Uncommon Blepharitis

Blepharitis is a common chronic inflammatory condition affecting the eyelid margins; the pathophysiology of blepharitis is complex and not fully understood. The disease is anatomically divided into anterior (inflammation of eyelashes) and posterior (meibomian gland dysfunction) types. Diagnosis relies on clinical examination, revealing characteristic features like scurf, vascular changes, and meibomian gland dysfunction. The main goals of blepharitis treatment are symptom relief, recurrence prevention, and complication risk minimization. Treatment options include lid hygiene, topical and systemic antibiotics, topical corticosteroids, and omega-3 supplements. However, it is important to highlight reported cases of blepharitis as side effects of systemic therapies, particularly in the context of chemotherapy, bortezomib, cetuximab, TNFα inhibitors, and dupilumab. It is crucial to monitor patients undergoing such treatments regularly and attentively in order to promptly set up adequate supportive therapy. Of even more importance is future research on the pathophysiological mechanisms responsible for the occurrence of these ocular side effects in order to find a nosological cure for the issue

Preventing and Managing Iatrogenic Dry Eye Disease during the Entire Surgical Pathway: A Study Focusing on Patients Undergoing Cataract Surgery

Patient expectations for cataract surgery are continuously increasing, and dry eye disease (DED) represents a major cause of patient dissatisfaction in eye surgery. The present opinion paper aims to provide useful insights to improve the entire pathway of a patient undergoing cataract surgery, from the preoperative setting to the postoperative one. The available evidence from main clinical trials published on this topic is presented in association with experience-based points of view by the authors. Ocular surface disease (OSD) is common in patients presenting for cataract surgery, and more than half of these patients have DED and meibomian gland dysfunction (MGD), even in the absence of symptoms. Therefore, there is a need to encourage preoperative assessments for the risk of DED development or worsening in all patients as a routine approach to cataract surgery. New all-in-one diagnostic machines allow for fast and noninvasive screening of the ocular surface status. Once a preoperative diagnosis of DED/OSD is reached, ocular surface optimization should be obtained before surgery. In the case of unresolved OSD, the decision to delay surgery should be considered. The surgical procedure can be optimized by avoiding large incisions, limiting microscope light intensity and exposure, and avoiding an aspirating speculum or preserved eye drops. Postoperatively, the continued avoidance of preserved agents is advisable, as well as a limited exposure to epitheliotoxic antibiotics and nonsteroidal anti-inflammatory drugs. Short-term, preservative-free, soft corticosteroids may be useful for patients with extensive or persistent inflammation

Comparing the vibrational behaviour of e-kick scooters and e-bikes: Evidence from Italy

E-kick scooters are currently among the most popular emerging electric-powered Personal micro–Mobility Vehicles (e-PMVs) and have recently been equated to e-bikes. However, even if the dynamic behaviour of e-bikes is well studied, much less has been done to understand the behaviour of e-kick scooters. Furthermore, comparisons between the two vehicles have rarely been investigated and only based on mechanical models. This study covers this gap by proposing a novel framework that evaluates the vibrational behaviours of both vehicles when driven by different users and exposed to the pavement irregularities, using both real and simulated data. The experimental data are collected equipping an e-kick scooter and an e-bike with Inertial Measurement Units, and then processed by ISO 2631–1 method to obtain an objective evaluation of the comfort. Next, the experimental data are expanded to include uncertainty applying a Monte Carlo Simulation based on a two-layer feed-forward Artificial Neural Network. Afterwards, several statistical analyses are performed to understand the key factors affecting the vibrational magnitude (and their extent) for each vehicle. This framework was tested in an Italian city (Brescia) along urban paths with five different pavement surfaces. The results showed that the e-kick scooter appears to be globally more solicited than the e-bike in terms of vibrational magnitude. Moreover, pavement surface, sensor position, user gender, user height, and travel speed are identified as crucial factors explaining the vibrational magnitude for both vehicles. The overall findings challenge the recent European regulations that equated e-kick scooters with bikes. These findings may help public administrations in planning the circulation of e-bikes and e-kick scooters in cities and recommend that manufacturers improve the e-kick scooter design by including shock absorbers to increase comfort

Usefulness of omega-3 fatty acid supplementation in addition to mesalazine in maintaining remission in pediatric Crohn's disease: a double-blind, randomized, placebo-controlled study.

AIM: To assess the value of long-chain omega-3 fatty acids (FAs) supplementation in addition to amino-salicylic-acid (5-ASA) in pediatric patients with Crohn's disease (CD). METHODS: Thirty-eight patients (20 males and 18 females, mean age 10.13 years, range 5-16 years) with CD in remission were randomized into two groups and treated for 12 mo. Group I (18 patients) received 5-ASA (50 mg/kg/d)+ omega-3 FAs as triglycerides in gastro-resistant capsules, 3 g/d (eicosapentanoic acid, EPA, 400 mg/g, docosahexaenoic acid, DHA, 200 mg/g). Group II (20 patients) received 5-ASA (50 mg/kg/d)+ olive oil placebo capsules. Patients were evaluated for fatty acid incorporation in red blood cell membranes by gas chromatography at baseline 6 and 12 mo after the treatment. RESULTS: The number of patients who relapsed at 1 year was significantly lower in group I than in group II (P < 0.001). Patients in group I had a significant increase in the incorporation of EPA and DHA (P < 0.001) and a decrease in the presence of arachidonic acids. CONCLUSION: Enteric-coated omega-3 FAs in addition to treatment with 5-ASA are effective in maintaining remission of pediatric CD

Origin–destination matrices from smartphone apps for bus networks

The knowledge of passenger flows between each origin–destination (OD) pair is a main requirement in public transport for service planning, design, operation, and monitoring, and is represented by OD matrices. Although they can be determined by traditional approaches (e.g., surveys, ride-check counts, and/or smartcard-based methods), the availability of new technologies and the proliferation of portable devices triggers an emerging interest in building OD matrices from the apps of bus operators. This research proposes the first framework for the estimation of OD matrices on transit networks by processing smartphone app call detail records (SACDRs). The framework is experimentally tested on a sample of 30 workdays of an Italian bus operator. The results are represented by easy-to-read control dashboards based on maps, which help quantify and visualise the OD matrices in the metropolitan area of Cagliari (Italy). The experimentation shows that the framework can properly estimate the number of trips for both origin and destination w.r.t. OD matrices built from household surveys: the mean absolute error is on average lower than five movements for 90% of the origins and 85% of the destinations

Spatial Engineering of Osteochondral Tissue Constructs Through Microfluidically Directed Differentiation of Mesenchymal Stem Cells

The development of tissue engineered osteochondral units has been slowed by a number of technical hurdles associated with recapitulating their heterogeneous nature ex vivo. Subsequently, numerous approaches with respect to cell sourcing, scaffolding composition, and culture media formulation have been pursued, which have led to high variability in outcomes and ultimately the lack of a consensus bioprocessing strategy. As such, the objective of this study was to standardize the design process by focusing on differentially supporting formation of cartilaginous and bony matrix by a single cell source in a spatially controlled manner within a single material system. A cell-polymer solution of bovine mesenchymal stem cells and agarose was cast against micromolds of a serpentine network and stacked to produce tissue constructs containing two independent microfluidic networks. Constructs were fluidically connected to two controlled flow loops and supplied with independently tuned differentiation parameters for chondrogenic and osteogenic induction, respectively. Constructs receiving inductive media showed differential gene expression of both chondrogenic and osteogenic markers in opposite directions along the thickness of the construct that was recapitulated at the protein level with respect to collagens I, II, and X. A control group receiving noninductive media showed homogeneous expression of these biomarkers measured in lower concentrations at both the mRNA and protein level. This work represents an important step in the rational design of engineered osteochondral units through establishment of an enabling technology for further optimization of scaffolding formulations and bioprocessing conditions toward the production of commercially viable osteochondral tissue products

Real-time evaluation of the on-board comfort of standing passenger in bus transit services

Bus on-board comfort may be intended as a multidimensional concept declined according to several attributes (e.g., vibrations, the load factor, the driving style, etc.) and represents a key factor of service quality. Thus, its measurement is crucial for public transport companies as it can support for the monitoring, evaluation and implementation of specific actions to improve their services. The objective of this paper is to build a numerical scale for real-time measurement of bus on-board comfort. This is pursued integrating subjective measurements of the driving style provided by the passengers with objective ones of longitudinal and transversal accelerations data collected by Intelligent Transportation System tools. The results are very useful because they represent a contribution to establish a comfort scale in a real operational environment, as a tool to regulate the driver's behavior: each driver is in the position of real-time monitoring the quality of a bus ride regarding on-board comfort level

One Soul and Several Faces of Evaporative Dry Eye Disease

The ocular surface system interacts with, reacts with, and adapts to the daily continuous insults, trauma, and stimuli caused by direct exposure to the atmosphere and environment. Several tissue and para-inflammatory mechanisms interact to guarantee such an ultimate function, hence maintaining its healthy homeostatic equilibrium. Evaporation seriously affects the homeostasis of the system, thereby becoming a critical trigger in the pathogenesis of the vicious cycle of dry eye disease (DED). Tear film lipid composition, distribution, spreading, and efficiency are crucial factors in controlling water evaporation, and are involved in the onset of the hyperosmolar and inflammatory cascades of DED. The structure of tear film lipids, and subsequently the tear film, have a considerable impact on tears’ properties and main functions, leading to a peculiar clinical picture and specific management

Clinical course and features of persistent polyclonal B-cell lymphocytosis with BCL-6 amplification during pregnancy

Background: Persistent polyclonal B-cell lymphocytosis is a rare nonmalignant disorder characterized by mild persistent lymphocyte proliferation with possible evolution to aggressive lymphoma. Its biology is not well known, but it is characterized by a specific immunophenotype with rearrangement of the BCL-2/IGH gene, whereas amplification of the BCL-6 gene has rarely been reported. Given the paucity of reports, it has been hypothesized that this disorder is associated with poor pregnancy outcomes. Case report: To our knowledge, only two successful pregnancies have been described in women with this condition. We report the third successful pregnancy in a patient with PPBL and the first with amplification of the BCL-6 gene. Conclusions: PPBL is still a poorly understood clinical condition with insufficient data to demonstrate an adverse effect on pregnancy. The role of BCL-6 dysregulation in the pathogenesis of PPBL and its prognostic significance are still unknown. Evolution into aggressive clonal lymphoproliferative disorders is possible and prolonged hematologic follow-up is warranted in patients with this rare clinical disorder

Mega-Events: Assessing Road Safety through an Operating Framework. An Application for the Milano–Cortina 2026 Winter Olympic Games †

To meet the United Nations and European Union goals of reducing road crash fatalities and injuries, it is also relevant to address the negative externalities due to mega-events on the road network and the local communities, to assess the safety of the road network involved, and to implement appropriate measures for different road environments. Despite their relevance, the literature often overlooks social costs and risks associated with mega-events. This study presents an operating framework for rapidly assessing the safety of the Milano–Cortina 2026—“Via Olimpica” road—which will host a significant proportion of the traffic during the Winter Olympic Games in 2026. The framework proposes a simplified Road Infrastructure Safety Management (RISM) to address the unique challenges posed by the limited time available for screening and implementation by local authorities. The framework integrates four data sources and follows a seven-step procedure. It provides recommendations for improving road safety by identifying critical road sections and blackspots. Road authorities, practitioners, and public administrations may all benefit from the framework, as it makes it easier to prioritise safety improvements within time constraints