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We estimated the effects of Environmental, Social, and Governance (ESG) scores on the credit ratings of firms in the sectors of manufacturing, mining and quarrying, wholesale and retail trade, information and communication, and real estate activities and located in North America, Europe, and Asia using a multivariate ordinal logit model. We use credit ratings by the S&P and Fitch agencies and the Refinitiv ESG pillar scores as measures of the performance of firms on sustainability matters. We found that the Environmental pillar score is the dimension of sustainability that most contributes to improving the goodness-of-fit of the credit rating model. It has a significant positive effect on credit ratings in all sectors investigated, with stronger effects for mining and quarrying firms. Firms that manage environmental matters better than their industry peers are perceived as more resilient to long-term risks and these tend to be rewarded by credit rating agencies. Some mixed evidence between credit rating agencies is found for the social and governance dimensions in terms of statistical significance and estimated marginal effects by sector.

SARS-CoV-2 can attack the central nervous system in the early stages of infection. Headache, anosmia, and dysgeusia are common symptoms. Disturbance of consciousness and seizures can occur as complications in case of severe COVID-19. We described the case of a COVID-19 patient admitted for interstitial pneumonia and seizures. MRI showed newly diagnosed demyelinating lesions. High-dose steroid treatment allowed neurological and respiratory recovery. We speculated a delayed immune response induced by SARS-CoV-2. The virus may lead to a SIRS-like immune disorder or play a role of infective trigger. Prompt invasive treatment should be adopted to avoid hypoxic neurotoxicity and prevent CNS injuries.

We explore Okun’s coefficient in several Latin American countries for the period from 1995 to 2017 and compare the results obtained using ordinary least squares (OLS) and generalised maximum entropy (GME) estimators. There are several advantages in considering the GME estimator over traditional regression approaches. First, it can estimate the parameters of an equation without imposing constraints on the probability distribution of the errors. Second, empirical and simulation studies available in the literature showed that GME worked well for ill-posed problems (e.g. when a model estimate is performed using a small sample of data). Among the main findings, we confirm the inverted relationship between changes in the unemployment rate and real gross domestic product growth in the explored countries except for Perù. Okun’s coefficient and the associated confidence intervals obtained by applying GME were very close to those obtained from OLS. Therefore, we did not observe a gain when using the GME estimator rather than the classic OLS approach.

The voluntary mobility of employees who change employers for a better job remains an unexplored area of labour market transitions in many European countries. We analyse whether and how the recent great economic recession has contributed to modifications in such voluntary job mobility when employees have a temporary contract in France, Italy and Spain. We analyse cross-sectional data from the EU-SILC survey for two sub-periods: 2005–2008 and 2009–2015. We find that employees who have invested in human capital, who are young and who work more than 40 h per week are more likely than their counterparts to change employers for a better opportunity given a temporary contract. After the great recession, we observe a curbing of the studied voluntary job mobility that is likely attributable to the difficulty experienced by employees in finding a job that provides more benefits than their current one, with heterogeneous effects across socio-economic and demographic characteristics and the country of residence.

Background: Intraoperative neurophysiological monitoring (IONM) is increasingly used during spinal surgery to reduce the risk of neurological complications. This systematic review evaluates both the clinical outcomes and cost-effectiveness of IONM in contemporary spinal surgery. Methods: A comprehensive literature search was conducted to identify studies evaluating IONM in spinal surgery. Twenty-three studies were included: twenty-one reporting clinical outcomes and two focusing on economic analysis. Data on neurological deficits, monitoring accuracy, and cost-effectiveness were extracted and analyzed. Results: Analysis of the included studies showed that IONM reduced the risk of neurological deficits across various types of spinal surgery. The diagnostic accuracy varied by modality, with MEP showing the highest sensitivity (90.2%) and SSEP demonstrating high specificity (97.1%). The greatest benefit was observed in deformity surgery and spinal tumors. D-wave monitoring showed efficacy for intramedullary tumors. Economic analysis demonstrated that IONM is cost-effective when the neurological complication rate exceeds 0.3%, with potential savings of over USD 23,000 per case. Conclusions: IONM significantly improves neurological outcomes in spinal surgery and is cost-effective in most clinical scenarios, particularly in high-risk procedures. Multimodal monitoring approaches provide the most comprehensive neurological assessment. These findings support the routine use of IONM in contemporary spinal surgery, especially for complex cases.

The invasive nature of glioblastoma is problematic in a radical surgery approach and can be responsible for tumor recurrence. In order to create new therapeutic strategies, it is imperative to have a better understanding of the mechanisms behind tumor growth and invasion. The continuous cross-talk between glioma stem cells (GSCs) and the tumor microenvironment (TME) contributes to disease progression, which renders research in this field difficult and challenging. The main aim of the review was to assess the different possible mechanisms that could explain resistance to treatment promoted by TME and GSCs in glioblastoma, including the role of M2 macrophages, micro RNAs (miRNAs), and long non-coding RNAs (lncRNAs) from exosomes from the TME. A systematic review of the literature on the role of the TME in developing and promoting radioresistance and chemoresistance of GBM was performed according to PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) guidelines. A dedicated literature review search was also performed on the immunotherapeutic agents against the immune TME. We identified 367 papers using the reported keywords. The final qualitative analysis was conducted on 25 studies. A growing amount of evidence in the current literature supports the role of M2 macrophages and non-coding RNAs in promoting the mechanisms of chemo and radioresistance. A better insight into how GBM cells interact with TME is an essential step towards comprehending the mechanisms that give rise to resistance to standard treatment, which can help to pave the way for the development of novel therapeutic strategies for GBM patients.

Background: Degenerative lumbar spine disease is a prevalent cause of chronic low back pain that significantly impairs daily function and quality of life. While conservative management is the first line of treatment, many patients ultimately require instrumented lumbar spine surgery. However, postoperative outcomes vary considerably, with emerging evidence suggesting that preoperative psychological factors such as anxiety, depression, and pain catastrophizing may influence recovery. The SAP-LD (Scale for Anxiety and Pain in Lumbar Degeneration) study was designed to assess the prognostic role of these psychological and physical parameters in surgical outcomes. Methods: This prospective observational study enrolled 70 adult patients with degenerative lumbar spine pathology scheduled for instrumented surgical treatment at the University of Brescia and ASST Spedali Civili di Brescia between March and December 2024. Preoperative assessments included demographic, clinical, and radiologic data along with validated scales: the Oswestry Disability Index (ODI), 36-Item Short Form Health Survey (SF-36), Visual Analogue Scale (VAS), Pain Catastrophizing Scale (PCS), and Hospital Anxiety and Depression Scale (HADS). Follow-up evaluations were performed at 45 days and at 6 months, and statistical analyses were conducted using correlation tests, ANOVA, and regression modeling. Results: The demographic analysis of the 70 enrolled patients shows a balanced gender distribution (38 females, 34 males) with a mean age of 61 years (range 23–81). The educational level distribution indicates that the majority of patients (44.29%) have a secondary education level, while 35.71% have a tertiary education level. Regarding employment status, 50% of the patients are retired or not working. Patients with clinically significant anxiety and/or depression showed higher levels of perceived pain, pain catastrophizing, and disability at baseline. These patients reported significantly worse scores on the Visual Analogue Scale (VAS), Pain Catastrophizing Scale (PCS), and Oswestry Disability Index (ODI). The Oswestry Disability Index (ODI) demonstrates a clinically significant improvement (reduction) in disability between the preoperative period (t0) and the 45-day follow-up (t2), with the median decreasing from 39.00 to 13.00. However, there is a partial regression at the 6-month follow-up (t3), with the median increasing to 27.00. For the SF-36 Health Survey, the General Health subscale shows an improvement between t0 and t2 (median increasing from 55.00 to 60.00), followed by a slight decrease at t3 (median 55.00). Similar patterns are observed in most other subscales, with initial improvement followed by partial regression. The Pain Catastrophizing Scale (PCS) shows a substantial reduction in catastrophizing between t0 and t2 (median decreasing from 16.00 to 3.00), followed by an increase at t3 (median 11.00), though still below baseline levels. Pain intensity as measured by the Visual Analogue Scale (VAS) shows a significant reduction at t2 (median decreasing from 5.00 to 3.00), but increases again at t3 (median 6.00), even exceeding the preoperative level. For the Hospital Anxiety and Depression Scale (HADS), no significant differences were observed across time points, with values indicating mild symptoms throughout the study period. Correlation analyses confirmed that higher preoperative anxiety and depression scores were predictive of poorer postoperative outcomes. Specifically, higher HADS scores at baseline are associated with higher ODI scores (increased disability) at all time points (p = 0.002), higher VAS scores (increased pain) at all time points (p = 0.015), and lower scores on SF-36 subscales, particularly Emotional Well-being (p = 0.00023) and Social Functioning (p = 0.002). Higher PCS scores at baseline are associated with higher ODI scores at all time points (p = 0.001), higher VAS scores at all time points (p = 0.008), and lower scores on SF-36 subscales, particularly Pain (p = 0.00023) and Physical Functioning (p = 0.04254). The mixed linear models analysis confirms these findings, showing that the ODI score decreases significantly between t0 and t2 (p = 0.00023) and increases between t2 and t3, though this increase is not statistically significant (p = 0.079). For VAS scores, there is a significant decrease between t0 and t2 (p = 0.00023) and a significant increase between t2 and t3 (p = 0.04254). Patients with elevated preoperative HADS scores tended to have slower recovery trajectories and reported lower satisfaction levels. These findings reinforce the prognostic value of psychological assessments in spine surgery and suggest that targeted psychological interventions could improve patient outcomes. Conclusions: By identifying psychological predictors of postoperative recovery, this study underscores the importance of integrating preoperative psychological screening into routine clinical practice. The results suggest that a multidisciplinary approach, including both surgical and psychological care, could enhance long-term functional outcomes and quality of life for patients undergoing instrumented lumbar spine surgery.

We employ cross-sectional microdata from 2010 through 2012 collected by the Italian National Institute of Statistics to investigate the proposed conceptual framework regarding the joint relationship between education, life satisfaction and the probability of social trust. The analysis has been carried out using two alternative specifications of the logit model: parametric and semiparametric. Our findings suggest that (a) both modelling methods that we utilise yield consistent results in terms of the positive effects of education and life satisfaction on social trust; (b) for unsatisfied individuals, social trust is generally low and largely unresponsive to the individual’s education level, whereas for ‘sufficiently satisfied’ individuals, social trust increases strongly with education; (c) there are some gender differences in the joint relationship between education, life satisfaction and social trust and (d) the parametric approach tends to mask some interesting patterns that are captured by the semiparametric specification. This finding implies that the parametric approach leads to a biased interpretation of the results, with an apparent failure of some of the assumptions made in the conceptual framework.