Oral Corticosteroid-Related Healthcare Resource Utilization and Associated Costs in Patients with COPD

Introduction: Oral corticosteroids (OCS) are used to manage chronic obstructive pulmonary disease (COPD) exacerbations but are associated with adverse outcomes that may increase healthcare resource utilization and costs. We compared attendance/costs associated with OCS-related adverse outcomes in patients who ever used OCS versus those who never used OCS and examined associations between cumulative OCS exposure and attendance/costs. Methods: This direct matched observational cohort study used the UK Clinical Practice Research Datalink GOLD database (data range 1987-2019). Patients with a COPD diagnosis on/after April 1, 2003, and Hospital Episode Statistics linkage were included. Emergency room, specialist or primary care outpatient, and inpatient attendance were analyzed. Costs, estimated using Health and Social Care 2019 and National Health Service Reference Costs 2019-2020 reports, were adjusted for sex, age, exacerbation number, and inhaler type used in the 12 months before index date. Results: The OCS cohort had higher annualized disease-specific (excluding respiratory) total attendance/costs versus the non-OCS cohort (adjusted incidence rate ratio [aIRR] with 95% confidence intervals [CIs]) ranging from 37% (1.37 [1.31, 1.43]) for emergency room attendances to 149% (2.49 [2.36, 2.63]) for specialist consultations. Disease-specific (excluding respiratory) attendance/costs increased in a positive dose-response relationship for most attendance categories versus the < 0.5 g reference dose. For the 0.5 to < 1.0 g cumulative dose category, the greatest increases in disease-specific (excluding respiratory) attendance/costs occurred for primary care consultations (aIRR [95% CI] 1.38 [1.32, 1.44]). For the ≥ 10 g cumulative dose category, the greatest increases were observed for primary care consultations (aIRR [95% CI] 2.83 [2.66, 3.00]), non-elective long stays (≥ 2 days; 2.54 [2.15, 2.99]), and non-elective short stays (≤ 1 day; 2.51 [2.12, 2.98]). Similar findings were observed for all-cause attendance/costs. Conclusion: Among patients with COPD, OCS-related adverse outcomes were associated with higher attendance and costs, with a positive dose-response relationship. A graphical abstract is available with this article

Digital Resources in Support of Students with Mathematical Modelling in a Challenge-Based Environment

In this paper, we report how digital resources support engineering students in the early stages of mathematical modelling within a Challenge-Based Education (CBE) course. The study was conducted in a second-year engineering course involving mathematics, physics, and ethics. Through a case study of two student teams, we analyze how a digital curriculum resource—specifically, a dashboard designed for feedback and progress monitoring—helped students identify, define, and begin modelling a real-world problem related to crowd flow on train platforms. Using the instrumental approach, we examined the dual processes of instrumentation (integration of resources) and instrumentalization (adaptation and repurposing of tools). Results show that the Dashboard played a central role in fostering self-regulated learning, interdisciplinary collaboration, and the iterative refinement of guiding questions. Students used data analysis, simulations, and modelling techniques to build and validate mathematical representations in answer to the guiding questions. Our findings contribute to ongoing discussions on how mathematics education in engineering can be enhanced through activity-based learning and targeted use of digital tools. We argue that digital feedback systems like dashboards can bridge the gap between abstract mathematical content and its meaningful application in engineering contexts, thus fostering engagement, autonomy, and authentic learning

ACOUSTIC OPTIMISATION OF SUSTAINABLE SOUND-ABSORBING PANELS FROM SARGASSUM ALGAE

Sargassum algae pose a growing environmental challenge along the Atlantic coast, particularly in the Caribbean and Equatorial Africa. This study presents the acoustic optimisation of modular sound-absorbing panels made from sun- -dried Sargassum algae. The methodology combines experimental characterisation of the material’s physical and acoustic properties as a function of apparent density with an analytical model to predict its acoustic performance. This research project contributes to the development of sustainable noise control solutions while addressing an urgent ecological issue

Combined Effects of Tillage and Fertilization Sources on Soil Characteristics and Tuber Yield of Potato (Solanum tuberosum L.) in a Mediterranean Environment

Soil tillage practices and fertilization are the backbones of potato crop production system. Sustainable agricultural practices are essential for enhancing potato production in the Mediterranean environment and addressing the food security challenges. The main goal of research is to evaluate the efficacy of different soil tillage practices in combination with different fertilization sources on two potato genotypes to enhance plant growth, yield, disease resistance, and soil characteristics in the Mediterranean environment over the period of two consecutive years. Three tillage practices were adopted: plowing as conventional tillage, subsoiling, and spading as conservation tillage. Two fertilization treatments included mineral and organic fertilization. The two potato varities cultivated were Levante and Agata. The total soil nitrogen (TN) percentage in the soil increased to 0.16% under subsoiling with organic fertilization, followed by improvements in total carbon percentage and carbon-to-nitrogen (C/N) ratio. However, these practices did not significantly impact potato yield. The highest yield of commercial tubers was observed with plowing (27.3 n. m− 2) and mineral fertilization (25.3 n. m− 2). For seed tubers, spading tillage (34.1 n. m− 2) and organic fertilization (33.8 n. m− 2) were effective in improving both yield and quality. The Levante potato variety, The 4th International Electronic Conference on Agronomy showed resistance to early blight (Alternaria spp.) and root rot (Sclerotium rolfsii), in contrast to the Agata variety. Implementing conservation tillage practices combined with organic fertilization and disease resistant potato varieties may enhance sustainability in potato production in Mediterranean environments

Toward axial channeling deployment at the Large Hadron Collider

Efficient steering of particle beams in accelerators by means of bent crystals has been pursued over the last decades. Recent achievements in their operational deployment at CERN has resulted in a renewed interest in their exploitation for advanced accelerator and high energy physics concepts. Efforts to date have been focused on establishing planar channeling, given the intrinsic complexity of the process. However, the know-how developed with operation of bent crystals at the Large Hadron Collider has allowed this to be pushed a step further, demonstrating that axial channeling can also be used in the multi-TeV regime. Present results were achieved through a combination of mechanical crystal rotation and local orbit bump, proving that incorporating an additional degree of freedom in the design of future goniometers could enable the operational deployment of axial channeling, opening up the possibility for new and more efficient particle steering applications with bent crystals

LA FORMAZIONE NEL NOME DI LIBERTÀ E UGUAGLIANZA. Ideologie educative in comparazione

In La formazione nel nome di Libertà e Uguaglianza. Ideologie educative in comparazione, viene proposta un’attenta analisi delle riviste politico-culturali del ferrarese, dal momento in cui viene fondato il Partito Socialista fino alla Prima guerra mondale, al fine di comparare ideologie contrapposte relativamente al rapporto educazione-istruzione, al compito dei maestri, agli interventi di salvaguardia degli strati più deboli della popolazione. Si tratta di un esempio comparativo che si sviluppa all’interno di un medesimo contesto, volto a dimostrare quanto questo tipo di ricerca possa raggiungere risultati interessanti e rilevanti al fine di costruire strumenti utili ad interpretare il presente. Quale ruolo assumeva il lavoro nelle campagne italiane del primo Novecento? Come veniva interpretato il ruolo dell’istruzione a partire da differenti visioni politiche

Clinical implementation of a secondary dose calculation system for patient-specific quality assurance of complex VMAT and SBRT treatments

Purpose: Advanced radiotherapy techniques require robust patient-specific quality assurance (PSQA). This study validated a secondary calculation software for plan dose verification, evaluating accuracy across different treatment sites, beam qualities, and plan complexities. Methods: Data from two beam-matched VersaHD linacs were used to commission RadCalc-V7.3.2.0. 33 end-to-end tests in homogeneous and anthropomorphic phantoms compared RadCalc Monte Carlo (RC-MC) and Collapsed Cone Convolution Superposition (RC-CCCS) algorithms with Pinnacle3 TPS, using gamma analysis (1.5 %/2mm) and ionization chamber measurements. 140 clinical VMAT plans of varying complexities, including 35 head and neck (H&N) and 65 SBRT treatments, were evaluated using gamma analysis (3 %/2mm) and relevant DVH metrics for PTV (D98%, D2%). RadCalc calculations were compared with pre-treatment Octavius 4D measurements. Results: Phantom studies showed excellent RadCalc-TPS agreement for homogeneous plans and lung SBRT with flattened beams (mean passing rates > 98 %, mean measured dose differences < 1 %). Larger discrepancies were observed in the anthropomorphic thorax phantom for FFF SBRT. For clinical plans, mean passing rates exceeded 98.5 %. Site-specific differences emerged: RC-MC performed better for H&N, RC-CCCS for other sites. RadCalc calculated slightly less homogeneous dose distributions than Pinnacle3, but averaging RC-MC and RC-CCCS results in reduced DVH discrepancies (mean ΔD98% −1.1 ± 1.1 %, mean ΔD2% +1.1 ± 1.5 %). Octavius measurements may underestimate calculation discrepancies due to tissue inhomogeneities. Conclusions: RadCalc produced very consistent results with Pinnacle3 and can be integrated into our PSQA program for efficient 3D dose verification, reducing measurement workload while maintaining high standards of dosimetric accuracy. Using both RadCalc algorithms effectively reduced calculation uncertainties

Effect of Dupilumab on Health-Related Quality of Life and Respiratory Symptoms in Patients With COPD and Type 2 Inflammation: BOREAS and NOTUS

Background: Patient-reported outcomes should be considered alongside clinical assessments to guide therapy for COPD. Research question: Does add-on dupilumab treatment improve health-related quality of life and respiratory symptoms in patients with COPD and type 2 inflammation? Study design and methods: In this pooled analysis of two phase 3 trials, patients with COPD and type 2 inflammation receiving triple therapy were randomized 1:1 to receive dupilumab 300 mg (n = 938) or placebo (n = 936) every 2 weeks for 52 weeks. Quality of life and respiratory symptom severity were measured by change from baseline to week 52 in St. George's Respiratory Questionnaire (SGRQ; total [0-100 units, lower scores indicating better quality of life] and domain scores for symptoms, activity, and impacts) and Evaluating Respiratory Symptoms in COPD (E-RS:COPD; total [0-40 units, lower scores meaning less severe respiratory symptoms] and domain scores for breathlessness, cough and sputum, and chest symptoms) scores. Results: In total, 1,660 patients reached week 52 (n = 830 in each treatment arm). At week 52, dupilumab vs placebo reduced SGRQ and E-RS:COPD total scores by least squares mean differences (95% CI) of -3.4 (-5.0 to -1.8; P < .0001) and -0.9 (-1.4 to -0.4; P = .0006), respectively. Similar reductions were observed across SGRQ domain scores of symptoms (-3.5 [-5.5 to -1.5]), activity (-4.0 [-5.9 to -2.1]), and impacts (-2.9 [-4.6 to -1.1]), and E-RS:COPD domain scores of breathlessness (-0.6 [-0.8 to -0.3]), cough and sputum (-0.2 [-0.3 to 0.0]), and chest symptoms (-0.1 [-0.3 to 0.0]). Interpretation: Dupilumab exhibited improvements in SGRQ and E-RS:COPD total and domain scores in patients with COPD and type 2 inflammation

Learning by writing: The influence of handwriting and typing on novel word learning in typically developing readers and readers with dyslexia

Background: Writing-based spelling is crucial for acquiring written word knowledge, contributing to form lexical representations that integrate motor information. Modern educational settings incorporate multiple modalities, with typing increasingly complementing handwriting. However, evidence on their relative effectiveness in supporting orthographic and semantic learning, particularly when these processes are impaired, remains limited. Aims: This study examines the impact of the two writing modalities on the learning of orthographic and semantic information in typically developing (TD) children and those with developmental dyslexia (DD). Sample: Eighteen Italian middle school students with DD and eighteen age-matched TD readers participated. Methods: Participants learned a set of nonwords, varying in transcription regularity, paired with images, either through typing or handwriting. Their spelling and nonword-image association skills were then tested. Recorded metrics included accuracy, writing duration during learning and spelling tasks, and reaction time in the nonword-image mapping task. Results: TD children benefited from both writing modalities during learning. Crucially, the DD group showed better spelling and nonword-image association performance when learning occurred through typing. Accuracy in retrieving orthographic and semantic information was not significantly affected by the time spent handwriting or typing during learning. Performance differences based on transcription complexity provided insights into the extent to which children internalized lexical representations. Conclusions: Both writing modalities can support orthographic and semantic learning, but the complex graphomotor demands of handwriting may hinder novel word acquisition in dyslexic individuals. Incorporating typing into educational strategies could alleviate the cognitive load associated with handwriting and enhance word retention for these students

Individual Differences in Vertebrate Behavioural Lateralisation: The Role of Genes and Environment

In humans, certain functions such as language and spatial attention are lateralised, meaning they are predominantly or exclusively performed by one hemisphere. Intriguingly, a significant portion of individuals exhibit a mirrored pattern of asymmetry, which has been attributed to genes, environmental influences, or other factors. As lateralisation occurs across all major groups of vertebrates, literature in other species might provide valuable insights into these mechanisms. We reviewed current knowledge on the genetic and environmental factors underlying individual variability in lateralisation in non-human vertebrates. Evidence of a genetic basis for the direction, strength of asymmetries, or both has been reported in about a dozen species of fish and mammals. Nevertheless, a careful examination revealed that none of these studies can definitively exclude the influence of non-genetic factors. On the other hand, studies from the past decade have suggested that environmental factors can shape both the direction and strength of lateralisation in adaptive ways, aligning the individual’s phenotype with local environmental conditions. Overall, this review supports the potential role of both genetic differences and environmentally driven plasticity in shaping lateralisation variance while highlighting literature gaps that prevent a precise disentanglement of the roles of these factors