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Intranasal Corticosteroids and Oral Montelukast for Paediatric Obstructive Sleep Apnoea: A Systematic Review
Get PDFBackground/Objectives: Paediatric Obstructive Sleep Apnoea (OSA) is characterised by recurrent episodes of upper airway obstruction during sleep, manifesting as snoring, intermittent oxygen desaturation, and frequent nocturnal awakenings. Standard treatments include surgical interventions, pharmacological therapies, intranasal corticosteroids, and oral montelukast. However, significant variability exists across studies regarding dosage and outcome assessment. This literature review systematically evaluated clinical evidence regarding the efficacy and safety of intranasal corticosteroids and oral montelukast for treating sleep-disordered breathing and its primary underlying condition, adenoid hypertrophy, in otherwise healthy children. Methods: The MEDLINE (PubMed), Scopus, and Web of Science databases were systematically searched up to 13 February 2025, using tailored search terms combining keywords and synonyms related to paediatric OSA, adenoidal hypertrophy, corticosteroids, montelukast, and randomised controlled trials. Owing to variability in outcome measures, Fisher's method for p-value combination was employed to enable a comprehensive comparison of drug effects. Results: Available evidence shows that intranasal corticosteroids (mometasone, beclometasone, budesonide, fluticasone, and flunisolide), either as monotherapy or in combination with other agents, consistently lead to clinical and instrumental improvements in adenoid hypertrophy and related respiratory symptoms, with a generally favourable safety profile. Combining montelukast with intranasal corticosteroids appears to offer superior benefits compared with monotherapy. Nevertheless, the reviewed studies varied widely in dosage, treatment duration, design, and sample size. The reported side effects are mostly mild; however, long-term studies are lacking to establish the complete safety of these treatments in children. Conclusions: Intranasal corticosteroids and oral montelukast effectively and safely manage adenoid hypertrophy and mild-to-moderate OSA symptoms in children. Nonetheless, the heterogeneity of study designs necessitates larger prospective trials with standardised protocols and more extended follow-up periods to draw more robust conclusions. Future studies should aim to stratify treatment outcomes based on OSA severity and duration to tailor therapeutic approaches better
Parlamento europeo: lo stato dell'arte della riforma della legislazione farmaceutica
No full textIl contributo svolge un primo esame delle previsioni contenute nelle proposte di riforma della legislazione farmaceutica dell'Unione europea, tenendo in particolare considerazione lo stato dell'arte rappresentato dalla posizione in prima lettura del Parlamento europeo adottata il 10 aprile 2024, al fine di valutare, seppure in via necessariamente provvisoria, se il quadro normativo, a seguito della revisione, sia in grado di raggiungere gli obiettivi prefissati in conformità con il consolidato approccio volto alla creazione di un "mercato unico del settore farmaceutico"
Impact of smoking exposure on disease progression in high risk and very high-risk nonmuscle invasive bladder cancer patients undergoing BCG therapy
No full textIntroduction: The nonmuscle invasive bladder cancer treated with BCG instillations in patients who smoke could potentially lead to poorer oncological results in the light of the new EAU risk groups classification for NMIBC that did not include BCG treated patients or smoking status. Patient and Methods: Outcomes from 1313 patients with nonmuscle invasive bladder cancer treated with TURBT, re-TURBT and BCG instillations at 13 academic hospital centers, since 2002, has been included in this retrospective study. The study variables, including cumulative smoking exposure have been analyzed. A multivariable Cox proportional hazard model was used to assess associations between smoking variables and disease progression and repeated in the EAU high risk and very high-risk group. The statistical significance threshold was set at 0.05, and the statistical analysis was performed using Stata/SE version 17 (StataCorp, College Station, TX, USA). Results: Cox regression analysis revealed in 1313 patients diagnosed with T1G3 NMIBC that patients with a history of heavy and longterm smoking faced a more than twofold increased risk of disease progression compared to nonsmoker patients (HR 2.35; 95% CI: 1.7-3.2; P <0.01) and a significantly poorer PFS for patients with a history of heavy long-term smoke exposure (P < 0.01). Patients with heavy long-term smoking exposure according to the EAU21 high-risk group had a PFS comparable to very high-risk patients and high-risk patients with heavy long-term smoking exposure showed a higher risk of progression when compared to the high-risk group (HR 1.4; 95% CI: 1.3-1.6; P < 0.01). Conclusions: This study adds valuable information on the relationship between smoking and the progression of NMIBC and BCG therapy. The findings emphasize the need for healthcare providers to consider a patient's smoking history when managing NMIBC and express the need for individualized smoking cessation counseling and individualized treatment approach. (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies
Environmental sustainability and technology as interconnected drivers of business model innovation in the agri-food industry: insights from multiple case studies
No full textPurpose
Business model innovation (BMI) plays a key role in accelerating the transition toward greater environmental sustainability in the agri-food industry. However, knowledge of the mechanisms that activate BMI in agri-food firms remains scarce. This study aims to clarify the interdependencies between environmental sustainability and new technologies as drivers of BMI. It explores the relationships between these drivers and the locus (i.e. internal and/or external to the firm) of the stimulus activating BMI.
Design/methodology/approach
An in-depth analysis of 13 cases of small- and medium-sized agri-food firms that have successfully introduced BMI is performed, drawing on information collected through interviews with these firms’ decision-makers.
Findings
The analysis unveils the mechanisms behind the activation of BMI in agri-food firms. A framework combining the drivers and the locus of BMI is proposed, highlighting BMI paths in agri-food firms.
Originality/value
This study proposes an original framework that outlines three main paths to BMI in agri-food businesses: purpose-driven BMI, technology-exploration-driven BMI and compliance-driven BMI
A multilab investigation into the N2pc as an indicator of attentional selectivity: Direct replication of Eimer (1996)☆,☆☆,☆☆☆,☆☆☆☆,☆☆☆☆☆
Get PDFThe N2pc is widely employed as an electrophysiological marker of an attention allocation. This interpretation was largely driven by the observation of an N2pc elicited by an isolated relevant target object, which was reported as Experiment 2 in Eimer (1996). All subsequent refined interpretations of the N2pc had to take this crucial finding into account. Despite its central role for neurocognitive attention research, there have been no direct replications and only few conceptual replications of this seminal work. Within the context of #EEGManyLabs, an international community-driven effort to replicate the most influential EEG studies ever published, the present study was selected due to its strong impact on the study of selective attention. We revisit the idea of the N2pc being an indicator of attentional selectivity by delivering a high powered direct replication of Eimer's work through analysis of 779 datasets acquired from 22 labs across 14 countries. Our results robustly replicate the N2pc to form stimuli, but a direct replication of the N2pc to color stimuli technically failed. We believe that this pattern not only sheds further light on the functional significance of the N2pc as an electrophysiological marker of attentional selectivity, but also highlights a methodological problem with selecting analysis windows a priori. By contrast, the consistency of observed ERP patterns across labs and analysis pipelines is stunning, and this consistency is preserved even in datasets that were rejected for (ocular) artifacts, attesting to the robustness of the ERP technique and the feasibility of large-scale multilab EEG (replication) studies
I talenti del Cavaliere: il Casanova di Stefan Zweig
No full textLa postfazione spiega i motivi per cui Stefan Zweig decise di rivalutare la figura di Casanova nel anni Venti del Novecent
A new human in vitro model of cytotypic and testosterone-producing organoids derived from testicular tissue of transgender women
Get PDFStudy question: Can testicular tissue from trans women (trans tissue) be used to create human testicular organoids? Summary answer: Testosterone-producing and cytotypic human testicular organoids with bicompartmental architecture can be successfully generated from trans tissue. What is known already: Testicular organoids are a promising tool for studying testicular function and the effects of toxicants. Immature testicular cells are currently the most efficient at forming organoids that closely recapitulate seminiferous tubule-like architecture and functions. However, the scarcity of immature human testicular tissue limits its use in high-throughput applications. Conversely, trans tissue is abundantly available and characterized by an immature phenotype. Study design size duration: Trans tissue-derived organoids (trans organoids) were histologically and androgenically compared to reference organoids derived from immature (prepubertal and pubertal) and adult cisgender testicular tissues. Additionally, long-term testosterone production and gonadotrophic stimulation were assessed in trans organoids. To evaluate their cytotypic and transcriptomic resemblance to reference testicular tissue stages, trans organoids were compared at the gene expression level to prepubertal, pubertal, and adult cisgender tissues, along with their tissue of origin. Participants/materials setting methods: Testicular tissue samples from transgender women, as well as from prepubertal, pubertal, and adult cisgender donors, were used to generate testicular organoids and to compare organoid formation efficiency and testosterone production according to tissue origin. These samples also served as references for transcriptomic comparisons with organoids derived from transgender women's testicular tissue at Day 14 of culture. Testicular organoids were generated and cultured using 3D Petri Dish® platforms. Histochemistry and immunofluorescence staining were employed to characterize cellular composition and spatial organization. Testosterone production in culture media was assessed using electrochemiluminescence immunoassays. RNA was extracted and sequenced from organoids derived from transgender women, as well as from tissue samples of all donor groups. Deconvolution and differential gene expression analyses were performed to compare the organoids with testicular tissues across all groups. Main results and the role of chance: Trans organoids form compartmentalized, cytotypic de novo tissues similar to those from pubertal testicular tissue. Additionally, trans organoids exhibit significant testosterone production, sustain this function over extended culture periods, and respond to gonadotrophic stimulation. Deconvolved bulk RNAseq data indicate that cell population proportions within these organoids are close to those in prepubertal and pubertal testicular tissues. Gene expression clusters trans organoids alongside prepubertal and trans tissues. Functional analysis reveals that trans organoids share with prepubertal, pubertal, and trans tissues varied cellular processes. Factors such as the duration of hormone therapy, the expression of anti-Müllerian hormone-an immaturity marker-within the tubules, and the proportion of peritubular myoid cells in the donor tissue were found to predict the success of trans organoid formation. Large scale data: The bulk RNA-seq raw and preprocessed data are stored under restricted access in the Vrije Universiteit Brussel (VUB) Institutional Data Repository (VUB/IVTD/1/000001) due to participant privacy concerns. Access to the data will be considered by contacting Prof. Yoni Baert ([email protected]). Limitations reasons for caution: Hormonal data from trans women donors were not acquired in a convenient manner for this study. Deconvolution data allow only cell proportions to be compared, not absolute numbers. Wider implications of the findings: This study highlights the potential of trans organoids as a novel and ethically sustainable human-based model for male reproductive health research, reproductive toxicology, and endocrine disruption studies. While trans tissue is a valuable replacement for immature tissue, further research should focus on optimizing organoid architecture, evaluating their utility in reprotoxicity testing, and promoting germ cell differentiation. Study funding/competing interests: This study was conducted with financial support from the VUB Research Council (OZR4004) to S.M.S., the Scientific Research Foundation-Flanders (G026223N) and the Scientific Fund Willy Gepts to Y.B., the Strategic Research Program 89 from the VUB to E.G., and the Mireille Aerens Chair to T.V. The authors declare no conflict of interest
L'Imaginaire de la langue italienne en France à l'âge classique entre polémique et fascination (1578-1754)
No full textCette étude examine l’évolution de l’imaginaire linguistique de la langue italienne en France entre la fin du XVIe siècle et le milieu du XVIIIe siècle, période marquée par un basculement progressif des rapports culturels et politiques entre les deux langues. En s’appuyant sur des travaux critiques majeurs (Balsamo, Dubos, Siouffi, Viola, Sozzi), elle met en lumière la manière dont l’anti-italianisme, d’abord politique à l’époque des guerres de religion, se déplace progressivement vers une critique linguistique et esthétique de l’italien.
Alors que l’italien dominait l’Europe comme langue de culture depuis le Trecento, il perd progressivement son statut en France, notamment au profit d’une langue française en quête de légitimation normative et culturelle (notamment à travers les grammaires et les remarques de Vaugelas). Ce glissement s’opère dans un contexte de tensions politiques fortes (Concini, Mazarin, la Fronde) et s’exprime à travers une production variée : pamphlets, traités grammaticaux, textes littéraires et de théorie musicale.
L’analyse s’inscrit dans une temporalité allant des Deux dialogues du nouveau langage françois italianizé d’Henri Estienne (1578) à la Querelle des Bouffons (1752-1754), et révèle une représentation ambivalente de
la langue italienne — à la fois admirée et rejetée — dans un processus non linéaire de construction d’une identité linguistique française.
Mots-clés : italianisme, polémique, imaginaire linguistique, génie des langues, Querelle des Bouffons, mazarinade
Introduction
No full textL'introduction, outre la présentation du contenu du livre, analyse l'actualité de la campagne anti-genre à la lumière de la politique de Trump aux États-Unis, en interrogeant les scénarios actuels de la politique LGBTQIA+
La partecipazione dei lavoratori nelle impresa: "Much Ado About Nothing")
No full textIl contributo propone alcune prime riflessioni sulla nuova normativa, introdotta in Italia nel giugno 2025, che consente - in via facoltativa e non obbligatoria - alle imprese e ai sindacati (o ad altri rappresentanti dei lavoratori) di poter concordare forme di partecipazione dei lavoratori agli organi di gestione e controllo delle imprese (oltre a forme di consultazione e di partecipazione al capitale)