University of Modena and Reggio Emilia
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Selected comorbidities and the probability of ART switch in PWH with undetectable HIV-RNA: a retrospective analysis in Italy
No full textObjectives To estimate the incidence of comorbidities in persons with HIV (PWH) with a stable viral load (VL) of <= 50 copies/mL and evaluate the likelihood of treatment switch (TS) according to the new development of dyslipidaemia (DP), kidney disease and a weight change that determined overweight. Methods We carried out six case-control studies nested within the Icona Foundation Study cohort with the outcome of TS of the current regimen (due to intolerance/toxicity or simplification) and investigated the incident comorbidities. Conditional logistic regression models were employed. Results Overall, the median age of study participants was 45 years (IQR: 36-52), 19% were female, 48% were MSM and 17% were migrants. DP was confirmed to be the most frequent incident comorbidity [138 events; incidence rate (IR) = 28.4%; 95% CI: 22.7%-34%], followed by estimated glomerular filtration rate (eGFR) deterioration and BMI elevation. None of the studied factors was associated with the risk of TS because of simplification. TS because of toxicity was predicted by incident DP [adjusted OR (aOR) = 2.49, 95% CI: 1.19-5.19, P = 0.02] and by a decline in eGFR of >10 mL/min/1.73 m2 (aOR = 1.51, 95% CI: 0.98-2.32, P = 0.06). The association with DP was stronger in participants who were receiving a boosted PI-based regimen at baseline (aOR = 3.38, 95% CI: 1.11-10.30, P = 0.03). Therapy discontinuation because of toxicity/simplification has remained common in PWH with VL of <= 50 copies/mL in recent years. Conclusions The onset of DP and a decline in eGFR was associated with discontinuations due to toxicity. Interventions aiming to mitigate the risk of developing lipid abnormalities in PWH are likely to also reduce the number of ART changes, which can potentially affect future drug options
Digital twins suggest a mechanistic basis for differing responses to increased flow rates during high-flow nasal cannula therapy
No full textBackground: Inconsistent responses to increased flow rates have been observed in patients with acute hypoxemic respiratory failure (AHRF) treated with high-flow nasal cannula (HFNC) therapy, with a significant minority in two recent studies exhibiting increased respiratory effort at higher flow rates. Digital twins of patients receiving HFNC could help understand the physiological basis for differing responses.
Methods: Patient data were collated from previous studies in AHRF patients who were continuously monitored with electrical impedance tomography and oesophageal manometry and received HFNC at flow rates of 30, 40 or 45 L/min. Patients, based on their responses to an increase in flow rate to 60 L/min, were categorised into two groups: five responders with reduced oesophageal pressure swings ΔPes (-3.1 cmH2O on average), and five non-responders with increased ΔPes (+2.0 cmH2O on average). Two cohorts of digital twins were created based on these data using a multi-compartmental mechanistic cardiopulmonary simulator. Digital twins’ responses to increased HFNC flow rates (60 L/min) were simulated with constant respiratory effort to assess changes in gas exchange and lung mechanics, and with varying respiratory effort to quantify their combined effects on lung mechanics and P-SILI indicators.
Results: The digital twins accurately replicated patient-specific responses at all flow rates. Responder digital twins showed a mean 20 ml/cmH2O increase in lung compliance at higher flow rates, versus a 6 ml/cmH2O decrease in compliance in non-responders. In digital twins of responders versus non-responders, increased flow rates produced a mean change in lung stress of -1.5 versus +1.2 cmH2O, in dynamic lung strain of –8.8 versus +16.4 %, in driving pressure of -1.3 versus +1.1 cmH2O, and in mechanical power of -0.8 versus +1.2 J/min. Higher flow rate dependent positive end-expiratory pressure in digital twins of non-responders did not cause recruitment, and reduced tidal volumes due to higher functional residual capacities – to compensate for the resulting worsened gas-exchange, non-responders increased their respiratory effort, in turn increasing patient self-inflicted lung injury (P-SILI) indicators. In digital twins of responders, reductions in tidal volumes due to higher FRCs resulting from increased PEEP were outweighed by alveolar recruitment. This increased compliance and improved gas exchange, permitting reduced respiratory effort and decreases in P-SILI indicators.
Conclusions: Failure to reduce spontaneous respiratory efforts in response to increased HFNC flow rates could be due to a deterioration in lung mechanics, with an attendant risk of P-SILI
Plant-based diets and risk of type 2 diabetes: systematic review and dose-response meta-analysis
Get PDFType 2 diabetes (T2D) incidence has been steadily increasing over the past few decades. Several studies have evaluated the effect of plant-based, vegetarian or vegan diets on the risk of T2D, although their potential benefits need to be confirmed and characterised. We performed a literature search up to 10 July 2025, using the terms/keywords related to plant-based index (PDI), vegetarian/vegan diets and T2D. We included observational non-experimental studies evaluating adherence to such diets in adult subjects assessing T2D risk. We specifically considered overall PDI and related healthy PDI (hPDI) and unhealthy PDI (uPDI), assessing intake of different food groups. We included 36 studies published between 1999 and 2025. We found an inverse association between adherence to vegetarian/plant-based dietary patterns and T2D risk. This association was stronger, though statistically imprecise, for the vegan diet (RR = 065, 95 % CI 042, 100) and for lacto-ovo-vegetarian diet (RR = 068, 057, 082). For studies using plant-based indices, the RR were 082 (069, 082), 076 (069, 082) and 113 (098, 130) for overall PDI, hPDI and uPDI, respectively. In the dose-response meta-analysis, overall PDI and hPDI showed an inverse and almost linear association with T2D risk. Conversely, adherence to uPDI directly correlated with T2D risk. Overall, adherence to vegan/vegetarian diets may reduce T2D risk, while an unhealthy plant-based diet appears to linearly increase disease risk, indicating caution in the consumption of such unhealthy foods even if of plant origin. The beneficial association between vegetarian and healthy plant-based diets may have major public health implications
Monolithic yellow fiber laser for ophthalmological applications
No full textThe paper presents the design and preliminary experimental validation of a fiber laser with direct emission in the yellow, which has been developed within the "Yellow-FLiCkEr" project, funded by the Italian Ministry of University and Research. The laser uses Dy-doped soft-glass fibers, both commercial and ad-hoc custom made. The pump is provided by high-power blue laser diodes and the mirrors are Bragg gratings directly inscribed in the soft-glass fiber with a femtosecond laser. Suitable models have been developed both to optimize the laser behavior and to study the laser-eye tissue interaction. Preliminary studies with cultivated cells have demonstrated the laser's potential for ophthalmology
Effects of Digestate from Biogas on Agronomic Traits, Functional and Health Properties of Hydroponic Cultivation of Rocket (Diplotaxis tenuifolia L.) and Parsley (Petroselinum crispum Mill.)
No full textThe study aimed to use vermicompost (V) from solid digestate and liquid digestate (LD) from biogas as renewable and sustainable growing medium and nutrient solution in a hydroponic cultivation of wild rocket (Diplotaxis tenuifolia L.) and parsley (Petroselinum crispum Mill.), under greenhouse condition. Four different combinations were considered, where peat (P) and standard solution (SS) were used as a comparison: P + SS, P + LD, V + SS, V + LD. Phytotoxicity was never induced on rocket, while a strong biostimulant effect was induced by vermicompost in parsley. In rocket V + SS showed the highest values of root dry weight (0.38 ± 0.05 g), while V + LD ensured optimal leaf size (around 10 cm). V + SS positively affected all growth parameters in parsley. Vermicompost induced positive effect on physiological parameters in both species (high values of specific leaf area and reduced transpiration rate). P + LD induced the highest values of polyphenolic compounds in both cuts for parsley and in the first cut for rocket. V + LD positively affected total phenols content, flavonoid productions and antioxidant powers in parsley. Qualitative analysis showed six different glucosinolates and several kaempferol derivatives in rocket, while parsley exhibited a higher number of polyphenolic compounds. PCA models indicated that the different substrate impacted the metabolites expression, V and LD inducing richness in sinapic acid derivatives in rocket, and higher concentration of apigenin derivatives in parsley. Our results suggest that V and LD could be valid alternatives to P and SS and that they could improve the leaf quality when combined together
Neoadjuvant Immunotherapy in Cutaneous Squamous Cell Carcinoma: Systematic Literature Review and State of the Art
Get PDFBackground/Objectives: Cutaneous squamous cell carcinoma (cSCC) is a prevalent skin cancer with increasing incidence worldwide. High-risk cSCCs often require extensive surgical treatments, which can impair anatomical function and aesthetics. Neoadjuvant immunotherapy, particularly immune checkpoint inhibitors (ICIs) such as cemiplimab and pembrolizumab, has emerged as a promising approach to enhance tumor control and surgical outcomes. We performed a systematic review to evaluate the efficacy and safety of neoadjuvant immunotherapy in high-risk cSCC. Methods: A systematic review and proportional meta-analysis focusing on neoadjuvant immunotherapy for cSCC were conducted following PRISMA guidelines. MEDLINE and Scopus databases were searched up to September 2024 using predefined terms. Recorded findings were pathological/radiological response, 1-year disease-free survival (DFS), and overall survival (OS). Data extraction and risk-of-bias assessment were independently performed by two reviewers. Statistical analysis included fixed- and random-effects models, with heterogeneity assessed using Cochran’s Q statistic and the I2 index. Results: Nine studies met the inclusion criteria. The pooled pathologic response rate was 72.2% (95% CI: 57.7–84.6), and the radiological response rate was 54.8% (95% CI: 38.6–70.5), with moderate heterogeneity. Pooled 1-year DFS and OS proportions were 91.1% (95% CI: 85.0–95.3) and 90.6% (95% CI: 85.1–95.0), respectively, demonstrating homogeneity across studies. Adverse events were consistent with previously reported immune-related toxicities, with rare severe events. Conclusions: Neoadjuvant immunotherapy is a promising therapeutic strategy for high-risk cSCC, with high pathologic response rates and high survival outcomes. However, standardization of treatment protocols and further trials are needed to optimize efficacy, ensure safety, and assess long-term benefits
A multilab investigation into the N2pc as an indicator of attentional selectivity: Direct replication of Eimer (1996)
No full textThe N2pc is widely employed as an electrophysiological marker of an attention allocation. This interpretation was largely driven by the observation of an N2pc elicited by an isolated relevant target object, which was reported as Experiment 2 in Eimer (1996). All subsequent refined interpretations of the N2pc had to take this crucial finding into account. Despite its central role for neurocognitive attention research, there have been no direct replications and only few conceptual replications of this seminal work. Within the context of #EEGManyLabs, an international community-driven effort to replicate the most influential EEG studies ever published, the present study was selected due to its strong impact on the study of selective attention. We revisit the idea of the N2pc being an indicator of attentional selectivity by delivering a high powered direct replication of Eimer's work through analysis of 779 datasets acquired from 22 labs across 14 countries. Our results robustly replicate the N2pc to form stimuli, but a direct replication of the N2pc to color stimuli technically failed. We believe that this pattern not only sheds further light on the functional significance of the N2pc as an electrophysiological marker of attentional selectivity, but also highlights a methodological problem with selecting analysis windows a priori. By contrast, the consistency of observed ERP patterns across labs and analysis pipelines is stunning, and this consistency is preserved even in datasets that were rejected for (ocular) artifacts, attesting to the robustness of the ERP technique and the feasibility of large-scale multilab EEG (replication) studies
Fatal Epstein-Barr Virus (EBV) Myopericarditis in a Young Adult Male
No full textEpstein-Barr virus (EBV), typically known for a self-limited infection, the "infectious mononucleosis"(IM), can rarely provoke cardiac complications. We present here a case of fatal EBV myopericarditis in a young adult recently diagnosed with IM. A 16-year-old patient, whose medical history was characterized by multiple chronic pathologic conditions, was diagnosed with IM during a hospitalization. A month after discharge, he was admitted to the hospital, where an exacerbation of chronic pericarditis was diagnosed. Then, a few hours later, the patient died. Autopsy, histologic, and microbiological examinations were performed. Internal examination demonstrated opalescent and thickened pericardium, containing 180 mL of a yellowish clear effusion. The epicardium was opalescent and thickened. Cardiac microscopical examination demonstrated a diffuse and intense inflammatory infiltrate of myocardium and pericardium, associated with focal myocyte necrosis. Qualitative real-time polymerase chain reaction, performed in the pericardial effusion, tested positive for EBV DNA. The cause of death was identified as a fatal moderate-to-severe myopericarditis caused by EBV that occurred in a young adult with multiple chronic pathologic conditions. This case report emphasizes that EBV infection should be considered as a cause of sudden death due to cardiac complications in young patients with a recent diagnosis of IM
