The drivers of customer satisfaction for academic library services: managerial hints from an empirical study on two Italian university libraries using the Kano model

The intent of this qualitative research is to investigate and understand the requisites of customer satisfaction for academic libraries’ users and to give managerial hints for the implementation of user centred academic library services. To this aim, we analyse the library services of two Italian Universities (the Faculty of Economics of University of Palermo and the Central Library of the University of Salerno) to find relations and congruencies and to evaluate the perceived relevance of the tangible and intangible aspects of these services. In the preliminary phase of the research, we conducted both focus groups and individual interviews involving students or researchers who regularly use the library services. This study supplies a significant analysis of qualitative data that can be functional for researchers and for university managers to plan strategic and operative activities in order to improve academic library services

Designing a Mobile App for Museums According to the Drivers of Visitor Satisfaction

The aim of this study is to identify the key factors as antecedents of visitor satisfaction for the design of a mobile app for museums. To our aim we use the Kano model that allows to categorize service attributes according to how they are perceived by customers and to estimate their impact on customer satisfaction. We collected qualitative data trough 300 questionnaires administered to tourists visiting the Sicilian cities of Palermo and Trapani over a period of 3 months (October- December 2012). The results of our analysis can be relevant for museum and public managers to plan strategic and operative activities, for researcher in the field of touristic marketing, for application developers, and for all those concerned with touristic and cultural heritage issues

Biomechanical performance of the Bicaval Transcatheter System for the treatment of severe tricuspid regurgitation

Introduction: Tricuspid regurgitation (TR) is a relatively common valvular disease, which can result from structural abnormalities of any anatomic part of the tricuspid valve. Severe TR is linked to congestive heart failure and hemodynamic impairment, resulting in high mortality when repaired by elective surgery. This study was undertaken to quantify the structural and hemodynamic performance of the novel Transcatheter Bicaval Valves System (TricValve) percutaneously implanted in the superior vena cava (SVC) and inferior vena cava (IVC) of two patients with severe TR and venous congestion. Methods: After developing the SVC and IVC device models, the contact pressure exerted on the vena cava wall was obtained by computational analysis. Both smoothed-particle hydrodynamics (SPH) and computational fluid dynamics were carried out to quantify caval reflux in the right atrium and the pressure field of pre- and post-TricValve scenarios, respectively. Results: Analysis of contact pressure highlighted the main anchoring area of the SVC device occurring near the SVC device belly, while the IVC device exerted pronounced forces in the device’s proximal and distal parts. SPH-related flow velocities revealed the absence of caval reflux, and a decrease in time-averaged pressure was observed near the SVC and IVC after TricValve implantation. Discussion: Findings demonstrated the potential of computational tools for enhancing our understanding of the biomechanical performance of structural tricuspid valve interventions and improving the way we design next-generation transcatheter therapies to treat the tricuspid valve with heterotopic caval valve implantation

Detection of SARS-CoV-2 N protein allelic variants by rapid high-throughput CLEIA antigen assay

We report the data obtained using an automated chemiluminescence enzyme immunoassay (CLEIA) for rapid antigen detection of SARS-CoV-2 with a number of variants

Equianalgesia, opioid switch and opioid association in different clinical settings: a narrative review

Emergency or postoperative pain often represents an authentic challenge in patients who were already on opioid treatment for chronic pain. Thus. their management requires not only the physician's ability to treat acute pain. but also competence in switching the opioid that lost efficacy. Different aspects should be considered, such as opioids titration, switching, association and equianalgesia.The objective of this paper is to provide a narrative review. which has been elaborated and discussed among clinicians through an iterative process involving development and review of the draft during two web-based meetings and via email. This expert opinion aims to facilitate the correct opioid use through appropriate practices with a focus on pain treatment in emergency and postoperative pain.Equianalgesia tables were reviewed and integrated by clinicians and researchers with expertise in anesthesia, postoperative medicine, intensive care, emergency medicine pharmacology and addiction medicine. Special populations (liver/kidney failure. elder, pediatric, pregnancy/lactation) are discussed in detail along with other critical scenarios, such as: (i) rapid pain worsening in chronic pain (aggravating pain due to disease progression or tolerance development to analgesic therapy): (ii) acute pain on maintenance treatment: and (iii) pain management of complicated patients in emergency care.Extended and updated equianalgesia tables and conversion rates for 17 different opioid formulations (of 9 different molecules) are presented as follows.Opioids remain the class that best suits clinical needs of emergency and post-operative medicine. However, it should be stressed that equianalgesia can be affected by drug-to-drug interactions and pharmacological imprecision. in a complex field where clinical experience may be the main guiding principle

Residual -Cell Function and Male/Female Ratio Are Higher in Incident Young Adults Than in Children: The registry of type 1 diabetes of the province of Turin, Italy, 1984-2000

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Nuclear Analyses for the Assessment of the Loads on the ITER Radial Neutron Camera In-Port System and Evaluation of Its Measurement Performances

The radial neutron camera (RNC) is a key ITER diagnostic system designed to measure the uncollided 14- and 2.5-MeV neutrons from deuterium-tritium (DT) and deuterium-deuterium (DD) fusion reactions, through an array of detectors covering a full poloidal plasma section along collimated lines of sight (LoS). Its main objective is the assessment of the neutron emissivity/alpha source profile and the total neutron source strength, providing spatially resolved measurements of several parameters needed for fusion power estimation, plasma control, and plasma physics studies. The present RNC layout is composed of two fan-shaped collimating structures viewing the plasma radially through vertical slots in the diagnostic shielding module (DSM) of ITER Equatorial Port 1 (EP01): the ex-port subsystem and the in-port one. The ex-port subsystem, devoted to the plasma core coverage, extends from the Port Interspace to the Bioshield Plug: it consists of a massive shielding unit hosting two sets of collimators lying on different toroidal planes, leading to a total of 16 interleaved LoS. The in-port system consists of a cassette, integrated inside the port plug DSM, containing two detectors per each of the six LoS looking at the plasma edges. The in-port system must guarantee the required measurement performances in critical operating conditions in terms of high radiation levels, given its proximity to the plasma neutron source. This article presents an updated neutronic analysis based on the latest design of the in-port system and port plug. It has been performed by means of the Monte Carlo MCNP code and provides nuclear loads on the in-port RNC during normal operating conditions (NOC) and inputs for the measurement performance analysis

SARS-CoV-2 infection in cancer patients on active therapy after the booster dose of mRNA vaccines

The protective role against SARS-CoV-2 infection by the third booster dose of mRNA vaccines in cancer patients with solid malignancies is presently un- known. We prospectively investigated the occurrence of COVID-19 in cancer patients on active therapy after the booster vaccine dose. Methods: Cancer patients on treatment at the Center for Immuno-Oncology (CIO) of the University Hospital of Siena, Italy, and health care workers at CIO who had received a booster third dose of mRNA vaccine entered a systematic follow-up monitoring period to prospectively assess their potential risk of SARS-CoV-2 infection. Serological and microneu- tralization assay were utilized to assess levels of anti-spike IgG, and of neutralizing antibodies to the SARS-CoV-2 Wild Type, Delta and Omicron variants, respectively, after the booster dose and after negativization of the nasopharyngeal swab for those who had developed COV- ID-19. Results: Ninety cancer patients with solid tumors on active treatment (Cohort 1) and 30 health care workers (Cohort 2) underwent a booster third dose of mRNA vaccine. After the booster dose, the median value of anti-spike IgG was higher (p Z 0.009) in patients than in healthy subjects. Remarkably, 11/90 (12%) patients and 11/30 (37%) healthy subjects tested positive to SARS-CoV-2 infection during the monitoring period. Similar levels of anti-spike IgG and of neutralizing antibodies against all the investigated variants, with geometric mean titers of neutralizing antibodies against the Omicron being the lowest were detected after the booster dose and after COVID-19 in both Cohorts. Conclusions: The occurrence of SARS-CoV-2 infection we observed in a sizable proportion of booster-dosed cancer patients and in healthy subjects during the Omicron outbreak indicates that highly specific vaccines against SARS-CoV-2 variants are urgently required

Immune-modulating effects of bevacizumab in metastatic non-small-cell lung cancer patients

The mPEBev is an anticancer regimen which combines a chemotherapy doublet, based on cisplatin and oral etoposide (mPE), with bevacizumab (mPEBev), a mAb targeting the vasculo-endothelial growth factor (VEGF). In previous studies, this regimen showed powerful anti-angiogenetic effects and significant antitumor activity in metastatic non-small-cell lung cancer (mNSCLC) patients. We also recorded the best benefit in patients exhibiting low-systemic inflammatory profile at baseline. On these bases, we hypothesized that mPEBev antitumor activity could be partially related to bevacizumab-associated immunological effects. For this reason, we performed an immunological monitoring in 59 out of 120 stage IIIb-IV NSCLC patients enrolled in the BEVA2007 phase II trial, who received fractioned cisplatin (30 mg/sqm days 1-3q21) and oral etoposide (50 mg, days 1-15q21) (mPE doublet) ±bevacizumab. In this group of patients, 12 received the mPE doublet alone and 47 the doublet in combination with bevacizumab (5 mg/kg on the day 3q21; mPEBev regimen). Blood cell counts, serum analysis, multiplex cytokine assay and immunocytofluorimetric analysis, performed on baseline and post-treatment on blood samples from these patients, revealed that bevacizumab addition to the doublet decreased levels of pro-angiogenic (VEGF, Angiostatin-1 and Follistatin) and inflammatory cytokines (interferon (IFN)γ, IL4 and IL17), improved in vivo and in vitro cytotoxic T-lymphocytes (CTL) response and promoted dendritic cell activation. These results suggest that the mPEBev regimen improve the micro-environmental conditions for an efficient antigen-specific CTL response, making it a feasible candidate regimen to be assessed in combination with immune-checkpoint inhibitors in NSCLC patients