Incidence, Risk Factors, and Management of Conjunctivitis in Atopic Dermatitis Patients Treated With Dupilumab or Tralokinumab: Results From a Multicenter, Observational, Retrospective Study

Background: Conjunctivitis is among the most frequent adverse events (AEs) emerged in clinical trials for all biologic drugs approved for atopic dermatitis (AD). However, real-world comparative data on the incidence, risk factors, and management of conjunctivitis remain limited. Objective: We aimed to compare the incidence, clinical features, and management of conjunctivitis in patients with moderate-to-severe AD treated with dupilumab or tralokinumab in a real-life setting. Patients and Methods: A multicenter, retrospective, observational study including adult patients with moderate-to-severe AD treated with dupilumab or tralokinumab for at least 16 weeks was carried out. Demographic, clinical, and therapeutic data were collected from 35 dermatological referral centers across Italy. Conjunctivitis incidence, severity, time to onset, and ophthalmologic management were analyzed and compared between treatment groups. Results: A total of 6668 patients were included (5899 on dupilumab and 769 on tralokinumab). Conjunctivitis occurred in 10.76% of dupilumab-treated and 12.61% of tralokinumab-treated patients, with no statistically significant difference in overall incidence. However, time to onset was significantly shorter with tralokinumab than with dupilumab (15.3 ± 14.5 weeks vs. 35.5 ± 45.2 weeks, respectively; p < 0.0001). Ophthalmologic management strategies were similar between groups, mainly involving lubricants and corticosteroid-based eye drops. Dupilumab-treated patients more frequently discontinued or switched treatment due to conjunctivitis than tralokinumab patients (25.4% vs. 14.4%, respectively; p < 0.05). Conclusions: Conjunctivitis represents a relatively frequent AE in patients with AD receiving dupilumab or tralokinumab. However, earlier onset of conjunctivitis with tralokinumab and higher discontinuation rates with dupilumab suggest differing tolerability profiles. Early recognition of ocular symptoms is essential, and dermatologists should promptly initiate supportive eye care and refer to ophthalmologists when appropriate to avoid unnecessary treatment interruptions

Existence and nonexistence of solutions for elliptic inequalities involving gradient terms and weights

In this paper we prove existence and nonexistence theorems for positive so- lutions of elliptic inequalities for general quasilinear operators, including m-Laplacian, mean curvature and generalized mean curvature operator, in the entire RN with a re- action involving power type gradient terms and positive weights, possibly singular or degenerate. A complete picture for the exponents involved is given. The proof technique is based on cumbersome integral a priori estimates, in the spirit of the nonlinear capacity method. No maximum principle or growth conditions at infinity for the solutions are required

Power hardware in the loop-based lifetime assessment of hybrid energy storage systems: A novel realistic approach

Reliable and cost-effective energy storage is essential for grid applications, but lithium-ion batteries face lifetime limitations due to cycling stress, temperature effects, and high power ramping. This paper presents a novel Power Hardware-in-the-Loop (PHIL) approach for experimentally assessing battery aging in Hybrid Energy Storage Systems (HESS) that combine batteries with flywheels. The proposed setup enables realistic emulation of field conditions and long-term degradation testing. Two configurations are experimentally evaluated: a standalone battery system and a hybrid flywheel-battery system with equivalent energy capacity. Results show that the HESS configuration significantly reduces power ramping and depth of discharge, resulting in lower degradation rates than a standalone battery. Furthermore, a Levelized Cost of Storage (LCOS) analysis confirms that the HESS achieves superior lifetime economics under realistic operating conditions, particularly under end-of-life criteria

Algebraic curves with a large cyclic automorphism group

The study of algebraic curves with numerous automorphisms in relation to their genus is a well-established area in Algebraic Geometry. In 1995, Irokawa and Sasaki gave a complete classification of curves over the complex field with an automorphism of order at least 2g+1. Such a classification does not hold in positive characteristic p, the curve with equation y^2=x^p-x being a well-studied counterexample. This paper successfully classifies curves with a cyclic automorphism group of order at least 2g+1 in positive characteristic greater than 2 , offering the positive characteristic counterpart to the Irokawa-Sasaki result. The possibility of wild ramification in positive characteristic has presented a few challenges to the investigation

Efficient Cross-Chain Smart Contract Execution via State Channels

Public blockchains offer transparency and security guarantees, but suffer from limited throughput, high latency, and unpredictable transaction costs, making them unsuitable for the high-frequency data flows of the Internet of Things. In this work, we address these scalability challenges by introducing a hybrid architecture that leverages state channels to enable efficient cross-chain smart contract execution between a permissioned ledger, responsible for capturing pollutant measurements from IoT sensors, and a public blockchain, used for final settlement. Our approach enables the processing of sensor readings to be performed off-chain in a lightweight, low-cost environment, while preserving the integrity and non-repudiation guarantees of on-chain settlement through a state channel. We describe the protocol design in detail, and the use of our solution in a case study involving water quality sensors

Machine learning for automated differentiation of parkinson’s disease and its mimics using 123I-mIBG scintigraphy: insights from a multicentre real-world cohort (ITA-mIBG study)

Purpose. To assess machine learning (ML) classifiers trained on harmonised multicentre 123I-mIBG planar scintigraphy for differentiating Parkinson’s disease (PD) from non-PD parkinsonian syndromes and to determine whether early imaging alone may ensure accurate discrimination. Methods. This retrospective study included patients with suspected PD who underwent early (~ 15 min) and delayed (~ 240 min) imaging and received a definitive diagnosis after ≥ 12 months. Harmonised region of interest (ROI) placement and ComBat correction were applied. Early and late heart-to-mediastinum (H/M) ratios and washout rate (WR) were calculated. Differences were tested by Mann-Whitney U test, and cut-points identified by ROC analysis. Logistic regression, Gaussian naïve Bayes, and support vector machine were trained on these features with Z-score normalisation and synthetic minority oversampling technique (SMOTE). Results. 127 patients were analysed (85 PD, 42 non-PD). Early and late H/M ratios were significantly lower in PD than non-PD (early H/M 1.45 ± 0.20 vs. 1.80 ± 0.20; late H/M 1.33 ± 0.22 vs. 1.68 ± 0.21; both p < 0.001). WR was modestly higher in PD (8.74 ± 5.76% vs. 6.49 ± 6.19%, p = 0.024). Optimal cut-points for PD were: early H/M ≤ 1.62 (accuracy 80.3%, sensitivity 83.3%, specificity 78.8%, and AUC 0.878), late H/M ≤ 1.52 (83.5%, 83.3%, 83.5% and 0.866) and WR ≥ 6.03% (70.1%, 70.6%, 69.0% and 0.645). ML achieved mean accuracy 78.9–80.7%, sensitivity 81.9–84.0%, specificity 68.6–78.0%, and AUC 0.850–0.875. Conclusion. Classifiers trained on 123I-mIBG semi-quantitative indices accurately distinguished PD from non-PD. Early H/M ratio alone provided excellent discrimination, supporting early-imaging; prospective validation is warranted

Positive Patch Test Reaction to Sodium Metabisulfite: Prevalence, Relevance and Clinical Implications

Background: Sodium metabisulfite (SMB) is widely used as a preservative in topical products, injectable drugs, and food. Contact allergy to SMB is increasing but the relevance of SMB positive patch test reactions and clinical implications of SMB systemic exposure remain challenging. Objectives: To assess the prevalence and relevance of SMB positive patch test reactions and to evaluate the tolerability of a local anaesthetic solution containing SMB. Methods: A retrospective study on consecutive patch tested patients with the Italian baseline series containing SMB was performed (January 2024–April 2025). In patients who tested positive for SMB, an intradermal test with SMB and a challenge with a local anaesthetic solution containing SMB were performed. Results: Among 550 patients consecutively patch tested with the Italian baseline series, 16 tested positive for SMB (2.9% [1.8%–4.7%]). The 16 positive reactions to SMB were not considered relevant. MOAHLFA index showed a significant positive association with Age > 40 (9.67 [1.249–74.89], p = 0.03). In all 16 patients, intradermal test with SMB and local anaesthetic challenge was negative. Conclusions: A high prevalence of positive patch test reactions to SMB in the absence of relevance was observed. Moreover, a positive patch test to SMB seems not to contraindicate the administration of a local anaesthetic containing SMB

Existence of optimal periodic strategies in a model with nonlocal spatiotemporal dispersal

In this paper, we investigate a control problem for a nonlinear integro-difffferential system incorporating both spatial and temporal nonlocal terms, subject to periodic condition in time. The equation, derived from population dynamics, describes the evolution of population density under growth, migration, and memory effects. The control set is feedback-based and spatially nonlocal, depending on a weighted integral of the state. We establish the existence of controlled trajectories that approximate the infimum or supremum of a cost functional with arbitrary precision. Moreover, under additional regularity assumptions on the bounding functions of the control set, we provide the existence of truly optimal controlled trajectories. The analysis employs topological methods in nonlinear analysis and tailored techniques to address temporal nonlocalities

Modeling of ammonia under-expanded jets for application in advanced propulsion systems

The adoption of ammonia as a fuel is gaining significance in various applications, including propulsion systems, gas turbines, and burners. In particular, the combustion of liquid ammonia presents an attractive option due to its low cost and its capacity to reduce local temperatures, thereby limiting thermal NOx emissions. In this context, investigating ammonia injection processes is relevant for optimizing and improving ammonia-fueled combustion systems. Thus, this work presents a combined experimental and numerical analysis of ammonia jets for applications in advanced propulsion systems, where the multiphase flow resulting from ammonia injection was investigated using a purposely developed CFD code characterized by low numerical dissipation and the adoption of real-fluid properties. The simulation methodology is validated against experiments performed at the Université d’Orléans, including optical measurements based on Schlieren and Diffuse Back-Illumination (DBI) extinction techniques, as well as local temperature measurements. This study provides insights into jet morphology and offers a quantitative assessment of parameters — including liquid penetration and local temperature — that are crucial for advancing the design of ammonia combustion systems. The outcomes offer an enhanced representation of jet structure, highlighting the presence of under-expanded jets and Mach discs when ammonia is injected at high pressures. They also demonstrate that under-expanded shock structures are strongly dependent on the temperature of liquid fuel injection