University of Florence

The present paper investigates the topic of ‘silent registered Geographical Indications’ (GIs), defined as GIs that after their registration, or nonetheless during a relevant period of time, have fallen into disuse or are employed considerably beyond their expected potential. In particular, by applying an empirical methodology, the research will constitute the first attempt to analyse and measure this phenomenon from an EU perspective, especially, although not exclusively, in the context of Italian GIs. First results highlight the extent of the silent GIs phenomenon and the need for further investigation to understand the reasons behind it. The issue of silent GIs can be tackled from two diverging perspectives: one considers silent GIs as detrimental to the GI system as a whole, while the second argues the need to maintain their protection in view of the prevention of generalisation of GIs and the indirect economic effects they can still play.

Antimicrobial photodynamic therapy (aPDT) is a promising strategy to overcome issues related to antibiotic resistance. Here the rationale for designing new photosensitizers is described based on the functionalization of bodipy dyes with triarylphosphonium rotaxanes, and an in‐depth characterization of their photophysical properties, applying different spectroscopic techniques, including ultrafast transient absorption spectroscopy is provided. While the addition of halogen atoms to some of the structures provides them the ability to efficiently produce singlet oxygen in organic solvents, such property is suppressed in water, where all the investigated compounds aggregate into spherical nanoparticles. The latter, independently of the presence of bromine, demonstrate high photothermal conversion efficiency and have been tested as photosensitizers in antibacterial photothermal therapy, highlighting the potential of self‐assembled organic nanostructures based on bodipy dyes for developing new and versatile nanomaterials for photomedicine applications.

Penile prosthetic devices stand as the foremost solution for medication-resistant erectile dysfunction. Frequently, medical conditions triggering erectile dysfunction also led to penile shortening, detrimentally impacting patients’ quality of life. This narrative review aims to explore and evaluate the various techniques available for penile lengthening that can be performed concurrently with inflatable penile prosthesis (IPP) insertion. We conducted a comprehensive examination of the literature, utilizing PubMed focusing on key terms such as “penile prosthesis corporal length”, “inflatable penile prosthesis and short penis”, and “buried penis”. The review identified several advanced methodologies for preserving and enhancing penile length during IPP insertion. These techniques include subcoronal IPP insertion, sliding technique, modified sliding technique, multiple slice technique, and circumferential incision with grafting. Supplementary procedures aimed at improving the perception of increased length involve ventral phalloplasty and suprapubic lipectomy. It is worth noting that the maximum length gain seems to be constrained by the length of the neurovascular bundles. In summary, the evidence available in the literature is limited due to the short of case series reported, lack of randomized controlled trials, and heterogeneity of the studies. The literature suggests that for carefully selected patients, surgical penile lengthening procedures performed concurrently with IPP insertion emerge as effective treatments for individuals grappling with penile shortening and severe erectile dysfunction. Well-designed, larger studies are needed to establish the safety and efficacy of these procedures.

In the semi-arid region of Morocco, water resources are limited and under severe strain. In this environment, watersheds are heterogeneous, have nonlinear hydrological responses, and are characterized by data scarcity. Considering these particularities, using an appropriate modeling approach that considers the unique characteristics of semi-arid watersheds with limited data is crucial for effective and sustainable water management. The physically based SWAT model combined with SWAT-CUP and the low-parameterized GR4J lumped model were used to that end. These models simulated daily observed streamflow and hydrological signature indices to investigate the utility of lumped and spatially distributed modeling approaches in reproducing the hydrological behavior of the Oued Issen watershed. Our findings demonstrated that both modeling approaches performed well (NSE > 0.50 and R² > 0.60). Furthermore, the comparison results indicated that the spatially distributed modeling approach outperformed the lumped modeling approach. The latter was less consistent due to its inability to account for spatial variability in precipitation and the hydrological characteristics of the Oued Issen watershed. Compared to the GR4J model, the SWAT model illustrated its superiority by more accurately reproducing the watershed’s hydrological response, specifically in terms of streamflow magnitude. Using the SWAT-CUP program reduced SWAT model uncertainties and avoided the risk of overparameterization. Using the semi-distributed SWAT model with SWAT-CUP proved to be the most practical approach for studying semi-arid Mediterranean watersheds, balancing process complexity with data scarcity. Overall, modelers can rely on this approach for better water resource management in data-scarce, semi-arid regions.

Surveying vegetation is essential for documenting plant diversity, especially for coastal vegetation that results among the most threatened ecosystems globally. To support conservation and management programs, we developed the SALt-affected vegeTatIon dataset of Tuscany coaStal Habitats (SALTISH). This dataset comprises 734 newly sampled vegetation plots of 4 m 2 (2 m × 2 m) from the Tuscany region in central Italy, including 569 sand dune plots and 165 salt marsh plots, recorded between 2018 and 2023. In total, the dataset contains 4,541 occurrences of vascular plant taxa. Overall, it comprehends 257 vascular plant taxa belonging to 165 genera and 56 families. The Poaceae family is the most diverse, represented by 50 taxa, while the most represented genus is Juncus, with seven species. Species richness within individual plots ranges from one to 55 species, with 622 plots (84%) containing fewer than 10 species. Juniperus macrocarpa emerges as the most frequent and dominant species in the dataset. Helichrysum stoechas, Festuca fasciculata, and Medicago littoralis are present in over 20% of the plots, whereas 157 taxa are recorded in fewer than 1% of plots. The dataset includes noteworthy taxa: four Italian endemics (Centaurea aplolepa subsp. subciliata, Limonium etruscum, L. multiforme, and Solidago virgaurea subsp. litoralis), eight taxa listed as threatened in the Italian Red List, and 18 archaeophyte and neophyte alien species. SALTISH provides critical data for monitoring and conserving threatened coastal habitats in Tuscany. This resource will facilitate comparisons of biodiversity status and vegetation changes over time and will aid in identifying habitats harboring rare and endangered plant species.

Sodium‐glucose cotransporter‐2 (SGLT2) inhibitors represent one of the main cornerstones of heart failure treatment. Nevertheless, while the cardiovascular beneficial effects of these drugs have been clearly demonstrated by several clinical trials, in clinical practice, it remains challenging to identify the appropriate timing to start SGLT2 inhibitors. The potential risk of side effects, like genito‐urinary infections and interaction with other drugs, may often lead to delay the prescription of these drugs in the acute setting. However, several studies have demonstrated the safety and the prognostic impact of SGLT2 inhibitors in the hospitalized patient, suggesting that treatment initiation during hospitalization or early post‐discharge may represent an ideal therapeutic option. In this review, we discuss the main trials on early administration of SGLT2 inhibitors in acute heart failure supporting early introduction of SGLT2 inhibitors to optimize heart failure treatment. The efficacy and safety of these drugs in patients with acute myocardial infarction are also discussed. Based on the review of existing evidences, a practical flowchart on early administration of SGLT2 inhibitors in the acute setting is proposed.

Background To evaluate the functional and morphological changes in patients with nAMD undergoing anti‐VEGF therapy, focusing on the impact of concomitant diabetes with or without diabetic retinopathy. Methods This retrospective cohort study included 1096 eyes from 916 patients with nAMD treated at the retina department of the University of Bari between August 2017 and May 2023. Patients were divided into two groups: 892 eyes without diabetes and 204 eyes with diabetes. Best‐corrected visual acuity (BCVA), central retinal thickness (CRT) and presence of intraretinal fluid (IRF), subretinal fluid (SRF), subretinal hyperreflective material (SHRM) and atrophy were assessed at baseline, post‐loading phase and at 12‐month follow‐up. Results At baseline, no significant differences were observed between groups. Post‐loading phase, both groups showed significant improvements in BCVA and reductions in CRT. However, SRF persistence was notably more frequent in the diabetic group (64.2% vs. 27.2%, p < 0.001). At 12 months, SRF was present in 53.7% of the diabetic group compared to 34.9% of the non‐diabetic group ( p < 0.001). Diabetic patients with moderate diabetic retinopathy (DR) exhibited significantly higher SRF persistence compared to those with mild DR or no DR. Conclusions While anti‐VEGF therapy improves visual and anatomical outcomes in both diabetic and non‐diabetic patients with nAMD, diabetic patients, particularly those with more severe DR, experience a higher rate of persistence of SRF. This suggests a less than optimal anatomic treatment response and the potential need for more tailored management strategies in this patient population. Precis This retrospective cohort study investigated the impact of diabetes mellitus and diabetic retinopathy on neovascular age‐related macular degeneration treatment outcomes. The study analysed 1096 eyes from 916 patients undergoing anti‐VEGF therapy over 12 months.

Introduction: The Federal Maternal and Child Health Bureau defines Children with special health care needs (CSHCN) as those who have, or are at increased risk for, chronic physical, developmental, behavioral, or emotional conditions, and require health and related services beyond what is generally required by other children. More than half of the entire Italian internationally adopted children (IAC) population has special needs. This monocentric retrospective study aims to describe the demographic features and prevalence of several chronic conditions in a large cohort of IAC. Methods Between 1 January 2009 and 31 October 2023, we consecutively enrolled all IAC referred to Anna Meyer Children’s University Hospital, in Florence. This process followed a standardized operative protocol developed internationally. Then, univariate logistic regression analyses were performed. Results Among 2694 IAC, 315 children (11.89%) were found to be affected by a chronic condition. Asia appears to have 101/561 (18.00%) prevalence of diseases in the total number of IAC from this region of origin, followed by Eastern Europe with 135/1030 (13.11%), Latin America 63/598 (10.54%) and Africa 16/435 (3.68%). The countries of origin with higher prevalence of chronic conditions were China (57.75%), India (15.89%), Russia (15.44%), and Ukraine (13.79%). Children adopted from China and India have a high prevalence of malformations (p = 0.016), while children adopted from Russia accounted for 69.77% of the total fetal alcohol syndrome affected in our cohort. Mental and behavioral disorders appear significantly more prevalent in children from Latin America (p = 0.015), whereas endocrinological disorders predominate in children from Africa (p = 0.014). High rates of precocious puberty were recorded in Asia (p = 0.018) and Africa (p = 0.001) in comparison with the other regions of origin. Conclusion A revision of the current definition of special needs for adoptive purposes is recommended. Italian screening of the adopted child could be tailored considering the country of origin, and the study of mental health should definitively become part of it.

This study investigates new anticonvulsant substances that target the epilepsy-associated carbonic anhydrase isoforms II and VII. The 1,2,3-triazole with a benzenesulfonamide motif is present in the produced molecules. Of these, 5b and 5c exhibited remarkable selectivity and inhibitory efficacy toward hCA VII and hCA II over hCA I. The KI values of 5b and 5c were 6.3 and 10.1 nM, respectively, and 21.6 and 18.9 nM, respectively. In a pilocarpine-induced paradigm, in vivo assessments showed decreased seizure severity and susceptibility with delayed seizure onset and diminished intensity. The quick absorption and in vivo stability of 5b were demonstrated by pharmacokinetic investigations. Evaluations of toxicity showed no neurotoxic effects and a high safety margin (LD50 > 2000 mg/kg). Mechanistic research has shown effectiveness in maintaining neuronal integrity, reducing mTOR activation, and raising hippocampus KCC2 levels. Compound 5b’s binding interactions with hCA II and hCA VII were clarified by docking and dynamics experiments.

Dating apps have become increasingly popular for seeking romantic partners. However, for a minority of individuals, their use can become problematic, making the study of risk factors increasingly relevant. Moreover, attachment-related vulnerabilities and sensitivity to rejection have been consistently associated with maladaptive relational behaviors and emotional dysregulation, which may increase susceptibility to problematic app use as a compensatory strategy. The present study explored the risk factors for problematic online dating app use among adults who use dating apps to find romantic partners, by specifically focusing on the role of adult anxious attachment and adult rejection sensitivity. A cross-sectional anonymous online survey was used to collect the data. The sample comprised 450 participants (54.9% female; M age = 27.57 years; SD = 6.044) who had used dating apps daily to find a romantic partner. The data were analysed using path analysis to test the hypothesized model. Significant total effects were found in the relationships between the anxious adult attachment patterns and problematic online dating apps use (preoccupied attachment: β = .11, p < .01; fearful attachment: β = .18, p < .001). This association was mediated by adult rejection sensitivity (rejection expectancy and rejection anxiety). Problematic online dating apps use was also significantly and positively related to daily time spent on dating apps (β = .41, p < .05). These findings demonstrate the critical role of attachment-related vulnerabilities and rejection sensitivity in favouring problematic dating app use. Such data may provide useful insight to inform targeted clinical interventions.

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.

Objective To quantify the prognostic value of mid-trimester cervical length for spontaneous preterm birth in asymptomatic women with twin pregnancy and to assess whether other factors may modify any association. Designs A two stage meta-analysis of individual participant data in a Cox proportional hazard model was performed using cervical length as a continuous variable. Data sources Medline, Embase, Cochrane, and LILACS, among others, were searched to identify eligible studies; the search was from 1 January 2000 to 30 September 2020. Risk of bias was assessed with the QUIPS tool. Studies were from eight countries between 2001 and 2018. Eligibility criteria Individual participant data were sought for eligible studies that reported mid-trimester (defined between 16 and 26 weeks) transvaginal sonographic cervical length and also gestational age at birth in asymptomatic women with twin pregnancy. The primary outcome was spontaneous preterm birth before 37 weeks. Results Among 29 eligible studies, authors of 17 studies provided individual participant data for 6437 women with a twin pregnancy (69.1% of individual participant data). Mean cervical length measurement was 39 mm (SD=9, range 1-74 mm). 2889 women (44.9%) delivered before 37 weeks' gestation, and 934 (14.9%) delivered before 34 weeks. Each 1 mm increase in cervical length was associated with a 4.0% reduction in the rate of spontaneous preterm birth before 37 weeks (hazard ratio 0.96 (95% confidence interval 0.95 to 0.97)), and a 6.8% reduction in the rate of spontaneous preterm birth before 34 weeks' gestation (0.93 (0.92 to 0.95)). The prognostic value remained stable in models adjusting for different sets of variables. Conclusion The prognostic value of cervical length for spontaneous preterm birth in twin pregnancy is on a continuous scale. No specific cervical length has been identified that can reliably predict or exclude all spontaneous preterm births. Study registration CRD42020146987.

This article examines several cases of problematic documents, arising from their improper, singular or anomalous placement, which have surfaced during the recent activities related to the reorganization and the study of the archives of Adolfo Mussafia and Ernesto Giacomo Parodi at the Biblioteca Umanistica of the University of Florence. Firstly, it clarifies why three letters from Gustav Gröber and one from Emil Levy in the Parodi Archive should instead be attributed to the Mussafia Fonds. The article then discusses the current extent of Gröber’s correspondence with Mussafia and suggests a date for the only letter lacking one, providing a full transcription of it. Subsequently, attention turns to the postcards sent by Kristoffer Nyrop to Ernesto Giacomo Parodi, with corrections made to their order, and to the inappropriate placement of a letter from Joseph Bédier found in his correspondence with Parodi. This letter, originally sent to someone else (presumably Francesco Novati), to serve as a mediator following an alleged discourtesy from the French philologist towards Parodi, was subsequently forwarded to Parodi.

Aims: Mucosal melanoma of the head and neck (MM–H&N) is an aggressive disease known for its frequent residual tumours/relapses (RT/R) at the surgical site, as well as eventual metastases. Our understanding of the MM–H&N mutational landscape, together with the correlation of specific mutations with clinical–pathological features, is significantly less comprehensive compared to that of cutaneous melanoma. Additionally, the mutational status of consecutive samples collected from single patients has not been investigated, which limits our ability to characterise the prognosis and treatment options for this patient subset. Methods and results: A total of 53 MM–H&N specimens from 27 patients were analysed using a laboratory-developed multigene next-generation sequencing (NGS) panel. Among these, material from 46 of 53 (86.8%) samples and from 25 of 27 patients (92.6%) was suitable for NGS. The most frequently detected mutations were found in the RAS genes family, specifically KRAS and NRAS (seven of 46, 15.2%), as well as TP53, KIT and BRAF (each in three of 46, 6.5%); 25 of 46 (54.3%) samples exhibited a wild-type (WT) status. A statistically significant association between BRAF/RAS mutations and mucosal lentiginous histology (P = 0.041) was observed. Additionally, four of 11 (36.4%) patients with consecutive specimens, with no pre-/intersurgery systemic therapies administered and all having at least two evaluable NGS results, demonstrated molecular heterogeneity in the analysed samples. Conclusions: MM–H&N shows a significant percentage of WT cases and a limited number of targetable mutations, predominantly involving BRAF/RAS mutations, the latter of which are associated with mucosal lentiginous histology. A subset of patients with consecutive samples demonstrates discordant molecular results, indicating that NGS of all samples may be necessary to determine the most appropriate therapeutic approach.