothermal processing and glycerol (mass ratio 8:20:2.5) were used to prepare gelled biomaterials stable for 3 months without microbial contamination. The soluble protein fraction, containing structural and muscle proteins with high nutritional value, was successfully proposed as biostimulant for sunflower. The waste solids exhibited biomethane potential (283.86 +/- 45.02 and 279.34 +/- 50.94 mL CH4/g VS for D + B and L + S) non significantly different from that of the untreated HKW (244.48 and 295.78 mL CH4/g VS for R_D + B and R_L + S). The proposed processing allows the product diversification during the valorization of a model kitchen waste into biomaterials, plant growth stimulants and bioenergy
Minimally invasive surgical treatment of recurrent endometrial carcinoma: A systematic review
No full textBackground: While the role minimally invasive surgery (MIS) is established for primary endometrial carcinoma (EC), its feasibility in recurrent cases remains underexplored. Objective: To systematically review the literature about MIS for EC recurrence. Search Strategy: A systematic literature search was conducted across six electronic databases, targeting studies published until October 31, 2024. Selection Criteria: Inclusion criteria encompassed all peer-reviewed studies reporting MIS for recurrent EC. Data Collection and Analysis: Data extraction focused on surgical outcomes and survival metrics, following PRISMA guidelines. Main Results: Out of 9652 results, 15 studies with 17 cases of patients with EC recurrence met the inclusion criteria. All patients underwent successful MIS, with no intraoperative complications reported. Complete resection (when reported) was achieved in 100% of cases, and adjuvant treatment was administered in 64.7% of patients. The mean follow-up duration was 23.6 months, with a disease-free survival rate of 63.6%. Risk of bias assessment indicated a predominance of low to medium risk of bias within studies. Conclusion: MIS might be feasible and safe in cases of abdominal recurrence of EC when the number of recurrence localizations is less than three. MIS might be a management option independently from EC histology, grade and stage (except for stage IV), previous adjuvant therapy and group of risk. The endoscopic approach could be both laparoscopic and robotic, without any apparent difference in terms of feasibility, safety and survival outcomes. However, data on this topic are limited and our findings need to be confirmed by additional studies
The Concept of Green Management for Improving the Environmental Performance of Traditional Energy Facilities.
No full textImproving the efficiency of environmental protection activities at traditional energy facilities is one of the key directions of eco-modernization of the industry in the next decade. The introduction of the best available environmental technologies, in addition to the need to comply with the SDGs, the transition to a circular economy and the general tightening of environmental policy with the slow renewal of outdated energy infrastructure poses new management challenges that hinder the improvement of environmental performance in the energy industry. It is necessary to improve current approaches to managing traditional energy facilities, develop new management concepts and introduce new tools for organizing internal business processes. Modern management should be aimed not only at achieving certain socio-economic results, but also at greening current activities. The purpose this study is to develop a concept of green management for traditional energy facilities. A list of criteria has been formed and a concept of green management with appropriate management tools has been proposed
Hyaluronic acid and chondroitin sulphate instillation in chronic bladder diseases: a meta-analysis
No full textObjective: To systematically summarise and meta-analyse all uncontrolled and controlled studies evaluating the role of intravesical instillation of hyaluronic acid (HA), with or without chondroitin sulphate (ChS), in the treatment of bladder pain syndrome (BPS), recurrent urinary tract infection (rUTI) and post-radiation cystitis (pRC). Methods: A systematic review was conducted, and a protocol was registered with PROSPERO (CRD42025640480). Studies published between 1 January 1969 and 31 August 2024 were retrieved from multiple databases. Data were analysed using random-effects and common-effects models with subgroup and sensitivity analyses. Results: A total of 131 studies were retrieved, of which 30, 10 and three investigated the use of HA/ChS in patients with BPS and rUTI or pRC, respectively, and were included in the analyses. Conclusion: The use of HA/ChS resulted in a significant improvement in pain as well as voiding and irritative symptoms in all the investigated conditions. In addition, the treatment reduced the risk of rUTI when compared to standard care. Although limited data were available, when randomised controlled trials were investigated, the combined use of HA/ChS resulted in better outcomes and a lower infection rate compared to either placebo or standard of care (odds ratio 0.42 [95% CI 0.25; 0.49]; P < 0.0001). Finally, an improvement in sexual function and quality of life was also observed
Surgical timing in advanced ovarian cancer during the TRUST trial era: A systematic review, meta-analysis and study-level meta-regression of randomized controlled trials
No full textThe best surgical timing for advanced epithelial ovarian cancer, whether primary debulking surgery or interval debulking surgery, remains debated. Recent data, including the preliminary ones from TRUST trial, necessitates an updated critical evaluation. A systematic search of PubMed identified only randomized controlled trials comparing interval debulking surgery versus primary debulking surgery in patients with newly diagnosed advanced ovarian cancer. Primary outcomes included overall survival (OS) and progression-free survival (PFS). A random-effects meta-analysis, meta-regression, cumulative synthesis, and leave-one-out influence analysis were performed. A total of 2303 patients were included. Compared to primary debulking surgery, interval debulking surgery was associated with lower rates of postoperative complications (OR = 0.37; 95 % CI: 0.18-0.79; P = 0.01) and mortality (OR = 0.23; 95 % CI: 0.09-0.57; P = 0.002). Meta-analysis showed higher rates of complete cytoreduction with interval debulking surgery (OR = 3.84; 95 % CI: 2.14-6.91; P < 0.00001) and lower rates of macroscopic residual disease (OR = 0.20; 95 % CI: 0.13-0.30; P < 0.00001). Pooled data revealed no significant difference in OS (HR = 0.95; 95 % CI: 0.87-1.04; P = 0.26) or PFS (HR = 0.94; 95 % CI: 0.85-1.03; P = 0.16). Subgroup analyses by stage and residual disease confirmed similar survival outcomes. The meta-regression results suggested that even in trials with very high complete cytoreduction rates, no clinically meaningful OS benefit was observed for upfront surgery. In conclusion, interval debulking surgery offers comparable survival outcomes to primary debulking, with reduced perioperative morbidity and mortality, supporting its role as a valid surgical alternative. PROSPERO REGISTRATION NUMBER: CRD420251105308
Ultrasonography for the positioning of esophageal multichannel intraluminal impedance/pH-metry catheter in newborns
No full textObjectives: To assess the use of ultrasound (US) to visualize and determine the correct position of a multichannel intraluminal impedance-pH probe (MII-pH). Methods: This is a monocenter study recruiting newborns who underwent MII-pH for suspicious of gastroesopahegal reflux (GER). Catheter position was based on US and was confirmed by X-ray. Moreover, the depth of the probe was compared with those calculated with several mathematical formula used for pH impedance. The US was performed using (US) system Alpinion-eCube-i7® in B-mode with linear and convex probe. US was used to evaluate the correct positioning of the MII-pH catheter before the beginning and during the MII-pH execution to evaluate any changes of the position. The results were also compared with retrospective cases collected in our center in previous years. Results: Thirty-six newborns were included. US allowed to visualize the esophageal probe in all the newborn tested. US-based positioning was correct in 100% of patients considering an error acceptance of 1 cm, and 66.7% with an error acceptance of 0.5 cm, compared to X-ray. The median duration of the US was 3.2 min (range 2.5–5.78 min), with prolonged time in crying babies. Previous cohort consisted of 35 newborns who underwent MII-pH: one patient had the probe in the respiratory tract and six patients needed new positioning of the MII-pH probe and second X-ray control because of bad positioning or accidental removal of the probe. Conclusions: US seems to be a valid alternative for the assessment of the MII-pH probe position and the identification of the pH sensor and the lower esophageal sphincter in real time. However, US expertise is needed to provide accurate results
