Archivio Istituzionale della Ricerca- Università degli Studi di Foggia
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Introducing Eco-Speak: Language and Style in Ecological Discourse
No full textThis volume takes its title and great inspiration from the pioneering work of Harré, Brockmeier, and Mühlhäusler on language and the environment, Greenspeak: A Study of Environmental Discourse (1999). Rooted in theoretical frameworks spanning stylistics, rhetorical studies, ecolinguistics, pragmatics and Critical Discourse Analysis (CDA), this collection explores the intricate and interconnected relationship between language and our understanding of ecology and the environment. By Eco-speak, we mean the body of texts and discourses that pertain to ecological issues, themes and preoccupations, and that function across different styles, genres and format
From Senescent Cells to Systemic Inflammation: The Role of Inflammaging in Age-Related Diseases and Kidney Dysfunction
No full textHighlights: What are the main findings? Inflammaging and immunosenescence are tightly interconnected processes that drive the onset and progression of major age-related diseases. In the aging kidney, the interplay between immunosenescence and inflammaging promotes a pro-inflammatory microenvironment that impairs tissue repair and accelerates functional decline. What is the implication of the main finding? Targeting inflammaging and senescence with senolytics, immunomodulation, and lifestyle interventions may represent promising strategies to extend healthspan and mitigate age-related diseases, particularly renal pathologies Aging is characterized by a chronic, low-grade inflammatory state known as inflammaging, which closely interacts with immunosenescence—the gradual deterioration of immune function. Together, these processes contribute to tissue dysfunction and the development of age-related diseases. This review explores the cellular and molecular mechanisms underlying inflammaging, including mitochondrial dysfunction, telomere attrition, impaired autophagy, and gut microbiota dysbiosis. A particular emphasis is given to the senescence-associated secretory phenotype (SASP), which sustains a pro-inflammatory microenvironment and exacerbates tissue damage. We further discuss the impact of inflammaging on major age-related pathologies, with a focus on the kidney as a paradigmatic model of age-related decline, where inflammaging and cellular senescence contribute to chronic kidney disease (CKD) and impaired regeneration. Finally, we summarize emerging therapeutic strategies such as senolytics, senomorphics, immunomodulation, and lifestyle interventions, aimed at reducing the burden of senescent cells, mitigating inflammaging and extending healthspan
Refining SME Internationalization Strategies to Boost Innovation and Business Performance in Italian Healthcare Organizations
No full textIl metodo Montessori per l’anzianità fragile: innovazione e sperimentazione in una RSA. Un caso di studio
No full textLa presente tesi esplora l'applicazione innovativa del metodo Montessori
nell'assistenza agli anziani fragili, evidenziandone il potenziale educativo e
relazionale. AttraversSo un approccio interdisciplinare che integra
pedagogia, gerontologia e neuroscienze, lo studio analizza come i principi
montessoriani, originariamente sviluppati per l'educazione infantile,
possano essere adattati per migliorare il benessere cognitivo, emotivo e
sociale degli anziani residenti in strutture assistenziali (RSA). Al centro
della ricerca vi è l'ambiente protesico, progettato per promuovere
autonomia e dignità, e le attività personalizzate volte a stimolare le capacità
residue degli individui.
La sperimentazione è stata condotta presso la Fondazione G. Palena,
contesto ideale per testare l'efficacia di questo approccio grazie alla sua
apertura verso pratiche innovative. I risultati evidenziano un impatto
positivo sul benessere degli anziani, nonché un miglioramento delle
dinarmiche relazionali tra personale, residenti e familiari, trasformando le
RSA in comunità di apprendimento e cura reciproca. L'analisi si articola in
sei capitoli, che spaziano dai fondamenti teorici dell'educazione permanente
e del lifelong learning, alle dinamiche socioculturali dell'invecchiamento,
fino a uno studio empirico che combina metodologie qualitative e
quantitative.
I dati raccolti mettono in luce i benefici del metodo Montessori, ma anche
le criticità operative che richiedono ulteriori approfondimenti. La tesi si
conclude con una riflessione teorica e la proposta di linee guida per
l'implernentazione su vasta scala, mirando a ridefinire le RSA come luoghi
inclusivie dignitosi, capaci di promuovere una visione dell'anzianità ricca
di significati e possibilità. Questo lavoro si configura non solo come
contributo accademico, ma come stimolo per un cambiamento culturale e
operativo nell'assistenza agli anziani fragili, orientato alla valorizzazione
dell'individuo e alla dignità della persona in ogni fase della vita.This thesis explores the innovative application of the Montessori method in
caring for the frail elderly, highlighting its educational and relational
potential. Through an interdisciplinary approach that integrates pedagogy, gerontology, and neuroscience, the study analyzes how Montessori
principles, originally developed for infant education, can be adapted to
improve the cognitive, emotional, and social well-being of elderly residents
in assisted living facilities (RSAS). The focus of the research is the prosthetic
environment, designed to promote autonomy and dignity, and personalized
activities designed to stimulate individuals' residual abilities.
The trial was conducted at the G. Palena, an ideal context for testing the
effectiveness of this approach due to its openness to innovative practices.
The results show a positive impact on the well-being of the elderly, as well
as improved relational dynamics among staff, residents and family
members, transforming RSAs into communities of learning and mutual
care. The analysis is divided into six chapters, ranging from the theoretical
foundations of lifelong education and lifelong learning, to the sociocultural
dynamics of aging, to an empirical study combining qualitative and
quantitative methodologies.
The data collected highlight the benefits of the Montessori method, but also
critical operational issues that require further investigation. The
dissertation concludes with a theoretical reflection and the proposal of
guidelines for large-scale implementation, aiming to redefine RSAs as
inclusive and dignified places, capable of promotinga vision of old age rich
in meaning and possibility. This work is intended not only as an academic
contribution, but as a stimulus for cultural and operational change in the
care of the frail elderly, oriented toward the enhancement of the individual
and the dignity of the person at every stage of life
Local Recurrence After Nephron Surgery: What to Do? An Italian Multicentric Registry
No full textIntroduction and objectives: Local recurrence (LR) in patients treated with surgery for renal cell carcinoma (RCC) remains a significant clinical challenge that requires thorough investigation. Our study aimed to identify the relative risk factors and explore the optimal clinical management of LR.
Materials and methods: We conducted a non-randomized, observational, retrospective multicentric registry involving multiple Italian urological centers. We included patients treated with surgery (either nephron-sparing or radical nephrectomy) who later developed LR, defined as recurrence in the ipsilateral kidney or renal fossa. Patients with hereditary syndromes or metastatic disease at the time of LR diagnosis were excluded.
Results: We reported 135 cases of LR with the following characteristics: most primary lesions were monofocal (85.7%), with a median size of 42 mm (23-53), the median R.E.N.A.L. score was 7 (6-8), and the median Padua score was 7 (6-9). Patients were treated with robot-assisted techniques in 59% of cases, laparoscopic surgery in 32.4%, and open surgery in 8.6%. Nephron-sparing surgery was performed in 75.2% of cases. Ischemia occurred in 61% of the cases, with a median ischemia time of 21 min (15.5-24). Intraoperative complications occurred in 3.8% of cases, while postoperative complications were reported in 13.8%, all of which were grade ≤3 according to the Clavien-Dindo classification. The primary tumors were pT1a in 43.5% of cases, pT1b in 26.3%, pT2 in 14.7% and pT3 in 15.5%. Histologically, 84% of cases were clear cell, 11.3% papillary type 1 or 2, and 3.7% chromophobe. Sarcomatoid/rhabdoid variants were present in 10.5% of cases. The median rate of LR was 1.3% (range 0.2-3.6), while the median time to LR was 18 months (12-39). LR occurred in the ipsilateral kidney in 70.5% of cases and in the ipsilateral renal fossa in 29.5%. The median rate of PSM in LR cases at initial surgery was 2.4% (range 0-4.3), while the median rate of negative surgical margin (NSM) in LR cases at initial surgery was 0.1 (0-0.3). Following LR diagnosis, most patients (49.2%) underwent surgery, 29.1% received cryoablation or radiotherapy, 17.1% received systemic treatment alone, and 4.6% followed a watchful waiting/active surveillance approach. At a median follow-up of 62 months, the highest oncological control in terms of 5-year cancer-specific survival and overall survival rates was achieved in surgically treated patients. The PSM, the histological variant, and their combination were found to be independent variables correlated with the occurrence of LR, with relative risks of 3.62, 2.71, and 8.12, respectively.
Conclusions: LR after nephron-sparing or radical nephrectomy represents a significant clinical dilemma. Known risk factors are not always sufficient to predict recurrence, emphasizing the necessity of consistent radiological follow-up per guideline recommendations. Early detection of recurrence and a multidisciplinary approach involving expert centers are crucial for optimizing patient outcomes
Phosphate metabolism in primary hyperparathyroidism: a real-life long-term study
No full textPurpose: Parathyroid hormone controls calcium and phosphate metabolism. The latter is also regulated by both FGF23 and 1–25(OH)2VitaminD. The polymorphic variant c.716 C > T of the FGF23 gene was previously found to be associated with renal phosphate leak/nephrolithiasis. The aim of our research is to study the metabolism of phosphate in a cohort of patients with primary hyperparathyroidism (PHPT) and its impact on bone and kidney. Methods: We have retrospectively compared a large sample of sporadic PHPT patients (339) with historical comparison cohort (HCC 503: Olivetti Study Group and Siena Osteoporosis Study). Moreover, in 51 PHPT patients, phosphate metabolism indexes were also revaluated at least 2 years after surgical cure. The variant c.716 C > T of the FGF23 gene was genotyped in patients and in a small sample of the control group. Results: In PHPT patients we found higher levels of serum calcium, PTH, alkaline phosphatase, beta-C-terminal telopeptide (CTx), urinary calcium, while serum phosphate, 25OH-VitaminD, maximal tubular renal phosphate reabsorption adjusted for glomerular filtration rate (TmPO4/GFR) were lower than what was found in HCC. In PHPT patients fibroblast growth factor 23 (FGF23) levels were higher than in controls. Patients with kidney stones carried the 716 T allele more frequently than patients without it (χ2 7.20, p = 0.027). In PHPT patients revaluated at least 2 years after surgery, we observed a significant reduction of 1–25(OH)2VitaminD and FGF23. According to the median of serum phosphate levels, PHPT patients were subdivided into two subgroups: ≤2.8 mg/dL and > 2.8 mg/dL. The lowest phosphate group had a significantly higher serum calcium, PTH, 1–25(OH)2VitaminD, urinary calcium and a higher prevalence of kidney stones than in the highest phosphate group. The rate of males in the lowest phosphate group was significantly higher than in the highest phosphate group. Conclusion: Our study shows that the regulators of phosphate metabolism in PHPT patients are higher than controls and they significantly reduce after surgical cure. PHPT patients with low serum phosphate have a worse biochemical and clinical phenotype
Endothelial Function And Ph: Correlations Between Flow-Mediated Dilatation And Invasive Hemodynamic Parameters
No full textBackground: Endothelial dysfunction plays a central role in the pathophysiology of
pulmonary hypertension (PH), contributing to vascular remodeling, vasoconstriction, and
increased pulmonary vascular resistance (PVR). While right heart catheterization (RHC)
remains the gold standard for PH diagnosis, its invasive nature underscores the need for
noninvasive predictive tools. This study aimed to evaluate the correlation between
peripheral endothelial function, assessed noninvasively by brachial artery flow-mediated
dilation (FMD), and invasive hemodynamic parameters in patients with suspected PH.
Methods: A prospective study was conducted on 95 consecutive outpatients with suspected
PH, referred to the Pulmonary Hypertension Ambulatory Clinic at “Policlinico Riuniti” in
Foggia, Italy, between February 2021 and June 2023. Patients underwent comprehensive
evaluations, including clinical examination, echocardiography, FMD, and RHC. FMD was
performed according to established guidelines, and hemodynamic parameters such as
systolic pulmonary artery pressure (sPAP), mean pulmonary artery pressure (mPAP), and
PVR were measured via RHC. Statistical analyses included Pearson’s correlation,
multivariable regression, and stratification based on FMD and peak tricuspid regurgitation
velocity (peak TRV).
Results: FMD values were inversely correlated with sPAP (r = -0.29, p = 0.016), with a
borderline correlation to PVR (r = -0.21, p = 0.78). Multivariable regression confirmed FMD
as an independent predictor of sPAP (B = -47, p = 0.02). Stratification by FMD and peak
TRV revealed progressively higher sPAP, mPAP, and PVR in patients with impaired FMD
and elevated peak TRV (p for trend <0.001). Patients with both impaired FMD and peak
TRV had the highest hemodynamic burden, suggesting FMD as a potential noninvasive
marker for PH severity.
Conclusion: This study demonstrates that FMD, in combination with echocardiographic
parameters, can serve as a noninvasive tool for predicting PH severity and guiding patient
selection for RHC. The inverse correlation between FMD and sPAP, along with the
progressive increase in hemodynamic parameters in patients with impaired FMD, highlights
the systemic nature of endothelial dysfunction in PH. These findings support the use of FMD
as a cost-effective and reproducible method for risk stratification and monitoring in PH.
Further multicenter studies are needed to validate these results and explore the role of FMD
in treatment response and disease progression
Impact of post treatment processes on the performance of 316L stainless steel parts manufactured through metal material extrusion additive manufacturing
No full textThe Pivotal role of hysteroscopy in diagnosing subtle uterine lesions in infertile patients: Seeing the unseen can make the difference
No full textBackground: Subtle uterine lesions are abnormal intracavitary conditions that, while not causing significant anatomical changes, can adversely impact fertility. Identifying these “subtle” lesions is challenging due to arbitrary interpretation, varied management strategies, unclear clinical significance, and insufficient clinician training in recognizing them. Hysteroscopy offers direct visualization and the capacity to obtain targeted biopsies, making it an invaluable tool for the diagnosis and treatment of these often overlooked conditions. Purpose: The lack of standardized and universally accepted terminology complicates the diagnosis and treatment of subtle uterine pathologies. A thorough understanding of how to identify and effectively manage these lesions is essential for the treatment of infertile patients. This review summarizes the critical and evolving subtle uterine lesions that clinicians frequently overlook during hysteroscopic procedures, highlighting the importance of accurate identification and its potential to improve reproductive outcomes. Methods: This literature review followed the Scale for the Quality Assessment of Narrative Review Articles (SANRA) guidelines. All articles discussing infertility-related issues and subtle lesions diagnosable with hysteroscopy were deemed eligible for inclusion. Results: We identified several subtle uterine lesions that are often overlooked during routine hysteroscopic evaluations but can adversely impact fertility. These include morphological abnormalities such as the T-shaped uterus, cystic lesions of the uterine wall, adenomyosis, cervicitis, cervical and tubal endometriosis, and endometrial conditions such as chronic endometritis, thin endometrium and endometrial calcifications. Conclusions: Effective diagnosis and treatment of subtle uterine lesions is essential to fertility care. Knowing which lesions are commonly missed and understanding their endoscopic features and potential clinical implications, is crucial for enhancing the diagnostic capacity of hysteroscopy. This, in turn, may improve reproductive outcomes and the overall quality of care of infertile patients
Spunti di fisiognomica e rappresentazione delle emozioni nella narrativa di Antonio Fogazzaro
No full textAbstract The essay focuses on aspects of physiognomy and their adoption for caricatural or humorous purposes in Fogazzaro’s work. It begins with the depiction of the Marchesa Orsola in Piccolo mondo antico; then examines some characters of the tales by Antonio Fogazzaro. The essayst reflects about elements of zoomorphism, distortion of character's features, introduction of contrasting factors, and about the specific use of clothing as a caricatural or humoristic factor. Riassunto Il saggio si sofferma su spunti di fisiognomica e loro adozione in funzione caricaturale o umoristica nell’opera fogazzariana. Muove dalla figura della marchesa Orsola in Piccolo mondo antico, per poi soffermarsi sui racconti di Antonio Fogazzaro. Sono indagati in particolar modo elementi di zoomorfismo, deformazione dei tratti, introduzione di fattori contrastivi e uso specifico del fattore abbigliamento