Fondazione Lanza

This research explores the convergence of fractal information theory and fractal geometry within computational linguistics. It also examines the application of the NooJ tool for structural analysis. The study posits that fractal analysis in computational linguistics offers a framework understand language as an intricate, self-similar, and dynamic system. Patterns recur at multiple scales, such as phrases within sentences and sentences within paragraphs. Fractal analysis uses methodologies to identify non-normal distributions and long-range dependencies textual data. NooJ leverages finite-state technology to parse large corpora and construct linguistic resources, such as lexicons and grammars. Although NooJ primarily functions as a finite-state machine, its ability to manage recursive graph structures, particularly recursive transition networks, makes it suitable for analyzing fractal structures

BackgroundMobile health (mHealth) technologies are increasingly used in paediatric oncology to promote physical activity, with growing evidence supporting their feasibility and effectiveness. Augmented reality (AR) is emerging as a promising addition, offering interactive features that may enhance participation in exercise for young people. As mHealth tools evolve, understanding user experiences and implementation challenges is essential to inform wider adoption in healthcare. The FORTEe clinical trial evaluates an individualised exercise programme designed for children, adolescents and young adults with cancer (CAYA). This sub-study explores the perspectives of CAYA and exercise and healthcare professionals involved in delivering the exercise intervention (exercise professionals) on the use of a novel AR application (app), designed to facilitate home-based exercise as part of the broader intervention. Key app features include personalised exercise programmes, AR demonstrations using a child-like avatar, and an integrated exercise diary.MethodsCAYA (9–21 years), and exercise professionals from the FORTEe trial's technology sub-study (six centres) were eligible. To explore experiences and perceptions of the AR app, half-structured interviews were conducted with CAYA and an anonymous online survey administered to exercise professionals. Interview data and open-ended text from survey was analysed using inductive qualitative content analysis. Survey data was analysed using descriptive statistics.ResultsA total of 46 CAYA (mean age 13.6 ± 2.7 years, 39% female) provided feedback on the AR app via interviews, and 31 exercise professionals completed the survey. CAYA and exercise professionals reported generally positive experiences, finding the AR demonstrations novel and engaging. The personalised workouts were valued by both groups. However, both groups reported some technical difficulties that impacted reliability, and that some features, such as the exercise diary, lacked usability. Exercise professionals emphasised the app should complement rather than replace face-to-face sessions. To enhance the app further, both groups suggested incorporating gamification and avatar customisation.ConclusionThis study emphasises the potential of AR technology to increase engagement in exercise among CAYA and highlights ways to optimise the technology. While AR shows promise in paediatric oncology care, it should complement in-person exercise interventions. Future development should prioritise user-friendly design, personalised approaches, and equal access for young patients.

In Autoimmunology, interpretative comments can significantly improve the quality of information in laboratory reports. Laboratory autoimmunologists play an increasingly important role in supporting clinicians with the request and interpretation of tests, considering the growing complexity of autoimmune diagnostic and the increase in requests for autoimmune tests by non-specialist physicians. In 2024, the Study Group on Autoimmunology (GdS-AI) of the Italian Society of Clinical Pathology and Laboratory Medicine (SIPMeL) in collaboration with the Study Group of Extra-Analytical Quality (GdS-QuEA) developed a project with the aim to define interpretative comments for systemic autoimmune diseases and organ-specific autoimmune diseases. Based on the analysis of the comments used by GdS-AI laboratories in routine practice, the working group drafted a summary document including no. 47 interpretative comments (22 for systemic autoimmune diseases and 25 for organ-specific autoimmune diseases), representative of possible findings in autoimmune laboratory reports. The document is intended as a proposal of interpretative comments to support laboratory reporting. Furthermore, it defines the important role of the laboratory autoimmunologist in improving the informational quality of reports, while promoting harmonization and appropriateness of test ordering.

Patient and public involvement and engagement (PPIE) in research is crucial for producing knowledge that is meaningful to the participating community. Sharing PPIE principles into practical tools and strategies enriches the development of participatory research methodologies. This article describes the co-creation process of ProSafe, a Community-Based Participatory Research (CBPR) project conducted in Italy, which explores community perspectives on the reorganization of territorial healthcare toward proximity care. The aims are: (1) to describe the co-creation process, (2) to examine its successes and challenges, and (3) to propose strategies and practical recommendations for fostering partnerships and engagement throughout all research stages. The project is based on an explanatory sequential mixed-method design. A Patient Safety Council (PSC) acted as a co-researcher. The five-level spectrum of public engagement developed by the International Association for Public Participation (IAP2) guided the analysis of the decision-making power balance between academics and the PSC at each phase. Emphasis was given to the process of survey co-creation. A SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis was performed to identify strategies and practical recommendations to strengthen engagement. The SWOT analysis results informed the development of OPERA-PACT (Opening a Participatory and Equitable Research Agreement based on Partnership, Awareness, Collaboration, and Trust), a framework co-created with the PSC to formalize shared principles, values, and attitudes that sustain collaborative partnerships. The framework also includes a commitment to continuous monitoring, verification, and feedback to reinforce partnership over time. All instruments, strategies, and methodological insights proposed in the article may serve as practical support tools to strengthen the voice of communities in research and to contribute to the production of valid and translational results. Implementing the OPERA-PACT framework may further help align team members with PPIE principles and lay the foundation for effective and sustainable collaboration.

The FORTEe randomised controlled trial (NCT05289739) investigates an exercise intervention for children and adolescents undergoing cancer treatment. Conducting research with this vulnerable population poses unique ethical challenges, including participant burden, child autonomy, and parental decision-making. This study explored the ethical experiences of healthcare professionals (HCPs) involved in the trial. A multicentre survey was conducted across ten clinical sites in Europe using a structured, browser-based questionnaire comprising both closed and open-ended questions. Domains included burden and benefits assessment, informed consent, child autonomy, parental influence and moral distress. Quantitative responses were analysed descriptively, while qualitative data underwent content analysis. Seventy-nine HCPs participated, including exercise professionals (n = 30), physicians (n = 19), nurses (n = 8), psychologists (n = 5), social workers (n = 3), one social scientist, one medical ethicist and 12 individuals in other roles. A large majority of respondents (86.1%) agreed or strongly agreed that the overall burden-benefit balance of trial participation was appropriate, while 11.4% were unsure and 2.5% disagreed. Open-text responses described perceived challenges related to questionnaire burden, logistical demands, and emotional discomfort associated with control-group allocation. Informed consent procedures were generally perceived as appropriate. However, some respondents reported situations in which parental influence appeared to outweigh children’s expressed preferences, and difficulties were noted in assessing children’s evolving decision-making capacity. Among HCPs who described prognosis-related events (n = 45), 68.9% described experiences they associated with moral distress, particularly in relation to communication and decisions regarding continuation of participation. The trial's ethical climate was largely perceived as positive, though emotional and logistical burdens were noted. Reports of emotional discomfort and moral distress among staff highlight the ethical tensions between research integrity and individual well-being. Furthermore, divergent views on children’s capacity to give consent suggest the need for clearer guidance on paediatric autonomy and shared decision-making. Ethically sound paediatric research must address real-world burdens and emotional dynamics beyond procedural compliance. Findings from the FORTEe trial staff survey highlight the importance of flexible, child-centred approaches, sustainable access to beneficial interventions, and institutional structures that promote ethical reflection. Registered on ClinicalTrials.gov (NCT05289739, 21 March 2022) and in the German Clinical Trials Register (DRKS00027978, 28 January 2022).

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Background Despite the strong emphasis in recent scientific literature on the pharmacological features of CAR‐T cells, patients’ quality of life (QoL) and needs, by contrast, have received little attention. Aim This study aims to investigate patients’ perspectives on their QoL and needs in a referral centre for CAR‐T cell treatment in Italy. Methods This is a descriptive, qualitative and prospective study conducted at a single centre. Patients were recruited from a list of those who underwent the treatment or who were eligible to do so. Patients were asked to participate in a semistructured interview. The number of people to be interviewed was not predetermined but was established continuously until meaning saturation was achieved. The interviews were audio recorded, transcribed verbatim, and analysed through constructivist lenses using reflexive thematic analysis. Results Participants were 12 patients (age mean: 57.88; SD = 9.62; range = 39–70) enrolled in an Italian Comprehensive Cancer Center. From the analysis of the interviews, 7 themes were identified: (1) therapeutic journey to reach CAR‐T cell therapy; (2) CAR‐T cell images; (3) perception of the quality of care received; (4) three challenging moments; (5) emerging issues to address; (6) coping strategies and (7) needs. Some themes have been organised into subthemes that detail their specific aspects. Starting from the quotations, 41 needs have been identified and organised into 5 macro areas: (1) needs during hospitalisation; (2) existential needs; (3) needs for improving QoL; (4) need for quality and quantity of information and (5) needs for care. The list of needs has been transformed into a checklist, serving as a preliminary step for subsequent studies aimed at identifying and quantifying the needs of patients. Conclusions Results indicate that the QoL of patients undergoing CAR‐T cell therapy is impaired during hospitalisation and in the subsequent months following infusion. Physical symptoms including fatigue, drowsiness, cognitive slowing or dysfunction emerged. Nonetheless, patients employ various coping strategies to cope with these challenging periods. A multitude of needs, often unaddressed, has emerged. For this matter, a first draft for a checklist of needs has been realised. Should future studies validate its structure, this tool may prove beneficial in both clinical and research settings to identify and monitor patients’ needs throughout the continuum of their treatment pathway.

An efficient, reliable, and cost-effective sensor of 2,3-butanedione, an organic compound with a distinctive buttery aroma, is here developed through the production of a sensible layer based on a tin oxide semiconductor decorated with platinum nanoparticles. The resulting material is subjected to characterization and testing to evaluate its capability to sense 2,3-butanedione, which is known to be responsible for health risks upon inhalation, including the potential to cause lung disease, and to be detected in the breath of individuals with cystic fibrosis. The results demonstrate that the developed sensor provides high sensitivity and selectivity for 2,3-butanedione in specific experimental conditions, featuring advantages such as simplicity, portability, and rapid response. In addition, it shows great potential for on-site safety and health applications, providing a practical solution for real time monitoring.