Archivio Istituzionale della Ricerca- Università degli Studi di Foggia
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Elevated serum concentrations of GFAP in hereditary transthyretin amyloidosis since pre-symptomatic stages
No full textBackground: Hereditary transthyretin amyloidosis (ATTRv) is a rare disorder caused by pathogenic TTR gene variants. Glial fibrillary acidic protein (GFAP) and neurofilament light chain (NfL) are potential biomarkers for astrocyte activation and neuroaxonal damage, respectively. This study investigates serum GFAP (sGFAP) and NfL (sNfL) levels in ATTRv patients, pre-symptomatic subjects, and healthy controls (HCs) to evaluate their utility as biomarkers of disease progression and CNS involvement. Methods: Our multicenter cross-sectional study included 111 ATTRv patients (56 symptomatic, 55 pre-symptomatic subjects) and 183 HCs. Serum levels of sGFAP and sNfL were measured using ultrasensitive immunoassays. The statistical comparisons were performed using ANCOVA models (age and sex adjusted), with correlations examined between serum biomarkers and disease severity (Neuropathy Impairment Score, NIS). Results: sGFAP levels were elevated in symptomatic (median: 238.35 pg/ml) and pre-symptomatic subjects (median: 105.50 pg/ml) vs. HCs (median: 75.5 pg/ml, p < 0.001). sNfL was elevated only in symptomatic patients (median: 43.68 pg/ml) compared to pre-symptomatic subjects (median: 9.36 pg/ml) and HCs (median: 7.54 pg/ml, p < 0.001). Both biomarkers correlated significantly with NIS, reflecting disease severity. Female HCs had higher sGFAP levels than males (median 88.6 pg/ml vs. 59.8 pg/ml; p 0.011). Conclusion: sGFAP and sNfL mark distinct ATTRv stages, with sGFAP indicating early preclinical changes and sNfL correlating with neurological progression. Sex differences in sGFAP levels among HCs suggest that sex should be considered as a covariate in biomarker analyses
Valve-Sparing vs Bio-Bentall Aortic Root Replacement in Patients Aged 60 to 75 Years: Survival, Reintervention, and Aortic Regurgitation
No full textBackground: Valve-sparing root replacement (VSRR) with the David technique is an established therapy for aortic root pathology in young patients. This study evaluated short- and long-term outcomes between VSRR and aortic root replacement (ARR) with a biological-valved conduit in sexagenarians. Methods: A multicenter retrospective review from 2002 to 2022 identified 299 sexagenarians undergoing aortic root surgery, among whom 82 (27.4%) underwent VSRR and 217 (72.6%) underwent bio-Bentall. Inverse probability of treatment weighting (IPTW) was applied to balance clinical variables. Median follow-up was 15 years (interquartile range, 12-18 years). Study end points were in-hospital mortality, long-term survival, freedom from reintervention, and recurrence of at least moderate aortic regurgitation (AR). Results: There were no major differences in baseline characteristics. The incidence of bicuspid valves (VSRR, 4.9%; ARR, 19%), severe AR (42% vs 51%), type A aortic dissection (1.2% vs 6.9%), and reoperation (4% vs 23%) were higher in ARR. After IPTW, there was no difference in in-hospital mortality (VSRR, 1.2%; ARR, 4.6%; P = .3). The incidence of neurologic complications (P = .003) and permanent pacemaker implantation (P = .022) were significantly higher in the bio-Bentall group. After IPTW, 10-year survival did not differ between VSRR (87%) and ARR (80%; P = .176). However, cardiac survival was significantly higher in VSRR patients (98% vs 92%, P = .018), with deaths mainly due to infective endocarditis and end-stage heart failure. No difference was reported in reoperation/recurrence of at least moderate AR among the groups at 10 years, with only 1 patient undergoing reintervention after bio-Bentall (P = .117). Conclusions: David and bio-Bentall procedures have low in-hospital mortality and good long-term survival in sexagenarians. VSRR is associated with improved long-term cardiac survival, lower rates of infective endocarditis, permanent pacemaker implantation, and heart failure episodes, with similar rates of reintervention/recurrence of moderate AR
Outcomes in patients with chronic heart failure undergoing non‐cardiac surgery: a secondary analysis of the METREPAIR international cohort study*
No full textIntroduction: Heart failure is a frequent comorbidity in patients undergoing non-cardiac surgery and an acknowledged risk factor for postoperative mortality. The associations between stable chronic heart failure and postoperative outcomes have not been explored extensively. The aim of this study was to determine associations between stable chronic heart failure and its peri-operative management and postoperative outcomes after major non-cardiac surgery. Methods: This is a secondary analysis of MET-REPAIR, an international prospective cohort study including patients undergoing non-cardiac surgery aged ≥ 45 y with increased cardiovascular risk. Main exposures were stable chronic heart failure and availability of a pre-operative transthoracic echocardiogram. The primary endpoint was the incidence of postoperative major adverse cardiovascular events at 30 days. Secondary endpoints included 30-day mortality and severe in-hospital complications. Multivariable logistic regression models were calculated. Results: Of 15,158 included patients, 3880 (25.6%) fulfilled the diagnostic criteria for stable chronic heart failure, of whom 1397 (36%) were female. Chronic heart failure was associated with increased risk of postoperative 30-day major adverse cardiovascular events (OR 2.04, 95%CI 1.59–2.60), 30-day mortality (OR 1.50, 95%CI 1.17–1.92) and in-hospital complications (OR 1.47, 95%CI 1.30–1.66). Transthoracic echocardiography was performed in 1267 (32.7%) patients with heart failure; 146 (11.5%) patients with heart failure presented with a left ventricular ejection fraction < 40%. Reduced ejection fraction was associated with major adverse cardiovascular events (OR 2.0, 95%CI 1.01–3.81). Discussion: Stable chronic heart failure is independently associated with major adverse cardiovascular events, mortality and severe postoperative complications when measured 30 days after non-cardiac surgery
Stressing Out the ‘Damsel in Distress’: Intersectional Shifts in Women’s Representation in Video Games
No full textDigital Versus Conventional Impression Techniques in Children: A Systematic Review and Meta‐Analysis of Efficiency, Comfort and Patient Preference
No full textBackground: Conventional alginate impressions are widely used in paediatric dentistry but present several limitations. Digital intraoral scanning has emerged as a promising alternative, potentially improving patient experience and clinical efficiency. Aim: Evaluate whether digital intraoral impressions differ from conventional alginate impressions in efficiency, comfort and acceptance among paediatric patients. Design: Systematic review and meta-analysis following PRISMA 2020. PubMed, Scopus, Web of Science and SIGLE were searched to February 2025. Eligible studies enrolled children receiving both digital and conventional full-arch impressions. Risk of bias was assessed with Cochrane RoB-1, and data pooled using random-effects models. Results: Seven studies with 337 children were included. Digital impressions were faster than conventional (mean difference 165.48 s; 95% CI 157.74–173.21; p < 0.00001). Patient-reported outcomes also favoured digital scanning: lower pain (MD 13.03 mm), greater comfort (MD −34.02 mm) and less breathing difficulty (MD 32.51 mm) and gag reflex (MD 38.07 mm), all p < 0.00001. Children were over four times likelier to prefer digital scanning (RR 4.28; 95% CI 1.47–12.44; p = 0.008). Heterogeneity was high but directionally consistent. Conclusions: Digital intraoral scanning is faster, more comfortable and better accepted than conventional impressions, supporting wider use in paediatric dentistry. Trial Registration: Open Science Framework Registration number: https://doi.org/10.17605/OSF.IO/8EFHS
Specchi digitali: come i contenuti visivi sui social media modellano emancipazione e omologazione
No full textI social media rappresentano un terreno ambivalente per la costruzione dell’identità attraverso i contenuti visivi. Da un lato, offrono spazi di espressione che possono favorire l’emancipazione; dall’altro, la diffusione di filtri estetici e modelli idealizzati alimenta fenomeni di standardizzazione e confronto sociale. Questo studio esplora la tensione tra la ricerca di autenticità e le pressioni verso l’omologazione nella fruizione e produzione di contenuti visivi sui social media.
L’indagine si concentra sulle percezioni e le esperienze di un gruppo di insegnanti della scuola secondaria di primo grado del territorio foggiano. Attraverso una metodologia qualitativa basata su interviste semi-strutturate, lo studio ha indagato come i docenti interpretano il concetto di “autenticità” online e quale impatto attribuiscono all’uso di strumenti di manipolazione estetica sulla percezione di sé e sulle dinamiche relazionali.
Le interviste sono state articolate attorno a tre aree tematiche principali: percezione dell’autenticità e della manipolazione digitale, impatto sulla percezione di sé e sul confronto sociale, e il ruolo della scuola con le relative strategie educative.
I dati raccolti sono stati analizzati tramite un’analisi tematica, finalizzata a identificare
i pattern ricorrenti nelle narrazioni dei partecipanti. L’obiettivo è far emergere le strategie discorsive e le cornici di significato attraverso cui gli insegnanti interpretano la negoziazione della propria identità visiva e di quella dei loro studenti in ambienti digitali.
Questo lavoro offre un contributo esplorativo e contestualizzato, mappando le specifiche modalità con cui la dialettica tra autenticità e omologazione viene vissuta e raccontata nel contesto educativo. I risultati fanno luce sulle complesse interpretazioni soggettive legate ai contenuti visivi, fornendo una base empirica per future riflessioni pedagogiche sull’educazione ai media digitali e sulla promozione di un uso più consapevole e critico di tali strumenti
MAGICIAN: Malware classification Approach through Generation Image using a Conditional and wassersteIn generative Adversarial Network variants
No full textOne of the main challenges of cybersecurity is the detection and classification of malware to prevent damage to systems by both companies and private users. Identifying the specific type of malware is critical to performing targeted actions. This study proposes a classification approach that generates synthetic images of malware using Conditional Generative Adversarial Networks (cGAN) and Wasserstein Generative Adversarial Networks (WGAN). Using the Malimg dataset, consisting of 25 malware classes, the ResNet50 model shows an overall accuracy of 91.4% and an F1-score of 90.8% for synthetic images generated with WGAN. Resizing and resampling were employed as preprocessing strategies to obtain images of size 48 × 48; resampling has been shown to be more effective. Thus, the proposed methodology allows malware to be classified quickly and efficiently, and, on the other hand, unbalanced datasets can be enriched to aid classification performance
How place matters for innovation: a spotlight in public and private sectors
No full textThis thesis presents a unique examination of the interplay between social innovation, public policy,
and organisational behaviour, with a specific focus on marginalised areas, such as the Italian Inner
Areas and Peripheries (ESPON), which face persistent economic and social challenges. The
research, presented in three interconnected chapters, explores the role of public and private
institutions in fostering innovation. Specifically, the first two chapters concentrate on the public
side, revealing the potential role of local authorities in social innovation initiatives. In contrast, the
second chapter examines the efficiency of public service delivery in municipalities, a crucial factor
in determining the quality of life in these areas. Delving into these two main topics, the first two
chapters offer a profound understanding of the marginalized Italian areas and their current
conditions. The final chapter, instead, shifts to the private side, applying the intelligent entity view
(IEV) to predict organizational sustainability, particularly in family firms in peripheral contexts.
The first chapter of this thesis examines the 'Strategia Aree Interne,' a policy launched in 2014
aimed at bridging disparities between urban and marginal areas. It explores how local authorities
can serve as potential facilitators of the social innovation process through the application of AI-
based methodologies to analyse interventions in forty-eight municipalities in the Apulian region.
The findings highlight key municipal characteristics—such as demographics, governance quality,
and gender diversity of administration—that influence the ability of local governments to foster
social innovation and improve community well-being.
The second chapter continues to focus on inner areas, but delving into the efficiency of their public
service provision, which is a critical factor in citizens' quality of life and social inclusion. Given
municipalities' financial and logistical constraints, particularly in less-developed areas, the analysis
assesses how different contextual factors, such as being in the north rather than the south or being
an inner area, affect the delivery of those services. Moreover, by looking deeply at marginalized
Italian areas, the chapter unveils that Italian inner areas are not focusing on social services, which
are the key factor in converting the demographic depopulation, but rather on local police and road
conditions, crowding out their resources from the missions that can attract more people and boost
their growth.
The final chapter introduces the concept of the intelligent entity view (IEV) to explore
organizational behaviour in family firms operating in peripheral areas. Using AI-driven analysis
of extensive firm-year data, the study finds that organizational age and family firm status
negatively correlate with sustainability, while local embeddedness acts as a mitigating factor,
underlining the key role played by the place and its embeddedness. The chapter also proposes the
"Intelligent Entity View" (IEV), framing organizations as entities shaped by memory (age) and
perception (family firm status), which influence their ability to adapt to sustainability challenges.
Collectively, these chapters highlight the practical implications of the research findings gathered
over the last three years. They highlight the significant role of place in shaping public policy
outcomes and their willingness to innovate, as well as reach service provision efficiency to boost
local growth. Moreover, this study demonstrates how place matters for organizational behaviour
and how it influences organizations towards sustainable practices. The thesis provides new insights
into the role of local authorities in fostering sustainable change and highlights broader implications
for family firms in peripheral areas. By integrating policy analysis, AI-driven methodologies, and
organizational theory, this research provides a comprehensive framework for understanding the
dynamics of Italy's Inner Areas and wide peripheries, as well as their potential for social and
economic revitalization
Design and validation of a semi-quantitative microneutralization assay for human Metapneumovirus A1 and B1 subtypes
No full textSince 2001, human Metapneumovirus has been a significant cause of human respiratory disease worldwide, and no vaccine or preventive treatment is currently available. The ELISA-based live virus microneutralization assay is a method to detect neutralizing antibodies against a target pathogen. The aim of this study was to demonstrate the suitability of this approach to quantifying neutralizing antibodies against A1 and B1 virus subtypes in human serum samples. To standardize and validate this microneutralization assay, we carried out analytical procedures according to the International Council of Harmonization guidelines; these procedures are described in detail. In addition, we compared the validated method with the indirect ELISA, and confirmed that the ELISA-based microneutralization assay provides reliable, accurate and reproducible results. The use of this high-throughput method for large-scale serological studies could effectively support the evaluation of the immunogenicity of new vaccines, thereby improving therapeutical strategies against human Metapneumovirus