Archivio istituzionale della Ricerca - Università degli Studi di Parma
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Reduction of CO2 emissions, climate damage and the persistence of business cycles: A model of (de)coupling
No full textThe paper develops a theoretical model to examine the effects of transitioning to green investment on business cycle dynamics and CO2 emissions reduction. Building on Goodwin's (‘The Nonlinear Accelerator and the Persistence of Business Cycles’, Econometrica, pp. 1–17, 1951) endogenous business cycle theory, the paper models the shift from brown to green investment as a logistic diffusion process. This framework captures the short-run procyclicality of emissions while allowing for both coupling and decoupling scenarios between output and emissions over the business cycles. The model demonstrates that the investment channel's impact on emissions varies depending on the transition's timing, magnitude, and sensitivity to green–brown investment dynamics. Furthermore, the paper shows that the integration of climate damage can result in milder expansion phases and sharper downturns, potentially offsetting the positive effects of the green transition. The analysis contributes to the understanding of short-run economy-ecology feedback mechanisms, with the model's flexibility capturing varying degrees of decoupling between emissions and output, thus accommodating scenarios in both advanced economies and emerging markets
Italian Multicenter Real-World Study on the Twelve-Month Effectiveness, Safety, and Retention Rate of Guselkumab in Psoriatic Arthritis Patients
No full textBackground/Objectives: Psoriatic arthritis (PsA) is a chronic inflammatory condition that primarily affects the musculoskeletal system and skin. While biologic and targeted synthetic DMARDs have improved treatment, many patients still fail to achieve remission. Combining conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) with biologic (b) DMARDs or targeted synthetic (ts) DMARDs shows no added benefit over monotherapy with IL-17, IL-23 inhibitors, or JAK inhibitors, unlike TNFi, which benefit from csDMARD co-administration. Guselkumab (GUS) and risankizumab (RKZ) target IL-23 with high specificity. RCTs (DISCOVER 1 and 2, COSMOS) have confirmed GUS efficacy regardless of methotrexate (MTX) use, though liver toxicity was higher with MTX. Real-world data on GUS remain limited, with gaps in understanding its long-term effectiveness and drug survival. The aim of this study is to assess the following three points within a multicenter Italian real-life cohort of PsA patients treated with guselkumab (GUS) and followed for 12 months: (1) effectiveness and safety of GUS; (2) drug retention rate (DRR) and reasons for discontinuation; (3) impact of comorbidities on achieving minimal disease activity (MDA). Methods: This study utilized data from the GISEA registry, which includes centers in different parts of Italy (north, center, south, and islands), and included patients aged 18 and older diagnosed with PsA according to the CASPAR criteria. Results: Data on 170 PsA patients treated with GUS were collected. In the first 6 months, a prompt mean percentage improvement in all clinimetric indexes was observed compared to the baseline. At 6-month follow-up, ACR 20 was reached by 60% of patients, ACR 50 by 30%, ACR 70 by 15%, MDA by 28%, and DAPSA < 14 by 50% of patients in the overall group. Significant differences were found in the rate of ACR 50 in the bDMARD-naive group (50%) compared to one bDMARDs non-responder (NR) (8%) (p = 0.021). At 12-month follow-up, a notable gap was observed in the rate of patients reaching MDA between bDMARD-naive (60%) and one bDMARDs NR (22%) (p = 0.035) and between bDMARD-naive (60%) and ≥2 bDMARDs NRs (22%) (p = 0.024). By using multivariate binary logistic analysis, the predictors of reaching MDA at 12-month follow-up were naive bDMARDs (OR: 7.9, 95% CI: 1.3–44.8, p = 0.019) and a higher value of pGA at baseline (OR: 1.1, 95% CI: 1–1.5; p = 0.046). The presence of comorbidities, including fibromyalgia and obesity, did not seem to affect the reaching of MDA. At 12-month follow-up, the GUS retention rate was 76%, with a mean survival time of 10.5 months ± 0.2 (95% CI: 10–10.9). No significant differences in GUS survival time were found among bDMARD-naive, one bDMARDs NR, and ≥2 bDMARDs NR patients (in the latter, regardless of the previous mechanism of action: TNFi or other mechanism), as well as between patients treated with GUS in monotherapy and those treated in combination with csDMARDs. A low rate (17%) of discontinuation was found due to both primary NR and secondary NR. The high safety of GUS was recorded. In fact, discontinuation due to adverse events (all definable as minor) was observed in just 4% of patients. By using COX regression multivariate analysis, the factors associated with higher GUS discontinuation risk were a more severe baseline PASI (HR: 1.05, 95% CI: 1–1.1, p = 0.038) and higher baseline ESR (HR:1.06, 95% CI: 1–1.03, p = 0.05). Conclusions: Good performance of GUS was observed in both biologic-naive patients and those with failure of previous bDMARDs (regardless of the mechanism of action of the previous drug: TNFi or non-TNFi), presenting good persistence in therapy even when used as a third mechanism of action. Its high safety profile allows the use of GUS even in particularly complex patients
Advances and Challenges in Pediatric Sepsis Diagnosis: Integrating Early Warning Scores and Biomarkers for Improved Prognosis
No full textIdentifying and managing pediatric sepsis is a major research focus, yet early detection and risk assessment remain challenging. In its early stages, sepsis symptoms often mimic those of mild infections or chronic conditions, complicating timely diagnosis. Although various early warning scores exist, their effectiveness is limited, particularly in prehospital settings where accurate, rapid assessment is crucial. This review examines the roles of clinical prediction tools and biomarkers in pediatric sepsis. Traditional biomarkers, like procalcitonin (PCT), have improved diagnostic accuracy but are insufficient alone, often resulting in overprescription of antibiotics or delayed treatment. Combining multiple biomarkers has shown promise for early screening, though this approach can be resource-intensive and less feasible outside hospitals. Predicting sepsis outcomes to tailor therapy remains underexplored. While serial measurements of traditional biomarkers offer some prognostic insight, their reliability is limited, with therapeutic decisions often relying on clinical judgment. Novel biomarkers, particularly those identifying early organ dysfunction, hold potential for improved prognostic accuracy, but significant barriers remain. Many are only available in hospitals, require further validation, or need specialized assays not commonly available, limiting broader clinical use. Further research is needed to establish reliable protocols and enhance the clinical applicability of these tools. Meanwhile, a multifaceted approach that combines clinical judgment with existing tools and biomarkers remains essential to optimize pediatric sepsis management, improving outcomes and minimizing risks
Clinical Picture, Diagnosis, Management of NEC, and Effects of Probiotics on its Prevention: A Narrative Review
No full textPreterm newborns represent a population at risk of developing intestinal dysbiosis as well as being predisposed to sepsis and Necrotizing Enterocolitis. Necrotizing Enterocolitis is a condition burdened by many complications and mortality due to an alteration of the intestinal barrier, an immaturity of the immune system, and intestinal dysbiosis. Low gestational age at birth, low birth weight, and early use of antibiotics are other predisposing factors. Instead, breast milk and probiotics are protective factors in providing intestinal homeostasis and microbiome regulation. In this mini-review, we analysed the protective role of probiotics in the onset of Necrotizing Enterocolitis in preterm populations
The Interplay of R-matrices and Quantum Groups
No full textThese are the expanded lecture notes of a mini-course given by the author in Milan in June 2024, during the conference GABY: Groups and Algebras in Bicocca for Young algebraists. We present a concise introduction to the theory of quantum groups, focusing on their ability to produce solutions of the quantum Yang-Baxter equation
Comparison of Digital Rectal Thermometry and a Non-Contact Veterinary Infrared Thermometer in Cats: Identifying Alternative Sites to Rectal Measurement.
No full textBackground: Rectal temperature measurement in cats, while crucial, can cause discomfort
and stress. This study evaluated non-contact infrared thermometry as a less invasive alternative.
Methods: A total of 95 cats were enrolled in this study. The cats were categorized
into three age groups: Group I (n = 20 kittens, 2–6 months), Group II (n = 34 young cats,
7–24 months), and Group III (n = 41 adult cats, >24 months). Results: The mean rectal
temperature in cats was approximately 38 ◦C, which was significantly higher than both
ocular temperature (p < 0.0001) and auricular pinna temperature (p < 0001). No statistically significant difference was found between rectal and perineal temperatures, nor in body temperatures between the age groups. Ocular temperature (p < 0.05) and auricular temperature (p < 0.0001) were influenced by ambient temperature. Perineal infrared temperatures showed a strong correlation and low bias compared to rectal temperature and were not affected by ambient temperature. Conclusions: Non-contact infrared thermometry offers advantages for feline temperature monitoring. Perineal infrared temperatures appear to be a useful, non-invasive alternative to rectal measurements in cats
GC/MS Investigations of Varnish Removal on Oil Paintings with Gelled Surfactant-Free Emulsions Made from Xanthan Gum and Benzyl Alcohol
No full textOver the last two decades, gelled surfactant-free emulsions containing benzyl alcohol have been commonly used in conservation for the removal of organic film-formers. The assumption that the strong solvent power of benzyl alcohol is mitigated precisely by its presence in moderate quantities in an aqueous environment has not yet had analytical confirmation. However, the low volatility of the solvent, and its strong swelling action on the oil binder, prompted this analytical verification. At a theoretical level, the saturation of the surface with Cyclomethicone D5 siloxane appears like a good strategy to reduce the diffusion of the solvent and decrease the interaction with the paint medium. This method was originally developed twenty years ago to allow the aqueous cleaning of acrylic paints: thanks to its complete immiscibility with water, siloxane acts as a temporary hydrophobic barrier, to repress diffusion and capillarity. Furthermore, D5 also appears immiscible with benzyl alcohol; therefore, it could act as a double barrier, towards water and alcohol. In this study, samples of an oil painting, treated with gelled emulsions containing benzyl alcohol with and without pre-saturation with D5 for varnish removal, were analyzed through GC/MS to monitor leaching and through SEM to highlight alterations in the surface morphology
Unveiling the root–rhizosphere environment of perennial wheat: a metabolomic perspective
No full textBackground: Perennial grain roots grow continuously, enhancing soil carbon sequestration and forming a "holobiont" with the microbiome, essential for nutrient acquisition and stress resilience. Consequently, perennial grains serve as ideal models for investigating long-term dynamics between root systems and the rhizosphere environment. Despite their potential, the rhizosphere environment of perennial grains remains underexplored. This research utilizes an untargeted metabolomic approach to characterize the root-rhizosphere molecular signals in four new perennial grain (NPGs) lines named 235a, 280b, 11,955, and OK72, across four years of growth. Results: Metabolomic analysis annotated 2,527 metabolites, most of which originated from fungi (30.3%), bacteria (23%), and plants (15.5%). Principal component analysis explained 54.8% of the variation between rhizosphere and root metabolites, with 8.7% variation separating 1st and 4th year root metabolites, while rhizosphere metabolites showed less variation between years. The comparison between the annual durum wheat variety and NPGs revealed 616 differentially abundant metabolites in roots and 15 in the rhizosphere, already at the 1st year of growth. In the 4th year, NPGs metabolomes diverged significantly from Thinopyrum intermedium, which stood in the soil for 11 years, with 184 root and 138 rhizosphere differentially abundant metabolites. Comparison between genotypes diversified NPGs in the 1st year, showing a higher abundance of root metabolites for OK72 compared to the other lines, including key modulators of root architecture like glutathione and serotonin, and compounds from α-linoleic acid metabolism, which are known to induce systemic resistance against pathogens and herbivore defense. Differences among NPGs also emerged in the 4th year, with OK72 separating from the other three, sharing with Thinopyrum intermedium a higher abundance of purine nucleosides and diazanaphthalenes. Conclusions: The metabolomic analysis revealed that starting from the 1st year, the roots of NPGs produce a set of metabolites distinct from those of the annual durum species, many of which are defense molecules against biotic and abiotic stresses (e.g., syringic acid, glutathione, and α-linoleic acid pathway compounds). The OK72 genotype, which exhibits below-ground traits more aligned with perennialism, differs from the other lines in the abundance of several interesting metabolites, confirming it as an ideal parental candidate for developing new perennial wheat lines
Outbreak of carbapenem resistant Klebsiella pneumoniae in a neurorehabilitation unit: Genomic epidemiology reveals complex transmission pattern in a tertiary care hospital
No full textObjectives: Infections by carbapenem-resistant Enterobacterales (CRE) in hospitals represent a severe threat but little is known on outbreaks in rehabilitation wards caused by Klebsiella pneumoniae producing Klebsiella pneumoniae Carbapenemase (KPC-Kp). We report an outbreak by KPC-Kp, in a neurorehabilitation unit in Italy, analysed through whole-genome sequencing (WGS) for transmission routes reconstruction to improve management of KPC-Kp infections in rehabilitation units. Methods: We investigated cases and KPC-Kp isolates collected from February to October 2022 from hospital surveillance. Carbapenem resistance was identified with disk diffusion and minimum inhibitory concentration tests, carbapenemase production through immunochromatographic lateral flow assays. All isolates were genotyped through WGS to highlight possible phylogenetic relationships. The most likely transmission networks of KPC-Kp were reconstructed with Bayesian discrete-time stochastic models. Results: Nineteen patients were colonized by KPC-Kp. Two isolates belonged to sporadic sequence types (STs; ST348 and ST219) whereas 9 of 19 and 8 of 19 isolates belonged to ST307 and ST716, respectively. Among the ST307 isolates, we identified two genomically distinct clusters of five and two cases. All ST716 isolates were highly similar. Genotyping and the reconstruction of transmission networks of KPC-Kp based on genomic data identified seven independent introductions into the neurorehabilitation unit rather than a single outbreak as initially hypothesized before genomic investigation. Three of the seven introductions generated chains of secondary infections, whereas the remaining four remained single cases. Conclusions: The outbreak root-causes were identified in temporary staff shortage and insufficient microbiological surveillance. Measures were adopted accordingly and the outbreak ended. The study highlights the critical role of genomic epidemiology in hospital outbreaks. © 2025 The Author(s). Published by Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy
Biventricular electromechanical dysfunction and molecular remodeling in a rat model of advanced pulmonary arterial hypertension
No full textBackground: Pulmonary arterial hypertension (PAH) is a severe condition characterized by elevated pulmonary arterial pressure, leading to significant morbidity and mortality. Despite ongoing research, its pathophysiology remains incompletely understood. Traditionally, PAH has been regarded as predominantly affecting the right ventricle (RV), often overlooking its potential impact on the left ventricle (LV), particularly in patients with preserved LV ejection fraction (EF). Methods: In this study, we investigate the late-stage effects of PAH on both electrical and mechanical functions, as well as their coupling, in each ventricle using the monocrotaline-treated rat model. Specifically, an integrative approach combining in-vivo epicardial potential mapping, in-situ video kinematic evaluation, and transcriptomic analysis was performed on rats injected with monocrotaline (MCT, n = 22) or saline solution (Physio, n = 16). Results: Our findings reveal that PAH induces global increases in refractoriness from 88.8 ± 1.9 ms to 152.7 ± 3.9 ms and reductions in conduction velocity in the RV from 0.59 ± 0.01 m/s to 0.55 ± 0.01 m/s and from 0.28 ± 0.01 m/s to 0.25 ± 0.01 m/s along and across the fiber orientation, respectively. Notably, a significant increase in electromechanical delay from 24.9 ± 1.2 ms to 35.8 ± 5.2 ms was also observed in the RV. In the LV, PAH also results in increased refractoriness from 95.4 ± 3.0 ms to 140.0 ± 11.5 ms and reduced transverse conduction velocity by 14%, despite preserved EF. Transcriptomic analysis indicates that while both ventricles exhibit upregulation of extracellular matrix remodeling-related genes, the RV primarily shows downregulation of electromechanical-related genes. On the contrary, an upregulation of the inflammatory pathways was detected mainly in the LV, alongside a downregulation of mitochondrial metabolism-related genes. Conclusions: Our findings revealed that both ventricles showed structural remodeling but only the RV underwent electromechanical alteration, while the LV displayed metabolic and inflammatory alteration. This was further validated by the preserved EF in the advanced stage of PAH. Our work highlights that a more comprehensive understanding of PAH pathophysiology can lead to targeted therapeutic strategies, challenging the conventional RV-centric perspective