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Background Three-dimensional (3D) models improve the comprehension of renal anatomy. Objective To evaluate the impact of novel 3D-derived parameters, to predict surgical outcomes after robot-assisted partial nephrectomy (RAPN). Design, setting, and participants Sixty-nine patients with cT1-T2 renal mass scheduled for RAPN were included. Three-dimensional virtual modeling was achieved from computed tomography. The following volumetric and morphological 3D parameters were calculated: VT (volume of the tumor); VT/VK (ratio between tumor volume and kidney volume); CSA3D (ie, contact surface area); UCS3D (contact to the urinary collecting system); Tumor-Artery3D: tumor’s blood supply by tertiary segmental arteries (score = 1), secondary segmental artery (score = 2), or primary segmental/main renal artery (scoren = 3); ST (tumor’s sphericity); ConvT (tumor’s convexity); and Endophyticity3D (ratio between the CSA3D and the global tumor surface). Intervention RAPN with a 3D model. Outcome measurements and statistical analysis Three-dimensional parameters were compared between patients with and without complications. Univariate logistic regression was used to predict overall complications and type of clamping; linear regression was used to predict operative time, warm ischemia time, and estimated blood loss. Results and limitations Overall, 11 (15%) individuals experienced overall complications (7.2% had Clavien ≥3 complications). Patients with urinary collecting system (UCS) involvement at 3D model (UCS3D = 2), tumor with blood supply by primary or secondary segmentary arteries (Tumor-Artery3D = 1 and 2), and high Endophyticity3D values had significantly higher rates of overall complications (all p ≤ 0.03). At univariate analysis, UCS3D, Tumor-Artery3D, and Endophyticity3D are significantly associated with overall complications; CSA3D and Endophyticity3D were associated with warm ischemia time; and CSA3D was associated with selective clamping (all p ≤ 0.03). Sample size and the lack of interobserver variability are the main limits. Conclusions Three-dimensional modeling provides novel volumetric and morphological parameters to predict surgical outcomes after RAPN. Patient summary Novel morphological and volumetric parameters can be derived from a three-dimensional model to describe surgical complexity of renal mass and to predict surgical outcomes after robot-assisted partial nephrectomy.

Thrombolysis (rTPA) and mechanical thrombectomy (MT) are cost-effective treatments for ischemic stroke. However, little is known about the impact of different types of health systems (HSs) on the outcome and cost of ischemic stroke.Literature search was performed on PubMed/OVID for studies without time limits. The year of publication, type of HS, cost of intervention treatment (rTPA/MT), cost of control strategy (conservative treatment or rTPA), quality-adjusted life years (QALYs) gained, and percentage of gross domestic product spent on health were recorded. The inclusion criteria were English literature, cost-effectiveness, and cost-utility analyses. The exclusion criterion was the absence of geographic coherence between the derived QALYs and the costs. The costs were inflated to 2021 and then converted to US dollar/euro. An analysis of variance or Kruskal-Wallis test was used to compare the percentage of cost reduction and the QALYs gained. Gross domestic product percentage was correlated with the QALYs gained.Thirty-five studies were analyzed. No significant differences in the percentage of cost reduction were found among the different types of HS (Beveridge -14.74% [95% confidence interval {CI} -57.94/53.08] vs. Bismarck -2.27% [95% CI -122.73/118.18] vs. national insurance -0.015% [95% CI -16.96/51.00] vs. private insurance -4.05% [95% CI -32.62/13.18]). No differences were found in QALYs gained among the different HS (Beveridge 1021 [95% CI -36.37/1705.04] vs. Bismarck 440 [95% CI -2290.68/3870.68] vs. national insurance 643 [95% CI -137.54/2366.21] vs. private insurance 550 [95% CI 131.54/1128.06]). No differences were found among the QALYs gained between rTPA/conservative treatment versus rTPA/MT and rtPA + MT/MT. The percentage of gross domestic product spent on health did not correlate with the QALYs gained (rho = -0.16; P = 0.56).MT and rTPA are independently cost-effective among different HS.

Placental dysfunction is one of the most common causes of Intrauterine Fetal Demise (IUFD). Due to its characteristics, the placenta may be the target of molecular research aimed to investigate potential causes of IUFD. In the literature, there are no studies on human placentas that have investigated possible associations between somatic mutations and the occurrence of IUFD. The aim of this study was to identify the presence of gene mutations in placental tissues in a series of cases of IUFD and to evaluate potential correlations with placental microscopic findings.Thirty-seven samples of formalin-fixed and paraffin-embedded placental tissues were retrospectively selected from pregnancies ending in IUFD between 23rd to 40th week. Six control placentas of physiological pregnancies were included as controls. After sampling, made according to standardized protocol and conventional histopathological examination, placental tissues were subjected to DNA extraction and sequencing by means of Next Generation Sequencing with a 56-gene panel.The most frequent mutation observed in 32/37 IUFD cases (86.5%) and absent in any of the 6 control placentas was in c-KIT gene, which is implicated in placental tissue differentiation. However, no significant correlation was found between the presence of individual gene mutations and placental histopatological findings.As the present study found an elevated frequency of c-KIT mutation in IUFD, it further supports the hypothesis that c-KIT is involved in abnormal tissue differentiation leading to altered placental vascularization and function.

Corn plants showing symptoms of midribs chlorosis, and leaf reddening, short internodes, ear proliferation, and plant growth reduction were collected in Peru from fields in nine localities in the provinces of Huancayo, Chupaca, and Jauja in the Junín region, and tested to verify phytoplasma presence and identity. Primers amplifying the phytoplasma ribosomal 16S and ribosomal protein genes were used. The phytoplasma presence was detected in symptomatic samples from all the surveyed areas. The sequencing of the obtained amplicons indicated the presence of ‘Candidatus Phytoplasma asteris’ and ‘Ca. P. pruni’-related strains. A BLASTn search of sequenced genes showed that the two ‘Candidatus Phytoplasma’ strains identified in corn shares 100% and 99.82% identity with the ‘Ca. P. asteris’ strains from maize and 99.92% and 99.55% with ‘Ca. P. pruni’-related strains, respectively. The RFLP analyses allowed to enclose these phytoplasma strains in the 16SrI-B and 16SrIII-J subgroups; however, the two phytoplasmas were, in some cases, present in mixed infection. The 16SrIII-J phytoplasma is for the first time reported associated with the maize bushy stunt disease and this represent a relevant information for the disease epidemiology towards its appropriate management in the affected area.

During 2016–2017 surveys, carried out for phytoplasma diseases in ornamental plants in Chaharmahal and Bakhtiari provinces, Iran, found symptoms of virescence, phyllody, reduced size of leaves and flowers in columbine (Aquilegia vulgaris). Total DNAs extracted from symptomatic and symptomless plants were tested for the presence of phytoplasma using P1/P7 and R16F2n/R16R2 primers in direct and nested PCR producing amplicons of about 1.8 and 1.2 kb, respectively, from all symptomatic A. vulgaris plants, but not from symptomless ones. The consensus sequence of the detected phytoplasma named Aquilegia phyllody (APh) was 100% identical with strains clustering to phytoplasmas enclosed in the 16SrI group as also confirmed by phylogenetic analyses. Both real and virtual restriction fragment length polymorphism analysis of R16F2n/R16R2 amplicons showed profiles that were identical to each other and indicated the affiliation of the APh phytoplasma to the 16SrI-R subgroup. This is the first report of a 16SrI-R phytoplasma associated with this A. vulgaris phyllody disease.

Background and Objectives: The aim of this article is to present a single-surgeon, open retroperitoneal lymph node dissection (RPLND) series for testicular cancer in a high-volume center. Materials and Methods: We reviewed data from patients who underwent RPLND performed by an experienced surgeon at our institution between 2000 and 2019. We evaluated surgical and perioperative outcomes, complications, Recurrence-Free Survival (RFS), Overall Survival (OS), and Cancer-Specific Survival (CSS). Results: RPLND was performed in primary and secondary settings in 21 (32%) and 44 (68%) patients, respectively. Median operative time was 180 min. Median hospital stay was 6 days. Complications occurred in 23 (35%) patients, with 9 (14%) events reported as Clavien grade ≥ 3. Patients in the primary RPLND group were significantly younger, more likely to have NSGCT, had higher clinical N0 and M0, and had higher nerve-sparing RPLND (all p ≤ 0.04) compared to those in the secondary RPLND group. In the median follow-up of 120 (56–180) months, 10 (15%) patients experienced recurrence. Finally, 20-year OS, CSS, and RFS were 89%, 92%, and 85%, respectively, with no significant difference in survival rates between primary vs. secondary RPLND subgroups (p = 0.64, p = 0.7, and p = 0.31, respectively). Conclusions: Open RPLND performed by an experienced high-volume surgeon achieves excellent oncological and functional outcomes supporting the centralization of these complex procedures.

We recorded Omia cyclopea (Graslin, [1837]) and Coenobia rufa (Haworth, 1809) for the first time in southern Italy. These are extremely rare species in Italy and conservation actions are needed to prevent Italian populations of C. rufa from extinction, locally extinct yet.

Multisensory integration is quintessential to adaptive behavior, with clinical populations showing significant impairments in this domain, most notably hallucinatory reports. Interestingly, altered cross-modal interactions have also been reported in healthy individuals when engaged in tasks such as the Sound-Induced Flash-Illusion (SIFI). The temporal dynamics of the SIFI have been recently tied to the speed of occipital alpha rhythms (IAF), with faster oscillations entailing reduced temporal windows within which the illusion is experienced. In this regard, entrainment-based protocols have not yet implemented rhythmic transcranial magnetic stimulation (rhTMS) to causally test for this relationship. It thus remains to be evaluated whether rhTMS-induced acoustic and somatosensory sensations may not specifically interfere with the illusion. Here, we addressed this issue by asking 27 volunteers to perform a SIFI paradigm under different Sham and active rhTMS protocols, delivered over the occipital pole at the IAF. Although TMS has been proven to act upon brain tissues excitability, results show that the SIFI occurred for both Sham and active rhTMS, with the illusory rate not being significantly different between baseline and stimulation conditions. This aligns with the discrete sampling hypothesis, for which alpha amplitude modulation, known to reflect changes in cortical excitability, should not account for changes in the illusory rate. Moreover, these findings highlight the viability of rhTMS-based interventions as a means to probe the neuroelectric signatures of illusory and hallucinatory audiovisual experiences, in healthy and neuropsychiatric populations.

Objectives: To assess acute lipid profiles, atrial fibrillation and other cardiovascular risk factors in patients undergoing treatments by thrombectomy (EVT) with acute ischemic stroke (AIS). Methods: We performed a retrospective analysis of the lipid profile and vascular risk factor in 1639 consecutive patients with acute ischemic stroke between January 2016 and December 2021. To assess lipid profiles, laboratory tests, including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG), were obtained the day after admission. We also examined assessed the association between lipid profile, AF and EVT in multivariate logistic regression analysis. Results: Median age of patients was 74 years, 54.9% were males (95% CI 52.5-57.4%), and 26.8% (95% CI, 24.7-29.0%) had AF. EVT patients (n= 370; 22.57 %; 95% CI, 20.6-24.7) showed no difference in age (median 73 years [IQR; 63-80 ] versus 74 years [ QR; 63-82+ HbA1c levels (median 5.8 [IQR; 5.4-6.2] versus 5.9 [ IQR; 5.4-6.4+TG/HDL ratio (median 2.40 [IQR; 1.65-3.48#43; versus[IQR; 1.73-3.64)] diabetes (OR 0.82; 95% CI 0.61 to 1.08), hypertension (OR 0.87; 95% CI 0.68 to 1.12) and obesity (OR 1.06; 95% CI 0.78 to 1.42) compared to non-EVT patients. Conversely, EVT patients showed lower levels of TC (160 mg/dl[ IQR;139-187] versus 173 mg/dl [ IQR;148-202] P Conclusion: Total cholesterol and all cholesterol-related measures were significantly lower in patients undergoing thrombectomy than in other stroke patients. Conversely, we found that AF was significantly high in patients with EVT, suggesting that hypercholesterolemia could be mainly linked to small-vessel occlusion stroke while large vessel occlusion (LVO) stroke could show different causes. AIS patients may have different pathogenesis and their understanding may improve enhance the discovery of specific and tailored preventive treatments.

Background/objectives: To compare the number of eye surgical procedures performed in Italy in the 2 months following the beginning of lockdown (study period) because of COVID-19 epidemic with those performed in the two earlier months of the same year (intra-year control) and in the period of 2019 corresponding to the lockdown (inter-year control). Methods: Retrospective analysis of surgical procedures carried out at 39 Academic hospitals. A distinction was made between elective and urgent procedures. Intravitreal injections were also considered. Percentages for all surgical procedures and incidence rate ratios (IRR) for rhegmatogenous retinal detachment (RRD) events were calculated. A p value Results: A total of 20,886 versus 55,259 and 56,640 patients underwent surgery during the lockdown versus intra-and inter-year control periods, respectively. During the lockdown, only 70% of patients for whom an operation/intravitreal injection was recommended, finally underwent surgery; the remaining patients did not attend because afraid of getting infected at the hospital (23%), taking public transportation (6.5%), or unavailable swabs (0.5%). Elective surgeries were reduced by 96.2% and 96.4%, urgent surgeries by 49.7% and 50.2%, and intravitreal injections by 48.5% and 48.6% in the lockdown period in comparison to intra-year and inter-year control periods, respectively. IRRs for RRDs during lockdown dropped significantly in comparison with intra- and inter-year control periods (CI: 0.65–0.80 and 0.61–0.75, respectively, p Conclusion: This study provides a quantitative analysis of the reduction of eye surgical procedures performed in Italy because of the COVID-19 epidemic.

This is a case of [68 Ga]Ga-Prostate-specific membrane antigen (PSMA)-11 PET/CT in a 73-years old patient presenting high Prostate Specific Antigen (PSA) levels despite both multi-parametric magnetic resonance imaging (mpMRI) and 12-core saturation biopsy negative for prostate cancer (Pca). This is a highly interesting case because, despite the advanced metastatic spread at initial presentation as showed by [68Ga]Ga-PSMA-PET/CT, the primary Pca was detected by none of the diagnostic techniques (12 random sample biopsy, mpMRI, PSMA PET/CT). However, [68Ga]Ga-PSMA-PET/CT showed a suspicious axillary lesion suitable for biopsy, which finally resulted as Pca metastasis. This case report is therefore a brilliant example of how [68Ga]Ga-PSMA-PET/CT optimized patient’s management.

The COVID-19 pandemic manifested around the World since February 2020, leading to disruptive effects on many aspects of people social life. The suspension of face-to-face teaching activities in schools and universities was the first containment measure adopted by the Governments to deal with the spread of the virus. Remote teaching has been the emergency solution implemented by schools and universities to limit the damages of schools and universities closure to students’ learning. In this contribution we intend to suggest to policy makers and researchers how to assess the impact of emergency policies on remote learning in academia by analysing students’ careers. In particular, we exploit the quasi-experimental setting arising from the sudden implementation of remote teaching in the second semester of academic year 2019/2020: we compare the performance of the cohort 2019/2020, which represents the treatment group, with the performance of the cohort 2018/2019, which represents the control group. We distinguish the impact of remote teaching at two levels: degree program and single courses within a degree program. We suggest to use Difference-In-Differences approach in the former case and multilevel modeling in the latter one. The proposal is illustrated analysing administrative data referred to freshmen of cohorts 2018/2019 and 2019/2020 for a sample of degree programs of the University of Florence (Italy).

The increasing interest in TinyML, i.e., near-sensor machine learning on power budgets of a few tens of mW, is currently pushing toward enabling TinyML-class training as opposed to inference only. Current training algorithms, based on various forms of error and gradient backpropagation, rely on floating-point matrix operations to meet the precision and dynamic range requirements. So far, the energy and power cost of these operations has been considered too high for TinyML scenarios. This paper addresses the open challenge of near-sensor training on a few mW power budget and presents RedMulE - Reduced-Precision Matrix Multiplication Engine, a low-power specialized accelerator conceived for multi-precision floating-point General Matrix-Matrix Operations (GEMM-Ops) acceleration, supporting FP16, as well as hybrid FP8 formats, with {sign, exponent, mantissa}=({1,4,3}, {1,5,2}). We integrate RedMule into a Parallel Ultra-Low-Power (PULP) cluster containing eight energy-efficient RISC-V cores sharing a tightly-coupled data memory and implement the resulting system in a 22 nm technology. At its best efficiency point (@ 470 MHz, 0.65 V), the RedMulE-augmented PULP cluster achieves 755 GFLOPS/W and 920 GFLOPS/W during regular General Matrix-Matrix Multiplication (GEMM), and up to 1.19 TFLOPS/W and 1.67 TFLOPS/W when executing GEMM-Ops, respectively, for FP16 and FP8 input/output tensors. In its best performance point (@ 613 MHz, 0.8 V), RedMulE achieves up to 58.5 GFLOPS and 117 GFLOPS for FP16 and FP8, respectively, with 99.4% utilization of the array of Computing Elements and consuming less than 60 mW on average, thus enabling on-device training of deep learning models in TinyML application scenarios while retaining the flexibility to tackle other classes of common linear algebra problems efficiently.

Emerging applications in the IoT domain require ultra-low-power and high-performance end-nodes to deal with complex near-sensor-data analytics. Domains such as audio, radar, and Structural Health Monitoring require many computations to be performed in the frequency domain rather than in the time domain. We present ECHOES, a System-On-a-Chip (SoC) composed of a RISC-V core enhanced with fixed and floating-point digital signal processing (DSP) extensions and a Fast-Fourier Transform (FFT) hardware accelerator targeting emerging frequency-domain application. The proposed SoC features an autonomous I/O engine supporting a wide set of peripherals, including Ultra-Low-Power radars, MEMS, and digital microphones over I2S protocol with full-duplex Time Division Multiplexing DSP mode, making ECHOES the first open-source SoC which offers this functionality enabling simultaneous communication with up to 16 I/Os devices. ECHOES, fabricated with 65nm CMOS technology, reaches a peak performance of 0.16 GFLOPS and a peak energy efficiency of 9.68 GFLOPS/W on a wide range of floating and fixed-point general-purpose DSP kernels. The FFT accelerator achieves performance up to 10.16 GOPS with an efficiency of 199.8 GOPS/W, improving performance and efficiency by up to 41.1x and 11.2x, respectively, over its software implementation of this critical task for frequency domain processing.

“Huanglongbing” (HLB) is one of the most devastating diseases of citrus orchards worldwide. Samples from 183 citrus plants of different cultivars and rootstock/cultivar combinations, showing HLB symptoms in three Caribbean countries (Cuba, Jamaica, and Guadeloupe-France), were collected to verify the possible co-infection of ‘Candidatus Phytoplasma’ and ‘Candidatus Liberibacter’ species. The 64% of the samples resulted positive to the ‘Ca. L. asiaticus’ and the 27% to diverse ‘Ca. Phytoplasma’-related species, moreover about the 14% of the samples infected with ‘Ca. Liberibacter’ were also found positive to phytoplasmas, indicating the presence of mixed infection especially in the orchards located in Cuba. Moreover, in one of the samples from Jamaica mixed phytoplasma infection was detected. Moreover the detection of only phytoplasmas in 11 symptomatic citrus samples collected from Cuba and Guadeloupe without ‘Ca. Liberibacter’ detection, confirmed that the symptomatology cannot be the sole criterium to discriminate between the presence of the two pathogens, and molecular detection is necessary to identify single or mixed infections. Diaphorina citri insects collected from Cuba and Guadeloupe resulted infected with ‘Ca. L. asiaticus’ confirming its active role in the dissemination of the pathogen. Only one insect of the Cicadidae family, collected in Guadeloupe, was found positive for phytoplasma presence. Considering that the phytoplasmas belonging to some ‘Candidatus species’ were detected in the three countries in different citrus varieties, a relevant role as phytoplasma reservoir can be attribute to citrus orchards.

Faba bean samples with symptoms of yellowing, dwarfism, shoot proliferation, internode shortening, leaf sprouts and lack of pod and seed production were collected from Huancayo and Chupaca provinces, Junin-Peru, and analysed to verify phytoplasma presence and identity. After total nucleic acid extraction, the amplification with universal phytoplasma primers, using nested polymerase chain reactions, on the 16S ribosomal gene followed by restriction fragment length polymorphism analysis and sequence analysis allowed the classification of the detected phytoplasma in the subgroup 16SrIII-J. The alignment of 30 16S ribosomal gene sequences from 15 faba bean symptomatic samples from single plants allowed verifying the consistent presence of 5 single nucleotide polymorphisms that are however not modifying the phytoplasma classification. The phytoplasma identity was also corroborated by the amplification and the restriction fragment length polymorphism analyses carried out on the ribosomal protein gene amplicons obtained with primers specific for the phytoplasmas enclosed in the 16SrIII group. This is the first description in Peru of a disease associated with phytoplasmas in faba beans.

The possibility to grow on artificial media phytoplasmas isolated from micropropagated infected periwinkle shoots and from field-infected tissues is a recent achievement. Isolation and cultivation together with biochemical and biological characterization of some phytoplasmas was consistently obtained. Colonies of phytoplasmas belonging to diverse ribosomal groups were obtained such as those related to a ‘Candidatus Phytoplasma pruni’- related isolate from cassava plants with frog skin diseased, ‘Ca. P. asteris’ and ‘Ca. P. solani’ from diverse infected host plants such as grapevine and coconut palms. Antisera production and their preliminary diagnostic use was also achieved for some of these isolates. Further phytoplasmas were also isolated in liquid and solid media from date palm and citrus tissues. Seed transmission in corn of aster yellows phytoplasmas was confirmed by isolation from seedlings of viable phytoplasma cells.

Since the potato purple top appeared and the potato psyllid was reported in Ecuador, crop losses have been significant. So far, phytoplasmas enclosed in two ribosomal groups (16SrI-F, 16SrII) and ‘Candidatus Liberibacter solanacearum’ were molecularly identified in symptomatic potato plants. Later, Bactericera cockerelli, a potato psyllid, was also first reported and correlated to the potato purple top disease. Molecular identification of the pathogens involved in this disease has been quite elusive. Samples of potato psyllids were analyzed in this study resulting in the identification of phytoplasmas enclosed in group 16SrXI, and others related to ‘Candidatus Phytoplasma prunorum’ and ‘Ca. P. solani’. Potato purple top in Ecuador is a complex disease that constitutes a severe threat for the potato production in the region.

Nucleic acid samples from tomato plants exhibiting witches’ broom symptoms were employed to characterize the identified phytoplasmas at a multigene level. Preliminary assays using PCR, restriction fragment length polymorphism analyses and sequencing on a fragment of the 16S rRNA gene allow the clustering of this phytoplasma within strains classified in subgroup 16SrII-D. Furthermore, RFLP characterization of phytoplasma tuf and rp genes confirmed that the restriction patterns of phytoplasmas from tomato samples were identical to each other and to those of strains in subgroup 16SrII-D. A primer pair designed on a RAPD amplicon sequence from a 16SrII-A phytoplasma strain resulted to specifically amplify the DNA of the tomato samples as well as phytoplasma strains in subgroups 16SrII-A and 16SrII-D specifically detecting and identifying the presence of this phytoplasma. This fragment could be useful for the rapid screening of the presence of this phytoplasma in tomato and other crops of economic importance.

Anticoagulants reduce embolic risk in atrial fibrillation (AF), despite increasing hemorrhagic risk. In this context, validity of congestive heart failure, hypertension, age ≥ 75 years, diabetes, stroke, vascular disease, age 65–74 years and sex category (CHA2DS2-VASc) and hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio, elderly, drugs/alcohol concomitantly (HAS–BLED) scales, used to respectively evaluate thrombotic and hemorrhagic risks, is incomplete. In patients with AF, brain MRI has led to the increased detection of “asymptomatic” brain changes, particularly those related to small vessel disease, which also represent the pathologic substrate of intracranial hemorrhage, and silent brain infarcts, which are considered risk factors for ischemic stroke. Routine brain MRI in asymptomatic patients with AF is not yet recommended. Our aim was to test predictive ability of risk stratification scales on the presence of cerebral microbleeds, lacunar, and non-lacunar infarcts in 170 elderly patients with AF on oral anticoagulants. Ad hoc developed R algorithms were used to evaluate CHA2DS2-VASc and HAS–BLED sensitivity and specificity on the prediction of cerebrovascular lesions: (1) Maintaining original items' weights; (2) augmenting weights' range; (3) adding cognitive, motor, and depressive scores. Accuracy was poor for each outcome considering both scales either in phase 1 or phase 2. Accuracy was never improved by the addition of cognitive scores. The addition of motor and depressive scores to CHA2DS2-VASc improved accuracy for non-lacunar infarcts (sensitivity = 0.70, specificity = 0.85), and sensitivity for lacunar–infarcts (sensitivity = 0.74, specificity = 0.61). Our results are a very first step toward the attempt to identify those elderly patients with AF who would benefit most from brain MRI in risk stratification.

Plant pathogen presence is very dangerous for agricultural ecosystems and causes huge economic losses. Phytoplasmas are insect-transmitted wall-less bacteria living in plants, only in the phloem tissues and in the emolymph of their insect vectors. They are able to manipulate several metabolic pathways of their hosts, very often without impairing their life. The molecular diversity described (49 ‘Candidatus Phytoplasma’ species and about 300 ribosomal subgroups) is only in some cases related to their associated symptomatology. As for the other plant pathogens, it is necessary to verify their identity and recognize the symptoms associated with their presence to appropriately manage the diseases. However, the never-ending mechanism of patho-adaptation and the copresence of other pathogens makes this management difficult. Reducing the huge impact of phytoplasma-associated diseases in all the main crops and wild species is, however, relevant, in order to reduce their effects that are jeopardizing plant biodiversity.

Molecular analyses with specific PCR primers and dodder transmission to periwinkle plants, allowed the detection of Spiroplasma citri strains, phytoplasmas and mixed infection of these bacteria during a survey performed on sesame fields of the Iranian Fars and Bushehr provinces. S. citri was identified alone or in mixed infection with phytoplasma strains in four areas and it was detected for the first time in Dashtestan and in two new areas, Khonj and Bakhtegan, in the Fars province. S. citri strains from Khonj and Zarghan were classified as group 1 and those of Bakhtegan and Dashtestan as groups 6 and 2, respectively. This is the first report of group 2 S. citri strain in Iran. In Bakhtegan, Dashtestan, Khonj and Zarghan, respectively, phytoplasma strains enclosed in subgroups 16SrVI-A, 16SrII-C, 16SrII-D, and 16SrIX-C were identified. In Bakhtegan, Dashtestan and Khonj, phytoplasmas associated with sesame phyllody are reported for the first time. The association of a 16SrII-C-related subgroup phytoplasma with sesame phyllody is reported for the first time in Iran. This work indicates that sesame fields could be sources of different phytoplasmas and S. citri strains from where they can be transmitted to other species, especially citrus cultivated in sesame growing areas. In mixed infected, experimentally inoculated periwinkle and sesame plants, some of the typical symptoms of infection with S. citri were not observed suggesting the presence of an antagonistic interaction between S. citri and phytoplasmas.

By adopting a dyadic extension of the Theory of Planned Behavior (Ajzen, 1991), this study examined whether perceived economic uncertainty afects fertility intentions. Three-hundred thirty one heterosexual couples living in Italy participated in a randomized between-group experimental study, in which we manipulated perceived economic uncertainty (low vs. high vs. control). The participants subsequently completed a questionnaire measuring their attitudes, subjective norms, perceived behavioral control, and fertility intentions. We employed Structural Equation Modelling in estimating the Actor–Partner Interdependence Model. The model showed a good ft to the data. Women’s attitudes, subjective norms, and perceived behavioral control were infuenced by the high economic uncertain scenario, whereas among men these variables were afected only by the positive economic scenario. Attitudes and perceived behavioral control were signifcant predictors of fertility intentions for both sexes. Signifcant partner efects were observed as well. These fndings suggest that fertility plans should be examined by adopting a dyadic perspective, as individuals’ intentions are afected not only by their own beliefs, but also by those of their partners. Perceived Economic Uncertainty and Fertility Intentions in Couples: A Dyadic Extension of the Theory of Planned Behaviour

BackgroundSudden cardiac arrest (SCA) in young people represents a dramatic event, often leading to severe neurologic outcomes or sudden cardiac death (SCD), and is frequently caused by genetic heart diseases. In this study, we report the results of the Tuscany registry of sudden cardiac death (ToRSADE) registry, aimed at monitoring the incidence and investigating the genetic basis of SCA and SCD occurring in subjects < 50 years of age in Tuscany, Italy.Methods and resultsCreation of the ToRSADE registry allowed implementation of a repository for clinical, molecular and genetic data. For 22 patients, in whom a genetic substrate was documented or suspected, blood samples could be analyzed; 14 were collected at autopsy and 8 from resuscitated patients after SCA. Next generation sequencing (NGS) analysis revealed likely pathogenetic (LP) variants associated with cardiomyopathy (CM) or channelopathy in four patients (19%), while 17 (81%) carried variants of uncertain significance in relevant genes (VUS). In only one patient NGS confirmed the diagnosis obtained during autopsy: the p.(Asn480Lysfs*20) PKP2 mutation in a patient with arrhythmogenic cardiomyopathy (AC).ConclusionSystematic genetic screening allowed identification of LP variants in 19% of consecutive patients with SCA/SCD, including subjects carrying variants associated with hypertrophic cardiomyopathy (HCM) or AC who had SCA/SCD in the absence of structural cardiomyopathy phenotype. Genetic analysis combined with clinical information in survived patients and post-mortem evaluation represent an essential multi-disciplinary approach to manage juvenile SCD and SCA, key to providing appropriate medical and genetic assistance to families, and advancing knowledge on the basis of arrhythmogenic mechanisms in inherited cardiomyopathies and channelopathies.

Introduction The purpose of this study was to evaluate the impact of 3-dimensional (3D) digital reconstructions of renal models on the arterial clamping approach during partial nephrectomy (PN). Patients and Methods Fifty-seven patients with T1 renal mass, referred for PN, were prospectively enrolled in 2 groups: Group 1 (n = 32) with revision of both 2-dimensional (2D) computed tomography (CT) imaging and 3D virtual model before surgery; Group 2 (n = 25) with revision of 2D CT imaging. Segmentation of the 3D models from preoperative high-quality CT scan was achieved using D2P software. In a sub-analysis of patients treated with PN with the on-clamp approach (n = 36), the effective intraoperative level of arterial clamping was compared with the preoperative planning. Results In the sub-group of patients referred to PN with the on-clamp approach, the intraoperative selective clamping was performed in 12 (57.1%) patients of Group 1 and in 2 (13.3%) cases of Group 2 (P = .01). The intraoperative management of the renal pedicle was done as preoperatively planned in 61.9% of patients in Group 1 and in 86.6% of cases in Group 2 (P = .1). Conclusion The 3D-guided plan of PN allows to perform selective clamping in higher proportion of patients compared with the standard 2D-guided approach without increasing intraoperative and postoperative complications.

Between 2016 and 2017, symptoms of witches’ broom, proliferation, drying of twigs and ball-like structures formation were observed in Pinus brutia in urban green areas and parks in Isfahan (Iran). All samples from affected P. brutia trees resulted positive in nested-PCR using primer pairs targeting the phytoplasma 16S rRNA gene. Amplicons were obtained only from all the symptomatic pine tree samples and RFLP analyses of R16F2n/R16R2 amplicons with KpnI, AluI, HaeIII, HhaI, HpaII, MseI, RsaI,ThaI, BfaI and TaqI restriction enzymes showed the presence of phytoplasmas enclosed in the 16SrVI group. Four amplicons were sequenced and showed 100% identity to each other. One of these sequences was deposited in the GenBank database (accession number MK158098) and the virtual RFLP pattern was identical (similarity coefficient 1.00) to the reference pattern of 16Sr group VI, subgroup A confirming that the phytoplasma detected in pine is a member of 16SrVI-A subgroup. This is the first report of a 16SrVI-A phytoplasma strain associated with pine tree witches’ broom (P. brutia) disease.

Pot marigold and tickseed are ornamental plants with many medicinal and cosmetic uses and for landscape, respectively. During a survey in 2018, phyllody symptoms were observed in high percentages in these plants in some regions of the Razavi Khorasan province (northeastern Iran). Total DNA was extracted from symptomatic and asymptomatic plants and polymerase chain reaction was carried on using universal phytoplasma primer pairs P1/P7 and nested primer pairs R16F2n/R16R2. The nested amplification of 1200-bp fragments confirmed the presence of phytoplasmas only in the symptomatic plants. BLAST search, phylogenetic analysis, and virtual RFLP patterns of cloned amplicons allowed to classify the pot marigold phyllody phytoplasma in the 16SrVI-A subgroup while tickseed phyllody was enclosed in the 16SrIX-I subgroup. This is the first report of the association of a 16SrVI phytoplasma with pot marigold phyllody in Iran and of the phytoplasma presence in tickseed.

Background: Incidental Prostate cancer (iPCa) is a relatively common finding during histopathological evaluation of radical cystectomy (RC) specimens. To reduce the high impact of RC on erectile function, several sexual-preserving techniques have been proposed. The aim of this study was to evaluate and compare the oncologic outcomes of patients with iPCa who underwent nerve spring and no-nerve sparing robot-assisted radical cystectomy (RARC). Methods: The clinicopathologic data of male patients who underwent RARC at our institution between 2006 and 2016 were retrospectively analysed. Patients with iPCa at definitive pathological examinations were stratified in two groups, according to the preservation of the neurovascular bundles (nerve sparing vs no nerve sparing). Significant PCa was defined as any Gleason score ≥ 3 + 4. Biochemical recurrence (BR) was defined as a sustained PSA level > 0.2ng/mL on two or more consecutive appraisals. BR rate was assessed only in patients with incidental prostate cancer and at least 2years of follow-up. Differences in categorical and continuous variables were analysed using the chi-squared test and the Mann–Withney U test, respectively. Biochemical recurrence curves were generated using the Kaplan–Meier method and compared with the Log-rank test. Results: Overall, 343 male patients underwent RARC for bladder cancer within the study period. Nerve-sparing surgery was performed in 143 patients (41%), of these 110 had at least 2years of follow up after surgery. Patients who underwent nerve-sparing surgery were significantly younger (p < 0.001). Clinically significant PCa was found in 24% of patients. No significant differences regarding preoperative PSA value (p = 0.3), PCa pathological stage (p = 0.5), Gleason score (p = 0.3) and positive surgical margin rates (p = 0.3) were found between the two groups. After a median follow-up of 51months only one patient, in the no-nerve-sparing group had developed a biochemical recurrence (p = 0.4). Conclusions: In our series most of the iPca detected in RC specimens can be considered as insignificant with a low rate of BR (0.9%). Nerve-sparing RARC is a safe procedure which did not affect oncological outcomes of patients with iPCa.

Bacteria and viruses are a natural component of Earth biodiversity and play an essential role in biochemical and geological cycles. They may also pose problems outside their native range, where they can negatively impact on natural resources, wildlife, and human health. To address these challenges and develop sustainable conservation strategies, a thorough understanding of their invasion related- factors is needed: origin, country and year of introduction, and pathways dynamics. Yet, alien bacteria and viruses are underrepresented in invasion ecology studies, which limits our ability to quantify their impacts and address future introductions. This study provides primary datasets of alien bacteria and viruses of plants and animals present in the European environment. The datasets contain expert-revised data on 446 taxa and their invasion related- factors across terrestrial and aquatic environments. Taxa information are complemented with spatial occurrences. The datasets provide a basis for collaborative initiatives to improve the collection of alien bacteria and viruses’ data, and a starting point for data-driven conservation practices.

Objectiveto evaluate the impact of 3D model for a comprehensive assessment of surgical planning and quality of partial nephrectomy (PN).Materials and methods195 patients with cT1-T2 renal mass scheduled for PN were enrolled in two groups: Study Group (n= 100), including patients referred to PN with revision of both 2D computed tomography (CT) imaging and 3D model; Control group (n= 95), including patients referred to PN with revision of 2D CT imaging. Overall, 20 individuals were switched to radical nephrectomy (RN). The primary outcome was the impact of 3D models-based surgical planning on Trifecta achievement (defined as the contemporary absence of positive surgical margin, major complications and ≤30% postoperative eGFR reduction). The secondary outcome was the impact of 3D models on surgical planning of PN. Multivariate logistic regressions were used to identify predictors of selective clamping and Trifecta’s achievement in patients treated with PN (n=175).ResultsOverall, 73 (80.2%) patients in Study group and 53 (63.1%) patients in Control group achieved the Trifecta (p=0.01). The preoperative plan of arterial clamping was recorded as clampless, main artery and selective in 22 (24.2%), 22 (24.2%) and 47 (51.6%) cases in Study group vs. 31 (36.9%), 46 (54.8%) and 7 (8.3%) cases in Control group, respectively (pConclusion3D-guided approach to PN increase the adoption of selective clamping and better predict the achievement of Trifecta.

Alpha oscillations (7–13 Hz) are the dominant rhythm in both the resting and active brain. Accordingly, translational research has provided evidence for the involvement of aberrant alpha activity in the onset of symptomatological features underlying syndromes such as autism, schizophrenia, major depression, and Attention Deficit and Hyperactivity Disorder (ADHD). However, findings on the matter are difficult to reconcile due to the variety of paradigms, analyses, and clinical phenotypes at play, not to mention recent technical and methodological advances in this domain. Herein, we seek to address this issue by reviewing the literature gathered on this topic over the last ten years. For each neuropsychiatric disorder, a dedicated section will be provided, containing a concise account of the current models proposing characteristic alterations of alpha rhythms as a core mechanism to trigger the associated symptomatology, as well as a summary of the most relevant studies and scientific contributions issued throughout the last decade. We conclude with some advice and recommendations that might improve future inquiries within this field.

Objective Discontinuation of antiepileptic drugs (AEDs) in seizure‐free patients is an important goal because of possible long‐term side effects and the social stigma burden of epilepsy. The purpose of this work was to assess seizure recurrence risk after suspension of AEDs, to evaluate predictors for recurrence, and to investigate the recovery of seizure control after relapse. In addition, the accuracy of a previously published prediction model of seizure recurrence risk was estimated. Methods Seizure‐free patients with epilepsy who had discontinued AEDs were retrospectively enrolled. The frequency of seizure relapses after AED withdrawal as well as prognosis after recurrence were assessed and the predictive role of baseline clinical‐demographic variables was evaluated. The aforementioned prediction model was also validated and its accuracy assessed at different seizure‐relapse probability levels. Results The enrolled patients (n = 133) had been followed for a median of 3 years (range 0.8–33 years) after AED discontinuation; 60 (45%) of them relapsed. Previous febrile seizures in childhood (hazard ratio [HR] 3.927; 95% confidence interval [CI] 1.403–10.988), a seizure‐free period on therapy of less than 2 years (HR 2.313; 95% CI 1.193–4.486), and persistent motor deficits (HR 4.568; 95% CI 1.412–14.772) were the clinical features associated with relapse risk in univariate analysis. Among these variables, only a seizure‐free period on therapy of less than 2 years was associated with seizure recurrence in multivariate analysis (HR 2.365; 95% CI 1.178–4.7444). Pharmacological control of epilepsy was restored in 82.4% of the patients who relapsed. In this population, the aforementioned prediction model showed an unsatisfactory accuracy. Significance A period of freedom from seizure on therapy of less than 2 years was the main predictor of seizure recurrence. The accuracy of the previously described prediction tool was low in this cohort, thus suggesting its cautious use in real‐world clinical practice.