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The transformative role of artificial intelligence (AI) and multiomics could enhance the diagnostic and prognostic capabilities of liquid biopsy (LB) for lung cancer (LC). Despite advances, the transition from tissue biopsies to more sophisticated, non‐invasive methods like LB has been impeded by challenges such as the heterogeneity of biomarkers and the low concentration of tumour‐related analytes. The advent of multiomics – enabled by deep learning algorithms – offers a solution by allowing the simultaneous analysis of various analytes across multiple biological fluids, presenting a paradigm shift in cancer diagnostics. Through multi‐marker, multi‐analyte and multi‐source approaches, this review showcases how AI and multiomics are identifying clinically valuable biomarker combinations that correlate with patients' health statuses. However, the path towards clinical implementation is fraught with challenges, including study reproducibility and lack of methodological standardization, thus necessitating urgent solutions to solve these common issues. [ABSTRACT FROM AUTHOR]

The in vivo three-dimensional genomic architecture of adult mature neurons at homeostasis and after medically relevant perturbations such as axonal injury remains elusive. Here, we address this knowledge gap by mapping the three-dimensional chromatin architecture and gene expression program at homeostasis and after sciatic nerve injury in wild-type and cohesin-deficient mouse sensory dorsal root ganglia neurons via combinatorial Hi-C, promoter-capture Hi-C, CUT&Tag for H3K27ac and RNA-seq. We find that genes involved in axonal regeneration form long-range, complex chromatin loops, and that cohesin is required for the full induction of the regenerative transcriptional program. Importantly, loss of cohesin results in disruption of chromatin architecture and severely impaired nerve regeneration. Complex enhancer-promoter loops are also enriched in the human fetal cortical plate, where the axonal growth potential is highest, and are lost in mature adult neurons. Together, these data provide an original three-dimensional chromatin map of adult sensory neurons in vivo and demonstrate a role for cohesin-dependent long-range promoter interactions in nerve regeneration. [ABSTRACT FROM AUTHOR]

Quantum technologies rely heavily on accurate control and reliable readout of quantum systems. Current experiments are limited by numerous sources of noise that can only be partially captured by simple analytical models and additional characterization of the noise sources is required. We test the ability of readout error mitigation to correct noise found in systems composed of quantum two-level objects (qubits). To probe the limit of such methods, we designed a beyond-classical readout error mitigation protocol based on quantum state tomography (QST), which estimates the density matrix of a quantum system, and quantum detector tomography (QDT), which characterizes the measurement procedure. By treating readout error mitigation in the context of state tomography the method becomes largely readout mode-, architecture-, noise source-, and quantum state-independent. We implement this method on a superconducting qubit and evaluate the increase in reconstruction fidelity for QST. We characterize the performance of the method by varying important noise sources, such as suboptimal readout signal amplification, insufficient resonator photon population, off-resonant qubit drive, and effectively shortened T1 and T2 coherence. As a result, we identified noise sources for which readout error mitigation worked well, and observed decreases in readout infidelity by a factor of up to 30. Significant efforts have been dedicated to mitigate gate errors in quantum devices, while comparatively little attention has been given to the increasing issue of readout errors. The authors present an explicit protocol for comprehensive readout error mitigation with quantum state tomography, and demonstrate its applicability experimentally on a superconducting qubit device. [ABSTRACT FROM AUTHOR]

Simple Summary: Prostate cancer is the second most diagnosed cancer in men. Focal laser ablation has been proposed as an alternative to radical treatments in carefully selected patients in order to achieve long-term cancer control and reduce the morbidity associated with surgery and radiation therapy. This study aimed to evaluate the oncological and functional outcomes of transperineal laser ablation (TPLA) as the focal therapy for localized prostate cancer. We assessed that TPLA is a safe, painless, and effective technique with good oncological results and the preservation of continence and sexual outcomes. Introduction and objectives: To evaluate the oncological and functional outcomes of transperineal laser ablation (TPLA) as the focal therapy for localized prostate cancer (PCa) after a 12-month follow-up. Materials and methods: Patients with low- and intermediate-risk localized PCa were prospectively treated with focal TPLA between July 2021 and December 2022. The inclusion criteria were the following: clinical stage < T2b; PSA < 20 ng/mL; International Society of Urological Pathology (ISUP) grade ≤ 2; MRI-fusion biopsy-confirmed lesion classified as PI-RADS v2.1 ≥ 3. Intra-, peri-, and post-operative data were collected. Variables including age, PSA, prostate volume (PVol), Charlson's Comorbidity Index (CCI), International Prostate Symptom Score (IPSS) with QoL score, International Index of Erectile Function (IIEF-5), International Consultation on Incontinence Questionnaire—Short Form (ICIQ-SF), and Male Sexual Health Questionnaire—Ejaculatory Dysfunction Short Form (MSHQ-EjD) were collected at baseline and at 3, 6 and 12 months after TPLA. Post-operative mpMRI was performed at 3 and 12 months. Finally, all patients underwent prostatic re-biopsy under fusion guidance at 12 months. The success of this technique was defined as no recurrence in the target treated lesion at the 12-month follow up. Results: Twenty-four patients underwent focal TPLA. Baseline features were age [median 67 years (IQR 12)], PSA [5.7 ng/mL (3.9)], PVol [49 mL (27)], CCI [0 (0)], IPSS [11 (9)], IPSS-QoL [2 (2)], IIEF-5 [21 (6)], ICIQ-SF [0 (7)], MSHQ-EjD ejaculation domain [14 (4)] and bother score [0 (2)]. Median operative time was 34 min (IQR 12). Median visual analogue scale (VAS) 6 h after TPLA was 0 (IQR 1). The post-operative course was regular for all patients, who were discharged on the second post-operative day and underwent catheter removal on the seventh post-operative day. No patient had incontinence at catheter removal. A significant reduction in PSA (p = 0.01) and an improvement in IPSS (p = 0.009), IPSS-QoL (p = 0.02) and ICIQ-SF scores (p = 0.04) compared to baseline were observed at the 3-month follow-up. Erectile and ejaculatory functions did not show any significant variation during the follow-up. No intra- and peri-operative complications were recorded. Three Clavien–Dindo post-operative complications were recorded (12%): grade 1 (two cases of urinary retention) and grade 2 (one case of urinary tract infection). At the 12-month follow-up, eight patients showed mpMRI images referable to suspicious recurrent disease (PIRADS v2.1 ≥ 3). After re-biopsy, 7/24 patients' (29%) results were histologically confirmed as PCa, 3 of which were recurrences in the treated lesion (12.5%). The success rate was 87.5%. Conclusions: The focal TPLA oncological and functional results seemed to be encouraging. TPLA is a safe, painless, and effective technique with a good preservation of continence and sexual outcomes. Recurrence rate at 12 months was about 12.5%. [ABSTRACT FROM AUTHOR]

Currently 1677 species are listed under the U.S. Endangered Species Act (ESA), yet only a small percentage have been delisted due to recovery. In the fall of 2021, the U.S. Fish and Wildlife Service proposed delisting 23 species due to extinction. Tracking changes in species 'recovery status over time is critical to understanding species' statuses, informing adaptive management strategies, and assessing the performance of the ESA to prevent further species loss. In this paper, we describe four key obstacles in tracking species recovery status under the ESA. First, ESA 5‐year reviews lack a standardized format and clear documentation. Second, despite having been listed for decades, many species still suffer major data gaps in their biology and threats, rendering it difficult if not impossible to track progress towards recovery. Third, many species have continued declining after listing, yet given the above (1 & 2), understanding potential causes (proximate and/or ultimate) can be difficult. Fourth, many species currently have no path to clear recovery, which represents a potential failing of the process. We conclude with a discussion of potential policy responses that could be addressed to enhance the efficacy of the ESA. [ABSTRACT FROM AUTHOR]

The Endangered Species Act (ESA) provides legal protection to imperiled populations and their associated habitats. As a part of this process, listed species must undergo a general status review (also called 5‐Year Review) to assess the progress toward recovery every 5 years. However, almost all 5‐year reviews result in a status of "no change," prompting scientists to question if the review process is robust enough to detect changes in recovery. The U.S. Fish and Wildlife Service (USFWS) was therefore interested in developing a standardized metric for monitoring more nuanced recovery progress as part of the status review. In collaboration with the USFWS, over 75 biologists from five different organizations developed and tested a set of novel metrics to summarize recovery progress of listed species by considering current and future conditions, threats, and conservation measures. We found that, although the majority of species had reviews with a recommendation of no change, scorers were able to use the metrics to interpret more nuanced changes in the 3Rs (resiliency, redundancy, and representation), threats, and conservation measures than in the status review. Our results suggest that these metrics could illuminate more nuanced areas of recovery and decline in species' conditions, but consistency among scorers and status reports should be a focus of future development. Our approach offers a rigorous set of metrics to systematically track the recovery progress of all ESA species. [ABSTRACT FROM AUTHOR]

Preoperative sonographic staging in patients with suspected parametrial endometriosis is essential to plan surgical intervention and anticipate the need for a multidisciplinary approach, and thus optimize surgical outcome. The results of a recent meta‐analysis suggest that there is a need to define more accurately the ultrasonographic criteria for parametrial involvement in endometriosis. This addendum to the International Deep Endometriosis Analysis (IDEA) consensus highlights the sonographic characteristics of the parametrium and identifies ultrasound techniques to diagnose deep endometriosis in this area. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Species richness is one of the fundamental metrics of biodiversity. Estimating species richness helps spotlight taxonomic groups that are particularly under-studied, such as the highly diverse Darwin wasps. The only available estimate of the number of Darwin wasps in the Afrotropics proposed almost 11,000 species, compared to the 2,322 recorded species. However, it relied exclusively on the ratio of morphospecies to described species in Henry Townes' personal collection. We provide an updated estimate of the Afrotropical Darwin wasp species, using empirical data from multiple sources, including the increase in species numbers following generic revisions, morphospecies sorting in natural history collections, and diversity patterns of better-studied insects (butterflies) for extrapolation. Our analyses suggest that our knowledge of Darwin wasps is highly incomplete, with only 13–22% of species known in the five most extensively studied countries in the Afrotropics. We estimate 9,206–15,577 species of Darwin wasps within the entire Afrotropics, with the highest concentration expected in the Equatorial Afrotropics and Madagascar. Due to data constraints, our approach tends to underestimate diversity at each step, rendering the upper estimate (15,577 species) more realistic. We highlight reasons contributing to the gap between recorded and estimated species richness, including logistical and financial factors, as well as post-colonial influences. [ABSTRACT FROM AUTHOR]

Avian eggs develop outside of the female body, and therefore embryonic development is subject to multiple internal (physiological) and external (ecological) factors. Embryonic developmental rate has important consequences for survival. Within species, embryos that develop too quickly often experience deformities, disorders, or mortality, while embryos that develop slowly risk inviability and increase the time they are exposed to various sources of mortality in the nest. These contrasting forces may lead to interspecific variation in developmental rates. We investigated potential factors affecting embryonic heart rate (EHR), a proxy of development, across 14 passerine species in the field. More specifically, we investigated if nest predation risk, clutch size, seasonality, and egg volume influenced EHR. From previous research, we expected, and found, that EHR was positively associated with embryonic age and egg temperature. Species with greater nest predation risk had higher EHR, shorter incubation periods, and lower nest temperature variance. EHR increased as the season progressed and with egg volume, while EHR declined with clutch size. Bird species exhibit varying strategies to increase nestling and fledgling survival in response to predation risk, and these results suggest that variation in embryonic development may be related to species‐specific differences in nest predation risk. [ABSTRACT FROM AUTHOR]

Background: A comprehensive assessment of upper limb (UL) function is mandatory in people with multiple sclerosis (PwMS), and the use of multiple objective and subjective measures is advisable. Findings on the role of cognitive impairment on the assessment of UL function are scant and inconclusive. The present study investigated the influence of cognitive function on the distribution of objective and subjective UL measures and on their association. Methods: In the cross-sectional study, subjects with a diagnosis of MS, age ≥ 18 years, right-hand dominance, no presence of orthopedic UL impairment, or other neurological diseases were recruited. The assessment protocol included the Nine-Hole Peg Test (9-HPT), Box and Block Test (BBT), and hand grip strength (HGS), a validated PROM (MAM-36), and the Symbol Digit Modalities Test (SDMT). Results: Two hundred forty-six PwMS were recruited (158 females, mean age = 51.65 ± 13.45 years; mean EDSS = 5.10 ± 1.88) Subject with mild-to-moderate cognitive impairment (SDMT ≤ − 2 SD of normative values) scored lower on the 9-HPT and higher on the BBT and MAM-36 when compared with subject with no cognitive impairment. Cognitive impairment showed a small but significant effect on the association between 9-HPT scores and the MAM-36. Discussion: Findings suggest that cognitive impairment is associated with subjects' performance on 9-HPT, BBT, and MAM-36 (but not HGS), resulting in scores indicating a poorer UL function. Interestingly, cognitive impairment slightly affected the congruence between subjective and objective UL measures, although only minor differences in the correlation pattern across groups reporting different cognitive performances emerged. [ABSTRACT FROM AUTHOR]

Avian eggs develop outside of the female body, and therefore embryonic development is subject to multiple internal (physiological) and external (ecological) factors. Embryonic developmental rate has important consequences for survival. Within species, embryos that develop too quickly often experience deformities, disorders, or mortality, while embryos that develop slowly risk inviability and increase the time they are exposed to various sources of mortality in the nest. These contrasting forces may lead to interspecific variation in developmental rates. We investigated potential factors affecting embryonic heart rate (EHR), a proxy of development, across 14 passerine species in the field. More specifically, we investigated if nest predation risk, clutch size, seasonality, and egg volume influenced EHR. From previous research, we expected, and found, that EHR was positively associated with embryonic age and egg temperature. Species with greater nest predation risk had higher EHR, shorter incubation periods, and lower nest temperature variance. EHR increased as the season progressed and with egg volume, while EHR declined with clutch size. Bird species exhibit varying strategies to increase nestling and fledgling survival in response to predation risk, and these results suggest that variation in embryonic development may be related to species‐specific differences in nest predation risk. [ABSTRACT FROM AUTHOR]

Introduction: Numerical simulations have demonstrated the superior bending flexibility of auxetic stents compared to conventional stent designs for endovascular procedures. However, conventional stent manufacturing techniques struggle to produce complex auxetic stent designs, fueling the adoption of additive manufacturing techniques. Methods: In this study, we employed DMLS additive manufacturing to create Titanium Ti64 alloy stent prototypes based on auxetic stent designs investigated in a previous study. These prototypes were then subjected to experimental three-point bending tests. Result: The experimental results were replicated using a finite element model, which showed remarkable accuracy in predicting the bending flexibility of four auxetic stents and two conventional stents. Discussion: Although this validation study demonstrates the promising potential of DMLS and other additive manufacturing methods for fabricating auxetic stents, further optimization of current stent design limitations and the incorporation of post-processing techniques are essential to enhance the reliability of these additive manufacturing processes. [ABSTRACT FROM AUTHOR]

In this article, we draw on various critical perspectives to theorize neoliberal choice and examine how it has been deployed to market new educational reforms in Ontario. We begin by offering a contemporary framing of neoliberalism that looks at its core elements as well as its chameleon-like tendencies to draw on neoconservative elements as needed. We also furnish critiques of neoliberalism by engaging Adams et al.'s (2019) description of neoliberal "choice" as one component of a larger psychological exercise in support of capitalism. We then examine how the language of choice has been used to position three recent Ontario education reforms: (a) mandatory e-learning; (b) growth of international students; and (c) the revision of curricula according to economic ends. Finally, we argue that the implementation of these reforms ironically has produced less choice for stakeholders through austerity and standardization. [ABSTRACT FROM AUTHOR]

(1) Background: Herpes zoster (HZ) is a disease caused by the reactivation of the Varicella Zoster Virus (VZV). Clinical reactivation, herpes zoster, takes place in 10–20% of subjects who contracted the primary infection, with a higher risk of developing zoster increasing proportionally with age, especially after 50 years of age. HZ is a common clinical problem, particularly among patients aged over 50 years and immunocompromised patients. Immunocompromised patients and adults could present an atypical and more severe course. In addition, they are at greater risk of complications. For this reason, it is important to understand the real burden of the disease and to identify the subjects who are at higher risk of HZ and its complications, also to direct preventive strategies at the right targets. The aim of the present study is to analyze HZ-related hospitalization trends in Abruzzo in the period of 2015–2021. (2) Methods: Data related to hospital admissions were extracted from the hospital discharge records (HDRs) of the whole region, considering all admissions during the years of 2015–2021. The trends in hospital admissions and length of stay were evaluated and analyzed. (3) Results: A total of 768 hospital discharges with a diagnosis of herpes zoster were registered in Abruzzo during the 7-year study period. During the study period, an increasing trend was observed from the year 2015 to the year 2017, ranging from 8.19 cases/100,000 to 11.5 cases/100,000 (APC (Annual percentage change) +20.8%; 95%CI −2.3; 47.6). After the year 2017, a significantly decreasing trend was observed, reaching 5.46 cases/100,000 in the year 2021 (APC −18.4%; 95%CI −31.5; −12.0). Across the entire study period, an average annual percentage change (AAPC) of −7.0% (95%CI −13.0; −1.3) was observed. (4) Conclusions: Despite the trend of a reduction in hospitalizations, this study highlights that HZ continues to have a great impact on public health. So, it is important to update recommendations for the use of the already available HZ vaccine and to implement new strategies to increase awareness of the prevention of the disease. [ABSTRACT FROM AUTHOR]

(1) Background: The lockdown, imposed to limit the pandemic evolution, impacted the social habits and lifestyle of inhabitants also from many countries other than Italy. Caffeine consumption could be a useful option to improve mood, as the lockdown strongly affected mental health, particularly increasing anxiety and sleep disorders. (2) Methods: It was a cross-sectional study aimed to evaluate the change in caffeine consumption after the pandemic period in a sample of Italian University students. It investigated coffee and products containing caffeine consumption, the anxiety level by State Trait Anxiety Inventory (STAI) and sleep quality with the Insomnia Severity Index (ISS). (3) Results: A total of 404 participants were enrolled in the study. During the lockdown period, 23% of subjects consumed more coffee compared to the pre-pandemic period. Daily coffee consumption also changed after the lockdown period compared to the pre-pandemic period, with 36.1% of subjects that increased their consumption. Comparing other caffeine-based products, energizing supplement consumption showed a greater increase after the lockdown period than energy drinks. Regarding anxiety, subjects who reported increased coffee consumption reported higher STAI scores and ISS. (4) Conclusions: About a quarter of university students increased their consumption of caffeine-based products after the pandemic, reporting higher levels of anxiety and poor sleep quality. [ABSTRACT FROM AUTHOR]

Simple Summary: Over the past few years, there has been a notable escalation in scholarly attention towards the implementation of focal therapeutic interventions for patients diagnosed with low- and intermediate-risk prostate cancer in order to achieve long-term cancer control and reduce morbidity associated with surgery and radiation therapy. This interventional pilot study (ClinicalTrials.gov ID NCT04045756) aimed to evaluate the short/medium-term (3 years) efficacy of trans perineal laser ablation (TPLA) in treating the index lesion of low–intermediate-risk prostate cancer, along with assessing the safety of the procedure and Quality of Life (QoL) of patients. Our results suggested that TPLA is a safe, feasible and effective treatment of low–intermediate-risk prostate cancer, with a high rate of tumor eradication and preservation of Quality of Life. Background: This interventional pilot study aimed to evaluate the short-term (3 years) efficacy of focal laser ablation (FLA) in treating the index lesion of low–intermediate-risk prostate cancer, along with assessing the safety of the procedure (ClinicalTrials.gov ID NCT04045756). Methods: Forty patients aged between 46 and 86 with histologically proven organ-confined prostate cancer and low-to-intermediate progression risk were included. FLA was performed under percutaneous fusion magnetic resonance/ultrasound guidance in a Day Hospital setting under local anesthesia. Patients underwent regular clinical and functional assessments through the international index of erectile function (IIEF-5) and the International Prostatism Symptom Score (IPSS), PSA measurements, post-procedure MRI scans, and biopsies at 36 months or if positive findings were detected earlier. Statistical analyses were conducted to assess trends in PSA levels and cavity dimensions over time. Results: Forty patients were initially included, with fifteen lost to follow-up. At 36 months, a mean PSA reduction of 60% was observed, and 80% of MRI scans showed no signs of in-field clinically significant residual/recurrent cancer. Biopsies at 36 months revealed no malignant findings in 20 patients. No deterioration in sexual function or urinary symptoms was recorded. Conclusions: FLA appears to be safe, feasible, and effective in the index lesion treatment of low–intermediate-risk prostate cancer, with a high rate of tumor eradication and preservation of quality of life. [ABSTRACT FROM AUTHOR]

The Gran Sasso carbonate aquifer is the largest and most productive in the Apennines. Its hydrogeological structure has been studied since the middle of the last century for the springs' characterization for drinking purposes and for a motorway tunnel. Meanwhile, its hydrodynamic parametrization is less developed and has been limited to monitoring the discharge and chemical and isotopic parameters. Secondary porosity characterizes the aquifer, and an underlying impermeable marly complex represents the basal aquiclude. It might appear inappropriate to characterize the hydraulic properties via pumping tests, as their reliability has been proven in homogeneous and isotropic media. However, the high extent of the aquifer, the wells' location, the scarcity of information available and the lack of alternatives has forced the estimation of hydrodynamic parameters as in porous aquifers and the experimental testing of the aquifer, especially in maximum pumping conditions, for a possible exploitation increase. Since aquifer testing was performed during the normal well field's activities, it was not possible to perform typical tests. Therefore, the step-drawdown test was conducted by turning on an increasing number of wells over time and keeping the observation points fixed. As results, a mean hydraulic conductivity of 5 × 10−3 m/s and a mean transmissivity of 0.3 m2/s were established without interrupting the water supply; meanwhile, the influence radius and flow directions were also estimated. [ABSTRACT FROM AUTHOR]

Detailed data on post-stroke depression (PSD) in older adults are limited in spite of the high vulnerability of this population to stroke. In fact, PSD prevalence in older adults ranges from 16.0 to 43.9%; however, timing and instruments of evaluation often differ significantly across all available studies. The etiology, genetic and inflammatory factors, as well as structural brain alterations, are claimed as part of a multifaceted mechanism of action in PSD onset. Thus, the aim of this narrative review was to further elaborate on the prevalence, etiology, diagnosis, consequences and treatment of PSD in older adults. The consequences of PSD in older adults may be devastating, including a poor functional outcome after rehabilitation and lower medication adherence. In addition, lower quality of life and reduced social participation, higher risk of new stroke, rehospitalization, and mortality have been reported. In this scenario, treating PSD represents a crucial step to prevent these complications. Both pharmacological and non-pharmacological therapies are currently available. The pharmacological treatment utilizes antidepressant drugs, such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TAs) and new multimodal antidepressants (NMAs). Non-pharmacological therapies include psychological interventions and non-invasive brain stimulation techniques, while excluding drug administration. In the general population experiencing PSD, SSRIs (sertraline in particular) are the most prescribed, whereas the combination of antidepressants and psychotherapy is underused. Furthermore, about one-third of patients do not receive treatment for PSD. In regard to older adults with PSD, the possibility of more adverse effects or contraindications to antidepressant prescription due to comorbidities may limit the therapeutic window. Although drugs such as citalopram, escitalopram, sertraline, venlafaxine, and vortioxetine are usually well tolerated by older patients with PSD, the few randomized controlled trials (RCTs) specifically considering older adults with PSD have been conducted with fluoxetine, fluvoxamine, reboxetine, citalopram and nortriptyline, often with very small patient samples. Furthermore, data regarding the results of non-pharmacological therapies are scarce. High-quality RCTs recruiting large samples of older adults are needed in order to better manage PSD in this population. In addition, adequate screening and diagnosis instruments, with reliable timing of evaluation, should be applied. [ABSTRACT FROM AUTHOR]

Purpose: Inappropriate stent-graft (SG) flexibility has been frequently associated with endovascular aortic repair (EVAR) complications such as endoleaks, kinks, and SG migration, especially in tortuous arteries. Stents derived from auxetic unit cells have shown some potential to address these issues as they offer an optimum trade-off between radial stiffness and bending flexibility. Methods: In this study, we utilized an established finite element (FE)-based approach to replicate the mechanical response of a SG iliac limb derived from auxetic unit cells in a virtual tortuous iliac aneurysm using a combination of a 180° U-bend and intraluminal pressurization. This study aimed to compare the mechanical performance (flexibility and durability) of SG limbs derived from auxetic unit cells and two commercial SG limbs (Z-stented SG and circular-stented SG models) in a virtual tortuous iliac aneurysm. Maximal graft strain and maximum stress in stents were employed as criteria to estimate the durability of SGs, whereas the maximal luminal reduction rate and the bending stiffness were used to assess the flexibility of the SGs. Results: SG limbs derived from auxetic unit cells demonstrated low luminal reduction (range 4–12%) with no kink, in contrast to Z-stented SG, which had a kink in its central area alongside a high luminal reduction (44%). Conclusions: SG limbs derived from auxetic unit cells show great promise for EVAR applications even at high angulations such as 180°, with acceptable levels of durability and flexibility. [ABSTRACT FROM AUTHOR]

In the framework of the PREDIS EU project, a wireless battery-operated gamma-ray detection system was developed in order to provide a medium-to-long-term monitoring system for radioactive waste drums. It was initially proposed to monitor the gamma radioactivity outcoming from steel drums containing cemented radwaste, even though it could be usefully employed in a wider range of applications. Gamma rays are penetrating and convey information from the drum's internal structure, as the count rate measured on the surface depends on the thickness and density of the crossed materials. A number of sensors arranged around a drum, typically four units, provide indications of the emission anisotropy, and any sensitive change in the measured count rate would hint at some anomaly, thus triggering a suitable inspection by operators. [ABSTRACT FROM AUTHOR]

The cognitive constraint hypothesis maintains reciprocity is rare among animals because it requires cognitive capabilities that are rare, if not absent, in animals. In particular, it suggests that temporal discounting, limited memory, and limited capability of complex calculations make long‐term reciprocation essentially impossible for animals. The cognitive constraint hypothesis therefore predicts that, if reciprocity ever occurs in animals, it should always be immediate. In this study, we tested for long‐term reciprocation in Himalayan tahr (Hemitragus jemlahicus), a species that is not notable for its advanced cognitive capabilities. We showed that tahr are able to reciprocate grooming over extended time periods, that is, that they groom preferentially those individuals from which they receive more grooming even when all cases of immediate reciprocation are excluded from analysis. These results do not support the cognitive constraint hypothesis. We note the cognitive constraint hypothesis makes two silent assumptions: that all reciprocation is necessarily calculated and that it is based on partner control processes. We suggest these assumptions are unwarranted, and that most group living animals base their ability to reciprocate on emotionally based partner choice. [ABSTRACT FROM AUTHOR]

Background: The mobile device diffusion has increasingly highlighted the opportunity to collect patient-reported outcomes (PROs) through electronic patient-reported outcomes measurements (ePROMs) during the clinical routine. Despite the ePROMs promises and advantages, the equivalence when a PRO measure is moved from the original paper-and-pencil to the electronic version is still little investigated. This study aims at evaluating equivalence between PROMs and ePROMs self-administration in people with multiple sclerosis (PwMS); in addition, preference of self-administration type was evaluated. Methods: The Manual Ability Measure-36 (MAM-36) and Fatigue Severity Scale (FSS) were selected for the equivalence test. The app ABOUTCOME was developed through a user-centered design approach to administer the questionnaires on tablet. Both paper-and-pencil and electronic versions were randomly self-administered. Intrarater reliability between both versions was evaluated through the intraclass correlation coefficient (ICC, excellent for values ≥ 0.75). Results: Fifty PwMS (35 females) participated to the study (mean age: 54.7±11.0 years, disease course: 27 relapsing-remitting and 23 progressive; mean EDSS: 4.7±1.9; mean disease duration: 13.3±9.5 years). No statistically significant differences were found for the means total scores of MAM-36 (p = 0.61) and FSS (p = 0.78). The ICC value for MAM-36 and FSS was excellent (0.98 and 0.94, respectively). Most of participants preferred the tablet version (84%). Conclusion: The results of the study provide evidence about the equivalence between the paper-and-pencil and electronic versions of PROs administration. In addition, PwMS prefer electronic methods rather than paper because the information can be provided more efficiently and accurately. The results could be easily extended to other MS PROs. [ABSTRACT FROM AUTHOR]

Aim: The Genetic Absence Epilepsy Rats from Strasbourg (GAERS) are an inbred polygenic model of childhood absence epilepsy (CAE), which, as their non‐epileptic control (NEC) rats, are derived from Wistar rats. While the validity of GAERS in reproducing absence seizures is well established, its use as a model for CAE psychiatric comorbidities has been subject to conflicting findings. Differences in colonies, experimental procedures, and the use of diverse controls from different breeders may account for these disparities. Therefore, in this study, we compared GAERS, NEC, and Wistar bred in the same animal facility with commercially available Wistar (Cm Wistar) as a third control. Methods: We performed hole board (HB) and elevated plus maze (EPM) tests that were analyzed with standard quantitative and T‐pattern analysis in male, age‐matched Cm Wistar and GAERS, NEC, and Wistar, bred under the same conditions, to rule out the influence of different housing factors and provide extra information on the structure of anxiety‐like behavior of GAERS rats. Results: Quantitative analysis showed that GAERS and NEC had similar low anxiety‐like behavior when compared to Cm Wistar but not to Wistar rats, although a higher hole‐focused exploration was revealed in NEC. T‐pattern analysis showed that GAERS, NEC, and Wistar had a similar anxiety status, whereas GAERS and NEC exhibited major differences with Cm Wistar but not Wistar rats. EPM results indicated that GAERS and NEC also have similar low anxiety compared to Cm Wistar and/or Wistar rats. Nevertheless, the analysis of the T‐pattern containing open‐arm entry showed GAERS and Wistar to be less anxious than NEC and Cm Wistar rats. Conclusion: To summarize, comorbid anxiety may not be present in male GAERS rats. This study also highlighted the importance of including a control Wistar group bred under the same conditions when evaluating their behavior, as using Wistar rats from commercial breeders can lead to misleading results. [ABSTRACT FROM AUTHOR]

The microstructures of 800 H samples affected by natural corrosion within industrial-like environmental conditions have been studied, and their potential effects on the creep response have been investigated based on literature information. Smooth cylindrical specimens of the alloy extracted from rolled sheet material have been placed into an industrial furnace, where they were exposed to high temperature thermal cycles within an air atmosphere. Samples spending 0 to 5 years inside the furnace underwent a microstructural characterisation campaign. Optical microscopy images reveal no grain coarsening. Macroscopic Vickers hardness shows a relatively wide surface hardness range (115≲HV10≲140). Compared to as-received material, micro-hardness profiles from specimens after years of high-temperature exposure exhibit a surface hardening trend within the vicinity of the edge exposed to the environment. Scanning electron microscopy analyses revealed two coexisting corrosion mechanisms: oxidation and nitridation. The latter is identified as the cause of the micro-indentation hardening trend. [ABSTRACT FROM AUTHOR]

Background: With promising outcomes, platelet-rich plasma (PRP) has recently been suggested as a treatment for olfactory dysfunction (OD). Methods: Clinical studies utilizing PRP in OD caused by COVID-19, trauma, anesthetic exposure, viral infection, and chronic rhinosinusitis were included in a systematic review. Results: Ten clinical studies were qualitatively analyzed. Six of these studies used the PRP for OD caused by COVID-19, one on OD after functional endoscopic sinus surgery, and three on post-infectious or post-trauma OD. The population included 531 patients, ranging in age from 15 to 63. Conclusion: The use of PRP may be a risk-free and efficient therapeutic option with very encouraging outcomes. Indeed, it enhances olfactory perception in patients who not only exhibit COVID-19 infection aftereffects, but also in those who have lost their sense of smell due to trauma, rhinosinusitis, rhinitis, or even surgery. To evaluate the PRP's therapeutic benefits in OD patients and to compare the efficacy of different therapeutic protocols with regard to treatment schedules, there is an urgent need for focused controlled trials. [ABSTRACT FROM AUTHOR]

This paper uses a dataset covering the universe of French firm-level value-added, imports, and exports and a quantitative multicountry heterogeneous firm model to study the propagation of foreign shocks to the domestic economy. Foreign shocks are transmitted primarily through large firms as they are the most likely to trade internationally. At the micro level, the majority of the GDP impact of foreign shocks is accounted for by the "foreign granular residual," a statistic capturing larger firms' greater responsiveness to foreign shocks. At the macro level, firm heterogeneity attenuates the GDP impact of foreign shocks relative to a homogeneous firm counterfactual. [ABSTRACT FROM AUTHOR]

High-grade glial tumors (HGGs) exhibit aggressive growth patterns and high recurrence rates. The prevailing treatment approach comprises radiation therapy (RT), chemotherapy (CMT), and surgical resection. Despite the progress made in traditional treatments, the outlook for patients with HGGs remains bleak. Tumor metabolism is emerging as a potential target for glioma therapies, a promising approach that harnesses the metabolism to target tumor cells. However, the efficacy of therapies targeting the metabolism of HGGs remains unclear, compelling a comprehensive review. This study aimed to assess the outcome of present trials on HGG therapies targeting metabolism. A comprehensive search of PubMed, Ovid MEDLINE, and Ovid EMBASE was conducted until November 2023. The search method used pertinent Medical Subject Heading (MeSH) terminologies and keywords referring to "high-grade gliomas", "metabolism", "target therapies", "monoclonal antibodies", "overall survival", and "progression-free survival". The review analyzed studies that focused on therapies targeting the metabolism of HGGs in human subjects. These studies included both randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs). Out of 284 articles identified, 23 trials met the inclusion criteria and were thoroughly analyzed. Phase II trials were the most numerous (62%). Targeted metabolic therapies were predominantly used for recurrent HGGs (67%). The most common targeted pathways were the vascular endothelial growth factor (VEGF, 43%), the human epidermal growth factor receptor (HER, 22%), the platelet-derived growth factor (PDGF, 17%), and the mammalian target of rapamycin (mTOR, 17%). In 39% of studies, the subject treatment was combined with CMT (22%), RT (4%), or both (13%). The median OS widely ranged from 4 to 26.3 months, while the median PFS ranged from 1.5 to 13 months. This systematic literature review offers a thorough exploration of the present state of metabolic therapies for HGGs. The multitude of targeted pathways underscores the intricate nature of addressing the metabolic aspects of these tumors. Despite existing challenges, these findings provide valuable insights, guiding future research endeavors. The results serve as a foundation for refining treatment strategies and enhancing patient outcomes within the complex landscape of HGGs. [ABSTRACT FROM AUTHOR]

Background: Multiple Breath washout (MBW) represents an important tool to detect early a possible pulmonary exacerbation especially in Cystic Fibrosis (CF) disease. Lung clearance index (LCI) is the most commonly reported multiple breath washout (MBW) index and in the last years was used as management measure for evaluation. Our aim was to analyze clinical utility of LCI index variability in pulmonary exacerbation in CF after intravenous (IV) antibiotic therapy. Methods: A single-center study was conducted at CF Unit of Bambino Gesù Children's Hospital among hospitalized > 3 years patients for pulmonary exacerbations and treated with antibiotic IV treatment for 14 days. MBW and spirometry were evaluated within 72 h of admission to hospital and at the end of hospitalization. Descriptive analysis was conducted and correlations between quantitative variables were investigated. Results: Fifty-seven patients (M22/F35) with an average age 18.56 (± 8.54) years were enrolled. LCI2.5 was significantly reduced at the end of antibiotic treatment in both pediatric and adult populations with an average reduction of -6,99%; 37/57 patients denoted an improvement, 20/57 are stable or worsened in LCI2.5 values and 4/57 (7.02%) had a significant deterioration (> 15%) at end of treatment. On the contrary a significative elevation of FEV1 and FVC were found, respectively of + 7,30% and of + 5,46%. A positive good correlection among LCI 2.5 and Scond (rho = + 0,615, p = 0.000) and LCI 2.5 and Sacin (rho = + 0,649, p = 0.000) and a negative strong correlation between FEV1 and LCI 2.5 were found in post treatment period. A similar modification of LCI 2.5 and FEV1 was noticed in both adult and pediatric population. Conclusions: LCI may have a role in the routine clinical care of both adult and pediatric CF patients as a good tool to assess response to IV antibiotic end-therapy in the same way as FEV1. [ABSTRACT FROM AUTHOR]

In the dense regions of star clusters, close encounters with black holes (BHs) can occur giving rise to a new class of gravitational-wave (GW) signals. Binary–single encounters between three BHs are expected to dominate the rate of signals from unbound systems in the frequency band of terrestrial GW detectors. The encounter can describe a quasi-hyperbolic trajectory, which was the focus of a recent study. In some cases, the encounter can take a more complex form including one or two BH mergers as a result of the encounter, repeating cycles of close proximity between the BHs, and the exchange of a BH that is part of the binary. The variety of types of encounters leads to a variety of GW signals emerging from these encounters. Using the ARWV N-body code, we performed 42 numerical simulations, to explore various outcomes of binary–single interaction, and we characterize the diverse GW signatures produced during these encounters. Additionally, we evaluated the detectability of these GW signals by injecting them into the simulated noise of the Einstein Telescope and exploring different methods to detect the signals. Our findings shed light on the complexities of these interactions and their potential implications for GW astronomy. [ABSTRACT FROM AUTHOR]

The widespread integration of digital technologies in the field of archaeology, facilitated by increasingly powerful and economically accessible tools, is producing a profound transformation in the conventional methodologies employed by archaeologists. This contribution specifically delves into the documentation of excavation phases and artifacts, presenting a workflow tested on the tomb 27 of the Colle Vaccaro necropolis (AP) within the educational project managed by the Istituto Centrale del Restauro (ICR). The digital representation of distinct layers and artifacts, developed together with with micro-excavation and restoration operations, serves as a tool for real-time analysis and documentation. Crucially, it acts as a foundational element for constructing an information system geared towards subsequent and more comprehensive historical-archaeological analyses. The outcome of this contribution is the formulation of a semi-automatic process designed to ensure a geometrically accurate and informed three-dimensional representation. This workflow for documenting an excavation and its artifacts is designed to facilitate efficient data utilization both for scholars and professionals. [ABSTRACT FROM AUTHOR]

(1) Background: Rotavirus is one of the leading causes of severe diarrhea and dehydration in infants and young children worldwide. The economic and social burden of rotavirus-related hospitalizations, particularly among children, remains a pressing concern for healthcare systems across the globe. Healthcare infrastructure and access to medical care can vary significantly within the region. Differences in the availability of healthcare facilities and the quality of care may influence the management and outcomes of rotavirus cases. (2) Methods: This was a retrospective study performed in the Abruzzo region, Italy. The study considered all hospitalization due to rotavirus gastroenteritis that occurred in the Abruzzo region from the year 2015 to 2021. Data were extracted from the hospital discharge records. The trend in hospital admissions, hospitalization costs and length of stay were evaluated and analyzed. (3) Results: A total of 664 admissions were reported during the study period. The incident rate grew till year 2019 with an annual percentage change of +13.9% (95%CI 12.6–15.2, p < 0.001). During the pandemic years, the incident rate showed a significant decrease with an annual percentage change of 12.5% (95%CI 15.5–9.3, p = 0.004). The length of stay of admissions was significantly higher among patients aged less than 1 year. (4) Conclusions: Rotavirus admission represents a heavy burden even in a high-income country such as Italy. These findings have the potential to inform targeted public health interventions, including vaccination strategies, and improve the overall well-being of children. [ABSTRACT FROM AUTHOR]

Background: Partial dopamine D2 receptor agonists are used for psychotic symptoms in adults with schizophrenia spectrum disorders. Recently, interest surged for partial dopamine D2 receptor agonists in substance use disorders (SUDs). Since it is believed that SUDs decrease the efficacy of pharmacotherapy of underlying psychiatric disorders, we tested the efficacy of the partial D2 agonist brexpiprazole in patients with schizophrenia who were either comorbid with a SUD (SUD group) or not comorbid (non-SUD) to assess treatment response and the eect of brexpiprazole on substance craving in SUD. Methods: We included patients with DSM-5/DSM-5-TR schizophrenia (using SCID-5-CV) aged 18-66 years with either comorbid SUD or non-SUD to treat with brexpiprazole 4 mg/day for 6 months during February-October 2022. Patients were assessed with the Clinical Global Impressions-Severity (CGI-S) scale, the 24-item Brief Psychiatric Rating Scale (BPRS), and the Positive And Negative Syndrome Scale (PANSS) at baseline, weekly for the first 2 months and monthly for the next four. Furthermore, we assessed substance craving in SUD with a visual analog scale for craving (VAScrav) at the same timepoints. Results: The total sample was 86 (85 analysable) 18- to 64-year-old (mean 39.32 ± 14.09) patients with schizophrenia [51 men (59.3%) and 35 women (40.7%)], of whom 48 SUD (55.8%) (37 men and 11 women) and 38 non-SUD (44.2%) (14 men and 24 women). No serious or persistent adverse events developed over the study period, but one patient dropped out for subjective akathisia. Results indicated the main eects of time with improvements over the course of the study for CGIS, BPRS, and PANSS in both SUD and non-SUD groups and the entire sample, and for VAScrav in SUD. Brexpiprazole was associated with similar significant improvements in both groups at the 6 month endpoint compared to baseline. Conclusion: Treatment with brexpiprazole for 6 months improved psychotic symptoms in patients with schizophrenia, independently from whether they belonged to the SUD or the non-SUD group; hence, SUD comorbidity did not confer treatment resistance to brexpiprazole. Furthermore, in the SUD group, we observed reduced substance craving. [ABSTRACT FROM AUTHOR]

(1) Background: when the pathologist faces histologic slides from colonoscopies in daily practice, given the large number of entities and etiologies under inflammatory bowel conditions, in-depth definition of the histological spectrum and the recommendations of current guidelines are often not enough to conclusively define a diagnostic framework. Histological patterns should be organized hierarchically in flowcharts that consider the correlation with clinical data. We conducted an online survey asking a group of gastroenteropathologists to apply a pattern classification based on the most significant lesions in colitis differential diagnosis: crypt distortion and activity. (2) Methods: digital slides from 20 endoscopy samples were analyzed by twenty pathologists and classified according to the occurrence of crypt distortion (nondestructive–destructive colitis) and subsequently to the evidence of activity (ND1-2-3, D1-2). (3) Results: in 8 out of 20 (40%) cases, the participants reached a full agreement regarding the evaluation of crypt distortion (5 cases: nondestructive colitis; 3 cases: destructive colitis). The calculated agreement was k = 0.432. In the second-level quiz (ND1-2-3 and D1-2), full agreement between participants was achieved for 7 of the 28 (25%) possible classifications, with k = 0.229. (4) Conclusions: The findings from this survey are indicative of an unexpectedly low consensus, even among dedicated pathologists, about the recognition of histological changes that are commonly considered critical lesions in the histologic identification of bowel non-neoplastic diseases. In our opinion, these divergences imply a significant risk of misdiagnosis of bowel inflammatory conditions, hampering the usefulness of histological assessment. [ABSTRACT FROM AUTHOR]

Grooming is a common cooperative behavior whose exact costs and benefits are still to be fully elucidated. In this study, we evaluated the emotional consequences of giving and receiving grooming in mandrills (Mandrillus sphinx), and how these may change along time after the termination of grooming. We used scratching as a behavioral indicator of anxiety‐like emotions. Groomees showed increased scratching immediately after the termination of grooming, while in the subsequent minutes scratching decreased below baseline. The initial increase was larger after longer grooming events, suggesting it represented a case of postinhibitory rebound. The subsequent decline in scratching rates was larger after grooming received by a kin, suggesting interactions with kin are particularly relaxing. Scratching rates shown by groomers were unaffected by grooming interactions. These results highlight that the emotional states following grooming can have a complex time course, and may contribute to explain the inconsistencies found in the previous literature. Research highlights: Receiving grooming had rapidly changing emotional consequences, as measured by scratching rates.Scratching increased above baseline immediately after grooming, particularly after longer grooming bouts.Scratching decreased below baseline in the subsequent minutes, particularly after grooming received from kin. [ABSTRACT FROM AUTHOR]

Recently, new numerical methods have been applied to weather data for the estimation of water budget, especially when the lack of measured data is considerable. Geostatistics is one of the most powerful approaches when it comes to studying spatially relevant natural phenomena, as it considers the spatial correlation among measurements over a specific study area and provides the associate uncertainty. In this study, we tested the feasibility of using a geostatistical method to provide a reliable estimation of the water budget of the Foro river basin (Central Italy) by comparing the obtained results with those of a traditional yet robust method. The results obtained with the geostatistical approach proved to be in line with the ones from the traditional method. Additionally, it was possible to quantify the uncertainty associated with the discharge values, making the estimates more reliable than the ones obtained with the traditional approach. However, the yearly distribution of river discharge obtained using both methods appeared to be dissimilar to the measured ones. The surface water uses, as well as the regulatory effect of the carbonate and alluvial aquifer regime, may affect the river discharge variability over the year and then can account for similar discrepancies between the inflow and outflow water volumes. [ABSTRACT FROM AUTHOR]

Introduction: Coronavirus disease (COVID-19) was associated with cognitive alterations affecting everyday life activities. These need input integration of both motor and cognitive systems. The study aim is to evaluate cognitive-motor interference phenomenon in previously independent patients with mild-to-moderate COVID-19 (PwMCOVID-19) compared with healthy controls (HC), through dual-task (DT) paradigm. Methods: PwMCOVID-19 were included if being independent at home, had no previous referred cognitive impairment, mechanical ventilation or oxygen need. They were assessed at admission and after 6 months with a motor-cognitive DT test (counting backward by twos while walking 2 min). HC were enrolled as control group. Differences between single-task (ST) and DT performance, DT effect (DTE) and task prioritization amongst groups and during time points were analyzed. Results: One-hundred PwMCOVID-19 [mean age=67.32(12.08) years; 53 M/47 F] and 39 HC [mean age=63.11(9.90) years; 20 M/19 F] were recruited. Upon T0, PwMCOVID-19 showed lower cognitive and motor DT performances than ST and HC. Mutual interference pattern was predominant in PwMCOVID-19. At T1, 41 PwMCOVID-19 were examined [mean age=64.85(10.75); 22 M/19 F]. They had a worse DT performance compared to ST, although DT improved at T1. A stronger cognitive ST-DT difference was present at T0, compared to ST-DT difference at T1, while motor ST-DT difference was unchanged over time in PwCOVID-19. Conclusion: In PwMCOVID-19, there is an impairment of DT counting while walking at baseline and after 6 months from hospitalization, with a more pronounced DT mutual interference pattern at T0. After 6 months, the motor and cognitive ST and DT performances ameliorated, not reaching the HC level. [ABSTRACT FROM AUTHOR]

Media accessibility services, and the related research, mainly focus on individuals with disabilities. As a consequence, they require a comprehensive understanding and acknowledgment of their needs and capabilities. In media accessibility research, there have been distinct turns: initially, the focus was on the end users, which subsequently led to numerous studies on comprehension, appreciation, and reception (Di Giovanni 2021). A significant turn, started a few years ago and still thriving, is related to collaborative and participatory practices involving media accessibility professionals at various levels: their skills, specialised training, the tools they utilise, their tasks and workfl ow. These topics are currently subjects of active debate worldwide, as there appears to be no homogeneous approach. Aft er examining the training programmes that are currently available, this paper presents the findings of a survey carried out with media access professionals in the European Union and the United Kingdom. The goal was to identify the competencies essential for accessibility professionals, delineate their responsibilities, detail the tools they use, and, most importantly, assess the involvement of individuals with different abilities in the entire process of designing, testing, and evaluating media accessibility services to shed light on the nature of collaborative media accessibility practices and processes. [ABSTRACT FROM AUTHOR]

Notions of participatory accessibility (Di Giovanni 2018), universal accessibility (Wang et al. 2022), co-accessibility (Okyayuz/Kaya 2020), integrated access (Fryer/Cavallo 2022), creative media access (Romero-Fresco 2021), and access as conversation (Romero-Fresco/Dangerfield 2022; Dangerfield in this special issue) are responses to perceived shortcomings of traditional approaches to media accessibility (MA) that were, in the past, devolved to the accessibility professional. Instead, these more recent approaches lay emphasis on collaborative processes and practices. Collaborative Media Accessibility (CMA) is in part an att empt to reframe MA, in recognition of the slogan used by disability activists since the 1980s "nothing about us without us". This introductory essay and the articles in this special issue aim to assess what these collaborative approaches have in common and how they mark a shift in approach from MA created 'for' a certain type of end user (most commonly a non-disabled expert creating access 'for' disabled audience members) to MA created 'by' or 'with' a certain type of end user. First the groundwork is laid by reconsidering definitions of MA and its aims, before considering the many actors (literal and figurative) on the participatory stage and how their inclusion affects the style of access as well as its content, delivery, and consequently the audience response. The content of the articles in this special issue is presented critically, in relation to the notions and issues raised in the sections below. [ABSTRACT FROM AUTHOR]

Limited longitudinal studies have been conducted on gait impairment progression overtime in non-disabled people with multiple sclerosis (PwMS). Therefore, a deeper understanding of gait changes with the progression of the disease is essential. The objective of the present study was to describe changes in gait quality in PwMS with a disease duration ≤ 5 years, and to verify whether a change in gait quality is associated with a change in disability and perception of gait deterioration. We conducted a multicenter prospective cohort study. Fifty-six subjects were assessed at baseline (age: 38.2 ± 10.7 years, Expanded Disability Status Scale (EDSS): 1.5 ± 0.7 points) and after 2 years, participants performed the six-minute walk test (6MWT) wearing inertial sensors. Quality of gait (regularity, symmetry, and instability), disability (EDSS), and walking perception (multiple sclerosis walking scale-12, MSWS-12) were collected. We found no differences on EDSS, 6MWT, and MSWS-12 between baseline and follow-up. A statistically significant correlation between increased EDSS scores and increased gait instability was found in the antero-posterior (AP) direction (r = 0.34, p = 0.01). Seventeen subjects (30%) deteriorated (increase of at least 0.5 point at EDSS) over 2 years. A multivariate analysis on deteriorated PwMS showed that changes in gait instability medio-lateral (ML) and stride regularity, and changes in ML gait symmetry were significantly associated with changes in EDSS (F = 7.80 (3,13), p = 0.003, R2 = 0.56). Moreover, gait changes were associated with a decrease in PwMS perception on stability (p < 0.05). Instrumented assessment can detect subtle changes in gait stability, regularity, and symmetry not revealed during EDSS neurological assessment. Moreover, instrumented changes in gait quality impact on subjects' perception of gait during activities of daily living. [ABSTRACT FROM AUTHOR]