University of Modena and Reggio Emilia
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Palliative care perceptions and well-being in nurses across healthcare settings: a comparative study from Reggio Emilia, Northern Italy
No full textBackground: Nurses play a crucial role in palliative care. They are employed across all settings including home care and hospitals, with potential differences in the perception of care, emotional burden and coping strategies. This study aims to explore the experience of nurses within the palliative care network of an Italian province. Methods: From January to March 2024, we carried out a tailored survey on nurses from three palliative care settings in Reggio Emilia (Northern Italy), namely home care, hospice and hospital ward. We investigated emotional and occupational experience, knowledge of palliative care and organizational challenges. Results: The study included 39 nurses, nearly 90% of whom female. Of these, 20 worked in hospices, 10 in hospital wards and 9 in home care. In relation to occupational issues, most participants believed that newly-graduated nurses need additional training before working independently in both hospital ward and home care. Home care seemed adequate to palliative care demands for most participants, who nonetheless remained skeptical about work in hospice. Major emotional challenges included supporting patients' families and feeling alone during emergencies or during sensitive communication, especially in home care. Emotional support was reported as adequate by 61.5% of nurses. However, 35.9% felt it was insufficient, while two thirds of participants admitted to having cried in front of patients. Almost all nurses frequently witnessed patients' deaths and noted that patients' preferences for their place of death were sometimes overruled by caregivers or doctors. Conclusion: Palliative care nursing requires strong emotional resilience, effective communication and comprehensive clinical training. This is true regardless of the setting. Our findings suggest that nurses in home care may need additional organizational support to manage emergencies and reduce emotional stress. This could improve quality of care for patients as well as caregivers, and reduce burnout risk in healthcare professionals in the palliative care network
Sintering mechanisms, phase transformations and microstructure of porcelain stoneware containing thermally inertized man-made vitreous fibres
No full textThe waste incorporation into porcelain stoneware is a key strategy for enhancing sustainability in ceramic production. To achieve a satisfactory finished product, a crucial aspect to be investigated is the effect that a waste can induce on the tile sintering behaviour, which, in turn, determines its final technological properties. This study investigates the effect of a glass deriving from the thermal inertization of man‐made vitreous fibres on the sintering of porcelain stoneware tiles, obtained by pressing and fast firing. Results indicated that it is easier to incorporate into porcelain stoneware than other peralkaline glasses, due to its tendency to crystallize in the early stage of the densification process, limiting the interaction with the ceramic matrix and allowing the achievement of a good densification. Otherwise, the microstructure of the fired tiles in overfiring conditions is influenced, since the loss of bulk viscosity and likely the Fe3 + reduction led to bloating phenomena
The effects of the European Pact on Migration and Asylum on the health of migrant populations
No full textCommodity risk assessment of Prunus spp. plants from United Kingdom
No full textThe European Commission requested the EFSA Panel on Plant Health to prepare and deliver risk assessments for commodities listed in Commission Implementing Regulation (EU) 2018/2019 as ‘High risk plants, plant products and other objects’. This Scientific Opinion covers plant health risks posed by: grafted potted plants up to 15 years old or bundles of grafted bare root plants up to 3 years old or graftwood up to 2 years old of Prunus armeniaca, P. cerasifera, P. domestica, P. incisa or P. persica imported from the United Kingdom (UK), taking into account the available scientific information, including the technical information provided by the UK. All pests associated with the commodities were evaluated against specific criteria for their relevance for this opinion. Two quarantine pests, Candidatus Phytoplasma aurantifolia-related strains (Pear decline Taiwan II, Crotalaria witches' broom phytoplasma, Sweet potato little leaf phytoplasma) and Scirtothrips dorsalis, two protected zone quarantine pests, Bemisia tabaci (European population) and Erwinia amylovora, and two non-regulated pests, Eulecanium excrescens and Colletotrichum aenigma, that fulfilled all relevant criteria were selected for further evaluation. The risk mitigation measures proposed in the technical Dossier from the UK were evaluated, taking into account the possible limiting factors. For these pests, expert judgement is given on the likelihood of pest freedom, taking into consideration the risk mitigation measures, including uncertainties associated with the assessment. The degree of pest freedom varied among the pests evaluated, with E. amylovora being the most frequently expected pest on the imported potted plants. The expert knowledge elicitation indicated with 95% certainty that between 9956 and 10,000 potted plants per 10,000 would be free from the above-mentioned bacterium
Interaction between tumor-infiltrating lymphocytes and BMI in early HER2-positive breast cancer: analysis of the ShortHER trial.
No full textBackground: We demonstrated the prognostic role of tumor-infiltrating lymphocytes (TILs) in patients with early human epidermal growth factor receptor 2 (HER2)-positive breast cancer (eBC) enrolled in the ShortHER trial. Here, we analyze how body mass index (BMI) modulates the prognostic role of TILs.
Patients and methods: The ShortHER study randomized 1253 patients with HER2-positive eBC to 9 weeks versus 1 year of adjuvant trastuzumab + chemotherapy. We assessed BMI at diagnosis (available for n = 1213, n = 34 underweight were excluded). Survival endpoints were disease-free survival (DFS), recurrence-free survival (RFS), distant DFS (DDFS) and overall survival (OS). We calculated the cumulative incidence of first event types by competing risk analysis.
Results: A total of 583 (48%) patients were lean, 360 (29.7%) overweight and 236 (19.5%) obese. Lean patients versus those with overweight or obesity had similar DFS, RFS, DDFS and OS. Within the TIL + BMI cohort (n = 819), TILs (5% increase) were independently associated with DFS (P = 0.003), RFS (P = 0.001) and DDFS (P = 0.018) in lean patients. In patients with overweight or obesity, TILs were independently associated only with DDFS (P = 0.044). In lean patients, TILs ≥20% were associated with improved DFS (P = 0.007), RFS (P = 0.002) and DDFS (P = 0.027) compared with TILs <20%. In patients with overweight or obesity, DFS, RFS, DDFS and OS did not significantly differ between TILs ≥20% and TILs <20%. In lean patients, there was a higher cumulative incidence of locoregional relapse (P = 0.001) and distant relapse (P = 0.07) in patients with TILs <20% versus TILs ≥20%. In patients with overweight or obesity, there was a higher cumulative incidence of distant relapse (P = 0.005) in patients with TILs <20% versus TILs ≥20%.
Conclusions: We suggest that BMI may impair the local, but not distant, protective effect of TILs in patients with overweight or obesity with HER2-positive eBC treated with adjuvant chemotherapy + trastuzumab
Unveiling the Molecular Structures and Interactions in Boronic Acid Functionalized Aniline Oligomers for Application in Self-Healing Battery Electrodes
No full textThis study delves into the structural and electronic properties of the ground and excited states of a series of n-B@PANI (boronic acid-functionalized polyaniline) oligomers with varying chain lengths. These oligomers are particularly interesting as self-healing components for high-capacity silicon anode binders in Li-ion batteries. The role of binders for silicon anodes is to repair the structural damage induced by the enormous volume expansion occurring during charge and discharge cycles. We elucidate the specific impact of the boronic acid functionalization on the oligomer structure and electronic properties by comparing functionalized and pristine PANI oligomers. Using accurate Density Functional Theory simulations, we provide insight into the structural modifications induced by the presence of the boronic acid radical and its interaction with the amine group, and show that this interaction plays a key role in determining the oligomer chain growth pattern and stability. Furthermore, we employ a comprehensive theoretical approach, including Bader's AIM analysis, to investigate the number, kind, and strength of the long-range intra-molecular and inter-chain interactions (mainly hydrogen bonds and van der Waals) and found a clear correlation with the length and conformation of the oligomers. The presence and the number of dynamic hydrogen bonds are important for combining n-B@PANI with different polymers and designing new binders for the silicon anodes. These insights provide a solid foundation for the rational design of advanced PANI-based materials with tailored properties for energy storage and self-repair applications
Dumbbell Spinal Desmoid Tumor Mimicking a Giant Schwannoma: Case Report and Literature Review
No full textBackground/Objectives: Desmoid tumors (DTs) are rare benign soft tissue neoplasms characterized by local aggressiveness and high rate of recurrence. Spinal localization is only anecdotally reported in the literature. When presenting in a dumbbell-shaped configuration, they can mimic neurogenic tumors. Methods: We report a rare case of a spinal intracanalar–intrathoracic DT, initially suspected to be a schwannoma, and review the literature. Results: A 24-year-old asymptomatic man was incidentally found to have a mediastinal mass on chest X-ray. CT and MRI revealed a left thoracic paravertebral mass (T9–T12), with intracanalar extension through the T10–T11 foramen, suggestive of a dumbbell-shaped neurogenic tumor. After embolization, the patient underwent surgery via a posterior combined intracanalar and endothoracic approach. Histology and immunohistochemistry analysis identified the tumor as a desmoid type fibromatosis (β catenin positive; S100, CD34, SMA negative). Follow-up MRI at 8, 12, and 18 months showed stable residual intrathoracic mass. Conclusions: To date, only 36 cases of spinal DTs have been reported in the literature, of which only 6 exhibited dumbbell morphology. Immunohistochemical and molecular pathological testing is essential for diagnosis. Although wide resection is preferred, anatomical limitations often necessitate marginal or subtotal surgery, which increases the risk of recurrence (24–77%). Our review showed a 29% overall recurrence rate (50% after subtotal, 29% marginal, 20% wide resection). Adjuvant radiotherapy or systemic therapies may help improve outcomes. Spinal DTs pose significant diagnostic and therapeutic challenges. In the absence of established guidelines, management should be individualized and multidisciplinary. Lifelong follow-up is essential due to the high risk of recurrence
Numerical Study of the Hydrogen/Air Mixing in a High Performance 2 Stroke Opposed Piston Engine
No full textHydrogen as a fuel for internal combustion engines is the most promising candidate for the achievement of the zero-emissions target fixed by the European institutions for sports car applications. The development of a high-specific-power hydrogen engine is not trivial considering the low volumetric energy density of hydrogen. Furthermore, the necessity to reduce the engine encumbrance in favour of on-board fuel storage makes alternative engine architectures, such as the two-stoke opposed-piston design, particularly attractive. A numerical study is conducted to evaluate the potential of such architecture. First, the overall engine is simulated in a 1D-CFD framework assuming a fully homogeneous hydrogen/air mixture. Then, the intake and exhaust port phasing are optimized, and a 3D CAD model of the cylinder is developed based on the defined parameters. 3D-CFD simulations of the scavenging process are performed and employed to tune the 1D model. Starting from a single point injection configuration, the simulations predict inhomogeneous mixture formation. This finding suggests that the hydrogen/air mixing process could be a critical aspect to be improved to reach the performance and efficiency targets. An extensive 3D-CFD study is then performed analysing the impact on mixture formation and combustion evolution/efficiency of the hydrogen injector location, orientation and injection phasing with the final aim to define design guidelines for the development of this new engine technology. To improve the mixture homogeneity an innovative multi-point injection ring is designed, virtually implemented and tested. This multi-point injection system proves effective in enhancing mixture homogeneity, which, although not ideal, is sufficient to achieve the combustion duration required for the target efficiency. The results of the current study confirm the feasibility of the proposed engine architecture and its potentiality in terms of performance and efficiency, as highlighted by the 1D simulations of the overall engine