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Real World Data from an Italian Outpatient Clinical Setting and from Home Care Assistance of Treatment-Experienced PWH Switching to CAB + RPV Regimen: A Prospective Observational Study
No full textThe new Cabotegravir + Rilpivirine long acting (CAB + RPV) is the injectable regimen for treatment-experienced people with HIV (PWH). Little data from real-world settings are available, particularly in more complex PWH. We aimed to investigate the effectiveness of CAB + RPV in our real-life cohort of experienced PWH. We conducted a prospective observational longitudinal study by enrolling PWH who switched to CAB + RPV. We recruited participants from our outpatient clinic and a lower percentage of complex PWH followed by our home-care assistance (HCA). We evaluated time to virological failure (VF) and time to treatment discontinuation (TD) for any cause using Cox regression analyses. In the subgroup followed by HCA we also analyzed the total HIV-DNA trend during the study period. We enrolled 62 participants: 52 were outpatients (83.9%) and 10 followed by HCA (16.1%). Mostly were males (66.1%), with a median age of 51 years (IQR 31–60). During a 31.5 person-years follow-up (PYFU), all participants maintained virological suppression (< 30cps/mL). We observed 9 discontinuations during follow-up, with a rate of discontinuation of 28.6 per 100 PYFU. The estimated probabilities of maintaining CAB + RPV at 24 and 48 weeks were 84.9% (SD: 0.5) and 79.2% (SD: 0.7), respectively. No significant predictors of discontinuations were found. In the subgroup, we found no significant changes in the HIV-DNA levels over time (p = 0.332). Our results confirm the efficacy of CAB + RPV as a switch strategy in virologically suppressed PWH and even in more complex individuals, encouraging its use in PWH in need, coupled with HCA home administration support
Concentrating solutions for a class of indefinite Schrodinger-Poisson systems with doubly critical growth
No full textWe study a Schrodinger-Poisson system involving critical nonlocal ter
La nuova figura della domanda giudiziale di esecuzione del contratto preliminare prevista nel comma 3 dell’art. 173 CCII
No full textQuesto breve saggio è dedicato alla peculiare figura di diritto potestativo riconosciuta dal comma 3 dell’art. 173 CCII al promissario acquirente di immobile ad uso abitativo o destinato a sede principale della propria attività di impresa. La sua peculiarità risiede nella necessità che il suo esercizio si cali in seno ad una domanda giudiziale di esecuzione del contratto preliminare, soggetta al concorso formale e quindi al rito di verificazione del passivo, entro i termini previsti per le domande di insinuazione. Non si tratta dell’azione ex art. 2932 c.c. ma di una peculiare azione di riscatto prevista a tutela del diritto di abitazione, che pone la curatela in una situazione giuridica di soggezione. Viene quindi esaminato il coordinamento tra il comma 3 ed il comma 4 dell’art. 173 CCII, relativo al potere purgativo del giudice delegato, nel senso che in questo caso non interviene una vendita definitiva tra il promissario acquirente e il curatore, come invece avveniva nel regime previgente fallimentare
Be ready to manage stress “Before” and “After” a critical event. What the EEG and autonomic correlates tell us
No full textThis study examined behavioral, electrophysiological (EEG), and autonomic responses to stress during the preparation and speech stages of five discourses among 26 adults. Participants underwent an increasingly stressful job-interview based on a modified Trier Social Stress Test, receiving feedback from an evaluative board. Findings showed increased RTs, higher cardiovascular responses [Pulse Volume Amplitude (PVA), and Heart Rate Variability (HRV)] and generalized increases in EEG frequency bands (delta, theta, alpha, beta, gamma) during the speech compared to the preparation stage. The rising emotional salience of the discourses induced a negativity bias and extensive low-frequency band activation (delta and theta) across the scalp in response to emotional demands. High-frequency bands exhibited a plateau effect, indicating less cognitive involvement as the discourses progressed. In our opinion, a possible interpretation is that this effect could be due to habituation mechanisms or coping strategies. Autonomic results revealed significant variations in PVA, with higher levels during the first discourse preparation, indicating substantial cognitive effort. Despite increased emotional arousal, participants managed stress effectively, as evidenced by increased HRV during the speech stage. Overall, during progressively increasing ecological psychosocial stress, individuals displayed marked emotional reactions in terms of low-frequency bands and cardiovascular indices, particularly during the first speeches rather than the preparation stages of an interview
EVALUATE THE IMPACT OF MICROPLASTICS AND OTHER POLLUTANTS IN AGROECOSYSTEMS ON DIFFERENT COLLEMBOLA SPECIES
No full textNella biosfera, il suolo svolge una funzione cruciale e indispensabile nel regolare la produttività primaria, la decomposizione della materia organica, i cicli biogeochimici e nel sostenere una serie di attività culturali ed economiche, come l'agricoltura, che dipendono dalla sua salute e qualità. Tuttavia, è il destinatario finale di alte concentrazioni di inquinanti.
La fauna del suolo comprende molti organismi diversi, come lombrichi, collemboli, acari e nematodi, e la sua attività è essenziale per mantenere un corretto livello di produttività e salute di questo ecosistema. I collemboli sono esapodi che vivono nel suolo e ne regolano la fertilità, la struttura, la massa, e il flusso di energia attraverso reti alimentari del sottosuolo, contribuendo alla dispersione di propaguli vegetali, fungini e batterici e promuovendo il mantenimento della biodiversità microbica del suolo. Grazie alla loro sensibilità alle variazioni delle condizioni del suolo, al disturbo, all'inquinamento e alle attività antropiche, sono riconosciuti come bioindicatori e impiegati in numerosi studi ecotossicologici. È essenziale conoscere la gamma di endpoint tossicologici per comprendere e prevedere come i contaminanti ambientali influenzeranno i collemboli e i servizi ecosistemici che forniscono. In questo contesto, l'obiettivo primario di questo lavoro è quello di valutare gli effetti di vari contaminanti presenti nel suolo su diverse specie di collemboli. A tal fine, questa tesi è strutturata intorno a tre obiettivi specifici.
Poiché la maggior parte dei metalli pesanti, non solo in ambito urbano, ma anche agricolo, deriva dal traffico stradale, in particolare dall'usura dei freni e dei pneumatici (fonti di emissione non dovute allo scarico), il primo obiettivo si propone di indagare, in condizioni di laboratorio, gli effetti dell'esposizione orale alle particelle emesse dalle pastiglie dei freni e dai dischi dei freni in ghisa, a bassa e ad alta dose, utilizzando come riferimento la legislazione italiana per lo Sn, su una specie euedafica, Orthonychiurus folsomi (Schäffer, 1900). Quest'ultimo è riconosciuto come bioindicatore e utilizzato in diverse indagini ecotossicologiche (Capitolo 3). I nostri risultati hanno dimostrato che l'esposizione orale alle particelle di usura del sistema frenante può causare effetti sub-letali a basse concentrazioni dopo 4 settimane, mentre ad alte dosi sono stati osservati tassi di mortalità del 50% dopo 4 giorni. Per analizzare la polvere delle pastiglie dei freni è stato utilizzato il microscopio elettronico a scansione (SEM) accoppiato ad una sonda a raggi X (EDX). Questa metodologia ha rivelato che la polvere aveva dimensioni diverse, da sub-micrometriche a PM inferiori a 10 μm, e ha confermato la presenza di metalli pesanti, solfuri e ossidi metallici e altri elementi. Le analisi SEM-EDX hanno dimostrato la presenza di marcatori chimici della polvere del sistema frenante nell'intestino e nelle feci dei collemboli esposti ad alta dose. L'analisi istologica ha rilevato alterazioni del sistema digestivo e riproduttivo e del corpo grasso addominale solo ad alte concentrazioni dopo 4 giorni. Non sono state riscontrate alterazioni istopatologiche ed i marcatori chimici di polvere proveniente dal sistema frenante nei collemboli e nelle loro feci esposti a basse dosi dopo 4 giorni.
Il secondo e il terzo obiettivo di questa tesi hanno esplorato gli effetti di diversi polimeri di microplastiche (MPs), uno non biodegradabile (Capitolo 4. e 5.) e due biodegradabili (Capitolo 5.), da soli o in combinazione con due inquinanti organici (OPs), quali albendazolo (ABZ) (Capitolo 4. e 5.) e piraclostrobina (PYR) (Capitolo 5.), su una specie emiedafica, Folsomia candida (Willem, 1902), considerata un artropode standard del suolo.
Gli MPs sono inquinanti ubiquitari che sono stati ampiamente riconosciuti come una minaccia per l'ecosistema suolo e possono innescare diversi effetti fisiologici negativi. Nelle aree di allevamento di bestiame e agricoltura intensivi, i residui di plastiche nel suolo spesso coesistono con farmaci veterinari, come l'ABZ, un antielmintico ad ampio spettro, e fungicidi, come il PYR, utilizzati contro diverse malattie fungine. In questo contesto, il progetto MINAGRIS (H2020-SFS-2020-2) mira a studiare l'impatto delle micro e nano-plastiche (MNPs) nei suoli agricoli e la loro interazione con altri inquinanti sugli organismi terrestri e sui servizi ecosistemici.
Alla luce di ciò, il secondo obiettivo di questa tesi ha esaminato gli effetti di un'esposizione di 28 giorni al suolo LUFA 2.2 contaminato da MPs di polietilene a bassa densità (LDPE) non biodegradabili a 0 e 0.1 w/w%, da soli o in combinazione con ABZ a 0, 0.0001, 0.1 e 1 w/w % su F. candida (Capitolo 4.). Gli endpoint registrati includevano la sopravvivenza degli adulti, la produzione di uova e la presenza di giovani. La forma delle particelle è stata esaminata con metodologie SEM-EDX e stereomicroscopio. Non sono stati osservati effetti sinergici tra ABZ e MPs. I risultati hanno mostrato che l'LDPE da solo non ha avuto effetti tossici su F. candida, mentre l'ABZ, da solo o in combinazione con gli MPs, ha ridotto significativamente la riproduzione dei collemboli (produzione di uova e presenza di giovani), indicando l'ABZ come il fattore chiave degli effetti avversi. Anche a basse dosi (0.0001 w/w%), l'ABZ ha inibito la riproduzione, suggerendo potenziali rischi per i suoli trattati con letame contaminato.
Infine, per realizzare il terzo obiettivo di questa tesi, F. candida è stata esposta, in condizioni di laboratorio, per 28 giorni ad un suolo contaminato da tre diversi polimeri di MPs, uno non biodegradabile, LDPE, e due biodegradabili, a base di polibutilene adipato tereftalato (PBAT) e un polimero a base di amido, a dosi di 0.01 e 0.1 w/w%, da soli o in combinazione (solo alla dose più elevata di MPs) con due OPs, come ABZ e PYR. a 0.0001 w/w% (per ciascun inquinante) (Capitolo 5.). La sopravvivenza degli adulti, la produzione di uova e la presenza di giovani sono stati registrati come endpoint. I nostri risultati indicano che le MPs da sole, alle due concentrazioni testate, non hanno influenzato significativamente la sopravvivenza e la riproduzione di F. candida. Tuttavia, nel suolo contaminato da ABZ e PYR, la presenza di MPs a base di PBAT in combinazione con OPs ha ridotto il numero di adulti, giovani e uova con differenze significative rispetto al controllo. Gli MPs a base di LDPE in combinazione con gli OP non mostrano effetti significativi, mentre gli MP a base di amido in combinazione con gli OP hanno influenzato significativamente il numero di uova, rispetto ai controlli. Questi risultati suggeriscono che i diversi MP potrebbero modulare la biodisponibilità e la tossicità del fungicida e del farmaco veterinario co-occorrenti negli ecosistemi del suolo, con implicazioni per la valutazione del rischio ecologico delle diverse plastiche biodegradabili e non biodegradabili nei suoli contaminati.In the biosphere, the soil plays a crucial and indispensable function in regulating primary productivity, the decomposition of organic matter, biogeochemical cycles, and supporting a number of cultural and economic activities, such as agriculture, that rely on its health and quality. Nevertheless, it is the ultimate recipient of high concentrations of pollutants.
Soil fauna includes many different organisms such as earthworms, Collembola, mites and nematodes, and its activity is essential for maintaining a correct level of soil productivity and health. Springtails (Collembola) are soil-dwelling hexapods regulating soil fertility, structure and bulk, flow of energy through above- and below-ground food webs, contributing to the dispersion of plant, fungal and bacterial propagules, promoting soil microbial biodiversity maintenance. Due to their sensitivity to variations in soil conditions, disturbance, pollution, and anthropogenic activities, they are recognized as bioindicators and employed in a number of soil ecotoxicological studies. It is essential understand the range of toxicological endpoints to comprehend and forecast how environmental contaminants will affect Collembola and the soil-based ecosystem services they provide. In this context, the primary aim of this work is to assess the effects of various soil contaminants on different springtails species. To achieve this, this thesis is structured around three specific objectives.
Since most of the heavy metals, not only in urban, but also in agricultural settings, derives from road traffic, particularly from tyres and brake wear (non-exhaust emission sources), the first objective aims to investigate, under laboratory conditions, the effects of oral exposure to particles emitted from brake pads and cast-iron brake discs, at a low and high dose, using the Italian legislation for Sn as reference, on the euedaphic Orthonychiurus folsomi (Schäffer, 1900). This species is recognized as bioindicator and utilized in several ecotoxicological investigations (Chapter 3.). Our results showed that oral exposure to brake wear particles can cause sub-lethal effects at low concentration after 4 weeks, while at high dose 50% rates of mortality were observed after 4 days. Here, scanning electron microscope (SEM) coupled with X-rays (EDX) was applied to analyse the braking pad powder. This methodology revealed that it had different sizes from sub-micrometric to PM less 10 μm, and it confirmed the presence of heavy metals, metal-sulphides and -oxides, and other elements. SEM-EDX analyses demonstrated braking pad powder chemical markers in the gut and faeces of Collembola exposed to high dose. Histological analysis detected alterations of the digestive and reproductive systems and of the abdominal fat body only at high concentration after 4 days. No histopathological alterations and braking pad powder markers were found in springtails and faeces exposed to low dose after 4 weeks.
The second and the third objectives of this thesis explored the effects of different microplastics (MPs) polymers, one non-biodegradable (Chapter 4. And 5.) and two biodegradable (Chapter 5.), either alone or in combination with two organic pollutants (OPs), such as albendazole (ABZ) (Chapter 4. and 5.) and pyraclostrobin (PYR) (Chapter 5.) on the hemiedaphic Folsomia candida (Willem, 1902), which is considered a standard soil arthropod.
MPs are ubiquitous pollutants which have been widely recognized as a threat to soil ecosystems, and they can trigger various adverse physiological effects. In areas of intensive livestock production and agriculture, plastics residues in soil often coexist with veterinary drugs, like ABZ, a broad-spectrum anthelmintic, and fungicides, such as PYR, employed against different fungal diseases. In this context, the MINAGRIS project (H2020-SFS-2020-2) aims to investigate the impact of micro- and nano-plastics (MNPs) in agricultural soils and their interaction with other pollutants on terrestrial organisms and ecosystem services.
Given this, the second objective of this thesis examined the effects of 28-day exposure to LUFA 2.2 soil contaminated by non-biodegradable low-density polyethylene (LDPE) MPs at 0 and 0.1 w/w%, alone or in combination with ABZ at 0, 0.0001, 0.1, and 1 w/w % on F. candida (Chapter 4.). Endpoints recorded included the survival of adults, the production of eggs, and the presence of juveniles. Particle shapes were examined through SEM-EDX methodologies and stereomicroscope. No synergistic effects were observed between ABZ and MPs. Results showed that LDPE alone had no toxic effects on F. candida, while ABZ, either alone or in combination with MPs, significantly reduced the springtails reproduction (production of eggs and presence of juveniles), pointing to ABZ as the key driver of the adverse effects. Even at low doses (0.0001 w/w%), ABZ inhibited reproduction, suggesting potential risks for soils treated with contaminated manure.
Finally, to achieve the third objective of this thesis, F. candida individuals were exposed, under laboratory conditions, for 28 days to soils contaminated by three different MP polymers, one non-biodegradable, LDPE, and two biodegradable, polybutylene adipate terephthalate-based (PBAT-based) and a starch-based polymer at 0.01 and 0.1 w/w% concentrations, alone or in combination (only at higher MPs dose) with two OPs, such as ABZ and PYR. at 0.0001 w/w% (per each pollutant) (Chapter 5.). Adults’ survival, egg production, and juveniles’ occurrence were recorded as endpoints. Our findings indicate that MPs alone, at the two concentrations tested, did not significantly affect the survival and reproductive outcomes of F. candida. However, in soils contaminated with ABZ and PYR, the presence of PBAT-based MPs in combination with OPs reduced the number of adults, juveniles, and eggs with significative differences, compared to the control. LDPE MPs in combination with OPs do not show any significant effects, while Starch-based MPs in combination with OPs significantly affected the number of eggs, compared to controls. These results suggest that the different MPs could modulates the bioavailability and toxicity of the co-occurring fungicide and veterinary drug in soil ecosystems, with implications for assessing the ecological risks of different biodegradable and non-biodegradable plastics in contaminated soils
Radiomic Feature Extraction from OCT Angiography of Idiopathic Epiretinal Membranes and Correlation with Visual Acuity: A Pilot Study
No full textPurpose: To explore the correlation between radiomics features extracted from OCT angiography (OCTA) of epiretinal membranes (ERMs) and baseline best-corrected visual acuity (BCVA). Design: Retrospective observational monocentric study. Participants: Eighty-three eyes affected by idiopathic ERMs, categorized into low (≤70 letters) and high (70 letters) BCVA groups. Methods: The central 3 × 3 mm2 crop of structural and vascular en-face OCTA scans of superficial and deep retina slab, and choriocapillaris of each eye was selected. PyRadiomics was used to extract 86 features belonging to 2 different families: intensity-based statistical features describing the gray-level distribution, and textural features capturing the spatial arrangement of pixels. By employing a greedy strategy, 4 radiomic features were selected to build the final logistic regression model. The ability of the model to discriminate between low and high baseline BCVA was quantified in terms of area under the receiver operating characteristics curve (AUC). Main Outcome Measures: The 4 selected informative radiomic features were as follows: the difference average (glcm_DifferenceAverage), quantifying the average difference in gray-level between neighboring pixels; the informational measure of correlation (glcm_Imc1), giving information about the spatial correlation of pixel intensities inside the image; the long run low gray-level emphasis (glrlm_LongRunLowGrayLevelEmphasis), highlighting long segments of low gray-level values within the image; and the large area emphasis (glszm_LargeAreaEmphasis), which quantifies the tendency for larger zones of uniform intensity to occur. Results: No features exhibited a statistically significant difference between low and high BCVA values for the superficial and deep retinal slabs. Conversely, in the choriocapillaris layer, the glcm_DifferenceAverage and glcm_Imc1 features were significantly higher in the high BCVA group (P = 0.047), whereas higher values for the glrlm_LongRunLowGrayLevelEmphasis and glszm_LargeAreaEmphasis were associated with the low BCVA group (P = 0.047). Overall, these radiomic features predicted BCVA with an AUC (95% confidence interval) of 0.74 (0.63–0.85) and sensitivity/specificity of 0.67/0.75. During the cross-validation, the metrics remained stable. Conclusions: Radiomics features of the choriocapillaris in idiopathic ERMs showed a correlation with BCVA, with lower structural complexity and higher homogeneity, together with the presence of homogeneous areas with low-intensity pixel values, reflecting flow voids due to reduced microvascular perfusion, and were correlated with lower visual acuity. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article
The effect of economic sanctions on world trade of mineral commodities. A gravity model approach from 2009 to 2020
No full textThis article employs a gravity model to examine the impact of sanctions on the trade of mineral commodities, classified at a detailed level (using the six-digit code of the Harmonized System — HS, a global classification system for traded goods), from 2009 to 2020. The dataset covers flows from 239 exporter countries to 38 OECD members. The primary findings highlight that: (i) a significant trade disruption is evident, characterized by an immediate 90 percent reduction, with a growing impact observed over time; (ii) sanctions-busting appears effective only in the very short term, albeit with weak supporting evidence; (iii) sender countries experience a decline in trade not only with target countries but also with third countries (negative network effect).
An analysis by regions and commodity groups provides different evidence. First, North American sender countries exhibit the ability to replace imports from target countries with alternative suppliers, while EU countries experience a clear trade disruption. Second, when examining different mineral commodities, findings indicate that sanctions lead to a reduction in trade of Ores and Slag (HS Chapter 26) and Mineral Fuels and Oils (HS Chapter 27), but not in Salt and Cement (HS Chapter 25). Regarding sanctions-busting, it is evident for Ores and Slag. However, sender countries importing Salt and Cement seem to be able to shift to other sources, whereas sender countries importing Mineral Fuels and Oils experience a substantial trade disruptio
Immagini svelate. Pittura romanica a Galliano e Civate
No full textAll’origine di questo libro è il rilievo internazionale della pittura romanica lombarda, che induce a nuovi approfondimenti in rapporto al centro episcopale di Milano, per quanto riguarda le sue origini e le committenze più importanti. Della basilica di San Vincenzo a Galliano, rinnovata nel 1007, vengono indagati i meno noti cicli della navata, d’iconografia biblica e agiografica; quindi sono studiati gli affreschi apocalittici di San Pietro al Monte in relazione a quelli veterotestamentari di San Calocero a Civate, databili tra fine XI e inizi XII secolo, dettagliatamente analizzati. L’obiettivo è la ricostruzione della ricca cultura caratterizzante l’arte romanica attraverso il recupero delle fonti esegetiche e dei modelli figurativi alla base dei singoli cicli, svelando la densità iconografica e “tipologica” delle immagini
Comparison of two inline photopheresis systems: A paired crossover trial
No full textBackground Extracorporeal photopheresis (ECP) has been demonstrated as an effective treatment for graft‐versus‐host disease (GvHD). The inline system was developed by Therakos in 1987. Recently, Fresenius Kabi implemented an integration of cell separator Amicus and a UVA photoactivation device (Phelix), realizing an inline photopheresis system. Study Design and Methods In 2022 we designed a prospective paired crossover trial (NCT05718674) comparing two integrated ECP protocols: Therakos CELLEX and Amicus ECP system. Twenty patients affected by corticosteroid resistant GvHD were submitted to 80 ECP, 40 paired procedures. Results All procedures were well tolerated, with no significant differences in procedure duration. CELLEX cell product showed higher granulocytes and platelet content, while Amicus cell product exhibited higher enrichment of lymphocytes, resulting in significantly higher MNC purity (92.9% vs. 84%). A significantly higher granulocytes and platelets absolute content was observed in CELLEX cell products, while Amicus cell products showed a significantly higher number of TNCs and MNCs. Differences in granulocyte and platelet content remained significant even after normalization of the data according to blood volume processed. These findings are confirmed by a statistically significant higher CE2% for CELLEX for granulocytes and platelets along with the lack of significant difference observed for TNCs and MNCs. Discussion Our analysis shows differences in the characteristics of the procedure and the cell product. Anyway, both devices are effective for performing ECP procedure, as they collect a cell product suitable for photopheresis. At present, our results represent the first data set comparing two available inline ECP devices
From food-to-human microplastics and nanoplastics exposure and health effects: A review on food, animal and human monitoring data
No full textThis review figures out the overall status on the presence of microplastics (MPs) and nanoplastics (NPs) in food and their bioaccumulation in animal and human tissues, providing critical insights into possible human health impacts. Data are discussed on both in-vivo and ex-vivo animal and human studies, and the role of physicochemical properties in determining the biological fate and toxicological effects of MPs and NPs. Particular attention is given to dietary exposure assessments, specifically evaluating daily intake through the consumption of contaminated food items. The current limitations in the body of knowledge and some considerations for future assessments are also reported. Overall, there is a pressing need to establish more robust biomarker research and develop standardized methodologies, for a better understanding of MPs and NPs fate and associated effects in more realistic scenarios for their safe consumption. The review underscores the importance of integrating the human biomonitoring into monitoring programs and interdisciplinary research to ultimately inform on MPs and NPs real burden in the human body