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Josep Lluis Carbonell Esteve,1 Rita Acosta,2 Yasmirian Pérez,2 Barbara Rodriguez,2 Isabel Seigler,2 Carlos Sanchez,2 Giuseppe Tomasi3 1Mediterránea Médica Clinic, Valencia, Spain; 2Eusebio Hernández Gynecology and Obstetrics Teaching Hospital, Havana, Cuba; 3University of The Basque Country, Bilbao, Spain Objective: To evaluate the efficacy, safety, and quality of life of 5 mg mifepristone per day compared with a placebo in treating uterine fibroids. Design: Randomized, double-blind clinical study. Location: Eusebio Hernández Gynecology and Obstetrics Teaching Hospital, Havana, Cuba. Subjects: One hundred twenty-four subjects with symptomatic uterine fibroids. Treatment: One daily capsule of 5 mg mifepristone or a mifepristone placebo over 3 months. Variables in evaluating safety: Changes in fibroid and uterine volumes, changes in symptom prevalence and intensity, and changes in quality of life. Results: Three months into treatment, fibroid volume was reduced by 28.5% in the mifepristone group with an increase of 1.8% in the placebo group (P = 0.031). There were significant differences between the groups with respect to pelvic pain prevalence (P = 0.006), pelvic pressure (P = 0.027), rectal pain (P = 0.013), hypermenorrhea (P < 0.001), and metrorrhagia (P = 0.002) at the end of treatment. Amenorrhea was 93.1% and 4.3% in the mifepristone and placebo groups, respectively (P < 0.001). Treatment side effects were significantly greater in the mifepristone group. Estradiol levels did not differ significantly between the placebo and mifepristone groups at the end of treatment. Improvement in quality of life was significantly greater in the categories of "symptoms" (P = 0.004) and "activity" (P = 0.045) in the mifepristone group. Conclusion: The 5 mg dosage of mifepristone presented significantly superior efficacy compared to the placebo. Keywords: mifepristone, leiomyoma, fibroid, antiprogestins

Josep LL Carbonell,1 Rita Acosta,2 Yasmiriam Pérez,2 Ana G Marrero,2 Edilia Trellez,2 Carlos Sánchez,2 Giuseppe Tomasi31Mediterránea Médica Clinic, Valencia, Spain; 2Eusebio Hernández Gynecology and Obstetrics Teaching Hospital, Havana, Cuba; 3Basque Country University, San Sebastian, SpainObjectives: The aim of this study was to evaluate the safety and improvement in quality of life using 10 mg and 5 mg daily doses of mifepristone for the treatment of uterine fibroids.Design: The research was a randomized double-blind clinical study undertaken at the Eusebio Hernández Hospital in Havana, Cuba.Subjects and methods: Seventy subjects with symptomatic uterine fibroids took one daily capsule of 10 mg or 5 mg mifepristone orally for 9 months. One to three endometrial biopsies were performed. In evaluating safety, the variables studied were endometrial changes associated with mifepristone, elevation of hepatic transaminases, side effects of mifepristone, and instances and duration of irregular bleeding.Results: There were 30/49 (61.2%) and 13/24 (54.2%) diagnoses of endometrial changes associated with mifepristone in the 10 mg and 5 mg groups, respectively (P = 0.282). At every evaluation visit the average endometrial thickness was significantly greater in the 10 mg group than in the 5 mg group (P = 0.013, P = 0.002, and P = 0.013, respectively). Only five subjects had slight elevations in their hepatic transaminases after 9 months' treatment. Sixteen of 35 (45.7%) and eight of 33 (24.2%) subjects had the occasional hot flush in the 10 mg and 5 mg groups, respectively (P = 0.032). In total, there were 12.9 ± 4.6 (n = 21) and 9.1 ± 3.9 (n = 18) days of irregular bleeding in the 10 mg and 5 mg groups, respectively (P = 0.009).Conclusion: According to the study findings, a 5 mg daily dose over 9 months has a relatively better safety profile than the 10 mg dose.Keywords: mifepristone, leiomyoma, fibroid, antiprogestins

Josep L Carbonell Esteve1, Ana M Riverón2, Mariela Cano2, Alma I Ortiz3, Aleta Valle2, Carlos S Texidó2, Giuseppe Tomasi41Mediterránea Médica Clinic, Valencia, Spain; 2Eusebio Hernández Obstetrics Teaching Hospital, Havana, Cuba; 3Alemán Hospital, Managua, Nicaragua; 4Chemistry Department, University of the Basque Country, San Sebastian, SpainObjectives: To evaluate the efficacy and safety of 2.5 mg and 5 mg mifepristone during 3 months for the treatment of uterine fibroids before surgery.Design: Multicenter randomized clinical trial.Locations: Eusebio Hernández Hospital, Havana, Cuba and the Alemán Hospital, Managua, Nicaragua.Subjects: Included in the study were 146 women with symptomatic uterine fibroids.Treatment: Group I: half a tablet of 5 mg (2.5 mg) mifepristone taken orally every 24 hours, and Group II: one tablet of 5 mg mifepristone taken orally every 24 hours over a period of 3 months in both groups. Two endometrial biopsies were performed.Variables to evaluate efficacy: Increase in average hemoglobin, changes in fibroid and uterine volume, and symptomatic improvement.Results: The average hemoglobin at the end of treatment was 0.6 g/dL greater in the 5 mg mifepristone group (P = 0.033). In both groups there were similar reductions in fibroid volumes. Clinical improvement was more significant in the 5 mg group.Conclusion: The dose to be used should be 5 mg.Keywords: mifepristone, leiomyoma, fibroid , antiprogestins

Study Question: What are the characteristics of doctor-couple communication content during actual ART visits?Summary Answer: Physicians were mainly focused on providing biomedical information, while communication content from couples had a 2-fold focus on providing biomedical information and on positive talk.What Is Known Already: Communication aspects in ART seem crucial for clinical decision-making, retention in care and critical conversations with couples due to low treatment success rates. However, no studies have been carried out on the actual interaction between the doctor and the couple in this context.Study Design, Size, Duration: This observational study involved 28 clinicians and 160 patients referred to eight Italian ART clinics during a one-year recruitment period.Participants/materials, Setting, Methods: ART visits at eight Italian clinics were videotaped. The visits were coded using the Roter Interaction Analysis System (RIAS), particularly focusing on RIAS composite categories, verbal dominance and patient-centeredness score.Main Results and the Role Of Chance: A total of 85 visits were eligible for analysis (62% acceptance rate), involving 28 clinicians and 160 patients (including 75 couples). The average visit duration was 37 ± 17.7 min. The mean verbal dominance was 1.9 ± 0.86 (range: 0.72-5.74). Physicians mainly focused on providing biomedical information. Communication content from couples had a 2-fold focus on providing biomedical information and on positive talk. The mean of patient centeredness index (PCI) was 0.51 (SD = 0.28; range 0.08-1.77); visits in which the doctor was a woman or the treatment indication was for heterologous fertilization showed higher PCI scores. Overall, females accounted for 67% of all patient talk. Taking this imbalance into account as expected frequencies for each composite category, males reported significantly more utterances in almost all of the socioemotional categories.Limitations, Reasons For Caution: These results are preliminary and observational and only regard Italy. Communication during visits may have been biased since the professionals who agreed to participate showed an interest in communication issues. Another limitation is a possible Hawthorne effect due to the fact that participants were aware of being videotaped.Wider Implications Of the Findings: Our study showed that ART physicians mainly adopted an informative model of communication and a more disease-oriented approach. Findings revealed the complexity of communication content during ART consultations, given its triadic characteristic in which the third party is also a patient; clinicians should be aware of this complex aspect and of the specific male and female perspectives to be taken into account. The results could be useful for training ART professionals.Study Funding/competing Interest(s): This study was possible thanks to an unconditional grant from Ferring Spa to the Department of Health Sciences, University of Milan. There are no competing interests to declare.Trial Registration Number: N/A. [ABSTRACT FROM AUTHOR]

Abstract: The increasing scientific and industrial interest towards metabonomics takes advantage from the high qualitative and quantitative information level of nuclear magnetic resonance (NMR) spectroscopy. However, several chemical and physical factors can affect the absolute and the relative position of an NMR signal and it is not always possible or desirable to eliminate these effects a priori. To remove misalignment of NMR signals a posteriori, several algorithms have been proposed in the literature. The icoshift program presented here is an open source and highly efficient program designed for solving signal alignment problems in metabonomic NMR data analysis. The icoshift algorithm is based on correlation shifting of spectral intervals and employs an FFT engine that aligns all spectra simultaneously. The algorithm is demonstrated to be faster than similar methods found in the literature making full-resolution alignment of large datasets feasible and thus avoiding down-sampling steps such as binning. The algorithm uses missing values as a filling alternative in order to avoid spectral artifacts at the segment boundaries. The algorithm is made open source and the Matlab code including documentation can be downloaded from www.models.life.ku.dk. [Copyright &y& Elsevier]

Introduction: Background: Little is known about the modifications in gambling patterns during the Covid-19 pandemic, which has shown signs of increase, particularly for individuals with preexisting gambling problems. Objectives: Our aim was to assess the behaviour of a cohort of patients in the Trentino Region. Methods: A semi structured questionnaire containing Hamilton Depression Rating Scale as well as open-ended questions on gambling activities, specifically online gambling, was administred over the telephone. The survey was administred for two months over the lockdown period (april-june 2020) and took approximately 20 minutes to complete. Results: About 50 responsens were collected. Data are currently been analyzed and will be avaiable at the time of the Congress. Conclusions: Will be show at the time of the Congress. [ABSTRACT FROM AUTHOR]

In this Letter, we investigate the fate of the non-Hermitian skin effect in one-dimensional systems that conserve the dipole moment and higher moments of an associated global U(1) charge. Motivated by field theoretical arguments and lattice model calculations, we demonstrate that the key feature of the non-Hermitian skin effect for m-pole conserving systems is the generation of an (m+1)th multipole moment. For example, in contrast to the conventional skin effect where charges are anomalously localized at one boundary, the dipole-conserving skin effect results in charges localized at both boundaries, in a configuration that generates an extremal quadrupole moment. In addition, we explore the dynamical consequences of the m-pole skin effect, focusing on charge and entanglement propagation. Both numerically and analytically, we provide evidence that long-time steady states have Fock-space localization and an area-law scaling of entanglement entropy, which serve as quantum indicators of the skin effect.

Introduction: Remote device monitoring is indicated under class I A standard of care according to the latest HRS/EHRA/APHRS/LAHRS Expert Consensus Statement on Practical Management of the Remote Device Clinic. Despite this strong endorsement and the supporting data, the adoption of remote monitoring practices remains lower than expected. One cause of the underutilization of telemonitoring devices is work overload. Thus, a crucial point for improving the adoption of remote monitoring systems is ensuring their sustainability., Materials and Method: After analyzing the resources necessary to manage a device telemonitoring clinic, we initiated a process to reduce redundant transmissions: 1. eliminated scheduled loop recorder transmissions, retaining only alert transmissions; 2. reduced the frequency of the scheduled transmissions of pacemakers from four to one per year and the scheduled transmissions for defibrillators from four to two per year; and 3. optimized and customized the programming of device alerts with two primary interventions., Results: These strategies allowed us to significantly reduce the number of transmissions/patient/year from 7.3 to 4.7. The first change was made in January 2020, which eliminated scheduled transmissions for loop recorders, reduced transmissions per patient from 14 to 10.4 for loop recorders, and decreased global transmissions per patient from 7.6 to 6.5. The subsequent adjustment in January 2021, which reduced the scheduled transmissions of pacemakers and defibrillators, further lowered transmissions per patient from 6.5 to 5.2 for pacemakers and from 4.7 to 3.1 for defibrillators. Additionally, enhanced attention to device reprogramming starting in January 2022 resulted in a further reduction in transmissions per patient from 5 to 4.7., Conclusion: Carrying out some simple changes in the number of scheduled transmissions and optimizing the programming of the devices made it possible to reduce the number of transmissions and make the remote monitoring of the devices more sustainable., Competing Interests: The authors declare no conflicts of interest

Quantitative nontarget analysis (qNTA) for liquid chromatography coupled to high-resolution mass spectrometry enables a more comprehensive assessment of environmental samples. Previous studies have shown that correlations between a compound's ionization efficiency and a range of molecular descriptors can predict the compound's concentration within a factor of 5. In this study, the qNTA approach was further improved by considering all mass adducts instead of only the protonated ion. The model was based on a quantitative structure-property relationship (QSPR), including 216 contaminants of emerging concern (CECs), of which 80 exhibited adduct formation that accounted for >10% of the total peak intensity. When all mass adducts were included, the test set coefficient of determination improved to Q 2 = 0.855 compared to Q 2 = 0.670 when only the protonated ions were considered (test set median RF error factor 1.6). The inclusion of all adducts was also important to transfer the RF QSPR model reliably. It was assumed that RF variations are sequence-dependent; therefore, a second QSPR model for the prediction of the transferability factor was built for each sequence. For validation, samples were analyzed up to two years apart. The median prediction fold change was 1.74 for analytical standards (63 compounds) and 2.4 for enriched wastewater effluent samples (41 compounds), with 80% of the compounds predicted within a fold change of 2.4 and 3.3, respectively. The model was also validated on a second instrument, where 80% of the 26 compounds in wastewater effluent were predicted within a factor of 3.8.

Aims: Implantable cardiac monitors (ICMs) can generate false-positive (FP) alerts. Although these devices have an extended programmability, there are no recommendations on their optimization to reduce not-relevant activations.We tested a strategic programming optimization guide based on the type of FP and investigated the safety and feasibility of the nurse-led insertion of ICMs with a long-sensing vector., Methods and Results: Consecutive patients implanted by trained nurses with long-sensing vector ICM were enrolled in a 1-month observational stage (Phase A). Patients who had ≥10 FP episodes underwent ICM reprogramming based on the predefined guide and were followed for an additional month (Phase B). A total of 78 patients had successful ICM insertion by nurses with a mean R wave amplitude of 0.96 ± 0.43 mV and an 86% P wave visibility. Only one patient reported a significant device-related issue, and nurse-delivered ICM was generally well accepted by the patients. During Phase A, 11 patients (14%) generated most of FP (3,627/3,849; 94%) and underwent ICM reprogramming. In the following month (Phase B), five patients (45%) were free from FP and six (55%) transmitted 57 FP alerts (98% reduction compared with Phase A). The median number of FP per patient was significantly reduced after reprogramming [195 (interquartile range, 50-311) vs. one (0-10), P = 0.0002]., Conclusion: A strategic reprogramming of ICM in those patients with a high FP alert burden reduces the volume of erroneous activations with potential benefits for the remote monitoring service. No concerns were raised regarding nurse-led insertion of ICMs with a long-sensing vector., Competing Interests: Conflict of interest: F.T. and D.G. are employees of BIOTRONIK Italia S.p.a., an affiliate of BIOTRONIK SE & Co. KG, Berlin, Germany., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

A nontarget screening method was developed based on D-optimal designs for ultra-high performance supercritical fluid chromatography with positive and negative electrospray ionization mode mass spectrometry. A mixture of organic contaminants such as pesticides, steroids, surfactants, phenolic and fatty acids, and polycyclic aromatic hydrocarbon derivatives, was used for the optimization. An aprotic mixture of dichloromethane and acetone [3:1] performed overall best as the injection solvent. The highest peak capacities (n) were accomplished at the shallowest gradient (1%B/min), ammonium formate (n = 378 in negative ionization mode), or ammonium acetate (n = 327 in positive ionization mode) in methanol as the modifier. Capillary voltage, make-up solvent flow rate, water, and additive concentration were the most significant factors for improving peak intensity: higher peak intensities were obtained at lower additive concentrations (5mM ammonium formate), and with 5% water in positive ionization mode. Conversely, water had detrimental effects in negative ionization mode. The optimized method was used to quantify organic contaminants in 17 freshwater sediment samples from Copenhagen, Denmark. Out of 50 monitored contaminants, 35 were detected in at least one sample. Further, the method has a potential for target and nontarget screening analysis of organic contaminants in solid matrices., (© 2022 The Authors. Journal of Separation Science published by Wiley-VCH GmbH.)

A major challenge in processing of complex data obtained from chromatography hyphenated to mass spectrometry is to resolve chromatographically co-eluting compounds. In this study, we present a workflow for the resolution of ultra-high pressure liquid chromatography high-resolution mass spectrometry data obtained by the broadband data-independent acquisition MS E operation (UHPLCHRMS E ). The workflow is based on a recently introduced algorithm for Parallel Factor Analysis 2 (PARAFAC2) that allows to enforce non-negativity on all the model coefficients. The workflow was tested on three sets of UHPLC-HRMS E measurements from a Lupinus angustifolius L. crop field study, which included plant tissue samples, soil samples and samples from drainage water as well as stream water close to the field. The three datasets included 93, 59, and 75 chromatographic runs in total for the plant, soil and water batches, respectively. Nonnegative-PARAFAC2 models were fitted on the summed high and low energy (HE and LE) traces on chromatographic intervals corresponding to spiked standard for the three sample sets independently. In soil and plant samples, 13 out of 14 spiked standards were resolved by NN-PARAFAC2 even in presence of chromatographic co-elution, and their mass spectral loadings could be matched to a reference spectrum. In contrast, only seven spiked standards were correctly resolved and matched for the water samples because a higher chromatographic baseline rendered the data noisier. The results show that the workflow we present can provide improved mass spectral selectivity for data-independent acquisition compared to using the raw mass spectra and can be used to match fragment ions from the HE trace, and precursor and adduct ions from the LE trace even in presence of co-eluting compounds., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:, (Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.)

In this study, micropollutants in wastewater effluents were prioritized by monitoring the composition of influent and effluent wastewater by liquid chromatography - high-resolution mass spectrometry (LCHRMS) non-target screening (NTS) analysis. The study shows how important data pre-processing and filtering of raw data is to produce reliable NTS data for comparison of compounds between many samples (37 wastewater samples) analyzed at different times. Triplicate injections were critical for reducing the number of false-positive detections. Intensity drift corrections within and between batches analyzed months apart made peak intensities comparable across samples. Adjustment of the feature detection threshold was shown to be important, due to large intensity variations for low abundance compounds across batches. When the threshold correction cut-offs, or the filtering of relevant compounds by the occurrence frequency, were too stringent, a high number of false positive transformation products (TPs) were reported. We also showed that matrix effect correction by internal standards can over- or under-correct the intensity for unknown compounds, thus the TIC matrix effect correction was shown as an additional tool for a retention time dependent matrix effect correction. After these preprocessing and filtering steps, we identified 78 prioritized compounds, of which 36 were persistent compounds, defined as compounds with a reduction in peak intensity between influent and effluent wastewater <50%, and 13 compounds were defined as TPs because they occurred solely in the effluent samples. Some examples of persistent compounds are 1,3-diphenylguanidine, amisulpride and the human metabolites from losartan, verapamil and methadone. To our knowledge, nine of the identified TPs have not been previously described in effluent wastewater. The TPs were derived from metoprolol, fexofenadine, DEET and losartan. The screening of all identified compounds in effluent samples from eight wastewater treatment plants (WWTPs) showed that potential drugs of abuse, anti-psychotic and anti-depressant drugs were predominant in the capital city region, whereas the anti-epileptic agents and agricultural pesticides were dominant in more rural areas., (Copyright © 2022. Published by Elsevier Ltd.)

The coronavirus pandemic affected the life of those suffering from addictive behaviors often confined to prolonged periods of self-isolation. To explore the variation of symptoms related to gambling, 46 outpatients of the mental health services in the Trento Province were invited to take part in a phone interview at the start of the national lockdown. Although only 2.17% increased gambling activity during this period, half of the sample (50.00%) experienced irritability, mood fluctuation (43.48%) and anxiety (39.13%). Follow-up studies should assess modifications in their behaviors that occurred after the reopening of gambling venues., Competing Interests: The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results., (© 2022 The Author(s).)

Background: The remote follow-up of pacemakers and implantable cardiac defibrillators (ICDs) usually includes scheduled checks and alert transmissions. However, this results in a high volume of remote data reviews to be managed. We measured the relative contribution of scheduled and alert transmissions to the detection of relevant conditions, and the workload generated by their management., Methods: At our center, the frequency of remote scheduled transmissions is 4/year. Moreover, all system-integrity and clinical alerts are turned on for wireless notification. We calculated the number of transmissions received from January to December 2020, and identified transmissions that necessitated in-hospital access for further assessment and transmissions that required clinical discussion with the physician. For all alert transmissions, we identified whether the alert was clinically meaningful (i.e. center was not previously aware of the condition and no action had yet been taken to treat it)., Results: Of 8545 transmissions received from 1697 pacemakers and ICDs, 5766 (67%) were scheduled and 2779 (33%) were alert transmissions received from 764 patients (45%); 499 (9%) scheduled transmissions required clinical discussion with the physician, but only 2 of these necessitated in-hospital visits for further assessment. Of the alert transmissions, 664 (24%) required clinical discussion, and 75 (3%) necessitated in-hospital visits. The proportion of alerts judged clinically meaningful was 7%., Conclusion: Scheduled transmissions generate 67% of remote data reviews for pacemakers and ICDs, but their ability to detect clinically relevant events is very low. A strategy that relies exclusively on alert transmissions could ensure continuity of patient monitoring while reducing the workload at the center., Competing Interests: Declaration of Competing Interest S. Valsecchi is an employee of Boston Scientific. No other conflicts of interest exist., (Copyright © 2021 Elsevier B.V. All rights reserved.)

The presence of global conserved quantities in interacting systems generically leads to diffusive transport at late times. Here, we show that systems conserving the dipole moment of an associated global charge, or even higher-moment generalizations thereof, escape this scenario, displaying subdiffusive decay instead. Modeling the time evolution as cellular automata for specific cases of dipole- and quadrupole conservation, we numerically find distinct anomalous exponents of the late time relaxation. We explain these findings by analytically constructing a general hydrodynamic model that results in a series of exponents depending on the number of conserved moments, yielding an accurate description of the scaling form of charge correlation functions. We analyze the spatial profile of the correlations and discuss potential experimentally relevant signatures of higher-moment conservation.

Objectives: The purpose of the study was twofold: (1) to test the hypothesis that tooth loss is independently associated with carotid atherosclerotic burden (CAB) among individuals with ischemic stroke (IS) or transient ischemic attack (TIA) and (2) to test the association between tooth loss and disability following the occurrence of cerebral ischemia., Materials and Methods: This observational study included 418 patients with IS or TIA. Tooth loss and the CAB were measured through a head and neck multidetector computed tomography angiography. CAB was analyzed in both common, internal, and external carotid arteries and classified in five levels of vascular occlusion. The modified Rankin Scale (mRS) was used to evaluate the functional outcome at patient discharge. Health records provided information on sociodemographic and medical covariates. The association between CAB and tooth loss, as well as between tooth loss and subtypes of cerebral ischemia were estimated through Poisson regression. Cox regression was carried out to evaluate the association between tooth loss and the mRS, with α = 5%., Results: Mean age was 65.6 ± 13.8 years, with 52.4% males. Multivariate analyses revealed that severe tooth loss (> 23 missing teeth) was independently associated with CAB ≥ 50% (PR = 2.86, 95% CI = 1.19-6.89) and mRS scores (> 2) (HR = 1.97, 95% CI = 1.10-3.75)., Conclusion: Tooth loss was independently associated with CAB and predicted a poorer functional outcome among IS and TIA patients., Clinical Relevance: Clinical assessment of tooth loss may provide important information on risk for CAB and poorer functional outcome among stroke patients.

Background: folliculogenesis is a strictly regulated process that may be affected by endocrine disrupting chemicals (EDCs) through sometimes not so clear molecular mechanisms., Methods: we conducted a multicentric observational study involving six fertility centers across Italy, prospectively recruiting 122 women attending a fertility treatment. Recruited women had age ≤42 years, and normal ovarian reserve. Blood and follicular fluid samples were taken for EDCs measurement using liquid chromatography tandem mass spectrometry and each woman completed an epidemiological questionnaire., Results: The main EDCs found were monobutyl phthalate (MBP) (median blood: 8.96 ng/mL, follicular fluid 6.43 ng/mL), monoethylhexyl phthalate (MEHP) (median blood: 9.16 ng/mL, follicular fluid 7.68 ng/mL) and bisphenol A (BPA) (median blood: 1.89 ng/mL, follicular fluid 1.86 ng/mL). We found that serum MBP concentration was significantly associated with the considered area ( p < 0.001, adj. mean: 7.61 ng/mL, 14.40 ng/mL, 13.56 ng/mL; Area 1: Milan-Turin, Area 2: Rome-Naples; Area 3: Catania-Bari, respectively) but negatively with home plastic food packaging ( p = 0.004). Follicular MBP was associated with irregular cycles ( p = 0.019). No association was detected between EDCs and eating habits and other clinical and epidemiological features., Conclusions: This study represents the first Italian biomonitoring of plastic EDCs in follicular fluid, laying the basis for future prospective evaluation on oocyte quality before assisted reproduction techniques (ART).

Aims: Current guidelines recommend remote follow-up for all patients with cardiac implantable electronic devices. However, the introduction of a remote follow-up service requires specifically dedicated organization. We evaluated the impact of adopting remote follow-up on the organization of a clinic and we measured healthcare resource utilization., Methods: In 2016, we started the implementation of the remote follow-up service. Each patient was assigned to an experienced nurse and a doctor in charge with preestablished tasks and responsibilities. During 2016 and 2017, all patients on active follow-up at our center were included in the service; since 2018, the service has been fully operational for all patients following postimplantation hospital discharge., Results: As of December 2018, 2024 patients were on active follow-up at the center. Of these, 93% of patients were remotely monitored according to the established protocol. The transmission rates were: 5.3/patient-year for pacemakers, 6.0/patient-year for defibrillators, and 14.1/patient-year for loop recorders. Only 21% of transmissions were submitted to the physician for further clinical evaluation, and 3% of transmissions necessitated an unplanned in-hospital visit for further assessment. Clinical events of any type were detected in 39% of transmissions. Overall, the nurses' total workload was 3596 h per year, that is, 1.95 full-time equivalent, which resulted in 1038 patients/nurse. The total workload for physicians was 526 h per year, that is, 0.29 full-time equivalent. After 1 year on follow-up, most patients judged the service positively and expressed their preference for the new follow-up approach., Conclusion: A remote follow-up service can be implemented and efficiently managed by nursing staff with minimal physician support. Patients are followed up with greater continuity and seem to appreciate the service.

In this work, we establish a relation between entanglement entropy and fractal dimension D of generic many-body wave functions, by generalizing the result of Page [Phys. Rev. Lett. 71, 1291 (1993)PRLTAO0031-900710.1103/PhysRevLett.71.1291] to the case of sparse random pure states (SRPS). These SRPS living in a Hilbert space of size N are defined as normalized vectors with only N^{D} (0≤D≤1) random nonzero elements. For D=1, these states used by Page represent ergodic states at an infinite temperature. However, for 01 and to genuine multifractal states and also show that their fluctuations have ergodic behavior in a narrower vicinity of the ergodic state D=1.

We developed and validated a method to estimate input functions for determination of regional rates of cerebral protein synthesis (rCPS) with L-[1- 11 C]leucine PET without arterial sampling. The method is based on a population-derived input function (PDIF) approach, with venous samples for calibration. Population input functions were constructed from arterial blood data measured in 25 healthy 18-24-year-old males who underwent L-[1- 11 C]leucine PET scans while awake. To validate the approach, three additional groups of 18-27-year-old males underwent L-[1- 11 C]leucine PET scans with both arterial and venous blood sampling: 13 awake healthy volunteers, 10 sedated healthy volunteers, and 5 sedated subjects with fragile X syndrome. Rate constants of the L-[1- 11 C]leucine kinetic model were estimated voxel-wise with measured arterial input functions and with venous-calibrated PDIFs. Venous plasma leucine measurements were used with venous-calibrated PDIFs for rCPS computation. rCPS determined with PDIFs calibrated with 30-60 min venous samples had small errors (RMSE: 4-9%), and no statistically significant differences were found in any group when compared to rCPS determined with arterial input functions. We conclude that in young adult males, PDIFs calibrated with 30-60 min venous samples can be used in place of arterial input functions for determination of rCPS with L-[1- 11 C]leucine PET.

Indoor potted plants are able to remove volatile organic compounds (VOC) from air, but only few studies have investigated the removal of compounds in mixtures. Here, we present a non-targeted pixel-based fingerprinting analysis documenting the removal of a complex mixture of gasoline VOCs by Hedera helix under dynamic chamber conditions allowing for air exchange and continuous gasoline exposure. For 15 days, the entire potted plant was exposed to gasoline; subsequently, the epigeous plant parts were removed and the soil microcosm (i.e. soil, plant roots and microorganisms) was exposed to gasoline for another eight days. Quantitative analysis was performed for heptane, 3-methylhexane, toluene, ethylbenzene and m,p-xylenes, and the CHEMSIC method (CHEMometric analysis of Selected Ion Chromatograms) was used for non-targeted pixel-based fingerprinting analysis. The quantitative analysis demonstrated that the presence of potted plants or pots without epigeous plant parts led to a reduction of selected VOCs by 16.7-22.6%. The CHEMSIC method confirmed this and revealed that all gasoline VOCs were reduced in concentration when H. helix was present. The estimate for the total VOC removal was in the range of 11-32%. The removal was highest for samples where the epigeous plant parts were absent and compounds known to be hard to degrade by microorganisms such as dimethylcyclopentanes were removed the least compared to compounds more easily degraded by microorganisms such as heptane when epigeous plant parts were removed. All findings support the conclusion that the soil microcosm was the main responsible for the removal of VOCs., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Forensic investigations of oil spills aim to find the responsible source(s) of the spill. Oil weathering processes change the chemical composition of the spilled oil and make the matching of oil spill samples to potential sources difficult. Diesel oil spill cases are more challenging, because biomarkers recalcitrant to long-term weathering are absent. We developed and tested a new method for the analysis and matching of diesel oil spills using two-dimensional gas chromatography-high resolution mass spectrometry (GC × GC - HRMS) and 2D-CHEMSIC (2-Dimensional CHEMometric analysis of Selected Ion Chromatograms), an extension of the CHEMSIC method to GC × GC data. The 2D-CHEMSIC performs pixel-based analysis using chemometrics on concatenated sections of 2D extracted ion chromatograms to assess the overall chemical variability of the samples, with potential applications for matching spill-source pairs in forensic investigations. The method was tested on samples from a number of diesel oil spill cases, (i) distinguishing chemically similar source diesels, (ii) investigating weathering effects on spill samples to determine type and degree of weathering, and (iii) improving the matching of diesel oil spills affected by weathering. Positive matches for spill-source pairs were identified after excluding the signals from the hydrocarbons most susceptible to evaporation, and photo-oxidized spills were also matched due to the presence of unaffected hydrocarbons. Forensic diagnostics obtained by the 2D-CHEMSIC were validated by the conventional CEN-Tr method.

Aims: Implantable loop recorders (ILR) are indicated in a variety of clinical situations when extended cardiac rhythm monitoring is needed. We aimed to assess the clinical impact, safety, and accuracy of the new Medtronic Reveal LINQTM ILR that can be inserted outside the electrophysiology (EP) laboratory and remotely monitored., Methods and Results: All 154 consecutive patients (100 males, 63 ± 15 year-old) who received the Reveal LINQTM ILR during the period July 2014-June 2016 were enrolled. The device was implanted in a procedure room and all patients where provided with the MyCareLinkTM remote monitoring system. Data were reviewed every working day via the Carelink® web system by a specialist nurse who, in case of significant events, consulted an electrophysiologist. During a mean follow-up of 12.1 (6.7-18.4) months (range 2-24 months), a diagnosis was made in 99 (64%) patients and in 60 (39%) ≥1 therapeutic interventions were established following recording of arrhythmias. In 26 of these 60 patients, remote monitoring prompted therapeutic interventions following asymptomatic arrhythmic events 3.8 months before the next theoretical scheduled in-office data download. False bradycardia detection for undersensing occurred in 44 (29%) patients and false tachycardia detection for oversensing in 4 (3%). One patient experienced skin erosion requiring explantation and none suffered from infection., Conclusion: The remote monitoring feature of the Reveal LINQTM allowed earlier diagnosis of asymptomatic but serious arrhythmias in a significant proportion of patients. Implantation of the device outside the EP laboratory appeared safe. However, R-wave undersensing and consequent false recognition of bradyarrhythmias remains a clinically important technical issue.

To examine effects of scan duration on estimates of regional rates of cerebral protein synthesis (rCPS), we reanalyzed data from thirty-nine previously reported L-[1-11C]leucine PET studies. Subjects consisted of 12 healthy volunteers studied twice, awake and under propofol sedation, and 15 subjects with fragile X syndrome (FXS) studied once under propofol sedation. All scans were acquired on a high resolution scanner. We used a basis function method for voxelwise estimation of parameters of the kinetic model of L-[1-11C]leucine and rCPS over the interval beginning at the time of tracer injection and ending 30, 45, 60, 75 or 90 min later. For each study and scan interval, regional estimates in nine regions and whole brain were obtained by averaging voxelwise estimates over all voxels in the region. In all three groups rCPS was only slightly affected by scan interval length and was very stable between 60 and 90 min. Furthermore, statistical comparisons of rCPS between awake and sedated healthy volunteers provided almost identical results when they were based on 60 min scan data as when they were based on data from the full 90 min interval. Statistical comparisons between sedated healthy volunteers and sedated subjects with FXS also yielded almost identical results when based on 60 and 90 min scan intervals. We conclude that, under the conditions of our studies, scan duration can be shortened to 60 min without loss of precision.

Functional quantification with PET is generally based on modeling that assumes tissue regions are kinetically homogeneous. Even in regions sufficiently small to approach homogeneity, spillover due to resolution limitations of PET scanners may introduce heterogeneous kinetics into measured data. Herein we consider effects of kinetic heterogeneity at the smallest volume accessible, the single image voxel. We used L-[1- 11 C]leucine PET and compared rates of cerebral protein synthesis (rCPS) estimated voxelwise with methods that do (Spectral Analysis Iterative Filter, SAIF) and do not (Basis Function Method, BFM) allow for kinetic heterogeneity. In high resolution PET data with good counting statistics BFM produced estimates of rCPS comparable to SAIF, but at lower computational cost; thus the simpler, less costly method can be applied. With poorer counting statistics (lower injected radiotracer doses), BFM estimates were more biased. In data smoothed to simulate lower resolution PET, BFM produced estimates of rCPS 9-14% higher than SAIF, overestimation consistent with applying a homogeneous tissue model to kinetically heterogeneous data. Hence with lower resolution data it is necessary to account for kinetic heterogeneity in the analysis. Kinetic heterogeneity may impact analyses of other tracers and scanning protocols differently; assessments should be made on a case by case basis.