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Physical and psychological consequences for nurses affected by workplace violence: a scoping review
No full textBackground Workplace violence (WPV) represents a major threat to nurses’ health and safety, leading to significant
psychological and physical consequences. Despite widespread documentation of its prevalence, evidence on the
specific outcomes affecting registered nurses (RNs) remains fragmented and has not been systematically synthesized.
The findings of this review extend the current understanding of WPV by demonstrating its cumulative effects on
individual RNs, workplace dynamics, and the sustainability of healthcare organizations. They also reveal critical gaps
in the literature, particularly regarding longitudinal data, intervention strategies, and the evaluation of organizational
policies. These insights provide the foundation for a detailed discussion of the implications of WPV for nursing
practices, workforce stability, and health system resilience.
Aim The aim of this scoping review was to identify and map the available evidence on the psychological and
physical consequences of WPV among RNs, with particular attention to short- and long-term outcomes and
differences across clinical and cultural contexts.
Method This scoping review was conducted following the PRISMA-ScR and JBI guidelines. Studies in English,
published between January 2020 and March 2025, with quantitative, qualitative, and mixed-methods designs were
included. Searches were conducted in PubMed, CINAHL, PsycINFO, Web of Science, and Scopus, complemented
by gray literature sources (Google Scholar, ProQuest Dissertations & Theses) and stakeholder consultation. The
search strategy, developed with the support of librarians and healthcare experts, combined controlled vocabulary
and keywords and was adapted to each database via the SR Accelerator, which is based on the PCC framework
(population, concept, context). Source selection, data extraction, and data synthesis followed the JBI approach.
Results A total of 5,598 relevant articles were identified, 15 of which met the inclusion criteria. Psychological violence
was the most frequently reported form, with outcomes including anxiety, fear, posttraumatic stress, depression,
reduced resilience, and cognitive impairments. The physical consequences included sleep disturbances, chronic
fatigue, and musculoskeletal pain. Workplace violence emerged as a significant determinant of job satisfaction and
turnover intention, with lower job satisfaction mediating up to 44% of the effect of violence on nurses’ intention to
leave. Exposure to WPV also contributes to burnout, emotional exhaustion, and feelings of insecurity, highlighting gaps in organizational support and preventive strategies. Important knowledge gaps remain regarding long-term
outcomes and cross-context comparisons.
Conclusion WPV compromises not only nurses’ psychological and physical well-being but also their organizational
climate, quality of care, and patient safety. The lack of adequate postincident institutional support and the
underestimation of the problem further exacerbate its impact. Integrated strategies for prevention, monitoring, and
management are urgently required, including standardized protocols, targeted training, and accessible psychological
support systems. At the same time, further research is needed to explore long-term physical and psychological
outcomes and to evaluate the effectiveness of institutional interventions aimed at sustaining resilience and
safeguarding patient safety
Production Volumes, Localisation, and Technological Upgrading: South Africa in the Global Automotive Value Chain
No full textDespite several decades of commitment by the South African government to foster industrialisation through the automotive sector, results in terms of local supply chain development, increasing value addition in relative terms and technological spillovers in the industry and in the rest of the economy have been disappointing. This chapter illustrates the combined findings from almost 100 interviews collected between 2016 and 2022 across different segments of the automotive sector in South Africa, with specific reference to localisation of automotive manufacturing and technology adoption. Such interviews revealed that volume, understood as the number of cars produced in the country, and here specifically the production volumes per vehicle model, play a critical role for both deeper localisation and further technology adoption. In other words, further localisation and upgrading of domestic suppliers, as well as technology localisation and domestic investment in technology, are constrained by the fact that vehicle assembly volumes are not higher than 600,000 cars per year. Indeed, South Africa is a unique case both for its geographical position, far from major markets, and for the lack of a domestic/regional market that could be attractive for higher volume production. This chapter illustrates the playing field a remote country without strong regional economic dynamics and a growing domestic market like South Africa finds itself in when engaging with the automotive GVC. Ultimately, by engaging with South Africa’s auto policy decisions and development trajectory, the chapter discusses existing structural constraints and available policy options to overcome them
Il ruolo potenziale dell'IL-1β nel determinare l'infiammazione vascolare e i biomarcatori solubili dell'attività della malattia nella vasculite dei grandi vasi
No full textLa vasculite dei grandi vasi (LVV) si manifesta come infiammazione dell’aorta e dei suoi rami principali. L’arterite a cellule giganti (GCA) e l’arterite di Takayasu (TAK) sono le due forme primarie, caratterizzate da infiammazione granulomatosa delle grandi arterie. I corticosteroidi sono la principale terapia, spesso combinata con farmaci immunosoppressori. Alcuni farmaci biologici sono disponibili per pazienti che sviluppano recidiva nonostante la terapia cortisonica o hanno avuto effetti avversi. Siccome alcuni pazienti rimangono refrattari, rimane necessario individuare nuovi target terapeutici. Un'esigenza clinica nella LVV è la mancanza di un approccio standardizzato per valutare l’attività di malattia. I marcatori infiammatori convenzionali non sempre riflettono l’infiammazione vascolare e servirebbero biomarcatori specifici di malattia per distinguere fase attiva e remissione. Il primo progetto mira a: i) investigare l’espressione dei membri dell’IL-1 nella GCA e le loro associazioni con le caratteristiche cliniche dei pazienti; ii) valutare gli effetti del trattamento con IL-1β sul trascrittoma delle colture primarie di arteria temporale (TABs); iii) valutare gli effetti dell’inibizione dell’IL-1β nelle TABs infiammate in vitro. Il secondo progetto mira a identificare possibili biomarcatori solubili per monitorare l’attività di malattia. L’influenza del tipo di matrice nel rilevamento degli immuno-checkpoint solubili (sICs) è stata valutata come scopo di medicina di laboratorio.
PROGETTO 1. L’espressione dei membri dell’IL-1 è stata valutata in 38 TABs di pazienti con GCA e in TABs normali. IL-1β e IL-1RA erano presenti solo nelle TABs infiammate, mentre IL-18 era sovra-regolato nelle TABs infiammate. I livelli di espressione di queste citochine non correlavano con le caratteristiche cliniche, con la terapia cortisonica in atto alla biopsia, o la risposta alla terapia. I cambiamenti trascrittomici indotti da IL-1β sono stati investigati tramite RNAseq in colture primarie di TAB e validati tramite real-time PCR in diversi modelli cellulari (colture primarie di TAB, fibroblasti, monociti e linfociti). IL-1β up-regola la sua espressione e quella di altri geni (CCL2, CCL20, CSF3, IL-6, IL-8, IL-1RA, FGF-10, TNFα, IFNγ, IL-10, ICAM-1, VCAM-1, e SELE). L’effetto dell’inibizione dell’IL-1β è stato valutato trattando 11 TABs infiammate in vitro e valutando lo stesso pannello di geni. Il Canakinumab inibisce l’espressione dell’IL-1RA nelle TABs e riduce i livelli di IL-1β, GROα, e CCL3 nei surnatanti. Quindi, IL-1β può promuovere l’infiammazione vascolare e potrebbe essere un target terapeutico per la GCA.
PROGETTO 2. Un pannello di 50 citochine, chemochine e fattori di crescita è stato valutato in siero e in plasma di 40 pazienti con LVV. I livelli plasmatici di FGF-2, IL-8 e MIP-1α diminuivano, mentre quelli sierici di BDNF, MCP-1 e SCF aumentavano in remissione. VEGF-A e MIG diminuivano in entrambe le matrici, suggerendo il loro possibile uso come biomarcatori di attività. Inoltre, sono stati quantificati 17 sICs. I livelli di VISTA diminuivano nel plasma, mentre quelli di ICOSL aumentavano nel siero dalla fase attiva alla remissione. Per valutare l’effetto matrice, gli stessi sICs sono stati analizzati nel siero e nel plasma di 38 pazienti sani. Dodici sICs su 17 erano comparabili tra siero e plasma. CD137, CD152, CD40, CD40L e LAG3 sono stati rilevati più frequentemente nel plasma, mentre CD40L nel siero. I livelli di PD-L2 erano più alti nel siero, mentre quelli di CD27 e VISTA nel plasma. CD27, CD80, GITRL, ICOSL, TIM3 e LAG3 hanno mostrato una leggera correlazione tra la concentrazione plasmatica e quella sierica. Questi risultati sottolineano la necessità di una scelta accurata della matrice per il rilevamento dei sICsLarge vessel vasculitis (LVV) manifests as inflammation of the aorta and its major branches. Giant cell arteritis (GCA) and Takayasu arteritis (TAK) are the two major forms, both characterized by granulomatous inflammation of large arteries. Glucocorticoids are the main therapy, often combined with immunosuppressive drugs. Some biological drugs are available for patients who develop flares despite glucocorticoid therapy or have glucocorticoid-related side effects. Since a fraction of patients show a refractory disease, there is still the need to discover and validate new therapeutic targets. Another clinical need in LVV is the lack of a standardized approach for assessing disease activity. Conventional inflammatory markers do not always reflect vascular inflammation, and identifying disease-specific biomarkers is key to discriminate between active disease and remission.
The first project aimed to: i) investigate the expression of IL-1 superfamily members in GCA, and their possible association with patients’ clinical characteristics; ii) evaluate the effects of IL-1β treatment on the transcriptome of primary cultures of temporal arteries (TABs); iii) evaluate the effects of IL-1β inhibition in inflamed TABs cultured in vitro. The second project aimed to: i) identify potential soluble biomarkers for monitoring the disease activity. The influence of matrix types in soluble immune checkpoint detection has also been assessed as a laboratory medicine aim.
PROJECT 1. The expression of IL-1 members was evaluated in 38 TABs of GCA patients compared to normal TABs. IL-1β and IL-1RA were present in inflamed TABs but not in normal TABs, while IL-18 was up-regulated in inflamed TABs. The expression levels of these cytokines did not correlate with clinical characteristics, GC treatment at TABs, or therapy response. Transcriptomic changes induced by IL-1β treatment were investigated using RNAseq in a primary culture of TAB, and validated by real-time PCR in different cell models (TAB primary cultures, fibroblasts, monocytes, lymphocytes). IL-1β treatment up-regulated both its own expression and that of several genes (CCL2, CCL20, CSF3, IL-6, IL-8, IL-1RA, FGF-10, TNFα, IFNγ, IL-10, ICAM-1, VCAM-1, and SELE). Then, the effects of IL-1β inhibition were assessed in TABs by treating 11 inflamed TABs with IL-1β inhibitors in vitro, and evaluating the same panel of genes. Canakinumab down-regulated IL-1RA expression in TABs and reduced IL-1β, GROα, and CCL3 levels in supernatants. Overall, IL-1β can promote vascular inflammation and may be a therapeutic target in GCA.
PROJECT 2. A panel of 50 cytokines, chemokines, and growth factors was evaluated in serum and plasma from 40 LVV patients. Plasma FGF-2, IL-8, and MIP-1α concentrations significantly decreased, while serum BDNF, MCP-1, and SCF concentrations increased from the active phase to remission. VEGF-A and MIG decreased in both matrices, suggesting their potential use as activity biomarkers. Additionally, 17 soluble immune checkpoints (sICs) were quantified. VISTA levels decreased in plasma, whereas ICOSL levels increased in serum when patients transitioned from the active phase to remission.
Finally, to assess matrix effects, the same sICs were analyzed in serum and plasma of 38 healthy donors. Twelve out of 17 sICs showed comparable detection rates between serum and plasma. CD137, CD152, CD40, CD40L, and LAG3 were detected more frequently in plasma, while CD40L was predominant in serum. PDL-2 levels were higher in serum, while CD27 and VISTA levels were higher in plasma. Finally, CD27, CD80, GITRL, ICOSL, TIM3, and LAG3 showed a slight correlation between plasma and serum concentrations. These findings highlight the need for a careful choice of matrix for sICs detectio
Chronostratigraphical ranges of Lower Jurassic larger benthic foraminifera and lithiotid bivalves calibrated by carbon and strontium isotope stratigraphy (Southern Alps, Italy)
No full textFollowing the end-Triassic biotic crisis, the first larger benthic foraminifera (LBF) emerged in shallow-water carbonate platforms of the Early Jurassic Tethys, during the Hettangian and Sinemurian. In inner-platform settings, these LBF frequently coexisted with large aberrant bivalves of the Lithiotis Facies, characterized by thick, gregarious accumulations. This study re-assesses the biostratigraphy of LBF and lithiotid bivalve faunas in a c. 200 m-thick Pliensbachian shallow-water sedimentary succession of the Rotzo Formation in the Trento Platform (Southern Alps, Italy). By integrating carbon and strontium isotope stratigraphy, we refine the chronostratigraphical framework for key LBF taxa that are widely used in Lower Jurassic carbonate platform biostratigraphy. Strontium isotope stratigraphy reveals that Orbitopsella primaeva first occurs in the lowermost Pliensbachian Jamesoni Zone, younger than the late Sinemurian age typically cited. Similarly, the last occurrence of Orbitopsella praecursor is in the lowermost upper Pliensbachian (early Margaritatus Zone), later than the traditionally accepted uppermost lower Pliensbachian. This study also constrains the timing of the appearance, development and demise of lithiotid bivalve associations in the Trento Platform. Lithioperna first appears in the lowermost Pliensbachian Jamesoni Zone, followed by Opisoma near the boundary between the Jamesoni and Ibex zones. Higher in the succession, Lithiotis becomes prominent near the Davoei-Margaritatus zone boundary, forming thick accumulations intercalated with brachiopod-rich beds. The final phase of the Lithiotis Facies is marked by Cochlearites-Lithioperna mounds, starting from the Subnodosus Subzone of the Margaritatus Zone. The disappearance of the lithiotid bivalves coincides with the onset of relatively deeper water conditions at the Rotzo Formation-Misone Limestone boundary in the uppermost Pliensbachian Spinatum Zone
Frequency-Band Estimation of the Number of Factors
No full textWe introduce consistent estimators for the number of shocks driving large-dimensional dynamic factor models. Our estimator can be applied to single frequencies and specific frequency bands, making it suitable for disentangling shocks affecting dynamic models with a factor model representation. Noticeably, our estimator requires the time-series and cross-section size to diverge simultaneously without any constraint, and it is free of nuisance parameters, such as penalization terms. Our methodology appears ideal for macroeconomic analysis, as one can investigate how many shocks drive the business cycle or the long run, although the applicability of our methods is much wider, given the popularity of GDFMs in economics and finance. Its small-sample performance in simulations is excellent. We apply our estimator to the FRED-QD dataset, finding that the U.S. macroeconomy is driven by two shocks: an inflationary demand shock and a deflationary supply shock. Our methodology permits one to accurately estimate the number of shocks that drive medium-sized DSGE models despite their moderate cross-sectional size
On-device AI and digital twins: A synergistic approach to intelligent cyber-physical systems
No full textGenetic Diversity and Dissection of Agronomic Traits in Durum Wheat Grown Under Contrasting Environments in Algeria
No full textDurum wheat productivity in Mediterranean regions faces growing challenges from drought and heat stress. Understanding the genetic architecture of diverse germplasm is therefore essential to support pre-breeding efforts and enhance stress adaptation. In this context, 125 durum wheat genotypes were evaluated for agro-morphological traits across two contrasting Algerian locations over two growing seasons. A subset of 94 genotypes, selected on the basis of phenotypic characterization, was genotyped using the Illumina 7K SNP array. Population structure analysis revealed two to four subgroups, with linkage disequilibrium decaying at 4.09 Mb. Genome-wide association analysis identified 27 distinct significant SNPs associated with eight traits, with most associations detected for spike length, thousand-kernel weight, and plant height. The marker TGWA25K-TG0010 on chromosome 4A showed pleiotropic effects on plant height and peduncle length and co-localized with the Dwarf8 and gibberellic-acid-insensitive genes. Additionally, wsnp_Ex_c2033_3814035 on chromosome 2A was associated with heading earliness and the number of fertile spikelets per spike, and wsnp_Ku_c51039_56457361 on chromosome 5A with plant height and peduncle length in a single site and season. Several other environment-specific associations were also identified. These results support future studies in which the identified markers may be deployed in breeding strategies aimed at improving yield stability and stress adaptability in durum wheat under Algerian conditions
Algorithmic unfolding for image reconstruction and localization problems in fluorescence microscopy
No full textWe propose an unfolded accelerated projected-gradient descent procedure to estimate model and algorithmic parameters for super-resolution and molecule localization problems in image microscopy. The variational lower-level constraint enforces sparsity of the solution and encodes different noise statistics (Gaussian, Poisson), while the upper-level cost assesses optimality w.r.t. the task considered. In more detail, a standard cost is considered for image reconstruction (e.g., deconvolution/superresolution,
semi-blind deconvolution) problems, while a smoothed loss with learned binarization is employed to assess localization precision in some exemplary fluorescence microscopy problems exploiting single-molecule activation. Several numerical experiments are reported to validate the proposed approach on synthetic and realistic ISBI data