American University of Rome

Fall from a height trauma is characterized by a multiplicity of injuries, related to multiple factors. The height of the fall is the factor that most influences the kinetic energy of the body and appears to be one of the factors that most affects the extent of injury. The purpose of this work is to evaluate, through machine learning algorithms, whether the autopsy injury pattern can be useful in estimating fall height. 455 victims of falls from a height which underwent a complete autopsy were retrospectively analyzed. The cases were enlisted by dividing them into 7 groups according to the height of the fall: 6 or less meters; 9 m, 12 m, 15 m, 18 m, 21 m, 24 m or more. Autoptic data were registered through the use of a previously published visceral and skeletal table. A total of 25 descriptors were used. Reduction of values in the range, standard and robust scaling were used as preprocessing methods. Principal Component Analysis, Single Value Decomposition and Independent Component Analysis were applied for dimensionality reduction. Cross validation was performed with 5 internal and external folds to ensure the validity of the results. The learning algorithms that generated the best models were Linear Regression, Support Vector Regressor, Kernel Ridge, Decision trees and Random forests. The best mean absolute error was 4.58 ± 1.28 m when dimensionality reduction was applied. Without any dimensionality reduction, the best result was 4.37 ± 1.27 m, suggesting a good performance of the proposed algorithms, with better performance when dimensionality is not automatically reduced.

According to several contemporary sources, the Ottoman success at the siege of Nicosia (September 1570) was completely foiled when the fleet shipping the spoils of war to Constantinople was blown out of the water while sailing from the harbour at Famagusta. It seems that a brave captive chose death rather than dishonor as a slave in the harem of Sultan Mehmed ii and fired the gunpowder magazine on board one of the ships blowing it and adjacent vessels in the flotilla to smithereens. A poetic rendition of this event is given by Famiano Strada (1572–1649) in his massive three-book commentary on ancient literature, intended for use in the Jesuit classroom: Prolusiones et paradigmata eloquentiae (Rome, 1617). Here, the story is retold in Virgillian hexameters as a blueprint of heroic behavior for seminarians as they pursue the Jesuit global mission. This article analyzes three short passages and places them within the larger context of Jesuit pedagogy at the Collegium Romanum.

Introduction MGRS are new rare clinical entities, whose recognition and optimal management is evolving. Methods To implement real‐life data, we retrospectively analysed a multicentre cohort of 60 patients with renal biopsy‐proven MGRS receiving mainly novel treatments (between 2006 and 2021) in eight Italian centres. Based on renal biopsy, patients were divided into two subgroups: AL amyloidosis (70%, n = 42) and other‐MGRS (30%, n = 18). Results Baseline characteristics follow typical manifestations of MGRS disorders in terms of small clonal burden, laboratory and clinical features. More patients with AL amyloidosis had monotypic lambda light‐chain disease, estimated glomerular filtration rate (eGFR) ≥ 60 mL/min and nephrotic proteinuria than other‐MGRS group. The most widely used drug was bortezomib, and about one‐third of patients underwent ASCT. Overall response rate was 86% with no differences in the two subgroups. However, high‐quality hematologic responses ≥very good partial response (VGPR) were greater in AL amyloidosis than in other‐MGRS group (67% vs 28%, p = 0.015). The depth of haematological response influenced renal response, obtained in 32 (59%) of evaluable patients, similarly in the subgroups. Indeed, 75% patients with ≥ VGPR (p = 0.049) and none with stable disease (p ≤ 0.001) obtained a renal response. No association between renal response and histotypes (p = 0.9) or type of first‐line therapy (p = 0.3) was found. At a median follow‐up of 54.4 months (IQR 24.8–102.8), median progression‐free survival (PFS) was 100.1 months (95% CI 34.9–NR), and median overall survival not reached (95% CI 129.8–NR). No significant difference emerged between the two groups in terms of survival outcomes. Achieving ≥ VGPR was confirmed as the main independent predictor of prolonged PFS in the general population (HR = 0.29, p = 0.023) and AL amyloidosis group (HR 0.23; p = 0.023). Preserved renal function at diagnosis was predictive of improved PFS in the AL amyloidosis group (eGFR ≥ 60 mL/min: HR = 0.003; p = 0.018; eGFR 30–60 mL/min: HR = 0.04, p = 0.046). Conclusion Further research is warranted to develop standardised response criteria and treatment strategies to improve MGRS management.

The conjoint application of the voltammetry of immobilized particles (VIMP) methodology and the Mott‐Schottky analysis (MS) of impedance data to studying metal corrosion patinas is described. The study is applied to copper and bronze objects exploiting the semiconducting character of cuprite and other copper corrosion products. A simplified theoretical modeling of MS analysis at microparticulate deposits extracted from metal corrosion layers attached to graphite electrodes is provided. The proposed model compensates for the disturbing effect of the regions of the basal electrode directly exposed to the electrolyte. Alternative models accounting for the variation of the density of charge carriers with depth are tested as well as the correlation between VIMP and MS data with reasonably satisfactory results.

Background: Resected rectal polyps with deep invasion into the submucosa (pT1b-sm2,3) or the muscle layer (pT2) are currently confronted with surgery due to non-curative resection. Aims: We evaluated the efficacy, safety, and locoregional control of adjuvant radiotherapy (RT) and/or chemotherapy (CT) following endoscopic KAR (knife-assisted resection) in patients with invasive early rectal cancers who are unwilling or unsuitable for additional surgical resection. Methods: Fifty-one patients with early rectal cancers, pT1b or pT2, underwent post-resection adjuvant RT and/or CT in 15 centers worldwide. “En bloc” macroscopic resection, R0 resection, recurrence rate, and adverse events following resection and adjuvant therapy were recorded in a multicenter retrospective cohort study. Results: Diagnostic staging (38/51, 75%) was the main reason for ELE. Macroscopic “en bloc” resection was demonstrated in 50/51 (98%), with an average follow-up of 20.6 months. Endoscopic recurrence occurred in 7/51 (13.7%) of patients, with mean time for diagnosis of recurrence at 8.9 months. Adjuvant therapy consisted of RT in 49.0% (25/51), CT in 11.8% (6/51), and combined CRT in 39.2% (20/51) of the cases. Perforation, severe post-procedural bleeding, and incontinence were the most frequent complications. The absence of superficial ulceration was associated with macroscopic complete resection, while the lesions with lower budding stage, clear lateral margins, lesion size < 40 mm, and needle-type knife used were associated with less endoscopic recurrencies. Conclusions: Our data investigated adjuvant RT and/or CT after endoscopic KAR of infiltrative rectal cancers (pT1bsm2,3-pT2) as being safe and effective for locoregional control and providing a non-surgical treatment option for patients with a non-curative resection.

Background and Aim Elevated lactate dehydrogenase (LDH), a marker of tumor aggressiveness and metabolic alterations, may predict treatment response and overall survival across various tumors. This study investigates the correlation between serum LDH levels and clinical outcomes in glioblastoma patients treated with radiotherapy (RT) and temozolomide (TMZ). Materials and methods This retrospective study analysed patients with IDH wild-type glioblastoma (IDH-wt GB) treated at the Radiotherapy Department of Azienda Ospedaliero-Universitaria Senese from 2018 to 2023. Clinical data, including hematologic parameters (e.g., LDH), imaging (MRI), and MGMT promoter methylation status, were collected. All patients received RT and TMZ following the Stupp protocol. Serum LDH levels were measured one week before RT, and Radiological Response (RR) was assessed using RANO criteria. Overall survival (OS), progression-free survival (PFS), and RR were primary endpoints. Statistical analyses included Kaplan-Meier, Cox regression, and decision tree analysis for LDH cut-off determination. Results In a cohort of 147 IDH wild-type glioblastoma patients treated with the Stupp protocol, the median OS was 14 months and median PFS was 8 months. Elevated baseline LDH levels were associated with significantly poorer outcomes, showing a median OS of 9 months versus 20 months and a median PFS of 6 months versus 13 months for lower LDH levels (p < 0.001 and p = 0.0001, respectively). LDH levels also correlated with RR (p = 0,001), Multivariate analysis confirmed high LDH as an independent predictor of worse OS (HR = 2.31) and PFS (HR = 2.60), suggesting its utility as a prognostic biomarker. Conclusions Elevated LDH levels before starting the Stupp protocol are clinically significant as they predict poorer overall survival and progression-free survival in glioblastoma patients and worse RR. Incorporating LDH measurements into treatment planning can help identify patients at higher risk of poor outcomes, allowing for more tailored and potentially aggressive treatment strategies to improve management and therapeutic responses in glioblastoma.

The integration of magnetic resonance (MR) imaging and linear accelerators into hybrid treatment systems has made MR-guided radiation therapy a clinical reality. This work aims to evaluate the influence of the Electron Return Effect (ERE) on the dose distributions. This study was conducted using MRIdian (ViewRay, Cleveland, Ohio) system. Monte-Carlo simulations (MCs) and experimental measurements with EBT3 Gafchromic films were performed to investigate the dose distribution in a slab water phantom with and without a 2-cm air gap. Plus, MCs took into account different field sizes and a lung gap. A gamma analysis compared calculated versus measured dose distributions. The MCs have shown an increase of the ERE with the radiation field size both in Percent Depth Dose (PDD) and crossline direction. As concerns to the PDD direction, the smallest field for which there was a significant dose accumulation was 4.15 × 4.15 cm² both for air-gap (13.5%) and lung-gap (3.3%). The largest field for which there was a significant dose accumulation was 24.07 × 24.07 cm² both for air-gap (39.7%) and lung-gap (4.9%). Instead for the crossline direction, the smallest field for which there was a significant dose accumulation was 2.49 × 2.49 cm² both for air-gap (8.6% ) and lung-gap (0.5%). The largest field for which there was a significant dose accumulation was 24.07 × 24.07 cm² both for air-gap (46.2%) and lung-gap (4.2%). PDD and crossline profiles showed good agreement with a gamma-passing rate higher than 91.15% for 2%/2 mm. The ERE can be adequately calculated by MC dose calculation platform available in the MRIdian Treatment Planning System. The MCs show an increase of the ERE directly proportional with the radiation field size. Good agreement was observed between the experimental measurements and calculated dose distributions.

The global shift towards plant-based diets underlines the critical need to thoroughly evaluate the nutritional value of alternative proteins to meet dietary requirements. To effectively assess the protein quality, it is crucial to understand its composition and digestibility. Through this study, the protein quality assessment of a panel of proteins deriving from emerging plants (i.e., legumes and cereals) and microalgae sources (n = 8) was conducted. Protein digestibility, analyzed using two different methods and expressed in three different ways, showed a high discrepancy. This suggests that relying on two quantification methods and different ways of result expression can give a broader insight into understanding the protein digestibility of alternative proteins compared to a unilateral approach. The amino acid profiles and digestibility scores of individual proteins revealed that all sources contained limiting amino acids and that none met the dietary requirements. Based on the individual amino acid scores, we conducted theoretical calculations to explore potential protein blends. The optimal blend identified contained no limiting amino acids and included pea protein isolates and corn protein concentrates as the primary components, supplemented with barley protein concentrates, Spirulina, or Nannochloropsis oceanica. These results underscore the importance of protein versatility, demonstrating that strategically blending cereals, legumes, and microalgae can significantly enhance nutritional quality.

Metal-organic frameworks (MOFs) are receiving growing interest as permanently porous, highly tunable materials for real-world atmospheric water harvesting applications. Although it is becoming clear that surface effects are key to initiating and regulating MOF water uptake, obtaining molecular-level details on this issue has proven to be elusive. Here, we present a novel methodology based on ambient pressure soft X-ray absorption spectroscopy, machine learning-assisted theoretical spectroscopy and molecular dynamics (MD) simulations to gain quantitative and selective insights into the structural and dynamical behaviour of water confined at a MOF crystal surface. We applied our combined experimental and theoretical method to investigate the properties of wa- ter at the surface of Mg-MOF-74, while obtaining complementary information on the water uptake and release from the bulk by synchrotron powder X-ray diffraction. MD simulations and state-of-the-art theoretical simulations of the spectroscopic data were then employed to describe the water/MOF interface with molecular detail, evidencing that water molecules directly bound to the framework Mg sites first give rise to one-dimensional water chains by establishing a dense hydrogen-bond network with an additional water molecule per metal site, and subsequently nucleate porous channel filling, with the water layers found in the center of the MOF channels exhibiting higher mobility and reduced reorientational ability. The developed method can inform the rational optimization of MOF interfaces for water harvesting.

Seasonal variations in natural environmental stressors represent preparatory factors of rock block deformation driving to failure on slopes as well as on underground contexts. To better assess the role of the environmental stressor regarding the rock slope stability, the present study focused on monitoring an unstable rock block cropping out in a quarry wall at the Acuto field laboratory (Italy), through a methodology for a high-resolution detection of acoustic emission (AE) signals, their characterization and correlation with the concomitant environmental stressors has been developed. Through the spectral analysis of the AE waveforms, the seasonal distribution of average frequencies varies significantly, and the main frequency band was 0–200 kHz. The two-step clustering method and frequency characteristics were used to initially identify group “I” as microcracks-related AE events. The identification results using the MLP neural network showed that microcracks-related AE events accounted for only 23.2% of the total monitoring cycle. This percentage rises to 51.1% and 55.2% for the periods May to December and December to February 2024, respectively, as the rainy season tapers off. The power-law index of AE event energy is variable in the considered time windows in which the monitoring was carried out. Results of a comparative statistic indicate a joining between high AE rates and cooling-relaxation processes, as well as a weak correlation among the waveform attributes and meteorological stressors. The power-law index of AE event energy decreases during the cooler months, particularly from July to December, correlating with the overall drop in temperature. During this period, the few high-energy events can be considered potential indicators of geological hazards.

Objective Patients with symptomatic uncomplicated diverticular disease (SUDD) may have a disrupted gut microbiota. However, current data are from small sample studies, and reported associations vary widely across studies. We aimed to profile the fecal microbiota in SUDD patients enrolled in primary care. Methods A retrospective study was conducted in SUDD ( N = 72) and asymptomatic diverticulosis (AD) ( N = 30), the latter serving as a control group. Results No significant differences in alpha and beta diversity were found between SUDD and AD, but SUDD was discriminated by a higher relative abundance of the family Streptococcaceae and the genera Alistipes , Agathobacter , and Butyricimonas . Interestingly, the gut microbiota of SUDD patients stratified by the severity of abdominal pain [according to the visual analog scale (VAS)]. In particular, higher diversity and health-associated taxa (such as Bifidobacterium , Eubacterium coprostanoligenes group, and Dorea ) characterized mild (VAS score 1–3) SUDD, Proteobacteria , Veillonellaceae and Blautia moderate (VAS score 4–7) SUDD, and Prevotellaceae and Megasphaera severe (VAS score 8–10) SUDD. Conclusion Our analysis suggests that specific taxa may be related to SUDD, but the associations vary depending on the severity of abdominal pain. In addition to advancing our ecological understanding of this complex disease, our findings may pave the way for the incorporation of gut microbiota profiling into clinical practice to aid patient management, including stratification and treatment.

The beam-scanning properties at a fixed frequency in the low terahertz range of one-dimensional periodic leaky-wave antennas composed by a periodic chain of circular dielectric cylinders coated with graphene are studied. A rigorous full-wave modal solver, based on the lattice-sums technique combined with the transition-matrix approach, is applied to the analysis of transverse electric (TE) and magnetic (TM) leaky modes, where the transition matrix suitably takes into account the conductivity of the external graphene sheet. The reconfigurable features of the leaky-wave structure have been investigated in terms of the dispersion behaviors of the phase and attenuation constants of the radiating proper $n=-1$ space harmonic of the Bloch leaky modes. The beam-scanning performance, variation of the beamwidth, and the appearance of grating lobes as functions of the graphene chemical potential are investigated. Three-dimensional structures composed by a finite number of graphene-coated dielectric rods sandwiched by metal or perfect magnetic conductor plates are finally validated through full-wave simulations, showing a good beam-scanning capability for both TE and TM polarizations, respectively, and a remarkable agreement with the theoretical leaky-wave model.

Indoor visible light communication (VLC) is considered secure against attackers outside the confined area where the light propagates, but it is still susceptible to interception from eavesdroppers inside the coverage area. A new technology, intelligent reflecting surfaces (IRS), has been recently introduced, offering a way to control and steer light propagation in VLC systems. This paper proposes an innovative approach for enhancing the physical layer security (PLS) in IRS-assisted VLC by utilising the effect of the time delay induced by the IRS reflections. More specifically, we consider how to allocate the IRS elements in a way that produces destructive intersymbol interference at the eavesdropper’s location while enhancing the signal reception at the legitimate user. Our results show that, at a fixed light-emitting diode power of 3W, the secrecy capacity can be enhanced by up to 253% at random positions for the legitimate user when the eavesdropper is located within a 1-meter radius of the LED. We show that careful IRS allocation can lead to enhanced PLS even when the eavesdropper has a more favorable position than the legitimate user.