University of Palermo

In subsurface drip irrigation systems (SDI), the emitter flow rate is affected by the root intrusion phenomena and by the so-called back pressure that limits the buried emitters’ outflow. This paper suggests a methodology to investigate the effect of root intrusion and back pressure in SDI performance, for different root guard emitter treatments in a 6-year experimental campaign (2018–2023), carried out in Sicily (Italy). Inlet discharges and pressure heads were collected over time, and their variations were used to quantify the effect of root intrusion in terms of local losses. The change in the SDI hydraulic performance was studied using a modified Hardy Cross method (HCM), which is suitable for lopped drip irrigation networks. The HCM applications also considered local losses and back pressure, requiring a comprehensive hydraulic characterisation of the soil to estimate accurately the factors influencing back pressure. Specifically, the influence of root intrusion in different emitters was analysed by considering the time variation of the fraction α of the kinetic head. The results showed diverse behaviours among the root guard emitter treatments. Emitters treated with different herbicides (He 1 and He 2), revealed no significant α-fraction variation over time, denoting the effectiveness of He 1 and He 2 treatments in root intrusion protection. Whilst, for Copper (Cu) and control (Ctrl) treatments, a severe decrease in emitter flow rate was observed, confirmed by high α-fraction variations over the investigated period.

Fabry disease (FD) is a rare lysosomal storage disorder that is characterized by renal, neurological, and cardiovascular dysfunction. Four treatments are currently available for patients with FD; three enzyme replacement therapies (ERTs; agalsidase alfa, agalsidase beta, and pegunigalsidase alfa) and one pharmacological chaperone (migalastat). This review focuses on the evidence for the benefits of ERTs and migalastat, and provides an overview of their impact on disease manifestations and quality of life (QoL). Agalsidase beta is associated with renal, neurological, and cardiovascular benefits, and may prevent renal disease progression. Agalsidase alfa provides stabilizing effects across all main organ systems, although minor sex-specific differences exist in patients with more advanced baseline disease. The benefits of agalsidase alfa and agalsidase beta are similar but depend on the extent of baseline disease. Some data indicate that agalsidase beta may be preferable over the longer term. Both agalsidase alfa and agalsidase beta are associated with improved gastrointestinal and pain symptoms, as well as improved QoL. Patients with advanced end-organ damage tend not to respond as optimally to ERTs as those who initiate ERTs before irreversible organ fibrosis develops, highlighting the need for early treatment initiation. Migalastat, which is only approved for patients with amenable missense gene variants, generally stabilizes renal parameters and provides cardiovascular benefits. Migalastat also improves diarrhea and pain, and stabilizes QoL (although ERT may be more effective for pain management), but the neurological effects of migalastat have not been studied. Real-world data raise concerns about effective in vivo amenability of some genetic variants. Future studies with direct treatment comparisons in patients with FD are needed.

We here describe a rare case of a 26‐year‐old male patient, presenting to our hospital after a motorcycle–car accident for the surgical management of long‐bone fractures to the tibia and femur and shoulder dislocation and undergoing orthopedic surgery, who postoperatively developed seizure, coma, and respiratory failure due to a cerebral fat embolism. After some hours after the surgery, a loss of consciousness was described by caregivers, and the ICU team was alerted, and the patient was admitted to ICU. Intracranial hemorrhage and stroke were subsequently excluded and, finally, a whole‐body computed tomography angiography scan and head magnetic resonance imaging showed lesions consistent with cerebral fat embolism. Patent foramen ovale was then suspected by contrasted echocardiography. An early diagnosis helped to choose the correct management, with early tracheostomy, and to correctly interpret and manage hemodynamic dysregulations. Overall, the care provided lead to positive long‐term outcomes, as the patient was discharged alive and successfully completed neurological rehabilitation, regaining many functional abilities. The initial management, diagnostic pathway, and ICU management are here described.

Syphilis is a re-emerging disease, and suspicion of syphilis infection should be considered in all cases with atypical skin manifestations, mainly when there is a history of unprotected sexual intercourse. Here, we describe a case of secondary syphilis in a woman aged 42 years, who presented with an atypical, painful and itchy skin rash with vegetative cerebriform lesions, which resolved after the administration of penicillin. Multiplex PCR targeting Treponema pallidum on vaginal and lesion swabs, along with syphilis serology, confirmed the diagnosis.

Background The Child Opportunity Index (COI) is a new and innovative tool designed to assess the environment in which children grow up, offering a broad evaluation of the opportunities available to them in different neighborhoods. This initiative aims to ensure improvements in children’s living conditions and future health outcomes. Methods The study was performed in the cities of Palermo and Rome. Our Italian COI consists of three main domains: education, health and environment, and economy, each subdivided into specific indicators. We collected information, when available, useful for our indicators from institutional sites and municipal archives. Furthermore, in the city of Rome, we distributed a questionnaire through local pediatricians, collecting data in 2 randomly chosen neighborhoods with questions on children’s health and quality of life, proposing an initial approach that, when implemented using data provided by the government and public and private health institutions, aims to evaluate the correlation between socio-economic opportunities and the psycho-physical health of children, as demonstrated in the literature. Results As a result, many aspects, such as the rate of air pollution or the illegal occupation of houses, were not taken into consideration. We therefore consider our COI proposal only a starting model that will have to be implemented once all the necessary information has been obtained. However, what can be deduced from this first descriptive study is how the opportunities in different neighborhoods are not the same for all children. The number of educational opportunities as well as the number of environmental opportunities differs between the various districts and is not homogeneous between different cities or within the same city. Conclusions In conclusion, it is not simple to analyze in a scientific manner the child’s health impact of living in different areas. The COI could be a useful and simple tool that can give us this information. Pediatricians could collaborate with institutions to implement intervention plans and to reduce existing differences, social and health inequalities. Future studies will have to implement this pilot study to create and validate an Italian model of COI to be used as a useful tool in children’s assistance.

The Mediterranean diet has gained significant attention for its potential health benefits on diverse pathological conditions including osteoarthritis (OA), a prevalent degenerative joint disease characterized by cartilage breakdown and inflammation. Numerous observational studies have suggested that adherence to the Mediterranean diet, may have protective effects against OA. The abundance of antioxidants and anti-inflammatory compounds and omega-3 fatty acids, among the Mediterranean diet components is believed to contribute to its beneficial effects on OA. Research investigating the association between the Mediterranean diet and OA has shown promising results. Several observational studies have reported that adherence to the Mediterranean diet is associated with a reduced risk of developing OA and with lower severity of OA symptoms. Additionally, intervention studies have demonstrated improvements in pain, function, and quality of life among OA patients following a Mediterranean diet intervention. Furthermore, emerging evidence suggests potential mechanisms underlying the protective effects of the Mediterranean diet against OA, including its ability to reduce inflammation, oxidative stress, and cartilage degradation. However, further well-designed randomized controlled trials and mechanistic studies are needed to elucidate the precise mechanisms and establish causality. In conclusion, the Mediterranean diet appears to be a promising dietary approach for the prevention and management of OA. Its rich array of nutrients and bioactive compounds may exert protective effects against OA development and progression, although more research is warranted to confirm these findings and elucidate underlying mechanisms. Graphical abstract

Striae distensae (SD) appear clinically as parallel striae, lying perpendicular to the tension lines of the skin. SD evolve into two clinical phases, an initial inflammatory phase in which they are called “striae rubrae” (SR) and a chronic phase in which they are called striae albae (SA). This study investigates the synergistic effect of nanofat and platelet-rich plasma (PRP) injections on collagen production in fibroblasts derived from SA (SAF). A prospective, randomized single-blind study was conducted in fifty women presenting with SA in the abdominal region who had voluntarily sought a conventional abdominoplasty procedure and accepted to test an autologous treatment for their SDs. SA were treated using: PrP 10 ml; PrP 2ml (20%) + nanofat 8ml (80%); nanofat 10ml. Following the abdominal dermolipectomy, biopsies from treated and untreated SDs were taken and analyzed for type I collagen quantification. Results were processed through statistical analysis models using the Student’s t test. Collagen concentration in untreated SA biopsies was significantly lower than in healthy skin. Both PRP and nanofat treatments significantly increased collagen biosynthesis compared to controls, with the combined PRP-nanofat treatment showing the highest increase in collagen levels (p < 0.0001). A superior clinical improvement was observed in the areas that received the combined treatment of PRP and nanofat (p = 0.001). Our findings indicate that both PRP and nanofat treatments effectively enhance collagen production in SA, with the combined PRP-nanofat treatment showing a synergistic effect. This combined therapy holds promise for effectively treating SA, providing a new potential treatment avenue for SMs and similar skin conditions. Further studies are needed to validate these results and explore clinical applications. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Background Unicompartmental knee arthroplasty (UKA) is a surgical procedure for managing osteoarthritis of one joint compartment, most commonly the medial side. This systematic review investigates the causes of UKA revision. The outcomes of interest were establishing the revision rate, time to revision, and the most common causes of revision in the long- and midterm follow-up. Methods This study was conducted according to the 2020 PRISMA statement. In October 2024, the following databases were accessed: PubMed, Web of Science, Google Scholar, and Embase. All the clinical studies investigating the rate and causes of revision in UKA were accessed. Only studies with a minimum of 10 years of follow-up were considered. Results Data from 56 studies (13,540 patients) were collected. Of them, 65.6% were women. The mean length of the follow-up was 13.1 ± 3.0 years. The mean age of the patients was 65.6 ± 5.6 years, and the mean BMI was 28.5 ± 2.2 kg/m². Revisions were performed in 8.8% (2641 of 30,140) of implanted UKAs. The mean time to revision was 6.5 ± 2.6 (range, 2.5 to 13.0) years. Conclusion 8.8% (2641 of 30,140) of UKAs were revised at a mean time of 6.5 ± 2.6 years. Level of evidence Level IV, systematic review.

The use of biostimulants in agriculture provides a sustainable and efficient technology to improve resource‐use efficiency. Biostimulants may boost vegetative growth, enhancing plant tolerance to biotic and abiotic stress. The tomato (Solanum lycopersicum L.) is sensitive to drought stress, particularly during fruit setting and fruit development stages. In Italy, long‐storage tomato genotypes characterised by drought resistance were selected. In this 2‐year study, the foliar application of different biostimulants (betaine, seaweed extracts, vegetal protein hydrolysate and animal protein hydrolysate) was evaluated to determine effects on yield and quality of a local tomato landrace (Pizzutello) cultivated in Sicily without irrigation. The highest dry matter (9.9%) and solid soluble content (6.9° Brix) were observed in plants treated with betaine. Plants treated with A. nodosum or animal protein hydrolysate showed the highest potassium concentrations, whereas those supplied with vegetal protein hydrolysate had the highest calcium concentrations. Tomato treated with betaine were found to have the highest nitrate concentrations. The highest marketable yield (13.8 t ha⁻¹) was recorded in plants treated with vegetal protein hydrolysate, with an increase of 17.4% compared to the control plants. The highest unmarketable yield was observed in control plants and in those treated with betaine (1.1 t ha‐1). In conclusion, we can say that each biostimulant had a different effect on the different parameters analysed. Overall, the application of biostimulants has improved tomato growth, productivity and quality in limited water conditions. Our results highlight the potential of biostimulant applications to optimise both the yield and fruit quality of renowned local varieties. This study demonstrated the improvement in the agronomic performance of the Pizzutello tomato, which is particularly significant not only in response to the growing consumer demand for high‐quality traditional tomatoes, but also for the enhancement of the technological traits valued by the food industry.

This article offers for the first time a facial approximation of the Ancient Egyptian Pharaoh Amenhotep III (reigned ca. 1388–1351 BC) based on photographic material of his mortal remains and anthropometric data collected at the time, and by adopting a novel technique previously used in similar research by our team. A comprehensive discussion of the mummy attributed to Pharaoh Amenhotep III is also annexed to the study, focusing on the bioarcheological and embalming aspects.

The growing interest in electrical machines equipped with multiphase configurations has directed the research to the conception of new design methods and optimization strategies to maximize the performance and the efficiency of the machine for its specific application. In this context, a noticeable gap persists in the comprehensive generalized theory of multiphase systems applied to electrical machines. Therefore, this article aims to propose a new possible classification of multiphase systems based on the electrical symmetries between the corresponding star of slots phasors, starting from the general law related to the spatial distribution of the air-gap magnetic flux density field. This theory extends beyond symmetrical configurations, encompassing both reduced and normal systems, which can be derived from redundant multiphase configurations. Furthermore, the proposed generalization applies to all possible m -phase configurations, including the structures with slight asymmetries or unbalances. The article provides illustrative examples to reinforce these theoretical concepts to establish a systematic and unified theory and classification that can be adopted for any possible topology of a multiphase system.

This chapter gives an overview of the recent state of knowledge regarding Tolypella glomerata. It contains a full morphological description including identification hints and remarks on the potential risks of confusion. It also provides information on the distribution and ecology of the species in Europe and tackles potential threats.

Background Although hemophilia A mainly affects males, carriers (defined as females with hemophilia A, as well as symptomatic or asymptomatic hemophilia A carriers) are at risk of excessive bleeding, particularly during trauma or during surgical procedures. Clinical trials have focused on male patients with severe disease, and data for females are limited. Improved, evidence-based treatment guidelines for management of hemophilia A carriers are required. Objectives and design The NuDIMENSION study is a phase IV, prospective, open-label, single-arm study that will evaluate the perioperative efficacy and safety of simoctocog alfa (Nuwiq®), a recombinant factor VIII (FVIII), in women/girls with hemophilia A undergoing major surgery. The study will be conducted at approximately 15 centers worldwide. Women/girls aged ⩾12 years, with mild or moderate hemophilia A (residual FVIII activity (FVIII:C) ⩾1% to <40%) and with no current/past FVIII inhibitors are eligible. All patients must be scheduled to undergo a major surgical procedure during which simoctocog alfa will be administered. Methods and analysis The primary endpoint is overall perioperative hemostatic efficacy (“success” or “failure”) of simoctocog alfa. Hemostatic efficacy will be assessed at the end of surgery and at the end of the postoperative period (i.e., completion of wound healing), with overall adjudication by an Independent Data Monitoring Committee. Safety endpoints will include the incidences of thrombotic events and FVIII inhibitor development. The aim is to recruit 28 patients to achieve 26 evaluable surgeries. Ethics Ethical approval will be received from institutional review boards/independent ethics committees, and the study will be conducted in compliance with the Declaration of Helsinki. Discussion Data from NuDIMENSION will generate much-needed evidence on surgical management of women/girls with hemophilia A, which will help to enable the development of treatment guidelines specific for such patients. Trial Registration CT EU 2022-502061-17-00; NCT05936580

Background: Tirbanibulin 1% ointment has been licensed to treat non-hyperkeratotic actinic keratosis (AK) on the face and scalp in adults. Recent evidence suggests that, besides the anti-neoplastic effect, tirbanibulin may also confer substantial cosmetic benefits to patients. Methods: We report a single-center retrospective study of patients affected by solar lentigines (SLs) and AKs in the context of field cancerization treated with tirbanibulin 1% ointment. Results: Among 42 patients, 35% (n = 15) experienced complete clearance of SLs, while partial clearance was observed in 50% (n = 21) of patients. Regarding AKs, complete and partial clearance were observed in 52% (n= 22) and 40%(n = 17) of patients, respectively. Major study limitations are the small sample size and the absence of a control group. Conclusions: Our results suggest that tirbanibulin 1% ointment may offer the dual benefit of treating AKs while simultaneously lightening aesthetically bothersome and difficult-to-treat lesions like SLs with just 5 days of application.

In the special issue of Bianco e Nero dedicated to Italian stardom, Italy is defined as “the country of the antidivi.” This chapter, through the case study of the young Italian actress Matilda de Angelis, questions that statement. De Angelis’ career shows instead an attitude toward showbusiness that is fully in line with international artistic and production values. Compared to performers of the previous generation such as Margherita Buy, Elio Germano, or Giovanna Mezzogiorno, the case of de Angelis—a young actress of Bolognese origin who, starting from 2015, quickly gained the attention of audiences and critics alike, becoming “the hope of Italian cinema,” is part of the new global trend in which the boundaries of the entertainment and advertising industries, and between spectacle and life are falling apart. As Landrini noted, de Angelis’ persona is characterized by a confrontation with the American entertainment business and the pervasiveness of the third-feminist idea, which facilitates it. This chapter looks closely at how, through the exploitation of the scandal of full-frontal nudity exhibited in the HBO television series The Undoing (2020), de Angelis managed to become an instant glamorous icon, beyond the shared notion of “celebrity.”

Female development includes significant size changes across the breast. Yet, whether differences in breast surface area (BrSA) modify breast sensitivity to warm, cold and wetness, and the associated epidermal properties (skin thickness and surface roughness) remain unclear. We investigated the relationship between BrSA and thermal and wetness perception, as well as epidermal properties, in 21 females (28±$\ \pm$10 years) of varying breast sizes (BrSA range: 147–502 cm²), at multiple breast sites (i.e., nipple, above and below the nipple, and bra triangle). Associations between BrSA and the perceptual and epidermal variables were determined via correlation analyses. Differences across test sites were assessed by repeated‐measures ANOVA. Our results did not support the hypothesis that larger breasts present reduced thermal and wetness sensitivity, except for the above nipple site, which presented reduced warm sensitivity with increasing BrSA (r = −0.61, P = 0.003). We also found a heterogeneous distribution of cold, but not warm or wetness, sensitivity across the breast, with the above nipple site presenting lower cold sensitivity than any other site (P < 0.015). Our findings did not indicate any association between BrSA and epidermal properties (thickness and roughness), nor any site‐dependent variation in these anatomical parameters (P > 0.15). We conclude that, while some skin‐site (i.e., above the nipple) and perceptual modality‐dependent (i.e., warm sensitivity) differences were observed, BrSA‐dependent variations in thermal and wetness sensitivity were not a generalised feature of the skin covering the breast. These observations advance our fundamental understanding of breast sensory function, and they could inform the design of user‐centred clothing such as bras.

Film blowing is one of the most widely used structuring processes to produce thin polymer films. During this process, unique morphologies are induced in polymer-filled composites by elongational flow. In this work, the effect of the presence of micro fibrillated cellulose (MFC) on the morphology and mechanical properties of poly (lactic acid) (PLA)/MFC biocomposites subjected to non-isothermal elongation flow in a melt spinning operation was evaluated to assess the filmability of the proposed formulations and the final morphology achieved during film blowing. The produced films were characterized to determine how the achieved morphology affected the thermal, optical, barrier, and mechanical properties of the films, paying particular attention on the improvements achieved thanks to the MFC addition. Graphical abstract