ARUd’A (Università “G. d’Annunzio CHIETI -PESCARA)
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Comunicare i territori. Lo strumento del video per il racconto delle strategie di design
No full textInformation-Theoretic Analysis of EEG Wave Amplitude and Heart Rate Variability Reveals the Time Scale-Dependent Nature of Brain-Heart Interactions
No full textGoal: Brain-heart interactions have been linked to physiological and pathological states and are typically studied through the use of electroencephalographic (EEG) signal and heart rate variability (HRV) time series. However, there are still major challenges to overcome, particularly in establishing a robust methodology to assess these complex multi-scale interactions and to extract meaningful information. To this end, we explore the time scale-dependent nature of brain-heart interactions by exploiting information-theoretic measures. Methods: We analyze cardiac vagal activity and EEG brain wave amplitudes at two time scales - heart rhythm (∼1 s) and longer (∼1 min) - in two groups of healthy subjects monitored during wakefulness and sleep, respectively. Different entropy-based measures are then employed to evaluate the regularity of each system's dynamics, as well as their static and dynamic coupling. Results: Different time-scales are involved in different physiological coupling mechanisms. While overall coupling strength values are low, longer time-scales show a stronger presence of coupling in terms of statistically validated brain-heart connections compared to shorter time-scales. Conclusions: This study shows that the presence and the strength of brain-heart interactions are highly dependent on the time-scale, which in turn is affected by the underlying physiological processes
Video-Assisted Thoracoscopic Surgery Versus Tube Thoracostomy with Fibrinolytics for Treatment of Empyema in Children: A Meta-Analysis of Randomized Controlled Studies
Full text linkBackground: The British Thoracic Society recommended tube thoracostomy plus intra-pleural fibrinolytics to treat empyema in children in 2005. However, numerous comparative studies have suggested Video-Assisted Thoracoscopic Surgery (VATS) as a first line of treatment for pediatric empyema due to its superior outcomes, including shorter length of hospital stay (LOS). This meta-analysis aimed to compare the following: (1) the LOS for VATS versus fibrinolytics to treat empyema in children; (2) secondary post-operative outcomes (fever, O2 support, time taken for chest tube removal, analgesia, complications, failure, and abnormal chest X-ray at follow-up). Methods: The study was conducted according to PRISMA guidelines. A systematic search of PubMed, Cochrane, Web of Science, and Scopus was conducted according to PRISMA guidelines. Two independent investigators identified relevant studies, excluding case reports, opinion articles, and gray literature publications. A meta-analysis of randomized controlled trials (RCTs) was performed using RevMan 5.4, with data expressed as mean ± standard deviation (SD). Results: Of 1374 abstracts screened, 104 full-text articles were analyzed, and 6 RCTs (345 patients) were included in the meta-analysis. Patients undergoing VATS had significantly shorter LOS compared to those receiving fibrinolytics (9.1 ± 1.8 vs. 11.5 ± 2.5 days, p = 0.05). VATS patients also experienced shorter postoperative fever duration (4.2 ± 0.8 vs. 6.9 ± 4.6 days, p = 0.007) and earlier chest tube removal (5.0 ± 2.6 vs. 9.5 ± 3.3 days, p = 0.01). No significant differences were found between the two groups for other secondary outcomes. Conclusions: Children with empyema appear to benefit from VATS compared to tube thoracostomy plus fibrinolytics, with improved outcomes. Further RCTs are needed to corroborate these results
FOGGIA FUTURA. Dalle premialità alla transizione ecologica: note introduttive.
No full textLe note introduttive per “Foggia Futura” delineano una metodologia di pianificazione urbana rigorosa e profondamente innovativa, fondata sulla necessità di trasformazione orientata alla sostenibilità, all’equità sociale e alla valorizzazione del patrimonio esistente. In un contesto globale caratterizzato da crescenti vulnerabilità climatiche e sfide sociali complesse, l'innovazione si traduce nell'adozione di un approccio sistemico alla trasformazione urbana.
Un elemento chiave di questo cambiamento è l'introduzione di un sistema di premialità volumetriche nei comparti edificatori. Questo meccanismo funge da strumento regolativo e selettivo, capace di bilanciare il principio di perequazione con il perseguimento di obiettivi strategici di interesse collettivo, incentivando interventi di interesse pubblico e comportamenti virtuosi da parte degli operatori privati attraverso un contenuto incremento della capacità edificatoria. Questa impostazione promuove un modello di cooperazione tra pubblico e privato orientando lo sviluppo urbano verso una maggiore responsabilità ambientale, sociale ed economica.
Le tematiche strategiche delineate – l’Adattamento ai Cambiamenti Climatici e Transizione Ecologica, la Mobilità Sostenibile, la Rigenerazione Ecologica e l’Abitare Sostenibile ed Edilizia Residenziale Sociale – costituiscono gli ambiti prioritari sui quali il Piano Urbanistico Generale (PUG) deve concludere il proprio lavoro, definendo una visione di Foggia come organismo vivo e adattivo.
1. Adattamento ai Cambiamenti Climatici e Transizione Ecologica Questo capitolo mira a promuovere un modello urbano resiliente e a basse emissioni. L'ambiente, inteso come insieme di processi ecologici e cicli vitali, è una risorsa strategica. Data la crescente aridità del contesto pugliese e foggiano, la pianificazione deve riconoscere la siccità come una componente permanente del rischio urbano. L’integrazione di Infrastrutture Verdi e Blu (IVB) e l'adozione di Nature-Based Solutions (NBS) sono fondamentali per l'adattamento.
2. Mobilità Sostenibile L’obiettivo è promuovere una mobilità urbana inclusiva, sicura e a basso impatto ambientale, riconoscendo le strade come la quota più ampia dello spazio pubblico urbano. Si propone la riconversione delle infrastrutture stradali da tradizionali a strade multimodali, capaci di accogliere in modo armonico molteplici funzioni e utenti (pedoni, ciclisti, mezzi pubblici, ecc.). Le azioni prioritarie includono la valorizzazione della mobilità attiva (reti ciclabili e pedonali continue e sicure), il potenziamento della mobilità collettiva e condivisa (integrazione tra trasporto pubblico e mobilità elettrica), e il riequilibrio dello spazio stradale, riducendo la dipendenza dall’auto privata a favore di soluzioni condivise.
3. Rigenerazione Ecologica La rigenerazione ecologica si focalizza sulla trasformazione sostenibile dei contesti urbani esistenti, garantendo coerenza con i Criteri Ambientali Minimi (CAM) e il principio Do No Significant Harm (DNSH).
4. Edilizia Residenziale Sociale e Abitare Sostenibile Questo capitolo promuove forme abitative orientate all’inclusione sociale e alla sostenibilità ambientale, valorizzando il patrimonio esistente. L’ERS non è solo fornitura di alloggi a canone calmierato, ma un approccio integrato per creare quartieri coesi e resilienti.
In conclusione, la pianificazione si basa sulla trasformazione di questi indirizzi in azioni concrete, applicabili ai 25 Ambiti d’Intervento individuati nella città, che spaziano dal tessuto compatto storico alle strade di quartiere, dai poli dell'intermodalità alle aree di verde incolto
Paleo-Earthquake Fingerprints and Along-Strike Slip Variation of the Silent Mt. Morrone Normal Fault (Central Italy): A Structural-Geochemical Approach
No full textThis study provides insights into the tectonic evolution of the normal Mt Morrone Fault System (MMFS) in Central Italy and highlights the utility of multidisciplinary approaches in reconstructing the seismic history of dormant fault systems. The MMFS comprises two parallel normal faults that traverse the western slope of Mt. Morrone, and although the system can produce M > 6 earthquakes, it has been aseismic in post Roman times. Here, we combine geochemical analysis of carbonate fault-scarp samples with new structural fault data and Lidar-based topographic analysis to provide new constraints on fault geometries and kinematics, the paleo-earthquake history of MMFS since the Last Glacial Maximum and its slip rates. Structural analysis reveals kinematic similarities between the two parallel strands, reflecting their response to the same stress regime. Rare Earth Elements analyses on 53 limestone samples reveal a minimum of eight concentration fluctuations upscarp, here interpreted as tectonic exhumation of the fault scarp due to post LGM earthquakes. Slip per event ranges from 30 to 110 cm typical of earthquakes with 6.3 ≤ M ≤ 6.8. Lidar analysis reveals triangular slip profiles on both fault strands. We estimate that an earthquake with an average M = 6.5–6.6 would have a recurrence interval of ∼2,125 ± 125 years. Slip rates were calculated to be 0.5–0.65 mm/yr on the lower and 0.65–0.7 mm/yr on the upper fault strand, with the combined system having slip rates of 0.62–0.69 mm/yr. Our findings indicate that both strands of the MMFS are active and accumulate slip interdependently, a finding that is critical for seismic hazard assessment
Enhancing PDAC therapy: Decitabine-olaparib synergy targets KRAS-dependent tumors
No full textPancreatic ductal adenocarcinoma (PDAC) shows limited response to chemotherapy, partly due to the absence of effective biomarkers for personalized treatment. Kirsten rat sarcoma viral oncogene homolog (KRAS) mutations are found in 90% of PDAC cases, and tumors dependent on KRAS (dKRAS) can be identified using gene expression signature scores. Previous research indicates that dKRAS-PDAC cells are sensitive to decitabine (DEC), an FDA-approved drug for hematological cancers, though its use in solid tumors is limited by side effects. We discovered that low-dose DEC combined with the poly (ADP-ribose) polymerase (PARP) inhibitor olaparib (OLA) enhances antitumor activity in dKRAS-PDAC. DEC induces DNA damage and activates the ataxia telangiectasia (ATR)/ataxia telangiectasia mutated (ATM)-mediated DNA damage response (DDR), with PARP1-mediated repair playing a key role. Inhibiting PARP with OLA further improves efficacy, even in BRCA1/2-wild-type and homologous recombination (HR)-proficient tumors but not in KRAS-independent tumors. The combination was especially effective in dKRAS-PDAC with a BRCA2 mutation, preventing metastasis growth. Our results support the clinical evaluation of DEC+OLA in PDAC
A Deep-Learning Approach for Vocal Fold Pose Estimation in Videoendoscopy
Full text linkAccurate vocal fold (VF) pose estimation is crucial for diagnosing larynx diseases that can eventually lead to VF paralysis. The videoendoscopic examination is used to assess VF motility, usually estimating the change in the anterior glottic angle (AGA). This is a subjective and time-consuming procedure requiring extensive expertise. This research proposes a deep learning framework to estimate VF pose from laryngoscopy frames acquired in the actual clinical practice. The framework performs heatmap regression relying on three anatomically relevant keypoints as a prior for AGA computation, which is estimated from the coordinates of the predicted points. The assessment of the proposed framework is performed using a newly collected dataset of 471 laryngoscopy frames from 124 patients, 28 of whom with cancer. The framework was tested in various configurations and compared with other state-of-the-art approaches (direct keypoints regression and glottal segmentation) for both pose estimation, and AGA evaluation. The proposed framework obtained the lowest root mean square error (RMSE) computed on all the keypoints (5.09, 6.56, and 6.40 pixels, respectively) among all the models tested for VF pose estimation. Also for the AGA evaluation, heatmap regression reached the lowest mean average error (MAE) (
5
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). Results show that relying on keypoints heatmap regression allows to perform VF pose estimation with a small error, overcoming drawbacks of state-of-the-art algorithms, especially in challenging images such as pathologic subjects, presence of noise, and occlusion
Revisiting eye blink in Parkinson’s disease
Full text linkSpontaneous blinking is a rapid and unconscious type of blinking that has been linked to several cognitive processes. Blink rate has been established as a reliable measure of cognitive processing and a predictor of dopamine-related cognitive function. Patients with Parkinson's disease (PD) have a reduced spontaneous blink rate. In this study, we propose an additional measure of blink characteristic, namely blink duration, and evaluate its alteration in a large cohort of 107 patients with PD. We also investigate the relationship between blink rate and blink duration and disease characteristics such as severity and dopaminergic neuronal loss. The results show that the blink rate is reduced, and blink duration is increased in patients compared to healthy controls. Blink rate is related to motor deficit severity and significantly correlated with dopamine depletion (dopamine transporter striatal binding ratio). Conversely, blink duration is related to non-motor aspects such as sleepiness. These findings highlight the potential of blink as a distinguishing feature of Parkinson's disease, underscoring the importance of incorporating blink assessments into standardized oculomotor testing protocols for PD
In Vitro CO-Releasing and Antioxidant Properties of Sulfonamide-Based CAI-CORMs in a H2O2-Stimulated Human Achilles Tendon-Derived Cell Model
Full text linkTendinopathy is often described as a complex and multifactorial condition which affects tendons. Tendon disorders are marked by a reduction in mechanical function, accompanied by pain and swelling. At the molecular level, tendinopathy leads to oxidative stress-driven inflammation, increased cell death, disruption of extracellular matrix balance, abnormal growth of capillaries and arteries, and degeneration of collagen formation. Here, we report an innovative approach to modulate oxidative stress during tendinopathy based on sulfonamide-based Carbonic Anhydrase Inhibitors—carbon monoxide releasing molecules (CAI–CORMs) hybrids endowed with dual carbon monoxide (CO) releasing activity and carbonic anhydrase (CA) inhibition. The synthesised compounds have been studied in a model of human Achilles tendon-derived cells stimulated by H2O2. Among the library, compound 1c and, to a greater extent, compound 1a, showed to be extremely effective in terms of restoration of cell metabolic activity and cell proliferation due to their capacity to release CO and inhibit the CA isoforms involved in inflammatory processes in the nanomolar range. Moreover, 1a can restore collagen type 1 secretion under pro-oxidant conditions
Lung Ultrasound After COVID-19: A Pivotal Moment for Clinical Integration—Navigating Challenges and Seizing Opportunities
No full textLung ultrasound (LUS) has emerged as a valuable bedside decision-making tool, particularly since the COVID-19 pandemic, with applications in diagnosing pneumonia, managing fluid, and monitoring interstitial lung diseases (ILDs) and acute respiratory distress syndrome (ARDS), ultimately improving patient outcomes. Its repeatability, environmental safety, and reduced radiation exposure make it ideal for vulnerable populations and resource-limited settings. However, challenges such as inadequate documentation and a lack of standardized reporting formats limit its widespread adoption. The evolution of technology offers different possibilities, and improvements in software open up a range of possibilities, but this contrasts with the lack of postgraduate and undergraduate training and formal accreditation. This review addresses the impact of lung ultrasound through the course of air–liquid ratio impairment, crossing different clinical scenarios and exploring the challenges and opportunities for the implementation of lung ultrasound in the post-COVID era