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In the colorectal cancer (CRC) niche, the transcription factors signal transducer and activator of transcription 3 (STAT3) and nuclear factor‐κB (NF‐κB) are hyperactivated in both malignant cells and tumor‐infiltrating leukocytes (TILs) and cooperate to maintain cancer cell proliferation/survival and drive protumor inflammation. Through drug repositioning studies, the anthelmintic drug rafoxanide has recently emerged as a potent and selective antitumor molecule for different types of cancer, including CRC. Here, we investigate whether rafoxanide could negatively modulate STAT3/NF‐κB and inflammation‐associated CRC. The antineoplastic effect of rafoxanide was explored in a murine model of CRC resembling colitis‐associated disease. Cell proliferation and/or STAT3/NF‐κB activation were evaluated in colon tissues taken from mice with colitis‐associated CRC, human CRC cells, and CRC patient‐derived explants and organoids after treatment with rafoxanide. The STAT3/NF‐κB activation and cytokine production/secretion were assessed in TILs isolated from CRC specimens and treated with rafoxanide. Finally, we investigated the effects of TIL‐derived supernatants cultured with or without rafoxanide on CRC cell proliferation and STAT3/NF‐κB activation. The results showed that rafoxanide restrains STAT3/NF‐κB activation and inflammation‐associated colon tumorigenesis in vivo without apparent effects on normal intestinal cells. Rafoxanide markedly reduces STAT3/NF‐κB activation in cultured CRC cells, CRC‐derived explants/organoids, and TILs. Finally, rafoxanide treatment impairs the ability of TILs to produce protumor cytokines and promote CRC cell proliferation. We report the novel observation that rafoxanide negatively affects STAT3/NF‐κB oncogenic activity at multiple levels in the CRC microenvironment. Our data suggest that rafoxanide could potentially be deployed as an anticancer drug in inflammation‐associated CRC. [ABSTRACT FROM AUTHOR]

The effect of the support in the incorporation of cobalt oxide nanoparticles on mesoporous materials (SBA‐15) and mesoporous cellular foam (MCF) was investigated. The materials were characterized using various techniques. The XRD diffraction patterns showed that the porous structures remained after cobalt incorporation, while high‐angle XRD of the MCF showed CoO peaks, in contrast to Co‐SBA‐15 which exhibited Co3O4. This was confirmed by XPS technique. The SEM‐EDS and HRTEM‐STEM microscopy indicate a distribution of cobalt oxides uniform in the samples synthesized and the average size of the particles is 1.88 nm. H2‐TPR analysis highlighted the interaction between the support surfaces and the metal oxide (SMSI). It was observed that in the SBA‐15 structure, small clusters of cobalt oxide formed with a strong interaction with silica, leading to high reduction temperatures. The catalysts activity was characterized in oxidation reactions of Methyl Phenyl Sulfide and a correlation was observed between the characterization results and the enhanced selectivity and yield towards sulfone exhibited by Co‐MCF. [ABSTRACT FROM AUTHOR]

Forest planning involves estimating the biomass of species present in the area. Two fundamental parameters are diameter and height through which it is possible to indirectly estimate of biomass present. Digitalisation of forestry operations, such as forest planning, is crucial and should be affordable and easy-to-use digital applications and open-source devices. A digital progressive web application (PWA) was designed to record measurements. The app was connected via bluetoot to an open-source IoT digital forestry caliper prototyped by modifying a commercial tree caliper. An economic analysis was carried out considering all costs necessary for the development and operation of the app on smartphones and the preparation of electronic means for creation of the digital caliper. A comparison was made between costs of detecting tree diameters through application of the technology developed compared to costs calculated by applying the use of a dendrometric caliper (three technological levels were considered: L1, L2 and L3). The PWA allowed for easy data entry and viewing, maps and tree densities. The open-source digital caliper showed accuracy and precision comparable with similar commercial devices (1.5% ± 0.9% and 0.0% ± 0.9%, respectively). Total time per operator was lower using the digital caliper. From an economic perspective, application of the digital technology was more sustainable than the traditional system. Use of the digital caliper in combination with the web application optimizes detection time of a single tree, and therefore decreases overall cost. [ABSTRACT FROM AUTHOR]

Background: Recent studies suggest that low-molecular-weight heparin (LMWH) may play a role in mitigating the severity of acute pancreatitis (AP). This systematic review and meta-analysis aims to synthesise existing evidence on the effectiveness and safety of LMWH in the treatment of moderately-severe and severe AP. Methods: This systematic review and meta-analysis was conducted in accordance with the 2020 update of the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. The systematic search was conducted in MEDLINE, the Cochrane Central Register of Controlled Trials, Scopus, and EMBASE, covering studies published up to February 2024. Randomised controlled trials (RCTs) and observational studies (n-RCTs) that reported the differences in the outcomes of AP for patients receiving LMWH in addition to the standard treatment (Intervention), compared to patients managed by standard treatment without LMWH (Control) were eligible. A random-effects model was used to calculate the pooled relative risk (RR) and mean differences (MD) with the corresponding 95% CI. Results: Thirteen studies were included in the meta-analysis, all published between 2004 and 2022. Eight studies were RCTs, and five were n-RCTs. Data from 13,709 patients (6.971 Interventions and 6.738 Controls) were analysed. The comparison of Intervention and Control groups showed the superiority of LMWH to standard treatments in terms of overall mortality (RR = 0.44, 95% CI = 0.31; 0.64, P < 0.0001, I2 = 51%), acute necrotic collections (RR = 0.24, 95% CI = 0.09; 0.62, P = 0.003, I2 = 0%), and organ failure (RR = 0.67, 95% CI = 0.48; 0.93, P = 0.02, I2 = 78%). The Intervention group showed superior outcomes compared with the Control group for gastrointestinal bleeding (RR = 0.64, 95% CI = 0.44; 0.94, P = 0.02, I2 = 0%), length of hospital stay (MD= − 6.08, 95% CI = − 10.08; − 2.07, P = 0.003, I2 = 98%), need for operative interventions (RR = 0.50, 95% CI = 0.29; 0.87, P = 0.01, I2 = 61%), and vascular thrombosis (RR = 0.43, 95% CI = 0.31; 0.61, P < 0.00001, I2 = 0%). Conclusions: Moderate to high-quality evidence suggests that early intervention with LMWH could improve the prognosis of non-mild AP in terms of mortality, organ failure, and decreased incidence of vascular thrombosis. In light of our findings, integrating LMWH into the treatment regimen for moderate-severe to severe AP is advocated. [ABSTRACT FROM AUTHOR]

Motivated by the leadership, scholarship, and activism of Indigenous Peoples, there are growing calls to transform and decolonize Canadian institutions that govern fisheries research in Canada. As a predominantly non-Indigenous group that works at the intersection of fisheries and justice, we encounter questions daily about how to act as allies in these efforts and take up this urgent call in our own work. Our goal with this perspective is to synthesize and share some of what we have learned about encountering and combatting colonialism in the hope that it may offer something to other non-Indigenous and settler fisheries researchers who are grappling with colonization in their own work. This synthesis is based on both Indigenous scholarship and our own experiential learning. We look to actions fisheries researchers may take to advance Indigenous sovereignty in fisheries research. We offer this to our fellow non-Indigenous researchers who likely also struggle with similar questions, and hope that in doing so, we can help move towards decolonial fisheries futures. [ABSTRACT FROM AUTHOR]

This study assessed the performance of different remotely sensed soil moisture products with in situ observations; six profile probes for the water content monitoring were selected, operating during 2016–2021 from the Voineşti Experimental Basin in the Romanian Subcarpathian region. The reliability of satellite observations has been analyzed on both single ground-based observation points and spatialized information, considering near-surface and root-zone soil moisture data. The physics-based index (HCI) and some statistical tests widely used in inter-comparison analyses have been computed. The study of HCI highlighted that the SMAP SP_L4_SM products have shown the best performances considering the near-surface and root-zone data evaluations. The comparison of SWI1km observations with in situ data produced good results for single-point and spatialized soil moisture estimations acquired at different depths over the experimental basin. The SSM1km and SMAP L2_SM_SP products exhibited the lowest performances. The results contribute to the validation of satellite products of surface and root-zone soil moisture in the Subcarpathian region, helping to provide information in an area not monitored by the International Soil Moisture Network. The findings offer valuable insights into evaluating the performance of satellite soil moisture products in the Romanian region. [ABSTRACT FROM AUTHOR]

Any sharing mobility service aims to make urban mobility sustainable to help reduce environmental impacts and improve the quality of life for all in cities. Many transport services are not currently self-sustainable. The Life for Silver Coast (LifeSC) opened its mobility services on 22 May 2021 and offered electric mobility services during the summer for a few cities in Tuscany. E-bikes and e-scooters can be financially neutral, and even profitable, thanks to the low costs of the vehicles, but they only see a high utilization rate in winter. Shared electric cars, meanwhile, are not profitable. A new shared service that is viable must be profitable to become widely adopted and significantly contribute to sustainability. A few key characteristics have been identified, and one has been tested with a new business model that combines ride-sharing and car-sharing. The innovative Ride Sharing Algorithm (RSA) has been tested based on data from a potential city, Monterondo, where many commuters travel daily to Rome by train. The Italian census and local survey data allowed for the simulation of the scheduling of vehicle rides and an evaluation of the economic results, which could be positive if enough interest for such a system exists among the people, as at least 400 commuters from Monterotondo go to the train station daily in the morning and return in the afternoon. Such a transport demand would justify a new commercial sharing service by using the model tested with the RSA algorithm. [ABSTRACT FROM AUTHOR]

Sex differences in metabolic dysfunction-associated steatotic liver disease (MASLD) have been reported. Oxidative stress and inflammation are involved in the progression of MASLD. Thus, we aimed to evaluate liver redox homeostasis and inflammation in male and female rats fed a high-fat diet (HFD). Male and female Wistar rats were divided into the following groups: standard chow diet (SCD) or HFD during 12 weeks. HFD groups of both sexes had higher hepatocyte injury, with no differences between the sexes. Portal space liver inflammation was higher in females-HFD compared to females-SCD, whereas no differences were observed in males. Lobular inflammation and overall liver inflammation were higher in HFD groups, regardless of sex. TNF-α, IL-6, and IL-1β levels were higher in males-HFD compared to males-SCD, but no differences were observed in females. Catalase activity was higher in males compared to females, with no differences between the SCD and HFD groups of both sexes. Glutathione peroxidase activity was higher in females compared to males, with no differences between the SCD and HFD groups in both sexes. Lipid peroxidation was higher in female-SCD when compared to male-SCD, and in both male- and female-HFD compared to SCD groups. Furthermore, both cytoplasmic and nuclear NRF2 staining were lower in the HFD group compared to the SCD group in males. However, female-HFD exhibited reduced nuclear NRF2 staining compared to the female-SCD group. In conclusion, our study demonstrated that while both male and female rats developed metabolic dysfunction-associated steatohepatitis after 12 weeks of HFD, the alterations in inflammatory cytokines and redox balance were sexually dimorphic. [ABSTRACT FROM AUTHOR]

background: We conducted a systematic review and meta-analysis to evaluate the role of High Energy Devices (HEDs) versus conventional clamp and tie technique in thyroidectomy. This work is endorsed by the Italian Society of Surgical Endoscopy (Italian Society of Endoscopic Surgery and new technologies—SICE) in the broader project on the evaluation of the role of HEDs in different surgical settings with the full health technology assessment report. Mehods: Inclusion criteria were adult patients (≥ 18 years old) undergoing Thyroidectomy/Parathyroidectomy conducted with High Energy Devices (as ultrasonic (US), radiofrequency (RF), and hybrid energy (H-US/RF)) in the setting of thyroid surgery (both partial and total) for benign and malign diseases. However, some variability was found in included studies and described in the text. This systematic review and meta-analysis were performed according to the Cochrane handbook for systematic reviews, and the recommendations of the 2020 updated Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines were pursuit. Selection of abstracts was performed in Ryyan system by 2 independent reviewers, and doubts were solved by another independent reviewer. At the end of literature research, Randomized controlled trials and observational studies were included. Risk of Bias was assessed with ROB2 for RCTs, and New Castle Ottawa Scale for Observational studies. Results: The literature search yielded 47 studies, including 29 RCTs and 18 observational studies. Meta-analysis was performed for 29 randomized clinical trials. Outcomes included in the comparison between High Energy Devise and conventional technique groups were operative time, operative blood loss, overall post-operative drainage volume, length of stay, complications, and costs. HED significantly reduced operative time (28 studies, 3097patients; MD -128.8; 95% CI -34.4 to -23.20; I2 = 96%, p < 0.00001, Random-effect), intra-operative blood loss (13 studies, 642 vs 519 patients; SMD -0.82; 95% CI -1.33 to -0.32; I2 = 93%, p < 0.00001, Random-effect), LOS (22 studies, 2808 vs 2789 patients; MD -0.38, 95% CI -0.59 to -0.17; I2 = 98%, p < 0.00001 Random-effect), and healthcare costs (8 studies, 1138 vs 1129 patients, SMD 1.05; 95% CI -0.06 to 2.16; I2 = 99%, p < 0.00001 Random-effect). The rate of overall intraoperative complications was significantly different between both groups (25 studies, 2804 vs 2775 patients; RR 0.88, 95% CI 0.80 to 0.97; I2 = 38%, p = 0.03 Random-effect), but the sensitivity analysis did not find a statistically significant difference (6 studies, 605 vs 594 patients, RR; 95% CI to; I2 = 0%, p = 0.50, Random-effect). There was no difference in the subgroup analysis for the occurrence of transient and permanent RLN palsy, nor hematoma formation and hypocalcaemia. Discussion: Though findings of our systematic review and metanalysis are limited by heterogeneous data, surgeons, hospital managers, and policymakers should note that the use of High Energy Devices compared to conventional clamp and tie technique have reduced operative times, intra-operative blood loss, length of stay, and hospital costs in patients underwent to tyroid surgery. Future work must explore issues of equity to mitigate barriers to patient access to safe thyroid surgical care and define better this initial results. [ABSTRACT FROM AUTHOR]

Dysplastic nevi represent one of the least agreed-upon entities in dermatopathology despite the existence of established criteria. This study explores preferentially expressed antigen in melanoma (PRAME) in dysplastic nevi, an uncharted area. We examined 22 common melanocytic nevi (CMN), 20 cutaneous melanomas (CM), 48 low-grade dysplastic nevi (LG-DN), and 40 high-grade dysplastic nevi (HG-DN). PRAME was immunohistochemically assessed using a five-tiered system (0 to 4 +). Among CMN, 59% scored 0, 32% scored 1 + , and 9% scored 2 +. CM had score 2 + and 4 + in 11% and 89% of cases, respectively. Among LG-DN, 38% presented score 0, 31% score 1 + , 17% score 2 + , 8% score 3 + , and 6% score 4 +. Thirty per cent of HG-DN demonstrated a score 0, 30% with score 1 + , 15% score 2 + , 10% score 3 + , and 15% score 4 +. Compared to CMN and CM, LG-DN and HG-DN showed heterogeneous expression profiles of PRAME. PRAME positivity effectively distinguished HG-DN from CM with 85% specificity and 80% sensitivity (p < 0.0001). Predictive values were 87% (negative) and 76% (positive). Furthermore, a trend of increased PRAME expression from LG-DN to HG-DN was observed. However, the applicability of PRAME in the differential diagnosis of dysplastic lesions remains unclear as can yield conflicting results with morphology, which remains the primary diagnostic tool for melanocytic lesions. [ABSTRACT FROM AUTHOR]

The production management models currently adopted in the construction industry do not adequately describe the relationships between activities and processes. Such models place emphasis on conversions to the detriment of internal logistics of input distribution for various work fronts. In the planning phase, tasks are commonly estimated using the critical path method, program evaluation and review technique, and Gantt charts. However, techniques capable of optimizing physical flows are not widely adopted. In view of this limitation, this study aimed to assess the potential of virtual manufacturing tools in estimating virtual production parameters based on product lifecycle management and real-life data. Data on mortar production and distribution to work locations were collected on site. Then, two simulations were performed. The first simulation was used to construct a virtual model of the mortar distribution process. The second simulation examined the impact of a mortar transportation device on the activity. Subsequently, the efficiency of both simulations was compared. The efficiency of the mortar transportation device was confirmed by the improvements provided by its implementation. Given their limited example of use in civil construction, it will need to be expanded in this study to validate their potential in all activities of the sector. Despite the limitation presented in this work, the virtual manufacturing can be used as one tool for the integrated product development and product lifecycle management to improve the quality, and to reduce the losses during the production lifecycle. [ABSTRACT FROM AUTHOR]

Teleoperation allows workers to safely control powerful construction machines; however, its primary reliance on visual feedback limits the operator's efficiency in situations with stiff contact or poor visibility, hindering its use for assembly of pre-fabricated building components. Reliable, economical, and easy-to-implement haptic feedback could fill this perception gap and facilitate the broader use of robots in construction and other application areas. Thus, we adapted widely available commercial audio equipment to create AiroTouch, a naturalistic haptic feedback system that measures the vibration experienced by each robot tool and enables the operator to feel a scaled version of this vibration in real time. Accurate haptic transmission was achieved by optimizing the positions of the system's off-the-shelf accelerometers and voice-coil actuators. A study was conducted to evaluate how adding this naturalistic type of vibrotactile feedback affects the operator during telerobotic assembly. Thirty participants used a bimanual dexterous teleoperation system (Intuitive da Vinci Si) to build a small rigid structure under three randomly ordered haptic feedback conditions: no vibrations, one-axis vibrations, and summed three-axis vibrations. The results show that users took advantage of both tested versions of the naturalistic haptic feedback after gaining some experience with the task, causing significantly lower vibrations and forces in the second trial. Subjective responses indicate that haptic feedback increased the realism of the interaction and reduced the perceived task duration, task difficulty, and fatigue. As hypothesized, higher haptic feedback gains were chosen by users with larger hands and for the smaller sensed vibrations in the one-axis condition. These results elucidate important details for effective implementation of naturalistic vibrotactile feedback and demonstrate that our accessible audio-based approach could enhance user performance and experience during telerobotic assembly in construction and other application domains. [ABSTRACT FROM AUTHOR]

Background: This multicentre case–control study aimed to identify risk factors associated with non-operative treatment failure for patients with CT scan Hinchey Ib-IIb and WSES Ib-IIa diverticular abscesses. Methods: This study included a cohort of adult patients experiencing their first episode of CT-diagnosed diverticular abscess, all of whom underwent initial non-operative treatment comprising either antibiotics alone or in combination with percutaneous drainage. The cohort was stratified based on the outcome of non-operative treatment, specifically identifying those who required emergency surgical intervention as cases of treatment failure. Multivariable logistic regression analysis to identify independent risk factors associated with the failure of non-operative treatment was employed. Results: Failure of conservative treatment occurred for 116 patients (27.04%). CT scan Hinchey classification IIb (aOR 2.54, 95%CI 1.61;4.01, P < 0.01), tobacco smoking (aOR 2.01, 95%CI 1.24;3.25, P < 0.01), and presence of air bubbles inside the abscess (aOR 1.59, 95%CI 1.00;2.52, P = 0.04) were independent predictors of failure. In the subgroup of patients with abscesses > 5 cm, percutaneous drainage was not associated with the risk of failure or success of the non-operative treatment (aOR 2.78, 95%CI − 0.66;3.70, P = 0.23). Conclusions: Non-operative treatment is generally effective for diverticular abscesses. Tobacco smoking's role as an independent risk factor for treatment failure underscores the need for targeted behavioural interventions in diverticular disease management. IIb Hinchey diverticulitis patients, particularly young smokers, require vigilant monitoring due to increased risks of treatment failure and septic progression. Further research into the efficacy of image-guided percutaneous drainage should involve randomized, multicentre studies focussing on homogeneous patient groups. [ABSTRACT FROM AUTHOR]

Purpose: This study assessed the performance of LLM-linked chatbots in providing accurate advice for colorectal cancer screening to both clinicians and patients. Methods: We created standardized prompts for nine patient cases varying by age and family history to query ChatGPT, Bing Chat, Google Bard, and Claude 2 for screening recommendations to clinicians. Chatbots were asked to specify which screening test was indicated and the frequency of interval screening. Separately, the chatbots were queried with lay terminology for screening advice to patients. Clinician and patient advice was compared to guidelines from the United States Preventive Services Task Force (USPSTF), Canadian Cancer Society (CCS), and the U.S. Multi-Society Task Force (USMSTF) on Colorectal Cancer. Results: Based on USPSTF criteria, clinician advice aligned with 3/4 (75.0%), 2/4 (50.0%), 3/4 (75.0%), and 1/4 (25.0%) cases for ChatGPT, Bing Chat, Google Bard, and Claude 2, respectively. With CCS criteria, clinician advice corresponded to 2/4 (50.0%), 2/4 (50.0%), 2/4 (50.0%), and 1/4 (25.0%) cases for ChatGPT, Bing Chat, and Google Bard, respectively. For USMSTF guidelines, clinician advice aligned with 7/9 (77.8%), 5/9 (55.6%), 6/9 (66.7%), and 3/9 (33.3%) cases for ChatGPT, Bing Chat, Google Bard, and Claude 2, respectively. Discordant advice was given to clinicians and patients for 2/9 (22.2%), 3/9 (33.3%), 2/9 (22.2%), and 3/9 (33.3%) cases for ChatGPT, Bing Chat, Google Bard, and Claude 2, respectively. Clinical advice provided by the chatbots stemmed from a range of sources including the American Cancer Society (ACS), USPSTF, USMSTF, and the CCS. Conclusion: LLM-linked chatbots provide colorectal cancer screening recommendations with inconsistent accuracy for both patients and clinicians. Clinicians must educate patients on the pitfalls of using these platforms for health advice. [ABSTRACT FROM AUTHOR]

The implementation of recycling techniques represents a potential solution to the plastic pollution issue. To date, only a limited number of plastic polymers can be efficiently recycled. In the Italian plastic waste stream, the residual, non-homogeneous fraction is called 'Plasmix' and is intended for low-value uses. However, Plasmix can be used to create new materials through mechanical recycling, which need to be tested for their eco-safety. This study aimed to investigate the potential toxicity of two amounts (0.1% and 1% MPs in soil weight) of microplastics (MPs) made of naïve and additivated Plasmix-based materials (Px and APx, respectively) on the earthworm Eisenia foetida. Changes in oxidative status and oxidative damage, survival, gross growth rate and reproductive output were considered as endpoints. Although earthworms ingested both MP types, earthworms did not suffer an oxidative stress condition or growth and reproductive impairments. The results suggested that exposure to low amounts of both MPs can be considered as safe for earthworms. However, further studies testing a higher amount or longer exposure time on different model species are necessary to complete the environmental risk assessment of these new materials. [ABSTRACT FROM AUTHOR]

The article discusses the oncological outcomes of patients with locally advanced rectal cancer who did not undergo completion total mesorectal excision (cTME) after local excision (LE) following neoadjuvant chemoradiotherapy (nCRT). The study found that a significant number of patients who were recommended for cTME did not undergo the procedure, with comparable long-term outcomes to those who did. The findings challenge the traditional notion of completion surgery as the standard of care for this patient population and suggest the need for a more nuanced approach tailored to individual patient characteristics and preferences. [Extracted from the article]

Blowups of derivatives and gradient catastrophes for the n -dimensional homogeneous Euler equation are discussed. It is shown that, in the case of generic initial data, the blowups exhibit a fine structure in accordance with the admissible ranks of certain matrix generated by the initial data. Blowups form a hierarchy composed by n + 1 levels with the singularity of derivatives given by ∂ u i / ∂ x k ∼ | δ x | − (m + 1) / (m + 2) , m = 1 , ... , n along certain critical directions. It is demonstrated that in the multi-dimensional case there is certain bounded linear superposition of blowup derivatives. Particular results for the potential motion are presented too. Hodograph equations are basic tools of the analysis. [ABSTRACT FROM AUTHOR]

Purpose: Emergency treatment of acute diverticulitis remains a hazy field. Despite a number of clinical studies, randomized controlled trials (RCTs), guidelines and surgical societies recommendations, the most critical hot topics have yet to be addressed. Methods: Literature research from 1963 until today was performed. Data regarding the principal RCTs and observational studies were summarized in descriptive tables. In particular we aimed to focus on the following topics: the role of laparoscopy, the acute care setting, the RCTs, guidelines, observational studies and classifications proposed by literature, the problem in case of a pandemic, and the importance of adapting treatment /place/surgeon conditions. Results: In the evaluation of these points we did not try to find any prospective evolution of the concepts achievements. On the contrary we simply report the individuals strands of research from a retrospective point of view, similarly to what Steve Jobes said: "you can't connect the dots looking forward; you can only connect them looking backwards. So you have to trust that the dots will somehow connect in your future". We have finally obtained what can be defined "a narrative review of the literature on diverticulitis". Conclusions: Not only evidence-based medicine but also the contextualization, as also the role of 'competent' surgeons, should guide to novel approach in acute diverticulitis management. [ABSTRACT FROM AUTHOR]

Assessing the financial, energy and emission levels associated with alternative harvesting prescriptions, techniques, and technologies is crucial to sustainable forest management. This study aims at developing an overall predictive system able to estimate productivity, fuel consumption and emissions for a set of different forest harvesting technologies as a function of stand characteristics, site conditions and silvicultural prescriptions. The system consists of two separate group of models, one for felling and processing, and the other for extraction. In the first model, six quantitative (DBH, tree volume, harvest, engine power, purchase price of the machine) and five qualitative independent variables (forest species, management, treatment, operation, type of machine, type of fuel) were considered. In the second model, four qualitative and six quantitative independent variables were applied. Both models have been trained on a large database of real field data using linear and nonlinear approaches based on artificial intelligence. The dataset was randomly separated into two subsets, one using for training the models and the other for validating them. The models reliably predicted fuel consumption (r = 0.84–0.95), energy emission and cost (r = 0.88–0.98), per hour and per hectare, and they were successfully validated. Despite being estimated from a heterogeneous input dataset, constituted by quantitative and qualitative variables, both models proved to be efficient, robust and generally representative. The input variables are intuitive and suitable for practical use by both entrepreneurs and policy makers at the institutional level. [ABSTRACT FROM AUTHOR]

The ciliate Climacostomum virens produces the metabolite climacostol that displays antimicrobial activity and cytotoxicity on human and rodent tumor cells. Given its potential as a backbone in pharmacological studies, we used the fruit fly Drosophila melanogaster to evaluate how the xenobiotic climacostol affects biological systems in vivo at the organismal level. Food administration with climacostol demonstrated its harmful role during larvae developmental stages but not pupation. The midgut of eclosed larvae showed apoptosis and increased generation of reactive oxygen species (ROS), thus demonstrating gastrointestinal toxicity. Climacostol did not affect enteroendocrine cell proliferation, suggesting moderate damage that does not initiate the repairing program. The fact that climacostol increased brain ROS and inhibited the proliferation of neural cells revealed a systemic (neurotoxic) role of this harmful substance. In this line, we found lower expression of relevant antioxidant enzymes in the larvae and impaired mitochondrial activity. Adult offsprings presented no major alterations in survival and mobility, as well the absence of abnormal phenotypes. However, mitochondrial activity and oviposition behavior was somewhat affected, indicating the chronic toxicity of climacostol, which continues moderately until adult stages. These results revealed for the first time the detrimental role of ingested climacostol in a non-target multicellular organism. [ABSTRACT FROM AUTHOR]

Fusarium oxysporum f. sp. lactucae is one of the most aggressive baby-lettuce soilborne pathogens. The application of Trichoderma spp. as biocontrol agents can minimize fungicide treatments and their effective targeted use can be enhanced by support of digital technologies. In this work, two Trichoderma harzianum strains achieved 40–50% inhibition of pathogen radial growth in vitro. Their effectiveness in vivo was surveyed by assessing disease incidence and severity and acquiring hyperspectral and thermal features of the canopies being treated. Infected plants showed a reduced light absorption in the green and near-red regions over time, reflecting the disease progression. In contrast, Trichoderma-treated plant reflectance signatures, even in the presence of the pathogen, converged towards the healthy control values. Seventeen vegetation indices were selected to follow disease progression. The thermographic data were informative in the middle–late stages of disease (15 days post-infection) when symptoms were already visible. A machine-learning model based on hyperspectral data enabled the early detection of the wilting starting from 6 days post-infection, and three different spectral regions sensitive to baby-lettuce wilting (470–490 nm, 740–750 nm, and 920–940 nm) were identified. The obtained results pioneer an effective AI-based decision support system (DSS) for crop monitoring and biocontrol-based management. [ABSTRACT FROM AUTHOR]

Micro-arc oxidation (MAO) is a versatile surface-modification method that promotes higher wear and corrosion resistance, osseointegration, and biological activity to titanium alloys' surfaces. This study aimed to modify the surface of a recently developed metastable β Ti alloy, which exhibits more favorable mechanical properties for implant applications compared to some commercial Ti alloys, by incorporating Ag into the coatings to introduce a bactericidal function to the surface. The Ti-30Nb-5Mo alloy, with lower elastic modulus, was treated by the MAO method using electrolyte solutions containing calcium acetate, magnesium acetate, β-glycerol phosphate, and varied concentrations of silver nitrate (1.5 mM, 2.5 mM, and 3.5 mM). With an increase in the concentration of silver ions in the electrolyte, the galvanostatic period during the MAO process decreased from 1.7 s to 0.5 s. The Ca/P ratio increased from 0.72 up to 1.36. X-ray diffraction showed that the MAO coatings were formed by rutile and anatase TiO2 main phases and calcium phosphates. X-ray photoelectron spectroscopy analysis detected the presence of amorphous Nb2O5, CaCO3, and MgCO3, and metallic and oxide forms of Ag. The increase in Ag in the electrolyte decreased the coating thickness (from 14.2 μm down to 10.0 μm), increased the contact angle (from 37.6° up to 57.4°), and slightly increased roughness (from 0.64 μm up to 0.79 μm). The maximum inhibition of Enterococcus faecalis, Pseudomonas aeruginosa, and Candida albicans strains growth was of 43%, 43%, and 61%, respectively. The Ag did not negatively affect the differentiation of adipose-tissue-derived mesenchymal stem cells. Therefore, the treatment of the surface of the innovative Ti-30Nb-5Mo alloy by the MAO method was effective in producing a noncytotoxic porous coating with bactericidal properties and improved osseointegration capabilities. [ABSTRACT FROM AUTHOR]

Aims: The identification of the anatomical components of the Calot's Triangle during laparoscopic cholecystectomy (LC) might be challenging and its difficulty may increase when a surgical trainee (ST) is in charge, ultimately allegedly affecting also the incidence of common bile duct injuries (CBDIs). There are various methods to help reach the critical view of safety (CVS): intraoperative cholangiogram (IOC), critical view of safety in white light (CVS-WL) and near-infrared fluorescent cholangiography (NIRF-C). The primary objective was to compare the use of these techniques to obtain the CVS during elective LC performed by ST. Methods: This was a multicentre prospective observational study (Clinicalstrials.gov Registration number: NCT04863482). The impact of three different visualization techniques (IOC, CVS-WL, NIRF-C) on LC was analyzed. Operative time and time to achieve the CVS were considered. All the participating surgeons were also required to fill in three questionnaires at the end of the operation focusing on anatomical identification of the general task and their satisfaction. Results: Twenty-nine centers participated for a total of 338 patients: 260 CVS-WL, 10 IOC and 68 NIRF-C groups. The groups did not differ in the baseline characteristics. CVS was considered achieved in all the included case. Rates were statistically higher in the NIR-C group for common hepatic and common bile duct visualization (p = 0.046; p < 0.005, respectively). There were no statistically significant differences in operative time (p = 0.089) nor in the time to achieve the CVS (p = 0.626). Three biliary duct injuries were reported: 2 in the CVS-WL and 1 in the NIR-C. Surgical workload scores were statistically lower in every domain in the NIR-C group. Subjective satisfaction was higher in the NIR-C group. There were no other statistically significant differences. Conclusions: These data showed that using NIRF-C did not prolong operative time but positively influenced the surgeon's satisfaction of the performance of LC. [ABSTRACT FROM AUTHOR]

Mycotoxin contamination of feed and feed materials represent a serious health hazard. This study details the occurrence of aflatoxin B1 (AFB1), zearalenone (ZEN) and ochratoxin A (OTA) in 826 feed and 617 feed material samples, collected in two Italian Regions (Umbria and Marche) from 2018 to 2022 analyzed using a UPLC-FLD platform. The developed method was validated and accredited (ISO/IEC 17025) with satisfactory accuracy and precision data obtained in repeatability and intralaboratory reproducibility conditions. Feed had a higher incidence of contaminated samples (26%) with respect to feed materials (6%). AFB1 was found up to 0.1045 mg/kg in cattle feeds and 0.1234 mg/kg in maize; ZEN was detected up to 6.420 mg/kg in sheep feed while OTA was rarely reported and in lower concentrations (up to 0.085 mg/kg). Co-contamination of at least two mycotoxins was reported in 0.8% of the analyzed samples. The incidence of above maximum content/guidance level samples was 2% for feed and feed materials while almost 3-fold-higher for maize (5.8%) suggesting how mycotoxin contamination can affect some matrices more than others. Obtained data can be useful to improve official monitoring plans and therefore further raise awareness of this issue between agriculture stakeholders, healthcare entities and non-professionals. [ABSTRACT FROM AUTHOR]

In the ever-evolving landscape of modern agriculture, the integration of advanced technologies has become indispensable for optimizing crop management and ensuring sustainable food production. This paper presents the development and implementation of a real-time AI-assisted push-broom hyperspectral system for plant identification. The push-broom hyperspectral technique, coupled with artificial intelligence, offers unprecedented detail and accuracy in crop monitoring. This paper details the design and construction of the spectrometer, including optical assembly and system integration. The real-time acquisition and classification system, utilizing an embedded computing solution, is also described. The calibration and resolution analysis demonstrates the accuracy of the system in capturing spectral data. As a test, the system was applied to the classification of plant leaves. The AI algorithm based on neural networks allows for the continuous analysis of hyperspectral data relative up to 720 ground positions at 50 fps. [ABSTRACT FROM AUTHOR]

In Kenya 26% of children under age 5 experience stunted growth, 4% are wasted and 11% are underweight. In pregnant women, the prevalence of iron deficiency is 36% and iron‐deficiency anaemia prevalence is 26%. Previous studies have identified affordability as a key barrier to the intake of nutrients, particularly from animal‐source foods (ASFs). Thus, this study analyzes to what extent the affordability of ASF in Kenya can be improved. It focuses on four ASFs: eggs, milk, chicken and beef. Using a computable general equilibrium model, three policy simulations were undertaken to establish the impact of potential changes on nutritious ASF availability and affordability: a 20% increase in total factor productivity (TFP) for the four products; a 20% TFP increase plus a 25% reduction in trade and transportation margins; and a 20% TFP increase for ASF and maize (a key input in animal feed). Simulations suggest increasing the productivity of the four ASF products would increase their availability and lower consumer prices (up to 17% lower). Household consumption of the four commodities would increase, resulting in improved household dietary diversity. Rural households would gain more compared with urban households. Poor households (the lowest 40%) would register larger welfare (Equivalent Variation) gains than other households in both urban and rural areas. The richest 20% of the population would neither lose nor gain following the policy changes. Reducing transportation costs and trade margins and increasing maize productivity could further reduce the price of ASFs through lower production costs and increased consumption. [ABSTRACT FROM AUTHOR]

Complementary feeding practices are greatly influenced by local contexts. Therefore, national home‐grown evidence, policies and guidelines are critical to improving infant and young children's diets. This Special Issue has provided a comprehensive, evidence‐based analysis of the situation, gaps and context‐specific opportunities for improving young children's diets in Kenya. The primary research findings of the Special Issue supported the identification of a set of recommendations articulated across the four systems (food, health, water, sanitation and hygiene [WASH] and social protection) to improve food availability and accessibility in Kenya at the national and subnational levels. It is anticipated that the decentralised government functions seen in Kenya provide a strong opportunity to develop and mainstream context‐specific recommendations into action. This Special Issue recommends adopting a multi‐sectoral systems approach, including a shared vision, joint planning, implementation and monitoring, towards improving young children's diets with a focus on service delivery as well as scaled‐up community social behaviour change interventions. In particular, the approach should entail advocacy for policy revisions for service delivery that support complementary feeding and development of costed implementation strategies in support of the same, across four critical systems—food, health, WASH and social protection, along with, the strengthening of national coordination, monitoring and accountability structures as per the Kenya Nutrition Action Plan. Finally, the development of a legal framework for enhanced accountability from all relevant sectors towards sustainable, nutritious, safe and affordable children's diets. These recommendations provide a clear direction in addressing the complementary feeding challenges, which the primary research of this Special Issue has presented. [ABSTRACT FROM AUTHOR]

Optimal complementary feeding between the ages of 6 and 23 months provides children with the required range of nutritious and safe foods while continuing to be breastfed to meet their needs for essential nutrients and develop their full physical and cognitive potential. The rates of exclusive breastfeeding in the first 6 months of life have increased from 32% in 2008 to 60% in 2022 in Kenya. However, the proportion of children between 6 and 23 months receiving a minimum acceptable diet remains low and has declined from 39% in 2008 to 31% in 2023. The Kenyan Ministry of Health, GAIN and UNICEF collaborated to understand the drivers of complementary feeding practices, particularly proximal determinants, which can be directly addressed and acted upon. A secondary analysis of household surveys and food composition data was conducted to outline children's dietary patterns within the different regions of Kenya and the extent to which the affordability of animal‐source foods could be improved. Ethnographic data were analyzed to identify socio‐cultural barriers to optimal complementary feeding. Furthermore, we outlined the critical steps for developing user‐friendly and low‐cost complementary feeding recipes. The results of all the analyses are presented in five of the six papers of this Special Issue with this additional paper introducing the Kenyan context and some of the critical findings. The Special Issue has highlighted multidimensional barriers surrounding the use and availability of animal‐source foods. Furthermore, it emphasizes the need for a multi‐sectoral approach in enacting policies and programmes that address these barriers. [ABSTRACT FROM AUTHOR]

Understanding runoff-controlling mechanisms requires hydro-meteorological data derived from experimental plots or catchments. The present study focuses on the Voineşti Experimental Basin (VEB - Romania), which is in the Curvature Subcarpathia and is characterised by outcropping continental fluvial deposits. VEB has different experimental plots built to understand the relations between runoff and its genetic and predisposing factors. The study analysed the monitoring data in a plot of 600 m² covered by grassland. An empirical model defined the runoff threshold by integrating ground data and satellite estimations. By identifying 45 runoff events in the 2016-2018 period, it was possible to define a runoff threshold considering the rainfall depth and the antecedent soil hydraulic conditions. Two indices were used based on the previous volumetric water content and the antecedent degree of saturation retrieved by the Copernicus Sentinel-1 mission. By adding the rainfall depth to the soil antecedent hydraulic conditions, a runoff threshold of about 65-67 mm was identified. These findings encourage using satellite moisture products to describe hydrogeological processes in scarcely instrumented areas. [ABSTRACT FROM AUTHOR]

Background: Circulating cell-free DNA (cfDNA, liquid biopsy) is a powerful tool to detect molecular alterations. However, depending on tumor characteristics, biology and anatomic localization, cfDNA detection and analysis may be challenging. Gliomas are enclosed into an anatomic sanctuary, which obstacles the release of cfDNA into the peripheral blood. Therefore, the advantages of using liquid biopsy for brain tumors is still to be confirmed. The present study evaluates the ability of liquid biopsy to detect IDH1 mutations and its correlation with survival and clinical characteristics of glioma patients. Methods: Blood samples obtained from glioma patients were collected after surgery prior to the adjuvant therapy. cfDNA was extracted from plasma and IDH1 p.R132H mutation analysis was performed on a digital droplet PCR. χ2-test and Cohen k were used to assess the correlation between plasma and tissue IDH1 status, while Kaplan Meier curve and Cox regression analysis were applied to survival analysis. Statistical calculations were performed by MedCalc and GraphPad Prism software. Results: A total of 67 samples were collected. A concordance between IDH1 status in tissue and in plasma was found (p = 0.0024), and the presence of the IDH1 mutation both in tissue (138.8 months vs 24.4, p < 0.0001) and cfDNA (116.3 months vs 35.8, p = 0.016) was associated with longer median OS. A significant association between IDH1 mutation both in tissue and cfDNA, age, tumor grade and OS was demonstrated by univariate Cox regression analysis. No statistically significant association between IDH1 mutation and tumor grade was found (p = 0.10). Conclusions: The present study demonstrates that liquid biopsy may be used in brain tumors to detect IDH1 mutation which represents an important prognostic biomarker in patients with different types of gliomas, being associated to OS. [ABSTRACT FROM AUTHOR]

Complementary feeding practices are greatly influenced by local contexts. Therefore, national home‐grown evidence, policies and guidelines are critical to improving infant and young children's diets. This Special Issue has provided a comprehensive, evidence‐based analysis of the situation, gaps and context‐specific opportunities for improving young children's diets in Kenya. The primary research findings of the Special Issue supported the identification of a set of recommendations articulated across the four systems (food, health, water, sanitation and hygiene [WASH] and social protection) to improve food availability and accessibility in Kenya at the national and subnational levels. It is anticipated that the decentralised government functions seen in Kenya provide a strong opportunity to develop and mainstream context‐specific recommendations into action. This Special Issue recommends adopting a multi‐sectoral systems approach, including a shared vision, joint planning, implementation and monitoring, towards improving young children's diets with a focus on service delivery as well as scaled‐up community social behaviour change interventions. In particular, the approach should entail advocacy for policy revisions for service delivery that support complementary feeding and development of costed implementation strategies in support of the same, across four critical systems—food, health, WASH and social protection, along with, the strengthening of national coordination, monitoring and accountability structures as per the Kenya Nutrition Action Plan. Finally, the development of a legal framework for enhanced accountability from all relevant sectors towards sustainable, nutritious, safe and affordable children's diets. These recommendations provide a clear direction in addressing the complementary feeding challenges, which the primary research of this Special Issue has presented.Key messages: Dietary patterns are varied across regions more so sub‐regions within the same country. Therefore, home‐grown and localized evidence is crucial for developing national complementary feeding guidelines.Food market forces, especially availability, and supply, are crucial aspects of food environments. Improving trade policies and tariffs infrastructure should become part of efforts to enhance complementary feeding diets of young children.Social‐behavior‐change focused on addressing socio‐cultural norms and skills for nutritionally optimal food utilization is needed to improve complementary feeding diets.This special issue shades light on the use of a multi‐sectoral systems approach in addressing the drivers of poor complementary feeding diets. [ABSTRACT FROM AUTHOR]

In Kenya 26% of children under age 5 experience stunted growth, 4% are wasted and 11% are underweight. In pregnant women, the prevalence of iron deficiency is 36% and iron‐deficiency anaemia prevalence is 26%. Previous studies have identified affordability as a key barrier to the intake of nutrients, particularly from animal‐source foods (ASFs). Thus, this study analyzes to what extent the affordability of ASF in Kenya can be improved. It focuses on four ASFs: eggs, milk, chicken and beef. Using a computable general equilibrium model, three policy simulations were undertaken to establish the impact of potential changes on nutritious ASF availability and affordability: a 20% increase in total factor productivity (TFP) for the four products; a 20% TFP increase plus a 25% reduction in trade and transportation margins; and a 20% TFP increase for ASF and maize (a key input in animal feed). Simulations suggest increasing the productivity of the four ASF products would increase their availability and lower consumer prices (up to 17% lower). Household consumption of the four commodities would increase, resulting in improved household dietary diversity. Rural households would gain more compared with urban households. Poor households (the lowest 40%) would register larger welfare (Equivalent Variation) gains than other households in both urban and rural areas. The richest 20% of the population would neither lose nor gain following the policy changes. Reducing transportation costs and trade margins and increasing maize productivity could further reduce the price of ASFs through lower production costs and increased consumption.Key messages: Affordability is a key barrier to the consumption of nutritious animal‐source foods (ASFs) in Kenya.We undertook simulations to understand how policy changes would impact ASF affordability and availability.Increasing the supply of ASFs could yield lower prices for these foods.The impact on prices could be magnified if supply increases were accompanied by reduced trade and transportation margins.Intake of ASFs and dietary diversity could increase if prices were lowered. [ABSTRACT FROM AUTHOR]

Blowups of vorticity for the three‐ and two‐dimensional homogeneous Euler equations are studied. Two regimes of approaching a blow‐up point, respectively, with variable or fixed time are analyzed. It is shown that in the n‐dimensional (n=2,3$n=2,3$) generic case the blowups of degrees 1,⋯,n$1,\text{\ensuremath{\cdots}},n$ at the variable time regime and of degrees 1/2,⋯,(n+1)/(n+2)$1/2,\text{\ensuremath{\cdots}},(n+1)/(n+2)$ at the fixed time regime may exist. Particular situations when the vorticity blows while the direction of the vorticity vector is concentrated in one or two directions are realizable. [ABSTRACT FROM AUTHOR]

Background: An emergency presentation of colorectal cancer is expected to be a poor prognostic factor as this mode of presentation usually indicates an advanced disease. The contribution of surgical expertise on the outcome of patients with CRC in an emergency setting is unknown. Objectives: An observational study of retrospective collected data of emergency CRC patients who undergo urgent surgical procedures. Design: Retrospective study. Setting: Thisstudy was conducted in the colorectal unit of a tertiary teaching hospital in London, UK. Patients (Materials) and Methods: Between 2013 and 2017, all patients who underwent an emergency surgery for CRC were enrolled. One group was operated on by colorectal surgeons (CRS) and the other by acute general surgeons (AGS). Main Outcome Measures: Indications for emergency surgery included intestinal bleeding, peritonitis, intra‑abdominal abscess, or complete bowel obstruction at presentation. All cases had a preliminary diagnosis of colon cancer. The differences between patients who underwent emergency surgery by CRS and AGS were assessed on four main levels: patient demographics, surgical pathology, and short‑ and long‑term outcomes. Sample Size: One hundred and one patients were analyzed, of which 61.4% were male. The median age was 68.2 years, and 71.3% of the patients were operated on by a CRS. Results: Sixteen procedures were done laparoscopically, all by CRS (P = 0.002). CRS were more likely to perform a tumor resection with primary anastomosis (P = 0.009) and a segmental resection with stoma formation (P = 0.02) compared to AGS who were more likely to perform palliative procedures (P = 0.045). Multivariate analysis showed that overall surgical intervention from a CRS correlated with a lower recurrence rate of ‑1.60 [odds ratio (OR) = 2.36, 95% confidence interval (CI) = 0.84–6.62] and death rate of 0.169 (OR = 0.73, 95% CI = 0.3–1.8); however, these were not statistically significant. The 5‑year overall survival rate for stage I and II tumors was statistically significant and in favor of CRS than AGS (P = 0.003, P < 0.001, respectively). Conclusions: We conclude that colorectal surgical expertise influences the procedures performed in an emergency setting and specialty may have an impact on the long‑term survival and recurrence rates in CRC. Limitations: As a retrospective study, this study has certain limitations. The data for this study was collected from electronic records and databases of patients after they had completed follow‑up. Conflict of Interest: The authors have no conflict of interest to declare. [ABSTRACT FROM AUTHOR]

Introduction: Inguinal hernia repair is one of the most commonly performed operations in general surgery. A total of 130.000 inguinal hernia repairs are performed yearly in Italy, and approximately 20 million inguinal hernias are treated worldwide annually. This report represents the trend analysis in inguinal hernia repair in Italy from a nationwide dataset for the 6-year period from 2015 to 2020. Materials and methods: Based on regional hospital discharge records, all the inguinal hernia repairs performed in public and private hospitals in Italy between 2015 and 2020 were reviewed based on diagnosis and procedure codes. For the aim of this study, data from the AgeNas (The National Agency for Regional Health Services) data source were analyzed. Results: Elective inguinal hernia repairs outnumbered urgent operations over the 6-year study period, ranging from 122,737 operations in 2015 to 65,780 in 2020 as absolute numbers, and from 87.96 to 83.3% of total procedures in 2019 and 2020 respectively, with an annual change ranging from − 66.58%, between 2020 and 2019, to − 2.49%, between 2019 and 2018 (mean = − 18.74%; CI =− 46.7%–9.22%; p < 0.0001). Conclusions: This large-scale review of groin hernia data from a nationwide Italian dataset provides a unique opportunity to obtain a snapshot of open groin hernia repair activity. More specifically, there is a trend to perform more elective than urgent procedures and there is a steady decrease in the amount of open hernia repairs in favor to laparoscopy. [ABSTRACT FROM AUTHOR]

Background: New evidence has emerged since latest guidelines on the management of paraesophageal hernia, and guideline development methodology has evolved. Members of the European Association for Endoscopic Surgery have prioritized the management of paraesophageal hernia to be addressed by pertinent recommendations. Objective: To develop evidence-informed clinical practice recommendations on paraesophageal hernias, through evidence synthesis and a structured evidence-to-decision framework by an interdisciplinary panel of stakeholders. Methods: We performed three systematic reviews, and we summarized and appraised the certainty of the evidence using the GRADE methodology. A panel of general and upper gastrointestinal surgeons, gastroenterologists and a patient advocate discussed the evidence in the context of benefits and harms, the certainty of the evidence, acceptability, feasibility, equity, cost and use of resources, moderated by a Guidelines International Network-certified master guideline developer and chair. We developed the recommendations in a consensus meeting, followed by a modified Delphi survey. Results: The panel suggests surgery over conservative management for asymptomatic/minimally symptomatic paraesophageal hernias (conditional recommendation), and recommends conservative management over surgery for asymptomatic/minimally symptomatic paraesophageal hernias in frail patients (strong recommendation). Further, the panel suggests mesh over sutures for hiatal closure in paraesophageal hernia repair, fundoplication over gastropexy in elective paraesophageal hernia repair, and gastropexy over fundoplication in patients who have cardiopulmonary instability and require emergency paraesophageal hernia repair (conditional recommendation). A strong recommendation means that the proposed course of action is appropriate for the vast majority of patients. A conditional recommendation means that most patients would opt for the proposed course of action, and joint decision-making of the surgeon and the patient is required. Accompanying evidence summaries and evidence-to-decision frameworks should be read when using the recommendations. This guideline applies to adult patients with moderate to large paraesophageal hernias type II to IV with at least 50% of the stomach herniated to the thoracic cavity. The full guideline with user-friendly decision aids is available in https://app.magicapp.org/#/guideline/j7q7Gn. Conclusion: An interdisciplinary panel provides recommendations on key topics on the management of paraesophageal hernias using highest methodological standards and following a transparent process. Guideline registration number: PREPARE-2023CN018. [ABSTRACT FROM AUTHOR]

Background: Variation exists in practice pertaining to bowel preparation before minimally invasive colorectal surgery. A survey of EAES members prioritized this topic to be addressed by a clinical practice guideline. Objective: The aim of the study was to develop evidence-informed clinical practice recommendations on the use of bowel preparation before minimally invasive colorectal surgery, through evidence synthesis and a structured evidence-to-decision framework by an interdisciplinary panel of stakeholders. Methods: This is a collaborative project of EAES, SAGES, and ESCP. We updated a previous systematic review and performed a network meta-analysis of interventions. We appraised the certainty of the evidence for each comparison, using the GRADE and CINeMA methods. A panel of general and colorectal surgeons, infectious diseases specialists, an anesthetist, and a patient representative discussed the evidence in the context of benefits and harms, the certainty of the evidence, acceptability, feasibility, equity, cost, and use of resources, moderated by a GIN-certified master guideline developer and chair. We developed the recommendations in a consensus meeting, followed by a modified Delphi survey. Results: The panel suggests either oral antibiotics alone prior to minimally invasive right colon resection or mechanical bowel preparation (MBP) plus oral antibiotics; MBP plus oral antibiotics prior to minimally invasive left colon and sigmoid resection, and prior to minimally invasive right colon resection when there is an intention to perform intracorporeal anastomosis; and MBP plus oral antibiotics plus enema prior to minimally invasive rectal surgery (conditional recommendations); and recommends MBP plus oral antibiotics prior to minimally invasive colorectal surgery, when there is an intention to localize the lesion intraoperatively (strong recommendation). The full guideline with user-friendly decision aids is available in https://app.magicapp.org/#/guideline/LwvKej. Conclusion: This guideline provides recommendations on bowel preparation prior to minimally invasive colorectal surgery for different procedures, using highest methodological standards, through a structured framework informed by key stakeholders. Guideline registration number PREPARE-2023CN045. [ABSTRACT FROM AUTHOR]

Mozzarella di Bufala Campana is a pasta filata cheese with a Protected Designation of Origin whose specifications require the use of fresh milk, forbidding the use of frozen curds. The goal is to develop a routine analysis to identify frozen curd presence. The Buffalo Mozzarella samples were analysed by the near‐infrared analytical technique, and the spectral data were processed through an artificial neural network. The results make it possible to identify the use of frozen curd in samples of Buffalo Mozzarella for up to 9 days of storage. The model reported very high accuracy either in training (0.5% of bad prediction) or in tests (6.8% of bad prediction). [ABSTRACT FROM AUTHOR]

Introduction: Artificial intelligence and computer vision are revolutionizing the way we perceive video analysis in minimally invasive surgery. This emerging technology has increasingly been leveraged successfully for video segmentation, documentation, education, and formative assessment. New, sophisticated platforms allow pre-determined segments chosen by surgeons to be automatically presented without the need to review entire videos. This study aimed to validate and demonstrate the accuracy of the first reported AI-based computer vision algorithm that automatically recognizes surgical steps in videos of totally extraperitoneal (TEP) inguinal hernia repair. Methods: Videos of TEP procedures were manually labeled by a team of annotators trained to identify and label surgical workflow according to six major steps. For bilateral hernias, an additional change of focus step was also included. The videos were then used to train a computer vision AI algorithm. Performance accuracy was assessed in comparison to the manual annotations. Results: A total of 619 full-length TEP videos were analyzed: 371 were used to train the model, 93 for internal validation, and the remaining 155 as a test set to evaluate algorithm accuracy. The overall accuracy for the complete procedure was 88.8%. Per-step accuracy reached the highest value for the hernia sac reduction step (94.3%) and the lowest for the preperitoneal dissection step (72.2%). Conclusions: These results indicate that the novel AI model was able to provide fully automated video analysis with a high accuracy level. High-accuracy models leveraging AI to enable automation of surgical video analysis allow us to identify and monitor surgical performance, providing mathematical metrics that can be stored, evaluated, and compared. As such, the proposed model is capable of enabling data-driven insights to improve surgical quality and demonstrate best practices in TEP procedures. [ABSTRACT FROM AUTHOR]

Several objective severity measurement questionnaires of the fecal incontinence (FI), are available to describe type, frequency and degree of FI, and their impact on quality of life, aiming to establish baseline scores measure response to treatment over time and allow comparison among patients treated using different strategies. Presently, despite their widespread use in clinical practice, none of these questionnaire have been validated in the Italian language. The aim is to test the translated Italian version of the Vaizey and Wexner and Fecal Incontinence Severity Index (FISI) questionnaires assessing their reliability and validity among Italian-speaking patients. Two researchers proficient in spoken English and Italian translated both questionnaires in the Italian language. They independently translated the two questionnaires from English and then they met to produce a single version of the two questionnaires, to solve any possible discrepancy. A forward–backward translation was then obtained by a professional bilingual translator, so as to define the final version of the questionnaires. The questionnaires were independently administered twice to 100 Italian-speaking patients by two different and independent raters. Cronbach's α of the first and second Vaizey and Wexner questionnaire was 0.755 and 0.727, respectively. While Cronbach's α of the first and second FISI questionnaire was 0.810 and 0.806, respectively. Spearman correlation and inter-rater reliability were 0.937 and 0.913 for Vaizey and Wexner questionnaire, respectively, and 0.915 and 0.871 for FISI questionnaire, respectively. Italian version of the Vaizey and Wexner and FISI questionnaires proved good consistency, reliability, reproducibility, showing good psychometric properties. [ABSTRACT FROM AUTHOR]

Minimally invasive abdominal wall surgery is growing worldwide, with a constant and fast improvement of surgical techniques and surgeons' confidence in treating both primary and incisional hernias (IH). The Italian Society of Endoscopic Surgery and new technologies (SICE) and the ISHAWS (Italian Society of Hernia and Abdominal Wall Surgery) worked together to investigate state of the art in IH treatment in elective and emergency settings in Italy. An online open survey was designed, and Italian surgeons interested in abdominal wall surgery were invited to fill out a 20-point questionnaire on IH surgical procedures performed in their departments. Surgeons were asked to express their points of view on specific questions about technical and clinical variables in IH treatment. Preferred approach in elective IH surgery was minimally invasive (59.7%). Open surgery was the preferred approach in 40.3% of the responses. In emergency settings, open surgery was the preferred approach (65.4%); however, 34.5% of the involved surgeons declare to prefer the laparoscopic/endoscopic approach. Most respondents opted for conversion to open surgery in case of relevant surgical field contamination, with a non-mesh repair of abdominal wall defects. Among those that used the laparoscopic approach in the emergent setting, the majority (74%) used the size of the defect of 5 cm as a decisional cut-off. The spread of minimally invasive approaches to IH repair in emergency surgery in Italy is gaining relevance. Code-sharing through scientific societies can improve clinical practice in different departments and promote a tailored approach to IH surgery. [ABSTRACT FROM AUTHOR]

Since 2010, several guidelines and consensus papers have been proposed to support surgeons in the decision-making process (Cuccurullo et al. in Hernia 17(5):557–566, 2013; Silecchia et al. in Surg Endosc 29:2463–2484, 2015; Bittner et al. in Surg Endosc 33(11):3511–3549, 2015) with the conclusion that laparoscopic repair (LR) has gained popularity in the treatment of IH. To date, however, it is not yet clear as to the uptake of LR for IH on national basis. Only dated studies encompassing of all types of incisional hernia repairs are available in literature (Bisgaard et al. in Br J Surg 96:1452–1457, 2009). The aim of our study is to present a snapshot of Italian data for LR of ventral hernias, over a 6 years period, including volume of LR, procedural features and major postoperative outcomes. Data were extracted from the Italian Hospital Information System (HIS) that collects clinical and administrative information regarding each hospital admission of every patient discharged from any hospital in Italy. Using Hospital Discharge records regional Databases (HDD), all laparoscopic ventral hernia procedures carried out in public and private hospitals between 2015 and 2020, in patients over 18 years and resident in Italy, were collected based on diagnosis and procedure codes. The National Agency for Regional Health Services (AgeNaS) oversees the management and analysis of data. All hospital admissions that occurred between 2015 and 2020 were analyzed. A total of 154,546 incisional hernia repairs were performed in Italy from 2015 to 2020. Of these, 20,789 (13.45%) were minimally invasive repairs. The number of procedures performed increased significantly over time, constituting 11.96 and 15.24% of all procedures performed in 2015 and 2020 respectively. However, considering the whole period, the mean annual change was—5.58% (CI − 28.6% to 17.44%; p < 0.0001). Urgent minimally invasive repairs were performed in 1968 cases (1.27%). The absolute rate of laparoscopically treated patients needing an urgent surgical procedure increased overtime (from 7.36% in 2015 to 13.418% in 2020). The mean annual change registered over the whole period was 7.42%. 92% (CI − 0.03 to 14.09%; p < 0.0001). However, when considering the period from 2015 to 2019, the mean annual change was 10.42% (CI 6.35 to 14.49%; p < 0.0001). To our knowledge this is the first nationwide Italian report presenting the national workload of surgical units and the main perioperative features of minimally invasive surgery for ventral hernia repairs. [ABSTRACT FROM AUTHOR]

In this study, we describe a Salmonella enterica serovar (S.) Rissen strain with a reduced susceptibility to meropenem, isolated from a urinary infection in an 89-year-old woman in 2018 during activity surveillance in Italy (Enter-Net Italia). The genomic characteristics, pathogenicity, and antimicrobial resistance mechanisms were investigated via a genomic approach. Antimicrobial susceptibility testing revealed a "susceptible, increased exposure" phenotype to meropenem in the S. Rissen strain (4_29_19). Whole-genome sequencing (WGS) was performed using both the NovaSeq 6000 S4 PE150 XP platform (Illumina, San Diego, CA, USA) and MinION (Oxford Nanopore). The S. Rissen 4_29_19 strain harboured two plasmids: a pKpQIL-like plasmid carrying the blaKPC-3 resistance gene in a Tn4401a transposon (pKPC_4_29_19), and a ColE-like plasmid (p4_4_29_19) without resistance genes, highly prevalent among Enterobacterales. Comparative analysis revealed that the pKPC_4_29_19 plasmid was highly related to the pKpQIL reference plasmid (GU595196), with 57% coverage and 99.96% identity, but lacking a region of about 30 kb, involving the FIIK2 replicon region and the entire transfer locus, causing the loss of its ability to conjugate. To our knowledge, this is the first time that a pKpQIL-like plasmid, carrying blaKPC-3, highly diffused in Klebsiella pneumoniae strains, has been identified in a Salmonella strain in our country. The acquisition of blaKPC genes by Salmonella spp. is extremely rare, and is reported only sporadically. In zoonotic bacteria isolated from humans, the presence of a carbapenem resistance gene carried by mobile genetic elements, usually described in healthcare-associated infection bacteria, represents an important concern for public health. [ABSTRACT FROM AUTHOR]

A Hamiltonian reduction approach is defined, studied, and finally used to derive asymptotic models of internal wave propagation in density stratified fluids in two-dimensional domains. Beginning with the general Hamiltonian formalism of Benjamin (1986 J. Fluid Mech. 165 445–74) for an ideal, stably stratified Euler fluid, the corresponding structure is systematically reduced to the setup of two homogeneous fluids under gravity, separated by an interface and confined between two infinite horizontal plates. A long-wave, small-amplitude asymptotics is then used to obtain a simplified model that encapsulates most of the known properties of the dynamics of such systems, such as bidirectional wave propagation and maximal amplitude travelling waves in the form of fronts. Further reductions, and in particular devising an asymptotic extension of Dirac's theory of Hamiltonian constraints, lead to the completely integrable evolution equations previously considered in the literature for limiting forms of the dynamics of stratified fluids. To assess the performance of the asymptotic models, special solutions are studied and compared with those of the parent equations [ABSTRACT FROM AUTHOR]