University of Modena and Reggio Emilia
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Untargeted Metabolomic Analysis of Cell-Free Supernatants (CFSs) from Different Clinical Isolates of Saccharomyces cerevisiae and Their Effects on Candida albicans Virulence
No full textForensic imaging in mass disasters: results of the use of post-mortem computed tomography in earthquake victims
No full textThe use of Post-Mortem Computed Tomography (PMCT) has been proposed to investigate victims of mass fatalities. This study presents forensic investigations conducted on victims of a mass disaster. In May 2012, an earthquake occurred in the province of Modena (Italy). On that occasion, 12 workers died and were found lifeless under the rubble of the industries in which they worked. All corpses were identified at the scene of the natural accident. The Prosecutor asked the forensic pathologist to perform only an external examination to identify the cause and manner of death. The forensic pathologist obtained permission to also perform PMCT to produce additional medico-legal evidence. The Prosecutor would request a judicial autopsy if the previous investigations had proved insufficient to define the cause and manner of death. External examination revealed the presence of bone fractures, enabling localization of the injuries by anatomical region (skull, thorax, pelvis, upper extremities, lower extremities). PMCT was beneficial in identifying the exact nature and extent of skeletal injuries and direct (e.g., shattered organ) and indirect (e.g., hemoperitoneum without obvious organ laceration) evidence of organ injury. In two cases, PMCT findings were essential to perfecting the diagnosis of the cause of death. Our experience supports the view that, in cases of major natural disasters, cause and manner of death may be determined with a reasonable degree of medical certainty thanks to circumstantial elements, external examination, and PMCT findings
Theoretically redesigning peritoneal dialysis products for sustainability: A life cycle inventory approach
No full text: Peritoneal dialysis (PD) is a life-sustaining treatment for end-stage kidney disease but contributes significantly to environmental degradation due to its reliance on single-use plastics, energy-intensive manufacturing and high-volume transport. Redesigning PD products for sustainability is increasingly important as healthcare systems seek to reduce their carbon footprint. In this study, ten high-use peritoneal dialysis (PD) products were redesigned using life cycle thinking. Interventions included low-carbon transport (electric vans), renewable energy and improved waste treatment (pyrolysis). Life cycle inventories (LCIs) were modelled in Open Life Cycle Assessment (OpenLCA)and modelled using cradle-to-gate carbon footprints (kg CO2-eq) to compare redesigned and conventional versions. All redesigned products achieved carbon footprint reductions, with eight showing decreases greater than 40%. The automated PD set and 2 L dialysate bag saw reductions of 63% and 54%, respectively (saving 1.15 and 0.86 kg CO2-eq per item). The APD machine achieved the largest percentage reduction at 87%, primarily driven by the elimination of printed packaging and the use of renewable electricity. Key contributors to emissions savings across products included lower-impact transport, sustainable packaging materials and circular waste strategies. Redesigning PD products using sustainable materials and processes can deliver substantial environmental benefits without compromising functionality. These findings support evidence-based pathways for reducing emissions in kidney care through product innovation and procurement reform
Optimizing Decentralized Congestion Control: Performance Evaluation on IEEE 802.11p Networks
No full text
Integrated terrestrial and submarine geomorphological mapping provides insights into the Quaternary landscape evolution of the Gulf of Corinth, Greece
No full textThis study presents a 1:150,000 scale geomorphological map of the Gulf of Corinth (central Greece), integrating terrestrial and submarine landforms. The Gulf, an asymmetric WNW-ESE half-graben, is one of the tectonically most active areas in the eastern Mediterranean, with an uplifting southern flank and a downward flexed northern one. A multidisciplinary approach, combining field surveys and high-resolution seafloor bathymetry, was used to map the emerged and submerged geological and geomorphological features. The southern terrestrial sector shows clear evidence of tectonic uplift, such as marine terraces, elevated Gilbert deltas, tidal notches at higher elevations, and reversed drainage features. In contrast, the northern part is notable for the absence of Quaternary marine or lacustrine sediments and displays a gently sloping shelf with submerged tidal notches, indicating ongoing tectonic subsidence. The map offers a comprehensive view of the complex geomorphology of the region, shaped by Quaternary tectonic activity
REGIMI DI TRATTAMENTO A BASE DI DARATUMUMAB IN PAZIENTI AFFETTI DA MIELOMA MULTIPLO CON GAIN/AMPLIFICATION DEL CROMOSOMA 1Q: REVISIONE DI LETTERATURA E STUDIO MONOCENTRICO RETROSPETTIVO.
No full textIl gain/amplification del braccio lungo del cromosoma 1 (+1q) è una delle anomalie citogenetiche più frequenti nel mieloma multiplo (MM), associato a prognosi sfavorevole e incluso in tutti i moderni score di rischio. Sebbene gli studi condotti prima dell’arrivo degli anticorpi monoclonali anti-CD38 ne abbiano stabilito il ruolo prognostico negativo, l’avvento di questi farmaci, e in particolare di daratumumab, ne ha migliorato significativamente la sopravvivenza e rivoluzionato la terapia.
Per questa ragione, abbiamo realizzato una revisione della letteratura per valutare le evidenze disponibili sull’impatto di +1q in pazienti trattati con regimi a base di daratumumab (DBT), seguita da un’analisi retrospettiva monocentrica per indagarne il ruolo in un contesto di real-world (RW).
La revisione ha incluso studi osservazionali, trial clinici, meta-analisi e database RW, evidenziando l’eterogeneità dei metodi impiegati e la scarsità di dati specifici per questi pazienti. Pur con tali limitazioni, le evidenze preliminari suggeriscono che i DBT possano attenuare, ma non annullare, la prognosi sfavorevole associata a +1q, in particolare nei pazienti con ≥4 copie o con associate anomalie citogenetiche ad alto rischio (HiRCA).
Abbiamo quindi condotto uno studio retrospettivo monocentrico per valutare l’impatto prognostico di +1q in una coorte di pazienti con MM trattati con DBT presso il nostro centro. In totale, sono stati inclusi 174 pazienti, con un’età mediana di 72 anni e una mediana di somministrazione DBT di 2 linee. 125 pazienti (71.8%) hanno ricevuto daratumumab-lenalidomide-desametasone (DaraRd). Dati citogenetici erano disponibili per 92 pazienti (52.9%): 18 presentavano +1q isolato, 20 +1q associato a ≥1 HiRCA (+1q+HiRCA), 11 HiRCA non-1q e 43 malattia a rischio standard (SR).
Dopo un follow-up mediano di 30.7 mesi, i pazienti con +1q isolato hanno mostrato una progression-free survival (PFS) significativamente inferiore rispetto ai SR (HR 4.77, 95%CI 1.68–13.53). Gli esiti peggiori si sono osservati nei sottogruppi HiRCA non-1q (HR 6.29, 95%CI 2,10–18,88) e +1q+HiRCA (HR 7.67, 95%CI 2.84–20.72). Anche il time to next treament (TTNT) è risultato significativamente più breve nei +1q isolati rispetto ai SR (HR 3.83, 95%CI 1.33–11.09), con un trend anche per l’overall survival (OS) (HR 2.69, 95%CI 0.72–10.01), mentre i +1q+HiRCA hanno mostrato le peggiori TTNT e OS (TTNT: HR 5.81, 95%CI 2.09–16.16; OS: HR 6.03, 95%CI 1.78–20.27). L’analisi multivariata ha confermato +1q isolato come predittore indipendente di peggior PFS (HR 4.56, 95%CI 1.61–12.95) e TTNT (HR 3.64, 95%CI 1.26–10.55), con un trend anche per OS (HR 2.62, 95%CI 0.70–9.79), mentre +1q+HiRCA si associava al rischio più elevato per tutti gli endpoint (PFS: HR 8.36, 95%CI 3.08–22.70; TTNT: HR 6.37, 95%CI 2.28–17.82; OS: HR 6.18, 95%CI 1.84–20.79).
Risultati simili sono emersi nel sottogruppo DaraRd, dove l’analisi multivariata ha confermato +1q isolato come fattore avverso indipendente per PFS (HR 8.20, 95%CI 2.12–31.66) e TTNT (HR 5.77, 95%CI 1.48–22.46), e un trend non significativo per OS (HR 3.75, 95%CI 0.69–20.50), mentre +1q+HiRCA ha mantenuto il maggiore effetto su tutti gli endpoint (PFS: HR 11.50, 95%CI 3.03–43.60; TTNT: HR 7.28, 95%CI 1.86–28.51; OS: HR 7.59, 95%CI 1.51–38.02).
In conclusione, il nostro lavoro – comprendente una revisione della letteratura seguita da un’analisi RW monocentrica – dimostra che +1q mantiene la propria rilevanza prognostica sfavorevole anche nei pazienti con MM trattati con DBT. La coesistenza di +1q con ulteriori HiRCA amplifica ulteriormente tale effetto. Infine, la standardizzazione di definizione e reporting di +1q sarà essenziale per rifinire la stratificazione del rischio e chiarirne il ruolo in questa nuova era terapeutica.Gain or amplification of chromosome arm 1q (+1q) is among the most frequent cytogenetic abnormalities (CAs) in multiple myeloma (MM), consistently associated with adverse outcomes and currently included in all modern risk stratification systems. While early studies predating the advent of anti-CD38 monoclonal antibodies (mAbs) established its negative prognostic role, the introduction of these agents, and especially daratumumab, has profoundly improved outcomes and reshaped MM therapy.
In this context, we first performed a comprehensive literature review to summarize current evidence on the prognostic impact of +1q in patients treated with daratumumab-based treatments (DBTs), followed by a retrospective single-center analysis to define its real-world (RW) clinical relevance.
The review included data from observational studies, clinical trials, meta-analyses, and RW databases, revealing heterogeneous methodologies used and a paucity of data specific to +1q. While acknowledging this limitation, preliminary evidence suggested that daratumumab may mitigate, but not overcome, the poor prognosis associated with +1q, especially in patients with 1q amplification (≥4 copies of 1q) or concomitant high-risk (HiR) CAs (HiRCAs).
Building on these observations, we conducted a retrospective single-center study to assess the prognostic impact of +1q in a cohort of MM patients treated with DBTs at our institution (Reggio Emilia, Italy). A total of 174 patients were included. Median age was 72.0 years. Median line of daratumumab administration was 2 (range 1–4). 125 patients (71.8%) received daratumumab-lenalidomide-dexamethasone (DaraRd). Cytogenetic data were available for 92 patients (52.9%); 18 had isolated +1q, 20 had +1q plus ≥1 HiRCAs (+1q+HiRCAs), 11 non-1q HiRCAs, and 43 standard-risk (SR) disease.
After a median follow-up of 30.7 months, patients with isolated +1q had significantly shorter PFS than SR patients (28.1 vs 66.8 mo; HR 4.77, 95% CI 1.68–13.53). The poorest outcomes were observed in non-1q HiRCA (24.8 mo; HR 6.29, 95% CI 2.10–18.88) and +1q+HiRCA patients (20.3 mo; HR 7.67, 95% CI 2.84–20.72). TTNT was also significantly shorter in isolated +1q vs SR (35.6 vs 67.4 months; HR 3.83, 95% CI 1.33–11.09), with only a non-significant trend for OS (NR vs NR; HR 2.69, 95% CI 0.72–10.01), while +1q+HiRCAs had the worst TTNT and OS outcomes (TTNT: HR 5.81, 95% CI 2.09–16.16; OS: HR 6.03, 95% CI 1.78–20.27). Multivariate analysis confirmed isolated +1q as an independent predictor of inferior PFS (HR 4.56, 95% CI 1.61–12.95) and TTNT (HR 3.64, 95% CI 1.26–10.55), with a non-significant trend for OS (HR 2.62, 95% CI 0.70–9.79). +1q+HiRCAs conferred the highest risk across all endpoints (PFS: HR 8.36, 95% CI 3.08–22.70; TTNT: HR 6.37, 95% CI 2.28–17.82; OS: HR 6.18, 95% CI 1.84–20.79).
Similar findings emerged in the DaraRd subgroup, where multivariate analysis confirmed isolated +1q as an independent adverse factor for PFS (HR 8.20, 95% CI 2.12–31.66) and TTNT (HR 5.77, 95% CI 1.48–22.46), with a non-significant trend for OS (HR 3.75, 95% CI 0.69–20.50), and +1q+HiRCAs retained the strongest impact across all endpoints (PFS: HR 11.50, 95% CI 3.03–43.60; TTNT: HR 7.28, 95% CI 1.86–28.51; OS: HR 7.59, 95% CI 1.51–38.02).
In conclusion, our work – comprising a comprehensive review of the literature followed by a single-center RW analysis – demonstrates that +1q retains its adverse prognostic relevance even in daratumumab-treated MM patients. The coexistence of +1q with additional HiRCAs further amplifies this effect. Finally, standardized definitions and reporting of +1q, including copy-number status, will be essential to refine risk stratification and clarify its role in the modern therapeutic era
Cancer burden and risk factors among women with HIV: a multi-regional study from the D:A:D and RESPOND cohort collaborations
No full textBackground Data on cancer incidence and associated risk factors among women with HIV are limited. We investigated cancer burden among women with HIV. Methods We included all women >= 18 years from the two large multicentre observational cohort collaborations (D:A:D and RESPOND). The primary outcomes were incidence of all cancers, HPV-related and common individual cancers including breast cancer, lung cancer, and non-Hodgkin lymphoma (NHL) from 2006 to 2021. Baseline was defined as the latest date of entry into local cohort enrolment and 1st January 2006 for D:A:D and 1st January 2012 for RESPOND. Participants were followed from baseline until the date of first cancer, final follow-up or administrative censoring-whichever occurred first. We assessed risk factors using multivariable Poisson regression by applying robust standard errors and determined a population attributable fraction (PAF) for key risk factors for cancers. Findings Among 17,512 women included, median age at baseline was 39.5 years (interquartile range, IQR 32.5-46.0). Over 141,404 person-years (PYS) and a median 9.2 (5.5-10.1) years of follow-up, 832 women were diagnosed with any cancer; incidence rate 5.9 (95% CI 5.5-6.4)/1000 PYS, 163 HPV-related cancers (1.1 [1.0-1.3]/1000 PYS), 150 breast cancers (1.1 [0.9-1.2]/1000 PYS), 94 lung cancers (0.7 [0.5-0.8]/1000 PYS) and 72 NHL (0.5 [0.4-0.6]/1000 PYS). Older age (>= 45 vs. <45 years), Southern Europe (vs. Western Europe) and smoking were associated with an increased risk of overall cancers. Lower pre-ART nadir CD4, time-updated CD4, and a prior AIDS diagnosis were associated with lung- and HPV-related cancer. In PAF analysis, smoking and HIV-related factors such as lower current CD4, nadir CD4 and HIV viremia significantly contributed to cancer risk. Interpretation Our findings suggest that women with HIV older than 45 years, past or current immunosuppressed or current smokers could be candidates for intensified cancer screening and prevention. (c) 2025 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
Filgotinib Effectiveness in Rheumatoid Arthritis: Observational Analysis of a Large Multicenter Cohort
No full textntroduction: The efficacy and safety of fil-
gotinib (FIL) for the treatment of patients with
rheumatoid arthritis (RA) have been evaluated in
a number of randomized controlled trials. How-
ever, there is a scarcity of real-world studies eval-
uating the effectiveness, persistence, tolerability,
and safety of FIL in everyday clinical practice.
This study aimed to assess the effectiveness and
retention rate of FIL in a real-world cohort of
patients with RA.
Methods: A multicenter retrospective cohort
study of patients with RA treated with FIL was
conducted in 27 Italian tertiary referral rheuma-
tology centers. The drug retention rate (DRR)
was estimated by the Kaplan–Meier method,
while multivariate Cox regression was used to
detect potential factors affecting drug survival
and persistence in therapy. Disease activity score
(DAS28-CRP) was assessed at baseline and after
6 and 12 months.esults: We enrolled 204 patients (80%
female). The DRR of FIL was 90.2% (95% con-
fidence interval (CI) 86–94.6%), 75.1% (95% CI
68.5–82.4%), and 64.7% (95% CI 56.3–74.3%)
at months 6, 12, and 18, respectively. The
DRR was negatively associated with the line of
treatment and the presence of rheumatoid fac-
tor. Effectiveness was evaluated as DAS28-CRP
response. At 6 months, DAS28-CRP remission
was observed in 65 (36.1%) patients, and remis-
sion or low disease activity in 98 (54.4%). At
12 months, DAS28-CRP remission was observed
in 64 (50.0%) patients, and remission or low dis-
ease activity in 81 (63.2%)
Nudging households' sustainable investments: results from a pilot lab-in-the-field experiment in two Italian cities
No full textThis paper investigates households' willingness to pay for sustainable investments using evidence from a pilot lab-in-the-field experiment run in different branches of a large Italian bank. The analysis reveals three main results. First, the willingness to pay is lower for graduated individuals, higher for those with a medium investment horizon, for those engaged in volunteering and for those concerned about climate change. Second, the exposure to a negative (vs. positive) visual treatment, causes an average increase in the willingness to pay for Environmental, Social, and Governance assets, albeit this effect vanishes once controls are added. Third, when dissecting results by the factor of interest, the negative visual treatment significantly increases the willingness to pay among the investors interested in the Environmental dimension only. This suggests that, with suitable leverage, the demand and willingness to pay for all sustainability dimensions can be nudged, with important industry and policy implications