Archivio Istituzionale della Ricerca- Università degli Studi di Foggia
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DAL PENSIERO CREATIVO ALL’AZIONE IMPRENDITORIALE: IL DESIGN THINKING PER INNOVARE LE AREE INTERNE
No full textContinuous positive airway pressure to prevent reintubation in patients recovering from cardiac surgery
No full textBACKGROUND Pulmonary complications, including atelectasis and reintubation, are common after cardiac surgery and are associated with increased morbidity and mortality. Postoperative continuous positive airway pressure (CPAP) may reduce these risks, but its effectiveness remains uncertain. OBJECTIVES To assess whether CPAP reduces the need for reintubation in hypoxaemic patients after cardiac surgery, and to evaluate its effect on other postoperative pulmonary complications. DESIGN Multicentre, open-label, randomised clinical trial. The study was prematurely terminated due to funding constraints, leading to an underpowered sample. SETTING Ten university-affiliated hospitals across Italy. PATIENTS Adults undergoing cardiac surgery with cardiopulmonary bypass who developed a PaO2/FiO2 ratio 200 or less within 1 h of extubation. Exclusion criteria included severe COPD, previous mechanical ventilation and lack of consent. MAIN OUTCOME MEASURES The primary endpoint was reintubation within 28 days of surgery. Secondary endpoints included atelectasis, pneumonia, sepsis, mortality and oxygenation. RESULTS The incidence of reintubation was 10.8% (95% confidence interval [CI], 6.52 to 15.15) in the control group and 8.3% (95% CI, 4.51 to 12.16) in the treatment group (P = 0.3908). In contrast, the occurrence of atelectasis was significantly higher in the control group at 24.1% (95% CI, 18.20 to 30.07) compared with 14.2% (95% CI, 9.38 to 19.05) in the treatment group (P = 0.0110). At 48 h, the incidence of reintubation was significantly lower in the CPAP group 2.94% (95% CI, 0.60 to 5.28) compared with the control group, 7.39% (95% CI, 3.76 to 11.02), P = 0.0425. No significant differences in pneumonia, sepsis or mortality were observed. CPAP significantly improved oxygenation (P < 0.0001). CONCLUSION CPAP did not significantly reduce 28-day reintubation rates compared with oxygen therapy via Venturi mask. However, CPAP was associated with a significant reduction in atelectasis and early reintubation at 48 h. Further research is warranted to confirm these findings and compare CPAP with other noninvasive support strategies. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01726140
H.M. Enzensberger e il Romanticismo. La poesia in un’epoca di cambiamenti culturali
No full textIl volume approfondisce l’indagine su una parte finora poco considerata, ma peculiare della produzione di Hans Magnus Enzensberger, relativa al suo interesse profondo per il Romanticismo, per le questioni di poetica e per la vita romantica. Mostrando come un capitolo così importante per la cultura e l’identità europea come il Romanticismo venga riletto e reinterpretato da Enzensberger, i saggi qui contenuti esaminano diversi aspetti di questo confronto. Il rapporto con il Romanticismo, e in particolare con Clemens Brentano, segna il percorso del poeta moderno con un’attenzione che rivela e rielabora caratteristiche e aspetti non consueti della poesia di Brentano, crea veri e propri esperimenti intermediali intorno alla relazione tempestosa e distruttiva del poeta romantico con la giovane Auguste Bußmann, che viene ripresa nel Requiem cinematografico di Dagmar Knöpfel tentando di leggere insieme vita e scrittura
Antioxidant Activity and Anti-Inflammatory Effect of Blood Orange By-Products in Treated HT-29 and Caco-2 Colorectal Cancer Cell Lines
No full textBlood orange peel flour (BO-pf)—a by-product of the citrus supply chain—still contains bioactive molecules with known health benefits, such as antiradical scavenging activity or an antiproliferative activity regarding tumors. In vitro studies have demonstrated that orange polyphenols showed potential involvement in necroptosis. In addition to previous research, we tested BO-pf on two colorectal cancer cell lines. Using HT29 and Caco2 cells, our experiments confirmed the regulation of inflammasome expression. They provided valuable insights into how BO-pf influences the cancer cell features (i.e., viability, proliferation, and pro- and anti-inflammatory activity). Notably, BO-pf extract is a rich source of polyphenolic compounds with antioxidant properties. Western blot and real-time PCR analyses showed that treatment with BO-pf extract demonstrated beneficial effects by influencing the expression of both pro-inflammatory cytokines (IL-1β, IL-6) through the modulation of the TLR4/NF-kB/NLRP3 inflammasome signaling. Moreover, the results of this study demonstrate that BO-pf extracts can enhance the expression of anti-inflammatory cytokines, such as IL-10 and TGFβ, suggesting that BO-pf extracts may represent a promising functional ingredient to counteract the intestinal inflammatory responses involved in IBD
Occupational zoonoses, neurological diseases, and public health: A one health approach
No full textZoonotic diseases, which constitute 60% of all human infectious diseases, present substantial risks to public health, economies, and livelihoods. These diseases emerge at the human-animal-environment interface, with occupational exposure representing a critical yet underexamined dimension of zoonotic risk. Workers in high-risk sectors such as agriculture, wildlife management, and laboratory research face elevated exposure to zoonotic pathogens, often under conditions of inadequate preventive measures and resource constraints. Neurological disorders resulting from zoonotic infections, including Guillain-Barré syndrome, encephalitis, and meningitis, illustrate the severe health consequences for occupational groups. Cases linked to swine hepatitis E virus, West Nile virus, Streptococcus suis, and Baylisascaris procyonis underscore the urgent need for robust surveillance and targeted interventions. The Ecohealth approach, integrated with the One Health framework, provides a transformative model for managing zoonotic risks by addressing the upstream drivers of disease emergence. By emphasizing environmental stewardship, ecological balance, and socio-economic equity, Ecohealth fosters sustainable preventive strategies. Occupational medicine is crucial in linking workplace safety with public health through tailored risk management, enhanced surveillance, and targeted education. Despite these frameworks, significant barriers persist, including data gaps, underreporting of occupational diseases, and insufficient coordination among health sectors. Addressing these challenges requires implementing standardized occupational health surveillance systems, enhancing reporting mechanisms through digital tools, and promoting cross-sectoral data-sharing initiatives. Successful models, such as sentinel surveillance programs in agricultural sectors and integrated biosurveillance networks, demonstrate the feasibility of these strategies. Leveraging these approaches can facilitate early detection, improve reporting accuracy, and support evidence-based interventions
Toward a Unified Definition of Progression Independent of Relapse Activity in Multiple Sclerosis
No full textObjectives: Progression independent of relapse activity (PIRA) is the main driver of disability accumulation in relapsing multiple sclerosis (MS). We tested various PIRA definitions against the risk of long-term disability.
Methods: Patients with relapsing MS, first visit ≥January 1, 2000, ≥3 visits with Expanded Disability Status Scale (EDSS), and ≥5-year follow-up were extracted from the Italian MS and Related Disorders Register on September 29, 2023. Eighteen PIRA definitions were obtained combining fixed or roving baseline, 24-week, 48-week confirmed or sustained disability accrual, no relapses ≤90 days before/≤30 days after the event (90d), ≤180 days before/≤30 days after the event, or absence of relapses from baseline to confirmation score (ABS). Predictive performance against the reaching of EDSS = 6.0 was calculated.
Results: A total of 30,203 patients were included. After a follow-up of 11.3 ± 4.3 years, PIRA ranged from 38.8% to 74.1%. EDSS = 6.0 was detected in 4,401 (15%) patients. Sensitivity of PIRA definitions against EDSS = 6.0 was higher using the 90d criterion (66.7%-69.4%), while the ABS criterion increased specificity (55.3%-62.2%).
Discussion: The definition of PIRA combining roving baseline, no relapses 90 days before and 30 days after the event and 24-week confirmation achieved the best predictive value and feasibility, supporting its use in routine practice and research
nuovo diritto civile
No full textLa nota analizza criticamente la pronunzia della S.C., la quale ha ritenuto che
nell’ambito di distinti pacchetti di viaggio tutto compreso, acquistati separatamente
seppur funzionalmente collegati, la sopravvenuta carenza di interesse alla fruizione
del servizio da parte di uno dei partecipanti costituisca giusta causa di scioglimento
dal vincolo anche per gli altri viaggiatori, soluzione che, addossando interamente al
tour operator il rischio per eventi sopravvenuti attinenti la sfera soggettiva del cliente,
sembra porsi in aperto contrasto con i principi ricavabili dalla disciplina nazionale
ed euro unitaria
