University of Sassari

Green tea is a traditional drink found in Asian countries, made up of four derivatives. One of the derivatives is epigallocatechin-3-gallate (EGCG). EGCG provides therapeutic benefits for cancer, heart disease, diabetes, and obesity. However, its poor absorption and instability limit its effectiveness, which can be improved using nanoparticle encapsulation. This work is a comprehensive review of the studies on green tea polyphenols, the impact of pro-oxidants and EGCG in cancer prevention, and their delivery using nanotechnology. Other plant sources of ellagitannin and its physicochemical properties, the therapeutic and preventive role of EGCG in breast cancer, and other cancers that can be treated using nano gold (NpAu) carriers are also discussed.

Bullous pemphigoid (BP) is the most common autoimmune blistering skin disease worldwide. In the difficult‐to‐treat BP or if standard therapies are contraindicated, the use of biologics may be also considered although there is no strong evidence supporting their use. This study aimed to investigate clinical and diagnostic findings as well as treatment outcomes among patients diagnosed with BP and undergoing omalizumab or dupilumab in a real‐world setting. A multicenter retrospective cohort study was performed across 15 Italian tertiary referral hospital. Medical records of 2435 BP patients were screened, identifying 58 (2.3%) Caucasian patients who met the inclusion criteria. Within this study population, 39 (67.2%) were treated with dupilumab and 19 (32.8%) received omalizumab. Disease control was achieved in 90.6% of dupilumab‐treated patients and complete remission on minimal therapy was observed in 71.0%. Omalizumab‐treated patients achieved disease control in 77.8% of cases and 64.7% obtained complete remission on minimal therapy. Log‐rank test comparing relapse rate between treatment groups was not significant ( p = 0.58). Finally, parameter estimates associated with the fixed effect of time were consistently negative, indicating a generally significant ( p = < 0.05) decrease in scores over time for patients treated with both biologics. This cohort of patients undergoing dupilumab or omalizumab adds to the existing evidence concerning the effectiveness of biologic agents in BP. Both biologics seem to be promising treatment adjuvants in the management of BP, with dupilumab showing a descriptive trend toward better outcomes.

Motivation De novo assembly creates reference genomes that underpin many modern biodiversity and conservation studies. Large numbers of new genomes are being assembled by labs around the world. To avoid duplication of efforts and variable data quality, we desire a best-practice assembly process, implemented as an automated portable workflow. Results Here we present Colora, a Snakemake workflow that produces chromosome-scale de novo primary or phased genome assemblies complete with organelles using PacBio HiFi, Hi-C, and optionally ONT reads as input. Colora is a user-friendly, versatile, and reproducible pipeline that is ready to use by researchers looking for an automated way to obtain high-quality de novo genome assemblies. Availability and Implementation The source code of Colora is available on GitHub (https://github.com/LiaOb21/colora) and has been deposited in Zenodo under DOI https://doi.org/10.5281/zenodo.13321576. Colora is also available at the Snakemake Workflow Catalog (https://snakemake.github.io/snakemake-workflow-catalog/?usage=LiaOb21%2Fcolora). Supplementary information Additional files are available at Bioinformatics online.

To evaluate the clinical practice and timing of use of tier-three therapies (TTT) after traumatic brain injury (TBI), and to explore their association with intensive care unit (ICU) mortality and 3 months neurological outcome. International multicenter, retrospective, observational, cohort study performed in 16 ICUs including 408 adult TBI patients requiring at least one of the TTT [i.e. metabolic suppression with barbiturates, secondary decompressive craniectomy (DC), and mild hypothermia] for the control of intracranial hypertension during the ICU stay. Among 408 adult TBI patients, secondary DC was the most frequent TTT utilized (n = 297, 72.8%), and was associated with reduced ICU mortality [Odds Ratio, OR 0.34 (95% Confidence Interval, CI 0.14–0.78) p = 0.012] and better neurological outcome (p = 0.047), whereas barbiturates were associated with increased ICU mortality [OR: 3.05 (95% CI 1.43–6.49); p = 0.004) and worse neurological outcome (p = 0.032). Two hundred and twenty-four (55%) patients received interventions in adherence to guidelines, which was associated with a non-significant trend towards better outcomes. The staircase approach before the use of TTT was not often utilized after severe TBI. Secondary DC was performed more often than other treatments and its use was associated with improved mortality and neurological outcome. The benefits of adherence to guidelines before TTT prescription should be further evaluated.

The relationship between rheumatic diseases (RDs) and endothelial dysfunction (ED) is intricate and multifaceted, with chronic inflammation and immune system dysregulation playing key roles. RDs, including Osteoarthritis (OA), Rheumatoid arthritis (RA), Systemic Lupus erythematosus (SLE), Ankylosing spondylitis (AS), Psoriatic arthritis (PsA), Sjogren’s syndrome (SS), Systemic sclerosis (SSc), Polymyalgia rheumatica (PMR) are characterized by chronic inflammation and immune dysregulation, leading to ED. ED is marked by reduced nitric oxide (NO) production, increased oxidative stress, and heightened pro-inflammatory and prothrombotic activities, which are crucial in the development of cardiovascular disease (CVD) and systemic inflammation. This association persists even in RD patients without conventional cardiovascular risk factors, suggesting a direct impact of RD-related inflammation on endothelial function. Studies also show that ED significantly contributes to atherosclerosis, thereby elevating cardiovascular risk in RD patients. This review synthesizes the molecular mechanisms connecting major RDs and ED, highlighting potential biomarkers and therapeutic targets. Ultimately, the review aims to enhance understanding of the complex interactions leading to ED in rheumatic patients and inform strategies to mitigate cardiovascular risks and improve patient outcomes.

The extensive and rising utilization of fossil fuels has had a substantial effect on irreversible global climate change. Therefore, it is imperative to increase the use of alternative energy sources to address this severe issue. Hydrogen is a highly promising energy source that can be stored via a variety of approaches. The current research enhances the H2 storage capacities of MgH2 by incorporating jute stick-derived activated carbon and a ternary oxide (Mg-Cu-O). Different composite nanomaterial samples were synthesized by ball milling and characterized using XRD, TGA, DTA, SEM, EDX, and FTIR. It was observed that both the ternary oxide and activated carbon exhibit a notable effect on H2 absorption and desorption processes. The inclusion of activated carbon increases the surface area, which contributes significantly to the increased adsorption capacity of the samples. On the other hand, the presence of MgCuO2 enhances the H2 desorption rate at lower temperatures. Therefore, the synergistic effects of jute stick-based activated carbon and MgCuO2 can provide highly robust H2 storage materials for alternative energy applications.

Oncocytic adrenocortical carcinoma (OAC) is a rare variant of conventional adrenocortical carcinoma (ACC), characterized by oncocytic tumor cells comprising more than 90% of the tumor. Due to its rarity, there is a lack of reliable data on the clinicopathological features and outcomes of OAC. The aim of this study was to assess the clinical presentation, treatment modalities, and outcomes of patients with OAC, comparing these results with a cohort of patients with conventional ACC. Data from 9 referral centers in Italy on 44 patients with OAC were retrospectively analyzed and compared with data from 145 patients with conventional ACC. Patients with OAC had a smaller median tumor size, more favorable resection margin status, and lower incidences of venous invasion and persistent/recurrent disease during follow-up. Additionally, patients with OAC exhibited longer times to progression (TTP) and overall survival (OS) compared to patients with conventional ACC. Multivariable analyses identified Ki67 and tumor size as features independently associated with disease progression during post-surgical follow-up, while Ki67 and distant metastases at diagnosis were independently associated with OS in OAC patients. After complete tumor removal, the risk of recurrent disease was higher in patients with either Ki67 ≥ 20% or ENSAT stage III/IV. OAC appears to have a more indolent clinical course and better prognosis than conventional ACC. Similar to conventional ACC, Ki67 remains a significant prognostic marker for OAC and, along with ENSAT stage, serves as a reliable biomarker for identifying patients who may benefit from adjuvant mitotane therapy.

After the First World War, the development of offensive air power necessitated a thorough overhaul of Italy’s coastal defences. The new air threats forced the reconfiguration of existing anti-ship and anti-submarine installations, the adoption of concealment measures to make them less visible to enemy aircraft, and the construction of new fortified batteries designed for active defence based on sighting and response fire. The primary objective of anti-aircraft defence was to minimise the damage caused by enemy bombardment and to hinder enemy offensive operations. It was in this context that the so-called ‘second generation defences’ were born, including the Luigi Serra Battery, located at Punta Filasca in the municipality of Golfo Aranci, which is the subject of this work. The aim of the research is to document the state of a currently abandoned historical testimony and to propose some solutions for its future valorisation.

The military complex of “Capo d’Orso” in Sardinia is set in a very importance coastal landscape. It is an example of valuable military architecture, which documents important national and international war strategies. The Battery was built at the end of the XIX century; it was never used during the various wars, but, in particular between the First and Second World Wars, it suffered of considerable modernization interventions. Starting from a general overview of the military architectural heritage of the 'La Maddalena Archipelago – Palau' area, this article examines how protection has been implemented in this architectural heritage, showing how every intervention, even minimal, on these architectures that have been abandoned for decades, strongly affects from the architectural to the landscape scale. These are architectures that need of particular attention for the correct identification of design solutions for "reuse", so that the fundamental principles such as restoration are simultaneously understood, i.e. those of minimum intervention, compatibility, reversibility and authenticity, are achieved. In this paper we will try to understand how restoration can preserve the peculiar characteristics of historic military architectures, for example the inaccessibility and minimal visibility of the built environment in the environmental context, etc., where is difficult to resist at the current pressures of tourist use, in the marine context.

Historical cartography represents an essential documentary resource for understanding territorial and urban transformations. This study examines the evolution of Alghero’s fortifications through an in-depth analysis of twelve maps covering three centuries. The maps, sourced from various archives, document architectural and urban changes linked to technological advances and the different dominations that have influenced the city. The methodology adopted combines the reading of the maps through georeferencing and digital redrawing. The overlaying of historical maps has allowed for detailed documentation of the transformations in the urban defensive system. The results highlight the importance of the fortifications in determining the city’s development, from its medieval configuration to its twentieth-century expansion, providing a framework for conserving and enhancing Alghero’s fortifications to further historical understanding and promote informed management of cultural heritage.

The establishment of Sardinia’s defensive system unfolded over a broad timespan, beginning in 1587 with the initiative of Philip II, King of Spain, to construct coastal towers for the Mediterranean war, marked by the creation of the Royal Administration of Towers, and concluding at the end of the 18th century with the diminishing need for defensive measures, a prelude to the definitive abolition of the Administration in 1842.In this complex and costly endeavour to control and protect the territory, the role of military engineers was pivotal from the very outset. This was exemplified by the 1577 report by military engineer Rocco Cappellino, who prepared topographical maps of Sardinia depicting 33 coastal towers. His work provided valuable insights for improving and enhancing the defensive system. Later, the engineer De Vincenti significantly contributed by proposing a new arrangement and design for the coastal towers, which became the cornerstone of the island’s defensive system. His efforts included an exploratory journey along the coastline, during which he documented the number and distribution of towers, listing 82 in total, and meticulously described their locations, conditions of preservation, and the repairs required for each.It is worth noting that for a considerable time, much of the technical work, both in the conceptual and execution phases, was carried out by ordinary master builders.The archives hold a vast collection of documents relating to the design of the towers and the planning of maintenance works. These records reveal not only the structural and typological characteristics of these architectural features but also the extent of the knowledge possessed by the workforce and military engineers. The latter, like De Vincenti, were often engaged in civil or religious projects, during which they demonstrated significant technical and formal expertise.

The form and architectural characteristics of the nuraghi and the surrounding walls have been decisive in the studies that initially focused on defensive and fortification aspects. From this, theories on Sardinia’s social and economic organization in protohistory developed.However, considering nuraghi only as defensive structures limits the understanding of their complexity. By abandoning a strictly militaristic view and adopting a broader perspective of the term ‘fortress’, their polyvalent function and significance, beyond mere military defence, becomes apparent.In this context, the nuragic complex of Palmavera in Alghero is reinterpreted as an emblematic example of a complex nuraghe, composed of three towers and surrounded by a second concentric wall, known as a structured ‘antemurale’. Contrary to the typical linear masonry, the ‘antemurale’ of Palmavera has a pentagonal shape with towers arranged at its vertices, among which the striking Capanna delle Riunioni.This study proposes a methodology for the documentation and digitalization of the site, divided into two main phases. The first phase is a detailed photogrammetric survey, capable of recording the morphological and dimensional characteristics of the complex. The second phase is based on advanced three-dimensional modelling, which will make it possible not only to represent the site’s current state but also to visualize reconstructive hypotheses based on archaeological theories to explore the original configurations of the nuraghe.

The unprecedented outbreak of the COVID-19 pandemic has altered the course of many lives, resulting in multiple health and social challenges. Due to the speed at which this pandemic spread, various public health ‘lockdown’ measures were introduced to mitigate its spread. The outcome of adherence to these measures has revealed the possible influence on individuals’ varying cognitive abilities. Accordingly, this study aimed to explore the predictive relationships between lockdown responses and COVID-19 restrictions, memory recall performance, and associated emotional responses while examining the sociodemographic influences of age and sex. Participants were drawn from a secondary dataset of an international online survey study of 1634 individuals aged 18–75 years across 49 countries. Participants’ demographic questionnaires, free memory recall, and hospital anxiety and depression scale scores were used to collect the data for analysis. Four-way MANOVA and hierarchical multiple regression were utilised to explore the mean differences and predict relationships between the study variables. Significant differences were found in memory recall performance and anxiety and depression scores across lockdown groups (the comply, sufferer, and defiant). Regression analysis indicated that age and gender were predictive markers of lockdown responses and anxiety (R² = 0.14, F4,1625 = 66.15, p < .001, f² = 0.17), while age was the only predictor of lockdown responses and depression association ($\:b$ = -0.78, t(1625) = -4.35, p < .001). Lockdown compliance was associated with better free recall (M = 8.51, SD = 6.38, p < .001; η² = 0.01), lockdown suffering was associated with greater anxiety (M = 9.97, SD = 4.36, p < .001; η² = 0.06), and lockdown deviance was associated with greater depression (M = 7.90, SD = 3.12, p < .001; η² = 0.05). The current study provides valuable information on the mechanisms of cognitive interpretations and emotional arousal in individuals’ social isolation responses to recent life stress and potential severe pandemics. This may support the need for robust interventions aimed at improving people’s psychological appraisals associated with anxiety in preparation for any new potential waves or future pandemics.

Background Several lines of evidence support the hypothesis of brain-first and body-first Parkinson’s disease (PD) subtypes, characterized by distinct origins of α-synuclein pathology. However, data on premotor non-motor burden and motor progression in these subtypes remain inconsistent. Objective To analyze the natural history of body-first versus brain-first PD subtypes. Methods Data from 400 PD patients enrolled at a single Italian center were analyzed. All patients underwent a standardized retrospective baseline assessment of premotor and motor symptoms at onset and were prospectively followed. Premotor REM sleep behavior disorder (RBD), considered a prodromal phenotype of the body-first subtype, was used to divide patients into two groups: 81 patients with probable premotor RBD (PDpreRBD+) and 319 patients without (PDpreRBD−). Results At motor onset, PDpreRBD+ patients were older than PDpreRBD− patients, exhibited less tremor, and more frequently presented with bilateral motor symptoms. PDpreRBD+ patients also reported a greater burden of premotor symptoms, including hyposmia, cognitive impairment, pain, constipation, and other dysautonomic symptoms. Over the follow-up period, PDpreRBD+ patients progressed more rapidly to Hoehn and Yahr stage 3, even after adjusting for sex, years of schooling, age at motor onset, and initial motor phenotype. Conclusions Our results align with the hypothesis of brain-first and body-first PD subtypes, providing novel insights into their different premotor non-motor burden and motor progression trajectories.

BACKGROUND This study describes the evolution of treatment outcomes in drug-resistant (DR) pulmonary TB, focusing on efficacy and effectiveness. METHODS We searched PubMed/MEDLINE, Embase, Cochrane CENTRAL, Scopus, and Web of Science reporting DR-TB regimens from 1 January 2009 to 8 May 2024 and performed a systematic literature review and meta-analysis. RESULTS A gradual increase in success rates in the treatment of DR pulmonary TB was observed from 2009 to 2024 across all studies. In observational studies, the average treatment success rate for mono-resistant TB (non-rifampicin-resistant TB, RR-TB) was 82.9%, while the average treatment success rate for RR/multidrug-resistant TB (MDR-TB) was 68.4%, and that of pre-extensively drug-resistant TB (pre-XDR-TB) and XDR-TB was 54.4% with an increasing trend over time. The outcomes of experimental studies, which included fewer patients, demonstrated 69.6% treatment success for RR/MDR-TB, with higher rates for pre-XDR/XDR-TB (79.2%) and a mix of the two groups (85.8%). Significant geographic variations in outcome rates were observed across studies. CONCLUSION The current study demonstrates a steady improvement in treatment outcomes for DR-TB after a long period of stagnation. However, new drugs and novel regimens are needed to maintain or further improve treatment outcomes in DR-TB.

Respiratory syncytial virus (RSV) causes substantial morbidity and mortality across the lifespan, with the highest burden seen in infants and older adults. Recently approved immunizing agents, including long-acting neutralizing monoclonal antibodies and a maternal vaccine for passive immunization of newborns, and three vaccines for adults aged 60 years and older who are vulnerable to RSV disease, have the potential to prevent severe RSV-associated disease if implemented successfully. The use of these agents will be implemented in some Italian regions over the next few months, although no consistent timelines or decisions for adoption at the national level are expected. A multidisciplinary group of experts in neonatology, obstetrics and gynecology, respiratory medicine, geriatric medicine, hygiene, and public health reviewed the evidence on RSV prevention and present here their considerations on implementing an RSV prevention strategy in Italy. Given the associated disease burden, it is essential to move quickly to deploy these agents in vulnerable populations, enhance surveillance to accurately detect/predict seasonal trends in RSV activity and measure the impact of prevention strategies. Continuing research combined with widespread use of more sensitive testing is needed to identify vulnerable populations and risk factors. Policies are needed to support these preventive measures in the Italian healthcare system, and access must be accompanied by educational initiatives and advocacy to promote acceptance by HCPs and the target population.