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Do asset managers engage in friendly investing to obtain privileged investment information? We test this hypothesis in the context of mutual fund connections to financial groups. Using brokers as the source of connections, we find that funds overweight the stock of connected financial groups and side with management in contested votes. We also find that fund performance improves with the extent of friendly investing. The improvement stems from trading the stock of companies that borrow from connected financial groups. Brokerage commissions do not drive the results. Our findings suggest that funds can obtain valuable information by acting as friendly shareholders. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the distortion probability in impressions of completely dentate arches when different impression materials are used in relation to operator experience. Materials and Methods: A total of 28 students (Group A) and 7 dentists (Group B) performed three maxillary impressions on 28 participants, each using vinyl siloxane ether (VSE), polyether (PE), and irreversible hydrocolloid (IHC). Gypsum master casts were fabricated and subsequently digitized. Intraoral scans were taken as a control. Differences between master casts and intraoral scans were visualized with heatmaps, and planar deviations were investigated. If planar deviations > 120 µm were found, the impression was rated as "distorted." An additional superimposition using the casts from VSE or PE was performed to confirm the presence of distortions. The relative number of surfaces with distortions in each impression was calculated. The procedure was repeated for a distortion threshold of 500 µm. The statistical analyses included repeated measures ANOVA (RMA) and post hoc tests (a < .05). Results: When 120 µm was considered as the threshold for distortions, IHC impressions showed higher distortion probability than PE impressions in Group A (P = .003) and Group B (P < .0001). In Group B, PE showed a lower distortion probability than VSE (P = .02). There was no significant difference between the study groups (P = .42). Considering 500 µm as a threshold for distortions, there was no difference between impression materials (P = .17) or study groups (P = .53). Conclusions: There were no statistically significant differences in relation to operator experience. Different impression materials had a significant impact on distortion probability. PE impressions showed the lowest distortion probability. [ABSTRACT FROM AUTHOR]

Influencer marketing is a popular strategy to connect with consumers. However, influencers' use of overly high-arousal language in promoting products (e.g., "it's totally AMAZING!") has raised questions about their true motivations. This article investigates how high-arousal language in micro- versus macro-influencers' sponsored posts might shape engagement. A multimethod approach, combining automated text, image, video, and audio analyses of thousands of Instagram and TikTok posts with controlled experiments, demonstrates that high-arousal language increases engagement with micro-influencers, but it decreases engagement with macro-influencers, seemingly because it makes micro- (macro-) influencers appear more (less) trustworthy. Yet the negative effect of arousal for macro-influencers can be mitigated if their posts provide counterbalanced valence (both positive and negative assessments) or if they indicate an informative, rather than commercial, goal. These findings deepen understanding of how language arousal shapes consumer responses, reveal a psychological mechanism through which language arousal affects perceptions, and provide actionable insights for crafting more effective social media content. [ABSTRACT FROM AUTHOR]

Background and Aims: Patients with overt or occult hepatitis B virus (HBV) infection receiving immunosuppressive treatments have a wide risk of HBV reactivation (HBVr). We performed meta‐analysis with decision curve analyses (DCA) to estimate the risk of HBVr in HBsAg‐negative anti‐HBc‐positive patients naïve to nucleos(t)ide analogues (NAs) receiving immunosuppressive treatments. Approach and Results: Studies were identified through literature search until October 2022. Pooled estimates were obtained using random‐effects model. Subgroup analyses were performed according to underlying disease and immunosuppressive treatments. DCA was used to identify the threshold probability associated with the net benefit of antiviral prophylaxis in HBsAg‐negative anti‐HBc‐positive patients. We selected 68 studies (40 retrospective and 28 prospective), including 8034 patients with HBsAg negative anti‐HBc positive. HBVr was 4% (95% CI 3%–6%) in HBsAg‐negative anti‐HBc‐positive patients, with a significantly high heterogeneity (I2 69%; p <.01). The number‐needed‐to‐treat (NNT) by DCA ranged from 8 to 24 for chemotherapy plus rituximab, from 12 to 24 for targeted therapies in cancer patients and from 13 to 39 for immune‐mediated diseases. Net benefit was small for monoclonal antibodies. Conclusions: Our DCA in HBsAg‐negative anti‐HBc‐positive patients provided evidence that NA prophylaxis is strongly recommended in patients treated with chemotherapy combined with rituximab and could be appropriate in patients with cancer treated with targeted therapies and in patients with immune‐mediated diseases. Finally, in patients with cancer treated with monoclonal antibodies or with chemotherapy without rituximab, the net benefit is even lower. [ABSTRACT FROM AUTHOR]

Background: to analyze, at one year, the efficacy and safety of treat-and-extend (T&E) intravitreal (IV) Brolucizumab in patients affected by macular neovascularization (MNV). Both naïve and previously treated (i.e., switched) patients were included, and the data from the two groups were compared. Methods: anatomical (i.e., central subfoveal thickness, CST; presence of fluid), functional (i.e., best corrected visual acuity, BCVA) and treatment-related (i.e., number of IV injections within the study period; number of patients reaching a 12-weeks interval between treatments) data from 41 eyes of 41 subjects (20 naïve and 21 switched) were analyzed. Patients were treated with 3 monthly IV injections followed by a T&E regimen based on a disease activity assessment performed at each scheduled IV treatment. Results: significant CST reduction (from 412.1 ± 115.8 to 273.2 ± 61.6; p < 0.05) and BCVA (mean; p) improvement were observed in the naïve group, while in the switched cohort, both parameters were almost stable. In the naïve and switched groups, 55% and 33.5% of patients, respectively, reached a 12-week IV interval at one year, with a mean of 6.55 ± 1 and 7.43 ± 0.68 IV treatments, respectively. One patient with mild anterior uveitis without sequelae was recorded. Conclusion: In patients with MNV, IV Brolucizumab injections following a T&E regimen demonstrated great efficacy and a good safety profile, with greater anatomical and functional results in naïve patients. Trial registration: This study was approved by the Local Ethics Committee (protocol number 155/2020, general registry number n°11486, InterHospital Ethics Committee, San Luigi Gonzaga Hospital, Orbassano, Italy). [ABSTRACT FROM AUTHOR]

Background: The benefit of immune checkpoint inhibitors (ICIs) for poor performance status patients with advanced urothelial carcinoma (UC) remains unknown. Objective: In the present sub-analysis of the ARON-2 study, we investigated the role of pembrolizumab for advanced UC patients with ECOG (Eastern Cooperative Oncology Group) performance status (ECOG-PS) 2. Patients and Methods: Patients aged ≥ 18 years with a cytologically and/or histologically confirmed diagnosis of advanced UC progressing or recurring after platinum-based therapy and treated with pembrolizumab between 1 January 2016 to 1 April 2024 were included. In this sub-analysis we focused on patients with ECOG-PS 2. Results: We included 1,040 patients from the ARON-2 dataset; of these, 167 patients (16%) presented an ECOG-PS 2. The median overall survival (OS) was 14.8 months (95% confidence interval (CI) 12.5–16.1) in the overall study population, 18.2 months (95% CI 15.8–22.2) in patients with ECOG-PS 0–1, and 3.7 months (95% CI 3.2–5.2) in subjects with ECOG-PS 2 (p < 0.001). The median progression-free survival (PFS) in the overall study population was 5.3 months (95% CI 4.3–97.1), 6.2 months (95% CI 5.5–97.1) in patients with ECOG-PS 0–1, and 2.8 months (95% CI 2.1–3.4) in patients with ECOG-PS 2. Among the latter, liver metastases and progressive disease during first-line therapy were significant predictors of OS at both univariate and multivariate analyses. For PFS, univariate and multivariate analyses showed a prognostic role for lung metastases, liver metastases, and progressive disease during first-line therapy. Conclusions: This large real–world evidence study suggests the effectiveness of second-line pembrolizumab for mUC patients with poor performance status. The presence of liver metastases and progressive disease during first-line therapy is associated with worse clinical outcomes and, thus, should be taken into account when making treatment decisions in clinical practice. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to provide an updated European narrative review spanning the last decade, focusing on the cost-effectiveness of cochlear implants (CIs) for adults with severe to profound post-lingual hearing loss. Methods: This review encompasses both prospective and retrospective approaches, as well as cross-sectional and longitudinal trials conducted on CIs in adults. All studies related to European countries (Austria, Germany, Switzerland, the Netherlands, Sweden, the UK and Poland) were conducted in English and were published between 2012 and June 2023. Results: Nine studies were included in the analysis. The patients' ages ranged from 18 years to over 67 years, with sample sizes ranging from 20 to 100 patients; two of these studies were focused on single-sided deafness in adults. The Markov model was identified as the most commonly utilized analysis method. Conclusions: This review identified a general consensus on CI cost-effectiveness, despite substantial variability among countries in factors such as observation time horizons, cost-effectiveness thresholds, methods of cost collection, discount rates, CI eligibility criteria and country-specific health systems. Generally, CIs yield positive societal benefits for working-age individuals, potentially less for seniors. Early unilateral CI enhances cost-effectiveness, highlighting the importance of prompt candidate identification. A consistent undersupply of CIs relative to the percentage of potential recipients emerged across countries. Therefore, further investigation into subcategories such as single-sided deafness is warranted, along with country-specific cost analyses. Emphasizing the significance of detailed information on health systems and associated costs and benefits is crucial for facilitating comparisons across different settings. [ABSTRACT FROM AUTHOR]

Influencer marketing has become big business. But while influencers have the potential to spread marketing messages and drive purchase, some posts get lots of engagement and boost sales, while others do not. What makes some posts more impactful? This work examines how sensory language (e.g. words like "crumble" and "juicy" that engage the senses) shapes consumer responses to influencer-sponsored content. A multimethod investigation, combining controlled experiments with automated text, image, and video analysis of thousands of sponsored social media posts, demonstrates that sensory language increases engagement and willingness to buy the sponsored product. Furthermore, the studies illustrate that these effects are driven by perceived authenticity. Sensory language leads consumers to infer that influencers actually use the product they are endorsing, which increases perceived authenticity, and thus engagement and purchase. These findings shed light on how language shapes responses to influencer-sponsored content, deepen understanding of the drivers of authenticity, and suggest how to develop more impactful social media campaigns. [ABSTRACT FROM AUTHOR]

Male infertility is a complex issue influenced by multiple environmental and pathological factors. In this context, the impact of Human papillomavirus (HPV) infection on male fertility remains controversial. The introduction of new WHO 2021 evaluation criteria, included in the 6th ed. of Laboratory Manual for the examination and processing of human semen, i.e. DNA fragmentation index (DFI), slow and rapid progressive motility, could provide additional information about this correlation. 121 semen samples of male partners of HPV-positive women attending In Vitro Fertilization (IVF) were evaluated following WHO 2021 and HPV-DNA test. Comparing HPV-negative and positive samples for rapid and slow progressive motility showed significantly different results (p = 0.0018, p = 0.0004), contrary to what was observed for total progressive motility. Regarding sperm DFI, only high-risk HPV infections affected DNA integrity. In addition, the correlation between the different semen parameters revealed a significant correlation between midpiece morphological defects and rapid progressive motility in the HPV-positive group (rho = 0.43, p = 0.0006). In conclusion, WHO 2021 provides additional information regarding HPV's impact on seminal parameters. The correlation between HPV positivity, midpiece defects and a higher rapid progressive motility opens new research perspectives that may help unravel the issues surrounding the role of HPV in compromising sperm quality. [ABSTRACT FROM AUTHOR]

Background: Gender differences in the access to advanced therapies for Parkinson's disease (PD) are poorly investigated. Objective: The objective of this study was to investigate the presence of any gender disparity in the access to advanced therapies for PD. Design: Retrospective study. Methods: Data from patients with consistent access to the Parkinson's and Movement Disorder Center of L'Aquila over the last 10-year period were screened. Patients selected for advanced therapies were included. Results: Out of 1,252 patients, 200 (mean age ± SD 71.02 ± 9.70; 72% males; median Hoen Yahr level: 3, minimum 1 maximum 5) were selected for advanced therapies: 133 for Magnetic Resonance guided Focused Ultrasound (MRgFUS) thalamotomy (mean age ± SD 70.0 ± 8.9; 77% males), 49 for Levodopa/Carbidopa Intestinal Gel (LCIG) infusion (mean age ± SD 74.3 ± 11.4; 59% males), 12 for Deep Brain Stimulation (DBS) (mean age ± SD 71.2 ± 6.3; 75% males), and 7 for Continuous Subcutaneous Apomorphine Infusion (CSAI) (mean age ± SD 69.7 ± 5.5; 43% males). No sex differences were found in relation to age (MRgFUS group: males vs. females 70.2 ± 8.9 vs. 70.8 ± 8.9, p -value = 0.809; LCIG group: males vs. females 73.5 ± 13.0 vs. 75.5 ± 8.5, p -value = 0.557; DBS group: males vs. females 77.2 ± 8.1 vs. 67.3 ± 8.6, p -value = 0.843; CSAI group: males vs. females 73.3 ± 4.0 vs. 67.0 ± 5.2, p -value = 0.144) and disease duration (MRgFUS group: males vs. females 8.3 ± 4.4 vs. 9.6 ± 6.7, p -value = 0.419; LCIG group: males vs. females 14.5 ± 5.81 vs. 17.3 ± 5.5; p -value = 0.205; DBS group: males vs. females 15.0 ± 9.6 vs. 15.5 ± 7.7, p -value = 0.796; CSAI group: males vs. females 11.7 ± 3.7 vs. 10.3 ± 3.7, p -value = 0.505). Conclusion: The predominance of males is higher than that expected based on the higher prevalence of PD in men. Women are less confident in selecting advanced therapies during the natural progression of their disease. Factors accounting for this discrepancy deserve further investigation. [ABSTRACT FROM AUTHOR]

Sperm motility is a crucial factor in male fertility. Photobiomodulation (PBM) has been reported to increase sperm motility, but a consistent approach suitable for identifying standardizable protocols is lacking. We collected asthenozoospermic (n = 70) and normozoospermic (n = 20) semen. The asthenozoospermic samples were irradiated with an 810 nm diode laser, in continuous wave mode, at 0.25 W, 0.5 W, 1 W and 2 W for 60 s on a circular area of 1 cm2 through a novel handpiece with an innovative flat-top profile. Sperm motility was assessed immediately, after 30 and 60 min. A sample size calculator, unpaired t-test and one-way ANOVA with post-hoc Tukey HSD tests were used for statistics. One and 2 W were the most effective outputs in increasing progressive motility compared to control (p < 0.001). The maximum effect was immediately after 1 W-PBM (p < 0.001) and decreased after 60 min (p < 0.001). Time physiologically decreased vitality (p < 0.001), but less in the 1 W-PBM samples (p < 0.05). 1 W-PBM did not affect chromatin condensation. Asthenozoospermic samples displayed an impairment of 80% in oxygen consumption and ATP production and a slight inefficiency of oxidative phosphorylation compared to normozoospermic samples (p < 0.001). 1 W-PBM partially restored the functionality of aerobic metabolism (p < 0.001) by recovery of oxidative phosphorylation efficiency. PBM did not affect lactate dehydrogenase (glycolysis pathway). No irradiated samples increased accumulated malondialdehyde, a marker of lipidic peroxidation. In conclusion, PBM improves progressive motility in asthenozoospermia through increased mitochondrial energetic metabolism without harmful oxidative stress. [ABSTRACT FROM AUTHOR]

Recent research has proposed using positron emission tomography/computed tomography (PET/CT) along with the administration of prostate-specific membrane antigen (PSMA)-targeting radiopharmaceuticals to identify breast cancer (BC) lesions. An extensive literature review to investigate the possible diagnostic utility of PET/CT with PSMA-targeting radiopharmaceuticals in BC patients was performed. The research comprised different clinical scenarios, including both newly diagnosed BC patients and those who had experienced disease relapse. This updated systematic review encompassed six studies investigating the diagnostic efficacy of PSMA-targeted PET/CT in BC. Throughout all clinical settings investigated, the papers presented data demonstrating a modest diagnostic performance of PSMA-targeted PET/CT in different subtypes of BC. In this setting, PSMA-guided PET/CT showed slightly higher accuracy in patients diagnosed with triple-negative BC. Based on the current literature, PSMA-targeted PET/CT cannot be suggested as a diagnostic tool to assess BC extent in any clinical scenario. However, based on the PSMA expression observed in triple-negative patients, it can be proposed as a tool to evaluate whether BC patients could benefit from PSMA-targeting radioligand therapy. [ABSTRACT FROM AUTHOR]

Simple Summary: The identification of robust prognostic biomarkers is paramount for refining cancer treatment strategies, particularly in the era of precision medicine. This systematic review and meta-analysis aim to assess the prognostic significance of the neutrophil-to-eosinophil ratio (NER) across various cancer types, with a specific focus on its correlation with OS and PFS. Pooled analyses demonstrated that elevated pretreatment NER levels were significantly associated with poorer OS and PFS. The study highlights NER as a promising and non-invasive biomarker that could help guide treatment decisions in cancer patients. However, further research is needed to confirm its potential across various cancer types and treatment settings. Background: The identification of reliable prognostic biomarkers is crucial for optimizing cancer treatment strategies, especially in the era of personalized medicine. This systematic review and meta-analysis evaluate the prognostic significance of the neutrophil-to-eosinophil ratio (NER) in various cancer types, with a focus on its association with overall survival (OS) and progression-free survival (PFS). Methods: We conducted a systematic literature search across PubMed, Scopus, and Web of Science databases for studies published up to 28 July 2024. We performed the meta-analyses with the generic inverse variance method with a random effects model and reported hazard ratios (HR) with 95% confidence intervals (CI). Results: The comprehensive literature search identified 10 studies comprising 2351 patients. Pooled analyses demonstrated that elevated pretreatment NER levels were significantly correlated with poorer OS (HR: 1.74, 95% CI: 1.28–2.36, p < 0.001) and PFS (HR: 1.53, 95% CI: 1.21–1.95, p < 0.001). Subgroup analyses confirmed a consistent adverse association between high NER and OS across various tumor types and geographic locations, although results from studies conducted in the Far East did not reach statistical significance. Conclusions: This meta-analysis demonstrates that elevated NER is associated with poorer OS and PFS in cancer patients, suggesting its potential utility as a non-invasive prognostic marker. Further validation in large, prospective studies is warranted to establish NER's role in guiding personalized treatment strategies across diverse oncologic contexts. [ABSTRACT FROM AUTHOR]

Torque measurement is a key task in several mechanical and structural engineering applications. Most commercial torquemeters require the shaft to be interrupted to place the sensors between the two portions of the shaft where a torque has to be measured. Contactless torquemeters based on the inverse magnetostrictive effect represent an effective alternative to conventional ones. Most known ferromagnetic materials have an inverse magnetostrictive behavior: applied stresses induce variations in their magnetic properties. This paper investigates the possibility of measuring torsional loads applied to a shaft made of ferromagnetic steel S235 through an inverse magnetostrictive torquemeter. It consists of an excitation coil that produces a time-varying electromagnetic field inside the shaft and an array of sensing coils suitably arranged around it, in which voltages are induced. First, the system is analyzed both in unloaded and loaded conditions by a Finite Element Method, investigating the influence of relative positions between the sensor and the shaft. Then, the numerical results are compared with the experimental measurements, confirming a linear characteristic of the sensor (sensitivity about 0.013 mV/Nm for the adopted experimental setup) and revealing the consistency of the model used. Since the system exploits the physical behavior of a large class of structural steel and does not require the introduction of special materials, this torquemeter may represent a reliable, economical, and easy-to-install device. [ABSTRACT FROM AUTHOR]

Ras homolog family member A (RhoA) acts as a signaling hub in many cellular processes, including cytoskeletal dynamics, division, migration, and adhesion. RhoA activity is tightly spatiotemporally controlled, but whether downstream effectors share these activation dynamics is unknown. We developed a novel single-color FRET biosensor to measure Rho-associated kinase (ROCK) activity with high spatiotemporal resolution in live cells. We report the validation of the Rho-Kinase Activity Reporter (RhoKAR) biosensor. RhoKAR activation was specific to ROCK activity and was insensitive to PKA activity. We then assessed the mechanisms of ROCK activation in mouse fibroblasts. Increasing intracellular calcium with ionomycin increased RhoKAR activity and depleting intracellular calcium with EGTA decreased RhoKAR activity. We also investigated the signaling intermediates in this process. Blocking calmodulin or CaMKII prevented calcium-dependent activation of ROCK. These results indicate that ROCK activity is increased by calcium in fibroblasts and that this activation occurs downstream of CaM/CaMKII. [ABSTRACT FROM AUTHOR]

The automatic analysis of histology images is an open research field where machine learning techniques and neural networks, especially deep architectures, are considered successful tools due to their abilities in image classification. This paper proposes a granular computing methodology for histopathological image classification. It is based on embedding tiles of histopathology images using deep metric learning, where a self-organizing map is adopted to generate the granular structure in this learned embedding space. The SOM enables the implementation of an explainable mechanism by visualizing a knowledge space that the experts can use to analyze and classify the new images. Additionally, it provides confidence in the classification results while highlighting each important image fragment, with the benefit of reducing the number of false negatives. An exemplary case is when an image detail is indicated, with small confidence, as malignant in an image globally classified as benign. Another implemented feature is the proposal of additional labelled image tiles sharing the same characteristics to specify the context of the output decision. The proposed system was tested using three histopathology image datasets, obtaining the accuracy of the state-of-the-art black-box methods based on deep learning neural networks. Differently from the methodologies proposed so far for the same purpose, this paper introduces a novel explainable method for medical image analysis where the advantages of the deep learning neural networks used to build the embedding space for the image tiles are combined with the intrinsic explainability of the granular process obtained using the clustering property of a self-organizing map. [ABSTRACT FROM AUTHOR]

The emergence of vaccinomics and system vaccinology represents a transformative shift in immunization strategies, advocating for personalized vaccines tailored to individual genetic and immunological profiles. Integrating insights from genomics, transcriptomics, proteomics, and immunology, personalized vaccines offer the promise of enhanced efficacy and safety, revolutionizing the field of vaccinology. However, the development of personalized vaccines presents multifaceted challenges, including technical, ethical, economic, and regulatory considerations. Addressing these challenges is essential to ensure equitable access and safety of personalized vaccination strategies. Despite these hurdles, the potential of personalized vaccines to optimize responses and mitigate disease burden underscores the significance of ongoing research and collaboration in advancing precision medicine in immunization. [ABSTRACT FROM AUTHOR]

Background: Malignant Distal Biliary Obstruction (MBDO) is a common event occurring along the natural history of both pancreatic cancer and cholangiocarcinoma. Epidemiological and biological features make MBDO one of the key elements of the clinical management of patients suffering for of pancreatic cancer or cholangiocarcinoma. The development of dedicated biliary lumen-apposing metal stents (LAMS) is changing the clinical work up of patients with MBDO. i-EUS is an Italian network of clinicians and scientists with a special interest in biliopancreatic endoscopy, EUS in particular. Methods: The scientific methodology was chosen in line with international guidance and in a fashion similar to those applied by broader scientific associations. PICO questions were elaborated and subsequently voted by a broad panel of experts within a simplified Delphi process. Results and conclusions: The manuscripts describes the results of a consensus conference organized by i-EUS with the aim of providing an evidence based-guidance for the appropriate use of the techniques in patients with MBDO. [ABSTRACT FROM AUTHOR]

This study explored various aspects of the memorable messages about math education that parents shared with their college aged children and parents' own experiences with math education. Findings revealed that the memorable messages parents recalled sending to their children about math education focused on encouragement, advice, necessity of math, how math skills don't define you, and math being logical. Memorable message themes were not predicted by parents' beliefs about their own math anxiety, math self-concept, or math self-efficacy. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

The combined use of finite element modeling and structural health monitoring is becoming increasingly relevant in bridge maintenance. A growing number of new and old structures is instrumented with different kinds of sensors driven by dedicated hardware and software, while numerical models are used to simulate the response of the structures under various scenarios. This paper presents the monitoring of the Smithfield Street Bridge, one of the oldest and most iconic bridges in the city of Pittsburgh (Pennsylvania, USA). The bridge was instrumented by an independent party, not involved with the research presented here, with strain, displacement, and rotation wireless sensors. A detailed finite element model of one of the spans of the bridge was developed to calculate the strains induced by standardized trucks under pristine and simulated damage conditions. In addition, the model enabled to determine the sensitivity necessary to detect relevant structural changes in the bridge. The results of the numerical analyses were then compared with the results of a test in which a truck of known weight crossed the bridge multiple times. Finally, the data relative to 3 years of uninterrupted monitoring were processed and analyzed to identify eventual anomalies. [ABSTRACT FROM AUTHOR]

Background: The widespread diffusion of Artificial Intelligence (AI) platforms is revolutionizing how health-related information is disseminated, thereby highlighting the need for tools to evaluate the quality of such information. This study aimed to propose and validate the Quality Assessment of Medical Artificial Intelligence (QAMAI), a tool specifically designed to assess the quality of health information provided by AI platforms. Methods: The QAMAI tool has been developed by a panel of experts following guidelines for the development of new questionnaires. A total of 30 responses from ChatGPT4, addressing patient queries, theoretical questions, and clinical head and neck surgery scenarios were assessed by 27 reviewers from 25 academic centers worldwide. Construct validity, internal consistency, inter-rater and test–retest reliability were assessed to validate the tool. Results: The validation was conducted on the basis of 792 assessments for the 30 responses given by ChatGPT4. The results of the exploratory factor analysis revealed a unidimensional structure of the QAMAI with a single factor comprising all the items that explained 51.1% of the variance with factor loadings ranging from 0.449 to 0.856. Overall internal consistency was high (Cronbach's alpha = 0.837). The Interclass Correlation Coefficient was 0.983 (95% CI 0.973–0.991; F (29,542) = 68.3; p < 0.001), indicating excellent reliability. Test–retest reliability analysis revealed a moderate-to-strong correlation with a Pearson's coefficient of 0.876 (95% CI 0.859–0.891; p < 0.001). Conclusions: The QAMAI tool demonstrated significant reliability and validity in assessing the quality of health information provided by AI platforms. Such a tool might become particularly important/useful for physicians as patients increasingly seek medical information on AI platforms. [ABSTRACT FROM AUTHOR]

Systemic sclerosis (SSc) is a chronic multisystemic disease characterized by immunological activation, diffuse vasculopathy, and generalized fibrosis exhibiting a variety of symptoms. A recognized precursor of SSc is Raynaud's phenomenon, which is part of the very early disease of systemic sclerosis (VEDOSS) in combination with nailfold videocapillaroscopy (NVC) impairment. The pathophysiology of ocular involvement, alterations in internal organs, and body integumentary system involvement in SSc patients are complicated and poorly understood, with multiple mechanisms presumptively working together. The most prevalent ocular symptoms of SSc are abnormalities of the eyelids and conjunctiva as well as dry eye syndrome, due to fibroblasts' dysfunction and inflammation of the ocular surface. In particular, lagophthalmos, blepharophimosis limitation of eyelid motion, eyelid telangiectasia, and rigidity or tightening of the lids may affect up to two-third of the patients. In addition, reduction in central corneal thickness, iris defects and higher rates of glaucoma were reported. In the first reports based on retinography or fluorescein angiography, about 50% of SSc patients showed signs of vascular disease: peripheral artery occlusion, thinning of retinal pigment epithelium and choroidal capillaries, ischemic areas surrounded by intraretinal extravasation and microaneurysms, and peripheral capillary non-perfusion. Successively, thanks to the advent of optical coherence tomography angiography (OCTA), several studies highlighted significant impairment of either the choriocapillaris and retinal vascular plexuses, also correlating with NVC involvement and skin disease, even in VEDOSS disease. Given the sensitivity of this technique, ocular micro-vasculopathy may act as a tool for early SSc identification and discriminate between disease stages. [ABSTRACT FROM AUTHOR]

Purpose: Chemotherapy-induced neutropenia poses a significant risk to cancer patients, with pegfilgrastim being commonly used for its prevention. While pegfilgrastim can be administered via prefilled syringe or pen device, patient preferences and experiences with these delivery methods remain unclear. Methods: We conducted a prospective, open-label, randomized, observational trial (NCT05910164) at the Rafael Institute, France, comparing patient preferences for pegfilgrastim administration using a prefilled syringe versus a prefilled pen device. Patients undergoing chemotherapy and requiring pegfilgrastim were enrolled and randomized 1:1 to receive either syringe or pen first, with crossover administration. Questionnaires assessed patient preferences, learning experiences, autonomy, pain levels, emotional responses, satisfaction with nursing care, and empowerment. Results: Among 150 randomized patients (mean age 58 years; 69% female), both groups showed a preference for the pen device, with significantly higher mean scores favoring pen administration (4.94 ± 1.70 vs. 4.27 ± 1.84; p = 0.00106). Patients reported significantly lower perceived pain with pen administration and stronger positive emotions compared to syringe use. Satisfaction with nursing care was higher with syringe use. Empowerment levels were similar across groups but significantly stronger when using the pen in complete autonomy. Conclusion: A preference for pegfilgrastim administration via the pen device was observed, though this may have been influenced by the administration sequence and the absence of syringe self-administration. The insights gained can help inform clinical decision-making and improve patient-centered care in managing chemotherapy-induced neutropenia. Trial registration: NCT05910164 on June 15, 2023. [ABSTRACT FROM AUTHOR]

The scaphotrapeziotrapezoid (STT) joint is involved in load transmission between the wrist and thumb. A quantitative description of baseline STT joint morphometrics is needed to capture the variation of normal anatomy as well as to guide staging of osteoarthritis. Statistical shape modeling (SSM) techniques quantify variations in three‐dimensional shapes and relative positions. The objectives of this study are to describe the morphology of the STT joint using a multi‐domain SSM. We asked: (1) What are the dominant modes of variation that impact bone and articulation morphology at the STT joint, and (2) what are the morphometrics of SSM‐generated STT joints? Thirty adult participants were recruited to a computed tomography study of normal wrist imaging and biomechanics. Segmentations of the carpus were converted to three‐dimensional triangular surface meshes. A multi‐domain, particle‐based entropy system SSM was used to quantify variation in carpal bone shape and position as well as articulation morphology. Articular surface areas and interosseous proximity distributions were calculated between mesh vertex pairs on adjacent bones within distance (2.0 mm) and surface‐normal angular (35°) thresholds. In the SSM, the first five modes of variation captured 76.2% of shape variation and contributed to factors such as bone scale, articular geometries, and carpal tilt. Median interosseous proximities—a proxy for joint space—were 1.39 mm (scaphotrapezium), 1.42 mm (scaphotrapezoid), and 0.61 mm (trapeziotrapezoid). This study quantifies morphological and articular variations at the STT joint, presenting a range of normative anatomy. The range of estimated interosseous proximities may guide interpretation of imaging‐derived STT joint space. [ABSTRACT FROM AUTHOR]

Introduction: Stroke negatively impacts both patients and their families, who must face multiple changes after the onset of the disease. Family caregivers must face new problems with a possible sense of inadequacy, stress and burden. Our retrospective study aimed to assess the burden of caregivers during the rehabilitation process of patients with Stroke. Material and method: This study included patients with a diagnosis of stroke and their caregiver, who attended the Day Hospital of the IRCCS Neurolesi Center "Bonino-Pulejo", Messina, Italy, between January 2018 and October 2019, using electronic recovery system data. The final sample consisted of 30 patients and their caregivers. Results: Significant improvements were observed in patients' cognitive and mood scores, reflecting the efficacy of rehabilitation therapies. Additionally, a correlation emerged between patients' reported anxiety levels and caregivers' reported depression levels, highlighting a dynamic interaction between the emotional states of the two groups. Conclusion: The study highlights the intricate interplay between caregiver characteristics, patient outcomes, and family dynamics in the context of caregiving. Targeted interventions aimed at improving family resilience and coping mechanisms are crucial to optimizing the well-being of both caregivers and patients. [ABSTRACT FROM AUTHOR]

To identify and confirm patterns of relationships connecting sense of community (SOC) and individual resilience with psychological well‐being, via the mediation of coronavirus disease 2019 (COVID‐19) impacts on life domains. An online survey was conducted with a sample of adults (n = 650) 1 year after the COVID‐19 outbreak in Italy and the United States (April–December 2021). Utilizing a Structural Equation Model, we tested a mediation model (n = 563) to identify the associations between SOC and individual resilience and the perceived impacts of the emergency situation and psychological well‐being. Results revealed that during the crisis, SOC had an influence on psychological well‐being, but only by mediating the effects of COVID‐19 impacts on life domains. Independently, individual resilience had a direct influence on psychological well‐being. The findings support the importance of the interaction of individual and collective variables that played different roles at different phases of the pandemic. The findings suggest for possible interventions to enhance well‐being during crises. [ABSTRACT FROM AUTHOR]

Cardiac toxicity is an adverse event of several classes of anti-cancer drugs. Herein, we present the case of a 52-year-old woman with metastatic renal cell carcinoma (RCC), previously treated with debulking surgery, pembrolizumab (immune checkpoint inhibitor) in combination with axitinib (tyrosine kinase inhibitor (TKI)), followed by lenvatinib (TKI) and belzutifan (HIF-2α inhibitor), who developed myocarditis proven by cardiac magnetic resonance and endomyocardial biopsy. The case was notable for reporting a not-yet described adverse event during treatment with belzutifan plus lenvatinib, the etiology of which was of unobvious determination given the pre-exposure to pembrolizumab, a known cause of drug-related myocarditis. We surmise that myocarditis was a delayed adverse event related to pembrolizumab (8 months after treatment interruption), although we emphasize that only attentive monitoring of cardiac adverse events of patients exposed to belzutifan and lenvatinib in the context of large clinical trials may rule out any causal implication of these drugs. [ABSTRACT FROM AUTHOR]

Background: Research and monitoring of human resources available for vision rehabilitation services has been a neglected area of work in the past. This study aims to offer an overview of the vision rehabilitation workforce available in Italy, in order to profile the distribution and number of human resources for vision rehabilitation. Methods: Data on the available vision rehabilitation professionals were collected from the yearly report on the state of implementation of policies relating to the prevention of blindness, education and vision rehabilitation, according to a law which was passed by the Italian Ministry of Health, Department of Health Prevention. The report presents a review of all professional workers dealing with low vision rehabilitation centers in Italy between January 2005 and December 2019. Data on the distribution and type of services of government-supported low vision centers across the country were also obtained and examined. Results: Of the 289 low vision rehabilitation workers in 2019, 28% were ophthalmologists, 31% orthoptists, 19% psychologists, 17% nurses and 5% social workers. The health workforce densities across the Italian regions ranged from 1.62 to 0.12 per 100.000. The density of vision rehabilitation workers showed a no growing trend from 2006 to 2015. During the study period, it was found a weak but statistically significant association of workforce density with the number of government-supported low vision centers across the Italian territory (r2 = 0.3, p < 0.05). The vision rehabilitation workforce was not associated with the number of low vision patients who accessed to a vision rehabilitation center (r2 = 0.05, p < 0.0001). Discussion: A critical review has identified the following national situation: need-based shortages of workers in the vision rehabilitation service sector, as well as deficiencies in data sources. Based on our results, we would recommend increasing the development of human resources trained and dedicated to vision rehabilitation and improve data collection and analysis; provide structural enhancements, across all service levels. These considerations may contribute to the enhancement of policy decisions in order to guarantee an adequate vision rehabilitation workforce and meet national rehabilitation needs. Furthermore, this analysis should be used as a lesson learned by other countries, as low-income ones, in order to develop vision rehabilitation services. [ABSTRACT FROM AUTHOR]

Background: To assess the reliability and comprehensibility of breast radiology reports simplified by artificial intelligence using the large language model (LLM) ChatGPT-4o. Methods: A radiologist with 20 years' experience selected 21 anonymized breast radiology reports, 7 mammography, 7 breast ultrasound, and 7 breast magnetic resonance imaging (MRI), categorized according to breast imaging reporting and data system (BI-RADS). These reports underwent simplification by prompting ChatGPT-4o with "Explain this medical report to a patient using simple language". Five breast radiologists assessed the quality of these simplified reports for factual accuracy, completeness, and potential harm with a 5-point Likert scale from 1 (strongly agree) to 5 (strongly disagree). Another breast radiologist evaluated the text comprehension of five non-healthcare personnel readers using a 5-point Likert scale from 1 (excellent) to 5 (poor). Descriptive statistics, Cronbach's α, and the Kruskal–Wallis test were used. Results: Mammography, ultrasound, and MRI showed high factual accuracy (median 2) and completeness (median 2) across radiologists, with low potential harm scores (median 5); no significant group differences (p ≥ 0.780), and high internal consistency (α > 0.80) were observed. Non-healthcare readers showed high comprehension (median 2 for mammography and MRI and 1 for ultrasound); no significant group differences across modalities (p = 0.368), and high internal consistency (α > 0.85) were observed. BI-RADS 0, 1, and 2 reports were accurately explained, while BI-RADS 3–6 reports were challenging. Conclusion: The model demonstrated reliability and clarity, offering promise for patients with diverse backgrounds. LLMs like ChatGPT-4o could simplify breast radiology reports, aid in communication, and enhance patient care. Relevance statement: Simplified breast radiology reports generated by ChatGPT-4o show potential in enhancing communication with patients, improving comprehension across varying educational backgrounds, and contributing to patient-centered care in radiology practice. Key Points: AI simplifies complex breast imaging reports, enhancing patient understanding. Simplified reports from AI maintain accuracy, improving patient comprehension significantly. Implementing AI reports enhances patient engagement and communication in breast imaging. [ABSTRACT FROM AUTHOR]

Unlike the inverters in the traditional alternating‐current (AC) microgrid, those in a microgrid with series microsource inverters (SMSI‐MG) are connected to the power grid after being cascaded. The authors of this study first divide the control sections according to the degree of grid voltage dips and formulate a coordinated scheme to suppress fluctuations in the output powers of the SMSI‐MG. For the section in which the degree of unbalanced grid voltage dips is relatively low, a current‐limiting strategy that reduces the output power of the SMSI‐MG through the coordinated control of the generator subunits (CCGU) is proposed. More active power can be provided by the SMSI‐MG when the proposed strategy is used, than in the strategy that is based on changing the reference power, and the output reactive power of the SMSI‐MG can be automatically changed with the degrees of dip and unbalance of the grid voltage. The Light Gradient‐Boosting Machine (LightGBM) is used to establish a mapping relationship between the parameters characterizing overcurrent and the reduction quantity in output active power of the SMSI‐MG to implement the CCGU‐based current‐limiting strategy. The complex collaborative control is simplified to improve the low‐voltage ride through (LVRT) capability of the SMSI‐MG. [ABSTRACT FROM AUTHOR]

The concept of love of life, which refers to a positive attitude towards one's own life, care for it and attachment to it, has recently captured the attention of researchers in the field of positive psychology. Despite its growing importance, there is a lack of research investigating the underlying mechanisms through which love of life impacts the flourishing and well-being of individuals. For the first time, the present study examined the mediating roles of optimism and hope in the association between love of life and flourishing in Turkish youth. The study comprised 374 young adults, aged between 18 and 24 years (55.3% female; Mean age = 20.94; SD = 1.78 years), who participated in an online survey assessing their levels of love of life, optimism, hope, and flourishing. Results from the mediation analysis revealed that love of life significantly predicted optimism, hope, and flourishing. Furthermore, optimism and hope had significant predictive effects on flourishing. Importantly, optimism and hope played a partial mediating role in explaining the positive influence of the love of life on individuals' flourishing. The findings suggest a positive association between love of life and heightened levels of optimism and hope. These psychological attributes, in turn, emerge as crucial factors contributing to increased flourishing. These results hold significant implications for the development of interventions focused on understanding how to foster the love of life and flourish through the cultivation of psychological strengths. [ABSTRACT FROM AUTHOR]

A palladium catalyst supported on silk fibroin (Pd/SF) has been tested in the Sonogashira coupling reactions of a wide range of aryl iodides and terminal alkynes. The best catalytic performance was obtained at 90 °C using only 0.25 mol % metal loading under copper‐free conditions, in the presence of a H2O/EtOH (3 : 2 v/v) solvent mixture and triethylamine as the base, affording the coupling products in good yields. The Pd/SF‐based protocol was then successfully extended to the synthesis of benzofurans through Sonogashira‐Cacchi type annulation of 2‐iodophenol with terminal alkynes. Preliminary investigations on the recyclability and the heterogeneous behaviour of the catalyst were performed: hot filtration test and leaching test evidenced the presence of a small amount of soluble active palladium species into the reaction mixture. Nevertheless, Pd/SF could be reused in recharging test and it can be recycled in four consecutive runs with no significant deactivation. [ABSTRACT FROM AUTHOR]

Background: This pilot prospective study aimed to evaluate ultrasound-guided cryoablation of breast cancer (BC) by assessing: (i) technical efficacy as the presence of necrosis in surgical specimens and rate of complete tumor ablation; (ii) safety as incidence and severity of complications; and (iii) patients' satisfaction using a dedicated questionnaire. In addition, (iv) we tested the capability of magnetic resonance imaging (MRI) or contrast-enhanced mammography (CEM) to predict cryoablation efficacy. Methods: From 07/2022 to 01/2023, we enrolled 20 patients with early-stage BC scheduled for breast surgery. Ten of them, with a cryo-feasible cancer location, were sent to cryoablation (cryo-group) and ten to routine surgical practice (control group). Both groups underwent surgery and were asked to answer a satisfaction questionnaire. Results: Of eleven patients screened for cryoablation, only one refused to be treated at another hospital (acceptance rate 10/11, 91%). Surgery was quadrantectomy in 19 cases and mastectomy in 1. In the cryo-group, the procedure was completed and steatonecrosis was observed in 10/10 cases, with complete tumor ablation in nine of them. The post-procedural status was evaluated with MRI in five patients, with CEM in four patients, and with ultrasound in one patient who refused MRI and CEM. MRI or CEM correctly predicted complete cryoablation in eight patients and incomplete cryoablation in one patient. Patients in both groups did not have serious complications and responded positively to satisfaction questionnaires. Conclusion: Ultrasound-guided cryoablation of early-stage BC is well accepted by patients, effective, and safe. MRI and CEM were able to predict the procedure's technical efficacy. Trial registration: https://clinicaltrials.gov/study/NCT05727813 updated February 14, 2023. Relevance statement: Our pilot study showed that ultrasound-guided cryoablation is a promising nonsurgical alternative for treating early-stage BC. Key Points: Ultrasound-guided cryoablation was effective and safe in early BC patients. The procedure was well-tolerated, with low morbidity and high patient satisfaction. MRI and CEM predicted cryoablation efficacy, in accordance with histopathologic findings. Cryoablation can be considered a potential alternative to surgery in selected patients. [ABSTRACT FROM AUTHOR]

The emergence of vaccinomics and system vaccinology represents a transformative shift in immunization strategies, advocating for personalized vaccines tailored to individual genetic and immunological profiles. Integrating insights from genomics, transcriptomics, proteomics, and immunology, personalized vaccines offer the promise of enhanced efficacy and safety, revolutionizing the field of vaccinology. However, the development of personalized vaccines presents multifaceted challenges, including technical, ethical, economic, and regulatory considerations. Addressing these challenges is essential to ensure equitable access and safety of personalized vaccination strategies. Despite these hurdles, the potential of personalized vaccines to optimize responses and mitigate disease burden underscores the significance of ongoing research and collaboration in advancing precision medicine in immunization. [ABSTRACT FROM AUTHOR]

Simple Summary: Treatment options for intrahepatic cholangiocarcinoma (iCCA), a highly malignant tumor with poor prognosis, are limited. Recent developments in immunotherapy and immune checkpoint inhibitors (ICIs) have offered new hope for treating iCCA. However, several issues remain, including the identification of reliable biomarkers of response to ICIs and immune-based combinations. Tumor immune microenvironment (TIME) of these hepatobiliary tumors has been evaluated and is under assessment in order to boost the efficacy of ICIs and to convert these immunologically "cold" tumors to "hot" tumors. Herein, we examine the role of iCCA TIME, highlighting its mechanisms, current applications and challenges, and future research directions. Treatment options for intrahepatic cholangiocarcinoma (iCCA), a highly malignant tumor with poor prognosis, are limited. Recent developments in immunotherapy and immune checkpoint inhibitors (ICIs) have offered new hope for treating iCCA. However, several issues remain, including the identification of reliable biomarkers of response to ICIs and immune-based combinations. Tumor immune microenvironment (TIME) of these hepatobiliary tumors has been evaluated and is under assessment in this setting in order to boost the efficacy of ICIs and to convert these immunologically "cold" tumors to "hot" tumors. Herein, the review TIME of ICCA and its critical function in immunotherapy. Moreover, this paper also discusses potential avenues for future research, including novel targets for immunotherapy and emerging treatment plans aimed to increase the effectiveness of immunotherapy and survival rates for iCCA patients. [ABSTRACT FROM AUTHOR]

This paper critically compares the turn-off performance of two package solutions, 3-lead (3L) vs. 4-lead (4L), in SuperJunction MOSFETs. It is commonly assumed that the better performance (lower switching losses) of the 4L MOSFET is obtained thanks to the decoupling of the power and driving loops. On the contrary, in this work, the experimental results, circuit models and Kirchhoff laws show that the turn-off improvement (lower turn-off losses) obtained by adopting the Kelvin source is due to the lower inductance of the driver loop of the 4L MOSFET, instead of the decoupling between the driver and power loops. In detail, an inductor is added to the gate path of the 4L MOSFET to obtain a total inductance in the driver loop equal to the 3L counterpart. The experimental results show that the 4L MOSFET presents the same drain current slew rate under this condition, although the driver and power loops are still decoupled. [ABSTRACT FROM AUTHOR]

Nasal delivery is a non-invasive strategy for effective drug delivery. Nevertheless, in order to promote drug uptake by the nasal mucosa, it is fundamental to increase its residence time in the administration site. To this aim, nano-sized drug delivery systems are widely exploited. Within this context, the commercially available nanoemulsion for parenteral nutrition is a biocompatible, safe and clinically approved vehicle for drug delivery. Furthermore, the nanodroplet surface can be modified via a well-established protocol to graft Concavalin A, a lectin capable of improving the mucosal adhesion, by binding to the α-mannose and α-glucose residues of the mucosal glycocalyx. The obtained targeted formulation is able to induce haemagglutination, as opposite to non-modified nanoemulsion. Furthermore, the ConA grafting maintains the physicochemical properties of the nanodroplets (size~230 nm, Z < −35 mV) and does not interfere with the loading of the Rose Bengal fluorescent probe. Fluorescently labelled ConA grafted nanodroplets showed enhanced permeation and accumulation in ex vivo bovine nasal mucosa. This study is a proof of concept that Concanavalin A can be used to decorate the surface of nanodroplets, acting as a permeation promoter. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is a neurodegenerative disorder that progressively involves brain regions with an often-predictable pattern. Damage to the brain appears to spread and worsen with time, but the molecular mechanisms underlying the region-specific distribution of AD pathology at different stages of the disease are still under-investigated. In this study, a whole-transcriptome analysis was carried out on brain samples from the hippocampus (HI), temporal and parietal cortices (TC and PC, respectively), cingulate cortex (CG), and substantia nigra (SN) of six subjects with a definite AD diagnosis and three healthy age-matched controls in duplicate. The transcriptomic results showed a greater number of differentially expressed genes (DEGs) in the TC (1571) and CG (1210) and a smaller number of DEGs in the HI (206), PC (109), and SN (60). Furthermore, the GSEA showed a difference between the group of brain areas affected early (HI and TC) and the group of areas that were subsequently involved (PC, CG, and SN). Notably, in the HI and TC, there was a significant downregulation of shared DEGs primarily involved in synaptic transmission, while in the PC, CG, and SN, there was a significant downregulation of genes primarily involved in protein folding and trafficking. The course of AD could follow a definite time- and severity-related pattern that arises from protein misfolding, as observed in the PC, CG, and SN, and leads to synaptic impairment, as observed in the HI and TC. Therefore, a map of the molecular and biological processes involved in AD pathogenesis may be traced. This could aid in the discovery of novel biological targets in order to develop effective and well-timed therapeutic approaches. [ABSTRACT FROM AUTHOR]

Immune checkpoint inhibitors (ICIs), such as durvalumab, tremelimumab, and atezolizumab, have emerged as a significant therapeutic option for the treatment of hepatocellular carcinoma (HCC). In fact, the efficacy of ICIs as single agents or as part of combination therapies has been demonstrated in practice-changing phase III clinical trials. However, ICIs confront several difficulties, including the lack of predictive biomarkers, primary and secondary drug resistance, and treatment-related side effects. Herein, we provide an overview of current issues and future challenges in this setting. [ABSTRACT FROM AUTHOR]

Background: Gender differences in the access to advanced therapies for Parkinson's disease (PD) are poorly investigated. Objective: The objective of this study was to investigate the presence of any gender disparity in the access to advanced therapies for PD. Design: Retrospective study. Methods: Data from patients with consistent access to the Parkinson's and Movement Disorder Center of L'Aquila over the last 10-year period were screened. Patients selected for advanced therapies were included. Results: Out of 1,252 patients, 200 (mean age ± SD 71.02 ± 9.70; 72% males; median Hoen Yahr level: 3, minimum 1 maximum 5) were selected for advanced therapies: 133 for Magnetic Resonance guided Focused Ultrasound (MRgFUS) thalamotomy (mean age ± SD 70.0 ± 8.9; 77% males), 49 for Levodopa/Carbidopa Intestinal Gel (LCIG) infusion (mean age ± SD 74.3 ± 11.4; 59% males), 12 for Deep Brain Stimulation (DBS) (mean age ± SD 71.2 ± 6.3; 75% males), and 7 for Continuous Subcutaneous Apomorphine Infusion (CSAI) (mean age ± SD 69.7 ± 5.5; 43% males). No sex differences were found in relation to age (MRgFUS group: males vs. females 70.2 ± 8.9 vs. 70.8 ± 8.9, p-value = 0.809; LCIG group: males vs. females 73.5 ± 13.0 vs. 75.5 ± 8.5, p-value = 0.557; DBS group: males vs. females 77.2 ± 8.1 vs. 67.3 ± 8.6, p-value = 0.843; CSAI group: males vs. females 73.3 ± 4.0 vs. 67.0 ± 5.2, p-value = 0.144) and disease duration (MRgFUS group: males vs. females 8.3 ± 4.4 vs. 9.6 ± 6.7, p-value = 0.419; LCIG group: males vs. females 14.5 ± 5.81 vs. 17.3 ± 5.5; p-value = 0.205; DBS group: males vs. females 15.0 ± 9.6 vs. 15.5 ± 7.7, p-value = 0.796; CSAI group: males vs. females 11.7 ± 3.7 vs. 10.3 ± 3.7, p-value = 0.505). Conclusion: The predominance of males is higher than that expected based on the higher prevalence of PD in men. Women are less confident in selecting advanced therapies during the natural progression of their disease. Factors accounting for this discrepancy deserve further investigation. [ABSTRACT FROM AUTHOR]

Virtual reality (VR) is a technology that allows users to experience multisensory and interactive environments that simulate real or imaginary scenarios. The effect of different VR immersive technology on mental workload (MWL), i.e., the amount of resources required to perform a task, is still debated; however the potential role of EEG in this context was never exploited. This paper aims to investigate the effects on MWL of performing a cognitive task in a VR environment in two conditions characterized by different degrees of immersion using a multimodal approach which combines well-assessed subjective evaluations of MWL with physiological EEG measures. A cognitive task based on the n-back test was proposed to compare the performance and MWL of participants who used either a head-mounted display (HMD) or a desktop computer to present the stimuli. The task had four different complexity levels (n = 1 or 2 with either visual or visual and audio stimuli). Twenty-seven healthy participants were enrolled in this study and performed the tasks in both conditions. EEG data and NASA Task Load indeX (NASA-TLX) were used to assess changes in objective and subjective MWL, respectively. Error rates (ERs) and reaction times (RTs) were also collected for each condition and task level. Task levels had significant effects on MWL, increasing subjective measures and decreasing performance, in both conditions. EEG MWL index have shown a significant increase especially if compared to rest. Different degrees of immersion did not show significant differences neither in individual's performance nor in MWL as estimated by subjective ratings. However, HMD reduced the EEG-derived MWL in most conditions indicating a lower cognitive load. In conclusion, HMD may reduce the cognitive load of some tasks. The reduced level of MWL, as depicted by the EEG MWL index, may have implications for the design and future evaluation of VR-based applications. [ABSTRACT FROM AUTHOR]

Defining the molecular mechanisms underlying cardiac resilience is crucial to find effective approaches to protect the heart. A physiologic level of ROS is produced in the heart by fatty acid oxidation, but stressful events can boost ROS and cause mitochondrial dysfunction and cardiac functional impairment. Melusin is a muscle specific chaperone required for myocardial compensatory remodeling during stress. Here we report that Melusin localizes in mitochondria where it binds the mitochondrial trifunctional protein, a key enzyme in fatty acid oxidation, and decreases it activity. Studying both mice and human induced pluripotent stem cell-derived cardiomyocytes, we found that Melusin reduces lipid oxidation in the myocardium and limits ROS generation in steady state and during pressure overload and doxorubicin treatment, preventing mitochondrial dysfunction. Accordingly, the treatment with the lipid oxidation inhibitor Trimetazidine concomitantly with stressful stimuli limits ROS accumulation and prevents long-term heart dysfunction. These findings disclose a physiologic mechanism of metabolic regulation in the heart and demonstrate that a timely restriction of lipid metabolism represents a potential therapeutic strategy to improve cardiac resilience to stress. Synopsis: FAO is catalyzed by the mitochondrial trifunctional protein (MTP) and, if overloaded, generates ROS. ROS are boosted during stressful events, favoring cardiac maladaptive remodeling. Melusin is a muscle-specific chaperone able to sustain heart resilience during a wide variety of stressful insults. Melusin interacts and inhibits the MTP, restraining FAO and ROS generation in the myocardium. Heart resilience depends on the rate of FAO during stressful events occurrence. Inhibiting lipid metabolism in a timely manner during stress protects the heart from dysfunction and prolongs the survival in preclinical models. FAO is catalyzed by the mitochondrial trifunctional protein (MTP) and, if overloaded, generates ROS. ROS are boosted during stressful events, favoring cardiac maladaptive remodeling. Melusin is a muscle-specific chaperone able to sustain heart resilience during a wide variety of stressful insults. [ABSTRACT FROM AUTHOR]

Background: Gender differences in the access to advanced therapies for Parkinson's disease (PD) are poorly investigated. Objective: The objective of this study was to investigate the presence of any gender disparity in the access to advanced therapies for PD. Design: Retrospective study. Methods: Data from patients with consistent access to the Parkinson's and Movement Disorder Center of L'Aquila over the last 10-year period were screened. Patients selected for advanced therapies were included. Results: Out of 1,252 patients, 200 (mean age ± SD 71.02 ± 9.70; 72% males; median Hoen Yahr level: 3, minimum 1 maximum 5) were selected for advanced therapies: 133 for Magnetic Resonance guided Focused Ultrasound (MRgFUS) thalamotomy (mean age ± SD 70.0 ± 8.9; 77% males), 49 for Levodopa/Carbidopa Intestinal Gel (LCIG) infusion (mean age ± SD 74.3 ± 11.4; 59% males), 12 for Deep Brain Stimulation (DBS) (mean age ± SD 71.2 ± 6.3; 75% males), and 7 for Continuous Subcutaneous Apomorphine Infusion (CSAI) (mean age ± SD 69.7 ± 5.5; 43% males). No sex differences were found in relation to age (MRgFUS group: males vs. females 70.2 ± 8.9 vs. 70.8 ± 8.9, p-value = 0.809; LCIG group: males vs. females 73.5 ± 13.0 vs. 75.5 ± 8.5, p-value = 0.557; DBS group: males vs. females 77.2 ± 8.1 vs. 67.3 ± 8.6, p-value = 0.843; CSAI group: males vs. females 73.3 ± 4.0 vs. 67.0 ± 5.2, p-value = 0.144) and disease duration (MRgFUS group: males vs. females 8.3 ± 4.4 vs. 9.6 ± 6.7, p-value = 0.419; LCIG group: males vs. females 14.5 ± 5.81 vs. 17.3 ± 5.5; p-value = 0.205; DBS group: males vs. females 15.0 ± 9.6 vs. 15.5 ± 7.7, p-value = 0.796; CSAI group: males vs. females 11.7 ± 3.7 vs. 10.3 ± 3.7, p-value = 0.505). Conclusion: The predominance of males is higher than that expected based on the higher prevalence of PD in men. Women are less confident in selecting advanced therapies during the natural progression of their disease. Factors accounting for this discrepancy deserve further investigation. [ABSTRACT FROM AUTHOR]

Purpose: Disk battery (DB) ingestion in children can lead to severe complications and mortality. This study details our experience in managing DB ingestion and its complications. Methods: We analyzed data from all patients treated for DB ingestion at our hospital from June 2010 to January 2024. A protocol established in 2010 requires angio-CT scans for esophageal DB cases and a multidisciplinary approach involving gastroenterologists, otolaryngologists, pediatric and airway surgeons, and cardiac surgeons. Results: We treated 22 patients. In June 2010, following the tragic death of a patient from an undiagnosed DB ingestion that led to an aortoesophageal fistula, our protocol was established. All DBs were removed endoscopically. Four patients needed additional surgery: two had tracheal resection/anastomosis and esophageal repair for large tracheoesophageal fistulas; one required aortic wall reinforcement with a patch; one underwent endoscopic removal with a sternal split to explore the aortic arch. All 22 patients survived and recovered clinically. One developed bilateral vocal cord palsy as a complication. Conclusion: Effective management of DB ingestion complications necessitates a collaborative, multidisciplinary approach. Our protocol has improved management strategies and patient outcomes. [ABSTRACT FROM AUTHOR]

In this work, silyl ethers of phenols and alcohols have been successfully prepared and tested as neutral carbon (silicon) centered radical precursors. The organophotocatalyzed oxidation (by the Fukuzumi catalyst) of these ethers caused the cleavage of a C−Si (or a Si−Si) bond for the release of the desired radical to be used for the forging of C(sp3) −C(sp3) (or C(sp3) −Si) bonds via a Giese reaction. [ABSTRACT FROM AUTHOR]