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We assessed with computed tomography (CT) densitometry the prevalence of emphysema in 266 (175 men and 91 women; mean age 64 ± 4 years) smokers and former smokers enrolled in the ITALUNG trial of lung cancer screening with low-dose thin-slice CT. Whole-lung volume and the relative area at −950 Hounsfield units (RA 950 ) and mean lung attenuation (MLA) in 1 of every 10 slices (mean, 24 slices per subject) were measured. Lung volume, MLA and RA950 significantly correlated each other and with age. Average RA950 >6.8% qualifying for emphysema was present in 71 (26.6%) of 266 subjects, with a higher prevalence in men than in women (30.3% vs 19.8%; p = 0.003). Only in smokers was a weak (r = 0.18; p = 0.05) correlation between RA950 and packs/year observed. In multiple regression analysis, the variability of RA950 (R2 = 0.24) or MLA (R2 = 0.34) was significantly, but weakly explained by age, lung volume and packs/year. Other factors besides smoking may also have a significant role in the etiopathogenesis of pulmonary emphysema.

We compared whole-lung densitometry with visual evaluation of pulmonary emphysema. Thirty patients with chronic obstructive pulmonary disease underwent multi-detector CT (150 mAs and 0.75 collimation) with double reconstruction: thick (5-mm) slices with smooth filter for whole-lung densitometry and thin (1 mm) slices with sharp filter for visual assessment (one of every ten slices). Densitometry and visual assessment were performed by three operators each, and the time required for assessment, the inter-observer agreement and the correlation with the results of the diffusion capacity of carbon monoxide (DL CO ) in the same patients were computed. The average time for densitometry (8.49 ± 0.13 min) was significantly longer (p < 0.0001) than that for visual evaluation (5.14 ± 0.11 min). However, the inter-operator agreement ranged between “moderate” to “almost perfect” for densitometry (kappa range 0.58–0.87) and “slight” for visual (kappa = 0.20) assessment. The correlation coefficients of DL CO with relative area at −960 and −970 Hounsfield units (HU) (both r = −0.66) and of the first percentile point of lung density (r = 0.66) were slightly stronger than that of the visual score (r = −0.62). Densitometry should be preferred to visual assessment because it enables a more reproducible evaluation of the extent of pulmonary emphysema, which can be carried out on the entire lung in a reasonable amount of time.

Key summary points Aim To evaluate the epidemiology of diabetes and quality of care to institutionalized older patients with diabetes in Italy. Findings Diabetes is a widespread condition within nursing homes in Italy (Prevalence 19.3%). Great heterogeneity in assisting nursing home residents with diabetes. Lack of communication and information exchange between doctors and nursing staff Discrepancies between what is recommended in guidelines and the real-world practice Message The institution of local diagnostic-therapeutic-pathways, shared by all caregivers, should be encouraged and properly funded to overcome communication problems between doctors and nurses and eventually improve the quality of care in institutionalized patients with diabetes. Purpose To evaluate the epidemiology of diabetes and quality of care of institutionalized patients with diabetes in Italian nursing homes. More specifically, to evaluate the adherence to the national/international guidelines for the management of older people with diabetes. Methods Data related to the epidemiology of diabetes and the quality of care were collected from questionnaires sent to 41 nursing homes. Data were extracted from papers, electronic medical records and validated operating protocols regulating the management of patients with diabetes in various homes. Completed questionnaires were returned in electronic format and centrally processed. Results Out of 4692 residents, 906 (19.3%) had diabetes. Among these residents, excluding patients undergoing diet treatment, more than half were on insulin treatment (alone or in combination with oral antidiabetic agents). The critical findings can be summarized as follows: a lack of shared diagnostic-therapeutic protocols, specifically related to evaluation of frailty; the preparation of nutritional and physical activity plans; the clarification of the objectives of the treatment; the timing of insulin administration (frequent use of sliding scale); the frequency and timing of capillary blood glucose; metabolic control methods; hypoglycemia and hyperglycemia treatment; and the scant use of new drugs that do not cause hypoglycemia. Conclusion Our data revealed substantial heterogeneity in the treatment of nursing home residents with diabetes in Italy with many discrepancies between what is recommended in the guidelines and real-world practice. The implementation of local diagnostic-therapeutic protocols shared by all caregivers should be encouraged and properly funded to overcome communication problems between doctors and nurses and eventually improve the quality of care for institutionalized patients with diabetes.

Minority languages are vital to preserving cultural heritage, yet they face growing risks of extinction due to limited digital resources and the dominance of artificial intelligence models trained on high-resource languages. This white paper proposes a framework to generate linguistic tools for low-resource languages, focusing on data creation to support the development of language models that can aid in preservation efforts. Sardinian, an endangered language, serves as the case study to demonstrate the framework's effectiveness. By addressing the data scarcity that hinders intelligent applications for such languages, we contribute to promoting linguistic diversity and support ongoing efforts in language standardization and revitalization through modern technologies.

We describe an early CT study of a rare case of blunt traumatic injury to the right submandibular salivary gland, without mandibular bone fractures, in a 30-year-old man after a car accident.[PUBLICATION ABSTRACT]

This paper offers a new edition of the of «Demotic graffito from Elephantine», first published by Erich of Lüddeckens in 1971. This inscription is dated to 277 BC, the month of Mechir. As in a flashback, the text mentions the following events: (i) the invasion of Egypt by Artaxerses III and (ii) its effects on the rise of the price of corn, (iii) the collapse of the tempie of Satet at Elephantine during the second year of the reign of Ptolemy II Philadelphos; (iv) the date and célébration of the wedding between Ptolemy II and his sister Arsinoe II (mentioned as nȝ pr-ʿȝ.w) on the 30th of Mesore 278 BC.; (v) Ptolemy's decision to reduce the price of corn; (vi) the beginning of the reconstruction of the temple of Satet, in 277 BC, the month of Tibi; (vii) the date of the inscription and the discovery of three earlier temples during the foundation works for the new building of Satet. The present edition offers significantly new readings and a new historical interpretation of the inscription.

The case of a 37 year old man with a longstanding HLA-B27 associated bilateral Achilles tendinitis without seronegative spondyloarthropathy is reported. This case suggests that heel enthesopathy may for a long time be the only clinical manifestation of the HLA-B27 associated disease process.

Proximal femur strength estimates from computed tomography (CT)-based finite element (FE) models are finding clinical application. Published models reached a high in-vitro accuracy, yet many of them rely on nonlinear methodologies or internal best-fitting of parameters. The aim of the present study is to verify to what extent a linear FE modelling procedure, fully based on independently determined parameters, can predict the failure characteristics of the proximal femur in stance and sideways fall loading configurations. Fourteen fresh-frozen cadaver femora were CT-scanned. Seven femora were tested to failure in stance loading conditions, and seven in fall. Fracture was monitored with high-speed videos. Linear FE models were built from CT images according to a procedure already validated in the prediction of strains. An asymmetric maximum principal strain criterion (0.73% tensile, 1.04% compressive limit) was used to define a node-based risk factor (RF). FE-predicted failure load, mode (tensile/compressive) and location were determined from the first node reaching RF=1. FE-predicted and measured failure loads were highly correlated (R2=0.89, SEE=814N). In all specimens, FE models correctly identified the failure mode (tensile in stance, compressive in fall) and the femoral region where fracture started (supero-lateral neck aspect). The location of failure onset was accurately predicted in eight specimens. In summary, a simple FE model, adaptable in the future to multiple loads (e.g. including muscles), was highly correlated with experimental failure in two loading conditions on specimens ranging from normal to osteoporotic. Thus, it can be suitable for use in clinical studies.

Recent efforts have succeeded in surveying open chromatin at the single-cell level, but high-throughput, single-cell assessment of heterochromatin and its underlying genomic determinants remains challenging. We engineered a hybrid transposase including the chromodomain (CD) of the heterochromatin protein-1α (HP-1α), which is involved in heterochromatin assembly and maintenance through its binding to trimethylation of the lysine 9 on histone 3 (H3K9me3), and developed a single-cell method, single-cell genome and epigenome by transposases sequencing (scGET-seq), that, unlike single-cell assay for transposase-accessible chromatin with sequencing (scATAC-seq), comprehensively probes both open and closed chromatin and concomitantly records the underlying genomic sequences. We tested scGET-seq in cancer-derived organoids and human-derived xenograft (PDX) models and identified genetic events and plasticity-driven mechanisms contributing to cancer drug resistance. Next, building upon the differential enrichment of closed and open chromatin, we devised a method, Chromatin Velocity, that identifies the trajectories of epigenetic modifications at the single-cell level. Chromatin Velocity uncovered paths of epigenetic reorganization during stem cell reprogramming and identified key transcription factors driving these developmental processes. scGET-seq reveals the dynamics of genomic and epigenetic landscapes underlying any cellular processes. Single-cell mapping of heterochromatin and euchromatin using chromatin velocity defines trajectories of epigenetic modifications.