https://hdl.handle.net/10807/95494 Wed, 13 May 2026 19:42:41 GMT 2026-05-13T19:42:41Z https://hdl.handle.net/10807/335278 Titolo: The risk of cardiovascular events in the Italian adult population without prior history of CVD: a systematic review of follow-up studies Autori: Valentini, Ilaria; Arcelli, Maddalena; Gobbetti, Camilla; Volpi, Francesca; Conciarelli, Lorenzo; Boccia, Stefania; de Waure, Chiara Abstract: Background: Cardiovascular diseases (CVDs) remain the leading cause of mortality and morbidity in Europe. Understanding their burden is essential to planning effective public health responses. However, in Italy, comprehensive data on the incidence and lethality of major cardiovascular events, including myocardial infarction and stroke, are fragmented and heterogeneous. This review aims to assess the incidence of fatal and non-fatal major cardiovascular events in Italian adults without prior CVD.Methods: A systematic review was conducted according to the PRISMA 2020 guidelines and registered on PROSPERO (CRD42025624126). We searched PubMed and Web of Science to identify longitudinal studies involving Italian adults aged 18–65 years without baseline CVD. Data extracted from the selected studies included study design, population characteristics, follow-up, and results. Quality was assessed using the Newcastle-Ottawa Scale. The results were synthesised narratively and stratified by cardiovascular event and study design.Results: Nineteen studies were included, with a follow-up of 1–50 years. The incidence of coronary heart disease ranged from 10‰ per year to cumulative values as high as 46.5‰ over 40 years. The incidence of stroke ranged from 1.6‰ to 2.75‰ per year, with early lethality (28–30 days after the event) between 18.1% and 33%. Variability in estimates was associated with differences in study design, baseline population characteristics, endpoints definition, calendar period and geographical context.Conclusions: This systematic review highlights the enduring burden of CVD in Italy in the short- and long-term horizon. Although incidence and lethality have declined in recent decades, the findings underscore the importance of ongoing surveillance and tailored prevention strategies to control CVD in Italy. Thu, 01 Jan 2026 00:00:00 GMT https://hdl.handle.net/10807/335278 2026-01-01T00:00:00Z https://hdl.handle.net/10807/335277 Titolo: Cost-effectiveness analysis of lorlatinib as first-line treatment for anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer in Italy Autori: Valentini, Ilaria; Rumi, Filippo; Di Brino, Eugenio; Bearz, Alessandra; Pasello, Giulia; Novelli, Giuseppe; Di Virgilio, Roberto; Basile, Michele Abstract: Background: Lorlatinib is a third-generation anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitor (TKI) with high central nervous system penetration and activity against resistance mutations. Although its clinical efficacy as first-line treatment for ALK-positive advanced non–small cell lung cancer (NSCLC) has been demonstrated, its economic value within the Italian healthcare system remains to be fully established. This study evaluated the cost-effectiveness of lorlatinib compared with alectinib as first-line therapy in Italy. Methods: A partitioned survival model with three health states (progression-free, progressed disease, and death) was developed from the Italian National Health Service and societal perspectives over a 30-year time horizon. Clinical efficacy inputs were derived from the CROWN trial and indirect treatment comparisons using network meta-analysis. Costs (2026 euros) included drug acquisition, subsequent treatments, healthcare resource use, adverse events, end-of-life care, and societal costs. Health outcomes were expressed as life-years (LYs) and quality-adjusted life-years (QALYs). Deterministic, probabilistic, and scenario analyses were conducted to assess uncertainty. Results: In the base case, lorlatinib was dominant over alectinib, providing higher benefits (+2.01 LYs; +1.66 QALYs) at lower costs (–€19,210 per patient). This finding was robust across pricing scenarios. Probabilistic sensitivity analysis showed an almost 98,40% probability of cost-effectiveness at Italian willingness-to-pay thresholds. Conclusions: From both NHS and societal perspectives, lorlatinib represents a cost-saving and clinically superior first-line treatment option compared with alectinib for patients with ALK-positive advanced NSCLC in Italy. Thu, 01 Jan 2026 00:00:00 GMT https://hdl.handle.net/10807/335277 2026-01-01T00:00:00Z https://hdl.handle.net/10807/334137 Titolo: Perceptions, Expectations, and Adherence in Interstitial Lung Disease: Insights from a Multicentre Mixed-Methods Study Autori: Volpato, Eleonora; Buscemi, Agata A. M. D.; De Petro, Claudia; Silani, Margherita S; Mantero, Marco; Blasi, Francesco; Banfi, Paolo I Abstract: BACKGROUND AND AIMS: Interstitial lung diseases (ILD) are a heterogeneous group of chronic disorders leading to progressive lung damage and disability. While their physiological impact is well documented, the effects on quality of life, fatigue, and daily functioning remain less clear. Understanding how patients perceive their illness and treatments may offer new insights into adherence and self-management.1 This study examined whether illness perceptions and expectations influence adherence to antifibrotic therapy, oxygen therapy, and non-invasive ventilation. It also explored emotional responses, perceived barriers, and perceived benefits associated with illness and treatment in individualswith ILD.2 MATERIALS AND METHODS: This multicentre, prospective, mixed-methods study was conducted by IRCCS Fondazione Don Carlo Gnocchi, Milan, in collaboration with the Ospedale Maggiore Policlinico of Milan, Italy. Respiratory function, comorbidities, and treatment adherence were assessed at baseline (T0), 6 months (T1), and 12 months (T2). Psychological measures included the Brief Illness Perception Questionnaire (B-IPQ), Beliefs about Medication Questionnaire (BMQ), Medication Adherence Rating Scale-5I (MARS-5I), and Illness Cognition Questionnaire (ICQ). In parallel, semi-structured interviews were analysed using Interpretative Phenomenological Analysis to capture patients’ lived experiences and meanings attached to illness and treatment. RESULTS: A total of 125 adults with ILD were enrolled (median age: 73 years; 72% male). The present report focuses on preliminary data from 48 participants who completed at least one follow-up assessment. Full adherence was observed in 61.5% of patients for antifibrotic therapy and 68.0% for oxygen therapy. A significant negative correlation emerged between diffusing capacity for carbon monoxide and antifibrotic adherence (r=−0.571; p<0.001). No significant linear associations were detected between illness perceptions, medication beliefs, and adherence scores. However, exploratory analyses suggested a non-linear trend: patients with moderate illness perception scores showed the highest adherence across time, whereas those with very low or very high perceived illness threat tended to adhere less. From a cognitive perspective, ICQ scores remained relatively stable, but higher ‘Acceptance’ and ‘Perceived Benefits’ scores were observed in participants with sustained adherence. The qualitative strand identified four major themes describing patients’ lived experiences: 1) illness perception and uncertainty; 2) illness and treatment knowledge; 3) relationship with therapy and healthcare professionals; and 4) expectations of the future. Together, these findings suggest that adherence is not merely a behavioural outcome, but a dynamic process shaped by how patients understand and emotionally integratetheir illness.3,4 CONCLUSION: Adherence in ILD appears to be influenced by both medical and psychological factors, with illness perception profiles and perceived benefits being particularly relevant. Extreme perceptions, either minimising or catastrophising illness, may undermine long-term engagement with therapy. Strengthening education, emotional support, and individualised communication could help realign patients’ beliefs and expectations, thereby promoting adherence and improving quality of life.1 Future studies with the full sample will clarify whether specific cognitive–emotional patterns predict adherence trajectories, and may inform tailored psychosocial interventions in ILD care. Wed, 01 Jan 2025 00:00:00 GMT https://hdl.handle.net/10807/334137 2025-01-01T00:00:00Z https://hdl.handle.net/10807/331816 Titolo: The Human in the Loop: Scaling a Generational-Defining LegalTech Company from Milan to the World. In Conversation with Martina Domenicali, Co-Founder and CRO, LEXROOM Autori: pezzuto, ivo Abstract: This article, written by Dr. Ivo Pezzuto as part of the Forward Thinkers’ Talks Series, features an in-depth conversation with Martina Domenicali, Co-Founder and CRO of Lexroom, and examines a defining question reshaping Europe’s LegalTech landscape: can hyper-specialized, jurisdiction-native AI outperform horizontally scaled, general-purpose models in high-liability professions? In February 2026, the company surpassed €10 million in Annual Recurring Revenue (ARR)—by curating over six million localized legal documents to build a data-first, deeply verifiable AI platform tailored to civil-law systems—an inflection point that places it among Europe’s fastest-scaling AI ventures. The article investigates how depth-driven localization creates structural defensibility and how governance-by-design, source traceability, and human-in-the-loop workflows redefine professional practice. Evidence shows that precision and accountability—rather than generic LLM capability—drive sustained adoption, reflected in 93% retention and strong Net Revenue Retention. Contrasted with Anthropic’s horizontal plugin model, Lexroom’s approach signals a broader theoretical shift: in regulated domains, competitive advantage stems from embedding AI within institutional authority and workflow infrastructure. The implication for scholars and executives is clear—durable AI leadership will be secured not by scale alone, but by context-embedded intelligence that transforms technology into a trusted professional backbone. Thu, 01 Jan 2026 00:00:00 GMT https://hdl.handle.net/10807/331816 2026-01-01T00:00:00Z