A multistage design procedure for planning and implementing public charging infrastructures for electric vehicles

Presented in this paper is a Multistage Design Procedure (MSDP) for planning and implementing Public Charging Infrastructures (PCIs) to satisfy intracity charging demand of Electric Vehicles (EVs). The proposed MSDP splits planning and design processes into multiple stages, from macroscale to fine-scale levels. Consequently, the preliminary results achieved at each stage can be refined at the subsequent stages, leading to determine the accurate number and precise geographical location of each charging point. The main advantage of the proposed approach is that it splits a very complicated procedure into multiple and simpler stages, at each of which appropriate goals, targets and constraints can be included. As a result, the iterative interactions among all the stakeholders involved in the PCI design process are significantly simplified. The proposed MSDP has been employed in the planning and design of the PCI of the Italian island of Sardinia, accordingly to all the public bodies

Follicular thyroid carcinoma: Differences in clinical relevance between minimally invasive and widely invasive tumors

Evidence on the biological behavior and clinical courses of minimally invasive and widely invasive follicular thyroid carcinoma (MI-FTC, WI-FTC) is still debatable. The current study was conducted to identify differences between MI and WI tumors and those prognostic parameters influencing late outcome such as local recurrence and survival

Stress among medical students: Factor structure of the University Stress Scale among Italian students

Objectives The main purpose of the current study was to investigate the psychometric properties of the Italian version of the University Stress Scale (USS) among Italian medical students. Design, setting and participants A cross-sectional observational study based on data from an online cross-sectional survey from 11 to 23 December 2018. A total of 1858 Italian medical students participated in the study. Outcome measures We measured perceived stress among medical students using the USS, the Effort-Reward Imbalance Student Questionnaire (ERI-SQ) and the Kessler-10 (K10). Results Results showed that a bifactor-Exploratory Structural Equation Modeling solution provided excellent levels of fit to the data. Our results suggest that the modified version of 19 items of the Italian version of the USS does not have a simple unidimensional structure. Overall, an inspection of ancillary indices (omega indices, ECV and percentage of uncontaminated correlations) revealed that these were too low to suggest the use of the USS as a composite measure of university stress. We tested an alternative unidimensional short form (eight items; USS-S) that assessed all the five sources of stress. This version provided a good fit to the data. Evidence of convergent validity of the USS-S was observed by analysing the correlations between the USS and ERI-SQ (ranging from-0.34 to 0.37, all p<0.01). Finally, based on the clinical cut-off recommended on the K10, results from receiver operating characteristic showed that considering the clinical cut-off of the USS is 7.5 and that 59.70% of medical students reported stress levels in the clinical range. Conclusion Finally, our results showed a lack of support for using the USS to measure a general university stress factor, as the general USS factor accounted for little variance in our sample. In this sense, stress scores among Italian students can be better assessed by the use of the USS-S

Type 2 diabetes mellitus, physical activity, exercise self-efficacy, and body satisfaction. An application of the transtheoretical model in older adults

Physical activity (PA) is a relevant component of the treatment of Type 2 diabetes mellitus (T2DM). However, to prevent its related morbidities, PA requires an immediate and lasting change of lifestyle. Exercise self-efficacy and body satisfaction were used in a sample of older adults with T2DM, classified in different stages of change, to predict levels of PA. Results show that exercise self-efficacy increases linearly from precontemplation to maintenance stage, while body satisfaction shows an inverted U shape. However, only stages of change, other than exercise self-efficacy, add a significant and noticeable contribution to prediction of levels of PA. This evidence claims a tailored approach to PA in older adults with T2DM and advises behavioural health interventions based on exercise self- efficacy

Mental health among university students: The associations of effort-reward imbalance and overcommitment with psychological distress

Background: Mental health problems are highly prevalent among university students, but little is known about their underlying determinants. This study explores mental health among university students, the association between “effort-reward imbalance” (ERI), overcommitment and mental health, and to what extent ERI and overcommitment explain gender differences in mental health. Methods: Cross-sectional data were analyzed from 4760 Italian university students. The Kessler Psychological Distress Scale-10 was used to measure self-reported psychological distress, as an indicator of mental health, and the ERI – Student Questionnaire to measure effort, reward and overcommitment. The associations between ERI and overcommitment with psychological distress were estimated with multinomial logistic regression analyses. Results: 78.5% of the respondents experienced psychological distress, with 21.3%, 21.1%, and 36.1% reporting respectively mild, moderate and severe psychological distress. Female students were more likely to report moderate and severe psychological distress. ERI and overcommitment were strongly associated with severe psychological distress with ORs respectively up to 19.9 (95% CI: 12.2–32.5) and 22.2 (95% CI: 16.1–30.7). ERI and overcommitment explained part of the higher odds of severe psychological distress among female students comparing to males, attenuating the ORs from 2.3 (95% CI: 1.9–2.7) to 1.4 (95% CI: 1.2–1.7). Limitations: This cross-sectional study was performed on a large, but convenient sample. Discussion: More than one out of three students reported severe psychological distress. Decreasing ERI and overcommitment may be beneficial in the prevention of psychological distress among university students and may reduce gender differences in psychological distress. Longitudinal studies are needed to further investigate these associations

Inter-individual variability in psychological outcomes of supervised exercise in adults with Type 2 Diabetes

Exercise is a key component in the management of Type 2 Diabetes Mellitus (T2DM), however despite the strong evidence of its protective effects, a majority of the population with this diagnosis remains inactive and those who start an exercise program are not willing to train themselves over the long-term. Self-ef cacy and perceived stress are related to barriers to exercise in T2DM, therefore the aim of this longitudinal study is to investigate variations across time and individual differences in both variables as effects of a supervised exercise training (6 months) in a small sample of persons diagnosed with T2DM. Results show a general decline in the mean values of self-ef cacy and perceived stress at 6 months and a high individual variability in both variables. These results support the need to develop customized pro- grams of exercise in T2DM that take into account different phases of the exercise process and individual variability.El ejercicio es un componente clave en la prevención y el tratamiento de Diabetes Mellitus Tipo 2 (DMT2); sin embargo, a pesar de la fuerte evidencia de sus efectos protectores, la mayoría de las personas con este diagnóstico permanece inactiva y aquellos que comienzan un programa de ejercicio no están dispuestos a entrenar a largo plazo. La autoefcacia y la percepción de estrés se relacionan con las barreras para realizar ejercicio en pacientes T2DM; por lo tanto, el objetivo de este estudio longitudinal consiste en investigar las variaciones a través del tiempo y las diferencias individuales en ambas variables, como efectos de un entrenamiento de ejercicio supervisado (6 meses), en una muestra pequeña de pacientes diagnosticados con TD2M. Los resultados muestran una disminución general de los valores promedio de la autoefcacia y del estrés percibido a los 6 meses y una alta variabilidad individual en ambas variables. Estos resultados apoyan la necesidad de desarrollar programas personalizados de ejercicio en pacientes T2DM con el objetivo de considerar las diferentes fases del proceso de ejercicio y de la variabilidad individual

Associations of university student life challenges with mental health and self-rated health: A longitudinal study with 6 months follow-up

Background: Mental health problems are highly prevalent among university students. Stress due to student life challenges may be a risk factor for poorer health. This study investigates to what extent student life challenges and changes therein are associated with mental health and self-rated health. Methods: In a longitudinal study with 568 Italian university students mental health was assessed using the Mental Health Inventory-5 (MHI-5) and self-rated health with a single item from the Short Form 36 Health Survey (SF36) (score ranges: 0-100) at baseline and at six months follow-up. Student life challenges were investigated using six subscales (score ranges: 1-4) of the Higher Education Stress Inventory (HESI). A between-within linear regression model was used to investigate whether a higher exposure to life challenges was associated with poorer health (between individuals) and whether changes in student life challenges were associated with changes in health (within individuals). Results: Higher exposure to student life challenges was associated with poorer mental health (b ranging from -5.3 to -10.3) and self-rated health (b ranging from -3.1 to -9.6). An increase in student life challenges within individuals was associated with poorer mental health and self-rated health, in particular for high workload (b up to -5.9), faculty shortcomings (b up to -5.7), and unsupportive climate (b up to -5.6). Discussion: Exposure to student life challenges and changes therein are associated with university students’ health. Our findings suggest that student life challenges may be a target for interventions to improve mental health and self-rated health among university students

Grape pomace for topical application: Green nades sustainable extraction, skin permeation studies, antioxidant and anti-inflammatory activities characterization in 3d human keratinocytes

Food waste is a global problem due to its environmental and economic impact, so there is great demand for the exploitation of new functional applications. The winemaking process leads to an incomplete extraction of high-value compounds, leaving the pomace still rich in polyphenols. This study was aimed at optimising and validating sustainable routes toward the extraction and further valorisation of these polyphenols, particularly for cosmeceutical applications. New formulations based on red grape pomace polyphenols and natural deep eutectic solvents (NaDESs) were here investigated, namely betaine combined with citric acid (BET-CA), urea (BET-U) and ethylene glycol (BET-EG), in which DESs were used both as extracting and carrying agents for polyphenols. The flavonoid profile determined by HPLC-MS/MS analysis showed similar malvidin content (51\u201356 \ub5g mL 121 ) in the DES combinations, while BET-CA gave the best permeation performance in Franz cells, so it was further investigated in 3D human keratinocytes (HaCat spheroids) injured with the pro-oxidant agent menadione. BET-CA treatment showed good intracellular antioxidant activity (IC50 0.15 \ub1 0.02 \ub5g mL 121 in malvidin content) and significantly decreased (p < 0.001) the release of the pro-inflammatory cytokine IL-8, improving cell viability. Thus, BET-CA formulation is worthy of investigation for potential use as a cosmetic ingredient to reduce oxidative stress and inflammation, which are causes of skin aging

Stress among medical students: factor structure of the University Stress Scale among Italian students

OBJECTIVES: The main purpose of the current study was to investigate the psychometric properties of the Italian version of the University Stress Scale (USS) among Italian medical students. DESIGN, SETTING AND PARTICIPANTS: A cross-sectional observational study based on data from an online cross-sectional survey from 11 to 23 December 2018. A total of 1858 Italian medical students participated in the study. OUTCOME MEASURES: We measured perceived stress among medical students using the USS, the Effort-Reward Imbalance Student Questionnaire (ERI-SQ) and the Kessler-10 (K10). RESULTS: Results showed that a bifactor-Exploratory Structural Equation Modeling solution provided excellent levels of fit to the data. Our results suggest that the modified version of 19 items of the Italian version of the USS does not have a simple unidimensional structure. Overall, an inspection of ancillary indices (omega indices, ECV and percentage of uncontaminated correlations) revealed that these were too low to suggest the use of the USS as a composite measure of university stress. We tested an alternative unidimensional short form (eight items; USS-S) that assessed all the five sources of stress. This version provided a good fit to the data. Evidence of convergent validity of the USS-S was observed by analysing the correlations between the USS and ERI-SQ (ranging from -0.34 to 0.37, all p<0.01). Finally, based on the clinical cut-off recommended on the K10, results from receiver operating characteristic showed that considering the clinical cut-off of the USS is 7.5 and that 59.70% of medical students reported stress levels in the clinical range. CONCLUSION: Finally, our results showed a lack of support for using the USS to measure a general university stress factor, as the general USS factor accounted for little variance in our sample. In this sense, stress scores among Italian students can be better assessed by the use of the USS-S

Best Possible Maximum Principles for Fully Nonlinear Elliptic Partial Differential Equations

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