University of Bergamo

Cardiac glycosides represent one of the oldest therapeutic pillars in medicine, although their role has progressively diminished in the modern era of neurohormonal therapy for heart failure (HF). Following publication of the Digitalis Investigation Group (DIG) trial in 1997, no randomized clinical trials evaluating this drug class were conducted for almost three decades, while observational studies and meta-analyses accumulated, often yielding conflicting results. The DIGIT-HF randomized clinical trial (2025) addressed a major unmet need by evaluating digitoxin in patients with HF with reduced ejection fraction in the contemporary era of guideline-directed medical therapy. Treatment with digitoxin was associated with favourable outcomes, including a reduction in the composite endpoint of all-cause mortality and hospitalizations for HF, thereby reopening a long-standing debate on the role of digitalis, which had remained marginal for many years. This article reviews the history of digitalis, the main evidence generated over recent decades, the evolution of clinical guidelines from 1997 to 2022, and the conceptual and clinical implications of the DIGIT-HF trial.

Pancreatic and periampullary cancers are among the most challenging malignancies. Centralization of care and multidisciplinary management have been associated with improved outcomes. In 2024,the Italian Ministry of Health established a national Steering Committee with the objective of defining a centralized model for the management of pancreatic and periampullary diseases and identifying the minimum requirements for referral centers across Italy. The Steering Committee met every four weeks through plenary and focused working groups. Using data from the National Agency for Regional Health Services and the National Outcome Program, all ICD-9 codes related to pancreatic, periampullary, and distal biliary diseases were analyzed. Criteria were developed according to international recommendations and structured into a Hub-and-Spoke network model. Pancreas Units(Hub centers) were defined as hospitals providing 24/7 multidisciplinary expertise, advanced diagnostic and interventional capabilities, and a minimum surgical volume of ≥ 30 pancreatic resections per year with 90-day mortality < 10% (target < 5% within 3 years). Spoke centers were required to adhere to standardized diagnostic–therapeutic pathways and participate in multidisciplinary team meetings, without performing pancreatic surgery. Based on catchment area analyses, one Hub center per 700,000–1,200,000 inhabitants was recommended. Additional requirements included structured multidisciplinary processes, standardized diagnostic pathways, and integration with national research and training networks. This national model provides a comprehensive framework for centralizing pancreatic and periampullary diseases care. By defining minimum standards, enhancing multidisciplinary coordination, and concentrating complex procedures in high-performance centers, this initiative aims to improve outcomes, reduce regional disparities, and create a sustainable national Pancreas Unit network.

Accent is a powerful, yet still socially acceptable, basis of discrimination that shapes interpersonal evaluations and access to opportunities, potentially disadvantaging entrepreneurs seeking funding. Bridging role congruity theory with sociolinguistic literature, we hypothesize that entrepreneurs whose regional accents align with the stereotypical entrepreneur are more likely to secure funding. We test this hypothesis in entrepreneurial pitching contexts using an observational study and two pre-registered experiments that manipulate entrepreneurs’ accents in pitch videos through a professional voice actor and AI. Across the UK, Italy, and the United States, the results support our hypothesis, providing robust evidence of accent-based discrimination in entrepreneurial fundraising.

To estimate the frequency and characterize the distinctive features of the serum electrophoretic pattern associated with polyclonal elevations of IgG4, and to evaluate its clinical relevance. A total of 127,827 serum protein electrophoresis (SPEP) analyses performed in our laboratory over two years were evaluated. Cases exhibiting suggestive morphology, an IgG4 concentration greater than 1.35 g/L, and no monoclonal component (MC) at serum immunofixation electrophoresis (SIFE) were classified as true positives. We selected 283 electropherograms from 112 individual patients. The characteristic morphological features included a narrow, bell-shaped rise in the anodal gamma globulin region, potentially mimicking an MC, a reduction in the albumin fraction, and an increased beta-2 globulin zone exhibiting a β-γ bridging pattern, without a necessary association with hypergammaglobulinemia and with normal IgA and IgM concentrations. SIFE revealed a pseudoclonal restriction, and the serum free light chain ratio was altered in 29 % of cases, complicating the interpretation of the serum protein profile. The observed frequency was 3 per 1,000 SPEPs. Notably, 59 % of newly identified cases with elevated IgG4 concentrations at our center during the study period were unexpectedly detected bySPEP. The SPEP pattern associated with elevated polyclonal IgG4 concentrations is significant not only as an MC mimicker to be recognised in the diagnostic workup of plasma cell dyscrasias, but also because, when confirmed by IgG4 measurement, it provides physicians with clinically relevant information, particularly within the context of IgG4-related conditions, potentially preventing unnecessary procedures that could harm the patient and delay diagnosis.

Assessing ground shaking at a high spatial resolution after a recent or future earthquake is crucial for a rapid impact assessment and risk management. This is particularly important in urban areas, where small-scale differences can significantly affect the impact of an earthquake on people and property. However, classical seismological networks are usually too sparse to capture the variability of ground shaking at such a high spatial resolution. In this study, we demonstrate how a multivariate spatial statistical model can enhance ShakeMaps by combining station data (e.g. peak ground accelerations) with information from Earthquake Network citizen science initiatives (e.g. smartphone accelerations). The statistical model accounts for the heterogeneity of the data sources in terms of spatial density, measurement uncertainty, and bias. The model achieves data fusion without the need for calibration relationships or co-located information and naturally provides ShakeMap uncertainty.We apply our approach to the highly monitored area of Campi Flegrei in Italy, where the Earthquake Network initiative involves around 9,000 participants and smartphones. By combining the data gathered from multiple seismic events, we also demonstrate how to generate a high-resolution amplification map of the area, which is useful for enhancing ground motion models.

Vassil Girginov and Katerina Girginova, consolidates a vast and often fragmented literature by treating sport not as a domain that merely "reflects" culture, but as a consequential arena where culture is made, produced, circulated, contested, institutionalized and monetized.The volume's most important achievement lies less in offering a single canonical theory, which handbooks rarely do, than in providing an integrative conceptual map that makes sport's cultural work legible across research traditions that do not always converse well: cultural sociology, media and communication, political economy, organization studies, and critical theory.As such, the book becomes an interesting resource to scholars and graduate students in sport studies and cultural sociology, and is equally relevant to communication researchers who treat sport as a high-density site of mediated meaning-making.At the same time, the book is also likely to serve policy-oriented readers interested in cultural governance and legitimacy, given that contemporary sport is increasingly assessed through public-facing narratives about integrity, inclusion, sustainability, and social impact (Manoli et al., 2020).In a field characterized by rapid platformization and intensifying political contestation (Petersen-Wagner & Lee Ludvigsen, 2025), a synthetic and agenda-setting reference work is itself a valuable intervention.

Abstract This paper offers a qualitative discussion about the possibility of achieving a more balanced relationship between excellence (via meritocracy) and pluralism (via diversity) in the allocation of public funding in economic research. The historical and methodological transformations that have shaped the discipline call for abandoning a strict meritocratic approach to funding in favour of supporting more varied research projects that still meet high standards of scientific research. Such an approach would help avoid distorting the endogenous evolution of economics, encouraging the development of new alternative research programs and fields alongside the traditional mainstream orthodox neoclassical perspective. Accordingly, we argue that the historical and methodological evolution of a discipline should be considered among the possible criteria policymakers adopt for funding research allocation. To support this argument, we first examine how mainstream pluralism has progressively counterbalanced economic imperialism, thus calling for a more inclusive definition of meritocracy that fosters major diversity also in funding allocation. We then offer a Schumpeterian interpretation of advantages and limitations of both strict meritocratic and pluralistic approaches to funding. The paper concludes with some policy recommendations to promote diversity in research funding as a means to reduce inequalities in academic contexts, particularly within the so-called “dismal science”.

With the rise of telecommunication systems in recent decades, the implications for human health have prompted a search for ways to reduce the impact of electromagnetic waves in buildings when necessary. A viable and promising solution to realize electromagnetic shielding could be the use of drywall panels coated with a biochar paste, as proposed in this study. Biochar (bio-charcoal), a low-cost and carbon-based material, can be obtained by the thermochemical conversion of different biomass sources. A commercial wood-based biochar thermally treated at 750 °C is considered in this work. Transmission coefficients of several gypsum board elements with a biochar coating are measured in the frequency K-band (18–27 GHz). In addition, the SE of a double panel configuration, obtained by joining two coated boards to form a multilayer structure, is evaluated. The results show that the biochar coating significantly enhances the SE compared to uncoated drywall. At the highest biochar loading investigated (0.20 g/cm2), the shielding effectiveness consistently exceeds 27 dB for single panels and 46 dB for double panels across the entire frequency band. These findings indicate that biochar-coated drywall systems offer a practical and sustainable solution for integrating electromagnetic shielding into building envelopes, paving the way for innovative applications in indoor exposure control.

Given a pair of non-negative random variables X and Y , we introduce a class of nonparametric tests for the null hypothesis that X dominates Y in the total time on test order. Critical values are determined using bootstrap-based inference, and the tests are shown to be consistent. The same approach is used to construct tests for the excess wealth order. As a byproduct, we also obtain a class of goodness-of-fit tests for the NBUE (New Better than Used in Expectation) family of distributions. • Bootstrap tests for the TTT and excess wealth orders. • Bootstrap tests for the NBUE property • Asymptotic properties are established under mild conditions. • Simulations and application to real data.