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1.
Environ Pollut ; 355: 124262, 2024 Aug 15.
Article in English | MEDLINE | ID: mdl-38810686

ABSTRACT

Various anthropogenic activities affect marine coastal habitats, leading to heavy litter pollution. However, whilst high litter concentrations are nowadays common in the proximity of metropolises, few studies investigated the magnitude of this phenomenon around coastal villages and small towns. We hereby characterized the benthic litter occurring in the trawlable grounds of the Gulf of Policastro (Tyrrhenian Sea, central-western Mediterranean), a low population density area that becomes a popular tourist destination during summer. We furthermore tested differences between two depths (∼100-200 and ∼500-600 m) and the impact of tourism on the shallower waters. The area was characterized by a litter abundance of 651.12 ± 130.61 item/km2, with plastic being almost totalitarian (93%). The shallower waters hosted two-thirds of the litter found. Almost all (∼95%) the litter items had a land-based origin, while the sea-based litter was mostly found at higher depths. About 14% of the litter was found to be fouled, with the development of litter-associated communities that somehow mimic the natural ones living on hard substrates. The higher litter presence noticed during the touristic peak (July-August) suggests that tourism is an important source of local litter, although it contributed to the local accumulation in a synergic way with other factors. The majority of the litter items presumably originated from the nearby coastline, while the deeper waters were or are used as a dumping site by the local trawling fleet. The discovery of such a critical waste accumulation and management in a somehow remote area contributes to widen the perspectives on the presence of benthic litter mostly in territories characterized by wide anthropization. Moreover, it confirms that appropriate local policies and communication plans are urged even at a regional level to stimulate citizen consciousness and mitigate the ever growing litter pollution.


Subject(s)
Environmental Monitoring , Water Pollution , Water Pollution/statistics & numerical data , Ecosystem , Seawater/chemistry , Humans , Solid Waste/analysis , Solid Waste/statistics & numerical data , Tourism , Italy , Aquatic Organisms , Animals , Environmental Policy
2.
Sensors (Basel) ; 24(10)2024 May 10.
Article in English | MEDLINE | ID: mdl-38793876

ABSTRACT

This study examined the efficacy of an optimized DeepLabCut (DLC) model in motion capture, with a particular focus on the sit-to-stand (STS) movement, which is crucial for assessing the functional capacity in elderly and postoperative patients. This research uniquely compared the performance of this optimized DLC model, which was trained using 'filtered' estimates from the widely used OpenPose (OP) model, thereby emphasizing computational effectiveness, motion-tracking precision, and enhanced stability in data capture. Utilizing a combination of smartphone-captured videos and specifically curated datasets, our methodological approach included data preparation, keypoint annotation, and extensive model training, with an emphasis on the flow of the optimized model. The findings demonstrate the superiority of the optimized DLC model in various aspects. It exhibited not only higher computational efficiency, with reduced processing times, but also greater precision and consistency in motion tracking thanks to the stability brought about by the meticulous selection of the OP data. This precision is vital for developing accurate biomechanical models for clinical interventions. Moreover, this study revealed that the optimized DLC maintained higher average confidence levels across datasets, indicating more reliable and accurate detection capabilities compared with standalone OP. The clinical relevance of these findings is profound. The optimized DLC model's efficiency and enhanced point estimation stability make it an invaluable tool in rehabilitation monitoring and patient assessments, potentially streamlining clinical workflows. This study suggests future research directions, including integrating the optimized DLC model with virtual reality environments for enhanced patient engagement and leveraging its improved data quality for predictive analytics in healthcare. Overall, the optimized DLC model emerged as a transformative tool for biomechanical analysis and physical rehabilitation, promising to enhance the quality of patient care and healthcare delivery efficiency.


Subject(s)
Movement , Neural Networks, Computer , Humans , Movement/physiology , Biomechanical Phenomena/physiology , Male , Female , Smartphone , Adult , Sitting Position , Standing Position , Motion Capture
3.
Children (Basel) ; 11(3)2024 Mar 08.
Article in English | MEDLINE | ID: mdl-38539357

ABSTRACT

The prevalence of scoliosis in people with cystic fibrosis (CF) seems to be greater than in the normal population. Over the last two years, a screening for spinal deformities was carried out in patients with CF aged 5 to 18 years, followed up at the CF regional Centre in Parma (Italy). Forty-three patients (twenty-seven males, mean age: 11.8 ± 4.5 years) were enrolled in the study. Nine patients (20.9%) were diagnosed with scoliosis, with a mean Cobb angle of 20.8 ± 9.4 (12-38°). Five patients (11.6%) were diagnosed with a postural kyphosis attitude and one with pathological fixed kyphosis. All patients with scoliosis and postural kyphosis started daily physiotherapeutic scoliosis-specific exercises (PSSE). Compared to people without CF, the prevalence of scoliosis in our paediatric CF population seems to be higher and more present in males; the curves were thoracic and mostly right-sided. CF disease, hyposthenic postural attitude and sedentary lifestyle can contribute to the pathogenesis of this musculoskeletal alteration. Spinal deformities may negatively affect pulmonary function, resulting in disability, pain and a decreased quality of life. Since the prevention of musculoskeletal deformities is easier than restoration, in CF population targeted screening during growth and interventions, including regular physical exercise, are mandatory.

4.
Health Policy ; 143: 105041, 2024 May.
Article in English | MEDLINE | ID: mdl-38492444
5.
Mol Ther Nucleic Acids ; 35(1): 102140, 2024 Mar 12.
Article in English | MEDLINE | ID: mdl-38425711

ABSTRACT

MicroRNAs (miRNAs) are involved in post-transcriptional gene expression regulation and in mechanisms of cancer growth and metastases. In this light, miRNAs could be promising therapeutic targets and biomarkers in clinical practice. Therefore, we investigated if specific miRNAs and their target genes contribute to laryngeal squamous cell carcinoma (LSCC) development. We found a significant decrease of miR-449a in LSCC patients with nodal metastases (63.3%) compared with patients without nodal involvement (44%). The AmpliSeq Transcriptome of HNO-210 miR-449a-transfected cell lines allowed the identification of IL6-R as a potential target. Moreover, the downregulation of IL6-R and the phosphorylation reduction of the downstream signaling effectors, suggested the inhibition of the IL-6 trans-signaling pathway. These biochemical effects were paralleled by a significant inhibition of invasion and migration in vitro and in vivo, supporting an involvement of epithelial-mesenchymal transition. These findings indicate that miR-449a contributes to suppress the metastasization of LSCC by the IL-6 trans-signaling block and affects sensitivity to external stimuli that mimic pro-inflammatory conditions.

6.
Acta Otorhinolaryngol Ital ; 44(1): 13-20, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38420717

ABSTRACT

Objective: Squamous cell carcinoma of the nasal vestibule (NV SCC) is a head and neck malignancy for which there is no established consensus on most aspects of clinical management. The purpose of this document is to give updated recommendations that incorporate recent evidence on its clinical characteristics and the high efficacy of brachytherapy as primary treatment modality. Methods: A working group consisting of the members of the Scientific Committee for Oncology and Reconstructive Surgery of the Italian Society of Otorhinolaryngology Head and Neck Surgery and radiation oncologists expert in brachytherapy was formed to achieve a consensus. Results: Consensus was reached on a set of recommendations, proposing a refined anatomical definition of the nasal vestibule, a novel T staging system of the NV SCC, and brachytherapy as standard of care, with a new method for catheter implantation. Conclusions: The Committee emphasises the critical role of an accurate classification in clinical practice and encourages further research to validate the novel staging system and further improve treatment strategies. Where appropriate, it is recommended that patients be referred to centres with specific experience in brachytherapy for NV SCC.


Subject(s)
Brachytherapy , Carcinoma, Squamous Cell , Head and Neck Neoplasms , Otolaryngology , Plastic Surgery Procedures , Humans , Head and Neck Neoplasms/surgery , Carcinoma, Squamous Cell/surgery , Brachytherapy/methods , Italy
7.
Value Health ; 2024 Feb 03.
Article in English | MEDLINE | ID: mdl-38316357

ABSTRACT

OBJECTIVES: Public expenditure aims to achieve social objectives by improving a range of socially valuable attributes of benefit (arguments in a social welfare function). Public expenditure is typically allocated to public sector budgets, where budget holders are tasked with meeting a subset of social objectives. METHODS: Decision makers require an evidence-based assessment of whether a proposed investment is likely to be worthwhile given existing levels of public expenditure. However, others also require some assessment of whether the overall level and allocation of public expenditure are appropriate. This article proposes a more general theoretical framework for economic evaluation that addresses both these questions. RESULTS: Using a stylized example of the economic evaluation of a new intervention in a simplified UK context, we show that this more general framework can support decisions beyond the approval or rejection of single projects. It shows that broader considerations about the level and allocation of public expenditure are possible and necessary when evaluating specific investments, which requires evidence of the range of benefits offered by marginal changes in different types of public expenditure and normative choices of how the attributes of benefit gained and forgone are valued. CONCLUSIONS: The proposed framework shows how to assess the value of a proposed investment and whether and how the overall level of public expenditure and its allocation across public sector budgets might be changed. It highlights that cost-benefit analysis and cost-effectiveness analysis can be viewed as special cases of this framework, identifying the weakness with each.

8.
Int J Integr Care ; 24(1): 9, 2024.
Article in English | MEDLINE | ID: mdl-38344427

ABSTRACT

Purpose: Achieving greater health and social care integration is a policy priority in many countries, but challenges remain. We focused on governance and accountability for integrated care and explored arrangements that shape more integrated delivery models or systems in Italy, the Netherlands and Scotland. We also examined how the COVID-19 pandemic affected existing governance arrangements. Design/methodology/approach: A case study approach involving document review and semi-structured interviews with 35 stakeholders in 10 study sites between February 2021 and April 2022. We used the Transparency, Accountability, Participation, Integrity and Capability (TAPIC) framework to guide our analytical enquiry. Findings: Study sites ranged from bottom-up voluntary agreements in the Netherlands to top-down mandated integration in Scotland. Interviews identified seven themes that were seen to have helped or hindered integration efforts locally. Participants described a disconnect between what national or regional governments aspire to achieve and their own efforts to implement this vision. This resulted in blurred, and sometimes contradictory, lines of accountability between the centre and local sites. Flexibility and time to allow for national policies to be adapted to local contexts, and engaged local leaders, were seen to be key to delivering the integration agenda. Health care, and in particular acute hospital care, was reported to dominate social care in terms of policies, resource allocation and national monitoring systems, thereby undermining better collaboration locally. The pandemic highlighted and exacerbated existing strengths and weaknesses but was not seen as a major disruptor to the overall vision for the health and social care system. Research limitations: We included a relatively small number of interviews per study site, limiting our ability to explore complexities within sites. Originality: This study highlights that governance is relatively neglected as a focus of attention in this context but addressing governance challenges is key for successful collaboration.

10.
Cancers (Basel) ; 15(22)2023 Nov 17.
Article in English | MEDLINE | ID: mdl-38001716

ABSTRACT

BACKGROUND: The acinic cell carcinoma (AciCC) of the parotid gland is a rare tumor with an indolent behavior; however, a subgroup of this tumor presents an aggressive behavior with a tendency to recur. The aim of this multicenter study was to identify and stratify those patients with AciCC at high risk of tumor recurrence. METHODS: A retrospective study was carried out involving 77 patients treated with surgery between January 2000 and September 2022, in different Italian referral centers. Data about tumor characteristics and its recurrence were collected. The histological specimens and slides were independently reviewed by a senior pathologist coordinator (L.C.) and the institution's local head and neck pathologist. RESULTS: The patients' age average was 53.6 years, with a female prevalence in the group. The mean follow-up was 67.4 months (1-258, SD 59.39). The five-year overall survival (OS) was 83.2%. The 5-year disease-free survival (DFS) was 60% (95% CI 58.2-61.7). A high incidence of necrosis, extraglandular spread, lymphovascular invasion (LVI), atypical mitosis, and cellular pleomorphism was observed in the high-risk tumors compared to the low-risk ones. CONCLUSION: AciCC generally had an indolent behavior, optimal OS, DFS with few cervical node metastases, and rare distant relapses. This multicenter retrospective case series provides evidence of the need for clinical-epidemiological-histological stratification for patients at risk of poor outcomes. Our results suggest that the correct definition of high-risk AciCC should include tumor size, the presence of necrosis, extraglandular spread, LVI, atypical mitosis, and cellular pleomorphism.

11.
BMJ Open ; 13(9): e070833, 2023 09 11.
Article in English | MEDLINE | ID: mdl-37696632

ABSTRACT

OBJECTIVES: Publicly funded adult social care (ASC) in England aims to improve quality of life through the provision of services for individuals with care needs due to physical and/or mental impairment or illness. Access to these services, however, is often restricted to contain public expenditure. With a fast-growing care need, information on whether extending eligibility is good value for money becomes policy-relevant. PRIMARY AND SECONDARY OUTCOME MEASURES: This study investigates the effect of extending ASC eligibility on user care-related quality of life (CRQoL), a policy-relevant measure of quality of life. DESIGN: We use English cross-sectional survey data from 2017/2018 to 2019/2020 on users receiving publicly funded long-term support including domiciliary and other community-based social care, as well as residential and nursing care from local authorities responsible for ASC. We employ the two-stage least square method to estimate the impact of ASC expenditure on CRQoL at various levels of ASC expenditure in each financial year. This includes the CRQoL effect of increasing expenditure from zero to some level, which captures the effect of extending ASC eligibility to new users. RESULTS: We find that publicly funded ASC improves the CRQoL of both existing and newly eligible users, although the latter are likely to experience greater CRQoL gains. Moreover, from 2017/2018 to 2019/2020, spending as much as an average user for a newly eligible user costs between £54 224 and £77 778 per social care-quality-adjusted life year (SC-QALY) gained. These results are statistically significant at the 5% level. Compared with this finding, increasing expenditure for an existing user has always a higher cost per SC-QALY gained. CONCLUSIONS: Extending ASC eligibility to new users is likely to be more cost-effective compared with using the same resources to increase expenditure for existing users.


Subject(s)
Eligibility Determination , Quality of Life , Humans , Adult , Cross-Sectional Studies , England , Social Support
12.
Indian J Otolaryngol Head Neck Surg ; 75(3): 2713-2721, 2023 Sep.
Article in English | MEDLINE | ID: mdl-37636674

ABSTRACT

Lateral skull base involvement from parotid cancers is a rare condition and is considered a poor prognostic indicator. The aim of this study was to systematically review the literature of parotid tumors with temporal bone invasion to analyze the survival outcome. A systematic literature review was performed in August 2022, without time limits, and 289 patients affected by parotid gland cancers and lateral skull base involvement were included. The most common symptoms in parotid tumors at the onset were indolent mass, facial weakness, pain, and hearing loss; the chi-square value is 23.1063, with a statistically significance (p = < 0.000121). The five most common histologies were adenoid cystic carcinoma, acinic cell carcinoma, mucoepidermoid carcinoma, adenocarcinoma, and squamous cell carcinoma. The facial nerve function after surgery showed statistically significance (functional vs. non-functional; chi-square was 91.7698, p = < 0.00001). Mean follow-up was 36.2 months (range 0.3-192). At the last follow-up, more patients died of disease (DOD; 60/289, 21%) than other causes (DOOC; 5/289, 2%). There is a statistically significant correlation between patients died for tumor (DOD) and patients died for other causes (DOOC) (p = < 0.0001), suggesting that the lateral skull base invasion negatively impacts on survival. Basing on the results of our systematic review, lateral skull base involvement from parotid recurrent/advance tumors should be considered a poor prognostic factor, as the majority of patients die due to this condition. It also would be necessary to have "clear"works, with full data (demographic, clinical, surgical data), and with a longer follow up, in order to assess the best treatment modality of these patients.

13.
Front Cell Neurosci ; 17: 1219270, 2023.
Article in English | MEDLINE | ID: mdl-37545882

ABSTRACT

Cyfip1, the gene encoding cytoplasmic FMR1 interacting protein 1, has been of interest as an autism candidate gene for years. A potential role in autism spectrum disorder (ASD) is suggested by its location on human chromosome 15q11-13, an instable region that gives rise to a variety of copy number variations associated with syndromic autism. In addition, the CYFIP1 protein acts as a binding partner to Fragile X Messenger Ribonucleoprotein (FMRP) in the regulation of translation initiation. Mutation of FMR1, the gene encoding FMRP, causes Fragile X syndrome, another form of syndromic autism. Here, in mice overexpressing CYFIP1, we study response properties of cerebellar Purkinje cells to activity of the climbing fiber input that originates from the inferior olive and provides an instructive signal in sensorimotor input analysis and plasticity. We find that CYFIP1 overexpression results in enhanced localization of the synaptic organizer neurexin 1 (NRXN1) at climbing fiber synaptic input sites on Purkinje cell primary dendrites and concomitant enhanced climbing fiber synaptic transmission (CF-EPSCs) measured using whole-cell patch-clamp recordings from Purkinje cells in vitro. Moreover, using two-photon measurements of GCaMP6f-encoded climbing fiber signals in Purkinje cells of intact mice, we observe enhanced responses to air puff stimuli applied to the whisker field. These findings resemble our previous phenotypic observations in a mouse model for the human 15q11-13 duplication, which does not extend to the Cyfip1 locus. Thus, our study demonstrates that CYFIP1 overexpression shares a limited set of olivo-cerebellar phenotypes as those resulting from an increased number of copies of non-overlapping genes located on chromosome 15q11-13.

14.
Cell Rep ; 42(8): 112901, 2023 08 29.
Article in English | MEDLINE | ID: mdl-37505982

ABSTRACT

Individuals with fragile X syndrome (FXS) are frequently diagnosed with autism spectrum disorder (ASD), including increased risk for restricted and repetitive behaviors (RRBs). Consistent with observations in humans, FXS model mice display distinct RRBs and hyperactivity that are consistent with dysfunctional cortico-striatal circuits, an area relatively unexplored in FXS. Using a multidisciplinary approach, we dissect the contribution of two populations of striatal medium spiny neurons (SPNs) in the expression of RRBs in FXS model mice. Here, we report that dysregulated protein synthesis at cortico-striatal synapses is a molecular culprit of the synaptic and ASD-associated motor phenotypes displayed by FXS model mice. Cell-type-specific translational profiling of the FXS mouse striatum reveals differentially translated mRNAs, providing critical information concerning potential therapeutic targets. Our findings uncover a cell-type-specific impact of the loss of fragile X messenger ribonucleoprotein (FMRP) on translation and the sequence of neuronal events in the striatum that drive RRBs in FXS.


Subject(s)
Autism Spectrum Disorder , Fragile X Syndrome , Animals , Humans , Mice , Fragile X Syndrome/metabolism , Autism Spectrum Disorder/genetics , Autism Spectrum Disorder/metabolism , Fragile X Mental Retardation Protein/genetics , Fragile X Mental Retardation Protein/metabolism , Neurons/metabolism , Synapses/metabolism , Mice, Knockout , Disease Models, Animal
15.
Eur Arch Otorhinolaryngol ; 280(9): 4205-4214, 2023 Sep.
Article in English | MEDLINE | ID: mdl-37280380

ABSTRACT

BACKGROUND: The submandibular gland (SMG) is routinely excised during neck dissection. Given the importance of the SMG in saliva production, it is important to understand its involvement rate by cancer tissue and the feasibility of its preservation. METHODS: Retrospective data were collected from five academic centers in Europe. The study involved adult patients affected by primary oral cavity carcinoma (OCC) undergoing tumor excision and neck dissection. The main outcome analyzed was the SMG involvement rate. A systematic review and a meta-analysis were also conducted to provide an updated synthesis of the topic. RESULTS: A total of 642 patients were enrolled. The SMG involvement rate was 12/642 (1.9%; 95% CI 1.0-3.2) when considered per patient, and 12/852 (1.4%; 95% CI 0.6-2.1) when considered per gland. All the glands involved were ipsilateral to the tumor. Statistical analysis showed that predictive factors for gland invasion were: advanced pT status, advanced nodal involvement, presence of extracapsular spread and perivascular invasion. The involvement of level I lymph nodes was associated with gland invasion in 9 out of 12 cases. pN0 cases were correlated with a reduced risk of SMG involvement. The review of the literature and the meta-analysis confirmed the rare involvement of the SMG: on the 4458 patients and 5037 glands analyzed, the involvement rate was 1.8% (99% CI 1.1-2.7) and 1.6% (99% CI 1.0-2.4), respectively. CONCLUSIONS: The incidence of SMG involvement in primary OCC is rare. Therefore, exploring gland preservation as an option in selected cases would be reasonable. Future prospective studies are needed to investigate the oncological safety and the real impact on quality of life of SMG preservation.


Subject(s)
Carcinoma, Squamous Cell , Head and Neck Neoplasms , Mouth Neoplasms , Adult , Humans , Squamous Cell Carcinoma of Head and Neck/pathology , Submandibular Gland/surgery , Retrospective Studies , Quality of Life , Mouth Neoplasms/surgery , Mouth Neoplasms/pathology , Carcinoma, Squamous Cell/surgery , Carcinoma, Squamous Cell/pathology , Neck Dissection , Head and Neck Neoplasms/pathology , Multicenter Studies as Topic
16.
Respir Med ; 216: 107328, 2023 09.
Article in English | MEDLINE | ID: mdl-37321310

ABSTRACT

INTRODUCTION: Elexacaftor/tezacaftor/ivacaftor (ELX/TEZ/IVA) improves CFTR function in cystic fibrosis (CF) patients homozygous or heterozygous for F508del mutation. The aim of the study was to evaluate the response to ELX/TEZ/IVA treatment both clinically and morphologically in terms of bronchiectasis, bronchial wall thickening, mucus plugging, abscess and consolidations. METHODS: We retrospectively collected data from CF patients followed at Parma CF Centre (Italy) treated by ELX/TEZ/IVA between March and November 2021. Post-treatment changes in respiratory function, quality of life, sweat chloride concentration, body mass index, pulmonary exacerbations and lung structure by chest magnetic resonance imaging (MRI) were assessed. T2-and T1-weighted sequences were acquired with a 20 min-long scanning protocol on a 1.5T MRI scanner (Philips Ingenia) without administration of intravenous contrast media. RESULTS: 19 patients (32.5 ± 10.2 years) were included in the study. After 6 months of treatment with ELX/TEZ/IVA, MRI showed significant improvements in the morphological score (p < 0.001), with a reduction in bronchial wall thickening (p < 0.001) and mucus plugging (p 0.01). Respiratory function showed significant improvement in predicted FEV1% (58.5 ± 17.5 vs 71.4 ± 20.1, p < 0.001), FVC% (79.0 ± 11.1 vs 88.3 ± 14.4, p < 0.001), FEV1/FVC (0.61 ± 0.16 vs 0.67 ± 0.15, <0.001) and LCI2.5% (17.8 ± 4.3 vs 15.8 ± 4.1 p < 0.005). Significant improvement was found in body mass index (20.6 ± 2.7 vs 21.9 ± 2.4, p < 0.001), pulmonary exacerbations (2.3 ± 1.3 vs 1.4 ± 1.3 p 0.018) and sweat chloride concentration (96.5 ± 36.6 vs 41.1 ± 16.9, p < 0.001). CONCLUSIONS: Our study confirms the efficacy of ELX/TEZ/IVA in CF patients not only from a clinical point of view but also in terms of morphological changes of the lungs.


Subject(s)
Cystic Fibrosis , Humans , Adolescent , Adult , Cystic Fibrosis/diagnostic imaging , Cystic Fibrosis/drug therapy , Cystic Fibrosis/genetics , Chlorides , Quality of Life , Retrospective Studies , Lung/diagnostic imaging , Mutation
17.
Sensors (Basel) ; 23(9)2023 May 07.
Article in English | MEDLINE | ID: mdl-37177753

ABSTRACT

The Internet of Things (IoT) is transforming various domains, including smart energy management, by enabling the integration of complex digital and physical components in distributed cyber-physical systems (DCPSs). The design of DCPSs has so far been focused on performance-related, non-functional requirements. However, with the growing power consumption and computation expenses, sustainability is becoming an important aspect to consider. This has led to the concept of energy-aware DCPSs, which integrate conventional non-functional requirements with additional attributes for sustainability, such as energy consumption. This research activity aimed to investigate and develop energy-aware architectural models and edge/cloud computing technologies to design next-generation, AI-enabled (and, specifically, deep-learning-enhanced), self-conscious IoT-extended DCPSs. Our key contributions include energy-aware edge-to-cloud architectural models and technologies, the orchestration of a (possibly federated) edge-to-cloud infrastructure, abstractions and unified models for distributed heterogeneous virtualized resources, innovative machine learning algorithms for the dynamic reallocation and reconfiguration of energy resources, and the management of energy communities. The proposed solution was validated through case studies on optimizing renewable energy communities (RECs), or energy-aware DCPSs, which are particularly challenging due to their unique requirements and constraints; in more detail, in this work, we aim to define the optimal implementation of an energy-aware DCPS. Moreover, smart grids play a crucial role in developing energy-aware DCPSs, providing a flexible and efficient power system integrating renewable energy sources, microgrids, and other distributed energy resources. The proposed energy-aware DCPSs contribute to the development of smart grids by providing a sustainable, self-consistent, and efficient way to manage energy distribution and consumption. The performance demonstrates our approach's effectiveness for consumption and production (based on RMSE and MAE metrics). Our research supports the transition towards a more sustainable future, where communities adopting REC principles become key players in the energy landscape.

18.
Health Policy ; 132: 104800, 2023 Jun.
Article in English | MEDLINE | ID: mdl-37004415

ABSTRACT

English data from 2003 to 2012 suggests that it costs the NHS £10,000 to generate an additional quality-adjusted life year (QALY).  This estimate relates to all NHS expenditure and no attempt was made to explore possible heterogeneity within this total.  Different types of expenditure - such as secondary care, primary care and specialized commissioning - may have different productivities and estimates of these may help policymakers decide where additional investment is most beneficial.  We use the two-stage least squares estimator and data for 2016 to explore the mortality response to three types of healthcare expenditure.  Three specifications are estimated for each type of expenditure: backward selection and regularized regression are used to identify parsimonious specifications, and a full specification with all covariates is also estimated.  The regression results are combined with information about survival and morbidity disease burden to calculate the marginal cost per QALY for each type of expenditure: the most conservative results suggest that this is about £8,000 for locally (CCG) commissioned services, while estimates for specialized commissioning and primary care are more uncertain.  When this heterogeneity is taken into account, the estimated marginal cost per QALY for all NHS expenditure increases slightly, from about £6,000 to £7,000.  Our results suggest that additional investment is likely to be most productive in primary care and in locally commissioned services.


Subject(s)
Health Expenditures , State Medicine , Humans , Quality-Adjusted Life Years , England , Delivery of Health Care , Cost-Benefit Analysis
19.
Neuron ; 111(11): 1760-1775.e8, 2023 06 07.
Article in English | MEDLINE | ID: mdl-36996810

ABSTRACT

The proteome of glutamatergic synapses is diverse across the mammalian brain and involved in neurodevelopmental disorders (NDDs). Among those is fragile X syndrome (FXS), an NDD caused by the absence of the functional RNA-binding protein FMRP. Here, we demonstrate how the brain region-specific composition of postsynaptic density (PSD) contributes to FXS. In the striatum, the FXS mouse model shows an altered association of the PSD with the actin cytoskeleton, reflecting immature dendritic spine morphology and reduced synaptic actin dynamics. Enhancing actin turnover with constitutively active RAC1 ameliorates these deficits. At the behavioral level, the FXS model displays striatal-driven inflexibility, a typical feature of FXS individuals, which is rescued by exogenous RAC1. Striatal ablation of Fmr1 is sufficient to recapitulate behavioral impairments observed in the FXS model. These results indicate that dysregulation of synaptic actin dynamics in the striatum, a region largely unexplored in FXS, contributes to the manifestation of FXS behavioral phenotypes.


Subject(s)
Fragile X Syndrome , Animals , Mice , Fragile X Mental Retardation Protein/genetics , Actins/metabolism , Brain/metabolism , Disease Models, Animal , Mice, Knockout , Dendritic Spines/metabolism , Mammals/metabolism
20.
Biology (Basel) ; 12(3)2023 Mar 09.
Article in English | MEDLINE | ID: mdl-36979112

ABSTRACT

The present paper represents the first all-encompassing study on all Mediterranean holopelagic octopods belonging to Argonautoidea (Argonauta argo, Ocythoe tuberculata, Tremoctopus gracilis, Tremoctopus violaceus). Argonautoidea octopuses were collected by different sampling methods in the Strait of Messina and southern Tyrrhenian Sea. The aim of this paper was to improve knowledge, using information from different data sources, such as the study of stranded individuals or accidental caught specimens, as well as the analysis of stomach content of large pelagic fishes. Moreover, we investigated their taxonomic profile through the amplification of the mitochondrial cytochrome c oxidase subunit I (COI). Overall, 47 fresh holopelagic octopods were collected, including valuable records of rare males. Moreover, 330 Argonautoidea octopuses were found in the stomachs of 800 predators. The results provided evidence that these cephalopods are more abundant than thought in the past. The molecular approach supported the ecological results with interesting insights. The similarity-based identifications and tree-based methods indicated that three females could be identified as Tremoctopus violaceus in agreement with their morphological classifications. The sequences obtained from the two T. gracilis individuals were clustered with the sequences of Tremoctopus violaceus from the Gulf of Mexico and were differentiated from the sequences attributed to T. gracilis and T. robsoni. The study represents a valuable contribution to the genetic characterization of Mediterranean individuals of the genera Tremoctopus, Argonauta and Ocythoe.

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