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Health Inequity in People with Cystic Fibrosis: Can We Close the Gap?
No full textBackground: Although advances in care have improved cystic fibrosis (CF) outcomes in higher-income countries (HICs), the situation remains alarming in lower-income countries (LICs). Methods People with CF (pwCF) enrolled in the European Cystic Fibrosis Society Patient Registry (ECFSPR) and carrying at least one F508del variant allele were evaluated in 2017 and in 2022 for predicted percent forced expiratory volume (ppFEV1), underweight status, and chronic Pseudomonas aeruginosa (Pa) infection, according to the gross national income (GNI) per capita divided into three terciles (low-income countries, LICs; middle-income countries, MICs; and high-income countries, HICs). Survival was evaluated in the periods 2013-2017 and 2018-2022. Generalized linear models and Cox regression models were fitted. Findings From the 31,723 pwCF reported in ECFSPR in 2022, 13.5% lived in LICs, 19.9% in MICs, and 66.6% in HICs. PwCF living in LICs had a significantly lower median survival age, reduced ppFEV1, and higher prevalence of Pa infection and underweight status compared with pwCF from MICs and HICs. Data modeling indicated that avoiding underweight status and Pa infection would increase survival by 42 years for pwCF living in LICs. Access to CFTR modulators would further increase their survival by 15 to 29 years depending on their nutrition and infection status, resulting in a survival up to 82 years in the best-case scenario. Interpretation Access to CFTR modulators equalizes survival between LICs and higher income countries within Europe. Optimizing care practices and social determinants of health remains crucial in LICs
Financial arrangements for rehabilitation services in health systems: an overview of systematic reviews
No full textBACKGROUND: Cochrane Rehabilitation and the World Health Organization (WHO) Rehabilitation Programme have collaborated to produce four Cochrane overviews of systematic reviews that synthesize current available evidence from health policy and systems research (HPSR) in rehabilitation. Each overview focuses on one of the four pillars of HPSR as identified by the Cochrane Effective Practice and Organisation of Care (EPOC) taxonomy: delivery arrangements, financial arrangements, governance arrangements, and implementation strategies. This overview focuses on financial arrangements, which Cochrane EPOC defines as changes in how funds are collected, how insurance schemes are structured, how services are purchased, and the use of targeted financial incentives or disincentives. OBJECTIVES: This overview aimed to synthesize the current evidence on financial arrangements in rehabilitation from a health policy and systems research (HPSR) perspective. Our series of four overviews, incorporating evidence on governance arrangements, delivery arrangements, financial arrangements, and implementation strategies, have the following overarching objectives. • To offer a broad synthesis of the existing evidence on health policy and systems interventions' effects. • To direct end-users, including policymakers, towards systematic reviews that may address their health policy questions. • To identify current research gaps and set priorities for future primary HPSR. • To pinpoint the needs and priorities for new evidence syntheses where no reliable, up-to-date systematic reviews currently exist. METHODS: We searched the Epistemonikos database, the Health Systems Evidence database, and EPOC Group systematic reviews to identify reviews published between 1 January 2015 and 17 November 2024. We applied no language limitations. We included Cochrane and non-Cochrane systematic reviews of randomized controlled trials (RCTs) and non-randomized studies of interventions (NRSIs) that evaluated the effectiveness of health policy and systems interventions for rehabilitation in health systems, specifically related to financial arrangements as defined in the EPOC taxonomy. All four overview teams collaborated to screen reviews and extract data. We used AMSTAR 2 to critically appraise the quality of the reviews. Reviews with ratings of high-to-moderate confidence are reported separately from low-confidence reviews. MAIN RESULTS: We identified two non-Cochrane systematic reviews relevant to rehabilitation and the EPOC category of financial arrangements. We excluded one review from the synthesis due to low methodological quality. The other review included 18 primary studies, but only one study reported data relevant to rehabilitation. This study, conducted in a single country (China), compared insured and uninsured children aged birth to 17 years with intellectual disabilities, focusing on the likelihood of receiving at least one rehabilitation service. The review reported that, based on this single study, enrollment in social health insurance, national health insurance, or community-based health insurance schemes may be associated with increased utilization of mental health services, including outpatient rehabilitation. However, due to the complexity and variability of mental health service utilization across contexts, the review authors noted that it was difficult to draw definitive conclusions about the overall impact of insurance enrollment on mental health outcomes and services. AUTHORS' CONCLUSIONS: We identified two non-Cochrane systematic reviews aligned with the EPOC classification of financial arrangements that addressed rehabilitation. One review including one single-center study on rehabilitation offered low-certainty evidence on insurance schemes and access to rehabilitation services. As a result, this overview cannot provide a clear understanding of the effects of financial arrangements for rehabilitation or offer meaningful signposts to end-users, including policymakers. Future Cochrane overviews in HPSR should broaden their scope to include qualitative and mixed-methods study designs. Robust primary studies and inclusive systematic reviews are urgently needed to guide financial policy decisions that integrate rehabilitation into resilient and equitable health systems. FUNDING: PC, CK, and SN were supported and funded by the Italian Ministry of Health (Ricerca Corrente). The funder played no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. REGISTRATION: Protocol (2025): DOI 10.23736/S1973-9087.24.08833-6
Uncontrolled donation after circulatory death lung transplantation program: Clinical outcomes and perspectives for implementation
No full textLung transplantation (LT) remains limited by the scarcity of suitable donor organs. Uncontrolled donation after circulatory death (uDCD) is a promising yet underutilized source due to logistical barriers. This study presents a prospective, single-center experience with uDCD LT. From 2014 to 2025, all uDCD lung referrals at our center in Milan were prospectively assessed. Lungs were preserved via open-lung ventilation without in situ cooling, followed by ex vivo lung perfusion (EVLP) evaluation. Clinical outcomes were analyzed, and regional donor potential was explored using 2023 cardiac arrest data from Lombardy. Among 72 referred donors, 30 met eligibility criteria, 25 proceeded to recovery, and 18 were transplanted after EVLP (72% post-EVLP utilization rate). The 30-day and 1-year survival rates were 94.4% (95% confidence interval [CI] 83.9%-100.0%) and 83.3% (95% CI 57.5%-99.8%), respectively. Primary graft dysfunction grade 3 within 72 hours occurred in 16.7% (95% CI 6.4%-34.8%), while chronic lung allograft dysfunction developed in 27.8% (95% CI 13.2%-50.3%). Median warm ischemia time was 240 minutes. Regional analysis identified 119 uDCD-eligible cases in 2023, 20 activations, with 5 transplants performed, and major untapped potential. uDCD LT is feasible and effective. Our simplified normothermic strategy is operationally scalable and yields outcomes comparable to those historically reported from conventional LT. Broader implementation, supported by regional coordination, could substantially expand the lung donor pool
Electromagnetic exposure changes human Schwann cell motility and transcriptomic profile of hearing-loss-related genes
No full textSchwann cells (SCs) are glial cells of the peripheral nervous system with functional plasticity in physio-pathological conditions, such as injury and oncotransformation. Interestingly, human SCs seem to develop, mature, and respond differently to other species to environmental challenges. Recently, concerns have been raised about the expansion of environmental electromagnetic fields (EMFs) and the increasing incidence of vestibular schwannoma (VS). We previously demonstrated that SCs respond to EMF by acquiring a state prone to oncotransformation. However, the biodependence of such transformation on the species (rodents versus humans) deserves clarification. Here, we obtained and characterized human SCs, showing that EMF affects proliferation, migration, and transcriptomic profile. The expression of motility proteins increased, while that of cell-to-cell adhesion proteins decreased. The functional clustering of genes differentially expressed matched those involved in hearing loss. In summary, we provide insights into the effects of chronic EMF on human SCs, highlighting its potential role in VS onset
Le vie della pietas : Itinerari tra repubblica e principato
No full textIl contributo ricostruisce l’evoluzione del concetto di pietas nella storia romana, seguendone gli sviluppi tra repubblica e principato. Da sentimento originariamente morale, la pietas viene progressivamente astratta in categoria teorica e assunta a modello comportamentale condiviso, capace di incidere su religione, società e diritto. In ambito religioso essa si configura come pietas erga deos, fondamento della coesione civica e strumento di legittimazione dell’espansione romana. La successiva deificazione della Pietas ne consolida il valore simbolico, mentre la sua trasformazione in emblema istituzionale consente agli uomini politici, e poi agli imperatori, di identificarsi con la Virtù e di farne strumento di propaganda. Parallelamente si sviluppa la pietas erga patriam, paradigma del sacrificio per la collettività. Sul piano giuridico, infine, la pietas diviene criterio normativo capace di fondare obblighi familiari e limiti all’autonomia privata. Il saggio mostra così la continuità e la metamorfosi di un concetto che, oscillando tra ideale etico e funzione prescrittiva, attraversa e struttura l’esperienza romana
La préposition chez en français: analyse syntactico-sémantique et traduction en italien
No full textDerived from the Latin noun casa, the French locative preposition chez, which always governs a human noun, is unique in Romance languages. Little studied until now, chez is characterised by the possibility of designating both concrete places ("spatial localisation" uses: house, institution, shop, workplace, city, country) and abstract places ("abstract localisation" uses: body, mind, work, community). Based on the syntactic and semantic properties of the French preposition and on translational data collected from a parallel bilingual corpus of contemporary French prose texts and their Italian translations, this study proposes a new contrastive classification of the uses of chez, listing the most frequent Italian translations for each meaning of the French preposition. The result is that, depending on the meaning it takes on in context, chez can be translated into Italian by six different prepositions, including five preposizioni proprie (a, da, in, per, tra) and one preposizione impropria avverbiale (presso).Dérivée du substantif latin casa, la préposition locative française chez, qui régit toujours un nom humain, est un cas unique dans les langues romanes. Très peu étudiée jusqu’à présent, chez se caractérise par la possibilité de désigner aussi bien des lieux concrets (emplois de « localisation spatiale » : maison, institution, magasin, lieu de travail, ville, pays) que des lieux abstraits (emplois de « localisation abstraite » : corps, esprit, œuvre, communauté). À partir des propriétés syntactico-sémantiques de la préposition française ainsi que des données traductologiques collectées dans un corpus parallèle bilingue de textes français contemporains en prose, accompagnés de leurs traductions en italien, cette étude propose un nouveau classement contrastif des emplois de chez, en indiquant, pour chaque sens de la préposition française, la liste de ses traductions les plus fréquentes en italien. Il en résulte que, selon le sens qu’elle prend dans le contexte, chez peut se traduire en italien par six prépositions différentes, dont cinq preposizioni proprie (a, da, in, per, tra) et une preposizione impropria avverbiale (presso)
work data 1 - metaling corpus
No full textThis collection contains the metadata related to the corpus on linguistic metalanguage on which the project is based. The data were compiled on Omeka.net and subsequently extracted and saved in CSV format. The files are logically related to one another through the “id” field
The Genus Apis in a Changing World: Distribution, Conservation, Climate, and Anthropogenic Stressors
No full text(1) Background: Bees of the genus Apis play a fundamental role in ecosystems thanks to their pollination activities and their long evolutionary history. This has resulted in species diversifying and spreading across Asia, Africa, and Europe. This review contextualises the genus within biogeographic and evolutionary frameworks, emphasising the importance of understanding the origins, adaptations, distribution and differences between species. (2) Methods: Recent studies on the biology, taxonomy and ecology of Apis species were analysed, including research on social behaviour, communication, genetics, morphology and environmental adaptations, as well as contributions using modern evolutionary and phylogeographic analytical methods. (3) Results: The gathered evidence shows that anthropogenic factors, including climate change, habitat loss, intensive agriculture, pollutants, competition with other bees and the spread of parasites and pathogens, significantly affect the stability of Apis populations and increase the vulnerability of wild species. (4) Conclusions: This review emphasises the importance of integrating ecological, genetic and management knowledge to develop effective conservation strategies that aim to reduce the impact of human activities and preserve the resilience of Apis species and the vital ecosystem services they provide
Nominis umbra. L’emersione dall’anonimato nella sperimentazione di un’anagrafica di stato a Milano nel secondo Quattrocento
No full textDal punto di vista degli studi di onomastica, il contesto milanese lascia ancora, per il basso medioevo, ampi margini di approfondimento. Le cancellerie degli organi centrali del governo sforzesco sfornavano quotidianamente liste, elenchi, reperto- ri, registri che descrivono, contano, concedono, vietano, includono ed escludono: tra questi, i Libri Mortuorum, ossia la trascrizione su registro dei bollettini prodotti dall’Ufficio di Sanità, che riportano i casi di decesso occorsi ogni giorno entro il perimetro cittadino. Il repertorio onomastico espresso da questa fonte, istituita da Francesco Sforza a partire dal 1451, di cui sono state prese in esame alcune annate, comprese tra il 1452 e il 1485, rappresenta un patrimonio ricchissimo di nomi, considerato che vi risultano registrati, oltre agli uomini adulti, le donne e i bambini, a partire dai neonati di poche ore di entrambi i sessi, senza distinzione cetuale, di religione o di provenienza.From the point of view of onomastic studies, the Milanese context still leaves, for the late Middle Ages, ample room for further study. The chancelleries of the central organs of the Sforza government churned out daily lists, directories, rep- ertories, and registers describing, counting, granting, forbidding, including and excluding: among these were the Libri Mortuorum, i.e., the transcription on regis- ters of the bulletins produced by the «Ufficio di Sanità», which reported the cases of death that occurred daily within the city perimeter. The onomastic repertoire expressed by this source, instituted by Francesco Sforza, represents a very rich heritage of names, considering that there are recorded, in addition to adult men, women and children, starting with infants of a few hours of both sexes, without distinction cetual, religious or origin
Science LTD. : Research Enterprise in the Age of Machines
No full textScience Ltd. examines the evolving relationship between scientific knowledge, technology, and society in an era where deep-tech companies are increasingly driven by discoveries rather than market demand. Written from the perspective of metascientific entrepreneurs, this timely work explores how scientific research struggles to balance profit with truth, individual objectives with collective values, and human creativity with machine capabilities. This book addresses the undisputed influence of science in contemporary society while questioning the sustainability of current research paradigms.
Science Ltd. tackles critical operational questions about modern science: How is scientific knowledge produced and prioritized? How are research funds distributed? What constitutes effective dissemination and application of discoveries? Chapters examine the journey from laboratory innovation to commercial implementation while exploring two fundamental challenges facing the scientific community. First, the urgent need to reform scientific practices, particularly by rethinking academic publishing and research funding models to create more open and sustainable science. Second, the complex prospect of human-machine collaboration in research, moving beyond traditional instruments to AI assistants with capabilities that exceed human limitations. Enriched with expert interviews and real-world anecdotes, this book provides both practical insights and speculative analysis of science’s automated future.
This accessible work is designed for researchers, entrepreneurs, policymakers, and anyone curious about the intersection of science and technology. It serves academics seeking to understand contemporary research dynamics, industry professionals navigating the deep-tech landscape, and general readers interested in how scientific discovery shapes society. This book offers valuable perspectives for those involved in research funding, science policy, and technology transfer, while remaining engaging for anyone concerned about the future of human-driven versus machine-assisted scientific innovation