Danieli (Italy)

Pickleball is one of the fastest growing sports in the United States. With its rising popularity, particularly in the aging population, comes concern for potential injuries. The purpose of this study was to investigate clinical outcomes and return to sport (RTS) after acute Achilles tendon rupture in this unique patient population. A retrospective analysis was performed of patients who sustained an acute Achilles tendon rupture while playing pickleball from 2013 to 2023. Patients were contacted through telephone to confirm mechanism and collect data regarding length of time playing pickleball before injury, RTS following injury, and Achilles Tendon Rupture Score (ATRS). A total of 42 patients who suffered an Achilles tendon rupture were identified, of whom 28 were able to be contacted and included in this study, with a response rate of 67%. The average age of patients who sustained a pickleball-associated Achilles tendon rupture was 63.9 (36 to 81) years. Sixty-eight percent of patients reported sustaining the injury within the 1st month of playing pickleball, with 32% playing for the first time. At a mean follow-up of 4.7 years, no significant differences were observed in ATRS or the rate of RTS between patients surgically and nonsurgically. The overall rate of RTS was 47% at an average of 1.6 years. All but one patient who did not RTS stated a fear of reinjury as their reasoning. The rising popularity of pickleball poses a notable risk to the aging population because of its associated injuries. Despite favorable long-term outcomes regardless of treatment modality, over half of patients who sustain an Achilles tendon injury from pickleball do not return to playing, most commonly out of fear of reinjury. IV; retrospective case series.

Abstract Background Echocardiography is a useful tool for evaluation of organ damage and ejection fraction (EF) is the parameter for the evaluation of cardiac function. New parameters such as Global Longitudinal Strain (GLS) and Myocardial Work (MW) seem to be more sensitive in left ventricular (LV) dysfunction detection. Purpose The study investigates whether parameters of LV function such as GLS and MW are more sensitive in detecting LV impairment in patients with hypertension compared with healthy controls, than traditional parameters. Methods Clinical and a comprehensive echocardiographic data of 40 patients with hypertension were analyzed in comparison with 10 normal subjects. In addition to LVEF and S’ on TDI, GLS and MW (Global Work Index (GWI), Global Constructive Work (GCW), Global Wasted Work (GWW) and Global Work Efficiency (GWE), were determined and compared with healthy controls after adjustment for confounders. Results Hypertensives and controls have normal LVEF(61,9% ± 0,77% vs 62,7% ± 0,15% respectively) and S' on TDI (9,4 cm/s ± 3,21 cm/s vs 10,5 cm/s ± 2,1 cm/s respectively),normal LV mass index. GLS and LV MW GWE in hypertensive patients were reduced (-18,5% ± 0,4% vs -20,8% ± 0,7% respectively with p<0,000; 91,4 mmHg% ± 0,6 mmHg% vs 96,2 mmHg% ± 1,2 mmHg% respectively with p<0,000), while LV MW GWW (221,4 mmHg% ± 22,3 mmHg% vs 80 mmHg% ± 43,4 mmHg% respectively with p<0,000, GCW (2557,6 mmHg% ± 75,5 mmHg% vs 2361,5 mmHg% ± 147,2 mmHg% respectively with p<0,000 and GWI (2018,6 mmHg% ± 56,6 mmHg% vs 1977 mmHg% ± 110,3 mmHg% respectively with p<0,000) increased in comparison to controls. Conclusion Despite a normal ejection fraction, novel echocardiographic parameters such as LV GLS and LV MW GWE are early reduced in hypertensive patients, while LV MW GWW, GCW and GWI early increased compared to healthy controls.

The study aims to evaluate the demand for forest bathing in northern Italy’s regions, underlining the willingness to pay and the potential tourists’ habits and flows on attending alpine contexts. Several studies have analyzed the psychophysical benefits of forest bathing, and there is a growing interest in assessing its economic value for tourism purposes. The sample’s answers have been analyzed employing a stratified sampling methodology considering three different macro areas (northwest regions, northeast regions, and the Friuli Venezia Giulia region). After analyzing the sample’s attitudes, the research approached the estimation section by calculating the flow as the number of potential forest bathing hikes per year and the willingness to pay through the contingent valuation method. The main results indicate that forest bathing activity in northern Italy has a considerable monetary value, and it is generally compared with positive feelings, particularly concerning well-being and fascination factors.

Was 1 haben erbauliche Textsorten des 17. und 18. Jahrhunderts mit Zeitungen des 19. und 20. Jahrhunderts gemein? Im ersten Moment -dies sei zugestandennicht viel. Und doch brachen wir mit einem Korpus aus genau diesen Textgruppen in ein Projekt zur Untersuchung der Mehrdimensionalität des Textmusterwandels auf. Warum? Im Projektantrag, der 2018 bei der Deutschen Forschungsgemeinschaft einging, heißt es dazu: Zeitungen dürfen als repräsentativ für die öffentliche Kommunikation, die Erbauungsliteratur als repräsentativ für die religiöse Kommunikation betrachtet werden. Sie erschließen in ihrer Entwicklung zunehmend Leserkreise, die weit über die politischen und akademi-

This article assesses work ability in a sample of blue-collar workers who often perform physically demanding tasks. The data collected resulted in 354 validly completed questionnaires from 426 participants (response rate: approximately 90%). In this sample, the average score on WAI of workers is 37.42 (SD = 6.62), indicating good work ability. Regression analyses revealed that work ability was significantly associated skill discretion (β = 0.365, P = 0.001), home-work conflict (β = -0.199, P = 0.001), and work-home conflict (β = -0.320, P = 0.001). Of the psychosocial factors examined in this study, skill discretion was the most important factor associated with work ability. Therefore, it is necessary to develop measures that support this component.

Data on race-related differences in the clinical outcomes of Takotsubo syndrome are limited, particularly for Black patients. This study aimed to assess whether race and sex may have an additional impact on the inpatient mortality of patients with Takotsubo syndrome. A total of 4,628 patients from the United States' National Inpatient Sample from 2012 to 2016 were identified; propensity score analysis revealed a similar propensity score between Black patients (n = 2,314) and White patients (n = 2,314), which was used to balance observed covariates. Sex and age distributions were identical between the 2 groups. The groups were also similar in baseline characteristics, including cardiovascular risk factors. White patients were compared with Black patients on in-hospital outcomes and inpatient mortality. A logistic regression analysis was conducted to measure the difference in mortality based on race and sex. Compared with White patients, Black patients had a higher percentage of in-hospital complications, including cerebrovascular accidents (4.9% vs 2.5%, P ≤ .01), acute kidney injury (25% vs 19%, P ≤ .01); longer lengths of stay (8 vs 7 days, P ≤ .01); and higher inpatient mortality (6.1% vs 4.5%, P < .01). When analysis was conducted with race and sex combined, inpatient mortality was higher among Black men than among White women (odds ratio, 2.7 [95% CI, 1.80-3.95]; P ≤ .01). This study showed that Black patients with Takotsubo syndrome have higher in-hospital complications and inpatient mortality rates. When race and sex were combined, inpatient mortality was significantly higher among Black men than among either White men and women or Black women.

Objective: Overweight or obesity (OvOb) is a risk factor for the development of cardiometabolic complications. However, according to some investigators, OvOb developed without hypertension and insulin resistance may be considered as a benign phenotype. The aim of the present study was to investigate the prognostic significance of OvOb (BMI&gt; = 25 kg/m2) without concomitant metabolic abnormalities in young-to-middle-age subjects screened for stage 1 hypertension. Design and method: We examined 1208, 18-to-45-year-old participants from the HARVEST study. Mean age was 33.1 ± 8.6 years and BP 145.5 ± 10.6/93.5 ± 5.7 mmHg. Participants were classified into four groups according to whether they had OvOb or not (0/1) and had normal (group 0) or at least one abnormal (group 1) metabolic syndrome parameter (glucose, triglyceride, HDL-cholesterol, and average 24-hour BP). The predictive role of OvOb/metabolic group for incident hypertension and cardiovascular or renal events (MACE) was evaluated in Cox survival analyses, adjusting for other risk factors and several confounders. Results: ObOv was present in 51.1% of the participants and at least one metabolic abnormality was present in 74.5%. Among the subjects with OvOb, 20.2% had no metabolic abnormalities, 40.5% had one metabolic abnormality, and 39.3% had two or more metabolic abnormalities. During a median follow-up of 17.4 years, 80.6% of the participants developed hypertension requiring pharmacological treatment and 8.9% had a MACE. In adjusted Cox models, OvOb participants with at least one metabolic abnormality had an increased risk of incident hypertension (HR, 1.43; 95%CI,1.12 - 1.81, p = 0.003) and MACE (2.34,1.03 - 5.36, p = 0.043) compared to those with normal metabolic parameters. Among the participants with normal BMI, a similar metabolic-related increase in risk was found for the hypertension outcome (HR, 1.52;95%CI,1.21 - 1.92, p = 0.0003), but not for MACE (1.64,0.70 - 3.81, p = 0.25). In a Cox model in the whole population, when controlled for each other the metabolic group (0/1) was a predictor of hypertension (p &lt; 0.0001) and MACE (p = 0.028) whereas the ObOv group was not (p&gt;0.05). Conclusions: These data show that in young-to-middle-age people, an abnormal metabolic profile is an important predictor of future hypertension needing treatment and MACE. OvOb without metabolic abnormalities does not carry an increased risk of adverse outcomes.

PurposeTo investigate the prevalence of orthostatic hypertension and the association of the blood pressure (BP) level, supine BP decline, and white-coat effect with the orthostatic pressor response.MethodsWe studied 1275 young-to-middle-age individuals with stage-1 hypertension. Orthostatic response was assessed three times over a 3 month period. The white-coat effect was assessed at baseline and after 3 months, and was calculated as the difference between office and average 24 h BP. In 660 participants, urinary epinephrine and norepinephrine were also measured.ResultsAn orthostatic systolic BP increase ≥ 20 mmHg was observed in 0.6–1.2% of the subjects during the three visits. Using the 20 mmHg cut-off, the prevalence of orthostatic hypertension was 0.6%. An orthostatic BP increase of ≥ 5 mmHg was found in 14.4% of participants. At baseline, the orthostatic response to standing showed an independent negative association with the supine BP level (p < 0.001), the supine BP change from the first to third measurement (p < 0.001), and the white-coat effect (p < 0.001). Similar results were obtained in the 1080 participants assessed at the third visit. Urinary epinephrine showed higher values in the top BP response decile (systolic BP increase ≥ 6 mmHg, p = 0.002 versus rest of the group).ConclusionAn orthostatic systolic BP reaction ≥ 20 mmHg is rare in young adults. However, even lower BP increases may be clinically relevant. The BP level, the supine BP decline over repeated measurement, and the white-coat effect can influence the estimate of the BP response to standing and should be considered in clinical and pathogenetic studies.

Highly restrictive for immigrants and their children living on national territory (ius soli), Italian citizenship law is among the most generous for the descendants of its emigrants abroad (ius sanguinis). Italian citizenship gives access to one of the world’s most powerful passports in addition to important political rights, it is thus the most sought-after citizenship for non-resident co-ethnics. By shifting the focus to how the right to this citizenship is implemented, and notably the role of non-State intermediaries (legal and non-legal professionals), the article questions how a nation-State defines its borders, both legal and symbolic or cultural, and brings to light the socio-economic and socio-legal mechanisms behind a citizenship acquired “by the right of blood”.