Archivio Istituzionale della Ricerca- Università degli Studi di Foggia
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Research AI: integrating AI and gamification in higher education for e-learning optimization and soft skills assessment through a cross-study synthesis
No full textCOVID-19: a global health system unfit for purpose
No full textThe COVID-19 pandemic has exposed critical weaknesses in global health systems, highlighting deep-rooted socioeconomic disparities and systemic vulnerabilities. Lower-income communities, particularly ethnic minorities, faced dispro-portionately higher infection and mortality rates due to overcrowding, limited healthcare access, and occupational expo-sure. Additionally, resource-limited settings and conflict-affected regions, such as Syria, encountered severe challenges in managing the pandemic due to fragile healthcare infrastructures. The pandemic also emphasized the role of community-driven interventions and the necessity of equitable healthcare policies. This narrative review synthesizes evidence from peer-reviewed studies, policy reports, and public health data to examine the interplay between socioeconomic disparities, healthcare accessibility, and pandemic outcomes. A systematic search of relevant literature was conducted to identify key factors contributing to health inequities during COVID-19, with a focus on healthcare workforce shortages, international migration, and the effectiveness of preventative measures. Findings indicate that lower-income populations experienced higher morbidity and mortality rates due to structural inequities in healthcare access and social determinants of health. The global shortage of healthcare workers, exacerbated by international migration, further strained health systems, particularly in low-resource settings. In conflict-affected regions, fragile healthcare infrastructures struggled to contain the virus. Community-driven interventions, including vaccination campaigns and localized public health initiatives, played a critical role in mitigating disease spread. However, systemic barriers persist, limiting the effectiveness of these mea-sures. Addressing global health inequities requires a multifaceted approach that integrates economic policies, healthcare reforms, and international collaboration. Strengthening primary care, investing in healthcare workforce retention, and re-ducing socioeconomic disparities are essential for building resilient health systems. The pandemic underscores the urgent need for structural reforms to enhance global pandemic preparedness and promote equitable health outcomes worldwide
I reperti lignei dal pozzo di Campo della Fiera: ambiente, tecnologia e vita quotidiana dal Convento alla Fiera
No full textModelling the counterparty credit risk of a swap on the spark spread
No full textWe consider the impact of counterparty risk on the pricing of financial derivatives contracts on energy commodities. We model the counterparty credit risk exposure within the Heath-Jarrow-Morton framework (Heath et al. Econ J Econ Soc. 6: 77-105, 1992), allowing the counterparty credit spread curve to evolve according to its own volatility and to the correlation between the risk-free interest rate and the credit spread. We focus on the case in which the underlying swap contract is the spark spread. We evaluate the counterparty credit valuation adjustment (CVA) of the swap fair price. In doing so, we take into consideration all relevant correlations, namely the correlation between the electricity and natural gas return processes and between these and the credit spread. Finally, we show how in our framework CVA varies with electricity and natural gas price volatilities, with the volatility of the credit spread, and as a function of the correlation between the spark spread and the counterparty credit spread
How to Assess Pulmonary Circulation and Right Heart Chambers in Systemic Sclerosis Patients?
No full textSystemic sclerosis (SSc) is a rare autoimmune connective tissue disease characterized by a widespread accumulation of extracellular matrix components leading to fibrosis of the skin and internal organs. Vascular changes occur in all involved tissues and are responsible for several distinctive clinical manifestations of the disease. This review focuses on the usefulness of various diagnostic tools in clinical practice for the early identification of clinical, functional, and/or structural RV impairment in SSc patients at risk of PH. It aims to identify specific causes of RV dysfunction, describe potential differences in outcome measures, and, ultimately, determine different cut-off values compared to subjects with PH not related to SSc
Robot-Assisted Radical Cystectomy with Ureterocutaneostomy: A Potentially Optimal Solution for Octogenarian and Frail Patients with Bladder Cancer
No full textBackground/Objectives: Robot-assisted radical cystectomy (RARC) has become the primary approach for treating bladder cancer, replacing the traditional open procedure. The robotic approach, when combined with ureterocutaneostomy (UCS), offers significant advantages for octogenarians, who are at increased risk for perioperative complications. Methods: This observational, prospective, multicenter analysis is based on data from the Italian Radical Cystectomy Registry (RIC), collected from January 2017 to June 2020 across 28 major urological centers in Italy. We analyzed consecutive male and female patients undergoing radical cystectomy (RC) and urinary diversion via the open, laparoscopic, or robot-assisted technique. Inclusion criteria: patients aged 80 years or older, with a WHO Performance Status (PS) of 2-3, an American Society of Anesthesiologist score ≥3, a Charlson Comorbidity Index (CCI) ≥ 4, and a glomerular filtration rate (GFR) <60 mL/min. Results: A total of 128 consecutive patients were included: 41 underwent RARC with UCS (Group 1), 65 open RC (ORC) with UCS (Group 2), and 22 laparoscopic RC (LRC) with UCS (Group 3). The cystectomy operative time was longer in robotic surgeries, while the lymph node dissection time was shorter. RARC with UCS showed statistically significant advantages in terms of lower median estimated blood loss (EBL), transfusion rate, and length of hospital stay (LOS) compared to open and laparoscopic procedures. Intra- and postoperative complications were also lower in the RARC groups. Conclusions: Robotic cystectomy in high-volume referral centers (≥20 cystectomies per year) provides the best outcome for fragile patients. Beyond addressing the baseline pathology, RARC with UCS may represent a leading option, offering oncological control while reducing complications in this vulnerable age group
Genetic Background and Clinical Phenotype in an Italian Cohort with Inherited Arrhythmia Syndromes and Arrhythmogenic Cardiomyopathy (ACM): A Whole-Exome Sequencing Study
No full textInherited arrhythmia syndromes include several different diseases, as well as Brugada syndrome (BrS), long QT syndrome (LQTS), catecholaminergic polymorphic ventricular tachycardia (CPVT), and short QT syndrome (SQTS). They represent, together with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C), an important cause of sudden cardiac death in the young. Most arrhythmia syndromes are inherited in an autosomal dominant manner, and genetic studies are suggested.: to report the spectrum of genetic variations and clinical phenotype in an Italian cohort with confirmed inherited arrhythmia syndromes and arrhythmogenic cardiomyopathy using whole-exome sequencing (WES). Patients with confirmed inherited arrhythmia syndromes and hereditary cardiomyopathy were recruited at the Cardiology Unit, University Polyclinic Hospital of Foggia, Italy and were included in this study. Genomic DNA samples were extracted from peripheral blood and conducted for WES. The variants were annotated using BaseSpace Variant Interpreter Annotation Engine 3.15.0.0 (Illumina). Reported variants were investigated using ClinVar, VarSome Franklin and a literature review. They were categorised agreeing to the criteria of the American College of Medical Genetics and Genomics. Overall, 62 patients were enrolled. Most of them had a clinical diagnosis of BrS (n 48, 77%). The remaining patients included in the present study had diagnosis of confirmed LQT (n 7, 11%), AR-DCM (n 4, 6.5%), ARVD (n 2, 3%), and SQT (n 1, 1.6%). Using the WES technique, 22 variants in 15 genes associated with Brugada syndrome were identified in 21 patients (34%). Among these, the SCN5A gene had the highest number of variants (6 variants, 27%), followed by KCNJ5 and CASQ2 (2 variants). Only one variant was identified in the remaining genes. In 27 patients with a clinical diagnosis of BrS, no gene variant was detected. In patients with confirmed LQT, SQT, 10 variants in 9 genes were identified. Among patients with ARVD and AR-DCM, 6 variants in 5 genes were found. Variants found in our cohort were classified as pathogenic (6), likely pathogenic (3), of uncertain significance (26), and benign (1). Two additional gene variants were classified as risk factors. In this study, 13 novel genetic variations were recognized to be associated with inherited arrhythmogenic cardiomyopathies. Our understanding of inherited arrhythmia syndromes continues to progress. The era of next-generation sequencing has advanced quickly, given new genetic evidence including pathogenicity, background genetic noise, and increased discovery of variants of uncertain significance. Although NGS study has some limits in finding the full genetic data of probands, large-scale gene sequencing can promptly be applied in real clinical practices, especially in inherited and possibly fatal arrhythmia syndromes
