Economic, social, and environmental sustainability is becoming increasingly important in territorialdevelopment policies in Europe and internationally. Among the sustainable development goals, the ...theme ofthe energy transition is particularly important, which translates not only into a move away from energyfrom fossil fuels in favor of renewable ones but also into an improvement in energy efficiency linked toenergy production and greater awareness of energy consumption by citizens. To achieve a paradigm ofsustainable development, combating the problem of resource scarcity and biodiversity loss, as well as theunsustainability of today's consumption and production systems, the Renewable Energy Communities (CER)can be a suitable model to support urban space redevelopment projects. Actions that aim to recover the pre-existing building heritage to give new life to abandoned areas are increasingly necessary for the protection ofthe environment. This encourages the propensity to act responsibly, promoting virtuous circles for theterritories and communities of reference. This work aims to analyze and understand the actual developmentof the eco-friendly model of Energy Communities, understanding its real benefits. In particular, the casestudy of the Energy Community of East Naples is reported which, through the involvement of citizens andbusinesses of the territory, can produce, consume and exchange energy with a view to self-consumption andcollaboration.
In (Gerla and Sessa, Fuzzy Logic and Soft Computing, Kluwer, Norwell, 1999, pp. 19–31) a methodology that allows to manage uncertain and imprecise information in the frame of the declarative paradigm ...of Logic Programming has been proposed. With this aim, a Similarity relation
R
between function and predicate symbols in the language of a logic program is considered. Approximate inferences are then possible since similarity relation allows us to manage alternative instances of entities that can be considered “equal” with a given degree. The declarative semantics of the proposed transformation technique of logic programs is analyzed. The notion of fuzzy least Herbrand model is also introduced. In this paper the corresponding operational semantics is provided by introducing a modified version of SLD resolution. This top-down refutation procedure overcomes failure situations in the unification process by using the
similarity relation. A generalized notion of most general unifier provides a numeric value which gives a measure of the exploited approximation. In this way, the SLD resolution is enhanced since it is possible both to handle uncertain or imprecise information, and to compute approximate answer substitutions, with an associated approximation-degree, when failures of the exact inference process occur. It can lead to the implementation of a more general PROLOG interpreter, without detracting from the elegance of the language.
To assess the efficacy of high-frequency (20 Hz) brain stimulation on lower limb motor function in subjects with chronic (> 6 mo) subcortical stroke.
Double-blind, placebo-controlled crossover study.
...University hospital.
Right-handed subjects (N=10) affected by a first-ever subcortical stroke in the territory of the middle cerebral artery were included in this study.
Repetitive transcranial magnetic stimulation (rTMS) was delivered with the H-coil, specifically designed to target deeper and larger brains regions. Each subject received both real and sham rTMS in a random sequence. The 2 rTMS cycles (real or sham) were composed of 11 sessions each, administered over 3 weeks and separated by a 4-week washout period.
Lower limb functions were assessed by the lower limb Fugl-Meyer scale, the 10-m walk test, and the 6-minute walk test before and 1 day after the end of each treatment period, as well as at a 4-week follow-up.
Real rTMS treatment was associated with a significant improvement in lower limb motor function. This effect persisted over time (follow-up) and was significantly greater than that observed with sham stimulation. A significant increase in walking speed was also found after real rTMS, but this effect did not reach statistical significance in comparison with the sham stimulation.
These data demonstrated that 3 weeks of high-frequency deep rTMS could induce long-term improvements in lower limb functions in the chronic poststroke period, lasting at least 1 month after the end of the treatment.
Over the last few decades, stakeholders' growing attention towards social and environmental issues has challenged universities' traditional accountability boundaries, imposing the adoption of ...innovative reporting tools that facilitate stakeholders' engagement in Corporate Social Responsibility (CSR) practices and performances. Against this backdrop, online communication tools, such as websites and social media platforms, have gained momentum as a pivotal means to increase dialogue with the myriad of stakeholders, especially during the pandemic period, as it has dramatically reduced physical interactions. Based on these premises, this study aims to dive deep into the use of social media to communicate CSR strategies in the university context by exploring the case of the University of Salerno. To this end, all posts published by the University of Salerno's official Twitter account from 2015 to 2021 have been extracted and analyzed. Accordingly, the degree of interactions with stakeholders and the communication direction and balance level have been examined based on Carroll' pyramid. Findings show a higher level of engagement for CSR posts and, in particular, for the philanthropic dimension. Results also highlight that, during the COVID-19 pandemic, the University of Salerno has empowered CSR disclosure through Twitter. The methodology adopted could be replicated for other universities to understand better how public universities use social media to involve a broader range of stakeholders in their CSR practices.
Background and Purpose:
Ischemic stroke is a major cause of death and disability worldwide. Large MCA stroke may evolve as malignant space occupying lesion and mortality rate reaches 80% despite ...maximal medical therapy. Early decompressive craniectomy is effective in reducing mortality and improving the functional outcome but is an extended and invasive surgical approach burdened with a significant complication rate. We report a surgical treatment based on partial strokectomy and basal cisterns opening with massive CSF drain.
Materials and Methods:
We retrospectively collected 15 cases of massive middle cerebral artery stroke treated with strokectomy between 2010 and 2017: nine males and six females, mean age 61.73 ± 9.5 years. The right side was affected in 66.7%. All patients show clinical deterioration despite standard medical therapy and indication for surgery was placed after collegiate evaluation by neurologists and neurosurgeons based on clinical and radiological data.
Results:
Surgical procedure was performed 24–96 h after the stroke onset. All the 15 patients survived the intervention, one patient died 20 days after the admission for massive lung embolism. Mean GCS and NIHSS at admission were 12.6 ± 1.18 (range 9–15) and 19.7 ± 2.3 (range 18–23), respectively. Mean mRS at 12 months was 3.6 ± 1.1 (range 2–6). Mean follow-up was 18.1 months (range 12–34). The outcome was evaluated as satisfactory (mRs ≤ 3) in 8 patients (53.3%). Mortality at 1 year was 6.7%. No patients developed hydrocephalus and 1 presented seizures. According to mRs outcome evaluation (mRs ≤ 3 vs. mRs ≥ 4) no quantitative variable resulted significantly different between the two groups, whereas the concomitant use of iv rTPA significantly differed (
P
< 0.05).
Conclusion:
Supratentorial strokectomy seems to be safe and could be a potential alternative to decompressive craniectomy for the acute management of malignant MCA stroke. Advantages of this approach could be low complication rate, avoidance of bone reconstruction procedure, and reduced occurrence of hydrocephalus or seizures. A co-operative multicentric, prospective pilot study will be necessary to validate this technical approach.
Over the last decade, the unsustainability of the current economic model, based on the so-called take-make-dispose paradigm, has emerged. In particular, the agro-food sector (AFS) has been severely ...affected by such problems as resource scarcity and food loss and waste generation along the supply chain. In addition, climate change and biodiversity loss have helped to define an imperative paradigm shift towards a circular economy. Recently, with the publication of Sustainable Development Goals (SDGs), the scientific research examining the adoption of circular economy (CE) models and tools has increased. In this context, the importance of shifting towards a circular economy has become urgent. In this paper, a systematic literature review (SLR) was performed to investigate the state-of-the-art research related to the adoption of circular economy models and tools along the agro-food supply chain. Furthermore, this review highlights that, due to the complexity of the agri-food supply chain, it is almost utopian to define a unique circular economy model for the whole sector. In addition, it emerges that future researches should be concentrated on the integration of different stages of the supply chain with circular economy models and tools in order to create a closed-loop agri-food system.
Central nervous system (CNS) lesions, especially invasive fungal diseases (IFDs), in immunocompromised patients pose a great challenge in diagnosis and treatment. We report the case of a 48-year-old ...man with acute myeloid leukaemia and probable pulmonary aspergillosis, who developed hyposthenia of the left upper limb, after achieving leukaemia remission and while on voriconazole. Magnetic resonance imaging (MRI) showed oedematous CNS lesions with a haemorrhagic component in the right hemisphere with lepto-meningitis. After 2 weeks of antibiotics and amphotericin-B, brain biopsy revealed chronic inflammation with abscess and necrosis, while cultures were negative. Clinical recovery was attained, he was discharged on isavuconazole and allogeneic transplant was postponed, introducing azacitidine as a maintenance therapy. After initial improvement, MRI worsened; brain biopsy was repeated, showing similar histology; and 16S metagenomics sequencing analysis was positive (
,
). Despite 1 month of meropenem, MRI did not improve. The computer tomography and PET scan excluded extra-cranial infectious-inflammatory sites, and auto-immune genesis (sarcoidosis, histiocytosis, CNS vasculitis) was deemed unlikely due to the histological findings and unilateral lesions. We hypothesised possible IFD with peri-lesion inflammation and methyl-prednisolone was successfully introduced. Steroid tapering is ongoing and isavuconazole discontinuation is planned with close follow-up. In conclusion, the management of CNS complications in immunocompromised patients needs an interdisciplinary approach.
Clinical records (n = 24) with an established diagnosis of 5α-reductase-2 deficiency were reviewed. A previous misdiagnosis was present in about 70% (period from first observation to definitive ...diagnosis: 9.1 ± 10.8 years), and in 8 children gonadal removal was performed before certain diagnosis. Initial sex assignment was female in 16/24 (67%) and male in 8/24 (33%) cases. After diagnosis, sex re-assignment was performed in 5 babies (4 girls to male sex; 1 boy to female sex). Baseline testosterone/DHT ratio was diagnostic in 6/12 subjects (first months of life n = 4; puberty n = 2), while post-hCG testosterone/DHT ratio was diagnostic in all tested individuals (choosing both the cut-off value 15 or 10). Eighteen different mutations in the steroid-5α-reductase-2 (SRD5A2) gene were identified, 5 of which have never been reported. In conclusion, a time lag exists before the diagnosis of 5α-reductase-2 deficiency is established; sex assignment and gonadal removal may be performed before certain diagnosis. Sex re-assignment is usually female to male, but the contrary may occur. A large variability in clinical phenotypes and genetic mutations was present in this cohort. Accurate endocrine evaluation is recommended in babies possibly affected by 5α-reductase-2 deficiency, since the use of appropriate cut-off values of testosterone/DHT ratio after hCG stimulation may permit to select individuals for SRD5A2 gene analysis. A genotype-phenotype correlation was not found in this study.
Steroidogenic factor 1, encoded by the NR5A1 gene, is a key regulator of endocrine function within the hypothalamic-pituitary-steroidogenic axis. Both homozygous, compound heterozygous and ...heterozygous mutations in the NR5A1 gene may determine 46,XY disorders of sex development (DSD).
NR5A1 gene sequencing was performed in a cohort of 6 patients with 46,XY DSD without specific diagnosis.
Heterozygous NR5A1 gene mutations were found in 2 girls, aged 0.5 years and 14 years. The older girl harbored the c.250C>T transition in exon 4 (p.Arg84Cys), previously reported in a Japanese girl. The younger girl presented a de novo novel exon 6 heterozygous frameshift mutation (c.1074dupG) in codon 359 associated with the p.Gly146Ala polymorphism the latter inherited from her father. This baby showed severe impairment of androgen secretion from the first months of life. Overt adrenal insufficiency did not occur, but the older girl showed subnormal cortisol peak after ACTH stimulation.
NR5A1 gene mutations are a relatively frequent cause of 46,XY DSD in humans. Clear indications for management of these individuals remain elusive, mainly when diagnosis is made in infancy. Long-term monitoring of adrenal function should be recommended.
In this study, we used targeted next-generation sequencing (NGS) to investigate the genetic basis of congenital hypothyroidism (CH) in a 19-year-old Tunisian man who presented with severe ...hypothyroidism and goiter.
The propositus reported the appearance of goiter when he was 18. Importantly, he did not show signs of mental retardation, and his growth was proportionate. A partial organification defect was detected through the perchlorate-induced iodide discharge test. NGS identified a novel homozygous mutation in exon 18 of the SLC26A7 gene (P628Qfs*11), which encodes for a new iodide transporter. This variant is predicted to result in a truncated protein. Notably, the patient's euthyroid brother was heterozygous for the same mutation. No renal acid-base abnormalities were found and the administration of 1 mg of iodine failed to correct hypothyroidism.
We described the first case of goitrous CH due to a homozygous mutation of the SLC26A7 gene diagnosed during late adolescence.
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