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Most of the studies carried out in the past on economically important fish species rely on single species approach. Ecosystem dynamics are characterized by complex interaction among species, sharing common habitat needs and thus forming characteristic assemblages. The analysis of spatio-temporal variability of fish community, coupled to the analysis of spatial indices, provides a synthetic view of the fish community status evidencing, if any, the way a community changes. Such considerations drive also to the development of ecosystem-based fishery management paradigm. In the present study changes in pelagic fish community structure in an upwelling ecosystem of the central Mediterranean Sea during the last 10 years was analysed, by focusing the attention on the five most abundant small pelagic species: Engraulis encrasicolus, Sardina pilchardus, Sardinella aurita, Trachurus trachurus and Boops boops. Our results evidenced a quite stable community structure, characterized by spatial occupation strongly driven by ecosystem characteristics and modulated according to specie-specific behaviour. Obtained results lead us to hypothesize that the observed stability of community could be linked to the presence of different environments leading to efficient space partitioning and resources utilization among species.

Recent in-vitro data have shown that the activity of monoclonal antibodies (mAbs) targeting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) varies according to the variant of concern (VOC). No studies have compared the clinical efficacy of different mAbs against Omicron VOC. The MANTICO trial is a non-inferiority randomised controlled trial comparing the clinical efficacy of early treatments with bamlanivimab/etesevimab, casirivimab/imdevimab, and sotrovimab in outpatients aged 50 or older with mild-to-moderate SARS-CoV-2 infection. As the patient enrolment was interrupted for possible futility after the onset of the Omicron wave, the analysis was performed according to the SARS-CoV-2 VOC. The primary outcome was coronavirus disease 2019 (COVID-19) progression (hospitalisation, need of supplemental oxygen therapy, or death through day 14). Secondary outcomes included the time to symptom resolution, assessed using the product-limit method. Kaplan-Meier estimator and Cox proportional hazard model were used to assess the association with predictors. Log rank test was used to compare survival functions. Overall, 319 patients were included. Among 141 patients infected with Delta, no COVID-19 progression was recorded, and the time to symptom resolution did not differ significantly between treatment groups (Log-rank Chi-square 0.22, p 0.90). Among 170 patients infected with Omicron (80.6% BA.1 and 19.4% BA.1.1), two COVID-19 progressions were recorded, both in the bamlanivimab/etesevimab group, and the median time to symptom resolution was 5 days shorter in the sotrovimab group compared with the bamlanivimab/etesevimab and casirivimab/imdevimab groups (HR 0.53 and HR 0.45, 95% CI 0.36-0.77 and 95% CI 0.30-0.67, p<0.01). Our data suggest that, among adult outpatients with mild-to-moderate SARS-CoV-2 infection due to Omicron BA.1 and BA.1.1, early treatment with sotrovimab reduces the time to recovery compared with casirivimab/imdevimab and bamlanivimab/etesevimab. In the same population, early treatment with casirivimab/imdevimab may maintain a role in preventing COVID-19 progression. The generalisability of trial results is substantially limited by the early discontinuation of the trial and firm conclusions cannot be drawn. This trial was funded by the Italian Medicines Agency (Agenzia Italiana del Farmaco, AIFA). The VOC identification was funded by the ORCHESTRA (Connecting European Cohorts to Increase Common and Effective Response to SARS-CoV-2 Pandemic) project, which has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement number 101016167. NCT05205759.

The reduction in clinical rotation hours, particularly in high-demand pediatric subspecialties such as Neonatal Intensive Care Units (NICU) and Pediatric Emergency Rooms (ER), has highlighted the need for innovative approaches to enhance pediatric residency education. A 2019 survey of Italian pediatric residency programs revealed that most residents receive fewer than five hours of simulation-based training annually, with 66% participating in no simulation activities. Additionally, pediatric ER rotation hours have seen significant reductions-daytime rotations decreased by 29%, while nighttime rotations were reduced by 60% over the past four years at the University of Genoa. These challenges emphasize the importance of simulation-based curricula to address gaps in clinical exposure.This study presents a gamified simulation-based curriculum developed at the University of Genoa, designed to improve both technical and non-technical competencies among pediatric residents while compensating for reduced clinical exposure. The curriculum spans five years, with Year 1 focusing on foundational skills such as airway management, vascular access, and diagnostic techniques. Year 2 introduces more advanced scenarios like neonatal resuscitation, shock management, and cardiac arrest, while Years 3-5 culminate in high-fidelity simulations involving complex trauma and crisis resource management.Throughout the program, gamification elements such as badges, leaderboards, and team-based rewards enhance engagement, motivation, and participation. These elements provide feedback and foster progression, reinforcing residents' commitment to mastering technical skills and non-technical competencies like teamwork, leadership, and decision-making. By combining simulation-based training with gamification, this curriculum offers an innovative approach to residency education, preparing pediatric residents for real-world challenges and developing essential skills for high-stakes pediatric care.

Purpose The value of FDG PET-derived parameters in predicting overall survival (OS), local relapse-free survival (LRFS) and distant relapse-free survival (DRFS) in treated patients with malignant pleural mesothelioma (MPM) was evaluated. Methods This retrospective evaluation included 55 MPM patients treated between March 2006 and February 2015 with FDG PET/CT-guided salvage helical tomotherapy (HTT) after previous surgery plus chemotherapy. Univariate Cox regression analysis was performed to assess the impact of the following FDG PET-derived parameters: biological target volume (BTV), mean and maximum standardized uptake values (SUV mean/max ), metabolic tumour volume (MTV) and total lesion glycolysis (TLG), measured using different uptake thresholds (40%, 50% and 60%). Logistic regression was then performed to identify the best FDG PET-derived parameters for selecting patients with poorer survival. Results The median OS was 9.1 months (range 0.0 – 69.6 months) after the end of HTT; 54/55 patients were dead at the last follow-up. BTV and TLG40, TLG50 and TLG60 were the most significant predictors of OS ( p  < 0.005). The median OS was 4.8 months in patients with MTV60 >5 cm 3 and TLG40 >334.4, compared with 13.8 months and 16.1 months in patients with smaller values, respectively. The median LRFS and DRFS were 6.2 months (range 1.2 – 39.4 months) and 6.5 months (0.0 – 66.4 months), respectively. TLG40, TLG50 and TLG60 were significantly correlated with LRFS ( p  < 0.015). Median DRFS was 6.4 months in patients with MTV40 >39.6 cm 3 and 6.2 months in patients with TLG40 >334.4, compared with 17 months and 18.8 months in patients with smaller values. BTV, TLG40 and MTV40 were also found to be good predictors in patients with poor OS/LRFS/DRFS (median survival times less than the median values). Conclusion FDG PET-derived parameters effectively discriminated patients with a poor prognosis and may be helpful in the selection of MPM patients for salvage HTT.

This volume examines crucial concerns in palliative care, including the proper balance between comfort and cure for the patient, the integration of spiritual well-being, and the challenges of providing care in the absence of basic medical services and supplies. In the first section, palliative-care pioneers Constance Dahlin, Eduardo Bruera, Neil MacDonald, and Declan Walsh recount the early history of the discipline. Part 2 discusses the role of poetry, prose, plays, and other aspects of the humanities in the practice of palliative care. Part 3 explores essential current issues in the field, including autonomy, the use of opioids, and the impact of artificial intelligence on the evolution of palliative care. The final section focuses on the spiritual dimensions of pain and suffering. Rich with anecdotes and personal stories and featuring contributions from pioneers and current practitioners, The Pursuit of Life is an essential assessment of the past, present, and future of palliative care. In addition to the editors, the contributors include W. Andrew Achenbaum, Stacy L. Auld, Elena Pagani Bagliacca, Costantino Benedetti, Courtenay Bruce, Eduardo Bruera, Joseph Calandrino, Jim Cleary, Constance Dahlin, Andrea Ferrari, Mauro Ferrari, Joseph J. Fins, Bettie Jo Tennon Hightower, Kathryn B. Kirkland, Robin W. Lovin, Neil MacDonald, Charles Millikan, Dominique J. Monlezun, Tullio Proserpio, Giovanna Sironi, Daniel P. Sulmasy, and Declan Walsh.