National Recovery Plan Research Articles

Optimizing public investments: A Sustainable Economic, Environmental, and Social Investment Multi-criteria Decision Model (SEESIM)

One of the most important aspects for the economic and social growth of a country is high efficiency of public investments. This imperative has never been more critical, especially in the context of Europe and Italy, where the integration of environmental, economic, and social goals is essential to address the multifaceted challenges of the 21st century. This research introduces the Sustainable Economic, Environmental, and Social Investment Model (SEESIM), a novel multi-criteria decision-making framework designed to ensure the sustainability of projects as their validity over time, especially from a National Recovery and Resilience Plan perspective. Utilizing the Analytic Hierarchy Process (AHP), SEESIM integrates environmental, economic, and social criteria as useful tool to evaluate a project in the post-funding phase, ensuring a balanced approach to efficiency and sustainability. The model is adaptable to various regional contexts, providing a transparent and replicable methodology for assessing the impacts and costs of public investments. An experimental scenario demonstrates SEESIM’s utility in guiding investment decisions, highlighting its potential to significantly enhance the effectiveness of public resources in achieving long-term sustainability goals. SEESIM represents a pivotal advancement in sustainable development strategies, offering a comprehensive tool for integrating multi-dimensional sustainability criteria into public investment decisions.

A cross-sectional study on health behavior changes during COVID-19 among adults in Malaysia

IntroductionCOVID-19 has triggered significant disruptions globally, necessitating swift adaptations in individuals’ health behaviors.MethodsThis cross-sectional study was conducted during Phase Four of Malaysia’s National Recovery Plan and examines how the pandemic has affected health behaviors among adult Malaysians. The study gathered data online using convenience sampling with 1,004 respondents aged 18 and above. The research focused on diverse health domains, including eating habits, physical activity, smoking, alcohol consumption, and sleep patterns. The Wilcoxon Signed Rank test and descriptive statistics were employed to compare health behaviors before and after COVID-19.ResultsFindings indicate noteworthy shifts in eating behaviors, with increased water and fruit consumption (p < .001). The frequency of home-cooked meals stayed relatively stable despite declining dinner preference and increasing daily snacks. Physical activity declined, marked by increased sedentary behavior and screen time (p < .001). There were differences in the patterns of smoking and alcohol consumption; some had started these behaviors during the pandemic. Notably, intentions to quit smoking among respondents were more prominent than attempts to stop drinking. Respondents’ sleep patterns also changed, with more sleeping fewer than seven hours daily (p < .001).ConclusionThe study emphasizes the need for focused interventions to address new challenges by highlighting the impact on health behaviors. As Malaysia navigates the post-pandemic landscape, understanding and mitigating the persisting effects on health behaviors are crucial for promoting overall well-being.

A new digital model for Italian Integrated Home Care: strengths, barriers, and future implications

Abstract Issue/Problem After the COVID-19 pandemic, Italy’s National Health Service (NHS) is transforming by adopting telemedicine through its National Recovery and Resilience Plan, aiming to modernize healthcare delivery and ensure equity. In this plan Territorial Coordination Centers (COT) were designed to improve patient access and continuity of care. However, regulatory challenges hinder the widespread adoption of telemedicine. Our work describes the technical, structural, and operational aspects of the new Italian Integrated Home Care (IHC) digital model, addressing strengths, barriers, and future implications. Description of the problem The implementation of the IHC digital model faces multiple challenges. Italy’s poor technical infrastructure, especially in rural areas, hampers access to critical services. Resistance to change among rural systems and the elderly, coupled with low digital literacy, inhibits telemedicine adoption. Fragmentation in the NHS leads to resource disparities, particularly disadvantaging southern regions. Italy also grapples with a severe shortage of healthcare professionals, posing a threat to the model’s sustainability. Results The National Digital Health Agency enacts the IHC model by overseeing telemedicine services through a cloud-based protocol. Each Region provides “Basic Telemedicine Services”: healthcare professionals’ and patient teleconsultation, telemonitoring, teleassistance. Communication between services, infrastructures, and local health authorities is facilitated by a modular interoperability layer, ensuring data standards and quality. A national telemedicine dissemination portal will contain data on all telemedicine solutions provided. Lessons Clear communication is essential for telemedicine acceptance. COTs enhance coordination and management. Bridging the technology gap for disadvantaged groups, supporting frontline employees and addressing adoption factors is vital to overcome the challenges faced. Key messages • The National Digital Health Agency drives telemedicine services under the IHC model. Each region offers Basic Telemedicine Services, ensuring data standards, quality and interoperability of data. • Italy’s telemedicine adoption faces poor infrastructure, resistance and workforce shortages. Focusing on equity, healthcare workers support and bridging the technology gap will be key.

Monitoring the digital healthcare transition in Italy: Initiatives, metrics and feedback from Primary Care Physicians

Abstract Italy’s healthcare sector has undergone significant digital transformation since 2008, driven by national strategies and reforms overseen by the Ministry of Health, the Ministry of Economy and Finance, and the Agency for Digital Italy. Key initiatives include the establishment of centralized booking systems, electronic health records (EHR), ePrescription, dematerialization of medical reports and disease certificates, patient summary, and telemedicine services. Despite regional variations, progress in the EHR adoption has been notable. Ongoing investments under the 2021 National Recovery Plan aim to further enhance digital healthcare infrastructure by 2025 through the involvement of the Italian National Agency for Regional Healthcare Services (AGENAS). Currently, Italy monitors progress through comprehensive measurement frameworks tracking digital health initiatives’ implementation and impact. These encompass indicators reported quarterly by public healthcare facilities regarding the implementation of patient portals, regional registries, network infrastructure, regional EHR systems (i.e., n° of users), and digital laboratory reports. In parallel, we conducted a cross-sectional survey assessing knowledge, opinions and concerns among primary care physicians (PCPs) following the 2022 reform, which introduced Community Hospitals, Community Houses, and telemedicine in primary care. The survey highlighted mixed opinions and insufficient knowledge among PCPs regarding the novelties. Clearer communication and coordination with territorial services appears necessary. Many GPs are engaging in telemedicine, but digital literacy gaps remain, as only 35.7% believed they had necessary digital literacy. This is an insight into Italy’s digital health roadmap, mainly involving primary care and focusing on achievements, challenges, and future prospects in utilizing digital solutions across healthcare settings.

Insights into the Sex-Related Effects of Dietary Polyphenols and Metabolic Disruptors on Inflammatory and (Neuro) Endocrine Pathways in Obesity: The HEAL Project

Background: this study was performed under the umbrella of the Health Extended Alliance for Innovative Therapies, Advanced Lab Research, and Integrated Approaches of Precision Medicine (HEAL ITALIA) partnership and funded under the National Recovery and Resilience Plan, Mission 4 Component 2 Investment 1.3, and by the European Union. Objectives: the overall objective of the HEAL project is to identify innovative and effective therapeutic approaches to reduce disease burden. The present research falls within Spoke 7: Prevention Strategies: Integrated and gender medicine approaches for prevention strategies based on environmental, lifestyle, and clinical biometric data. Obesity represents a primary risk factor worldwide for the onset of numerous life-threatening diseases, including metabolic, cardiovascular, and neurological diseases. Environmental and gender-related factors influence obesity development. However, the molecular mechanisms underlying the effects of those agents on different organs of the human body are not fully understood yet. Methods: here, we present a study protocol aimed at shedding light on (i) the complex interplays among adipose tissue, brain and gut in obesity, and (ii) the effects of specific dietary components and environmental metabolism-disrupting compounds on those interactions. To this purpose, we combined ex vivo, in vitro, and in vivo approaches to gain additional knowledge about the molecular mechanisms underlying connections between organs. Conclusions: the data provided by this study will contribute to defining new targets for therapeutic and/or preventive interventions, thereby allowing more personalized approaches to nutrition.

Policy and organisational learning in judicial reform: evidence from Italy

The Italian judicial system is well-known for its substandard performance by comparison with its European peers. In this article, we analyse the implementation of an important reform of the Italian judicial system designed and implemented in the context of the National Recovery and Resilience Plan funded by Next Generation EU. The reform, launched in February 2022, involves the introduction of a new organisational structure (The Office for the Trial) staffed with 16,500 newly appointed judicial assistants, representing an increase of about one third of the total judicial workforce employed in Italy. By leveraging the concepts of policy and organisational learning (OL), we show that variation of the modes of policy learning observed in implementation design is linked with variation in the organisational models adopted by different judicial offices to implement the reform. Then, by connecting organisational models to OL and focusing on the performance of five selected sections within the Court of Appeal of Milan, we show that organisational models informed by reflexivity are associated with better performance than models informed by hierarchy. The study contributes to scholarship on policy and OL, as well as providing a first, albeit limited and exploratory, empirical evaluation of a strategic public sector reform.

BIG DATA, BUSINESS PROCESSES, AND MATHEMATICAL ALGORITHMS FOR MULTI-OBJECTIVE MANAGERIAL DECISION OPTIMIZATION

The use of Big Data and the engineering of business processes are becoming increasingly important for managing the business of companies and large international corporate groups. For more successful outcomes, even for complex interventions such as those of the PNRR (National Recovery and Resilience Plan), the use of mathematical models to assist management decisions represents a significant lever to optimize time, costs, and planned overall performance. This analytical approach strengthens traditional qualitative techniques like SWOT analysis and finds useful application in the optimal definition of any form of PPP (Public-Private Partnership), such as the recent “Partnership for Innovation” (PPI) included in the new procurement code. The scientific work developed from the systematic analysis of processes proposes a particular multi-objective mathematical model that uses a system of vectors in an m-dimensional reference space.

Governing the European Union's recovery and resilience facility: National ownership and performance‐based financing in theory and practice

AbstractThe Recovery and Resilience Facility (RRF) adopted in response to the COVID‐19 pandemic marks an important departure in European Union (EU) governance, as it introduces an innovative “demand‐driven, performance‐based” model aimed at overcoming the limitations of past policies seeking to promote national reforms. In this study, we set out the theoretical assumptions underlying the RRF governance model, and assess its practical effectiveness and legitimacy by analyzing the drafting, implementation, and monitoring of National Recovery and Resilience Plans in eight member states. The study concludes by assessing the strengths and weaknesses of the RRF's governance model, relating them to theoretical expectations derived from previous international experience with similar approaches elsewhere, and considers the implications for future EU policy. Our core argument is that while the RRF's governance design has reinforced national ownership and commitment to reform and investment objectives, its performance‐based financing system leads to a mechanical focus on formal verification of predetermined milestones and targets, with negative consequences for both effectiveness and legitimacy. Addressing these problems would require a redesign of the RRF's complete contracting approach, giving member states greater flexibility on the means for achieving agreed commitments, as well as for revising them, not only in response to unanticipated changes in objective circumstances, but also to lessons learned during the implementation process.

Strengthening accountability for tuberculosis policy implementation in South Africa: perspectives from policymakers, civil society, and communities

BackgroundTranslating health policy into effective implementation is a core priority for responding effectively to the tuberculosis (TB) crisis. The national TB Recovery Plan was developed in response to the negative impact that the COVID-19 pandemic had on TB care in South Africa. We aimed to explore the implementation of the TB Recovery Plan and develop recommendations for strengthening accountability for policy implementation for this and future TB policies.MethodsWe interviewed 24 participants working on or impacted by TB policy implementation in South Africa. This included perspectives from national, provincial, and local health department representatives, civil society, and community representatives. In-depth interviews were conducted in English and isiXhosa and we drew on reflexive thematic methods for analysis.ResultsParticipants felt that there was potential for COVID-19 innovations and urgency to influence TB policy development and implementation, including the use of data dashboards. Implementation of the TB Recovery Plan predominantly used a top-down approach to implementation (cascading from national policy to local implementers) but experienced bottlenecks at provincial level. Recommendations for closing the TB policy-implementation gap included using phased implementation and enhancing provincial-level accountability. Civil society organisations were concerned about the lack of provincial implementation data which impeded advocacy for improved accountability and inadequate resourcing for implementation. Community health workers were viewed as key to implementation but were not engaged in the policy development process and were often not aware of new TB policies. At local level, there were also opportunities to strengthen community engagement in policy implementation including through community-led monitoring. Participants recommended broader multi-stakeholder engagement that includes community and community health worker representatives in the development and implementation phases of new TB policies.ConclusionsCommunities affected by TB, with the support of civil society organisations, could play a bigger role in monitoring policy implementation at local level and need to be capacitated to do this. This bottom-up approach could complement existing top-down strategies and contribute to greater accountability for TB policy implementation.

Comparative physiological effects of antipsychotic drugs in children and young people: a network meta-analysis

The degree of physiological responses to individual antipsychotic drugs is unclear in children and adolescents. With network meta-analysis, we aimed to investigate the effects of various antipsychotic medications on physiological variables in children and adolescents with neuropsychiatric and neurodevelopmental conditions. For this network meta-analysis, we searched Medline, EMBASE, PsycINFO, Web of Science, and Scopus from database inception until Dec 22, 2023, and included randomised controlled trials comparing antipsychotics with placebo in children or adolescents younger than 18 years with any neuropsychiatric and neurodevelopmental condition. Primary outcomes were mean change from baseline to end of acute treatment in bodyweight, BMI, fasting glucose, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, prolactin, heart rate, systolic blood pressure (SBP), and QT interval corrected for heart rate (QTc) for patients receiving either active treatment or placebo. For multigroup trials reporting several doses, we calculated a summary value for each physiological variable for all doses. After transitivity assessment, we fitted frequentist random-effects network meta-analyses for all comparisons in the network. A Kilim plot was used to summarise the results for all treatments and outcomes, providing information regarding the strength of the statistical evidence of treatment effects, using p values. Network heterogeneity was assessed with τ, risk of bias of individual trials was assessed with the Cochrane Collaboration's Tool for Assessing Risk of Bias, and the credibility of findings from each network meta-analysis was assessed with the Confidence in Network Meta-Analysis (CINEMA) app. This study is registered on PROSPERO (CRD42021274393). Of 6676 studies screened, 47 randomised controlled trials were included, which included 6500 children (mean age 13·29 years, SD 2·14) who received treatment for a median of 7 weeks (IQR 6-8) with either placebo (n=2134) or one of aripiprazole, asenapine, blonanserin, clozapine, haloperidol, lurasidone, molindone, olanzapine, paliperidone, pimozide, quetiapine, risperidone, or ziprasidone (n=4366). Mean differences for bodyweight change gain compared with placebo ranged from -2·00 kg (95% CI -3·61 to -0·39) with molindone to 5·60 kg (0·27 to 10·94) with haloperidol; BMI -0·70 kg/m2 (-1·21 to -0·19) with molindone to 2·03 kg/m2 (0·51 to 3·55) with quetiapine; total cholesterol -0·04 mmol/L (-0·39 to 0·31) with blonanserin to 0·35 mmol/L (0·17 to 0·53) with quetiapine; LDL cholesterol -0·12 mmol/L (-0·31 to 0·07) with risperidone or paliperidone to 0·17 mmol/L (-0·06 to 0·40) with olanzapine; HDL cholesterol 0·05 mmol/L (-0·19 to 0·30) with quetiapine to 0·48 mmol/L (0·18 to 0·78) with risperidone or paliperidone; triglycerides -0·03 mmol/L (-0·12 to 0·06) with lurasidone to 0·29 mmol/L (0·14 to 0·44) with olanzapine; fasting glucose from -0·09 mmol/L (-1·45 to 1·28) with blonanserin to 0·74 mmol/L (0·04 to 1·43) with quetiapine; prolactin from -2·83 ng/mL (-8·42 to 2·75) with aripiprazole to 26·40 ng/mL (21·13 to 31·67) with risperidone or paliperidone; heart rate from -0·20 bpm (-8·11 to 7·71) with ziprasidone to 12·42 bpm (3·83 to 21·01) with quetiapine; SBP from -3·40 mm Hg (-6·25 to -0·55) with ziprasidone to 10·04 mm Hg (5·56 to 14·51) with quetiapine; QTc from -0·61 ms (-1·47 to 0·26) with pimozide to 0·30 ms (-0·05 to 0·65) with ziprasidone. Children and adolescents show varied but clinically significant physiological responses to individual antipsychotic drugs. Treatment guidelines for children and adolescents with a range of neuropsychiatric and neurodevelopmental conditions should be updated to reflect each antipsychotic drug's distinct profile for associated metabolic changes, alterations in prolactin, and haemodynamic alterations. UK Academy of Medical Sciences, Brain and Behaviour Research Foundation, UK National Institute of Health Research, Maudsley Charity, the Wellcome Trust, Medical Research Council, National Institute of Health and Care Research Biomedical Centre at King's College London and South London and Maudsley NHS Foundation Trust, the Italian Ministry of University and Research, the Italian National Recovery and Resilience Plan, and Swiss National Science Foundation.

Churches and Monasteries in Northern Transylvania in Planning Documents and in Tourism Development Projects Financed by European Funds

Churches and Monasteries in Northern Transylvania in Planning Documents and in Tourism Development Projects Financed by European funds. In the present paper we studied the manner in which county and regional authorities from Northern Transylvania view churches and monasteries located in this area as tourist landmarks. In order to do that, we analyzed the county and regional policies and strategies and looked for projects addressing cultural heritage in the area that were financed by European programmes. While highlighting the diverse tourism potential of the religious buildings, the counties’ development strategies also recommended the preservation and rehabilitation of the historical monuments and promoting them in an integrated manner, as parts of cultural and/or religious routes. These objectives have been realized mostly with the help of the European funds – more than 40 churches were renovated and more than 80 have been promoted using REGIO and INTERREG funds, and wooden churches in Maramureș and Sălaj counties and medieval churches in Satu Mare County were included in thematic routes. Moreover, the creation and promotion of more cultural tourism routes is one of the main objectives of the Romania’s National Recovery and Resilience Plan, adding more value to the region’s tourism potential. Keywords: cultural heritage, tourist routes, European funds, churches, Northern Transylvania.

Shaping Romania's National Recovery and Resilience Plan

During the shaping of Romania’s National Recovery and Resilience Plan (NRRP), an environment conducive to the creation of institutional arrangements for socio-centric governance was established. However, these arrangements were not enduring and could not modify the specific path dependency of state-centric governance arrangements. This research presents and analyzes perceptions regarding the extent and way Civil Society Organizations (CSOs) were engaged in the shaping process of Romania’s NRRP. Based on semi-structured interviews with the relevant CSOs, factors that have influenced the involvement of CSOs in shaping Romania’s NRRP about other European fund programming processes, the lessons learned from this process, as well as possibilities of enhancing the current governance regime specific to European funds management were examined.

Environmental quality between regulatory synthesis and project verification

Regulatory references governing design activities have gradually expanded, and national and EU regulations often overlap redundantly. This aspect is particularly evident in environmental obligations, where the Italian requirements about Minimum Environmental Criteria (CAM) have been supplemented by the constraints of the Do No Significant Harm principle (DNSH) introduced for all PNRR (National Recovery and Resilience Plan) measures. A process of rationalisation and synthesis has been conducted for the regulations to address their interpretational complexity, enabling the differentiation of overlaps and novel elements. The result is a tool to support designers, validating authorities and administrations responsible for measures. It is helpful in guiding design choices, monitoring compliance with different requirements and verifying environmental quality.

Europeanisation in the aftermath of COVID-19: the organisational adaptation of the central governance of the National Recovery and Resilience Plan in Italy

AbstractWhile much of the recent literature on the impact of COVID-19 has focussed on governance at the EU level and specific policy areas, the changing political institutional arrangements within the EU Member States themselves have received significantly less attention. This article aims to contribute filling this gap by asking: how, and to what extent, has the core executive in Italy changed to manage and implement the National Recovery and Resilience Plan (NRRP)? Italy has been heavily hit by the COVID-19 pandemic and has subsequently been allocated the largest proportion of the Next Generation EU (NGEU) funds: it is therefore a ‘most likely’ case of organisational adaptation. We argue that the implementation of the NRRP triggers centralisation of power in the core executive. Such concentration of power, however, takes different forms depending on the composition of the executive. We also find that ‘coordinative’ Europeanisation occurs through the continuous interaction and exchange between the executive actors (political and administrative) based in Rome and the European Commission in Brussels. Such interaction showcases the attempt to manage both further integration and politicisation of the EU. The collaboration between the European Commission and the national executive is based both on the recognition of the value of the political ownership of the NRRP and the importance of the EU support for post-pandemic recovery.

The Contribution of the National Recovery and Resilience Plan to the Development of Digital Skills in Romanian Public Administration

The Contribution of the National Recovery and Resilience Plan to the Development of Digital Skills in Romanian Public Administration

Agile Transformation through the Performing Management of It and Cyber Security Projects, at the Government Level

Abstract Modern theories of intelligence have developed from the observation that the person, throughout life, is in constant development. In order to be successful, certain conditions must be met. These conditions for achieving success in life depend on the skills that are formed during formal education, or at least should be pursued as goals, beyond the disciplines. In a current information society, the quality of life as well the perspectives of social change and economic development depend on information and its exploitation, especially in the institutional field of managing computer applications for the absorption of European funds, becoming a matter of national importance, with critical values for national security, characterized by the state of economic equilibrium. Scientific knowledge and information are of particular importance in the global information society by: supporting innovation through technology, promoting economic development through the use of emerging technologies, making decisions efficiently and transparently at government level. The implementation and use of intelligent technologies have a decisive role in the development of the degree of digitization of public services through non-refundable funding from European funds and the National Recovery and Resilience Plan. The reinvention of the government can be transformed into a reality through the digitization and computerization of the public administration, assuming the modernization of the infrastructure through specific sources of funding, such as European funds, ensuring security through advanced cyber protection and defense capabilities against possible vulnerabilities, risks or cyber-attacks. Achieving performance within the public institution requires an increased concern for innovation, creativity and change.

Linking crises: inter-crisis learning and the European Commission’s approach to the National Recovery and Resilience Plans

AbstractThe article examines potential linkages between the management of the Eurozone crisis and the EU’s economic response to the COVID-19 pandemic. It does so by focusing on the Commission and its approach to conditionality-based lending. The analysis employs the concept of inter-crisis learning to argue that the lessons the Commission drew from the Eurozone crisis informed its conditionality-related proposals for the National Recovery and Resilience Plans (NRRPs). By using qualitative data, including eight elite interviews, the article suggests that the Commission derived lessons regarding the design, negotiation, implementation, and monitoring of conditionality programs. These lessons led to cognitive changes within the organisation and to behavioral changes that were reflected in its proposals regarding the conditionality attached to NRRPs. The article contributes to the literature examining the EU’s economic response to the pandemic by discussing the Commission’s drivers and preferences during that period. It also complements the literature on coordinative Europeanisation by offering insights on how the European Commission shapes its proposals on conditionality-based lending; a central element of its relationship with member states when it comes to crisis management. Finally, it discusses the implications of the article’s main thesis for the process of European integration.

The effects of siRNA-mediated knockdown of AP-1 on pulmonary arterial and right ventricular dysfunction associated with cardiac and pulmonary fibrosis in cardiopulmonary disease

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Romania’s National Recovery and Resilience Plan, PNRR-III-C9-2022-I8, CF 93/15.11.2022, Financing Contract no. 760063/23.05.2023, and by the Romanian Academy Background Pulmonary hypertension (PH) is a complex multifactorial vascular pathology characterized by an increased pulmonary arterial pressure, vasoconstriction, remodelling of the pulmonary vasculature, thrombosis in situ and inflammation associated with right-side heart failure. Purpose Herein, we explored the potential beneficial effects of treatment with siRNA AP-1 on pulmonary arterial and right ventricular dysfunction and perivascular and interstitial fibrosis in pulmonary artery (PA), right ventricle (RV) and lung in an experimental animal model of monocrotaline (MCT)-induced pulmonary arterial hypertension. Methods Golden Syrian hamsters were divided into: (1) C group; (2) MCT group obtained by a single subcutaneous injection of 60 mg/kg MCT at the beginning of the experiment; (3) MCT- siRNA AP-1 group received a one-time subcutaneous dose of MCT and subcutaneous injections containing 100nM siRNA AP-1, every two weeks. All animal groups received water and standard chow ad libitum for 3 months. Results In comparison with the MCT group, siRNA AP-1 treatment had significant beneficial effects contributing to: (1) a reduction in TGF-β1/ET-1/IL-1β plasma concentrations; (2) a reduced level of cytosolic ROS production in PA, RV and lung, and ultrastructural improvements of these tissues; (3) a decrease of inflammatory and fibrotic marker expressions in PA (COL1A, Fibronectin, Vimentin, α-SMA, CTGF, Calponin, MMP-9), RV (COL1A, CTGF, Fibronectin, α-SMA, F-actin, OB-cadherin) and lung (COL1A, CTGF, Fibronectin, α-SMA, OB-cadherin), and an increase of endothelial marker expressions (CD31/VE-cadherin) in PA; (4) structural and functional recoveries of PA (reduced VTI/Vel, restored vascular response) and RV (enlarged internal cavity diameter in diastole, increased TAPSE/PRVOFs) associated with a decrease in systolic/diastolic blood pressure, and heart rate; (5) a reduced protein expression profile of AP-1S3/ pFAK/FAK/pERK/ERK and a significant decrease in the expression levels of miRNA-145, miRNA-210, miRNA-21, and miRNA-214 along with an increase of miRNA-124 and miRNA-204. Conclusion The siRNA AP-1-based therapy led to an improvement of pulmonary arterial and right ventricular function accompanied by a regression of perivascular and interstitial fibrosis in PA, RV and lung and a down-regulation of key inflammatory and fibrotic markers in MCT-treated hamsters.

Mapping Hydrogen Initiatives in Italy: An Overview of Funding and Projects

The global momentum towards hydrogen has led to various initiatives aimed at harnessing hydrogen’s potential. In particular, low-carbon hydrogen is recognized for its crucial role in reducing greenhouse gas emissions across hard-to-abate sectors such as steel, cement and heavy-duty transport. This study focuses on the presentation of all hydrogen-related financing initiatives in Italy, providing a comprehensive overview of the various activities and their geographical locations. The examined funding comes from the National Recovery and Resilience Plan (PNRR), from projects directly funded through the Important Projects of Common European Interest (IPCEI) and from several initiatives supported by private companies or other funding sources (hydrogen valleys). Specific calls for proposals within the PNRR initiative outline the allocation of funds, focusing on hydrogen production in brownfield areas (52 expected hydrogen production plants by 2026), hydrogen use in hard-to-abate sectors and the establishment of hydrogen refuelling stations for both road (48 refuelling stations by 2026) and railway transport (10 hydrogen-based railway lines). A detailed description of the funded initiatives (150 in total) is presented, encompassing their geographical location, typology and size (when available), as well as the funding they have received. This overview sheds light on regions prioritising decarbonisation efforts in heavy-duty transport, especially along cross-border commercial routes, as evident in northern Italy. Conversely, some regions concentrate more on local transport, typically buses, or on the industrial sector, primarily steel and chemical industries. Additionally, the study presents initiatives aimed at strengthening the national manufacturing capacity for hydrogen-related technologies, alongside new regulatory and incentive schemes for hydrogen. The ultimate goal of this analysis is to foster connections among existing and planned projects, stimulate new initiatives along the entire hydrogen value chain, raise an awareness of hydrogen among stakeholders and promote cooperation and international competitiveness.

Consumer participation in the credit market during the COVID-19 pandemic and beyond

Abstract This article analyses the consumer’s decision to apply for credit and the probability of the credit being accepted in the euro area during a period characterized by the unprecedented concomitance of events and changing borrowing conditions linked to the global coronavirus disease 2019 (COVID-19) pandemic and the Russian invasion of Ukraine. We use data between 2020Q1 and 2023Q2 from the ECB’s Consumer Expectations Survey. We find that credit demand is the highest when the first lockdown ends and it drops when supportive monetary compensation schemes are implemented. There is evidence that constrained households are significantly less likely to apply for credit. Credit is more likely to be accepted under favourable borrowing conditions and after the approval of national recovery plans. We also find that demographic, economic factors, perceptions, and expectations are associated with the demand for credit and the credit grant.