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State-of-the-art planning theory considers cities as cyborg entities composed by a “natural” part (human beings and their social structures) and an “artificial” part (buildings, infrastructure and other urban artifacts). We contend that this hybrid conception is indissolubly coupled with the ability to discriminate perfectly between the “natural” and the “artificial”. But is this actually the case? We will provide a critical reflection on this ontological issue pointing out that current urban planning theory as well as the general philosophical reflection is not able to produce a rigorous, consistent epistemic criterion to draw this distinction. Long-standing difficulties in this respect are exponentially amplified by recent developments in artificial intelligence, nanotechnology and biotechnology, and their growing relevance in urban environments of the near future risk making the cyborg conception informing the complexity theory of cities obsolete. We will conclude our reflection identifying a possible path for overcoming this dualism toward a more socio-natural conception internalizing the proteiform character of the concept of “nature” itself as well as its inherent cognitive/political element.

Laser treatments have become popular in Dermatology. In parallel to technologic development enabling the availability of different laser wavelengths, non-invasive skin imaging techniques, such as reflectance confocal microscopy (RCM), have been used to explore morphologic and qualitative skin characteristics. Specifically, RCM can be applied to cosmetically sensitive skin areas such as the face, without the need for skin biopsies. For these reasons, apart from its current use in skin cancer diagnosis, our systematic review reveals how RCM can be employed in the field of laser treatment monitoring, being particularly suitable for the evaluation of variations in epidermis and dermis, and pigmentary and vascular characteristics of the skin. This systematic review article aims to provide an overview on current applications of RCM laser treatment monitoring, while describing RCM features identified for different applications. Studies on human subjects treated with laser treatments, monitored with RCM, were included in the current systematic review. Five groups of treatments were identified and described: skin rejuvenation, scar tissue, pigmentary disorders, vascular disorders and other. Interestingly, RCM can assist treatments with lasers targeting all chromophores in the skin and exploiting laser induced optical breakdown. Treatment monitoring encompasses assessment at baseline and examination of changes after treatment, therefore revealing details in morphologic alterations underlying different skin conditions and mechanisms of actions of laser therapy, as well as objectify results after treatment.

Auricular keloids pose significant aesthetic and functional challenges, and traditional treatments often fall short in addressing these issues. Our study presents an innovative combined approach of ablative CO2 and dye laser therapy for improved keloid management. This treatment protocol was applied to 15 patients with auricular keloids after an initial multispectral analysis to assess keloid composition. The laser sequence was tailored per patient based on this analysis. Evaluations using the Vancouver Scar Scale and Patient and Observer Scar Assessment Scale were carried out at baseline and at 3-week intervals post-treatment. The results showed a significant reduction in these scores at the final follow-up (p < 0.05), suggesting improvements in keloid color, texture, and pliability, with minimal adverse events. Additionally, no recurrence of keloids was observed. Our findings indicate that this novel methodology of multispectral analysis followed by tailored laser therapy may offer a safe and effective solution for auricular keloids, promising enhanced keloid treatment and prevention of recurrence. However, further investigations, including randomized controlled trials, are needed to confirm and optimize this treatment protocol.

Background/Objectives: Rhinophyma, an advanced form of rosacea, is characterized by significant nasal tissue enlargement and deformation, leading to aesthetic and psychosocial challenges. Traditional treatments are often invasive with variable outcomes, emphasizing the need for improved therapeutic approaches. This study evaluates the efficacy of a dual-laser therapy (CO2 and dye lasers) in treating rhinophyma. An innovative diagnostic algorithm using multispectral imaging guided treatment decisions, while Optical Coherence Tomography (OCT) was utilized to analyze post-treatment vascular and collagen changes. Methods: A prospective study was conducted involving 20 patients with rhinophyma. Multispectral imaging was used to guide the tailored application of CO2 laser, dye laser, or both, depending on the predominant vascular or glandular components in the nasal tissue. Post-treatment analysis employed OCT to assess changes in vascular and collagen density, providing insights into the tissue modifications induced by laser therapy. Results: The treatment significantly reduced vascular density from 35,526.75 to 26,577.55 at 300 microns and from 46,916.25 to 35,509.25 at 500 microns. Collagen density decreased from 81.35 to 66.34. All reductions were statistically significant, with highly significant p-values. These findings highlight the dual-laser therapy’s effectiveness in addressing the pathological features of rhinophyma. Conclusions: Dual-laser therapy guided by multispectral imaging provides a targeted and effective treatment for rhinophyma, addressing its vascular and glandular components. The use of OCT enhances understanding of laser-induced tissue changes and confirms significant reductions in vascular and collagen density. This approach represents a significant advancement in the management of rhinophyma, offering improved precision and therapeutic outcomes.

This single-arm observational study evaluated the efficacy and safety of a novel topical formulation containing a complex mixture of polyphenols (CMP) – a proprietary blend rich in oleocanthal and oleuropein aglycone (each >60%), along with hydroxytyrosol and other extra virgin olive oil (EVOO)-derived polyphenols – combined with triticum vulgare germ (TVG) oil, betaine, propanediol, and tocopheryl acetate in patients with mild palmoplantar psoriasis (PPP). Twenty participants (aged 20-55) applied the formulation twice daily for 8 days, with assessments conducted on days 0 (baseline), 5, and 8. Participants underwent a 60-day follow-up to assess the durability of benefits and potential late-onset adverse events. Clinical evaluations measured lesion extent, keratinization, inflammation, desquamation, and infiltration. A patient-reported questionnaire evaluated quality of life (QoL) and symptom burden. By day 8, the mean lesion extent had decreased by approximately 40%, inflammation had improved by about 50%, and desquamation had resolved fully in most cases. Patient-reported outcomes improve alongside clinical measures. At day 60, these improvements persisted in 85% of participants, and no adverse events emerged. The formulation’s mechanism of action is hypothesized to involve the concerted antioxidant and anti-inflammatory activities of polyphenols (oleocanthal, oleuropein aglycone, and hydroxytyrosol) in synergy with TVG oil’s supportive lipid matrix and other excipients. These findings suggest that EVOO-derived polyphenols formulated in TVG oil may serve as a valuable adjunct for managing PPP with good tolerability and sustained benefits.

Background: Melasma and facial hyperpigmentation are common dermatologic conditions that significantly impact patients’ quality of life. New approaches such as laser-assisted delivery of topical agents have been proposed to enhance treatment outcomes. Objective: To evaluate the comparative effectiveness of fractional CO2 laser-assisted delivery of 2-mercaptonicotinoyl glycine (2-MNG) versus topical 2-MNG alone in a real-world clinical setting. Methods: Fourteen female patients with mild-to-moderate melasma or hyperpigmentation were enrolled, and eleven completed the 16-week study. Participants were allocated to either the laser +2-MNG group (n = 6) or topical 2-MNG only group (n = 5). Assessments were performed at baseline and every four weeks using VISIA CR® imaging (visible, UV, and brown spots), Modified Melasma Area and Severity Index (mMASI), and Dermatology Life Quality Index (DLQI). Results: Both groups showed significant improvement in visible spots, brown spots, mMASI, and DLQI scores. The laser group showed earlier improvement, with significant changes starting at week 8, while the control group reached significance at week 12. No significant change in UV spot scores was observed. Conclusion: Both approaches were effective in reducing clinically visible pigmentation and improving quality of life. Fractional CO2 laser-assisted delivery offered a faster onset of efficacy.

Cosmetic dermatology increasingly utilizes laser technologies to address various aesthetic concerns. This study evaluates the efficacy of the flash-lamp pulsed-dye laser (FPDL) in treating vascular and scar-related conditions. A cohort of 71 patients with diverse vascular lesions, including facial telangiectasia, port-wine stains (PWSs), striae rubrae, erythematous acne scars, facial traumatic scars, and keloids, was treated using the FPDL (Synchro Vas-Q, Deka MELA). Treatment protocols varied based on lesion type, with sessions ranging from one to eight at intervals of four to eight weeks. Clinical outcomes were assessed using a four-point grading scale and patient satisfaction surveys. Results indicated that 70.4% of patients achieved excellent clearance of lesions, while 16.9% and 9.9% showed moderate-good and slight clearance, respectively. Minimal or no improvement was observed in 2.8% of cases. High patient satisfaction was reported, correlating with effective lesion reduction and manageable side effects, primarily post-operative purpura. The study underscores FPDL’s selective efficacy for hemoglobin-rich lesions and its safety profile, advocating for its continued use in cosmetic dermatological practices. These findings contribute to the growing evidence supporting laser therapy as a pivotal tool in aesthetic medicine, emphasizing the importance of tailored treatment protocols and patient education for optimal outcomes.

Inflammatory bowel disease (IBD) affects not only patients but also their informal caregivers. Enhancing caregiver resilience may improve both caregiver well-being and patient outcomes. This study aimed to assess resilience levels in caregivers of individuals with IBD and identify key psychological and contextual predictors, including caregiver contributions to self-care, self-efficacy, and perceived care load. A multicentre cross-sectional study was conducted across nine IBD outpatient clinics in Italy. Caregiver resilience was measured using the Connor–Davidson Resilience Scale (CD-RISC 25). Additional tools included the Caregiver Contribution to Self-Care of Chronic Illness Inventory (CC-SC-CII) and Caregiver Self-Efficacy in Contributing to Patient Self-Care Scale (CSE-CSC). Robust regression models identified predictors of total resilience and its subdomains. Among 275 caregivers (median age 53; 58.2% female) CD-RISC-25 levels were moderately high (median = 74 [IQR = 65–84]), with no significant differences between those caring for patients with Crohn’s disease or ulcerative colitis. SEM analyses showed that self-efficacy significantly predicted contributions to disease monitoring and management, but not maintenance. In turn, the management dimension was significantly associated with higher levels of resilience across four of five domains (trust, control, acceptance of change, and spirituality), while maintenance was uniquely associated with personal competence. Predictors including education and employment status showed no significant direct or indirect effects on CC-SC-CII. In conclusion, caregiver resilience in IBD is positively associated with self-efficacy and active engagement in disease management. Targeted support strategies may strengthen caregiver resources and promote sustainable care.

: Humanitarian surgical missions play a critical role in addressing health disparities, particularly in low-resource settings where conditions such as cleft lip and palate (CL/P) are prevalent. The success of these missions relies heavily on the commitment of volunteers, including healthcare professionals and logistical personnel. While their contributions are widely acknowledged, the psychological and emotional impact of participating in such missions remains underexplored. : This study protocol aims to explore the lived experience of volunteers involved in humanitarian surgical missions. : A qualitative study, using Interpretative Phenomenological Analysis (IPA), will be conducted. Semi-structured interviews will be carried out with volunteers who have participated in at least one humanitarian surgical mission. Interviews will be audio-recorded, transcribed verbatim, and analyzed to identify emerging themes. Data collection will continue until saturation is reached. The reporting of this study will follow the COREQ guidelines. : This study is expected to provide a deeper understanding of the emotional and professional experiences of volunteers in surgical missions. Expected results include identifying key themes related to motivation and preparation, on-site engagement, field experience, interpersonal relationships and group dynamics, and personal reflections. These results will inform strategies to enhance the effectiveness of missions, improve volunteer support, and ensure the sustainability of humanitarian interventions. Additionally, these findings will contribute to the broader field of international health volunteering and support future program development. : This protocol outlines a rigorous qualitative approach to investigating the lived experience of volunteers in humanitarian surgical missions. The anticipated findings are expected to inform targeted training, psychological support, and organizational strategies, ultimately improving the effectiveness and sustainability of future missions and the well-being of volunteers.

Background: Eczematous dermatitis refers to a group of inflammatory skin disorders—including seborrheic, atopic, and contact dermatitis—characterized by epidermal barrier dysfunction and chronic inflammation. Disrupting the itch–scratch cycle and reversing microscopic skin changes are key to improving patient outcomes and quality of life. Aims: This study aimed to assess the clinical and microscopic effects of a topical medical device containing N-butanoyl glutathione (GSH-C4) and hyaluronic acid in patients with inflammatory eczematous dermatitis, combining clinical scores with in vivo confocal and OCT imaging. Methods: A prospective clinical trial enrolled 30 patients with active eczematous lesions. Participants applied a GSH-C4/hyaluronic acid-based product (GSEBA®) for 28 days. Clinical improvement was evaluated at baseline, day 14, and day 28 using the Investigator’s Global Assessment (IGA), a Visual Analog Scale (VAS) for itching, and a self-reported index of disease impact on quality of life (IDL). Microscopic changes were assessed using optical coherence tomography (OCT) and reflectance confocal microscopy (RCM). Results: After 28 days, the mean IGA score improved from 2.48 to 0.18 (p < 0.001), VAS itching score decreased from 4.52 to 0.32 (p < 0.001), and IDL dropped from 4.86 to 0.79 (p < 0.001). RCM analysis showed significant reductions in key inflammatory features such as spongiosis, vesiculation, and inflammatory infiltrate. OCT revealed a significant decrease in vascularization at 150 μm depth, with no change in collagen density. Conclusions: The GSH-C4/hyaluronic acid-based mousse (GSEBA®) demonstrated strong clinical efficacy and excellent tolerability in managing eczematous dermatitis. It effectively reduced both symptoms and microscopic markers of inflammation without compromising dermal structure.