Archivio Istituzionale della Ricerca- Università degli Studi di Foggia
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Comparative Effectiveness of Cladribine and S1P Receptor Modulators in Treatment-Naive Relapsing-Remitting MS
No full textImportance: Early treatment choice in relapsing-remitting multiple sclerosis (RRMS) is prognostically crucial, yet robust comparative data on cladribine vs sphingosine-1-phosphate receptor modulators (S1PRMs) in treatment-naive patients with RRMS are limited.
Objective: To compare the clinical effectiveness of cladribine vs S1PRMs in treatment-naive individuals with RRMS.
Design, setting, and participants: This comparative effectiveness research study used data from 108 Italian multiple sclerosis (MS) centers affiliated with the Italian Multiple Sclerosis and Related Disorders Register. All treatment-naive patients with RRMS who initiated cladribine or an S1PRM (fingolimod, ozanimod, or ponesimod) between January 2011 and October 2021 and had at least 12 months of follow-up were included. Propensity score matching and pairwise censoring were used to balance baseline differences and follow-up duration. Patient data were extracted from the register in September 2024.
Exposure: Initiation of cladribine or an S1PRM, with duration reflecting clinical practice.
Main outcomes and measures: The primary outcome was no evidence of disease activity (NEDA-3) and its subcomponents. Secondary analyses evaluated disability accrual subdivided into progression independent of relapse activity (PIRA) and relapse-associated worsening (RAW), plus variables associated with treatment response. Cox proportional hazards models, adjusted for visit and magnetic resonance imaging (MRI) frequency, were used to compare outcomes.
Results: Of the 1587 patients (485 taking cladribine and 1102 taking S1PRMs), matching yielded 475 pairs (950 individuals; mean [SD] age, 34.7 [10.7] years; 686 female [72.2%]), with a median (IQR) follow-up period of 25 (12-60) months. For the cladribine vs S1PRM groups, no significant differences were observed in relapse rates (72 patients [15.2%] vs 76 patients [16.0%]), MRI activity (137 patients [31.3%] vs 145 patients [34.8%]), or NEDA-3 loss (194 patients [44.4% vs 219 patients [52.2%]). Cladribine was associated with a lower risk of disability worsening vs S1PRM (54 patients [11.4%] vs 70 patients [14.7%]; hazard ratio [HR], 0.64; 95% CI, 0.42-0.96; P = .03), a finding that was confirmed in sensitivity analyses for patients younger than 40 years, those whose diagnoses were made according to the 2017 McDonald Criteria, and those with Expanded Disability Status Scale score less than or equal to 3.0. This was mainly driven by reduced PIRA risk with cladribine (HR, 0.40; 95% CI, 0.20-0.79; P = .009), with no RAW difference. After 36 months, patients treated with cladribine showed higher relapse risk (HR, 1.81; 95% CI, 1.02-3.20; P = .04) and increased NEDA-3 loss (HR, 2.08; 95% CI, 1.18-3.67; P = .01). Discontinuation rates were similar (HR, 0.92; 95% CI, 0.67-1.15; P = .58).
Conclusions and relevance: These findings suggest cladribine was associated with superior effectiveness in reducing disability progression over 25 months, likely due to reduced PIRA, despite comparable short-term NEDA-3 outcomes. However, relapse prevention declined after 36 months, suggesting retreatment or therapy modification within 3 years may be needed to maintain long-term disease control
Correction: Ventilation practices in acute brain injured patients and association with outcomes: the VENTIBRAIN multicenter observational study (Intensive Care Medicine, (2025), 51, 2, (318-331), 10.1007/s00134-025-07808-1)
No full textWhen this article was published, the names of some participants of the study group were reversed. Instead of: Friz, Melisa Juliana Polo; Valentina, Chiarini; Silvia, Cavagna; Lorenzo, Gamberini; Piergiorgio, Lochner; Michele, Beomonte Zobel; Estera, Harajdova. Their names have been corrected to: Melisa Juliana Polo Friz, Valentina Chiarini, Silvia Cavagna, Lorenzo Gamberini, Piergiorgio Lochner, Michele Beomonte Zobel, and Estera Harajdova. The Original Article has been corrected
Cristanziano Serricchio e la parola incisa nel canto
No full textL'intervento traccia un sintetico profilo di Cristanziano Serricchio, per poi soffermarsi sulla sua produzione poetica e, in particolare, sulle "Stele daunie" (1978)
Endodontic Surgery for Separated Instrument Removal: Success Rates and Techniques in a Systematic Review
No full textBackground: Instrument separation is a frequent issue in root canals, often complicated by intriguing anatomical variations that make treatment more challenging. These variations in canal structure can lead to various iatrogenic complications, such as missed canals, instrument separation, gouging, perforation, and overextension of obturation materials. One such complication is instrument breakage, which can disrupt the cleaning and shaping processes and potentially cause pain or discomfort. Materials and Methods: The present systematic review was conducted following PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. The present systematic review aimed to identify all clinical trials focused on the removal of separated instruments from endodontic canals using an endodontic surgical approach. Results: A total of 21 studies were included, reporting 22 cases involving surgical approaches for separated instrument removal. Conclusions: The analysis of available evidence, although prim Information added.arily based on clinical cases and case series, emphasizes that surgical approaches for removing separated endodontic instruments are a viable therapeutic option when non-surgical treatments are ineffective or not feasible. Techniques such as apicoectomy, intentional replantation, surgical removal, and the technique provide innovative, customized solutions for addressing complications related to separated instruments, showing favorable clinical and radiographic success rates in follow-up assessments
Hyaluronic Acid in Female Reproductive Health: Tailoring Molecular Weight to Clinical Needs in Obstetric and Gynecological Fields
No full text
Risk Factors for Teen Dating Violence Among Sexual and Gender Minority Youths: A Systematic Review
No full textBackground: Teen dating violence (TDV) is a serious public health concern, with sexual and gender minority youth (SGMY) at elevated risk due to minority stress and systemic inequalities. This systematic review examines individual, relational, and contextual risk factors for TDV among SGMY. Methods: A systematic search was conducted in Scopus, Web of Science, and APA PsycInfo on 10 December 2024. Studies published between 2014 and 2024 focusing on teen dating violence (TDV) as an outcome among sexual and gender minority youth (SGMY) aged 13-19 were included. Study selection was independently performed by multiple reviewers using Rayyan. Risk of bias was assessed using the JBI Critical Appraisal Tools. Due to heterogeneity in the study design and measurement tools, a narrative synthesis was conducted. Results: Six risk domains emerged: (1) Demographic/Identity (e.g., gender, orientation, or race); (2) Psychological/Behavioral (e.g., distress or substance use); (3) Violence/Bullying (e.g., cyberbullying or exclusion); (4) Family/Sexual Abuse (e.g., family rejection); (5) Relational/Social (e.g., partner outing); and (6) School/Community (e.g., non-inclusive environments). Bisexual, pansexual, transgender, and racialized youth showed heightened vulnerability. Most studies were conducted in the USA and relied on non-validated TDV measures and cross-sectional designs, limiting comparability and causal inference. Conclusions: SGMY face unique, often overlooked TDV risks. There is a need for intersectional, longitudinal research and inclusive, developmentally appropriate prevention efforts that address both relational and structural factors. This review received no external funding and was not registered
Comparative volatilome profiling of milk kefir and cereal-based kefir analogues fermented with milk and water kefir grains
No full textMilk and water kefir are traditional fermented beverages attracting considerable scientific and commercial interest, due to their microbial diversity, health-enhancing properties and consumer preferences. They are linked to tradition, meet the tastes of global consumers, and are model microbiomes/fermented products of considerable relevance. In this study, a Direct Injection Mass Spectrometry (DIMS) technique, i.e., Proton Transfer Reaction Time of Flight Mass Spectrometry (PTR-ToF-MS), was exploited for the rapid and non-invasive profiling of volatile organic compounds (VOCs) during the fermentation of i) milk, ii) oat, iii) corn, and iv) barley, using both milk kefir grains and water kefir grains as fermentation microbiomes. The impact of the supplementary inoculation of a strain of Lactiplantibacillus plantarum M5MA1-B2 of biotechnological relevance, in association with kefir microbiomes, has also been evaluated. The intensity 62 ions, corresponding to volatile compounds belonging to the chemical classes of acids, aldehydes, ketones, esters, alcohols, lactones and sulfur compounds, was monitored at 13 different times, representative of the different phases of the overall fermentation time of 48 h, offering a time-scale omics approach in microbiomes study (i.e. kefir microbiomes in milk and in cereal flours). The addition of L. plantarum M5MA1-B2 to kefir grains serves as a suitable model for demonstrating the perturbation of a single-strain starter culture when inoculated in matrices fermented by complex microbiomes. A complex modulation was detected, with an overall intensity-reducing effect for many VOCs, including acetoin, diacetyl, acetaldehyde, and ethanol. Heptanal/2-heptanone (in cereal-based matrices) 2-nonanone (in all the matrices) are good markers of strain addition with respect to milk kefir grains. This study also contributed to extending the volatilome of milk kefir, describing for the first time 19 VOCs associated with this matrix (e.g. propenoic acid, methanethiol, hexenal, 2,4-heptadienal)
AI and VR as architectures of inclusive learning ecosystems: redesigning education through universal design for learning 3.0
No full textThe Universal Design for Learning (UDL) 3.0 guidelines emphasize the uniqueness of each learner and the variety of learning styles, highlighting the role of digital technologies in supporting inclusive education (CAST, 2024). This study, through a review of the existing literature, explores how the integration of Artificial Intelligence (AI) in Virtual Reality (VR) environments enables immersive and adaptive learning experiences. These experiences align with the principles of UDL 3.0, contributing to a more equitable, accessible, and personalized educational approach