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Background: Head elevation is recommended as a tier zero measure to decrease high intracranial pressure (ICP) in neurocritical patients. However, its quantitative effects on cerebral perfusion pressure (CPP), jugular bulb oxygen saturation (SjvO2), brain tissue partial pressure of oxygen (PbtO2), and arteriovenous difference of oxygen (AVDO2) are uncertain. Our objective was to evaluate the effects of head elevation on ICP, CPP, SjvO2, PbtO2, and AVDO2 among patients with acute brain injury. Methods: We conducted a systematic review and meta-analysis on PubMed, Scopus, and Cochrane Library of studies comparing the effects of different degrees of head elevation on ICP, CPP, SjvO2, PbtO2, and AVDO2. Results: A total of 25 articles were included in the systematic review. Of these, 16 provided quantitative data regarding outcomes of interest and underwent meta-analyses. The mean ICP of patients with acute brain injury was lower in group with 30° of head elevation than in the supine position group (mean difference [MD] − 5.58 mm Hg; 95% confidence interval [CI] − 6.74 to − 4.41 mm Hg; p < 0.00001). The only comparison in which a greater degree of head elevation did not significantly reduce the ICP was 45° vs. 30°. The mean CPP remained similar between 30° of head elevation and supine position (MD − 2.48 mm Hg; 95% CI − 5.69 to 0.73 mm Hg; p = 0.13). Similar findings were observed in all other comparisons. The mean SjvO2 was similar between the 30° of head elevation and supine position groups (MD 0.32%; 95% CI − 1.67% to 2.32%; p = 0.75), as was the mean PbtO2 (MD − 1.50 mm Hg; 95% CI − 4.62 to 1.62 mm Hg; p = 0.36), and the mean AVDO2 (MD 0.06 µmol/L; 95% CI − 0.20 to 0.32 µmol/L; p = 0.65).The mean ICP of patients with traumatic brain injury was also lower with 30° of head elevation when compared to the supine position. There was no difference in the mean values of mean arterial pressure, CPP, SjvO2, and PbtO2 between these groups. Conclusions: Increasing degrees of head elevation were associated, in general, with a lower ICP, whereas CPP and brain oxygenation parameters remained unchanged. The severe traumatic brain injury subanalysis found similar results. [ABSTRACT FROM AUTHOR]

• Persistence of a right-to-left shunt during intrauterine life and childhood appears to influence normal cardiac development. • Remnants of right venous valves can represent an unrecognized cause of dyspnea and cyanosis in early post-natal life. • Remnants of the venous valves are rare and likely underreported in fetal imaging, despite potential pathological consequences. • Prenatal diagnosis can be helpful in planning fetal surveillance identifying the newborns at risk of hypoxia or heart failure. • The dilation and overload of the right atrium may contributed to the development of fetal and neonatal arrhythmia. During fetal life the right valve of the sinus venosus directs oxygenated blood from the inferior vena cava to the left atrium through the foramen ovale, until the regression of the right valve which usually occurs within the 15th week of pregnancy. Incomplete regression of the right venous valve in varying degrees can lead to different types of remnants such as the Eustachian valve, the Chiari Network and Cor Triatriatum Dexter. Prenatal diagnosis of remnants of right venous valve has only rarely been reported in the literature. We present a case of prenatal diagnosis of Chiari Network associated with severe tricuspid regurgitation, further complicated by tachyarrhythmia and signs of fetal heart failure with the appearance of abundant pleural and ascitic effusion. A cesarean section was performed at 32 weeks. After 48 h of life, because of persistence of atrial flutter, an electrical cardioversion was performed. The physical examination 7 months after being discharged showed a normal growth, good condition and persistence of mild tricuspid regurgitation. We also reviewed the available evidence on persistent right venous valve diagnosed in utero or early postnatal life. In conclusion we believe that prenatal recognition is helpful in planning fetal surveillance identifying those newborns at risk of dyspnea, cyanosis or neonatal heart failure. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions The present observational cross‐sectional study aimed at investigating the prevalence of feeding and eating disorders (FEEDs) in adults with intellectual disability (ID)/intellectual developmental disorder (IDD) with or without autism spectrum disorder (ASD) and specific problem behaviours (PBs).Two hundred six adults with ID/IDD consecutively attending residential and rehabilitative facilities, 59.2% of which had co‐occurring ASD, were assessed for presence of FEEDs by a structured interview specifically developed for the study and Diagnostic Manual – Intellectual Disability criteria.The 4.3% of the sample fully met the diagnostic criteria for anorexia nervosa, 6.7% for bulimia nervosa (BN) and 22.8% for binge eating disorder (BED). Furthermore, at least one observable symptom of these disorders was found in higher percentages of the sample. A higher prevalence of FEEDs was found in ID/IDD plus ASD than in ID/IDD alone. PBs were also significantly higher in participants with co‐occurring ASD and had a positive correlation with the number of FEED symptoms, especially for BN and BED.The study enriches previous literature and considers novel aspects such as the behavioural/observable presentation of symptoms as well as the association with ASD and PBs. These issues deserve a specific consideration within standard psychiatric assessment and future research, especially in persons with major communication and/or cognitive difficulties. [ABSTRACT FROM AUTHOR]

Background: Rib fractures are one of the most common traumatic injuries and may result in significant morbidity and mortality. Despite growing evidence, technological advances and increasing acceptance, surgical stabilization of rib fractures (SSRF) remains not uniformly considered in trauma centers. Indications, contraindications, appropriate timing, surgical approaches and utilized implants are part of an ongoing debate. The present position paper, which is endorsed by the World Society of Emergency Surgery (WSES), and supported by the Chest Wall Injury Society, aims to provide a review of the literature investigating the use of SSRF in rib fracture management to develop graded position statements, providing an updated guide and reference for SSRF. Methods: This position paper was developed according to the WSES methodology. A steering committee performed the literature review and drafted the position paper. An international panel of experts then critically revised the manuscript and discussed it in detail, to develop a consensus on the position statements. Results: A total of 287 studies (systematic reviews, randomized clinical trial, prospective and retrospective comparative studies, case series, original articles) have been selected from an initial pool of 9928 studies. Thirty-nine graded position statements were put forward to address eight crucial aspects of SSRF: surgical indications, contraindications, optimal timing of surgery, preoperative imaging evaluation, rib fracture sites for surgical fixation, management of concurrent thoracic injuries, surgical approach, stabilization methods and material selection. Conclusion: This consensus document addresses the key focus questions on surgical treatment of rib fractures. The expert recommendations clarify current evidences on SSRF indications, timing, operative planning, approaches and techniques, with the aim to guide clinicians in optimizing the management of rib fractures, to improve patient outcomes and direct future research. [ABSTRACT FROM AUTHOR]

Diabetic retinopathy (DR) is a common complication of diabetes characterized by vascular pathology and neuroinflammation. Pentraxin 3 (PTX3) is a soluble pattern recognition molecule that functions at the crossroads between innate immunity, inflammation, and tissue remodeling. DR is known to involve inflammatory pathways, although the potential relevance of PTX3 has not been explored. We found that PTX3 protein levels increased in the retina of diabetic mice. Similarly, evaluation of a publicly available transcriptomic human dataset revealed increased PTX3 expression in DR with diabetic macular edema and proliferative retinopathy, when compared to nondiabetic retinas or diabetic retinas without complications. To further understand the role of PTX3 within DR, we employed the streptozotocin-induced diabetes model in PTX3 knockout mice (PTX3KO), which were followed up for 9 mo to evaluate hallmarks of disease progression. In diabetic PTX3KO mice, we observed decreased reactive gliosis, diminished microglia activation, and reduced vasodegeneration, when compared to diabetic PTX3 wild-type littermates. The decrease in DR-associated pathological features in PTX3KO retinas translated into preserved visual function, as evidenced by improved optokinetic response, restored b-wave amplitude in electroretinograms, and attenuated neurodegeneration. We showed that PTX3 induced an inflammatory phenotype in human retinal macroglia, characterized by GFAP upregulation and increased secretion of IL6 and PAI-1. We confirmed that PTX3 was required for TNF-α-induced reactive gliosis, as PTX3KO retinal explants did not up-regulate GFAP in response to TNF-α. This study reveals a unique role for PTX3 as an enhancer of sterile inflammation in DR, which drives pathogenesis and ultimately visual impairment. [ABSTRACT FROM AUTHOR]

Background: Over the past three decades, our understanding of sleep apnea in women has advanced, revealing disparities in pathophysiology, diagnosis, and treatment compared to men. However, no real-life study to date has explored the relationship between mask-related side effects (MRSEs) and gender in the context of long-term CPAP. Methods: The InterfaceVent-CPAP study is a prospective real-life cross-sectional study conducted in an apneic adult cohort undergoing at least 3 months of CPAP with unrestricted mask-access (34 different masks, no gender specific mask series). MRSE were assessed by the patient using visual analog scales (VAS). CPAP-non-adherence was defined as a mean CPAP-usage of less than 4 h per day. The primary objective of this ancillary study was to investigate the impact of gender on the prevalence of MRSEs reported by the patient. Secondary analyses assessed the impact of MRSEs on CPAP-usage and CPAP-non-adherence depending on the gender. Results: A total of 1484 patients treated for a median duration of 4.4 years (IQ25–75: 2.0–9.7) were included in the cohort, with women accounting for 27.8%. The prevalence of patient-reported mask injury, defined as a VAS score ≥ 5 (p = 0.021), was higher in women than in men (9.6% versus 5.3%). For nasal pillow masks, the median MRSE VAS score for dry mouth was higher in women (p = 0.039). For oronasal masks, the median MRSE VAS score for runny nose was higher in men (p = 0.039). Multivariable regression analyses revealed that, for both women and men, dry mouth was independently and negatively associated with CPAP-usage, and positively associated with CPAP-non-adherence. Conclusion: In real-life patients treated with long-term CPAP, there are gender differences in patient reported MRSEs. In the context of personalized medicine, these results suggest that the design of future masks should consider these gender differences if masks specifically for women are developed. However, only dry mouth, a side effect not related to mask design, impacts CPAP-usage and non-adherence. Trial Registration: InterfaceVent is registered with ClinicalTrials.gov (NCT03013283).First registration date is 2016–12-23. [ABSTRACT FROM AUTHOR]

Fusobacterium necrophorum is a Gram-negative anaerobic bacterium responsible for localized infections of the oropharynx that can evolve into bacteremia and/or septic thrombophlebitis of the jugular vein or peritonsillar vein, called Lemierre’s syndrome. To identify microbial genetic determinants associated with the severity of this life-threatening disease, 70 F. necrophorum strains were collected and grouped into two categories according to the clinical presentation: (i) localized infection, (ii) bacteremia with/without Lemierre’s syndrome. Comparative genomic analyses revealed two clades with distinct genetic content, one clade being significantly enriched with isolates from subjects with bacteremia. To identify genetic determinants contributing to F. necrophorum pathogenicity, genomic islands and virulence factor orthogroups (OVFs) were predicted. The presence/absence profiles of OVFs did not group isolates according to their clinical category, but rather according to their phylogeny. However, a variant of lktA, a key virulence factor, with a frameshift deletion that results in two open reading frames, was associated with bacteremia. Moreover, a genome-wide association study identified three orthogroups associated with bacteremic strains: (i) cas8a1, (ii) a sodium/solute symporter, and (iii) a POP1 domain-containing protein. Further studies must be performed to assess the functional impact of lktA mutation and of these orthogroups on the physiopathological mechanisms of F. necrophorum infections. [ABSTRACT FROM AUTHOR]

This paper presents a detailed characterization of the positron beam delivered by the Beam Test Facility at Laboratori Nazionali of Frascati to the PADME experiment during Run III, which took place from October to December 2022. It showcases the methodology used to measure the main beam parameters such as the position in space, the absolute momentum scale, the beam energy spread, and its intensity through a combination of data analysis and Monte Carlo simulations. The results achieved include an absolute precision in the momentum of the beam to within ~1–2 MeV/c, a relative beam energy spread below 0.25%, and an absolute precision in the intensity of the beam at the level of 2%. [ABSTRACT FROM AUTHOR]

Distal nerve transfers can restore precise motor control in tetraplegic patients. When nerve transfers are not successful, tendon transfers may be used for subsequent reconstruction. In this case, an extensor carpi radialis brevis (ECRB) tendon transfer was used to restore thumb and finger flexion following an unsuccessful ECRB to anterior interosseous nerve transfer in a young tetraplegic patient. Twelve months following tendon transfer, the patient demonstrated functional grip and pinch strength and was using both hands for daily activities. Level of Evidence: Level V (Therapeutic) [ABSTRACT FROM AUTHOR]

Background: Biparametric MRI (bpMRI) has an important role in the diagnosis of prostate cancer (PCa), by reducing the cost and duration of the procedure and adverse reactions. We assess the additional benefit of the ADC map in detecting prostate cancer (PCa). Additionally, we examine whether the ADC value correlates with the presence of clinically significant tumors (csPCa). Methods: 104 peripheral lesions classified as PI-RADS v2.1 score 3 or 3+1 at the mpMRI underwent transperineal MRI/US fusion-guided targeted biopsy. Results: The lesions were classified as PI-RADS 3 or 3+1; at histopathology, 30 were adenocarcinomas, 21 of which were classified as csPCa. The ADC threshold that maximized the Youden index in order to predict the presence of a tumor was 1103 (95% CI (990, 1243)), with a sensitivity of 0.8 and a specificity of 0.59; both values were greater than those found using the contrast medium, which were 0.5 and 0.54, respectively. Similar results were also found with csPCa, where the optimal ADC threshold was 1096 (95% CI (988, 1096)), with a sensitivity of 0.86 and specificity of 0.59, compared to 0.49 and 0.59 observed in the mpMRI. Conclusions: Our study confirms the possible use of a quantitative parameter (ADC value) in the risk stratification of csPCa, by reducing the number of biopsies and, therefore, the number of unwarranted diagnoses of PCa and the risk of overtreatment. [ABSTRACT FROM AUTHOR]

Matching of various chalcogenide films shows the advantage of delivering multilayer heterostructures whose physical properties can be tuned with respect to the ones of the constituent single films. In this work, (Ge–Sb–Te)-based heterostructures were deposited by radio frequency sputtering on Si(100) substrates and annealed up to 400 °C. The as-deposited and annealed samples were studied by means of X-ray fluorescence, X-ray diffraction, scanning transmission electron microscopy, electron energy loss spectroscopy and Raman spectroscopy. The heterostructures, combining thermally stable thin layers (i. e. Ge-rich Ge5.5Sb2Te5, Ge) and films exhibiting fast switching dynamics (i. e. Sb2Te3), show, on the one side, higher crystallization-onset temperatures than the standard Ge2Sb2Te5 alloy and, on the other side, none to minimal Ge-segregation. [ABSTRACT FROM AUTHOR]

O modelo de produção capitalista, com uma imperceptível indução ao consumo e aliado ao crescimento demográfico em regiões do Brasil, faz com que a produção de resíduos sólidos seja cada vez mais crescente. Com a finalidade de preservar o meio ambiente, o bem-estar da população e, sobretudo, o direito fundamental à vida, a Constituição Federal impôs a implantação da Política Nacional de Resíduos Sólidos, com metas e questões de ordem prática trazidas pela Lei n°. 14.026/20. O presente trabalho, portanto, visa analisar o panorama jurídico brasileiro relacionado aos resíduos sólidos, partindo-se de uma análise da Constituição Federal, da Lei n°. 14.026/20, com levantamento de dados da região da Bacia dos Rios Sapucaí Mirim/Grande. [ABSTRACT FROM AUTHOR]

Seeking to reduce the environmental impacts arising from human activities, the Ecological-Economic Zoning (ZEE) is a technical and political instrument for planning and managing the territory that provides subsidies for the elaboration and implementation of public policies, environmental licensing and decision-making by public or private entities. In this way, the present work presents proposals for the Ecological Economic Zoning for the Canoas River Sub-Basin as a planning and management tool for the municipalities of São Paulo (Franca, Cristais Paulista and Pedregulho) and Minas Gerais (Ibiraci and Claraval). The methodology used was through the Methodological Guidelines for the Ecological-Economic Zoning of Brazil, proposed by the Ministry of the Environment (2006), consisting of four stages: Planning, Diagnosis, Prognosis and Subsidies for Implementation. Thus, it was possible to define strategic guidelines and level of priority for application in the Sub-Basin, such as: Implementation of ecological corridors between vegetation remnants, cultivation with conservation techniques, registration and monitoring of wells, support for Basin committees, stimulating actions for the preventing and mitigating the impacts of drought, expanding domestic sewage collection and treatment infrastructure, etc. Therefore, it is concluded that through a systemic integration of the ZEE at federal, state and municipal levels, it is necessary to promote the permeability and environmental recovery of the study area for the conservation of the remaining species of fauna and flora in the Canoas River Sub-Basin. [ABSTRACT FROM AUTHOR]

Esta pesquisa tem como objetivo traçar uma discussão a respeito da aplicabilidade do instituto denominado Pagamento por Serviços Ambientais (PSA) para proprietários rurais produtores de água. A metodologia aplicada é qualitativa, com levantamento bibliográfico de estudos e exemplos de aplicações, em plataforma acadêmica digital e livros da área, e legislação brasileira do PSA. O PSA é uma ação que parte do princípio protetorrecebedor, que consiste em uma pessoa física ou pessoa jurídica que fornece serviços ambientais e recebe um incentivo pecuniário de quem provê financiamento para tal, geralmente, organizações que se beneficiam com as ações. Este trabalho resultou em uma análise crítica e comparativa das legislações vigentes de PSA nos âmbitos federal, estadual e municipal. Espera-se que este estudo sirva como fonte para embasamento legal e bibliográfico a respeito do PSA. [ABSTRACT FROM AUTHOR]

Esta pesquisa tem como objetivo apresentar metodologias de estudos no campo da Educação Ambiental para a proteção do Cerrado na UGRHI 08. Utiliza-se da metodologia qualitativa com pesquisa bibliográfica e artigos científicos voltados ao tema. O Cerrado é um dos maiores biomas brasileiros e sofre com o desmatamento e degradação devido a introdução das culturas agrícolas e da pecuária. Entretanto, um acontecimento que gerou mudanças significativas foi o afastamento do ser humano com o meio ambiente natural, motivo este que se torna necessária a aplicação de metodologias de Educação que proponham a sua reaproximação para então proteger o Cerrado. Este trabalho teve como resultado a apresentação das metodologias utilizadas por pesquisadores que discutem a educação crítica, dialógica e participativa, ligando as diretrizes gerais do Plano Diretor de Educação Ambiental do Comitê da Bacia Hidrográfica dos rios Sapucaí-Mirim/Grande - SP, de 2020. Espera-se que estes estudos sejam considerados os estudos, bem como suas metodologias, no que tange a proteção da vegetação de Cerrado presente na bacia, para serem aplicadas nos próximos planos de Educação Ambiental. [ABSTRACT FROM AUTHOR]

Este estudo tem como objetivo apresentar microrganismos que podem ser utilizados como bioinsumos para as culturas de maior ocupação da Bacia dos rios Sapucaí Mirim/Grande. A pesquisa se concentra na região da bacia UGRHI-08, no nordeste do estado de São Paulo, onde as principais culturas são cana-de-açúcar, pastagens, café e cereais. Bioinsumos são utilizados para aumentar a eficiência, qualidade e a sustentabilidade dos sistemas agrícolas. Já o uso dos microrganismos como bioinsumos atua como agente biológico de controle, bioestimulante e fertilizante. A metodologia aplicada foi qualitativa com uso de material referencial como artigos científicos e literatura atual. Este trabalho teve como resultado que, em culturas de Cana-deaçúcar na Bacia, para o controle de nematoides como Pratylenchus sp. e Meloidogyne sp. Podem ser utilizados como bioinsumos os microrganismos Bacillus sp. (B. subtilis, B. amyloliquefaciens, etc.). No caso das pastagens, para o controle de Cigarirnhas-das-pastagens (Deois flavopicta), pode ser utilizado o Metarhizium anisopliae, um fungo que parasita as ninfas. Para o controle nas culturas de café, quanto a Broca-do-café (Hypothenemus hampei), pode ser utilizado o fungo Beauveria bassiana. No caso dos cereais, como a soja e o milho, na soja, para o controle de Nematoides como Pratylenchus sp. e Meloidogyne sp. podem ser utilizadas as espécies de bactérias do gênero Bacillus, e no milho, para o controle de Cigarrinha-do-milho (Dalbulus maidis), podem ser utilizados fungos como a Beauveria bassiana e Cordyceps fumosorosea. Espera-se, com isso, que sejam consideradas a utilização desses mecanismos na bacia, em prol da sustentabilidade. [ABSTRACT FROM AUTHOR]

O presente artigo tem o objetivo de discutir o Código Florestal Brasileiro, no que tange a previsão de áreas consolidadas, sob o aspecto ambiental e socioeconômico. Para isso, analisa-se a Lei Federal n°14.119/2021, que instituiu os pagamentos por serviços ambientais (PSA) e sua aplicação na recuperação das áreas consolidadas, em áreas de preservação permanente, como meio de mitigar os danos ambientais negativos, ocasionados pela anistia legislativa. A metodologia aplicada é qualitativa, com levantamento de material referencial que trata do assunto. Concluiu-se com o respectivo trabalho, que o Pagamento por Serviços Ambientais, PSA, das áreas consolidadas, em áreas de preservação Permanente, possibilita o desenvolvimento sustentável, na medida em que, há o reconhecimento monetário, ao produtor rural, por serviços prestados de conservação e recuperação de áreas degradadas, possibilitando a sustentabilidade no que tange os Objetivos do Desenvolvimento Sustentável da ONU, instituídos em 2015. [ABSTRACT FROM AUTHOR]

Esse artigo objetiva demonstrar o uso múltiplo dos recursos hídricos, como o levantamento do potencial energético da bacia hidrográfica do Rio Sapucaí Mirim (Potencial Instalado e o Potencial Futuro) das PCH existentes e da construção de futuras PCH. O incremento do potencial hidrelétrico através da implantação de novas PCH por ordem da união ou da iniciativa privada é um investimento, que automaticamente visa atender as necessidades da região e de seus investidores, mas também, pode melhorar a realidade econômica local e lindeiras ao empreendimento, contribuição em impostos, geração de empregos, enriquecimento da mata ciliar e monitoramento constante do meio ambiente, tudo isso além de gerar energia pontual para o local, aliviando a matriz elétrica e diminuindo as perdas de distribuição na linha, quanto mais próximo do ponto de geração é seu consumo, menor é seu desperdício. [ABSTRACT FROM AUTHOR]

A partir da dinâmica entre impactos ambientais causados por empreendimentos hidrelétricos e das medidas mitigadoras utilizadas para minimizá-los, este trabalho buscou avaliar o papel dos mecanismos de transposição de peixes de três Pequenas Centrais Hidrelétricas localizadas no Rio Sapucaí-mirim, entre São Joaquim da Barra e Guará, no nordeste do Estado de São Paulo, tendo como base os estudos e trabalhos técnicos já realizados na área, no período pré-instalação e pós início das operações dos empreendimentos. Apurou-se que uma parcela significativa da ictiofauna local (48,83% das espécies) se utiliza dos mecanismos para sua translocação neste trecho do rio, sendo este um indicativo que as escadas de peixes contribuem com a permanência do fluxo gênico local, mesmo após a instalação dos barramentos. [ABSTRACT FROM AUTHOR]

A fragmentação da vegetação é um dos principais impactos ambientais enfrentados pelas aves para o seu desenvolvimento. Este trabalho buscou realizar uma análise comparativa da composição da evolução da avifauna na área do empreendimento PCH Anhanguera, no rio Sapucaí-mirim, entre São Joaquim e Guará, no nordeste do Estado de São Paulo. A avifauna local apresentou aumento significativo na riqueza de espécies entre o período pré-instalação e operação, impactando no aumento da diversidade de grupos tróficos, e na presença de espécies com exigências ambientais mais elevadas, sendo este um indicativo que as condições ambientais locais também evoluíram. [ABSTRACT FROM AUTHOR]

The objective of this study was to analyze the trends in publications on intrathecal baclofen (ITB) therapy. We searched Elsevier's Scopus database in February 2022 to find articles focused on ITB therapy. Data extracted included citation count, publication year, author's country and income category, journal and its 5-year impact factor, research type, disease requiring ITB, and target population. The analysis covered 615 articles from 1985 to 2022. The average citation count per article was 27.47 (95% confidence interval 23.75–31.18) and the mean impact factor was 4.54 (95% confidence interval 3.84–5.24). The majority (76.42%) were primary research, with 8.1% being interventional and 91.9% observational. Even so, one half of the top ten most cited were interventional. Secondary research and case reports made up 12.68% and 10.73% respectively, with narrative reviews making up most of the secondary research (79.48%). Only 1 study conducted a meta-analysis. The United States was the most prolific country. High-income countries published 96.42% of articles. The rising number of ITB articles and citations indicates growing interest and expanding knowledge in this field. However, there's a notable scarcity of research from low- and middle-income countries, particularly those with high prevalence of ITB-treatable diseases. The need for more evidence to overcome potential barriers to ITB implementation is emphasized. Despite an increasing number of publications, a large proportion presented low levels of evidence, such as case reports and narrative reviews, highlighting the need for more rigorous research methods to solidify the evidence base for ITB therapy. [ABSTRACT FROM AUTHOR]

Bibliometric analyses are a well-established strategy for understanding the dynamics of publications. Aneurysmal subarachnoid hemorrhage (aSAH) is a hot topic in neurology and neurosurgery research. To perform a bibliometric analysis of recent publications within aSAH. Articles addressing aSAH published between 2017 and 2021 were included and had their information extracted from Scopus. A total of 2177 articles were included. The mean number of citations was 6.18 (95%CI = 5.77–6.59). 2021 and 2020 were the most prolific years. World Neurosurgery (N = 389/2,177 articles; 17,87%) was the leading publisher, and American Journal of Neuroradiology had the highest number of citations per article (14.82) among journals with ≥ 10 publications. Primary research (N = 1624/2177) predominated, followed by case reports (N = 434/2,177). Among secondary studies, systematic reviews (N = 78/119) surpassed narrative reviews (N = 41/119). USA led the number of publications (N = 548/2,177 articles; 25.17%), followed by China (N = 358/2,177 articles; 16.44%). High-income countries had a higher number of publications (N = 1624/2177) and more citations per article (6.84) than middle-income countries (N = 553/2177 and 4.25, respectively). There were zero articles from low-income countries. European and North American institutions had the greatest research impact. There was an increase in the number of published articles in the last few years (2020 and 2021). Many studies had a low level of evidence, whereas interventional studies were uncommon. [ABSTRACT FROM AUTHOR]

Novel Food is a new category of food, regulated by the European Union Directive No. 2015/2283. This latter norm defines a food as "Novel" if it was not used "for human consumption to a significant degree within the Union before the date of entry into force of that regulation, namely 15 May 1997". Recently, Novel Foods have received increased interest from researchers worldwide. In this sense, the key areas of interest are the discovery of new benefits for human health and the exploitation of these novel sources of materials in new fields of application. An emerging area in the pharmaceutical and medicinal fields is nanotechnology, which deals with the development of new delivery systems at a nanometric scale. In this context, this review aims to summarize the recent advances on the design and characterization of nanodelivery systems based on materials belonging to the Novel Food list, as well as on nanoceutical products formulated for delivering compounds derived from Novel Foods. Additionally, the safety hazard of using nanoparticles in food products, i.e., food supplements, has been discussed in view of the current European regulation, which considers nanomaterials as Novel Foods. [ABSTRACT FROM AUTHOR]

Background: Cognitive impairment of intellectual developmental disorders (IDD) is determined by several different combinations of specific cognitive alterations. People with IDD present a rate of mental health problems that is up to 4 times higher than that of the general population. Despite this, the relationship between specific cognitive dysfunctions and co‐occurring mental disorders has not been adequately studied. The aim of the present paper is to investigate the association between specific cognitive dysfunctions and specific psychiatric symptoms and syndromes in people with IDD. Methods: One hundred and twenty adults with mild to moderate IDD living in residential facilities underwent a clinical and instrumental assessment for specific cognitive and psychopathological features. Results: Participants with IDD and ASD have significantly lower scores compared to those without respect to who has not the diagnosis on the Processing Speed Index (PSI) and Perceptual Reasoning Index (PRI) on the WAIS‐IV and higher time scores on the TMT A. Moreover, there is a significant association between years of hospitalisation and TMT B and TMT B A time scores; the longer a participant with IDD was hospitalised, the worse their performance on the TMT. Although not statistically significant, many psychopathological clusters showed substantial cognitive profiles. Conclusions: Although further research is needed, neuropsychological and IQ tests scores seem to be differently associated to various psychopathological conditions co‐occurring with IDD, and with ASD especially. Cognitive assessment seems to support diagnosis and treatment of psychopathological co‐occurrences in persons with IDD, also in consideration of indirect implications including a better knowledge of the patient's characteristics beyond IQ deficit. [ABSTRACT FROM AUTHOR]

Magnetic imaging based on nitrogen-vacancy (NV) centers in diamond has emerged as a powerful tool for probing magnetic phenomena in fields ranging from biology to physics. A key strength of NV sensing is its local-probe nature, enabling high-resolution spatial images of magnetic stray fields emanating from a sample. However, this local character can also form a drawback for analyzing the global properties of a system, such as a phase transition temperature. Here, we address this challenge by using statistical analyses of magnetic-field maps to characterize the first-order temperature-driven metamagnetic phase transition from the antiferromagnetic to the ferromagnetic state in FeRh. After imaging the phase transition and identifying the regimes of nucleation, growth, and coalescence of ferromagnetic domains, we statistically characterize the spatial magnetic-field maps to extract the transition temperature and thermal hysteresis width. By analyzing the spatial correlations of the maps in relation to the magnetocrystalline anisotropy and external magnetic field, we detect a reorientation of domain walls across the phase transition. The employed statistical approach can be extended to the study of other magnetic phenomena with NV magnetometry or other sensing techniques. [ABSTRACT FROM AUTHOR]

This article argues that regulatory trust is established and maintained through a relationship between stakeholders and the government, with the former group of organizations and individuals relying on their understanding of this relationship. Federal administrative law in the United States makes the expectations about the regulatory environment on which stakeholders rely more meaningful by granting stakeholders the right to bring actions in court when their expectations are being (or seem likely to be) dashed. To make this argument, I begin with the threshold question of how courts serve as a forum for voicing claims of distrust in regulatory regimes. I then consider the importance of political accountability over regulatory decision making, illustrating the concerns about the structure of agencies that regulate consumer and housing finance. Next, I will discuss a second major challenge to trust that arises from the extent to which the authority of regulatory agencies is circumscribed by legislation. Along the way, I draw on the case law presented to argue that problems of trust in financial regulation center on the reliance interests of stakeholders. Finally, the argument suggests a research agenda into trust as a reliance interest that I sketch in the conclusion. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the presence of potentially pathogenic variants of 29 candidate genes known to cause spermatogenic failure (SPGF) in patients with non-obstructive azoospermia (NOA) who underwent testicular histology. Materials and Methods: Forty-eight patients with unexplained NOA referred to the Department of Transfusion Medicine and Transplantation Biology, University Hospital Center Zagreb, Zagreb, Croatia for testicular biopsy. They were divided into three groups: those who had cryptorchidism (n=9), those with varicocele (n=14), and those with idiopathic NOA (n=25). All included patients underwent blood withdrawal for next-generation sequencing (NGS) analysis and gene sequencing. Results: We found a possible genetic cause in 4 patients with idiopathic NOA (16%) and in 2 with cryptorchidism (22%). No pathogenic or possibly pathogenic mutations were identified in patients with varicocele. Variants of undetermined significance (VUS) were found in 11 patients with idiopathic NOA (44%), 3 with cryptorchidism (33%), and 8 patients with varicocele (57%). VUSs of the USP9Y gene were the most frequently as they were found in 14 out of 48 patients (29%). In particular, the VUS USP9Y c.7434+14del was found in 11 patients. They showed varied histological pictures, including Sertoli cellonly syndrome, mixed atrophy, and hypospermatogenesis, regardless of cryptorchidism or varicocele. No direct correlation was found between the gene mutation/variant and the testicular histological picture. Conclusions: Different mutations of the same gene cause various testicular histological pictures. These results suggest that it is not the gene itself but the type of mutation/variation that determines the testicular histology picture. Based on the data presented above, it remains challenging to design a genetic panel with prognostic value for the outcome of testicular sperm extraction in patients with NOA. [ABSTRACT FROM AUTHOR]

This article, published in the journal Ultrasound in Obstetrics & Gynecology, discusses a study that aimed to obtain fetal upper esophagus biometry and identify a second trimester marker for esophageal atresia (AE). The study enrolled single physiological pregnancies between 19 and 23 weeks and performed 2D and 3D ultrasound evaluations of the upper esophagus. The results showed that a thickening in a specific area of the esophagus, referred to as "P2," correlated with a subsequent esophageal pouch (EP) and AE. However, further studies are needed to confirm these findings due to the rarity of the disease and the small sample size. [Extracted from the article]

The host transmembrane protein SERINC5 is incorporated into retrovirus particles and inhibits HIV-1 infectivity. The lentiviral Nef protein counteracts SERINC5 by downregulating it from the cell surface and preventing its incorporation into virions. The ability of Nef to antagonize the host factor varies in magnitude between different HIV-1 isolates. After having identified a subtype H nef allele unable to promote HIV-1 infectivity in the presence of SERINC5, we investigated the molecular determinants responsible for the defective counteraction of the host factor. Chimeric molecules with a subtype C Nef highly active against SERINC5 were constructed to locate Nef residues crucial for the activity against SERINC5. An Asn at the base of the C-terminal loop of the defective nef allele was found in place of a highly conserved acidic residue (D/E 150). The conversion of Asn to Asp restored the ability of the defective Nef to downregulate SERINC5 and promote HIV-1 infectivity. The substitution was also found to be crucial for the ability of Nef to downregulate CD4, but not for Nef activities that do not rely on the internalization of receptors from the cell surface, suggesting a general implication in promoting clathrin-mediated endocytosis. Accordingly, bimolecular fluorescence complementation revealed that the conserved acidic residue contributes to the recruitment of AP2 by Nef. Altogether, our results confirm that Nef downregulates SERINC5 and CD4 by engaging a similar machinery and indicates that, in addition to the di-leucine motif, other residues in the C-terminal flexible loop are important for the ability of the protein to sustain clathrin-mediated endocytosis. [ABSTRACT FROM AUTHOR]

Europe has faced a massive spread of the varicella-zoster virus through the years. Since the introduction of an effective vaccine, complications and severe forms of chickenpox have been restricted. Nevertheless, among the population, some categories need specific care, such as pregnant women, who present one of the most fragile conditions facing this infection, both for the mother and the fetus. In this review, we highlight how the varicella-zoster virus can be dangerous during pregnancy, underlining the problem of treatment and vaccination, and collect information about the European epidemiology among this particular category of women. [ABSTRACT FROM AUTHOR]

Left ventricular lead positioning represents a key step in CRT optimization. However, evidence for its guidance based on specific topographical factors and related imaging techniques is sparse. To analyze reverse remodeling (RR) and clinical events in CRT recipients based on LV cathode (LVC) position relative to latest mechanical activation (LMA) and scar as determined by cardiac magnetic resonance (CMR). This is a retrospective single-center study of 68 consecutive Q-LV-guided CRT-D and CRT-P recipients. Through CMR-based 3D reconstructions overlayed on fluoroscopy images, LVCs were stratified as concordant, adjacent, or discordant to LMA (3 segments with latest and greatest radial strain) and scar (segments with >50% scar transmurality). The primary endpoint of RR (expressed as percentage ESV change) and secondary composite endpoint of HF hospitalizations, LVAD/heart transplant, or cardiovascular death were compared across categories. LVC proximity to LMA was associated with a progressive increase in RR (percentage ESV change: concordant −47.0 ± 5.9%, adjacent −31.4 ± 3.1%, discordant +0.4 ± 3.7%), while proximity to scar was associated with sharply decreasing RR (concordant +10.7 ± 12.9%, adjacent +0.3 ± 5.3%, discordant −31.3 ± 4.4%, no scar −35.4 ± 4.8%). 4 integrated classes of LVC position demonstrated a significant positive RR gradient the more optimal the category (class I -47.0 ± 5.9%, class II -34.9 ± 2.8%, class III -5.5 ± 4.3%, class IV + 3.4 ± 5.2%). Freedom from composite secondary endpoint of HF hospitalization, LVAD/heart transplant, or cardiovascular death confirmed these trends demonstrating significant differences across both integrated as well as individual LMA and scar categories. Integrated CMR-determined LVC position relative to LMA and scar stratifies response to CRT. [Display omitted] • CMR reconstructions of latest mechanical activation (LMA) and scar in CRT patients • LV cathode proximity to LMA associated with progressive increase in CRT response. • Scar proximity associated with sharply decreasing CRT response. • Integrated LMA/scar LVC position stratifies response to CRT. [ABSTRACT FROM AUTHOR]

SUMMARY: Many persons with intellectual developmental disorders and/or autism spectrum disorder presenting problem behaviours undergo pharmacotherapy without receiving an appropriate psychiatric assessment and diagnosis. Instead, prescription of psychotropic medication should have specific aims and involve interdisciplinary assessment, personalisation and patient and family participation. Current knowledge about pharmacological management of problem behaviours in this population is limited, necessitating extreme caution in clinical practice and more research into the complex interrelated factors that affect presentation, course and treatment response. [ABSTRACT FROM AUTHOR]

Spontaneous neuronal recovery is an expected phenomenon in brachial plexus palsy patients. However, the spontaneous recovery owing to retrograde regeneration is an evolving phenomenon with dearth of adequate research on it. Pectoralis major contraction on stimulation of median nerve (in the arm) is an unexpected phenomenon, in the absence of any anomalous communication and with distal coaptation site of intraplexal nerve repair. We presumably attribute it to the retrograde regrowth of axons. The case described supports our hypothesis. Level of Evidence: Level V (Therapeutic) [ABSTRACT FROM AUTHOR]

Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders caused by enzyme deficiencies required for cortisol biosynthesis in the adrenal cortex. The majority of CAH are due to the deficiency of the 21-hydroxylase enzyme, while 3β-hydroxysteroid dehydrogenase type 2 deficiency accounts for less than five percent of all CAH cases. We report two Moroccan twins from a spontaneous triplet pregnancy. The 46,XY newborn exhibited a disorder of sexual differentiation (DSD) with hypo virilization, while the 46,XX newborn had normal female external genitalia. In the first week of life, they showed hyponatremia and primary adrenal insufficiency with a slight 17OHP elevation and increased DHEAS and renin levels. The aCGH-SNP analysis disclosed a 8.36 Mb long contiguous stretch of homozygosity (LCSH) on chromosome 1p13.2-p11.2 including the candidate HSD3B2 gene, a LCSH of 7.3 Mb on 14q31.1-q32.11, and a 7 Mb duplication on 10q22.3-q23.2. Clinical exome sequencing revealed the biallelic c.969T > G (p.Asn323Lys) HSD3B2, likely pathogenic, variant in both of the affected twins. This case emphasizes the importance of a prompt molecular diagnosis performed through the combination of aCGH and clinical exome, both for establishment of correct therapy and for follow-up, as the newborns also carry a genomic rearrangement with possible clinical implications. [ABSTRACT FROM AUTHOR]

(1) Background: Leadless (LL) stimulation is perceived to lower surgical, vascular, and lead-related complications compared to transvenous (TV) pacemakers, yet controlled studies are lacking and real-life experience is non-conclusive. (2) Aim: To prospectively analyse survival and complication rates in leadless versus transvenous VVIR pacemakers. (3) Methods: Prospective analysis of mortality and complications in 344 consecutive VVIR TV and LL pacemaker recipients between June 2015 and May 2021. Indications for VVIR pacing were "slow" AF, atrio-ventricular block in AF or in sinus rhythm in bedridden cognitively impaired patients. LL indication was based on individualised clinical judgement. (4) Results: 72 patients received LL and 272 TV VVIR pacemakers. LL pacemaker indications included ongoing/expected chronic haemodialysis, superior venous access issues, active lifestyle with low pacing percentage expected, frailty causing high bleeding/infectious risk, previous valvular endocarditis, or device infection requiring extraction. No significant difference in the overall acute and long-term complication rate was observed between LL and TV cohorts, with greater mortality occurring in TV due to selection of older patients. (5) Conclusions: Given the low complication rate and life expectancy in this contemporary VVIR cohort, extending LL indications to all VVIR candidates is unlikely to provide clear-cut benefits. Considering the higher costs of LL technology, careful patient selection is mandatory for LL PMs to become advantageous, i.e., in the presence of vascular access issues, high bleeding/infectious risk, and long life expectancy, rendering lead-related issues and repeated surgery relevant in the long-term perspective. [ABSTRACT FROM AUTHOR]

Clinico-radiological presentation of granulomatous prostatitis (GP) is quite similar to cancer, and differential diagnosis can be very challenging. The study aims to highlight GP features based on clinical findings and multiparametric magnetic resonance imaging (mpMRI) characteristics. We retrospectively reviewed eleven patients from a cohort undergoing targeted biopsy between August 2019 and August 2021. Retrospective data including serum prostate-specific antigen (PSA) levels, PSA density and mpMRI findings were collected. Histopathology revealed seven cases of non-specific GP and four cases of specific GP as a result of intravesical Bacillus Calmette–Guérin (BCG) instillation. All lesions showed low signal intensity in T2w images, restricted diffusivity with hyperintensity in Diffusion-Weighted Imaging (DWI) and low Apparent Diffusion Coefficient (ADC) values. In Dynamic Contrast-Enhanced (DCE) imaging, the enhancement was high-peak and persistent in the majority of cases, especially in BCG-GPs. Moreover, almost all those latter lesions showed avascular core and peripheral rim enhancement. All areas identified on mpMRI were assessed with high to very high suspicion to hold prostate cancer (PIRADS v2.1 scores 4–5). Despite recent advances in imaging modalities and serological investigations, it is currently still a challenge to identify granulomatous prostatitis. Histopathology remains the gold standard in disease diagnosis. However, a differential diagnosis should be considered in patients with prior treatment with BCG. [ABSTRACT FROM AUTHOR]

The aluminothermic welding process (ATW) of rail tracks is the most used in the field due to its low cost, execution time, and light equipment. In recent years, some experimental and numerical models have been developed to study ATW. The accuracy of the models is still being demonstrated. In this work, a new three-dimensional thermoelastoplastic numerical model of the ATW process is proposed. This model uses the Element Birth and Death (EBD) technique with Ansys® software to accurately simulate filling the pouring region with filler metal. The thermal and mechanical phenomena of all stages of a conventional rail track welding process were considered, as well as the effects of the material's phase transformations during the process. First, the validation was carried out with experimental and numerical data from studies available in the literature for UIC60 rails. Then, the validated model was applied in the simulation of welding a TR68-type rail and an unprecedented analysis of the residual stresses resulting from this type of rail was performed. The ATW process could then be simulated using significantly fewer elements than the numerical models available in the literature and proved to be applicable for the study of the ATW process of railway tracks. [ABSTRACT FROM AUTHOR]

1. Utilizing an observational, cross-sectional, and multicenter approach, participants will self-report the ability to evaluate major differences in south America public and private hospital service, as an opportunity for improvement and considerations for future practices applications. 2. Utilizing quality control, data visualization and comparation, participants will self-report the ability to identify key elements in the emergency service to support the decision-making of implement palliative care. In our observational, cross-sectional, multicenter study, four emergency services in the city of Campinas, SP, Brazil participated. A total of 293 interviews were conducted with one third of the patients eligible for palliative care (PC). Thus, there is an extreme need for PC services and hospice in Brazil. Currently, it is estimated that only 14% of patients who need palliative care (PC) receive it1,2. In Brazil, this movement is still incipient, there are only 123 doctors specialized in PC, 340 services, but none with a hospice model. Therefore, the emergency room is the main access for these patients2. Objectives: To identify and characterize the demand of patients eligible for PC through the eligibility scales: Supportive and Palliative Care Indicators Tool (SPICT-BR) and the functionality scale "Palliative Performance Scale" (PPS), in emergency services in a city of 1 million inhabitants in the state of São Paulo (SP), Brazil. This is an observational, cross-sectional, multicenter study involving four emergency services in this metropolis of SP, Brazil. Being two public service and school hospital, and two private service. Interviews were conducted with patients admitted to the emergency rooms, and the following eligibility scales were applied: SPICT-BR and PPS, determining the incidence of eligible patients, comparisons between public and private services, and associations with the main comorbidities and symptoms. Results: A total of 293 interviews were conducted, of which 23 were excluded, leaving 270 patients for analysis. Of this population sample, 101 (37.4%) patients were eligible for PC, 82 (53.2%) were in the public service and 19 (16.4%) in the private service. Neoplasia was the most prevalent disease, affecting 37 (36.6%) patients, and pain was the main symptom affecting 28 (27.7%) patients. There was a high number of patients eligible for PC who come to emergency departments with uncontrolled symptoms, leading to congestion of the emergency departments and avoidable suffering. This fact stems from the lack of PC Services and Model Hospice in the country. Thus, there is a need for efficient public policies related to PC and Hospice Quality Improvement; Models of Palliative Care Delivery [ABSTRACT FROM AUTHOR]

Persons with intellectual disability (PwID) and/or and autism spectrum disorder with high support needs (ASD-HSN) have resulted to be among the most vulnerable populations to COVID-19 and distress factors associated to the measures for containing its spread. Many health, rehabilitation, and assistance needs were managed through the use of telemedicine, specifically teleassistance (TA) and telerehabilitation (TR), with regard to the prevention and treatment of the epidemic illness as well as the continuity of care required for the condition of developmental disability and co-occurring physical or mental disorders. TA and TR can function either directly or indirectly with the PwID/ASD; in the latter case, a family member, a regular caregiver, or a technician provides local mediation. This paper examines the most common TA and TR activities, along with their requirements, applications, and goals. All of these activities should be in line with the overarching goal of each customized therapy and rehabilitation plan, which is to enhance and support the quality of life for people with intellectual and developmental disabilities. Studies on TA and TR efficacy for PwID/ASD are limited, especially concerning adulthood. The scant research that is currently available demonstrates efficacy in maintaining or marginally enhancing cognitive, adaptive, and vocational skills. In addition to managing both routine and unusual activities as well as critical episodes, family members and other caregivers reported feeling more empowered about their educational and interpersonal abilities with the PwID/ASD. The primary benefits over traditional in-person services have been found to be greater accessibility and availability as well as a reduction in both physical and psychological distance. The primary limits include the absence of all elements of the therapeutic alliance pertaining to face-to-face communication, possible poor ability to use technology, accessibility of the technology itself, concerns regarding privacy, and variables that divert attention connected to the household setting. Even while telemedicine has proven to be feasible and beneficial thus far, it is doubtful that traditional techniques will be able to be replaced, at least not anytime soon. Telemedicine could, nonetheless, serve as a useful addition, integration, or short-term substitute. Future studies should provide light on the indications, contextual deployment, efficacy evaluation, and operational stability over time of certain TA and TR activities in addition to the use of artificial intelligence, machine learning, and interactive avatars. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

The objective of this study was to assess the Author Impact Factor (AIF) as a useful metric and as a complement to the h-index among neurosurgical researchers. The 5-year AIF and h-index were compared among 3 groups of researchers: 1) the 100 most prolific of all time within general neurosurgical journals ("Experienced"), 2) the 100 most prolific during the 2015–2019 period within general neurosurgical journals ("Trending Group"), and 3) the 100 postgraduation year 7 neurosurgical residents with the highest h-index ("Amateur"). The Amateur group had a lower median h-index than the Experienced (6 vs. 55; P < 0.001) and Trending (6 vs. 43; P < 0.001) groups. The highest h-index of the Amateur group (24) was lower than the first quartile of the Experienced (46.25) and Trending (26.00) groups. The Amateur group had a lower median 5-year AIF than the Experienced (2.15 vs. 3.17; P < 0.001) and Trending (2.15 vs. 2.85; P = 0.02) groups. Unlike the h-index, the gap between the 5-year AIF distribution of the Amateur group and other groups was not profound. Although there was a positive correlation between the metrics in the 3 groups, they did not proxy for each other. For instance, while the h-index of some experienced authors that have not published recently was high, their AIFs were zero. Also, some Amateur authors published very impactful articles and had a high 5-year AIF. However, since their number of publications is inevitably low, their h-index were low. The AIF provides intuitive and complementary information to the h-index regarding the research output of neurosurgical authors. [ABSTRACT FROM AUTHOR]

The volume‐regulated anion channel (VRAC) is formed by LRRC8 subunits. Besides their role in the maintenance of cell homeostasis, VRACs are critically involved in oxidative stress mechanisms: reactive oxygen species directly modulate VRACs in a subunit‐dependent manner. It was reported that LRRC8A–LRRC8E heteromeric channels are activated by oxidation, whereas LRRC8A–LRRC8C heteromers are inhibited. Here we adopted chimeric‐ as well as concatemeric‐based strategies to identify residues responsible for the divergent effect of oxidants. We identified two cysteines in the first two leucine rich repeats of LRRC8E, C424 and C448, as the targets of oxidation. Oxidation likely results in the formation of a disulfide bond between the two cysteines, which in turn induces a conformational change leading to channel activation. Additionally, we found that LRRC8C inhibition is caused by oxidation of the first methionine. We thus identified crucial molecular elements involved in channel activation, which are conceivably relevant in determining physiological ROS effects. Key points: Volume‐regulated anion channels (VRACs) are heterohexameric complexes composed of an essential LRRC8A subunit and a variable number of LRRC8B–E subunits.VRACs are directly regulated by oxidation, with LRRC8A–LRRC8E heteromers being potentiated and LRRC8A–LRRC8C heteromers being inhibited by oxidation.We identified two LRRC8E specific intracellular cysteines that form a disulfide bond upon oxidation leading to LRRC8A–LRRC8E potentiation.Inhibition of LRRC8A–LRRC8C heteromers is mediated by the oxidation of the start methionine, being additionally dependent on the identity of the LRR domain.Besides providing physiological insights concerning the outcome of reactive oxygen species modulation, the results point to key structural elements involved in VRAC activation. [ABSTRACT FROM AUTHOR]

Background: Right-side fixation of the sigmoid colon is a rare anatomical variant associated with intestinal malrotation (Choi et al. in J Korean Surg Soc. 84(4):256-60, 2013). Differently from other forms of malrotation, this variant has not been associated thus far with acute surgical conditions.Case Presentation: In this report, we present a 65-year-old Caucasian patient admitted for bowel obstruction symptoms. Computed tomography scan revealed right-side fixation of the sigmoid colon extended to the subhepatic recess complicated by obstructed internal herniation of the ileum. In this patient, the sigmoid colon occupied a recess posterior to the ascending colon and right Toldt's fascia. Within this narrow anatomical space, an ileal loop was trapped causing internal herniation with resultant close-bowel obstruction of both ileum and sigmoid colon. The ileal loop was released surgically and the anatomical abnormality corrected.Conclusions: To our knowledge, this is the first case of right-side fixation of the sigmoid colon causing acute obstruction secondary to internal herniation of the small intestine. Early recognition and precise anatomical definition of such anatomical variants are essential to optimize their surgical approach. [ABSTRACT FROM AUTHOR]

Background: The prognostic role of the Pupillary Pain Index (PPI), derived from automated pupillometry, remains unknown in post-anoxic brain injury.Methods: Single-center retrospective study in adult comatose cardiac arrest (CA) patients. Quantitative PPI and Neurologic Pupil Index (NPi) were concomitantly recorded on day 1 and day 2 after CA. The primary outcome was to assess the prognostic value of PPI to predict 3-month unfavourable outcome (UO, defined as Cerebral Performance Category of 3-5). Secondary outcome was the agreement between PPI and NPi to predict unfavourable outcome.Results: A total of 102 patients were included; patients with UO (n = 69, 68%) showed a lower NPi (4.2 [3.5-4.5] vs. 4.6 [4.3-4.7]; p < 0.01 on day 1-4.3 [3.8-4.7] vs 4.6 [4.3-4.8] on day 2), and PPI (3 [1-6] vs. 6 [3-7]; p < 0.01 on day 1-3 [1-6] vs 6 [4-8]; p < 0.01 on day 2) than others. A PPI = 1 on day 2 showed a sensitivity of 26 [95% CI 16-38]% and a specificity of 100 [95% CI 89-100]% to predict UO (p = 0.003 vs. NPi ≤ 2). On day 2, a total of 6 patients had concomitant PPI = 1 and NPi ≤ 2, while 12 showed NPi > 2 and PPI = 1; the coefficient of agreement was 0.42. Moreover, NPi and PPI values showed a moderate correlation both on day 1 and day 2.Conclusions: In this study, PPI = 1 on day 2 could predict UO in comatose CA patients with 100% specificity, but with a low sensitivity (yet higher than NPi). The agreement between PPI and NPi values was moderate. [ABSTRACT FROM AUTHOR]

The morphological, structural, and electrical properties of as-grown and annealed Ge2Sb2Te5 (GST) layers, deposited by RF-sputtering on flexible polyimide, were studied by means of optical microscopy, atomic force microscopy, X-ray diffraction, Raman spectroscopy, and electrical characterization. The X-ray diffraction annealing experiments showed the structural transformation of GST layers from the as-grown amorphous state into their crystalline cubic and trigonal phases. The onset of crystallization of the GST films was inferred at about 140 °C. The vibrational properties of the crystalline GST layers were investigated via Raman spectroscopy with mode assignment in agreement with previous works on GST films grown on rigid substrates. The electrical characterization revealed a good homogeneity of the amorphous and crystalline trigonal GST with an electrical resistance contrast of 8 × 106. [ABSTRACT FROM AUTHOR]