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Isernia La Pineta
No full textIsernia La Pineta è uno dei principali siti del Paleolitico inferiore europeo, datato a circa 600.000 anni fa. Il giacimento ha restituito abbondanti industrie litiche su scheggia e un ricco assemblaggio faunistico attribuibili a fasi di occupazione ripetute. Le evidenze indicano attività di macellazione e sfruttamento delle risorse animali in un contesto ambientale fluvio-lacustre, offrendo dati chiave sulle strategie tecnologiche e comportamentali degli ominini nel Pleistocene medio
Targeted Treatment in Asthma-Opportunities and Challenges
No full textThis review summarizes the key insights and future directions on targeted asthma treatment discussed during the 2025 Expert Meeting supported by the Central and Southern European Allergy and Asthma Alliance (CSEA3). Targeted treatment in asthma is becoming an attainable goal for selected patients but is not yet established as a standard asthma care pathway. The expert panel identified 4 key priorities to advance targeted asthma management: (1) Defining remission-a universally accepted, evidence-based definition is needed to guide clinical practice and guideline development. (2) The management of mild asthma guided by patient stratification according to asthma pathogenetic pathways (endotype) and risk profile may enable more tailored therapy and better outcomes. (3) Biomarker discovery and validation-research must prioritize predictive biomarkers that are easy to measure at the point of care, supported by innovative trials that combine precision immunology and machine learning. (4) Optimizing implementation and addressing the barriers to adopting stratified care, including limited resources and cost-effectiveness concerns, must be addressed. Digital tools offer promise but require further validation. Coordinated efforts are essential to translate advances in personalized asthma treatment into better outcomes and more sustainable care, particularly in resource-limited settings
Public Space and Urban Identity. Tracing the Shifts of Epidamn Boulevard, Durrës
No full textThis research aims to investigate the transformation of one of the main axes of public, social, and cultural interactions in Durrës, the “Epidamn” Boulevard. Since its inception as a
boulevard, it has undergone a series of functional and symbolic changes, influencing not only the urban shape but also the social life of its inhabitants. These changes were mainly dictated by political approaches, which were reflected directly in the public space. Through these morphological and comparative analyses of the boulevards across historical periods, this study identifies how public spaces are shaped and oriented by the relationships between built structures and public space. At the centre of this study is the evaluation of how urban and architectural interventions have influenced the shape and morphological aspects of public space.
The findings suggest that “Epidamn” Boulevard serves as a pure reflection of the dynamic urban development of Durres, while also serving as a case study to better understand the
relation between the urban form, local identity, and influence from political jurisdictions. By looking at how both form and function have changed, this research underlines not only the
sustainability but also the fragility of urban public spaces as they evolve. In addition to these contextual observations, the study draws on existing literature about public space and urban form – most notably Kevin Lynch’s ideas on the image of the city, along with other works that examine boulevards and similar urban environments. Building on these theoretical
perspectives, the focus here is to situate Durrës within a wider debate on urban form and spatial change, while stressing the importance of keeping the identity of Mediterranean cities
intact in the face of fast urban growth and fragmented planning. By analyzing changes in form and function, this research highlights the sustainability and vulnerability of urban public spaces through their transformations.
Besides these contextual analyses, this study also relies on literature about public spaces and urban form, including Kevin Lynch’s theories on the image of the city and other research that had in focus the same topic as boulevards and public spaces. While grounded in these theoretical frameworks, this study aims to place Durrës within a broader discussion on urban form and spatial transformation, focusing on maintaining the identity of Mediterranean cities facing rapid urban growth and fragmented interventions.
In conclusion, the research proposes a regenerative approach that balances the preservation of historical and cultural values with the improvement of public access and reorganization of
public space as a vital key component in civic life
Nanoparticle approaches for hepatitis therapy and clinical translation
No full textBackground: Hepatitis B and C viruses (HBV and HCV) remain major global health challenges, contributing significantly to liver-related morbidity and mortality worldwide. Although direct-acting antivirals (DAAs) have improved patient outcomes, key limitations persist, including suboptimal hepatic targeting, emerging drug resistance, incomplete viral eradication, and systemic side effects. Area covered: Nanotechnology offers a promising avenue for enhancing and personalizing antiviral treatments. This review explores recent advances in nanoparticle (NP)-based strategies for HBV and HCV therapy, focusing on design principles, delivery platforms, and translational applications. Lipid-based, polymeric, metallic/inorganic, and biomimetic nanocarriers are examined for drug delivery, gene editing, and vaccine development. Targeted strategies-such as galactose-mediated hepatic uptake and pH-responsive release-demonstrate the potential to improve drug localization and reduce off-target toxicity. Preclinical studies, including siRNA-loaded lipid nanoparticles, have shown significant antiviral effects in animal models. In addition, emerging AI-driven frameworks for nanoparticle design and prediction are highlighted as tools that may accelerate optimization and therapeutic personalization. Despite these advances, translation into clinical practice remains limited due to challenges such as immunogenicity, systemic instability, manufacturing scalability, and regulatory complexity. Expert opinion: To facilitate clinical translation, a clear developmental roadmap is needed that emphasizes interdisciplinary collaboration, standardized safety evaluations, and patient-centered treatment strategies. Continued innovation-including integration of nanotechnology with artificial intelligence, gene-editing approaches, and immunomodulatory platforms-holds strong potential to transform HBV and HCV management and enable safer, more effective therapeutic options beyond current antiviral approaches
Response to the letter of Tekiner and Kelestimur
No full textDear Editor,
We appreciate the interest of Tekiner and Kelestimur in
our review article [1]. Their letter raises several important
endocrinological and clinical points, which we welcome as
complementary to our primarily evolutionary and anthropological
focus. However, we feel that certain aspects of their
comment require clarification to avoid a partial or misleading
interpretation of our work
Discussion over debate. Scenari storici, teorici e operativi nell'Educazione degli adulti
No full textScopo del saggio è quello di dimostrare come la discussione, quale metodologia didattica, possa rivelarsi determinante nello sviluppo del pensiero critico-riflessivo e di come sia essa da prediligere rispetto al debate. Verranno presentate alcune riflessioni teoriche ed esperienze paradigmatiche di inizio Novecento nel campo dell’Educazione degli adulti. Sarà poi analizzata la peculiarità della discussione nel contribuire alla massimizzazione dell’engagement all’interno dei contesti d’aula. Verrà dunque rilevata la correlazione tra la pratica della discussione e lo sviluppo del pensiero critico-riflessivo nel novero dei programmi di istruzione degli adulti. Infine, si vedrà come la rinegoziazione di punti di vista sul mondo e l’integrazione di nuove conoscenze possano giocare un ruolo centrale nella formazione degli insegnanti e dei professionisti dell’educazione
Cost-effectiveness of as-needed budesonide-formoterol in adults with mild asthma: the Novel START trial
No full textBackground: The Global Initiative for Asthma recommends as-needed combination inhaled corticosteroid-formoterol reliever for mild asthma. Its cost-effectiveness is uncertain outside double-blind regulatory trials. The study objectives were to assess the cost-effectiveness of as-needed budesonide-formoterol versus maintenance budesonide plus as-needed salbutamol, and versus as-needed salbutamol, in averting exacerbations in adults with mild asthma during 12-month follow-up of the New Zealand participants (n=551) of the open-label Novel START multicountry clinical trial.
Methods: New Zealand health-system and societal perspectives were adopted using 2025 resource costs. Healthcare utilisation comprised electronically monitored inhaler use (with multiple imputation for missing data), asthma-related pharmaceuticals, primary-care visits, emergency-department visits and hospitalisations. Regression methods were used for cost-effectiveness analysis. Scenarios included generic substitution and prescription-charge exemption.
Results: As-needed budesonide-formoterol, compared with maintenance budesonide plus as-needed salbutamol, is more effective at reducing severe exacerbations and provides an annual health-system cost saving of NZD 12 (95% CI 0-28) per patient, increasing to NZD 22 (95% CI -15-58) if a societal perspective is adopted. Compared with as-needed salbutamol alone, as-needed budesonide-formoterol costs the health system NZD 38 and NZD 111, respectively, to prevent an exacerbation and a severe exacerbation. From a societal perspective it is cost-saving NZD 70 (95% CI 2-134). Findings were robust to scenario analyses.
Conclusion: For patients with mild asthma, as-needed budesonide-formoterol 200/6 μg is cost-saving from health-system, patient and societal perspectives, while improving outcomes, dominating maintenance budesonide plus as-needed salbutamol. Compared with as-needed salbutamol, as-needed budesonide-formoterol is cost-effective from a health-system perspective and dominates from a societal perspective
Borghi storici e villaggi operai: storie parallele di abbandono e opportunità di rigenerazione
No full textThe Italian territory can be interpreted as a complex palimpsest of historical and social stratifications, where rural and industrial settlements have shaped landscapes, identities, and community networks. Within this framework, the contribution proposes a comparative analysis between the historic village of Campolo and the workers’ village of Ca’ di Landino, both located in the Bolognese Apennines in Emilia-Romagna. Although different in origin and function, both now share conditions of depopulation, decay, and marginality, outcomes of historical processes, ruralization and industrialization, that have produced fragile landscapes and incomplete infrastructures. The study compares urban structure, relationship with the territory, original functions, and infrastructures, highlighting significant analogies and differences. The historical evolution of these territories suggests replicable trajectories to foster resilience and new opportunities in small Apennine settlements. Urban and territorial regeneration emerges as a key strategy to enhance local communities, historical memory, and environmental resources, combining cultural, social, and economic interventions through a sustainable approach
Effects of intraoperative higher versus lower positive end-expiratory pressure during one-lung ventilation for thoracic surgery on postoperative pulmonary complications (PROTHOR): a multicentre, international, randomised, controlled, phase 3 trial
No full textBackground: The effect of higher positive end-expiratory pressure (PEEP) and recruitment manoeuvres aimed at lung expansion as compared with lower PEEP without recruitment manoeuvres aimed at permissive atelectasis on postoperative pulmonary complications (PPCs) in patients undergoing one-lung ventilation (OLV) during thoracic surgery is unclear. We aimed to determine the contribution of an intraoperative lung expansion strategy to preventing PPCs.
Methods: In this multicentre, randomised, controlled, international phase 3 trial (PROTHOR) conducted at 74 sites in 28 countries, we enrolled adult patients (aged ≥18 years) with a BMI of less than 35 kg/m2 who were scheduled for open thoracic or video-assisted thoracoscopic surgery under general anaesthesia requiring one-lung ventilation with a double-lumen tube, with a planned operative time of more than 60 min, and an expected duration of one-lung ventilation longer than that of two-lung ventilation. Patients were randomly assigned (1:1), using permuted blocks of random size (4, 6, and 8) and stratified by study site, to receive one-lung ventilation with either a higher PEEP of 10 cm H2O and periodic lung recruitment manoeuvres (high PEEP group) or a lower PEEP of 5 cm H2O without routine recruitment manoeuvres (low PEEP group). All patients received protective tidal volumes of 5 mL/kg predicted body weight during one-lung ventilation and 7 mL/kg predicted body weight during two-lung ventilation. Postoperative assessors were masked to treatment allocation. The primary outcome was a composite of PPCs during the first 5 postoperative days, including aspiration pneumonia, moderate or severe respiratory failure, acute respiratory distress syndrome (ARDS), pulmonary infection, atelectasis, cardiopulmonary oedema, pleural effusion, non-operative pneumothorax, pulmonary infiltrates, prolonged air leak, purulent pleuritis, pulmonary embolism, and pulmonary haemorrhage. A modified intention-to-treat analysis was performed, with patients analysed according to their assigned treatment group, except in cases of withdrawal of informed consent, cancellation of surgery, and or loss to follow-up. This trial is registered with ClinicalTrials.gov (NCT02963025) and is completed.
Findings: Between Jan 3, 2017, and Feb 12, 2024, 2200 patients were randomly allocated: 1099 to the high PEEP group and 1101 to the low PEEP group. 43 patients in the high PEEP group and 33 in the low PEEP group were excluded from the modified intention-to-treat analysis after randomisation. The primary outcome occurred in 555 (53·6%) of 1036 patients in the high PEEP group and 592 (56·4%) of 1049 patients in the low PEEP group (absolute risk difference -2·68 percentage points [95% CI -6·36 to 1·01]; p=0·155). Intraoperative complications occurred in 484 (49·8%) of 972 patients in the high PEEP group and in 305 (31·3%) of 974 patients in the low PEEP group (absolute risk difference 18·09 percentage points [95% CI 14·41-21·77]), among which hypotension (360 [37·3%] of 966 patients in the high PEEP group vs 140 [14·3%] of 978 in the low PEEP group) and new arrhythmias (89 [9·9%] of 899 vs 37 [3·9%] of 956) were more frequent in the high PEEP group, while hypoxaemia rescue manoeuvres were more frequent in the low PEEP group (29 [3·3%] of 888 vs 86 [8·8%] of 982). The proportions of patients with extrapulmonary postoperative complications (110 [10·6%] of 1036 vs 107 [10·2%] of 1049 patients), and the numbers of adverse events (209 vs 204 events), did not differ between groups.
Interpretation: In patients with a BMI of less than 35 kg/m2 undergoing thoracic surgery, one-lung ventilation using higher PEEP with recruitment manoeuvres, compared with lower PEEP without recruitment manoeuvres, did not reduce PPCs. The choice for intraoperative lung expansion or permissive atelectasis should take the individual gas-exchange and haemodynamic conditions into account, which might vary during the intraoperative period
The Ep−Liso correlation: A new diagnostic tool for kilonova transients
No full textThe AT2017gfo kilonova transient remains a unique multi-messenger event thanks to its proximity (z = 0.00987) and the possibility to investigate time-resolved spectra, thus providing evidence of r-process nucleosynthesis. The kilonova signal was extensively studied in the spectral and time domains, providing key insights into the chemical composition and physical properties of the ejecta. Here, we report the discovery of a novel correlation between two fundamental observables: the peak energy of the E FE spectrum, Ep , and the isotropic-equivalent luminosity, Liso . In particular, we show that up to about 2.5 days after the merger, the AT2017gfo spectrum evolves according to: log10 [Ep ∕eV] = −0.13+0.02 + 0.62+0.02 log10 [Liso ∕(1041 erg s−1 )] (68 % C.L.) while in the sub-sequent epochs, Ep remains almost constant with Liso , flattening around 1 eV. Exploiting simulations from a state-of-the-art radiative transfer code, we demonstrate that our kilonova model inherently predicts this peculiar correlation, hence suggesting a new diagnostic tool for comparing observables against simulations. Future kilonova observations will provide additional insight into the physics behind the Ep − Liso correlation