ARUd’A (Università “G. d’Annunzio CHIETI -PESCARA)
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L’evoluzione del rapporto bancassicurazione: tra compliance e nuove strategie di processo e di prodotto alla luce dei rischi legati ai cambiamenti climatici e ambientali
No full textCurrent use of donor lymphocyte infusions after allogenic stem cell transplantation in Europe: a survey on behalf of the cellular therapy and immunobiology working party of the EBMT
No full textUnmanipulated donor lymphocyte infusions (DLI) are crucial for enhancing the graft versus tumor (GVT) effect in post-transplant settings. Practices regarding DLI use vary widely among centers, encompassing differences in indications, prerequisites, and application methods. To explore current DLI policies, we developed a comprehensive survey that garnered responses from 165 EBMT centers across 43 countries. Notably, 97% of respondents reported using DLI in their practices. Indications for DLI included preemptive use for minimal residual disease (MRD) positivity in 86.9% of centers and mixed chimerism in 73.1%; therapeutic use for hematological relapse in 73.1%; and prophylactic use for high-risk disease in 43.8%. Active graft-versus-host disease (GVHD) and active infections were deemed absolute contraindications by 85.6% and 57.5% of centers, respectively. 35% of centers did not consider a prior history of acute (a)GVHD as an exclusion criterion. The majority (71.9%) requested immunosuppression withdrawal before DLI. Most centers (71.3%) collected DLI post-transplant, with 78.1% utilizing unstimulated apheresis. The cell doses applied at the first DLI varied significantly, depending on indication, timing, and donor type. This survey provides the largest overview of current DLI practices, highlighting the need for high-quality data to assess the risks and benefits of different approaches
Interleukin-1β in circulating mononuclear cells predicts steatotic liver disease improvement after weight loss in subjects with obesity and prediabetes or type 2 diabetes
Get PDFBackground: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a major cardiovascular risk (CV) factor. Interleukin-1β (IL-1β), a cytokine involved in the pathogenesis of obesity-associated inflammation and type 2 diabetes (T2D), promotes hepatic steatosis. The Canakinumab Anti-inflammatory Thrombosis Outcome (CANTOS) trial showed that the inhibition of the IL-1β pathway was associated with a reduction of CV events in high-risk patients. The present study was designed to determine: (i) whether an equal degree of weight loss by liraglutide or lifestyle changes has a different impact on MASLD extent and IL-1β expression in peripheral blood mononuclear cells from obese subjects with prediabetes or early T2D; (ii) whether baseline IL-1β levels may predict the extent of weight loss and related metabolic changes. Methods: Thirty-two obese subjects with prediabetes (n = 16) or newly diagnosed T2D (n = 16), were randomized to the glucagon-like peptide receptor agonist (GLP1-RA) liraglutide or lifestyle counselling until achieving a comparable weight loss. Visceral adipose tissue (VAT) and gene expression of IL-1β in peripheral blood mononuclear cells were assessed by magnetic resonance and real time PCR, respectively. Results: At baseline, IL-1β was positively correlated to body mass index (BMI), fasting plasma glucose, HbA1c, VAT, MASLD extent, platelet count, chemerin and interleukin-1 receptor antagonist (IL1-RA). After achievement of the weight loss target in the two groups, a significant but comparable reduction of IL-1β (p for difference = 0.56) was observed in both arms, in parallel with a comparable improvement in glycaemic control, C reactive protein (CRP), BMI and MASLD. Furthermore, basal IL-1β levels independently predicted the extent of MASLD decrease (p = 0.030); subjects in the highest tertile showed a median decrease of - 8.0 (95% CI - 12.3 to - 4.8) compared with - 23.0 (95% CI - 39.5 to - 16.3) in the lowest tertile. Conclusion: In patients with obesity with initial impairment of glucose metabolism successful weight loss is associated with a reduction of both IL-1β levels and MASLD degree. Of interest, basal levels of IL-1β predict the extent of MASLD improvement, regardless of the intervention. Our results may set the stage for ad-hoc studies investigating the usefulness of baseline IL-1β a level as a drug-response biomarker
Evaluating the Resilience of ESG Investments in European Markets During Turmoil Periods
No full textThis study investigates the resilience of Environmental, Social, and Governance (ESG) investments during periods of financial instability, comparing them with traditional equity indices of the three largest economies in the European Union by gross domestic product: Germany, France, and Italy. Using daily returns from January 2018 to December 2024, the analysis explores the effects of key global disruptions such as the COVID-19 pandemic and the Russia-Ukraine conflict on market performance. A mixture of two generalised normal distributions (MGND) and EGARCH-in-mean models is used to identify periods of market turmoil and assess volatility dynamics. The findings suggest that during crises, ESG investments exhibit lower volatility in Germany, while their volatility remains comparable to that of traditional indices in Italy and France. Thus, the volatility of the ESG indices shows country-specific variations in the European context. These results underscore the importance of integrating ESG factors into long-term investment strategies, particularly in the face of unpredictable financial turmoil
The Italian University System in the Aftermath of National Unification. Background, Reforms Trends and New Goals
No full textThe purpose of this contribution is to analyse the situation of the Italian University System in the aftermath of the national unification process. The establishment of the Kingdom of Italy and the implementation of the Casati Law throughout the peninsula gave rise to numerous inquiries concerning the new direction and reforms trends of the university system. In this regard, it is deemed pertinent to delve into the historical backdrop that served as the foundation of this system, from the Boncompagni Law and
the creation of the Ministry of Public Education to the end of the 19th century. Lastly, the final section is devoted to a reflection on the goals of university education. The need for renewal that emerged at the close of the 19th century, in reality, has been a perpetual companion to the subsequent history of the university and higher education as a whole. This transformation has also marked the final transformation of universities into active institutions in terms of social and territorial impact
Digitalisation in proximity health care services in Italy: an analysis upon possible different trajectories and the key role of both GPs and patients
No full textPurposeWe aim to uncover challenges in the digitalisation of health services in a public healthcare system in circumstances of major changes in primary care. The focus is on the response and impact on health professionals of a national policy designed to foster, among others things, the use of telemedicine in the changing setting of territorial assistance. For the first time a huge budget (8.6 billion, Mission 6 of the National Recovery and Resilience Plan - PNNR) by the central government was planned to favour the diffusion of e-health, after decades of unsuccessful attempts.Design/methodology/approachApplying a qualitative approach and triangulating data gathered through document analysis, semi-structured interviews and focus groups, we detected insights on the ongoing digitalisation of public primary healthcare services.FindingsOur results confirm that a huge problem in the health sector is not innovation per se and, in this case, not even budget allocation, but the dissemination of innovative concepts. A fundamental role in the shift towards community care has been found in the general practitioners, seen as change agents and strategic promoters. Further, our research highlights the need of "educating/training" both health professionals and patients, thus revealing the importance of really creating a co-production scheme for developing an effective digitalised system.Originality/valueBeing among the first papers at the intersection between public health care and the impact of PNNR, our study suggests policymakers rethink ways of designing public policies about digitalisation and telemedicine
Availability, diffusion and application of the outcome measures in the outpatient rehabilitation setting: a literature analysis based on an Italian survey
Get PDFIn outpatient rehabilitation, the outcome measures (OM) play a
crucial role in correctly formulating the Individual Rehabilitation
Plan and determining the functional prognosis, adhering to the biopsycho-social approach.1 The available OMs in rehabilitation are
numerous and this diversity is justified by the complexity of the
several variables characterizing the patients and their disorders.2
On the other hand, this diversity might cause a large variability in
patients’ evaluation, because each OM can rarely explore the totality of patients’ aspects and because a professional might only use a
limited amount of the available OM.
Our study aims to evaluate the use of the most commonly used
OM in clinical practice in the various Italian rehabilitation clinics,
considering the most frequently studied pathologies and settings,
also comparing them with the most commonly used OM in the
scientific literature
