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Abstract Background Left atrium (LA) is far from simply being a passive connection chamber between left ventricle and the pulmonary circulation. In patients affected by mitral regurgitation (MR) an impairment in LA compliance and reservoir function, which can be evaluated using Speckle Tracking echocardiography, lead to elevated atrial pressure, resulting in increased pulmonary capillary pressures and the onset of dyspnea. Our study aims to evaluate the correlation between left atrial dysfunction and symptoms onset in patients with severe degenerative MR. Identifying left atrial dysfunction as a predictor of symptoms could be helpful to guide management strategy of asymptomatic patients with severe degenerative MR. Methods In a retrospective analysis, we examined all patients diagnosed with severe degenerative MR who underwent evaluation for potential cardiac surgery using transthoracic and transesophageal echocardiogram between May 2019 and July 2022 at IRCCS San Raffaele Hospital. The cohort was stratified into two groups: symptomatic patients (NYHA > I) and asymptomatic (NYHA = I) patients. A comprehensive assessment of LA function and compliance was performed including: LA fractional atrial change, LA reservoir strain (LASr), LASr/E/e’, and LA reservoir work. Results The final study cohort comprised 401 patients. There were no significant differences observed in terms of left ventricle size, function, and mitral regurgitation volume between the two groups. Atrial dysfunction and dilatation were significantly associated with symptoms. Among the atrial functional indexes LASr, a marker of LA compliance, showed the strongest association with symptoms (AUC: 0.85, OR: 7.45, p

Background. Breast cancer is a leading type of cancer in women. Imaging techniques (ultrasound, mammography, and magnetic resonance imaging (MRI)) play a crucial role in tumor detection and evaluation. The last emerging technique is contrast-enhanced mammography (CEM) which provides both morphological and functional information.Objective: to evaluate CEM accuracy in measuring breast tumor lesions. Material and methods. The study involved 69 patients followed by the Breast Unit from January 2018 to September 2023. Breast tumor dimensions measured in CEM in the pre-operative stage by three experienced radiologists were compared to the dimension obtained at the histological examination, the current gold standard in assessing tumor size. Results. We observed a slight overestimation by CEM compared to histology, with a difference between the two measurements not more than 10 mm. CEM underestimated the dimensions in 12 of 69 cases. Conclusion. The study demonstrated excellent CEM accuracy in preoperative assessment of breast tumors, consistent with previous findings in the literature. CEM could prove to be a valid and safer alternative to MRI in preoperative breast tumor measuring.

Background: Musculoskeletal pain is a non-negligible multifaceted condition affecting more than 30% of the global population. Superficial heat therapy (HT), through increasing tissue temperatures, plays a role in increasing local metabolism and function and relieving pain. Knee (KP) and sports pain represent two relevant fields of superficial HT application. Methods: In the present paper, a panel of experts performed a narrative review of the literature regarding the role of superficial HT in the management of knee and sports activity-related pain. Results: According to the reviewed literature, HT represents a therapeutic option in the management of musculoskeletal pain due to three main effects: pain relief, promotion of healing, and return to normal function and activity. Moreover, HT plays a role in sport activities both before and after exercise. Before performing sports, HT helps in preparing muscles for performance. After performing sports, it is capable to promote recovery and healing pathways. Combining and sequencing superficial heat and cold therapy represent an interesting topic of study. Overall, the application of heat wraps for superficial HT can be considered safe. Conclusions: HT has been shown to be a potentially beneficial and safe option in the management of several conditions including KP and sports. The key in the application of superficial HT is a multimodal and multidisciplinary approach.

Abstract In mammals, sexual size dimorphism often reflects the intensity of sexual selection, yet its connection to genomic evolution remains unexplored. Gene family size evolution can reflect shifts in the relative importance of different molecular functions. Here, we investigate the associate between brain development gene repertoire to sexual size dimorphism using 124 mammalian species. We reveal significant changes in gene family size associations with sexual size dimorphism. High levels of dimorphism correlate with an expansion of gene families enriched in olfactory sensory perception and a contraction of gene families associated with brain development functions, many of which exhibited particularly high expression in the human adult brain. These findings suggest a relationship between intense sexual selection and alterations in gene family size. These insights illustrate the complex interplay between sexual dimorphism, gene family size evolution, and their roles in mammalian brain development and function, offering a valuable understanding of mammalian genome evolution.

Purpose: Describe the clinical features and management of this uncommon case of late-onset Capsular bag distension syndrome that occurred 33 years after cataract surgery. Observation: An 87-year-old male was referred to our clinic complaining of blurred and gradual, painless reduction in vision in his left eye over the past year. A complete ophthalmological examination, Ultrasound biomicroscopy (UBM), anterior segment optical coherence tomography (AS-OCT), and optical biometry were performed to confirm the diagnosis. A 25-gauge pars plana vitrectomy combined with posterior capsulotomy was performed. The aspirated fluid was sent for microbiological analyses. After surgery, the patient's visual acuity returned to previous values, and anterior chamber depth slightly deepened. Samples taken were negative for bacteria. Conclusions and Importance: Late-onset Capsular bag distension syndrome may occur up to 33 years following cataract surgery. A surgical approach offers the advantage of complete clearance of the turbid fluid, also removing the residual cortical material and enabling microbial and pathological testing.

BackgroundIdiopathic intracranial hypertension (IIH) is defined as elevated intracranial pressure and consequent symptoms (mainly headache and visual deterioration) occurring in the absence of secondary causes. Surgical and interventional radiology procedures should be considered for refractory IIH and mainly include cerebrospinal fluid (CSF) diversion techniques, optic nerve sheath fenestration (ONSF), and venous sinus stenting (VSS). Our study aims to review the current literature on the application of these techniques in clinical practice.MethodsA systematic literature review on the surgical and interventional radiology treatment of IIH was conducted, focusing on ONSF, VSS, and CSF diversion techniques. According to PRISMA guidelines, all reports published in PubMed in the last 30 years (1993–2023) were considered, and among 722 papers, 48 were included in the present study, resulting in a total study population of 454 children or adolescents (11 months–17 years old).ResultsAmong 454 patients, 193 underwent an invasive approach, divided into CSF diversion (115/193), ONSF (65/193), VSS (11/193), cranial subtemporal decompression (8/193), and internal cranial expansion (9/193). Sixteen of the 193 patients (8%) required reintervention due to relapsing symptoms or surgical complications, particularly those who underwent CSF diversion. Furthermore, 9/115 required shunt revision due to shunt obstruction or malfunction. We extracted data on the outcome of each procedure: of the 193 patients, 71 experienced a positive outcome with symptom resolution or improvement, while 27 demonstrated a negative outcome.Discussion and conclusionsSevere and refractory cases of IIH are eligible for invasive treatments. CSF diversion is the most frequently used technique, despite its high failure risk and need for reintervention. ONSF has shown good results in terms of outcome and safety, particularly in children with visual symptoms. VSS is the most recent approach, indicated in children with stenosis of the venous sinus. In our study population, VSS demonstrated good results in terms of symptom resolution and need for reintervention, but its use remains limited to a few centers.Systematic Review Registrationhttps://www.crd.york.ac.uk/, PROSPERO (CRD42024504244).

Background Mitral regurgitation (MR) is frequent in patients with aortic stenosis (AS). Although primary MR is an established negative prognostic factor, whether different mechanisms of MR have different effects on outcome is currently unknown. The aim of this study was to evaluate the impact of the MR mechanism in patients undergoing transcatheter aortic valve replacement (TAVR). Methods and Results This is a retrospective observational study of patients who underwent TAVR for severe aortic stenosis in a high‐volume tertiary care center. Echocardiographic comprehensive MR assessment was performed at baseline and within 3 months post TAVR. The study population was divided into 4 groups according to MR mechanism: Group I: fibro‐calcific leaflet degeneration; Group II: prolapse/flail; Group III: ventricular secondary MR (functional MR); and Group IV: atrial functional MR. The study end point was a combination of death from cardiovascular cause and heart failure–related hospitalization. The study population included 427 patients (mean age 81.7±6.5 years; 71% primary MR; 62% ≥moderate MR). At 3‐year follow‐up, survival free from the composite end point significantly differs according to MR mechanism: it was higher in group IV (atrial functional MR, 96.6%) compared with group I (80.4%, P=0.002) and group II patients (60.7%, P=0.001), and group III (84.8%, P=0.037); patients with MR due to leaflet prolapse showed poorer prognosis compared with patients with functional MR (group III, P=0.023 and group IV, P=0.001) and with group I (P=0.040). Overall, severe MR after TAVR identified patients with poorer prognosis and was significantly more frequent in group II (46.4%, P=0.001). Conclusions In patients undergoing TAVR, preprocedural identification of MR mechanism and mechanism provides prognostic insights.

Andrea Spini,1 Luca L’Abbate,2 Ylenia Ingrasciotta,1 Giorgia Pellegrini,1 Massimo Carollo,1 Valentina Ientile,2 Olivia Leoni,3 Martina Zanforlini,4 Domenica Ancona,5 Paolo Stella,5 Anna Cavazzana,6 Angela Scapin,6 Sara Lopes,7 Valeria Belleudi,7 Gianluca Trifirò1 1Department of Diagnostics and Public Health, University of Verona, Verona, Italy; 2Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy; 3Lombardy Regional Centre of Pharmacovigilance and Regional Epidemiologic Observatory, Milan, Italy; 4Azienda Regionale per l’Innovazione e gli Acquisti, S.p.A, Milan, Italy; 5Apulian Regional Health Department, Bari, Italy; 6Azienda Zero, Regione Veneto, Italy; 7Department of Epidemiology, Lazio Regional Health Service, Rome, ItalyCorrespondence: Gianluca Trifirò, Department of Diagnostics and Public Health, University of Verona, P. le L.A. Scuro 10, Verona, 37134, Italy, Tel +39 045 802 7679, Email gianluca.trifiro@univr.itPurpose: This research aimed to develop and validate a META-algorithm combining individual immune-mediated inflammatory disease (IMID)-specific algorithms to identify the exact IMID indications for incident biological drug users from claims data within the context of the Italian VALORE project.Methods and Patients: All subjects with at least one dispensing of TNF-alpha inhibitors, anti-interleukin agents, and selective immunosuppressants approved for IMIDs were identified from claims databases of Latium region in Italy (observation period: 2010– 2020). Validated coding algorithms for identifying individual IMIDs from claims databases were found from published literature and combined into a META-algorithm. Positive predictive value (PPV), sensitivity (Se), negative predictive value (NPV), specificity (Sp), and accuracy (Acc) were estimated for each indication against the electronic therapeutic plans (ETPs) of the Latium region as the reference standard. Lastly, the frequency of the indication of use across individual biologic drugs was compared with that reported in three other Italian regions (Lombardy, Apulia, and the Veneto region).Results: In total, 9755 incident biological drug users with a single IMID indication were identified. Using the newly developed META-algorithm, an indication of use was detected in 95% (n=9255) of the total cohort. The estimated Acc, Se, Sp, PPV, and NPV, against the reference standard were as follows: 0.96, 0.86, 0.97, 0.82, and 0.98 for Crohn’s disease, 0.96, 0.80, 0.98, 0.85, and 0.97 for ulcerative colitis, 0.93, 0.76, 0.99, 0.95, and 0.92 for rheumatoid arthritis, 0.97, 0.75, 0.99, 0.85, and 0.98 for spondylarthritis, and 0.91, 0.92, 0.91, 0.88, and 0.94 for psoriatic arthritis/psoriasis, respectively. Additionally, no substantial difference was observed in the frequency of indication of use by active ingredient among Latium and the other three Italian regions included in the study.Conclusion: The newly developed META-algorithm demonstrated high validity estimates in the Italian claims data and was capable of discriminating with good performance among the most frequent IMID indications.Plain Language Summary: In the claims database, the lack of information on the indication of use represents a well-known limitation for the conduct of observational studies. This study was conducted to develop and validate a META-algorithm that accurately identifies the exact indication for the use of biological drugs in treating various immune-mediated inflammatory diseases. Using claims databases from the Latium region, we developed and validated a META-algorithm. The META-algorithm combines disease-specific algorithms for different immune-mediated inflammatory diseases (ie, Crohn’s disease, ulcerative colitis, rheumatoid arthritis, spondyloarthritis, psoriasis, and psoriatic arthritis) and was tested against a reference standard (electronic therapeutic plans of the Lazio region). The META-algorithm reported high validity estimates and was able to distinguish with a good performance among the most frequent IMIDs as indications for use. Applying this META-algorithm may facilitate post-marketing surveillance of biological drugs such as TNF-alpha inhibitors, anti-interleukin, and selective immunosuppressants in specific therapeutic areas in an Italian setting.Keywords: immune-mediated inflammatory diseases, biological drugs, validation, claims data, META-algorithm, indication for use

Abstract Background In November 2022, Italy participated in the third edition of the European Centre for disease prevention and control (ECDC) point prevalence survey (PPS) of healthcare-associated infections (HAIs) in acute-care hospitals. A questionnaire based on the WHO infection prevention and control assessment framework (IPCAF) was included, which aims to investigate multimodal strategies for the implementation of IPC interventions. Methods A PPS was conducted using the ECDC PPS protocol version 6.0. The Regional health authority of the region of Piedmont, in north-western Italy, chose to enlist all public acute-care hospitals. Data were collected within one day per each ward, within 3 weeks in each hospital, at hospital, ward and patient level. A score between 0–1 or 0–2 was assigned to each of the 9 items in the IPCAF questionnaire, with 14 points representing the best possible score. HAI prevalence was calculated at the hospital-level as the percentage of patients with at least one HAI over all included patients. Relations between HAI prevalence, IPCAF score, and other hospital-level variables were assessed using Spearman's Rho coefficient. Results In total, 42 acute-care hospitals of the region of Piedmont were involved, with a total of 6865 included patients. All participant hospitals reported they employed multimodal strategies to implement IPC interventions. The median IPCAF overall score was 11/14 (interquartile range, IQR: 9.25–12). The multimodal strategy with the highest level of adherence was education and training, followed by communication and reminders. Strategies with the lowest level of adherence were safety climate and culture of change, and system change. Overall HAI prevalence was 8.06%. A weak to moderate inverse relation was found between IPCAF score and HAI prevalence (Spearman’s Rho -0.340, p 0.034). No other significant correlation was found. Conclusions This study found a high self-reported overall level of implementation of multimodal strategies for IPC in the region. Results of this study suggest the relevance of the multimodal approach and the validity of the IPCAF score in measuring IPC programs, in terms of effectiveness of preventing HAI transmission.

Abstract Background Contrast-enhanced mammography (CEM) is a promising technique. We evaluated the diagnostic potential of CEM performed immediately after contrast-enhanced computed tomography (CE-CT). Methods Fifty patients with breast cancer underwent first CE-CT and then CEM without additional contrast material injection. Two independent radiologists evaluated CEM images. The sensitivity of CEM for detecting index and additional malignant lesions was compared with that of mammography/ultrasonography by the McNemar test, using histopathology as a reference standard. Interobserver agreement for detection of malignant lesions, for classifying index tumors, and for evaluating index tumor size and extent was assessed using Cohen κ. Pearson correlation was used for correlating index tumor size/extent at CEM or mammography/ultrasonography with histopathology. Results Of the 50 patients, 30 (60%) had unifocal disease while 20 (40%) had multicentric or multifocal disease; 5 of 20 patients with multicentric disease (25%) had bilateral involvement, for a total of 78 malignant lesions, including 72 (92%) invasive ductal and 6 (8%) invasive lobular carcinomas. Sensitivity was 63/78 (81%, 95% confidence interval 70.27–88.82) for unenhanced breast imaging and 78/78 (100%, 95.38–100) for CEM (p

Because of its taste, texture, and aroma, chocolate is consumed as a way to generate pleasant sensations. Due to its high caloric density, moderate consumption is recommended. Seeking to offer the benefits of this product to a more selective public, the aim of this research was to determine the chemical composition and sensory properties of a sugar-free dark chocolate added with inulin and sweetened with stevia extract obtained by pressurized hot water, which was compared with a commercial dark chocolate and accompanied by a sensory analysis of the samples. A completely randomized statistical experimental design was used to compare the properties of the alternative and commercial chocolates. The treatments were carried out in triplicate and the results obtained were analyzed by descriptive statistics and one-way analysis of variance with 95 % confidence level. The results showed that the treatment of stevia leaves with hot pressurized water allowed an extraction of 41.51 g of steviol glycosides for rebaudioside A and 6.76 g for stevioside per 100 g of leaves subjected to processing. The chemical analysis of the alternative and commercial chocolates indicated that the fat and total dietary fiber contents showed no significant difference (p > 0.05) between the dark chocolates, unlike the other components. Moisture, ash, fat, and protein contents were slightly higher in the two types of chocolate, and carbohydrate content was 4.1 % lower than in the commercial chocolate. Both products had 0 % added sugars and high dietary fiber content (> 37 %), and there was a reduction of 100 kcal/100 g compared to the commercial brand. Consumer sensory evaluation showed a higher level of liking (p < 0.05) for the elaborated chocolate with respect to the commercial product in attributes such as appearance, color, and texture. These findings suggest the use of stevia extracts obtained by pressurized hot water as a non-caloric sweetener for healthy, alternative dark chocolates suitable for people with diabetes.

Abstract The superhydrophobicity of submerged surfaces typically pertains to the trapped air film at the liquid–solid interface, subject to wettability transitions from a Cassie–Baxter state to more unstable states that gradually collapse to high retention regimes, which are energetically more favorable. In this work, the dynamic evolution of those transient metastable states is correlated to the underwater acoustic performance of laser textured superhydrophobic surfaces, resolving the dependence of the ultrasound spectral response with the immersion time to capture the genuine contribution of the hierarchical subwavelength morphology, regardless of the air layer effects. Acoustic wave attenuation of the incident ultrasound energy is extensively quantified in transmission, accounting for instantaneous broadband sound blocking (>30 dB) within the spectral range 0.5–1.5 MHz. As a result of the air layer detachment with the immersion time, transmission coefficients increase accordingly, while acoustic fields in reflection unexpectedly evolve toward stealthiness and naïve acoustic camouflage, mostly ascribable to dissipative mechanisms at air layer interfaces. The intrinsic decay of the air layer effect is tentatively determined at different frequencies, since quantitative understanding of the transient lifetime governing underwater surface wettability is critical to design stable superhydrophobic character of laser induced subwavelength metastructures on the most promising acoustic materials – from eco‐friendly natural to artificial.

Objetivo. Evaluar la composición fisicoquímica y el valor nutritivo de leche de cabra en tres diferentes sistemas de manejo productivo a pequeña escala en Mérida, Yucatán, México; con la finalidad de producir leche destinada a la alimentación humana con problemas de asimilación de lactosa. Materiales y métodos. Se recolectaron muestras de leche cada dos semanas durante cuatro meses y se les cuantificó sólidos totales, grasa, proteína, lactosa, cenizas, calcio y fósforo. Se determinó densidad, pH, acidez, ácidos grasos por cromatografía de gases y caseínas por electroforesis. Resultados. La composición promedio fue 2.69% grasa, 4.10% proteína, 4.12% lactosa, 12.96% sólidos totales, 0.83% cenizas, 139 mg/100g calcio y 105 mg/100g fósforo. La densidad, acidez como ácido láctico y pH obtenidos fueron 1.032 g/cm3, 1.36 g/L y 6.51, respectivamente. Las leches aportaron MUFAs como ácidos oleico y gadoleico, y PUFAs como ácido linoleico y araquidónico, implicados procesos metabólicos que reducen el riesgo del síndrome metabólico. El patrón electroforético de las caseínas mostró bandas más abundantes con pesos moleculares de 20 a 36 kDa. Conclusiones. La composición de la leche de cabra producida resultó ser superior, con ventajas nutricionales, y potenciales beneficios a la salud respecto a la leche de otras especies. El contenido de lactosa, el pH y la acidez de la leche de cabra fueron diferentes en función de las unidades de producción; y la densidad, grasa, proteína y cenizas no se vieron influenciadas. La ausencia αs1-caseína sería ventajoso para la reducción de alergias asociadas al consumo de leche.

IntroductionCitrus is one of the most important fruit crops worldwide, and the root-associated microbiota can have a profound impact on tree health and growth.MethodsIn a collaborative effort, the International Citrus Microbiome Consortium investigated the global citrus root microbiota with samples collected from nine citrus-producing countries across six continents. We analyzed 16S rDNA and ITS2 amplicon sequencing data to identify predominant prokaryotic and fungal taxa in citrus root samples. Comparative analyses were conducted between root-associated microbial communities and those from the corresponding rhizosphere and bulk soil samples. Additionally, genotype-based group-wise comparisons were performed to assess the impact of citrus genotype on root microbiota composition.ResultsTen predominant prokaryotic phyla, containing nine bacterial phyla including Proteobacteria, Actinobacteria, Acidobacteria, and Bacteroidetes and one archaeal phylum (Thaumarchaeota), and multiple fungal phyla including Ascomycota and Basidiomycota were identified in the citrus root samples. Compared with the microbial communities from the corresponding rhizosphere and bulk soil samples from the same trees, the prokaryotic and fungal communities in the roots exhibited lower diversity and complexity but greater modularity compared to those in the rhizosphere. In total, 30 root-enriched and 150 root-depleted genera in bacterial community were identified, whereas 21 fungal genera were enriched, and 147 fungal genera were depleted in the root niche compared with the rhizosphere. The citrus genotype significantly affected the root prokaryotic and fungal communities. In addition, we have identified the core root prokaryotic genera comprising Acidibacter, Allorhizobium, Bradyrhizobium, Chitinophaga, Cupriavidus, Devosia, Dongia, Niastella, Pseudomonas, Sphingobium, Steroidobacter and Streptomyces, and the core fungal genera including Acrocalymma, Cladosporium, Fusarium, Gibberella, Mortierella, Neocosmospora and Volutella. The potential functions of these core genera of root microbiota were predicted.ConclusionOverall, this study provides new insights into the assembly of microbial communities and identifies core members of citrus root microbiota across a wide geographic range. The findings offer valuable information for manipulating root microbiota to enhance plant growth and health.

Background: We aimed to assess the characteristics, management and long-term prognosis of a cohort of patients with multiple valvular disease, focusing on the context of severe mitral or aortic disease with concomitant significant tricuspid regurgitation (TR). Methods: After using a propensity score matching for age, 975 patients with ≥ moderate TR, diagnosed at our centers from 2012 to 2020, were included and divided in four groups, including isolated TR patients as reference group. Primary endpoint was all-cause death (ACD), secondary endpoint was the composite of heart failure (HF) hospitalization + any valvular intervention. Results: Patients with isolated TR (356, 37 %) had more history of atrial fibrillation and were more often asymptomatic and with preserved left-ventricular ejection fraction (LVEF). Patients with severe mitral regurgitation (MR) + TR (466, 48 %) showed higher rates of concomitant coronary artery disease, advanced functional class symptoms and larger left atrial volumes. Severe aortic stenosis (AS) patients (131, 13 %) were older, with more comorbidities and lower LVEF. Patients with severe aortic regurgitation and TR (22, 2 %) were younger, with larger LV dimensions and higher pulmonary arterial pressures.After a median follow-up of 2.8 years, both endpoints were univariably more frequent in patients with severe AS + TR (all p

Abstract The decline of the iconic monarch butterfly (Danaus plexippus) in North America has motivated research on the impacts of land use and land cover (LULC) change and climate variability on monarch habitat and population dynamics. We investigated spring and fall trends in LULC, milkweed and nectar resources over a 20-year period, and ~ 30 years of climate variables in Mexico and Texas, U.S. This region supports spring breeding, and spring and fall migration during the annual life cycle of the monarch. We estimated a − 2.9% decline in milkweed in Texas, but little to no change in Mexico. Fall and spring nectar resources declined

Background: Despite the well-known efficacy of anti-COVID-19 vaccines in preventing morbidity and mortality, several vaccinated individuals are diagnosed with SARS-CoV-2 breakthrough infection, which might require hospitalisation. This multicentre, observational, and retrospective study aimed to investigate the clinical characteristics and outcomes of vaccinated vs. non-vaccinated patients, both hospitalised with SARS-CoV-2 infection in 3 major hospitals in Northern Italy. Methods: Data collection was retrospective, and paper and electronic medical records of adult patients with a diagnosed SARS-CoV-2 infection were pseudo-anonymised and analysed. Vaccinated and non-vaccinated individuals were manually paired, using a predetermined matching criterion (similar age, gender, and date of hospitalisation). Demographic, clinical, treatment, and outcome data were compared between groups differing by vaccination status using Pearson’s Chi-square and Mann-Whitney tests. Moreover, multiple logistic regression analyses were performed to assess the impact of vaccination status on ICU admission or intra-hospital mortality. Results: Data from 360 patients were collected. Vaccinated patients presented with a higher prevalence of relevant comorbidities, like kidney replacement therapy or haematological malignancy, despite a milder clinical presentation at the first evaluation. Non-vaccinated patients required intensive care more often than their vaccinated counterparts (8.8% vs. 1.7%, p = 0.002). Contrariwise, no difference in intra-hospital mortality was observed between the two groups (19% vs. 20%, p = 0.853). These results were confirmed by multivariable logistic regressions, which showed that vaccination was significantly associated with decreased risk of ICU admission (aOR=0.172, 95%CI: 0.039–0.542, p = 0.007), but not of intra-hospital mortality (aOR=0.996, 95%CI: 0.582–1.703, p = 0.987). Conclusions: This study provides real-world data on vaccinated patients hospitalised with COVID-19 in Northern Italy. Our results suggest that COVID-19 vaccination has a protective role in individuals with higher risk profiles, especially regarding the need for ICU admission. These findings contribute to our understanding of SARS-CoV-2 infection outcomes among vaccinated individuals and emphasise the importance of vaccination in preventing severe disease, particularly in those countries with lower first-booster uptake rates.

Research background. Enzymatically resistant maltodextrins (ERM) are a resistant starch type 4, synthesized from native starch. They are obtained by the sequential application of two processes: pyrodextrinization, which produces pyrodextrins, and enzymatic hydrolysis, which produces ERM. In these processes atypical bonds are formed that confer pyrodextrins and ERM similar properties to dietary fiber, such as resistance to digestion. The aim of this work is to determine and evaluate some physicochemical properties of pyrodextrins and ERM obtained from native starch isolated from makal (Xanthosoma yucatanense) tubers. Experimental approach. Pyrodextrinization and complementary hydrolysis were conducted using factorial designs. For pyrodextrinization, factors and their levels were (m(starch):V(HCl))=80:1 and 160:1 (c(HCl)=2.2 M), temperature 90 and 110 °C and reaction time 1 and 3 h, and for CH, α-amylase per pyrodextrin volume fractions 0.5 and 1 µL/mL and reaction time 10 and 30 min. The physicochemical profile included determination of resistant starch content, estimation of color change (ΔE), microscopy and determination of dextrose equivalents (DE). Results and conclusions. According to the factorial design, the best treatment conditions for pyrodextrinization were: (m(starch):V(HCl))=160:1, 90 °C and 3 h, since they resulted in the highest resistant starch content (84.73 %) and the lowest ΔE (3.742). Due to the low DE (13.89 %), increased amount of resistant starch (90.73 %) and low ΔE (4.24) in the resulting ERM, complementary hydrolysis with α-amylase per pyrodextrin volume fraction 0.5 µL/mL and hydrolysis time 10 min was selected as the best treatment. Novelty and scientific contribution. The results show that the pyrodextrins and ERM obtained from makal can be used as ingredients for the development of functional foods, due to their high content of indigestible material and low degree of browning.

Huanglongbing (HLB), also known as citrus greening disease, is a devastating disease of citrus. However, there is no known cure so far. Recently, under Section 24(c) of the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA), a special local need label was approved that allows the trunk injection of antimicrobials such as oxytetracycline (OTC) for HLB management in Florida. The objectives of this study were to use UAS-based remote sensing to assess the effectiveness of OTC on the HLB-affected citrus trees in Texas and to differentiate the levels of HLB severity and canopy health. We also leveraged UAS-based features, along with machine learning, for HLB severity classification. The results show that UAS-based vegetation indices (VIs) were not sufficiently able to differentiate the effects of OTC treatments of HLB-affected citrus in Texas. Yet, several UAS-based features were able to determine the severity levels of HLB and canopy parameters. Among several UAS-based features, the red-edge chlorophyll index (CI) was outstanding in distinguishing HLB severity levels and canopy color, while canopy cover (CC) was the best indicator in recognizing the different levels of canopy density. For HLB severity classification, a fusion of VIs and textural features (TFs) showed the highest accuracy for all models. Furthermore, random forest and eXtreme gradient boosting were promising algorithms in classifying the levels of HLB severity. Our results highlight the potential of using UAS-based features in assessing the severity of HLB-affected citrus.

The pitahaya Selenicereus undatus is a fruit widely consumed in the Yucatan Peninsula in Mexico, and its cultivation is promising due to its adaptability to adverse climatic conditions, its nutritional quality, and its bioactive compounds. The objective of this work was to determine the physical parameters of the fresh fruit (weights and diameters) and chemical parameters of the pulp (stored at -18 ºC) of pitahaya grown in two locations in the state of Yucatán, as well as to estimate the yield of fructooligosaccharides (FOS) present in freeze-dried pulp and peel flour, using the solid/liquid extraction method. Six physicochemical and six proximal descriptors (in freeze-dried pulp and peel), which were statistically compared using the t-student test, were quantified. The fruits had an average weight of 534.81 and 520.36 g for the pitahaya grown in Kinchil and Yobain, respectively. The peel weight of the fruit from Kinchil was significantly (p < 0.05) higher. The pulp represented between 67 – 72 % of the weight of the fruits. The physicochemical analysis of the fruit pulp indicated that the average total soluble solids/titratable acidity (TSS/TA) ratio was 20.5, and the pH was 3.29. The proximal analysis expressed on a dry basis (% d.b.) showed average values for the pulp of 4.80 % ash, 0.47 % crude fat, 10.42 % crude fiber, and 6.92 % protein; while for the peel 14.20 % ash, 1.39 % crude fat, 22.22 % crude fiber, and 5.31 % protein. The values of crude fiber and total carbohydrates in the peel, as well as the crude fat content in the pulp, were different (p < 0.05) between the locations. The estimated extraction yield of FOS with water was 86.49 g/kg for the freeze-dried pulp and 17.64 g/kg for the freeze-dried peel flour. This fruit exhibited good nutritional properties, and the freeze-dried flour from its peel could be used as supplement rich in dietary fiber and, together with the freeze-dried pulp, could be added to products such as juices, yogurt, and jams, among others, with a potential prebiotic effect due to its fructooligosaccharides content.

Las hojas de stevia (Stevia rebaudiana Bertoni) son consideradas edulcorantes naturales, bajos en calorías e inocuos. Por su parte, los tallos de stevia han sido menos estudiados y se consideran subproductos agroindustriales, aunque representan una buena fuente de fibra con propiedades tecnofuncionales que podría utilizarse como ingrediente alimentario. El objetivo del presente trabajo fue evaluar las propiedades químicas y tecnofuncionales de los tallos de stevia como potencial ingrediente de alimentos funcionales. Los tallos fueron obtenidos de plantaciones de stevia en Yucatán – México, y se les determinó la composición química proximal y su perfil tecnofuncional considerando la retención de agua y de aceite, la absorción y adsorción de agua y la absorción de moléculas orgánicas. Las determinaciones analíticas fueron realizadas por triplicado y se utilizó un análisis de varianza de una vía para el análisis estadístico de los datos obtenidos. Estos presentaron un alto contenido de carbohidratos (54,84 %), fibra cruda (32,33 %), cenizas (6,99 %) y proteína (4,46 %). Los tallos retuvieron cinco veces su peso en agua y en aceite (5,57 y 5,00 g/g), respectivamente. La capacidad de absorción de moléculas orgánicas fue de 2,09 g/g, la absorción de agua iguala a 4,49 g/g y la adsorción de agua de 0,29 g/g. Los tallos como subproducto agrícola de la cosecha de hojas de stevia son una alternativa funcional para usar en la elaboración de alimentos con potenciales efectos fisiológicos.

Abstract Over 4,400 large-scale solar photovoltaic (LSPV) facilities operate in the United States as of December 2021, representing more than 60 gigawatts of electric energy capacity. Of these, over 3,900 are ground-mounted LSPV facilities with capacities of 1 megawatt direct current (MWdc) or more. Ground-mounted LSPV installations continue increasing, with more than 400 projects appearing online in 2021 alone; however, a comprehensive, publicly available georectified dataset including spatial footprints of these facilities is lacking. The United States Large-Scale Solar Photovoltaic Database (USPVDB) was developed to fill this gap. Using US Energy Information Administration (EIA) data, locations of 3,699 LSPV facilities were verified using high-resolution aerial imagery, polygons were digitized around panel arrays, and attributes were appended. Quality assurance and control were achieved via team peer review and comparison to other US PV datasets. Data are publicly available via an interactive web application and multiple downloadable formats, including: comma-separated value (CSV), application programming interface (API), and GIS shapefile and GeoJSON.

Juvenile-Onset recurrent respiratory papillomatosis (JO- RRP) is the most frequent benign neoplasm in children with tendency to recur. Human Papilloma Virus (HPV) types 6 and 11 are involved in its etiology. Maternal transmission during the passage through the birth canal is the most frequent modality of infection. Clinical mani- festations of JO-RRP may include dysphonia, dysphagia, hoarseness, cough and, in the most severe cases, respira- tory distress. We report a case of a 3-year-old infant with a history of hoarseness and persistent dysphonia. Laryn- goscopy showed diffuse papillomatous warts involving the glottic space and the false vocal cords. An accurate preoperative anesthesiological evaluation was provided. Surgical intervention in microlaryngos- copy was performed under general anaesthesia. Removal of the papillomatous warty growths in micro- laryngoscopy was achieved, with significant improve- ment of the glottic space. No intraoperative or postoper- ative complications occurred, the patient resumed per os feeding on the same day and was discharged the second postoperative day. At the follow up visit at 1-month, im- portant improvement of the voice quality was evident; laryngoscopy showed the absence of pathology; a strict follow up was planned in order to detect any recurrences.

Inertial focusing-based Lab-on-Chip systems represent a promising technology for cell sorting in various applications, thanks to their alignment with the ASSURED criteria recommended by the World Health Organization: Affordable, Sensitive, Specific, User-friendly, Rapid and Robust, Equipment-free, and Delivered. Inertial focusing techniques using spiral microchannels offer a rapid, portable, and easy-to-prototype solution for cell sorting. Various microfluidic devices have been investigated in the literature to understand how hydrodynamic forces influence particle focusing in spiral microchannels. This is crucial for the effective prototyping of devices that allow for high-throughput and efficient filtration of particles of different sizes. However, a clear, comprehensive, and organized overview of current research in this area is lacking. This review aims to fill this gap by offering a thorough summary of the existing literature, thereby guiding future experimentation and facilitating the selection of spiral geometries and materials for cell sorting in microchannels. To this end, we begin with a detailed theoretical introduction to the physical mechanisms underlying particle separation in spiral microfluidic channels. We also dedicate a section to the materials and prototyping techniques most commonly used for spiral microchannels, highlighting and discussing their respective advantages and disadvantages. Subsequently, we provide a critical examination of the key details of inertial focusing across various cross-sections (rectangular, trapezoidal, triangular, hybrid) in spiral devices as reported in the literature.

Bloodstream infections (BSIs) and sepsis are a major cause of morbidity and mortality. Appropriate early antibiotic therapy is crucial for improving the survival of patients with sepsis and septic shock. T2 magnetic resonance (T2MR®) technology may enable fast and sensitive detection of ESKAPEc pathogens directly from whole-blood samples. We aimed to evaluate concordance between the T2Bacteria® Panel and standard blood culture and its impact on antibiotic therapy decisions. We conducted a single-centre retrospective study on patients with sepsis-induced hypotension or septic shock admitted to general, post-operative/neurosurgical, and cardiothoracic Intensive Care Units who were tested with the T2Bacteria® Panel from January 2021 to December 2022. Eighty-five consecutively admitted patients were included, for a total of 85 paired tests. A total of 48 ESKAPEc pathogens were identified by the T2Bacteria® Panel. The concordance rate between the T2Bacteria® Panel and blood cultures was 81% (69/85), with 20 concordant-positive and 49 concordant-negative cases. For the 25 microorganisms grown from accompanying blood cultures, blood pathogen coverage by the T2Bacteria® Panel was 88%. In this cohort of severely ill septic patients, the T2Bacteria® Panel was highly concordant and was able to detect more ESKAPEc pathogens, with a significantly shorter turn-around time compared to conventional blood cultures. The T2Bacteria® Panel also significantly impacted decisions on antibiotic therapy.

Andrea Spini,1 Luca L’Abbate,2 Ylenia Ingrasciotta,1 Giorgia Pellegrini,1 Massimo Carollo,1 Valentina Ientile,2 Olivia Leoni,3 Martina Zanforlini,4 Domenica Ancona,5 Paolo Stella,5 Anna Cavazzana,6 Angela Scapin,6 Sara Lopes,7 Valeria Belleudi,7 Gianluca Trifirò1 1Department of Diagnostics and Public Health, University of Verona, Verona, Italy; 2Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy; 3Lombardy Regional Centre of Pharmacovigilance and Regional Epidemiologic Observatory, Milan, Italy; 4Azienda Regionale per l’Innovazione e gli Acquisti, S.p.A, Milan, Italy; 5Apulian Regional Health Department, Bari, Italy; 6Azienda Zero, Regione Veneto, Italy; 7Department of Epidemiology, Lazio Regional Health Service, Rome, ItalyCorrespondence: Gianluca Trifirò, Department of Diagnostics and Public Health, University of Verona, P. le L.A. Scuro 10, Verona, 37134, Italy, Tel +39 045 802 7679, Email gianluca.trifiro@univr.it