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While it is widely acknowledged that fingerprint recognition has played an essential part in policing and forensic science, little is known about fingerprint alterations in medical science, specifically as a consequence of anticancer treatments. Thus, we aimed to analyze the extent of evidence between cancer treatments and fingerprint alterations in adults with cancer.

Assessing the performance of spontaneous plants in abandoned quarries under future environmental scenarios is important for successful restoration practises. Air warming is one of the most relevant ongoing climatic changes in the Mediterranean. We tested the effects of increasing temperature on the germination of five species spontaneously colonising the abandoned sectors of a Carrara marble quarry (Tuscany, central Italy). We selected five plant species with different widths of their distribution range, from local endemic to invasive alien: Santolina pinnata, Globularia incanescens, Hypericum coris, Helichrysum italicum,and Buddleja davidii. Seeds were collected in situ and their germination was tested in laboratory conditions at 10, 15, 20, 25, and 30 °C. The effects of temperature and species on germination percentage (GP) and mean germination time (MGT) were tested through two-way ANOVA. Increasing temperatures negatively affected the GP of S. pinnataand H. coris. G. incanescensperformed better at intermediate temperatures, whilst H. italicumbenefited from increasing temperatures. B. davidiishowed a similar high GP under all the treatments. MGT decreased with increasing temperature for all the species, except for S. pinnata, which showed an increase of MGT with increasing temperature. We highlighted that, under future warmer climatic conditions, the two endemic species will be disadvantaged with respect to the species with a wider distribution range and the non-native species in the studied quarry. This evidence is relevant for restoration planning since seeding the two endemic species could be unsuccessful under future environmental scenarios, when H. italicumand B. davidiiwill be more competitive in the colonisation of the quarry.

Tricuspid valve disease is an often underrecognized clinical problem that is associated with significant morbidity and mortality. Unfortunately, patients will often present late in their disease course with severe right-sided heart failure, pulmonary hypertension, and life-limiting symptoms that have few durable treatment options. Traditionally, the only treatment for tricuspid valve disease has been medical therapy or surgery; however, there have been increasing interest and success with the use of transcatheter tricuspid valve therapies over the past several years to treat patients with previously limited therapeutic options. The tricuspid valve is complex anatomically, lying adjacent to important anatomic structures such as the right coronary artery and the atrioventricular node, and is the passageway for permanent pacemaker leads into the right ventricle. In addition, the mechanism of tricuspid pathology varies widely between patients, which can be due to primary, secondary, or a combination of causes, meaning that it is not possible for 1 type of device to be suitable for treatment of all cases of tricuspid valve disease. To best visualize the pathology, several modalities of advanced cardiac imaging are often required, including transthoracic echocardiography, transesophageal echocardiography, cardiac computed tomography, and cardiac magnetic resonance imaging, to best visualize the pathology. This detailed imaging provides important information for choosing the ideal transcatheter treatment options for patients with tricuspid valve disease, taking into account the need for the lifetime management of the patient. This review highlights the important background, anatomic considerations, therapeutic options, and future directions with regard to treatment of tricuspid valve disease.

Venous thromboembolism (VTE) is rare in patients aged <21 years. Young adults aged 18 to 21 years are frequently included in adult VTE studies, whereas pediatric VTE studies include patients aged up to either 18 or 21 years. The clinical characteristics of young adult patients with VTE have not been well defined.

Here, we present a detailed description of the in situ isothermal crystallization of poly(trimethylene 2,5-furandicarboxylate)(PTF) as revealed by real-time Fourier transform infrared spectroscopy (FTIR) and grazing incidence wide-angle X-ray scattering (GIWAXS). From FTIR experiments, the evolution of hydrogen bonding with crystallization time can be monitored in real time, while from GIWAXS, crystal formation can be followed. Density functional theory (DFT) calculations have been used to simulate FTIR spectra for different theoretical structures, enabling a precise band assignment. In addition, based on DFT ab initiocalculations, the influence of hydrogen bonding on the evolution with crystallization time can be understood. Moreover, from DFT calculations and comparison with both FTIR and GIWAXS experiments, a crystalline structure of poly(trimethylene 2,5-furandicarboxylate) is proposed. Our results demonstrate that hydrogen bonding is present in both the crystalline and the amorphous phases and its rearrangement can be considered as a significant driving force for crystallization of poly(alkylene 2,5-furanoate)s.

Faced with increasing waste production, authorities are seeking to encourage better household waste management and need to identify levers for change. We propose a model integrating the major determinants of pro-environmental behaviour assumed in prominent theoretical models. Based on meta-analytical evidence, we incorporated situational, normative, attitudinal and self-processes and tested this integrative model to predict intentions to perform two overlooked behaviours: food waste separation and deposit at waste disposal centres. To go beyond intention we also investigated habits to sort food waste. An online survey was administered to two samples (Ntotal= 2,814) and data were analysed using structural equation modelling. The results showed a good fit of an integrative model (CFIs > .917; TLIs > .910; RMSEAs < .043; SRMRs < .071). Waste management intentions and habits are directly predicted mainly by personal norms and perceived behavioural control. The latter is predicted by facilitating conditions and pro-environmental identity. Personal norms are predicted by social norms, pro-environmental identity and perceived behavioural control. Our results confirm the relevance of a model integrating situational, normative, attitudinal and self-processes to explain waste management intentions and provide a basis for the development of waste management interventions.

Energy citizenship (EC) is a concept that has received little attention in psychological research. However, citizen participation and engagement in the energy system play an important part in the EU’s vision of a low-carbon economy. The expectation is that EU citizens take an active role in a decentralized energy market and become ‘energy citizens’. Psychologically, it remains unclear who is likely to support this transition. In this paper, we investigate which psychological factors predict support for EC and might motivate individuals to become active in the energy transition using an online questionnaire. Results from Austria (n= 272) show that personal norms predict support for an EC scenario in a multiple linear regression, whereas biospheric values, ecological attitudes, awareness of adverse consequences, as well as ascription of responsibility do not. Further unique variance is explained by right-wing authoritarianism, a concept understudied but important for the massive societal changes involved in the energy transition. We highlight the importance of feeling personally responsible and obliged and being open to overcome conventions for the transition towards EC.

Walking and cycling are considered sustainable transport modes, promoted as a means to reduce car traffic. In the scientific literature, they have mostly been investigated separately, but should be considered jointly to enable a modal shift. Both daytime and dark conditions need to be studied, to improve understanding of how environmental features are affected by temporal variation. A conceptual model is introduced to advance understanding of the significance of different environmental factors for walking/cycling, and serves as the basis for the design of an empirical study. A between-subject design was used, comparing two pedestrian/cycle paths located in two mid-sized Swedish cities during daytime and after dark. Pedestrians (n= 90) and cyclists (n= 74) responded to questionnaires assessing environmental parameters hypothesized to be of importance for walking and cycling. Three-factor ANOVAs indicated differences between the two locations (perceived stimuli), between pedestrians and cyclists (environmental appraisal, affective response, behavioural intention) and between daytime and dark conditions (visual accessibility, restorative potential). The conceptual model helps identify the importance of various environmental features.

An online survey was distributed to a national sample of the Norwegian public (N= 699) to investigate factors associated with the extent to which people worry about microplastics. Respondents were asked about their familiarity with and the extent to which they worry about the issue, after which they answered a battery of questions about their perceptions of risk and personal values. Microplastics were judged to be moderately known, somewhat uncontrollable, very threatening to humankind, and even more so to plants and animals. Perceived personal threat was lower than that to plants, animals and humankind. Regression analyses predicted worry about microplastics from sociodemographic variables and personal values, and from different aspects of people’s risk perceptions. Gender, age group and endorsing self-transcendence over self-enhancement values predicted greater worry, yet these variables were not significantly associated when risk perceptions were included in the regression model. These findings shed further light on how individual risk judgements can explain self-reported levels of worry about microplastics, beyond individual differences in personal values.

Abstract: Background: The literature does not support the choice between open and laparoscopic management of splenic artery aneurysms (SAA).Methods: We designed a prospective, randomized comparison between open and laparoscopic surgery for SAA. Primary end points were types of surgical procedures performed and clinical outcomes. Analysis was developed on an intention-to-treat basis. Results: Fourteen patients were allocated to laparotomy (group A) and 15 to laparoscopy (group B). Groups displayed similar patient- and aneurysm-related characteristics. The conversion rate to open surgery was 13.3 %. The type of surgical procedure performed on the splenic artery was similar in the two groups: aneurysmectomy with splenic artery ligature or direct anastomosis was performed in 51 % and 21 % of patients in group A and in 60 % and 20 % in group B, respectively. The splenectomy rate was similar (14 % vs. 20 %). Postoperative splenic infarction was observed in one case in each group. Laparoscopy was associated with shorter procedures (p = 0.0003) and lower morbidity (25 % vs. 64 %, p = 0.045). Major morbidity requiring interventional procedures and blood transfusion was observed only in group A. Laparoscopy was associated with quicker resumption of oral diet (p < 0.001), earlier drain removal (p = 0.046), and shorter hospital stay (p < 0.01). During a mean follow-up of 50 months, two patients in group A required hospital readmission. In group B, two patients developed a late thrombosis of arterial anastomoses. Conclusions: Our study demonstrates that laparoscopy permits multiple technical options, does not increase the splenectomy rate, and reduces postoperative complications. It confirms the supposed clinical benefits of laparoscopy when ablative procedures are required but laparoscopic anastomoses show poor long-term results.

There is a lack of academic literature that explores the evaluation of football club’s carbon footprints. To the best of the author’s knowledge, this study is the first study where the football’s club’s overall carbon footprints were assessed. This study’s main objectives were to measure the football club environmental impact and promote the reduction of greenhouse gases (GHGs) emissions for famous significant sports events such as the Federation Internationale de Football Association (FIFA) and The Union of European Football Associations (UEFA) matches. The football club is a part of one of the biggest football clubs in Europe, which operates, manages, and maintains various facilities by assisting the football club in decision-making processes to identify the most relevant business engagement areas. The following research questions were considered: (a) What are the hotspots and the most significant contributors to GHG emissions of a football club? (b) How to improve emissions management within the stadium organization? (c) How to establish a carbon reduction and management plan? The researchers visited this stadium to collect data and interview managers of the football club. The GHG assessment results provide some relevant confirmation of the guidelines that emerged during the onsite visit. This study found that indirect emissions produced by a supporter’s transportation mode are equivalent to 38%, followed by energy consumption, accounting for 25% of the total GHG emissions. Specific future recommendations for sports organizations, such as (i) intermediate goal is to cut GHG emissions by at least 50% by 2030 and (ii) model scope 3 emissions and set scope 3 targets if scope 3 emissions account for 40% or more of their overall emissions, have emerged after this study.

Using vegetation as a bioindicator in urban and degraded areas is an effective way to assess the status of the environment. In this work, we present the results of a phytosociological investigation of a suburban river and of its surroundings in southern Tuscany (Bestina river and its tributary Bestinino in Asciano, Province of Siena). By means of 94 phytosociological relevés, we identified 34 plant communities belonging to the 17 classes. Six habitats included in the 92/43/EEC Directive, plus two habitats recently proposed for inclusion, were identified, as well as one habitat of regional interest. The study revealed that, despite the high levels of human disturbance, aquatic and herbaceous riparian vegetation is still well-preserved, though mostly represented by stress-tolerant communities. On the contrary, most of the vegetation types not being directly linked to the river dynamic are in poor conservation status. Despite this, some habitats of community interest were detected even in non-riverine sites. Our work provides the basic knowledge for future restoration of the Bestina river and of its surroundings, wished by the Tuscany Region.

In patients with a prohibitive surgical risk, the AngioVac cannula can be used to remove left-sided cardiac masses, as an off-label adaptation of the device. We herein describe a novel micro-invasive approach to gain access to the left atrium for the aspiration of a mitral valve mass in a patient affected by severe coronavirus disease 2019. Through a right anterior mini-thoracotomy, the right superior pulmonary vein was accessed and used to insert the aspiration cannula. A parallel venous-arterial extracorporeal membrane oxygenation (ECMO)-like circuit provided circulatory and respiratory support to ensure proper intra- and postoperative hemodynamic stabilization.

Background: The coronavirus pandemic had a major impact in Italy. The Italian health system’s re-organization to face the emergency may have led to significant consequences especially in the diagnosis and treatment of malignancies. This study aimed to assess the impact of the pandemic in the diagnosis and treatment of gastric cancer in nine Gruppo Italiano RIcerca Cancro Gastrico (GIRCG) centers.Methods: All patients assessed for gastric adenocarcinoma at nine GIRCG centers between January 2019 and November 2020 were included. Patients were grouped according to the date of “patient 1’s” diagnosis in Italy: preCOVID versus COVID. Clinico-pathological and outcome differences between the two groups were analyzed.Results: A total of 632 patients were included in the analysis (205 in the COVID group). The cT4 weighted ratios were higher in 2020 from April to September, with the greatest differences in May, August and September. The cM+ weighted ratio was significantly higher in July 2020. The mean number of gastrectomies had the greatest reduction in March and May 2020 compared with 2019. The median times from diagnosis to chemotherapy, to complete diagnostic work-up or to operation were longer in 2019. The median time from the end of chemotherapy to surgery was 17 days longer in the preCOVID group.Conclusions: A greater number of advanced or metastatic cases were diagnosed after the spread of SARS-CoV-2 infection, especially after the “full lockdown” periods. During the pandemic, once gastric cancer patients were referred to one of the centers, a shorter time to complete the diagnostic work-up or to address them to the best treatment option was required.

Delirium, often underdiagnosed in the intensive care unit, is a common complication of critical illness that contributes to significant morbidity and mortality. Clinicians should be aware of common risk factors and triggers and should work to mitigate these as much as possible to reduce the occurrence of delirium. This review first provides an overview of the epidemiology, pathophysiology, evaluation, and consequences of delirium in critically ill patients. Presented next is the current evidence for the pharmacologic management of delirium, focusing on prevention and treatment of delirium in the intensive care unit. It concludes by outlining some emerging treatments of delirium.

Background: A difficulty score for laparoscopic adrenalectomy (LA) is lacking in the literature. A retrospective cohort study was designed to develop a preoperative “difficulty score” for LA. Methods: A multicenter study was conducted involving four Italian tertiary centers for adrenal disease. The population was randomly divided into two subsets: training group and validation one. A multicenter study was undertaken, including 964 patients. Patient, adrenal lesion, surgeon’s characteristics, and the type of procedure were studied as potential predictors of target events. The operative time (pOT), conversion rate (cLA), or both were used as indicators of the difficulty in three multivariate models. All models were developed in a training cohort (70% of the sample) and validated using 30% of patients. For all models, the ability to predict complicated postoperative course was reported describing the area under the curve (AUCs). Logistic regression, reporting odds ratio (OR) with p-value, was used. Results: In model A, gender (OR 2.04, p= 0.001), BMI (OR 1.07, p= 0.002), previous surgery (OR 1.29, p= 0.048), site (OR 21.8, p&lt; 0.001) and size of the lesion (OR 1.16, p= 0.002), cumulative sum of procedures (OR 0.99, p&lt; 0.001), extended (OR 26.72, p&lt; 0.001) or associated procedures (OR 4.32, p= 0.015) increased the pOT. In model B, ASA (OR 2.86, p= 0.001), lesion size (OR 1.20, p= 0.005), and extended resection (OR 8.85, p= 0.007) increased the cLA risk. Model C had similar results to model A. All scores obtained predicted the target events in validation cohort (OR 1.99, p&lt; 0.001; OR 1.37, p= 0.007; OR 1.70, p&lt; 0.001, score A, B, and C, respectively). The AUCs in predicting complications were 0.740, 0.686, and 0.763 for model A, B, and C, respectively. Conclusion: A difficulty score based on both pOT and cLA (Model C) was developed using 70% of the sample. The score was validated using a second cohort. Finally, the score was tested, and its results are able to predict a complicated postoperative course.

ABSTRACTIntroductionTildrakizumab is a monoclonal antibody that targets the p19 subunit of IL-23, a crucial cytokine for Th17 cells. Tildrakizumab has been assessed in several Phase I, II, and III clinical trials and is approved for treatment of adults with moderate to severe plaque psoriasis who are indicated for systemic therapy.Areas coveredThe available evidence on the efficacy, safety, and use of tildrakizumab in special populations was evaluated by 14 experts who critically reviewed the current literature.Expert opinionTildrakizumab has good efficacy that lasts for at least 5 years in patients with moderate to severe psoriasis, and appears to be safe and well tolerated in the long-term with no apparent dose-related differences in adverse events, a low incidence of discontinuation due to adverse events, and no evidence of increased risk of malignancies. The safety and the efficacy of tildrakizumab has also been confirmed in special populations such as those with inflammatory bowel disease, cardiovascular disease, metabolic syndrome, and advanced age. Early intervention with IL-23-inhibitors, such as tildrakizumab, may help to control symptoms and change the long-term course of the disease in patients affected by plaque psoriasis, while improving the quality of life and potentially minimizing the risk of developing comorbidities.

Sorghum halepenseis a synanthropic tall grass distributed worldwide from tropical to temperate zones, and it is often considered an invasive alien. It is a perennial, rhizomatous plant that tends to form dense stands derived from vegetative and sexual propagation. Despite roadside plant communities dominated by Sorghum halepenseare very common in southern Europe, their phytosociological aspects are scarcely studied. In this work, we present the results of a vegetation survey in peninsular Italy, carried out by means of the phytosociological method. In total, we carried out 73 relevés in Liguria, Tuscany, Latium, Campania, Basilicata, and Apulia. We statistically compared our relevés to those from the Balkans classified in the Cynodonto-Sorghetumhalepensis, an association of agricultural annual weed vegetation of the class Stellarietea mediaes.l. used in the past as a reference for Italian S. halepense-dominated communities. Our results show that the Italian communities are different from the Cynodonto–Sorghetum halepensiscommunities, since the latter are rich in annual species, while the former are rich in perennial species. From the syntaxonomic point of view, the Italian communities are better classified in the class Artemisietea vulgaris. We describe the new (sub-)ruderal association Potentillo reptantis–Sorghetum halepensis, including a meso-hygrophilous variant with Urtica dioicaand an agricultural variant with Elymus repens. We have evidence that the Potentillo–Sorghetumoccurs in Italy, Kosovo and Slovenia, but its distribution is possibly wider due to conspicuous presence of cosmopolitan species characterizing the association. Our work provides a baseline for the knowledge of an alien-dominated plant community that can invade habitats with high conservation value.

Frailty is a relatively new concept for intensivists, and is defined as a status of increased vulnerability to stressors associated with reduced reserve and function of different physiological systems. Supporting the hypothesis that frailty may be an important predictor of poor prognosis among older patients admitted to Intensive Care Unit (ICU), this study seeks to evaluate the association between frailty at ICU admission and short and long-term mortality.

In this work, laser‐induced periodic surface structures (LIPSS) are generated on the surface of thin films of poly(trimethylene terephthalate) (PTT) fabricated by spin coating on silicon. Previous studies have shown the appearance of LIPSS in this type of materials with femtosecond laser pulses in the near‐infrared region of the spectrum, despite the extremely low absorption of the polymer. The present work consists of an exploration of the effect of adding complexity to the femtosecond laser fields employed for irradiation. Changes in the repetition rate of the pulse train, the pulse duration, and the pulse temporal chirp are explored, and conditions for optimum LIPSS formation are identified. The effects of these modifications on the polymer surface topography, assessed by atomic force microscopy, are described and discussed. Periodic surface structures in the sub‐micron range have been generated on the surface of a polymeric thin film deposited on Si by irradiation with trains of near‐infrared, ultrashort laser pulses. The effects of varying properties of the train of pulses (inter‐pulse delay, pulse duration, and frequency chirp) on the characteristics of the laser‐induced surface topography have been investigated.