Since the first description of COVID-19 infection, among clinical manifestations of the disease, including fever, dyspnea, cough, and fatigue, it was observed a high incidence of thromboembolic ...events potentially evolving towards acute respiratory distress syndrome (ARDS) and COVID-19-associated-coagulopathy (CAC). The hypercoagulation state is based on an interaction between thrombosis and inflammation. The so-called CAC represents a key aspect in the genesis of organ damage from SARS-CoV-2. The prothrombotic status of COVID-19 can be explained by the increase in coagulation levels of D-dimer, lymphocytes, fibrinogen, interleukin 6 (IL-6), and prothrombin time. Several mechanisms have been hypothesized to explain this hypercoagulable process such as inflammatory cytokine storm, platelet activation, endothelial dysfunction, and stasis for a long time. The purpose of this narrative review is to provide an overview of the current knowledge on the pathogenic mechanisms of coagulopathy that may characterize COVID-19 infection and inform on new areas of research. New vascular therapeutic strategies are also reviewed.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Idiopathic pulmonary fibrosis (IPF) is a chronic interstitial lung disease with rapidly progressive evolution and an unfavorable outcome. Nintedanib (NTD) is an antifibrotic drug that has been shown ...to be effective in slowing down the progression of the disease. The aim of our study was to examine the efficacy, especially in terms of the functional decline, and the safety profile of NTD in patients treated with the recommended dose and subjects who reduced or suspended the therapy due to the occurrence of adverse reactions.
We conducted a real-life retrospective study based on the experience of NTD use in two centers between 2015 and 2022. Clinical data were evaluated at baseline, at 6 and 12 months after the NTD introduction in the whole population and in subgroups of patients who continued the full-dose treatment, at a reduced dosage, and at the discontinuation of treatment. The following data were recorded: the demographic features, IPF clinical features, NTD therapeutic dosage, tolerability and adverse events, pulmonary function tests (PFTs), the duration of treatment upon discontinuation, and the causes of interruption.
There were 54 IPF patients who were included (29.6% females, with a median (IQR) age at baseline of 75 (69.0-79.0) years). Twelve months after the introduction of the NTD therapy, 20 (37%) patients were still taking the full dose, 11 (20.4%) had reduced it to 200 mg daily, and 15 (27.8%) had stopped treatment. Gastrointestinal intolerance predominantly led to the dose reduction (13.0%) and treatment cessation (20.4%). There were two deaths within the initial 6 months (3.7%) and seven (13.0%) within 12 months. Compared to the baseline, the results of the PFTs remained stable at 6 and 12 months for the entire NTD-treated population, except for a significant decline in the DLCO (% predicted value) at both 6 (38.0 ± 17.8 vs. 43.0 ± 26.0;
= 0.041) and 12 months (41.5 ± 15.3 vs. 44.0 ± 26.8;
= 0.048). The patients who continued treatment at the full dose or a reduced dosage showed no significant differences in the FVC and the DLCO at 12 months. Conversely, those discontinuing the NTD exhibited a statistically significant decline in the FVC (% predicted value) at 12 months compared to the baseline (55.0 ± 13.5 vs. 70.0 ± 23.0;
= 0.035).
This study highlights the functional decline of the FVC at 12 months after the NTD initiation among patients discontinuing therapy but not among those reducing their dosage.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Do investments in Information and Communication Technology (ICT) create jobs? The literature suggests that, even if innovations are labour saving, there may be compensating mechanisms that lead to a ...positive employment effect. We investigate this issue using country-level data for the European Union from 1995 to 2019. The results suggest an average positive net effect of ICT investment on total employment. An increase of €100,000 in the ICT investment stock is associated with an average increase of 3.3 jobs in the European Union. However, the magnitude of the impact is heterogeneous across countries. The differences are explained by the country-specific characteristics of ICT investment (non-machine versus machine-based) and the existing skill endowment of the labour force. Moreover, the rate of return on investment expressed in terms of net job creation tends to decline over time, as the share of high-skilled workers in the market increases.
•ICT investment has an average positive net effect on total employment.•A €100,000 increase in ICT investment stock increases jobs in the European Union by 3.3•The digitalisation impact on employment is heterogeneous across countries.•Machine-based ICT investment has bigger employment impacts than intangibles.•The impact decreased over time between 1995 and 2019.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The paper illustrates the effect of a permanent demand‐side shock in the perturbed regions and the associated spillover effects in the non‐perturbed regions using a spatial‐numerical general ...equilibrium model of the EU economy. We test to what extent gradual upward pressure on wages generated by a domestic increase in demand alters the magnitude of the economic impacts in the long‐run and the degree to which this could result in changes in trade patterns. We also assess the size and the direction of the effects with varying trade substitution elasticities and under both perfectly and imperfectly competitive product markets.
Resumen
El artículo ilustra el efecto de una perturbación permanente de la demanda en las regiones perturbadas y los efectos de spillover asociados en las regiones no perturbadas mediante un modelo de equilibrio general numérico‐espacial de la economía de la UE. Se comprueba hasta qué punto el aumento gradual de la presión sobre los salarios generada por un aumento de la demanda interna altera la magnitud de los impactos económicos a largo plazo y en que medida podría esto dar lugar a cambios en los patrones de comercio. También se evalúa el tamaño y la dirección de los efectos con diferentes elasticidades de sustitución comercial y bajo mercados de productos perfecta e imperfectamente competitivos.
抄録
本稿では、EU経済の空間的数値の一般均衡モデルを用いて、摂動領域における永続的な需要側のショックの作用と、それに関連した、非摂動領域における波及効果を説明する。国内の需要増加による緩やかな賃金上昇圧が、どの程度まで長期的な経済インパクトの規模を変えるのか、そしてこれがどの程度、結果的に取引パターンの変化をもたらすかを検討する。また、完全および不完全競争製品市場の両方の条件下で、貿易の弾力性を変化させて、効果の規模と方向を評価する。
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DOBA, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, UILJ, UKNU, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
We use a spatial general equilibrium model to assess the macroeconomic and distributional impact of the European Commission's Recovery and Resilience Facility (RRF). We employ two alternative ...regional distributions of investments: one based on the regional share of population only, and the other based on Cohesion Policy criteria. Our results suggest that the disbursement of RRF grants would lead to an increase in the European Union's gross domestic product (GDP) of approximately 0.85% in 2026, corresponding to a present value GDP multiplier of 1.22. The latter rises to 3.25 in the long run. Under the population criterion, GDP impacts are higher relative to the Cohesion criterion, at the detriment of territorial cohesion.
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BFBNIB, NUK, PILJ, SAZU, UL, UM, UPUK
We quantify the general equilibrium effects on economic growth of improving the quality of institutions at the regional level in the context of the implementation of the European Cohesion Policy for ...the European Union and the UK. The direct impact of changes in the quality of government is integrated in a general equilibrium model to analyse the system‐wide economic effects resulting from additional endogenous mechanisms and feedback effects. The results reveal a significant direct effect as well as considerable system‐wide benefits from improved government quality on economic growth. A small 5 per cent increase in government quality across European Union regions increases the impact of Cohesion investment by up to 7 per cent in the short run and 3 per cent in the long run. The exact magnitude of the gains depends on various local factors, including the initial endowments of public capital, the level of government quality, and the degree of persistence over time.
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BFBNIB, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, ODKLJ, OILJ, PILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
•Monitoring of the cloud of fragments using BIRALES.•Detection of Cosmos 1408 fragmentation using PUZZLE software.•Epoch estimation of Cosmos 1408 fragmentation using PUZZLE software.
The population ...of objects in space has increased dramatically over recent decades. Space debris now represents the majority of objects in space resulting from inactive satellites, breakups, collisions and fragmentations. It has become a concern for institutions all over the world and, as such, it has led to the fostering of several programmes to counter the issues. Among these, the use of ground-based sensors for Space Surveillance Tracking (SST) activities and services and tools for analysing fragmentations play a crucial role.
This work presents the activities carried out by Politecnico di Milano, Italian Space Agency and Italian National Institute of Astrophysics in this framework, using data from SST networks and the observation measurements from Bistatic Radar for LEo Survey (BIRALES), an Italian bistatic radar belonging to the EUropean Space Surveillance and Tracking (EUSST), which contributed most to the monitoring of the cloud of fragments. Exploiting Two-Line Elements (TLEs) of observed fragments, a reverse engineering approach is used to reconstruct a fragmentation in orbit through the use of the software suite PUZZLE developed at Politecnico di Milano. The analyses focus on studying the fragmentation of the Cosmos 1408 satellite, which occurred on November 15th 2021 following an Anti-SATellite (ASAT) missile test. More than 1000 trackable pieces and millions of smaller debris (estimated from numerical analysis) were produced by this event, increasing the population of inactive objects around the Earth, and threatening nearby orbiting objects.
First, the processing method adopted from BIRALES in observing Cosmos debris is presented and discussed and a critical analysis about the derivable information is conducted. Then, these data and those from SST network observations are used to identify the epoch and the location of the fragmentation. In this procedure, the software toolkit PUZZLE, developed by Politecnico di Milano within a project funded by the Italian Space Agency and extended through the European Research Council, is used.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Abstract Sausage is one of the meat products most consumed in Brazil, although the incorporation of fat is necessary for its elaboration, influencing its technological and sensory characteristics and ...its caloric value. The aim of this study was to evaluate the addition of resistant starch as a fat substitute in sausage on physicochemical properties and sensory acceptance. The analyses performed were the centesimal composition, emulsion stability, instrumental colour, texture profile analysis and sensorial acceptance. The resistant starch was evaluated for thermal properties, demonstrating that it required a high temperature for gelatinization, indicating that there was probably no gelatinisation of the starch in the cooking of the sausages. There was a significant difference between the treatments T1 and T2 with partial fat reduction and caloric value reduction. The study showed that the partial fat reduction positively influenced the reduction of caloric value, emulsion stability, colour parameters and texture profile analysis. All treatments were well accepted by the consumers. The incorporation of resistant starch in sausages did not influence the centesimal composition, texture profile analysis and sensory analysis, showing it to be a promising ingredient in the making of healthier meat products.
Objective
Osteoporosis and hypogonadism are common in men with HIV infection. Ageing Male Symptoms (AMS) scale measures symptoms related to hypogonadism. FRAX provides 10‐year probability of major ...fractures. We investigated the role of AMS scale combined with FRAX without bone mineral density (BMD), in identifying HIV men with bone fragility.
Design
Cross‐sectional observational study.
Methods
Fifty HIV‐positive men treated with highly active antiretroviral therapy and 27 controls underwent hormonal evaluation, BMD scan and spine X‐ray. The AMS questionnaire was administered.
Results
Osteoporosis was found in 24·0% of HIV patients and in 3·7% of controls (P = 0·05). In HIV patients, 9 radiological vertebral fractures were found (none in controls, P = 0·04). Calculated free testosterone suggested hypogonadism in 26% of HIV patients vs 4% of controls (P = 0·04); an abnormal AMS score (≥27) was found in 62% HIV patients compared with 41% controls (P = 0·04). ROC curves showed that FRAX for major fracture had a 23% sensitivity and a 100% specificity in identifying HIV patients with bone fragility (P = 0·002, with the threshold of 7% at which bisphosphonate therapy is cost‐effective). Considering a value of AMS ≥27, we obtained an 82·6% sensitivity and a 42·9% specificity (P = 0·04). The combination of AMS and FRAX score achieved a 77·3% sensitivity and a 69% specificity (P = 0·02, cut‐off 34).
Conclusion
Combination of FRAX (without BMD) and AMS improved sensitivity of FRAX alone in identifying HIV patients at fracture risk, at the expense of reduced specificity.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Although general practitioners (GPs) are frequently the first healthcare professionals whom asthma patients refer to for their symptoms, few studies have explored the extent of adherence to ...guidelines for asthma management based on data provided directly by GPs.
Aims of the present study were to assess drug prescriptions for asthma by GPs and to evaluate prescriptive adherence to GINA guidelines (GL) and its relationship with disease control in real life.
995 asthmatic patients (45% males, mean age 43.3 ± 17.7 yrs) were enrolled by 107 Italian GPs distributed throughout the country. Data on diagnosis, disease severity, prescribed anti-asthmatic drugs and control were collected through questionnaires filled out by GPs taking into consideration the 2009 GINA Guidelines. Data on drug use and chronic sinusitis, nasal polyposis, chronic bronchitis, emphysema were reported by patients through a self-administered questionnaire.
The large majority of patients were classified by GPs as having intermittent (48.4%) or mild persistent asthma (25.3%); 61% had co-morbid allergic rhinitis (AR). The prevalent therapeutic regimen used by patients was a combination of inhaled corticosteroids (ICS) plus long-acting β2-agonists (LABA) (54.1%), even in the intermittent/mild persistent group. ICS as mono-therapy or in combination with other drugs but LABA, was the second most frequently adopted treatment (14.4%). In general, the GPs adherence to GL treatment indications was 28.8%, with a significant association with a good asthma control (OR 1.85, 95% CI 1.18–2.92). On the other hand, comorbidity (OR 0.52, 95% CI 0.32–0.84), moderate (0.44, 0.28–0.69) and severe (0.06, 0.02–0.20) persistent asthma showed significant negative effects on asthma control.
Our results show that over-treatment of intermittent/mild persistent asthma is frequent in the GPs setting while therapeutic regimens are more appropriately applied for moderate/severe asthma. In general, we found low adherence to GINA GL treatment recommendations even if its relevance in asthma control was confirmed.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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