Archivio Istituzionale della Ricerca- Università del Piemonte Orientale
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Trust e Comunità Energetiche Rinnovabili: una governance fiduciaria per l’impatto socio-ambientale
No full textGli incentivi economici percepiti dalle Comunità Energetiche Circolari (CER) possono, attraverso l’impiego del trust, trasformarsi in un patrimonio destinato a beneficio del territorio nel quale le CER sono insediate, garantendo continuità, trasparenza e misurabilità degli impatti generati dalla condivisione dell’energia, che è lo scopo
principale della Comunità.
In questa prospettiva, il trust opera non soltanto come presidio di tutela patrimoniale, ma anche come veicolo capace di orientare l’impiego delle risorse via via raccolte verso progetti di utilità sociale e ambientale, assicurando che il valore generato rimanga radicato nel territorio che ospita la CER e venga redistribuito, al suo interno, in
maniera programmata, trasparente e verificabile.
Questa applicazione potrebbe originare un modello standardizzato di “trust di comunità energetica”, replicabile in contesti diversi e capace di fungere da catalizzatore di fiducia, di attrarre co-finanziamenti e di consolidare buone pratiche di governance a beneficio della transizione ecologica e social
Single-Inhaler Triple Therapy in Primary Care Across Europe: Expert Panel Consensus on the Consequences of Payer-Driven Access Rules and Call to Action
Get PDFBackground: Chronic obstructive pulmonary disease (COPD) is a prevalent condition characterized by persistent airflow obstruction and respiratory symptoms. Single-Inhaler Triple Therapy (SITT) has been shown to improve patient adherence, reduce exacerbations, and lower healthcare resource utilization in patients who are not controlled despite being on dual therapy or Multiple-Inhaler Triple Therapy (MITT). Despite evidence supporting SITT, payer-driven access rules across Europe sometimes limit its use in primary care, creating barriers to optimal COPD management. Purpose: Through expert consensus, the study seeks to generate a shared understanding of the unintended consequences of payer-driven access criteria for SITT in managing moderate-to-severe COPD in primary care. Methods: A targeted literature review (TLR) was conducted to assess SITT initiation in primary care across Europe and examine the impact of access criteria. Semi-structured interviews were held with 14 experts from nine European countries, including clinicians, health economists, and patient advocacy representatives. A consensus generation workshop was conducted, where experts evaluated the findings and developed position statements to highlight the challenges posed by payer-driven access criteria. Results: The TLR identified variability in access to SITT in Europe, with several countries restricting its initiation to specialists, thus limiting primary care physicians’ (PCPs) ability to prescribe SITT. The expert panel generated seven consensus points stating that enabling PCPs to step up or switch eligible patients to SITT has the potential to support care continuity, enhance clinical autonomy for PCPs, reduce reliance on potentially less effective treatment options, improve patient and healthcare system outcomes, avoid unnecessary referrals to specialists, enable prompt initiation of guideline-directed medical therapy for COPD in primary care and reduce access inequalities. Conclusion: Restrictions for SITT initiation in primary care may need to be revisited to mitigate their unintended health and cost consequences and improve equitable access to treatment. This should take into consideration each country’s unique healthcare system
. “La sostanza come forma separabile in Aristotele”, in Atti della Società Italiana di Storia della Filosofia Antica. Dibattiti antichi: ontologia, fisica e metafisica. Cinque studi a cura di C. Lo Casto , S. Maso - Edizioni di Storia e Letteratura - 2025, pp. 1-27.
No full textSearches for hidden sectors using K+→ π+X decays
No full textResults from the study of the rare decays K+→π+νν ̄, K+ → π+μ+μ− and K+ → π+γγ at the NA62 experiment at CERN are interpreted in terms of improved limits for BK+→π+X and coupling parameters of hidden-sector models, where X is a mediator. World-leading limits are achieved for dark photon, dark scalar and axion-like particle models
Myosin-ATPase inhibitor in real-world patients with obstructive HCM: a report by the Cardiomyopathies and Pericardial Diseases WG of the Italian Society of Cardiology
No full textIntroductionApproximately two-thirds of patients suffering from hypertrophic cardiomyopathy present with an obstructive (HOCM) physiology. For years, medical therapy has been limited to beta blockers, verapamil and/or disopyramide. Recently, a novel class of drugs, the allosteric inhibitors of the cardiac-specific myosin head adenosine triphosphatase (ATPase), have been demonstrated to be effective in relieving the dynamic obstruction and related clinical condition. In July 2024 the Cardiomyopathies and Pericardial Diseases WG of the Italian Society of Cardiology started with a nationwide multicentre registry aimed at investigating the pathophysiology of dynamic obstruction in real-world patients with HOCM. Based on the medical records, this brief report deals with the proportion of patients who were eligible for Mavacamten based on the Explorer-HCM entry criteria, and then admitted for compassionate use by the end of 2024.Methods and resultsThe Hypertrophic Obstructive Physiology Study (HOPS) was designed as a registry on consecutive adult patients admitted to 19 tertiary Cardiac Centres in Italy until June 2024. A total of 424 patients, 53% males, aged 64 ± 13 years, were included. We retrospectively recognized 200 Mavacamten-eligible patients (47.2%) on 5 Explorer-HCM requirements. Forty out of this latter group, along with 15 more patients on 4 criteria, were admitted to the compassionate use programme (n = 55, 13% of the whole population). Forty-three showed subaortic obstruction and 12 a mid-ventricular variant. Ethical committee approval items varied among centres and regions.DiscussionThis study confirmed our recent demonstration that approximately half of real-world HOCM patients are suitable for Mavacamten therapy based on the full Explorer-HCM trial entry criteria. Due to the current limitation of compassionate use programmes in Italy, only one in four patients was admitted for treatment
Metabolic profile of biodiverse diets in a healthy European cohort
No full textBackground: There is increasing evidence that diets characterized by food biodiversity could contribute to health outcomes. Greater dietary species diversity has been linked to reduced gastrointestinal cancer risk and all-cause mortality. However, mechanistic pathways supporting the association between food biodiversity and health are just beginning to be explored. Aim: To characterize the metabolic profile associated with food biodiversity of diets in a pan-European population. Methods: Dietary species richness (DSR), or the absolute number of unique species in an individual's diet, was calculated for 7,983 cancer-free control participants within the European Prospective Investigation into Cancer and Nutrition cohort study. Usual dietary intakes in the preceding year were assessed at recruitment with country-specific dietary questionnaires. Metabolomic profiles from blood which included 128 circulating endogenous metabolites,32 polyphenol compounds, and 39 fatty acid isomers were used as biomarkers of potential mechanisms underlying nutrition and health associations. Lasso regression identified key metabolites in discovery and replication sets, and multivariable stepwise linear regression were used to quantify associations between DSR and metabolomic profiles. Results: A total of 52 metabolites were selected using Lasso regression in the replication set, of which 70% were statistically significant in stepwise linear regression. Higher DSR was associated with lower levels of 4 amino acids (e.g., tyrosine, -0.0231, 95% CI: -0.0362, -0.0100, p = 0.0009) and 2 acylcarnitines (e.g., C14:2, -0.0834, 95% CI: -0.1084, -0.0583, p < 0.0001). Conversely, higher levels were observed for 7 amino acids (e.g., tryptophan, -0.0954, 95% CI: -0.1049, -0.0860, p < 0.0001) and 9 polyphenols (e.g., epicatechin, p = 0.0017). Conclusion: In this European middle-aged adult population, the circulating metabolic profiles of biodiverse diets are consistent with the metabolome linked with health-promoting diets, indicating metabolite groups that provide metabolic homeostasis, anti-inflammatory, anti-oxidative stress, and anti-obesogenic properties. These findings support the health benefits of consuming more diverse dietary species and may partially explain the inverse associations found in relation with mortality or gastrointestinal cancer
Sheathless delivery of a transfemoral pulsatile left ventricular assist device for high-risk percutaneous interventions: a case series
No full textBackground The use of mechanical circulatory support (MCS) can reduce adverse events in patients with severely impaired left ventricular (LV) function and precarious haemodynamics during complex cardiovascular procedures. Despite numerous benefits, MCS requires large-bore access, which increases the risks of vascular complications. The iVAC2L (PulseCath BV, Arnhem, The Netherlands) provides up to 2.0 L/min output using pulsatile flow and is an effective tool for LV unloading, but requires a large-bore sheath (18 Fr). Case summary We describe four cases of sheathless insertion of iVAC2L during high-risk cardiovascular interventions. Two cases consisted in high-risk percutaneous coronary interventions, and two other cases were transcatheter edge-to-edge mitral valve repair. All cases were successful, and no adverse events could be observed. Discussion The sheathless approach requires an 11% smaller arteriotomy. This case series aims to display how the iVAC2L catheter can be deployed without a sheath to minimize access size in a safe and feasible manner and proposes a structured approach to its deployment. When performed in selected patients, this strategy may reduce vascular complications. Conclusion Sheathless introduction of iVAC2L was feasible and safe safely deployed in selected cases of coronary and structural interventions. Larger studies are necessary to further define its impact on event rates
Model-agnostic search for dijet resonances with anomalous jet substructure in proton–proton collisions at s = 13 TeV
No full text: This paper presents a model-agnostic search for narrow resonances in the dijet final state in the mass range 1.8-6 TeV. The signal is assumed to produce jets with substructure atypical of jets initiated by light quarks or gluons, with minimal additional assumptions. Search regions are obtained by utilizing multivariate machine-learning methods to select jets with anomalous substructure. A collection of complementary anomaly detection methods-based on unsupervised, weakly supervised, and semisupervised algorithms-are used in order to maximize the sensitivity to unknown new physics signatures. These algorithms are applied to data corresponding to an integrated luminosity of 138 fb-1, recorded by the CMS experiment at the LHC, at a center-of-mass energy of 13 TeV. No significant excesses above background expectations are seen. Exclusion limits are derived on the production cross section of benchmark signal models varying in resonance mass, jet mass, and jet substructure. Many of these signatures have not been previously sought, making several of the limits reported on the corresponding benchmark models the first ever. When compared to benchmark inclusive and substructure-based search strategies, the anomaly detection methods are found to significantly enhance the sensitivity to a variety of models
Circulating microRNAs as Early Biomarkers of Colon Cancer: A Nested Case-Control Study Within a Prospective Cohort
No full textCirculating microRNAs (miRNAs) have emerged as non-invasive biomarkers that may be associated with cancer risk, but their role in the development of colon cancer is still not well understood. We conducted a nested case-control study within the EPIC-Italy cohort to investigate the association between pre-diagnostic serum levels of eight candidate miRNAs (Let7, Mir21, Mir155, Mir181, Mir222, Mir145, Mir92, and Mir20) and subsequent colon cancer occurrence. A total of 104 incident colon cancer cases were matched to 104 controls by center, sex, age, recruitment date, and vital status. miRNA expression was quantified using RT-qPCR and normalized to Mir484. Logistic regression models were applied to estimate odds ratios, 95% confidence intervals, and p-values, adjusting for age at recruitment, smoking status, body mass index, physical activity, adherence to a Mediterranean diet, and socioeconomic position. Elevated expression of Let7 (OR = 0.91; 95% CI: 0.84–1.00; p = 0.04) was associated with slightly lower odds of colon cancer in unadjusted models. Mir21 and Mir222 showed borderline associations (p = 0.07 and p = 0.09, respectively), but these did not remain significant after Bonferroni correction. This result was consistent in the multivariate logistic model: higher levels of Let7 (OR = 0.91; 95% CI: 0.82–1.00; p = 0.06) and Mir222 (OR = 0.75; 95% CI: 0.57–1.00; p = 0.05) are suggestive of an association with lower odds of colon cancer. Our findings highlight the challenges of using circulating miRNAs as very early biomarkers, particularly when samples are collected nearly a decade before diagnosis. Future studies with larger sample sizes, serial blood collections, and integration with inflammatory and immune markers will be crucial to clarify the temporal dynamics of circulating miRNA alterations and their potential role in risk-adapted screening strategies
