University Of Milano-Bicocca Research Articles

Corneal Endothelial Microscopy: Does a Manual Recognition of the Endothelial Cells Help the Morphometric Analysis Compared to a Fully Automatic Approach?

This study investigated whether manual integration in the recognition of the endothelial cells produces different outcomes of morphometric parameters compared to a fully automatic approach. Eight hundred and ninety endothelial images, originally acquired by the Perseus Specular Microscope (CSO, Florence, Italy), from seven positions of right and left corneas were selected from the database of the Research Centre in Optics and Optometry at the University of Milano-Bicocca. For each image selected, two procedures of cell identification were performed by the Perseus: an automatic identification and a manual-integrated procedure to add potential additional cells with the available editing tool. At the end of both procedures, the endothelial cell density (ECD), coefficient of variation (CV), and hexagonality (HEX) of the mosaic were calculated. The HEX in the two procedures was significantly different for all comparisons (p < 0.001), but clinically negligible. No significant differences were found for the CV and ECD in the images of both eyes irrespective of the corneal position of acquisition (except for ECD in three corneal portions, p < 0.05). To conclude, it is possible to recognise a significantly higher number of cells using the manual-integrated procedure than it is using the fully automatic one, but this does not change the morphological parameters achieved.

Evaluating the impact of a peer-education digital literacy course on older adults' digital skills and wellbeing: a mixed-methods study protocol.

The digital transition poses relevant challenges and opportunities for older adults in aging European societies. To unleash the potential of the digital transition in old age and avoid the risk of exclusion, digital education for older adults seems to be a valuable solution. One of the most suitable approaches to digital education for older adults appears to be the peer-to-peer approach. However, not much literature is available on this topic. Within the ACTIVE-IT project, we aimed to design, implement, and evaluate a digital peer education course for older adults, focusing specifically on the use of smartphones and daily utility apps, such as mailing, e-Gov, and e-commerce. The purpose of this contribution is to document the protocol adopted to evaluate the course. The course involved 32 participants aged 65 or older, who, between March 2024 and June 2024, divided into three groups, attended a 10-lesson weekly course taught by a peer. We aim to measure the effect of the course on participants' digital skills and their perceived wellbeing. To do so, we will adopt a mixed methods approach, employing: digital methods by collecting and analyzing data on participants' smartphone use (i.e., log data on smartphone use before/during/after the intervention); a quasi-experiment, collecting information on course participants' wellbeing before/after the course attendance using a questionnaire survey; ethnographic observation conducted during the course, observing interactions between subjects during the course. The study has been approved by the Ethic Committee of the University of Milano Bicocca (prot.nr. 167541/2024).

Health-Related Lifestyles among University Students: Focusing on Eating Habits and Physical Activity

The transition to higher education at University is a critical moment for young adults to acquire unhealthy habits regarding physical activity (PA) and adherence to a healthy diet. Negative behaviors might be maintained in the years to come with a major risk of suffering from a Non-Communicable Disease. This study aims to determine the relationship between diet and PA in the student community of University of Milano-Bicocca. Students between 18 and 30 years old completed an online survey (6949 students). Two analyses of covariance (ANCOVA), chi-square tests of independence, and a binomial logistic regression were performed to examine the relationship between adequacy of food consumption and PA, in association also with sociodemographic characteristics. Data show a strong correlation between behaviors analyzed, with a proportional positive association between PA and healthy diet. Nevertheless, a third of the sample students incur in incorrect habits for both diet and PA. Further, students performing intensive PA have the healthiest food consumption in general but the worst red meat and pork intake. Accordingly, men practice more PA but have a less adequate diet, exactly contrary to women. In conclusion, policies promoting consciousness of well-being would transform Universities into healthy hubs for virtuous habits.

Innovating the Use of Labour Market Intelligence Within European Universities

Abstract The “Innovating the Use of Labour Market Intelligence within European Universities” (LMI-EUniv) project, set within the Erasmus+ programme’s Key Action 2, represents a pioneering effort to harness Labour Market Intelligence (LMI) for enhancing the alignment between higher education offerings and labour market demands across Europe. This initiative, led by a consortium including the West University of Timisoara, University of Milano-Bicocca, University of Tallinn, Prospektiker, and the Luxembourg Institute of Socio-Economic Research, aimed to explore the current utilisation of labour market information and intelligence by European universities in planning and delivering their educational provisions. With a focus on fostering the congruence of educational supply with labour market demand through innovative learning and teaching methodologies, the project sought to empower Higher Education Institutions (HEIs) with the skills and competencies necessary to meet these challenges. By mapping essential LMI sources at a national level, examining the use of LMI across European HEIs, and developing a comprehensive training course and an online Labour Market Intelligence Hub, this project aspired to create an indispensable reference for HEIs. This article synthesises the project’s key findings, underscoring the critical role of labour market intelligence in adapting academic curricula to meet specific labour market needs, thereby contributing to the broader discourse on the integration of LMI in higher education and its implications for curriculum development, graduate employability, and the overarching alignment between education and labour market expectations.

University students’ perspectives towards digital mental health: a qualitative analysis of interviews from the cross-country ‘CAMPUS study’

IntroductionPoor mental health of university students is a growing concern for public health. Indeed, academic settings may exacerbate students’ vulnerability to mental health issues. Nonetheless, university students are often unable to seek mental health support due to barriers, at both individual and organisational level. Digital technologies are proved to be effective in collecting health-related information and in managing psychological distress, representing useful instruments to tackle mental health needs, especially considering their accessibility and cost-effectiveness.ObjectivesAlthough digital tools are recognised to be useful for mental health support, university students’ opinions and experiences related to such interventions are still to be explored. In this qualitative research, we aimed to address this gap in the scientific literature.MethodsData were drawn from “the CAMPUS study”, which longitudinally assesses students’ mental health at the University of Milano-Bicocca (Italy) and the University of Surrey (United Kingdom). We performed detailed interviews and analysed the main themes of the transcripts. We also performed a cross-cultural comparison between Italy and the United Kingdom.ResultsAcross 33 interviews, five themes were identified, and an explanatory model was developed. From the students’ perspective, social media, podcasts, and apps could be sources of significant mental health content. On the one hand, students recognised wide availability and anonymity as advantages that make digital technologies suitable for primary to tertiary prevention, to reduce mental health stigma, and as an extension of face-to-face interventions. On the other hand, perceived disadvantages were lower efficacy compared to in-person approaches, lack of personalisation, and difficulties in engagement. Students’ opinions and perspectives could be widely influenced by cultural and individual background.ConclusionsDigital tools may be an effective option to address mental health needs of university students. Since face-to-face contact remains essential, digital interventions should be integrated with in-person ones, in order to offer a multi-modal approach to mental well-being.Disclosure of InterestNone Declared

Understanding University Students' Perspectives towards Digital Tools for Mental Health Support: A Cross-country Study.

Organisational and individual barriers often prevent university students from seeking mental health support. Digital technologies are recognised as effective in managing psychological distress and as a source of health-related information, thus representing useful options to address mental health needs in terms of accessibility and cost-effectiveness. However, university students' experiences and perspectives towards such interventions are little known. We thus aimed to expand the existing base of scientific knowledge, focusing on this special population. Data were from the qualitative component of "the CAMPUS study", longitudinally assessing the mental health of students at the University of Milano-Bicocca (Italy) and the University of Surrey (UK). We conducted in-depth interviews and thematically analysed the transcripts using the framework approach. An explanatory model was derived from five themes identified across 33 interviews (15 for Italy, 18 for the UK). Students perceived that social media, apps, and podcasts could deliver relevant mental health content, ranging from primary to tertiary prevention. Wide availability and anonymity were perceived as advantages that make tools suitable for preventive interventions, to reduce mental health stigma, and as an extension of standard treatment. These goals can be hindered by disadvantages, namely lower efficacy compared to face-to-face contact, lack of personalisation, and problematic engagement. Individual and cultural specificities might influence awareness and perspectives on the use of digital technologies for mental health support. Although considering some specific features, digital tools could be a useful instrument to support the mental health needs of students. Since personal contact remains crucial, digital tools should be integrated with face-to-face interventions through a multi-modal approach.

Climate-related risk assessment in water safety plans: the case study of Acque Bresciane (Italy).

Acque Bresciane is a public company that manages the integrated water cycle for more than 580,000 inhabitants in the Province of Brescia, in the north of Italy, providing drinking water, waste water treatment, and sewer systems. Drinking water systems are supplied with different types of groundwater, springs, and surface water sources (from lakes and rivers) whose availability and quality can be affected by climate change events. A multidisciplinary team, in collaboration with the University of Milano Bicocca, developed a specific Water Safety Plan (WSP) risk matrix focusing on the evaluation of climate-related hazardous events and calculation of their likelihood of occurrence, also using thematic maps. Moreover, to reduce the residual risks, in the risk matrix, possible control measures are suggested, such as the activation of an emergency plan, the use of other water sources, storage tanks, and interconnection with other water distribution networks. This work shows a simple and effective tool that can be applied by drinking water utilities to evaluate climate-related catchment risks, using a WSP risk matrix, thematic maps, and possible control measures to reduce risks in terms of water quality and availability and to respond with resilience to changes.

Comparison of isometric strength in rotator cuff and scapulothoracic muscles between elite volleyball athletes versus non-athletes.

Volleyball is an exceptionally popular global sport that involves repetitive, rapid, powerful and wide overhead movements, which can seriously alter normal shoulder kinematics. A recognized hallmark of shoulder muscle balance is the ratio of shoulder external (ER) and internal (IR) rotators. By extension, objective measurement of shoulder muscles' strength could help identify at risk athletes and preempt those injuries by engaging in prescriptive strength training programs. This cross-sectional study measured the isometric strengths of 1) shoulder internal and external rotator muscles, as well as the 2) supraspinatus, 3) rhomboid, and 4) middle and inferior trapezius muscles, in addition to calculation of ER:IR ratios, in professional volleyball players as well as in non-athletes. Measurements were made for dominant- and non-dominant upper limbs, in different position of the body (supine and orthostatic) and in different position of upper limb (adducted and abducted position). Our subject population included 11 male professional volleyball players as well as 14 healthy male orthopedic interns from Orthopedics and Trauma school of University of Milano Bicocca. Strengths were assessed by a handheld dynamometer. Each subject's isometric strength was assessed in triplicate in each limb position through a "make test" procedure; the greatest of each triplicate value was the accepted measure of isometric strength. We observed a gradient in muscle strength in the scapulothoracic complex in both groups; the rhomboid, middle trapezius, and lower trapezius ranked from greatest to least strength, respectively. The data suggest also that intrarotators are stronger in rotation adducted position than in rotation abducted position; however, extrarotators seem to be weaker in rotation adducted position than in rotation abducted position. There is also some indication that force development is enhanced in the supine position compared with the orthostatic position. Our findings indicate a scapulothoracic strength gradient with a rank order of strength of the rhomboid>middle trapezius>lower trapezius. The data further suggest that volleyball players have stronger intrarotation in rotation adducted position than in the rotation abducted position, while extra rotation shows the opposite trend. Finally, our data suggest that force development is greater in the supine position compared to the orthostatic position.

The authors reply.

1 Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy. 2 Department of Emergency and Intensive Care, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy. The authors have disclosed that they do not have any potential conflicts of interest.

Pathologist Validation of a Machine Learning–Derived Feature for Colon Cancer Risk Stratification

Identifying new prognostic features in colon cancer has the potential to refine histopathologic review and inform patient care. Although prognostic artificial intelligence systems have recently demonstrated significant risk stratification for several cancer types, studies have not yet shown that the machine learning-derived features associated with these prognostic artificial intelligence systems are both interpretable and usable by pathologists. To evaluate whether pathologist scoring of a histopathologic feature previously identified by machine learning is associated with survival among patients with colon cancer. This prognostic study used deidentified, archived colorectal cancer cases from January 2013 to December 2015 from the University of Milano-Bicocca. All available histologic slides from 258 consecutive colon adenocarcinoma cases were reviewed from December 2021 to February 2022 by 2 pathologists, who conducted semiquantitative scoring for tumor adipose feature (TAF), which was previously identified via a prognostic deep learning model developed with an independent colorectal cancer cohort. Prognostic value of TAF for overall survival and disease-specific survival as measured by univariable and multivariable regression analyses. Interpathologist agreement in TAF scoring was also evaluated. A total of 258 colon adenocarcinoma histopathologic cases from 258 patients (138 men [53%]; median age, 67 years [IQR, 65-81 years]) with stage II (n = 119) or stage III (n = 139) cancer were included. Tumor adipose feature was identified in 120 cases (widespread in 63 cases, multifocal in 31, and unifocal in 26). For overall survival analysis after adjustment for tumor stage, TAF was independently prognostic in 2 ways: TAF as a binary feature (presence vs absence: hazard ratio [HR] for presence of TAF, 1.55 [95% CI, 1.07-2.25]; P = .02) and TAF as a semiquantitative categorical feature (HR for widespread TAF, 1.87 [95% CI, 1.23-2.85]; P = .004). Interpathologist agreement for widespread TAF vs lower categories (absent, unifocal, or multifocal) was 90%, corresponding to a κ metric at this threshold of 0.69 (95% CI, 0.58-0.80). In this prognostic study, pathologists were able to learn and reproducibly score for TAF, providing significant risk stratification on this independent data set. Although additional work is warranted to understand the biological significance of this feature and to establish broadly reproducible TAF scoring, this work represents the first validation to date of human expert learning from machine learning in pathology. Specifically, this validation demonstrates that a computationally identified histologic feature can represent a human-identifiable, prognostic feature with the potential for integration into pathology practice.

Mental health and COVID-19 in university students: a qualitative study comparing Italy and the UK

IntroductionThe worldwide spread of the COVID-19 pandemic affected all major sectors, including higher education. The measures to contain this deadly disease led to the closure of universities across the globe, introducing several changes in students’ academic and social experience. During the last two years, self-isolation together with the difficulties linked to online teaching and learning, have amplified psychological burden and mental health vulnerability of students.ObjectivesWe aimed to explore in depth students’ feelings and perspectives regarding the impact of the COVID-19 on their mental health and to compare these data among students from Italy and the UK.MethodsData were resulting from the qualitative arm of “the CAMPUS study”, a large ongoing project to longitudinally assess the mental health of university students enrolled at the University of Milano-Bicocca (Unimib, Italy) and the University of Surrey (UoS, Guildford, UK). We conducted in-depth interviews through the Microsoft Teams online platform between September 2021 and April 2022, and thematically analysed the transcripts.ResultsA total of 33 students (15 for Unimib and 18 for UoS), with a wide range of sociodemographic characteristics, were interviewed. Four themes were identified: i) impact of COVID-19 on students’ mental health; ii) causes of poor mental health; iii) most vulnerable subgroups; vi) coping strategies.Anxiety symptoms, social anxiety, and stress were frequently reported as negative effects of the pandemic, while the main sources of poor mental health were identified in loneliness, exceeding time online, unhealthy management of space and time, bad organization/communication with university, low motivation and uncertainty about the future. Freshers, international or off-campus students, as well as both extremely extroverted and introverted subjects, represented the most vulnerable populations, because of their extensive exposure to loneliness. Among coping strategies, the opportunity to take time for yourself, family support, and mental health support were common in the sample.Some differences were found comparing students from Italy and the UK. While at Unimib the impact of COVID-19 on mental health was mainly described in relation to academic worries and the inadequate organization of the university system, UoS students, familiar to the conviviality of campus life, explained these effects as a result of the drastic loss of social connectedness.ConclusionsThe current study highlights the key role of mental health support for university students, mainly during crisis times, and calls for measures to improve communication between students and the educational institution, as well as to encourage social connectedness.Disclosure of InterestNone Declared

Mental Health and COVID-19 in University Students: Findings from a Qualitative, Comparative Study in Italy and the UK

COVID-19 restrictions introduced several changes in university academic and social experience. Self-isolation and online teaching have amplified students' mental health vulnerability. Thus, we aimed to explore feelings and perspectives about the impact of the pandemic on mental health, comparing students from Italy and the UK. Data were collected from the qualitative portion of "the CAMPUS study", longitudinally assessing mental health of students at the University of Milano-Bicocca (Italy) and the University of Surrey (UK). We conducted in-depth interviews and thematically analysed the transcripts. The explanatory model was developed from four themes identified across 33 interviews: anxiety exacerbated by COVID-19; putative mechanisms leading to poor mental health; the most vulnerable subgroups; and coping strategies. Generalised and social anxiety resulted from COVID-19 restrictions by being associated with loneliness, excessive time online, unhealthy management of time and space and poor communication with the university. Freshers, international students, and people on the extremes of the introversion/extroversion spectrum, were identified as vulnerable, while effective coping strategies included taking advantage of free time, connection with family and mental health support. The impact of COVID-19 was mostly related to academic issues by students from Italy, whereas to the drastic loss of social connectedness by the UK sample. Mental health support for students has an essential role, and measures that encourage communication and social connectedness are likely to be beneficial.

From the Streets to the Judicial Evidence: Determination of Traditional Illicit Substances in Drug Seizures by a Rapid and Sensitive UHPLC-MS/MS-Based Platform

According to the 2021 World Drug Report, around 275 million people use drugs of abuse, and 36 million people suffer from addiction, fostering a thriving market for illicit substances. In Italy, 30,083 people were reported to the Judicial Authority for offenses in violation of the Italian Law D.P.R. 309/1990. These offences are sentenced after a qualitative-quantitative analysis of seized materials. Given the large quantity of seized drugs and the need to perform accurate analytical determinations, Italian forensic laboratories struggle to complete analyses in a short time, delaying the entire reporting process needed to achieve sentencing. For this purpose, an UHPLC-MS/MS-based platform was developed at the University of Milano-Bicocca to support law-enforcement authorities. Software was designed to easily manage street seizure acquisition, documentation registration, and sampling. A sensitive UHPLC-MS/MS method was fully validated for the quantification of the traditional illicit substances (cocaine, heroin, 6-MAM, morphine, amphetamine, methamphetamine, MDMA, ketamine, GHB, GBL, LSD, trans-∆9-THC, and THCA) at the ppb level. The final report is relayed to the Prefecture in 3-4 days, even within 24 h for urgent requests. The platform allows for semi-automatic data handling to minimize erroneous results for an accurate report generation by standardized procedures.

Critical Analysis of MXene Production with In‐Situ HF Forming Agents for Sustainable Manufacturing

AbstractInvited for this issue's Front Cover is the Research group of Prof. Riccardo Ruffo from University of Milano Bicocca (Italy). The cover picture shows schematically the synthesis of the MXene 2D material (on the right) using acidic solutions starting from the lamellar 3D MAX phase (on the left) avoiding the direct use of HF to improve the sustainability of the MXenes production. Read the full text of the Research Article at 10.1002/celc.202200891.

A Mobile App Leveraging Citizenship Engagement to Perform Anonymized Longitudinal Studies in the Context of COVID-19 Adverse Drug Reaction Monitoring: Development and Usability Study.

Over the past few years, studies have increasingly focused on the development of mobile apps as complementary tools to existing traditional pharmacovigilance surveillance systems for improving and facilitating adverse drug reaction (ADR) reporting. In this research, we evaluated the potentiality of a new mobile app (vaxEffect@UniMiB) to perform longitudinal studies, while preserving the anonymity of the respondents. We applied the app to monitor the ADRs during the COVID-19 vaccination campaign in a sample of the Italian population. We administered vaxEffect@UniMiB to a convenience sample of academic subjects vaccinated at the Milano-Bicocca University hub for COVID-19 during the Italian national vaccination campaign. vaxEffect@UniMiB was developed for both Android and iOS devices. The mobile app asks users to send their medical history and, upon every vaccine administration, their vaccination data and the ADRs that occurred within 7 days postvaccination, making it possible to follow the ADR dynamics for each respondent. The app sends data over the web to an application server. The server, along with receiving all user data, saves the data in a SQL database server and reminds patients to submit vaccine and ADR data by push notifications sent to the mobile app through Firebase Cloud Messaging (FCM). On initial startup of the app, a unique user identifier (UUID) was generated for each respondent, so its anonymity was completely ensured, while enabling longitudinal studies. A total of 3712 people were vaccinated during the first vaccination wave. A total of 2733 (73.6%) respondents between the ages of 19 and 80 years, coming from the University of Milano-Bicocca (UniMiB) and the Politecnico of Milan (PoliMi), participated in the survey. Overall, we collected information about vaccination and ADRs to the first vaccine dose for 2226 subjects (60.0% of the first dose vaccinated), to the second dose for 1610 subjects (43.4% of the second dose vaccinated), and, in a nonsponsored fashion, to the third dose for 169 individuals (4.6%). vaxEffect@UniMiB was revealed to be the first attempt in performing longitudinal studies to monitor the same subject over time in terms of the reported ADRs after each vaccine administration, while guaranteeing complete anonymity of the subject. A series of aspects contributed to the positive involvement from people in using this app to report their ADRs to vaccination: ease of use, availability from multiple platforms, anonymity of all survey participants and protection of the submitted data, and the health care workers' support.

Meet the Editors

Meet the Editors

Single-trial stimuli classification from detected P300 for augmented Brain–Computer Interface: A deep learning approach

The purpose of advanced Brain–Computer Interfaces (BCIs) is to connect the human brain with an external device without using the muscular system. To do this, they must effectively process mental activity and infer information on the users’ intentions and directives. This work proposes a novel and explainable BCI system capable of recognizing P300 deflection in single-trial EEGs with higher accuracy compared to the literature gold standard. Moreover, the proposed deep-learning approach allows us to go beyond the mere P300 detection, which is, to our best knowledge, the current state of the art. Indeed, we first identify the P300-related signal in the single-trial EEG signal, and then, we further discriminate the ERPs associated to the detected P300 between visual and auditory stimuli-related. To do this, we employ a CNN–LSTM neural network, which manages a 3D data representation of the acquired EEG signals. The performance of the approach is tested on experiments carried out on 22 subjects, revealing a 82.4% F1-score in P300 identification and 82.4% discriminating between visual and auditory stimuli. The employed algorithmic procedure also reports the most relevant each EEG channels in determining the predictions, adding interpretability to the proposed AI-based tools. These results pave the way for more sophisticated BCIs, capable of extending the set of available actions for the patients. The project was pre-approved by the Research Assessment Committee of the Department of Psychology (CRIP) for minimal risk projects, under the aegis of the Ethical Committee of University of Milano-Bicocca, on May 27th, 2019, protocol number RM-2019-193.

Information matters: attitude towards organ donation in a general university population web-survey in Italy

PurposeTransplantation extends and improves lives, but the shortage of organs is one of the main factors limiting the number of transplants in Italy, as well as in other countries. This study investigated the awareness about organ donation and the socio-demographic factors associated with donation will in a general population.Design/methodology/approachIn 2019, a survey was carried out by computer-assisted web interviewing. A questionnaire was sent via e-mail to 39,360 individuals (i.e. students, administrative and teaching staff of the University of Milano-Bicocca, Italy). The response rate was 10.6% and 4,191 weighted cases were used in the analysis.FindingsThis study showed a strong, positive attitude towards donation: over 96% of respondents stated to be keen on organ donation. Of the respondents, 40.8% considered themselves informed on medical procedures involving organ donation, and only 15.8% thought to have sufficient legal information. Overall, only 17.7% of respondents thought that the information available was sufficient to make informed decisions. According to the respondents, ethical and religious implications were the main reasons (30% of answers) that limited the level of information. Just 57.9% of respondents had already recorded their willingness to donate. Among them, renewal of the identity card was the most common motivation (55.8%) and the main motivation reported for lack of expression of donation will was the lack of opportunity or time (61.5%).Originality/valueA positive attitude towards donation demands a wide public education programme and opportunities to declare one's will to donate to increase the population of potential organ donors.

Simulation-Based Medical Education and Training Enhance Anesthesia Residents' Proficiency in Erector Spinae Plane Block.

BackgroundAdvances in regional anesthesia and pain management led to the advent of ultrasound-guided fascial plane blocks, which represent a new and promising route for the administration of local anesthetics. Both practical and theoretical knowledge of locoregional anesthesia are therefore becoming fundamental, requiring specific training programs for residents. Simulation-based medical education and training (SBET) has been recently applied to ultrasound-guided regional anesthesia (UGRA) with remarkable results. With this in mind, the anesthesia and intensive care residency program of the University of Milano-Bicocca organized a 4-h regional anesthesia training workshop with the BlockSim® (Accurate Srl, Cesena) simulator. Our study aimed to measure the residents' improvement in terms of reduction in time required to achieve an erector spinae plane (ESP) block.MethodsFifty-two first-year anesthesia residents were exposed to a 4-h training workshop focused on peripheral blocks. The course included an introductory theoretical session held by a locoregional anesthetist expert, a practical training on human models and mannequins using Onvision® (B. Braun, Milano) technologies, and two test performances on the BlockSim simulator. Residents were asked to perform two ESP blocks on the BlockSim: the first without previous practice on the simulator, the second at the end of the course. Trainees were also also asked to complete a self-assessment questionnaire.ResultsThe time needed to achieve the block during the second attempt was significantly shorter (131 [83, 198] vs. 68 [27, 91] s, p < 0.001). We also observed a reduction in the number of needle insertions from 3 [2, 7] to 2 [1, 4] (p = 0.002), and an improvement aiming correctly at the ESP from 30 (58%) to 46 (88%) (p < 0.001). Forty-nine (94%) of the residents reported to have improved their regional anesthesia knowledge, 38 (73%) perceived an improvement in their technical skills and 46 (88%) of the trainees declared to be “satisfied/very satisfied” with the course.ConclusionsA 4-h hands-on course based on SBET may enhance first-year residents' UGRA ability, decrease the number of punctures and time needed to perform the ESP block, and improve the correct aim of the fascia.

How to preserve healthy aging through nutritional strategies: The new approach of the Food Social Network (Food NET) project

BACKGROUND: Aging is a process that does not refer only to the accumulation of damage in a human being over time but rather to individual changes determined by genetic, lifestyle, social and environmental factors. Aging is one of the greatest known risk factors for most human diseases. An older person in good health has a good level of independence, weighs less on the national health system and plays a productive and active role in his/her community; thus, the concept of “healthy aging”, reflecting older adult-environment fit should be promoted. The interactions between lifestyle, including nutrition, and health play a fundamental role in the aging process; eating habits and eating behaviours are recognized as important modifiable factors potentially leading to a healthy “phenotype”. OBJECTIVE AND METHODS: A multidisciplinary consortium with three Italian universities (the University of Milano-Bicocca, University of Pavia and University of Calabria) and Italian Small-Medium Enterprises proposed the Food Social Network (Food NET) project. Food NET overall outcome is to achieve target-specific guidelines and exact technologies for accessible functional foods, aimed at improving the quality of life and nutritional status of citizens (aged&gt;65) of the Metropolitan City of Milan (Italy). CONCLUSIONS: This project is part of the “Smart Living” and food-related strategies aimed at responding to the needs of this target population, developing new food products, appropriate to meet the specific requirements and ensuring and promoting sustainable diets for healthy aging by effective food policy approaches.