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Background: Adding immunotherapy to first-line chemotherapy might improve outcomes for patients with advanced or recurrent endometrial cancer. We aimed to compare carboplatin and paclitaxel versus avelumab plus carboplatin and paclitaxel as first-line treatment with avelumab given concurrent to chemotherapy and as maintenance after the end of chemotherapy. Methods: MITO END-3 is an open-label, randomised, controlled, phase 2 trial conducted at 31 cancer institutes, hospitals, and universities in Italy. Eligible patients were aged 18 years or older with histologically confirmed advanced (FIGO stage III–IV) or recurrent endometrial cancer, an Eastern Cooperative Oncology Group (ECOG) performance status of 0–1, and no previous systemic anticancer therapy as primary treatment for advanced or metastatic disease. Participants were randomly assigned (1:1) using a computerised minimisation procedure stratified by centre, histology, and stage at study entry, to either receive carboplatin (area under the curve [AUC] 5 mg/mL × min) and paclitaxel (175 mg/m2; standard group) intravenously every 3 weeks for six to eight cycles or avelumab (10 mg/kg intravenously) added to carboplatin and paclitaxel (experimental group) every 3 weeks and then every 2 weeks as a single maintenance treatment after the end of chemotherapy until disease progression or unacceptable toxicity. Patients, treating clinicians, and those assessing radiological examinations were not masked to study treatment. The primary endpoint was investigator-assessed progression-free survival, measured in the intention-to-treat (ITT) population. Patients who received at least one dose of study drug were included in the safety analysis. Experimental group superiority was tested with 80% power and one-tailed α 0·20. This trial is registered with ClinicalTrials.gov (NCT03503786) and EudraCT (2016–004403–31). Findings: From April 9, 2018, to May 13, 2021, 166 women were assessed for eligibility and 39 were excluded. 125 eligible patients were randomly assigned to receive carboplatin and paclitaxel (n=62) or avelumab plus carboplatin and paclitaxel (n=63) and included in the ITT population. The median follow-up was 23·3 months (IQR 13·2–29·6) and was similar between the two groups. 91 progression-free survival events were reported, with 49 events in 62 patients in the standard group and 42 events in 63 patients in the experimental group. The median progression-free survival was 9·9 months (95% CI 6·7–12·1) in the standard group and 9·6 months (7·2–17·7) in the experimental group (HR of progression or death 0·78 [60% CI 0·65–0·93]; one-tailed p=0·085). Serious adverse events were reported more frequently in the experimental group (24 vs seven events in the standard group); neutrophil count decrease was the most frequent grade 3–4 adverse event (19 [31%] of 61 patients in the experimental group vs 26 [43%] of 61 patients in the standard group). Two deaths occurred in the experimental group during treatment (one respiratory failure following severe myositis [possibly related to treatment] and one cardiac arrest [not related to treatment]). Interpretation: Adding avelumab to first-line chemotherapy deserves further testing in patients with advanced or recurrent endometrial cancer, although consideration of mismatch repair status is warranted.

Purpose of ReviewPeripheral nervous system vasculitides (PNSV) are a heterogeneous group of disorders with a clinical subset that may differ in prognosis and therapy. We provide a comprehensive update on the clinical assessment, diagnosis, complications, treatment, and follow-up of PNSV.Recent FindingsProgress in neuroimaging, molecular testing, and peripheral nerve biopsy has improved clinical assessment and decision-making of PNSV, also providing novel insights on how to prevent misdiagnosis and increase diagnostic certainty. Advances in imaging techniques, allowing to clearly display the vessel walls, have also enhanced the possibility to differentiate inflammatory from non-inflammatory vascular lesions, while recent histopathology data have identified the main morphological criteria for more accurate diagnosis and differential diagnoses. Overall, the identification of peculiar morphological findings tends to improve diagnostic accuracy by defining a clearer boundary between systemic and non-systemic neuropathies. Therefore, the definition of epineurium vessel wall damage, type of vascular lesion, characterization of lymphocyte populations, antibodies, and inflammatory factors, as well as the identification of direct nerve damage or degeneration, are the common goals for pathologists and clinicians, who will both benefit for data integration and findings translation. Nevertheless, to date, treatment is still largely empiric and, in some cases, unsatisfactory, thus often precluding precise prognostic prediction. In this context, new diagnostic techniques and multidisciplinary management will be essential in the proper diagnosis and prompt management of PNSV, as highlighted in the present review.Thirty to fifty percent of all patients with vasculitis have signs of polyneuropathy. Neuropathies associated with systemic vasculitis are best managed according to the guidelines of the underlying disease because appropriate workup and initiation of treatment can reduce morbidity. Steroids, or in severe or progressive cases, cyclophosphamide pulse therapy is the standard therapy in non-systemic vasculitic neuropathies. Some patients need long-term immunosuppression. The use of novel technologies for high-throughput genotyping will permit to determine the genetic influence of related phenotypes in patients with PNSV.

Food waste is one of the main topics of various scientific studies of the last decade. In this regard, this work analyzed an essential oil (EO) extracted from the flavedo of Citrus aurantium ‘Crispifolia’ fruit. The analysis, performed by GC-MS, showed a chemically variegated chromatogram characterized by the presence of limonene (33.35%), but also by oxygenated monoterpenes such as β-linalool (7.69%), α-terpineol (7.06%), and geranyl acetate (10.12%). EO from the external part of the C. aurantium peel had several properties, including excellent antimicrobial and good antibiofilm activities. It also showed antioxidant activity in vitro and decreased the amount of cellular ROS, thus stimulating the catalytic activity of crucial enzymes involved in mitigating oxidative stress.

The study’s aims are to analyze the endorsement of the ethos of conflict (EoC )‎narrative in the Serbian-Albanian conflict among the adults in Serbia, its relation ‎to political conservatism, and its role in pushing conservative political action. A total of N = 1613 adults (aged 18+) were recruited for face-to-face interviewing, ‎in a representative sampling procedure, in December 2019 in Serbia.‎ The results show high endorsement of EoC in the Serbian-Albanian fray; the‎ mediation effect of EoC (having both high EoC and high conservatism is associated‎ with greater political activism); the relation between EoC and political‎ activism is moderated by age (the older population endorsing higher EoC‎ was more politically active). In the future, we should address more actively the‎ mobilizers of reactionary political actions in public and individual spheres, to‎ better understand the mechanisms for achieving long-term peace.‎

Shared strategies and correct information are essential to guide physicians in the management of such an uncommon disease as Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). A systematic review of the literature was performed to collect the most relevant evidence on BIA-ALCL reported cases. A panel of multidisciplinary experts discussed the scientific evidence on BIA-ALCL, and updated consensus recommendations were developed through the Delphi process. The lastest reported Italian incidence of BIA-ALCL is 3.5 per 100.000 implanted patients (95% CI, 1.36 to 5.78), and the disease counts over 1216 cases worldwide as of June 2022. The most common presentation symptom is a late onset seroma followed by a palpable breast mass. In the event of a suspicious case, ultrasound-guided fine-needle aspiration should be the first step in evaluation, followed by cytologic and immunohistochemical examination. In patients with confirmed diagnosis of BIA-ALCL confined to the capsule, the en-bloc capsulectomy should be performed, followed by immediate autologous reconstruction, while delayed reconstruction applies for disseminate disease or radically unresectable tumor. Nevertheless, a multidisciplinary team approach is essential for the correct management of this pathology.

Abstract Chest CT is a useful initial exam in patients with coronavirus disease 2019 (COVID-19) for assessing lung damage. AI-powered predictive models could be useful to better allocate resources in the midst of the pandemic. Our aim was to build a deep-learning (DL) model for COVID-19 outcome prediction inclusive of 3D chest CT images acquired at hospital admission. This retrospective multicentric study included 1051 patients (mean age 69, SD = 15) who presented to the emergency department of three different institutions between 20th March 2020 and 20th January 2021 with COVID-19 confirmed by real-time reverse transcriptase polymerase chain reaction (RT-PCR). Chest CT at hospital admission were evaluated by a 3D residual neural network algorithm. Training, internal validation, and external validation groups included 608, 153, and 290 patients, respectively. Images, clinical, and laboratory data were fed into different customizations of a dense neural network to choose the best performing architecture for the prediction of mortality, intubation, and intensive care unit (ICU) admission. The AI model tested on CT and clinical features displayed accuracy, sensitivity, specificity, and ROC-AUC, respectively, of 91.7%, 90.5%, 92.4%, and 95% for the prediction of patient’s mortality; 91.3%, 91.5%, 89.8%, and 95% for intubation; and 89.6%, 90.2%, 86.5%, and 94% for ICU admission (internal validation) in the testing cohort. The performance was lower in the validation cohort for mortality (71.7%, 55.6%, 74.8%, 72%), intubation (72.6%, 74.7%, 45.7%, 64%), and ICU admission (74.7%, 77%, 46%, 70%) prediction. The addition of the available laboratory data led to an increase in sensitivity for patient’s mortality (66%) and specificity for intubation and ICU admission (50%, 52%, respectively), while the other metrics maintained similar performance results. We present a deep-learning model to predict mortality, ICU admittance, and intubation in COVID-19 patients. Key Points • 3D CT-based deep learning model predicted the internal validation set with high accuracy, sensibility and specificity (> 90%) mortality, ICU admittance, and intubation in COVID-19 patients. • The model slightly increased prediction results when laboratory data were added to the analysis, despite data imbalance. However, the model accuracy dropped when CT images were not considered in the analysis, implying an important role of CT in predicting outcomes.

This brief background highlights Brazil as a 'climate-health hotspot', i.e. a country where climate affects local populations negatively through multiple pathways (Di Napoli et al. BMC Public Health 22(1):1-8, 2022). Knowledge gaps still need to be filled concerning the various climaterelated dimensions of tourism, vector-borne diseases, mortality and morbidity in urban centers in the country (Krüger et al. Int J Biometeorol 66(7):1297-1315, 2022). Motivated by this, the first Brazilian Symposium on Human Biometeorology (Simpósio Brasileiro de Biometeorologia Humana 2022) was organized and held at the Federal University of Rio Grande do Norte (UFRN) in Natal, northeastern Brazil, between July 4 and 8, 2022. The symposium was organized as a hybrid event by a committee composed of researchers acting in different regions of the country, and who had an ongoing research collaboration on matters related to human biometeorology. The event was partly sponsored by the ISB and partly self-supported by the organizers and institutions involved. The symposium aimed to promote the development of the research area on human biometeorology in Brazil in facing challenges imposed by a globally and locally changing climate. To achieve this, the symposium focused on five main topics of discussion: a) climate-driven diseases; b) thermal comfort, urban and architectural biometeorology; c) atmospheric pollution and health; d) climate change; e) climate, health and climate change. This summary highlights the main findings, future research directions, and policy implications in each topic from the presentations and panel discussions.

A new therapeutic class of oral agents firstly used for the treatment of type 2 diabetes mellitus is represented by gliflozines or sodium-glucose co-transporter 2 (SGLT2) inhibitors. SGLT2 inhibitors might be effective alone or in combination with any other drugs. This therapeutic class currently includes five agents: canagliflozin, dapagliflozin, empagliflozin, ertugliflozin, and sotagliflozin. SGLT2 inhibitors prevent the renal reabsorption of filtered glucose and sodium by blocking the SGLT2 co-transporters in the proximal convoluted renal tubule, facilitating glucose excretion in the urine (glycosuria) and lowering blood glucose levels. SGLT2 inhibitors have also shown to have pleiotropic effects and determine cardiovascular and renal prevention, thus leading to an extension of their therapeutic indication to include the heart failure. Despite their clinical benefits, warnings about adverse events have been implemented by Regulatory Agencies in the product's information since their introduction to the market. In particular, SGLT2 inhibitors have shown a strong impact on a high number of risk factors. They can cause hypoglycaemia, hypotension, lower limb amputation, fractures, genito-urinary infections, and diabetic ketoacidosis with different frequencies of onset. Despite some of these events are rare, they can lead to serious and dangerous complications, highlighting the importance of a strict monitoring of patients. Overall, SLGT-2 inhibitors are effective antidiabetic drugs with favorable advantages in renal and cardiovascular protection, and with a generally well-tolerated safety profile. This review aims to summarize the safety profile of SGLT2 inhibitors available in the market.

Background and purpose: Clinical outcomes of multiple sclerosis (MS) patients affected by coronavirus disease 2019 (COVID-19) have been thoroughly investigated, but a further analysis on main signs and symptoms and their risk factors still needs attention. The objective of this study was to group together and describe based on similarity the most common signs and symptoms of COVID-19 in MS patients and identify all factors associated with their manifestation. Method: Logistic and linear regression models were run to recognize factors associated with each pooled group of symptoms and their total number. Results: From March 2020 to November 2021, data were collected from 1354 MS patients with confirmed infection of COVID-19. Ageusia and anosmia was less frequent in older people (odds ratio [OR] 0.98; p=0.005) and more in smoker patients (OR 1.39; p=0.049). Smoke was also associated with an incremental number of symptoms (OR 1.24; p=0.031), substance abuse (drugs or alcohol), conjunctivitis and rash (OR 5.20; p=0.042) and the presence of at least one comorbidity with shortness of breath, tachycardia or chest pain (OR 1.24; p=0.008). Some disease-modifying therapies were associated with greater frequencies of certain COVID-19 symptoms (association between anti-CD20 therapies and increment in the number of concomitant symptoms: OR 1.29; p=0.05). Differences in frequencies between the three waves were found for flu-like symptoms (G1, p=0.024), joint or muscle pain (G2, p=0.013) and ageusia and anosmia (G5, p < 0.001). All cases should be referred to variants up to Delta. Conclusion: Several factors along with the choice of specific therapeutic approaches might have a different impact on the occurrence of some COVID-19 symptoms.

Malaria is caused by the protozoan Plasmodium and its infection can occur in several ways, being the most common through the bite of the female mosquito Anopheles darlingi. The life cycle of the vector is related to the dynamics of the ecosystem, situations such as global warming generate a great concern regarding the possible amplification of the reproduction capacity of vectors according to climate change. These diseases are much more frequent in regions where the climate is tropical, such as Brazil. The incidence of the vector is characterized by several factors, such as biological, ecological, sociopolitical, cultural, and economic factors, the latter influence health expenditures in Brazil regarding the preventive measures of infection. The economic impact includes expenses with any health care, lost service days, loss of classes in the education system, as well as lower income at work due to brain injuries, among others. Malaria breeds poverty and poverty breeds Malaria. Through the Factorial Planning method: A brief review, data were collected in all Brazilian regions affected by the disease. The research strategy consisted of the use of the keywords in English: 1. Climate Change in Brazil; 2. Anopheles Darlingi vector life cycle; 3. Impact of climate change on the life cycle of Anopheles Darlingi; 4. Sensitive socioeconomic factors. Finally, this set of data suggests that public health programs act strategically in the population conjuncture, on the fronts of prevention, diagnosis, and treatment of the disease.

In this paper, we consider minimizers of integral functionals of the type $$\begin{aligned} {\mathcal {F}}(u) := \int _\Omega \big [\tfrac{1}{p} \big (|Du|-1)^p_+ + f\cdot u\big ]\mathrm {d}x\nonumber \end{aligned}$$ F ( u ) : = ∫ Ω [ 1 p ( | D u | - 1 ) + p + f · u ] d x for $$p>1$$ p > 1 in the vectorial case of mappings $$u:{\mathbb {R}}^n\supset \Omega \rightarrow {\mathbb {R}}^N$$ u : R n ⊃ Ω → R N with $$N\ge 1$$ N ≥ 1 . Assuming that f belongs to $$L^{n+\sigma }$$ L n + σ for some $$\sigma >0$$ σ > 0 , we prove that $${\mathcal {H}}(Du)$$ H ( D u ) is continuous in $$\Omega $$ Ω for any continuous function $${\mathcal {H}}:{\mathbb {R}}^{Nn}\rightarrow {\mathbb {R}}^{Nn}$$ H : R Nn → R Nn vanishing on $$\{\xi \in {\mathbb {R}}^{Nn} : |\xi |\le 1\}$$ { ξ ∈ R Nn : | ξ | ≤ 1 } . This extends previous results of Santambrogio and Vespri (Nonlinear Anal 73:3832–3841, 2010) when $$n=2$$ n = 2 , and Colombo and Figalli (J Math Pures Appl (9) 101(1):94–117, 2014) for $$n\ge 2$$ n ≥ 2 , to the vectorial case $$N\ge 1$$ N ≥ 1 .

The study presents the Italian adaptation of the Personal and General Belief in a Just World (P-BJW and G-BJW) Scales. Dalbert and colleagues developed these scales to capture the belief in a just world for oneself and a just world in general. After the translation and back-translation, the P-BJW and G-BJW scales were administered first to a pilot sample of 213 university students and then to a national sample of 2683 Italian people. Results showed that it was necessary to make some revisions to the predicted two correlated factor structure. These changes entailed correlating the error terms for some manifest variables and removing the first item of the P-BJW factor. The final structure of the P-BJW and G-BJW scales presented satisfactory indexes of model fit as well as high reliability and moderate validity values. Additionally, this structure proved to fit the data better than an alternative one-factor or a bi-factor model with two orthogonal-specific factors. As predicted, well-being strongly predicted scores on the BJW, but age and gender did not. Multigroup comparisons among Northern, Central, and Southern Italy respondents indicated that Italian people interpret scale items equivalently, regardless of their geographical location. Introducing the P-BJW and G-BJW scales to the Italian justice scholarship is very useful to unpack the reasons why Italy reports lower levels of social justice than other European countries and also to investigate the link between justice, well-being, and other socio-psychological variables.

This study was to compare the incidence and clinical outcomes of SARS-CoV-2 infection between Italian and non-Italian nationals.We retrospectively analysed data from the COVID-19 Italian integrated surveillance system (14 September 2020 to 17 October 2021).We used multivariable Cox proportional hazards models to estimate the hazard ratio (HR) of infection and, among cases, the HRs of death, hospitalisation and subsequent admission to intensive care unit in non-Italian nationals relative to Italian nationals. Estimates were adjusted for differences in sociodemographic characteristics and in the week and region of diagnosis.Of 4,111,067 notified cases, 336,265 (8.2%) were non-Italian nationals. Compared with Italian nationals, non-Italians showed a lower incidence of SARS-CoV-2 infection (HR = 0.81, 95% confidence interval [CI]: 0.80-0.81). However, once diagnosed, they were more likely to be hospitalised (HR = 1.90, 95% CI: 1.87-1.92) and then admitted to intensive care unit (HR = 1.08, 95% CI: 1.04-1.13), with differences larger in those coming from countries with a lower human development index. Compared with Italian cases, an increased rate of death was observed in non-Italian cases from low-human development index countries (HR = 1.41, 95% CI: 1.23-1.62). The HRs of SARS-CoV-2 infection and severe outcomes slightly increased after the start of the vaccination campaign.Underdiagnosis and delayed diagnosis in non-Italian nationals could explain their lower incidence compared with Italians and, among cases, their higher probability to present clinical conditions leading to worse outcomes. Facilitating early access to vaccination, diagnosis and treatment would improve the control of SARS-CoV-2 transmission and health outcomes in this vulnerable group.

Tamarind has a good nutritional composition, presenting good values of proteins, carbohydrates, dietary fibers, calcium, and low lipid and cholesterol content. The germination pattern of tamarind seeds is like that of other legume species, in which the hard integument interferes in the absorption of water and oxygen thus limiting germination. Therefore, this study aimed to evaluate the viability and vigor of tamarind seeds submitted to different extraction methods. The extraction methods for seed removal were washing in running water with the aid of a knife, washing in running water with the aid of a sieve, blender, fermentation for 48h with 66.6% water + 33.3% sugar, fermentation for 48h with 50% water + 50% sugar and fermentation only with water for 72h.

Cagaita seeds quickly lose their germination power when stored in the natural environmental conditions of the Cerrado. Like most native Cerrado species, data on more favorable seed viability conservation conditions are still quite scarce. The experiment was carried out in the greenhouse of the Federal Institute of Education, Science and Technology of the Tocantins in the city of Gurupi - TO, between November 5, 2019, and March 7, 2020. Cagaita seeds (Eugenia dysenterica DC.) were used to perform it. The treatments applied to the seeds consisted of five sowing times, at intervals of three days. In general, the evaluated characteristics showed sensitivity by indicating differences between sowing times, where the highest values, root, and shoot length were obtained when the seeds were sown on 11/05/2019 (12.8 cm; 10.2 cm), respectively, and lower at sowing of 11/17/2019 (7.8 cm; 7.0 cm), respectively. The values obtained from the first emergency count allowed us to differentiate the sowing times at vigor levels, they were influenced by the sowing times. Cagaita seeds, sowing soon after fruit collection, showed higher viability and vigor.

Daucus is a genus of economically important plants belonging to Apiaceae family spread in temperate regions. Species of this genus are used as food and several biological properties have reported. The chemical composition of the essential oils from different organs (roots, stems and flowers) of Daucus carota subsp. maximus, a species not previously investigated, was analyzed by GC-MS. Our results showed the presence of β-phellandrene as the most abundant component of stems and flowers and of γ-terpinene as a major compound of the oil from the roots. Flower essential oil caused a greater increase in the activity of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX) in polymorphonuclear leukocytes (PMN) cells compared to stem and root essential oils. The antimicrobial activity of the flower and stem oil were more effective, compared to root oil, against Escherichia coli and Staphylococcus aureus.

Background and purpose Some studies have shown that air pollution, often assessed by thin particulate matter with diameter below 2.5 µg/m3 (PM2.5), may contribute to severe COVID‐19 courses, as well as play a role in the onset and evolution of multiple sclerosis (MS). However, the impact of air pollution on COVID‐19 has never been explored specifically amongst patients with MS (PwMS). This retrospective observational study aims to explore associations between PM2.5 and COVID‐19 severity amongst PwMS. Methods Data were retrieved from an Italian web‐based platform (MuSC‐19) which includes PwMS with COVID‐19. PM2.5 2016–2018 average concentrations were provided by the Copernicus Atmospheric Monitoring Service. Italian patients inserted in the platform from 15 January 2020 to 9 April 2021 with a COVID‐19 positive test were included. Ordered logistic regression models were used to study associations between PM2.5 and COVID‐19 severity. Results In all, 1087 patients, of whom 13% required hospitalization and 2% were admitted to an intensive care unit or died, were included. Based on the multivariate analysis, higher concentrations of PM2.5 increased the risk of worse COVID‐19 course (odds ratio 1.90; p = 0.009). Conclusions Even if several other factors explain the unfavourable course of COVID‐19 in PwMS, the role of air pollutants must be considered and further investigated., Air pollution, often assessed by particulate matter with diameter below 2.5 µg/m3, may contribute to severe COVID‐19 courses. 1087 patients were included, of whom 13% required hospitalization and 2% were admitted to an intensive care unit or died. Even if several other factors explain the unfavourable course of COVID‐19 in patients with multiple sclerosis, the role of air pollutants must be considered and further investigated.

IntroductionAssessing the response to vaccinations is one of the diagnostic criteria for Common Variable Immune Deficiencies (CVIDs). Vaccination against SARS-CoV-2 offered the unique opportunity to analyze the immune response to a novel antigen. We identify four CVIDs phenotype clusters by the integration of immune parameters after BTN162b2 boosters.MethodsWe performed a longitudinal study on 47 CVIDs patients who received the 3rd and 4th vaccine dose of the BNT162b2 vaccine measuring the generation of immunological memory. We analyzed specific and neutralizing antibodies, spike-specific memory B cells, and functional T cells.ResultsWe found that, depending on the readout of vaccine efficacy, the frequency of responders changes. Although 63.8% of the patients have specific antibodies in the serum, only 30% have high-affinity specific memory B cells and generate recall responses.DiscussionThanks to the integration of our data, we identified four functional groups of CVIDs patients with different B cell phenotypes, T cell functions, and clinical diseases. The presence of antibodies alone is not sufficient to demonstrate the establishment of immune memory and the measurement of the in-vivo response to vaccination distinguishes patients with different immunological defects and clinical diseases.

This work describes the effects of waves on the hydroelastic response of a hydrofoil in fully wetted and ventilated flows. In the absence of vaporous cavitation (described in Part 2 of this paper series), shallow long-period non-breaking waves delayed ventilation inception because velocity fluctuations prevent the formation of a stably separated region of flow at the foil's leading edge. Aerated von Kármán vortex shedding occurred from the blunt trailing edge, producing vortex-induced vibration of the hydrofoil at a near-constant Strouhal number. Regular waves led to near sinusoidal oscillations of the load and deformations at the wave encounter frequency, while the mean response and the dynamic response at other frequency peaks corresponding to hydrodynamic and structural modes remained mostly unaffected. Significant dynamic load amplification was observed at a submerged aspect ratio of 2 for cases with low angles of attack because of coalescence between the second and third wetted structural modes; at high angles of attack, the amplitude of the load fluctuations and flow-induced vibrations reduced because energy was diverted away from the coalescence frequencies to the nearby vortex shedding frequency. In both calm water and wave conditions, transition from fully wetted to fully ventilated flow resulted in sudden and significant reduction in the load coefficients, as well as foil deflections. An impulse-like signature was observed in the time-frequency spectra during these transitions. In many of the cases, transition to fully ventilated flow also led to substantially reduced amplitudes in the load and deformation fluctuations.

In recent decades, developing countries have experienced an increase in the impact of natural disasters due to ongoing climate change and the sustained expansion of urban areas. The intrinsic vulnerability of settlements, due to poverty and poor governance, as well as the lack of tools for urban occupation planning and mitigation protocols, has made such impacts particularly severe. Cuenca (Ecuador) is a significant example of a city that in recent decades has experienced considerable population growth (i.e. exposure) and an associated increase in loss due to landslide occurrence. Despite such effects, updated urban planning tools are absent, so an evaluation of multitemporal exposure to landslides and related risks is required. In this perspective, a potential urban planning tool is presented based on updated data depicting the spatial distribution of landslides and their predisposing factors, as well as population change between 2010 and 2020. In addition, a multitemporal analysis accounting for changes in exposure between 2010 and 2020 and an estimation of relative landside risk was carried out. Due to the absence of spatially distributed population data, energy supply contract data have been used as a proxy of the population. The results show that the current higher exposure and related relative risk are estimated for parishes (parroquias) located in the southern sector of the study area (i.e. Turi, Santa Ana, Tarqui, Nulti, Baños and Paccha). Moreover, the exposure multitemporal analysis indicates that most parishes located in the hilly areas bounding the city centre (i.e. Sayausi, San Joaquin, Tarqui, Sidcay, Baños, Ricaurte, Paccha and Chiquintad) are experiencing sustained population growth and will be potentially exposed to an increased risk with a consistently growing trend. The obtained relative risk map can be considered a valuable tool for guiding land planning, land management, occupation restriction and early warning strategy adoption in the area. The methodological approach used, which accounts for landslide susceptibility and population variation through proxy data analysis, has the potential to be applied in a similar context of growing population cities in low- to mid-income countries, where data usually needed for a comprehensive landslide risk analysis are non-existing or only partially available.

Background During the COVID-19 pandemic, migrants arriving in host countries irregularly have not infrequently been perceived as increasing the COVID-19 burden. Italy is a transit and destination country for migrants who cross the Central Mediterranean route and, during the pandemic, all migrants who landed on Italian shores were COVID-19 tested and quarantined. Our study aimed to investigate the impact of the SARS-CoV-2 infection among migrants who landed on the Italian coasts by analyzing both incidence and health outcomes. Methods A retrospective observational study has been designed. The population of interest was represented by 70,512 migrants (91% male, 99% Results 2,861 migrants out of those landed in Italy during the observation period tested positive, with an incidence rate of 40.6 (39.1–42.1) cases per 1,000. During the same period, 177.6 (177.5-177.8) cases per 1,000 were reported in the resident population, with an IRR of 0.23 (0.22–0.24). 89.7% of cases were male and 54.6% belonged to the 20–29 age group. 99% of cases reported no symptoms, no relevant comorbidities were reported and no cases were hospitalized. Conclusions Our study found a low rate of SARS-CoV-2 infection in migrants reaching Italy by sea with an incidence rate that is roughly a quarter of that of the resident population. Thus, irregular migrants who arrived in Italy during the observation period did not increase the COVID-19 burden. Further studies are needed to investigate possible reasons for the low incidence observed in this population.

We consider weak solutions $(u,\pi ):{\Omega }\to \mathbb {R}^{n}\times \mathbb {R}$ ( u , π ) : Ω → ℝ n × ℝ to stationary ϕ-Navier-Stokes systems of the type $ \left \{ \begin {array}{ll} -\mathrm {div~} a(x,\mathcal {E} u)+\nabla \pi +[Du]u=f \\ \mathrm {div~} u=0 \end {array} \right . $ − div a ( x , E u ) + ∇ π + [ D u ] u = f div u = 0 in ${\Omega }\subset \mathbb {R}^{n}$ Ω ⊂ ℝ n , and to the corresponding ϕ-Stokes systems, in which the convective term [Du]u does not appear. In the above system, the function a(x,ξ) depends Hölder continuously on x and satisfies growth conditions with respect to the second variable expressed through a Young function ϕ. The notation $\mathcal {E} u$ E u is used for the symmetric part of the gradient Du. We prove results on the fractional higher differentiability of both the symmetric part of the gradient $\mathcal {E} u$ E u and of the pressure π.

In June 2021, an unprecedented extreme heatwave impacted the Pacific Northwest of North America, resulting in more than 1000 excess deaths and affecting infrastructure and wildlife. Predicting such extreme events is key for preparedness and early action, and beyond temperature, it is important to consider biometeorological forecasts, accounting for the effects of the environment on the human body. The performance of ECMWF's (the European Centre for Medium-Range Weather Forecasts) temperature and heat stress (Humidex and the Universal Thermal Climate Index) forecasts during this heatwave is explored, and highlights that several days in advance, an event surpassing the maximum of climatology was predicted with extremely high confidence (100% of ensemble members) – successfully predicting the unprecedented.

Forty years (1980–2019) of reanalysis data were used to investigate climatology and trends of heat stress in the Caribbean region. Represented via the Universal Thermal Climate Index (UTCI), a multivariate thermophysiological-relevant parameter, the highest heat stress is found to be most frequent and geographically widespread during the rainy season (August, September, and October). UTCI trends indicate an increase of more than 0.2°C·decade−1, with southern Florida and the Lesser Antilles witnessing the greatest upward rates (0.45°C·decade−1). Correlations with climate variables known to induce heat stress reveal that the increase in heat stress is driven by increases in air temperature and radiation, and decreases in wind speed. Conditions of heat danger, as depicted by the heat index (HI), have intensified since 1980 (+1.2°C) and are found to occur simultaneously to conditions of heat stress suggesting a synergy between heat illnesses and physiological responses to heat. This work also includes the analysis of the record-breaking 2020 heat season during which the UTCI and HI achieved above average values, indicating that local populations most likely experienced heat stress and danger higher than the ones they are used to. These findings confirm the gradual intensification of heat stress in the Caribbean and aim to provide a guidance for heat-related policies in the region.

In cancer patients undergoing surgery, tumor biology and anticancer treatments can increase the risk of perioperative bleeding and blood transfusions. Notably, blood transfusions can be potentially associated with an increased risk of life-threatening immune responses, acute lung injury, postoperative infections, and thromboembolism. Moreover, the link between perioperative transfusion and increased risk of cancer recurrence cannot be excluded. On the other hand, cancer patients have an increased risk of thromboembolism due to cancer itself and antineoplastic systemic treatments including chemotherapy and anti-angiogenic drugs. In this complex scenario, effective and safe strategies aimed at the prevention of blood transfusions are warranted. This narrative review addresses the efficacy, and the safety of the synthetic antifibrinolytic agent tranexamic acid (TXA) when used perioperatively in cancer surgery. Although in not oncologic surgery the use of TXA has been extensively studied, in the setting of cancer patients requiring surgery, the evidence is scarce. An overview of the ongoing clinical research is also provided.

This issue serves as a companion piece to a previous JPIC publication (

With the increase in agriculture in the state of Tocantins, especially with soybean cultivation, areas with concrete have been increasingly applied to high doses of limestone, although they do not know the dynamics of the reaction of these correctives in the soil conditions of Tocantins. For the study, soil with different soil/gravel ratio and 01:02, 01:05 and 1:10 proportions of fine ground/gravel were used. The incubation assay was installed under a greenhouse in a completely randomized experimental project. The 15 treatments were obtained in a 3x5 factorial scheme, combining three fine ground/gravel (01:02, 01:05 and 01:10) and five limestones (0; 1.0; 2.0; 4, 0 and 6.0 t ha−1). The soils were prepared as TFSA and sent to the soil laboratory for analysis of Ca + Mg, Ca, Al, potential acidity (H + Al) and pH. Al levels and potential acidity (H + Al) were reduced and Ca and Ca + Mg contents were significantly increased with the increase of the limestone dose in gravel ratios. The pH of the 1:5 ratio decreased until reaching its lowest value at the dose of 3.31 t ha−1, increasing the dose rate greater than 3.31 t ha−1. The pHs of ratio 1:2 and 1:10 increased as the limestone dose increased. Ca, Ca + Mg levels and pH value are already at adequate levels in 0t ha-1dose of limestone, and it is not necessary to recommend correctives for gravel relations.

Nematodes can damage and cause significant suppression in soybean productivity (Glycine max) directly because of their migration and feeding activities, or indirectly as partners in disease complexes with other organisms. Several cultural practices have been investigated as possible management strategies for nematodes, including manipulation of planting season, soil preparation, and cultivars with higher resistance levels than currently available. This literature review shows that gall nematodes (Meloidogyne spp.) significantly reduce soybean productivity [Glycine max (L.) Merr.] in the Brazilian cerrado. The most important pathogenic nematodes of soybean, worldwide, are the soybean cyst nematode, Heterodera glycines, and some of the gall nematodes, Meloidogyne spp. Currently, different management methods are necessary, being chemical, biological, and cultural to obtain maximum efficiency in the control of this pest.

Nitrogen when applied to the surface, suffers losses by volatilization. Therefore, one of the ways to reduce this loss is to use substances that delay the hydrolysis of NH3. The objective of this study was to evaluate the physiological characteristics of Mombasa grass as a function of nitrogen sources associated or not with volatilization inhibitors (ASP4) and nitrification (CTN). The experiment was conducted in a greenhouse, UFT - Gurupi, in DBC, with six treatments and five replications, being: SN1 - Sulfammo without ASP4; SN3 - Sulfammo + 6kg/ton of ASP4; NC1 - Sulfammo + CTN without ASP4; NC3 - Sulfammo + CTN + 6kg/ton of ASP4, URE - Urea and control without nitrogen. It is note point that all treatments received 100 kg ha-1 of N. The following parameters were evaluated: Chlorophyll A, Chlorophyll B, Total Chlorophyll, internal CO2 concentration, transpiration rate, stomatic conductance, CO2 assimilation rates, water use efficiency, and instantaneous efficiency of ribulose enzyme (RUBI) carboxylation Data were analyzed by MANOVA, using the main component technique (PCA) using the R® 3.5 software. According to the PCA scores, the productive characteristics are CloB; CloA; CloTO. ASSI, RUBI showed the highest variations, all positive, both in PC1 and PC2. The treatments that most influenced the characteristics were NC1 and NC3, demonstrating an inverse tendency to the controls. Crop development was significantly influenced by urea and sources with and without inhibitors.

Watermelon is one of the most consumed cucurbits worldwide. Its production, nevertheless, is threatened by different pathogens that compromise the development of plants and, consequently, fruits. Here, plants showing typical virus-like symptoms were collected in the Tocantins State, Brazil. Aiming for the identification of viruses, viral RNA was sequenced by Illumina. Four virus genomes were sequenced and assembled, corresponding to isolates of Papaya ringspot virus (PRSV) and Zucchini Yellow Mosaic Virus (ZYMV) from the family Potyviridae, Groundnut ringspot virus (GRSV) from the family Bunyaviridae, and Citrullus lanatus partitivirus (CiLPV) from family Partitiviridae. Although these viruses have been previously reported infecting watermelon, we have sequenced the first complete genome of GRSV and the first complete genome of a ZYMV isolate from Brazil. Symptomatic watermelon leaves from the field were also used as inoculation for virus mechanical transmission to indicative plants. Despite co-infecting watermelon plants in the field, only the potyviruses were mechanically transmitted to indicative plants, in which ZYMV presented the broadest host range.

Many of the UNESCO World Heritage Sites face geological threats which could have negative effects on the value, integrity and accessibility of their heritage assets. A relevant example is the Derwent Valley Mills UNESCO World Heritage site, one of the key sites of Britain's industrial revolution of the 18th century and located along the Derwent River Valley. Individual susceptibility scenarios of natural hazards in the area like collapsible deposits, compressible ground, debris flow, landslide, running sands, shrink-swell, soluble rock and flooding (both riverine and groundwater) are available, but a comprehensive product able to support disaster mitigation measurement and land planning still does not exist. On this basis, a multi-hazard susceptibility analysis was completed with the added benefit of reducing the complexity and providing a methodological framework for multi-hazard estimation. The analysis was completed in a GIS environment through an Analytical Hierarchy Process (AHP) multicriteria decision-making process. Since the AHP method is affected by a user selection bias, a quantitative Relative significance index was derived to rank the AHP factors during the susceptibility estimation. This index suggests that flooding is the principal natural hazard for the Derwent Valley Mills UNESCO World Heritage site. The multi-hazard susceptibility map also indicates that most of the areas where the mills are located are subject to significant susceptibility to natural hazards.

We establish the local Lipschitz continuity and the higher differentiability of vector-valued local minimizers of a class of energy integrals of the Calculus of Variations. The main novelty is that we deal with possibly degenerate energy densities with respect to the 𝑥-variable.

In the lungs, asbestos develops an Fe-rich coating (Asbestos Body, AB) that becomes the actual interface between the foreign fibers and the host organism. Conventional approaches to study ABs require an invasive sample preparation that can alter them. In this work, a novel combination of x-ray tomography and spectroscopy allowed studying unaltered lung tissue samples with chrysotile and crocidolite asbestos. The thickness and mass density maps of the ABs obtained by x-ray tomography were used to derive a truly quantitative elemental analysis from scanning x-ray fluorescence spectroscopy data. The average mass density of the ABs is compatible with that of highly loaded ferritin, or hemosiderin. The composition of all ABs analyzed was similar, with only minor differences in the relative elemental fractions. Silicon concentration decreased in the core-to-rim direction, indicating a possible partial dissolution of the inner fiber. The Fe content in the ABs was higher than that possibly contained in chrysotile and crocidolite. This finding opens two opposite scenarios, the first with Fe coming from the fiber bulk and concentrating on the surface as long as the fiber dissolves, the second where the Fe that takes part to the formation of the AB originates from the host organism Fe-pool.

Capillary leak syndrome (CLS) emerged as new adverse event after immunization (AEFI) associated to COVID-19 vaccination. CLS is a rare condition characterized by increased capillary permeability, resulting in hypoalbuminemia, hypotension, and edema mainly in the upper and lower limbs. Our pharmacovigilance study aims to evaluate the CLS onset following receipt of COVID-19 mRNA vaccines (mRNA-1273 and BNT162b2) compared to viral vector vaccines (Ad26.COV2-S and ChAdOx1-SARS-COV-2). We carried a cross-sectional study using all Individual Case Safety Reports (ICSRs) reporting a COVID-19 vaccine as suspected drug and CLS as AEFI, which were collected in the pharmacovigilance database EudraVigilance from January 1st, 2021, to January 14th, 2022. We applied the Reporting Odds Ratio (ROR) 95% CI for the disproportionality analysis. During our study period, CLS was described as AEFI in 84 out of 1,357,962 ICRs reporting a vaccine COVID-19 as suspected drug and collected in the EV database. Overall, the ICSR reported by CLS were mainly related to the viral vector COVID-19(ChAdOx1-SARS-COV-2 = 36; Ad26.COV2-S = 9). The mRNA COVID-19 vaccines were reported in 39 ICSRs (BNT162b2 =33; mRNA-1273 =6). Majority of ICSRs were reported by healthcare professionals (71.4%). Majority of the patients were adult (58.3%) and the female gender accounted in more than 65% of ICSRs referred both to classes vaccines. In particular, women were more represented in ICSRs referred to mRNA-1273 (83.3%) and to ChAdOx1-SARS-COV-2 (72.2%). The CLS outcome was more frequently favorable in mRNA ICSRs (33,3%) than the viral vector ones (13.3%). Among the ICSRs reporting CLS with unfavorable outcome, we found also 9 fatal cases (BNT162b2 = 1; ChAdOx1-SARS-COV-2 = 4; Ad26.COV2-S = 4). From disproportionality analysis emerged a lower CLS reporting probability after vaccination with mRNA vaccines compared to viral vector-based ones (ROR 0.5, 95% CI 0.3–0.7; p

Soybean is one of the most important crops globally, despite significant numbers the crop in the Cerrado biome presents low natural fertility with a higher demand for fertilization. Seeking to improve the production of culture by reducing costs there is the possibility of using organic waste, which can be a very advantageous and interesting option when well used. The objective of this work was to evaluate the physiological, nutritional, and productive aspects of soybean crops grown with cattle manure associated with chemical fertilizers. The experimental design was in randomized blocks with eight replications (4 for destructive analyses and 4 for grain harvesting). The treatments were composed of 5 doses of cattle manure (0.0, 2.5, 5.0, 10.0, and 20.0 t ha-1) and control treatment (Control) without fertilization, without the use of manure and mineral fertilizer. The cattle manure provided a positive increase in the increase of levels of Ca, Mg, M.O, P, K, Fe, Zn and in the characteristics of plant height, stem diameter, soybean node number, dry weight of shoot, Falker chlorophyll index, root length and dry weight of root. The dose of 20.0 t ha-1 was the best response dose for soil nutritional conditioning for both physical and chemical characteristics, with an average increase of 68.26% in a comparison with only the use of conventional mineral fertilization.

The white Guava (Psidium guajava L.) is a native fruit tree belonging to the family Myrtaceae, which has a lot of rusticity, adapting to various edaphoclimatic conditions. White Guava is a fruit native to tropical America and the most cultivated species of the Myrtaceae family. It is an excellent source of vitamin C and has an appreciable amount of minerals such as calcium, phosphorus, and iron. The objective of this work was to determine the viability and vigor of white guava seeds at different stages of fruit maturation. The experiment was carried out in the greenhouse of the Federal Institute of Education (IFTO), Science and Technology of Tocantins, in the city of Gurupi – Tocantins - Brazil, between February 17 and July 28, 2020. The white guava seeds collected directly from the fruit were used, which were harvested in the urban region of Gurupi – Tocantins - Brazil in February 2020. Root and shoot length, number of leaves, first emergency count, and seedling emergence were evaluated. White Guava seeds, taken from ripe fruits, provided the highest viability and vigor values.

The socio-economic importance of pitomba fruits in the North and Northeast regions is a concrete fact, however, the commercialized fruits are still acquired from extractivism and cultivation in backyards without any use of technology aimed at their production. The experiment was carried out in the greenhouse of the Federal Institute of Education, Science and Technology of Tocantins in the city of Gurupi - TO, between February 14 and June 2, 2019. The treatments applied to the seeds consisted of two stages of fruit maturation, which were classified as: ripe fruits collected in the plant with light brown peel color and ripe fruits collected on the ground with dark brown peel coloration. The substrates used were: Black Soil; Washed Sand; Commercial Substrate; Black Soil + Washed Sand + Humus; Sawdust Powder + Washed Sand + Commercial Substrate. The highest physiological quality was obtained from the seeds taken from the ripe fruits harvested in the plant, where the highest values, ripe fruits harvested in the plant and ripe fruits harvested from the ground, were obtained when the seeds were sowed in the substrates Sawdust Powder + Washed Sand + Commercial Substrate (92%; 70%), (97%; 73%) and Washed Sand substrate (84%; 67%), (90%; 65%) respectively, and lower on the substrate Black Soil (54%; 50%) and (60%; 60%), respectively. The pitomba seeds, removed from the ripe fruits harvested in the plant, sowing on the substrates: Sawdust Powder + Washed Sand + Commercial Substrate and Washed Sand, showed greater vigor and viability.

Purpose The authors’ purpose was to create a valid multiparametric MRI model for the differential diagnosis between glioblastoma and solitary brain metastasis. Materials and methods Forty-one patients (twenty glioblastomas and twenty-one brain metastases) were retrospectively evaluated. MRIs were analyzed with Olea Sphere® 3.0. Lesions’ volumes of interest (VOIs) were drawn on enhanced 3D T1 MP-RAGE and projected on ADC and rCBV co-registered maps. Another two VOIs were drawn in the region of hyperintense cerebral edema, surrounding the lesion, respectively, within 5 mm around the enhancing tumor and into residual edema. Perfusion curves were obtained, and the value of signal recovery (SR) was reported. A two-sample T test was obtained to compare all parameters of GB and BM groups. Receiver operating characteristics (ROC) analysis was performed. Results According to ROC analysis, the area under the curve was 88%, 78% and 74%, respectively, for mean ADC VOI values of the solid component, the mean and max rCBV values in the perilesional edema and the PSR. The cumulative ROC curve of these parameters reached an area under the curve of 95%. Using perilesional max rCBV > 1.37, PSR > 75% and mean lesional ADC −3 mm2 s−1 GB could be differentiated from solitary BM (sensitivity and specificity of 95% and 86%). Conclusion Lower values of ADC in the enhancing tumor, a higher percentage of SR in perfusion curves and higher values of rCBV in the peritumoral edema closed to the lesion are strongly indicative of GB than solitary BM.

Background . In the last decades some studies observed a moderate progressive decrease in short-term mortality in incident hemodialysis patients. The aim of the study is to analyse the mortality trends in patients starting hemodialysis using the Lazio Regional Dialysis and Transplant Registry. Methods . Patients who started chronic hemodialysis between 2008 and 2016 were included. Annual 1-year and 3-year Crude Mortality Rate*100 Person Years (CMR*100PY) overall, by gender and age classes were calculated. Cumulative survival estimates at 1 year and 3 years since the date of starting hemodialysis were presented as Kaplan-Meier curves for the three periods and compared using the log-rank test. The association between periods of incidence in hemodialysis and 1-year and 3-year mortality were investigated by means of unadjusted and adjusted Cox regression models. Potential determinants of both mortality outcomes were also investigated. Results . Among 6,997 hemodialysis patients (64.5% males, 66.1% over 65 years old) 923 died within 1 year and 2,253 within 3 years form incidence; CMR*100PY were 14.1 (95%CI: 13.2–15.0) and 13.7 (95%CI: 13.2–14.3), respectively; both remained unchanged over the years. Even after stratification by gender and age classes no significant changes emerged. Kaplan-Meier mortality curves did not show any statistically significant differences in survival at 1 year and 3 years from hemodialysis incidence across periods. No statistically significant associations were found between periods and 1-year and 3-year mortality. Factors associated with a greater increase in mortality are: being over 65 years, born in Italy, not being self-sufficient, having systemic versus undetermined nephropathy, having heart disease, peripheral vascular disease, cancer, liver disease, dementia and psychiatric illness, and receiving dialysis by catheter rather than fistula. Conclusions . The study shows that the mortality rate in patients with end-stage renal disease starting hemodialysis in the Lazio region was stable over 9 years.

ObjectivesThis study aimed to evaluate the differences in incidence, non-intensive care unit (non-ICU) and intensive care unit (ICU) hospital admissions, and COVID-19-related mortality between the “inner areas” of Italy and its metropolitan areas.Study designRetrospective population-based study conducted from the beginning of the pandemic in Italy (20 February 2020) to 31 March 2022.MethodsThe municipalities of Italy were classified into metropolitan areas, peri-urban/intermediate areas and “inner areas” (peripheral/ultra-peripheral). The exposure variable was residence in an “inner area” of Italy. Incidence of diagnosis of SARS-CoV-2 infection, non-ICU and ICU hospital admissions and death within 30 days from diagnosis were the outcomes of the study. COVID-19 vaccination access was also evaluated. Crude and age-standardized rates were calculated for all the study outcomes. The association between the type of area of residence and each outcome under study was evaluated by calculating the ratios between the standardized rates. All the analyses were stratified by period of observation (original Wuhan strain, Alpha variant, Delta variant, Omicron variant).ResultsIncidence and non-ICUs admissions rates were lower in “inner areas.” ICU admission and mortality rates were much lower in “inner areas” in the early phases of the pandemic, but this protection progressively diminished, with a slight excess risk observed in the “inner areas” during the Omicron period. The greater vaccination coverage in metropolitan areas may explain this trend.ConclusionPrioritizing healthcare planning through the strengthening of the primary prevention policies in the peripheral areas of Italy is fundamental to guarantee health equity policies.