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La Bodleian Library di Oxford. I fondi scientifici di una biblioteca inglese di età moderna
No full textIl saggio tratteggia in maniera ampia ed estesa storia e sviluppo del sapere bibliotecario e tecnico-scientifico ad Oxford dal tardo Medioevo sino al primo Ottocento, usando metodi e strumenti della storia culturale
Questo matrimonio s’ha da (ri)fare. Etica ed economia come discipline di soglia
No full textThe idea that economics as a discipline dealing with a certain type of behaviour and relations was closely linked to ethics characterized the ancient and medieval paradigms. Modernity has separated them for epistemological reasons: the descriptive and a-valutative character of economics, the prescriptive character of ethics, the fact/value dichotomy, the anthropology of homo oeconomicus and an idea of quantitative growth. The crisis we are experiencing brings out the need for a new paradigm in which ethics and economics return to coexist for the affirmation of a new growth model centred on the quality of life and on an ecologically sustainable relationship with other living beings and the planet. Companies by developing the purpose economy can be a privileged place for a new fruitful coexistence between ethics and economics
An FMEA Assessment of an HTR-Based Hydrogen Production Plant
No full textThe topic of hydrogen as an energy vector is widely discussed in the present literature, being one of the crucial technologies aimed at human carbon footprint reduction. There are different hydrogen production methods. In particular, this paper focuses on Steam Methane Reforming (SMR), which requires a source of high-temperature heat (around 900 °C) to trigger the chemical reaction between steam and CH4. This paper examines a plant in which the reforming heat is supplied through a helium-cooled high-temperature nuclear reactor (HTR). After a review of the recent literature, this paper provides a description of the plant and its main components, with a central focus on the safety and reliability features of the combined nuclear and chemical system. The main aspect emphasized in this paper is the assessment of the hydrogen production reliability, carried out through Failure Modes and Effects Analysis (FMEA) with the aid of simulation software able to determine the quantity and origin of plant stops based on its operational tree. The analysis covers a time span of 20 years, and the results provide a breakdown of all the failures that occurred, together with proposals aimed at improving reliability
Artificial intelligence in gastroenterology: Ethical and diagnostic challenges in clinical practice
No full textThis article discusses the manuscript recently published in the World Journal of Gastroenterology, which explores the application of deep learning models in decision-making processes via wireless capsule endoscopy. Integrating artificial intelligence (AI) into gastrointestinal disease diagnosis represents a transformative step toward precision medicine, enhancing real-time accuracy in detecting multi-category lesions at earlier stages, including small bowel lesions and precancerous polyps, ultimately improving patient outcomes. However, the use of AI in clinical settings raises ethical considerations that extend beyond technological potential. Issues of patient privacy, data security, and potential diagnostic biases require careful attention. AI models must prioritize diverse and representative datasets to mitigate inequities and ensure diagnostic accuracy across populations. Furthermore, balancing AI with clinical expertise is crucial, positioning AI as a supportive tool rather than a replacement for physician judgment. Addressing these ethical challenges will support the responsible deployment of AI, through equitable contribution to patient-centered care
The Genoa Vascular Biobank: A Today Resource for Future Perspectives in Vascular Research
No full textBackground: Biological knowledge and patient care have been significantly improved by the emergence of big data analysis and -omics sciences, requiring high quality standards for biospecimen and data collection. Biobanks are complex and dynamic units designated to fulfill these needs. Objectives: The Genoa Vascular Biobank (GTB-VD) is a collaborative network between the IRCCS Ospedale Policlinico San Martino (Centre of Biological Resources), and the University of Genoa (Vascular and Endovascular Surgery Unit; Anatomic Pathology Unit; Laboratory of Clinical and Experimental Vascular Biology). This work describes workflow, ethic and governance requirements, demographic and clinical characteristics of subjects enrolled in the GTB-VD, and the volume of open or endovascular surgical interventions. Design: The GTB-VD recruits patients undergoing surgical repair for carotid artery stenosis (CS) and abdominal aortic aneurysm (AAA), enrolled on the basis of selection criteria and subdivided for pathology and type of intervention, upon informed consent. Methods: Biospecimens comprise serum, plasma, whole blood, peripheral blood mononuclear cells, and urine (from AAA only), stored at -80°C; lesions from open surgeries are frozen and formalin fixed paraffin embedded. Samples are associated with donor's clinical data through pseudonymization to prevent patient identification. Data accuracy and sample quality are ensured by harmonized standard operative procedures. Results: From 2018 to the end of 2023, 442 CS (distinguished into severe-asymptomatic or symptomatic, displaying a ratio of 5:1) and 214 AAA have been collected. CS is more frequently associated with diabetes and peripheral artery diseases, AAA with pulmonary history, and renal function impairment. Open surgery is more used for CS and endovascular for AAA. Conclusion: The GTB-VD, as organized, represents an "unicum" in our Country; it supports studies to identify molecular targets and biomarkers associated with specific arteriopathy, for developing secondary prevention strategies and minimally invasive, in situ therapies. Collaborative studies and sample sharing are welcome
Intercultural Medicine and Ethics of care: an Operational Proposal to Combat Social and Health Inequalities
No full textThe immigration policies adopted by European states are required to recognise migration processes as a structural phenomenon and, in the health sphere, to implement inclusive
interventions capable of promoting integration and well-being for all people living in and/or transiting through Europe. At the national level, despite the forward-thinking measures put in place by the legislator and the establishment of the National Health Service, access to the right to health still seems far from fully inclusive for the more vulnerable segments of the population, particularly people from foreign countries. This article intends to propose an innovative model for ethics of care aimed at the implementation and optimisation of healthcare practices towards migrants living in our country, whether temporarily or more permanently
Comparison of Serenoa repens, lycopene, and selenium versus dutasteride for the treatment of LUTS/BPH: an Italian multicenter case-control prospective study (COMP study)
No full textIntroduction: Historically, medical therapy of BPH has had its foundations in alpha-blockers in monotherapy or in combination with 5 alpha reductase inhibitors (5-ARIs); in particular, two important trials (COMBAT and MTOPS) have demonstrated the pivotal role of combination therapy instead of monotherapy and have individuated which patients are most likely to benefit from alpha-blockers, 5-ARIs, or their combination. However different side effects of these drugs, such erectile dysfunction, ejaculatory disorders, loss of libido, could affect the adherence to treatment. In fact, SeR-Se-Ly would work by blocking 5-alpha reductase and the binding between the dihydrotestosterone and the androgen receptor, antagonizing the a1-adrenergic receptor, and preventing cell proliferation and the production of COX-2 and 5-leukotrienes. Prior randomized controlled trials confirmed the use of alpha-blockers in conjunction with Lipidic Extract (LE) of Serenoa Repens (SeR), specifically compounds containing both Selenium (Se) and Lycopene (Ly). Based on these premises, the aim of this Italian multicenter case-control prospective non-randomized study is to compare the therapy with SeR-Se-Ly alone versus Dutasteride alone against BPH, in order to research a good therapeutic alternative with limited side effects. Materials and methods: From April 2021 to April 2022, 269 consecutive patients from 21 Italian centers were enrolled in this case-control study. The inclusion criteria were: age between 55 and 80 years old, digital rectal examination negative for prostate nodules, PSA<<4 ng/ml, IPSS<>12, prostate volume >40 cc (assessed by ultrasound), Qmax <<15 ml/sec. Patients with prostate cancer, prior bladder cancer, diabetes mellitus, neurogenic disorders, severe liver disease, history of orthostatic hypotension or syncope, recent a-blocker treatment (within 1 month) or phytotherapy, including saw palmetto extract (within 3 months), prior medical therapy with 5-ARI or surgical treatment for LUTS/BPH, patients with catheter or QoL, Qmax measured at an episode of acute urine retention within the last 4 weeks, and patients with any ejaculatory disorders were excluded. During treatment period, patients received SeR-Se-Ly for one year (Group A), or Dutasteride 0.5mg for one year (Group B). The main outcome measures included International Prostatic Symptoms Score (IPSS) and IPSS quality-of -life (QoL), International Index of Erectile Function (IIEF-5), Qmax measured at uroflowmetry and the Male Sexual Health Questionnaire (MSHQ). Results: We have observed increasing of Qmax of 2 points in group A and 2,5 points group B; IPSS has been reduced of 4 points in group A and 4,5 points in group B; IIEF-5 didn’t change in group A and it has been reduced in group B by -1; regarding the MSHQ, only the item MSHQ-Satisfaction has changed in group A: -1, in group B MSHQ was reduced by -2 points in ED, by -5 points in EJ, by -2,5 points in Satisfaction, by -0,5 points in Intercourse, by -3,2 points in Desire. Conclusions: SeR-Se-Ly could be a valid alternative to dutasteride, providing comparable effects on symptoms related to LUTS/BPH and avoiding sexual dysfunctions. SeR-Se-Ly should not be substituted for dutasteride in those patients for whom prostate volume reduction is desired