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This study investigates the managerial approaches family SMEs adopt to address sustainability in the context of the Blue Economy. Using a qualitative methodology, we conduct nine case studies of family firms operating in Sicily's COSVAP Fishing District area. The data are collected via semi-structured interviews with the founders/managers and analyzed using the Gioia method. The results reveal that family SMEs approach sustainability by adopting three managerial approaches. In the first approach, SME managers conceive sustainability as a threat to the economic sustainability of their firms. The second approach implies that sustainability must undergo specific compromises. The third approach considers sustainability as an opportunity whereby social, environmental, and economic sustainability goals are balanced. Regarding the theoretical implications, our work provides a comprehensive account of managerial approaches of family SMEs toward sustainability. The study offers insights for practitioners and policymakers concerning how to facilitate the transition of family SMEs – and, specifically, fisheries – toward sustainability.

Cardiac resynchronization therapy (CRT) via biventricular pacing (BVP) is a well-established therapy for patients with heart failure with reduced ejection fraction and left bundle branch block, who remain symptomatic despite optimal medical therapy. Despite the long-standing clinical evidence, as well as the familiarity of cardiac electrophysiologists with the implantation technique, CRT via BVP cannot be achieved or may result ineffective in up to one-third of the patients. Therefore, new alternative techniques, such as conduction system pacing and left ventricular pacing, are emerging as potential alternatives to this technique, not only in case of BVP failure, but also as a stand-alone first choice due to several potential advantages over traditional CRT. Specifically, due to its procedural characteristics, left bundle branch area pacing appears to be the most convincing technique, showing comparable efficacy outcomes when compared with traditional CRT, not increasing short-term device-related complications, as well as improving procedural times. However, transvenous leads remain a major limitation of all these pacing modalities. To overcome this limit, a leadless left ventricular endocardial pacing has been developed as an additional tool to achieve a left endocardial activation, although being still associated with non-negligible pitfalls, limiting its current use in clinical practice. This article focuses on the current state and latest progresses in cardiac resynchronization therapy.

PurposeThis research employed two neurophysiological techniques (electroencephalograms (EEG) and galvanic skin response (GSR)) and machine learning algorithms to capture and analyze relationship-oriented leadership (ROL) and task-oriented leadership (TOL). By grounding the study in the theoretical perspectives of transformational leadership and embodied leadership, the study draws connections to the human body's role in activating ROL and TOL styles.Design/methodology/approachEEG and GSR signals were recorded during resting state and event-related brain activity for 52 study participants. Both leadership styles were assessed independently using a standard questionnaire, and brain activity was captured by presenting subjects with emotional stimuli.FindingsROL revealed differences in EEG baseline over the frontal lobes during emotional stimuli, but no differences were found in GSR signals. TOL style, on the other hand, did not present significant differences in either EEG or GSR responses, as no biomarkers showed differences. Hence, it was concluded that EEG measures were better at recognizing brain activity associated with ROL than TOL. EEG signals were also strongest when individuals were presented with stimuli containing positive (specifically, happy) emotional content. A subsequent machine learning model developed using EEG and GSR data to recognize high/low levels of ROL and TOL predicted ROL with 81% accuracy.Originality/valueThe current research integrates psychophysiological techniques like EEG with machine learning to capture and analyze study variables. In doing so, the study addresses biases associated with self-reported surveys that are conventionally used in management research. This rigorous and interdisciplinary research advances leadership literature by striking a balance between neurological data and the theoretical underpinnings of transformational and embodied leadership.

Determining the relative influence of, and possible synergistic relationships among, environmental and biotic processes on individual growth rates can identify key mechanisms that contribute to variation in body size observed among similar-aged individuals. The timing of ontogenetic shifts in diet or habitat, which themselves can be size-dependent, can have considerable impacts on individual growth trajectories, survival, and year class formation. The southern flounder Paralichthys lethostigma is a coastal flatfish species with juvenile cohorts that occupy diverse estuarine settlement habitats and commonly display 2-3 fold variation in body size by the end of the first growing season. We examined abiotic and biotic factors contributing to differences in early juvenile growth for the 2018 year-class of southern flounder in a North Carolina estuary. Following peak larval settlement (Febuary/March), flounder body sizes began to diverge by April, with differences between settlement habitats contributing to roughly 3-fold variation by August. Stomach content analyses indicated a greater occurrence of fish prey in the diets of southern flounder recovered in mesohaline versus oligohaline settlement habitats. Increased piscivorous foraging in mesohaline habitats was linked to nitrogen (δ15N)-enriched tissues and faster growth rates relative to fish collected in oligohaline habitats. Results from a controlled laboratory experiment provided evidence for the strong effects of diet, with only minor direct effects of salinity on juvenile southern flounder growth. Our findings support the critical role of ontogenetic shifts to piscivorous feeding for growth in young-of-the-year southern flounder and highlights the potential for growth-mortality tradeoffs to exist among estuarine settlement habitats.

Objectives. During coronavirus disease (COVID-19) pandemic, preoperative screening before thoracic surgery is paramount in order to protect patients and staff from undetected infections. This study aimed to determine which preoperative COVID-19 screening tool was the most effective strategy before thoracic surgery. Methods. This retrospective cohort multicenter study was performed at 3 Italian thoracic surgery centers. All adult patients scheduled for thoracic surgery procedures from 4th March until 24th April, 2020, and submitted to COVID-19 preoperative screenings were included. The primary outcome was the yield of screening of the different strategies. Results. A total of 430 screenings were performed on 275 patients; 275 anamnestic questionnaires were administered. 77 patients were screened by an anamnestic questionnaire and reverse transcriptase polymerase chain reaction (RT-PCR). 78 patients were selected to combine screening with anamnestic questionnaire and chest computed tomography (CT). The positive yield of screening using a combination of anamnestic questionnaire and RT-PCR was 7.8% (95% CI: 2.6–14.3), while using a combination of anamnestic questionnaire and chest CT was 3.8% (95% CI: 0–9). Individual yields were 1.1% (95% CI: 0–2.5) for anamnestic questionnaire, 5.2% (95% CI: 1.3–11.7) for RT-PCR, and 3.8% (95% CI: 0–9). Conclusions. The association of anamnestic questionnaire and RT-PCR is able to detect around 8 positives in 100 asymptomatic patients. This combined strategy could be a valuable preoperative SARS-CoV-2 screening tool before thoracic surgery.

Background: Breast cancer (BC) with lymphangitic spread to the chest wall is a rare clinical entity affecting about 2% of pts, with poorer survival outcomes. A brisk immune infiltrate is typically reported, with up-regulation of inflammation and immune-tolerogenic genes. PERICLES clinical trial is testing the administration of pembrolizumab 200 mg Q3w plus cyclophosphamide 50 mg daily for BC with chest wall disease. In this exploratory biomarker analysis, we assessed the prevalence of the TILs score and the PD-L1 combined positive score (CPS) obtained from skin biopsies performed at screening. Methods: PERICLES (NCT03971045) is a single-center, single-arm, interventional phase 2 trial. Main inclusion criteria: histologically confirmed, inoperable, locally recurrent and/or metastatic BC with lymphangitic spread to the chest wall (including and not limited to inflammatory BC); PD-L1 positive (CPS≥1; 22C3 pharmDx®) and/or TILs positive (≥1% of CD3 or CD20-positive cells) disease on skin biopsy obtained at screening; progression to at least one prior cytotoxic treatment; no prior immune checkpoint inhibitors. The primary endpoint is objective response rate as per immune-related RECIST criteria. 46 pts will be required for the study to power for the primary hypothesis. In this analysis, we describe the baseline immune-biomarker status, in the overall population enrolled based on hormone receptor status and HER2. Correlative analyses were provided (significance at p-value< 0.05). Results: 37 pts were screened with skin biopsy of the chest wall disease (June 2020-June 2022). Biopsy and biomarker analysis were successful in 35 pts. Median age was 58 years (range: 35-79). Among the 35 pts included in the biomarker analysis, 25 (71%) pts had visceral disease and 20 (57%) had skin metastases at the diagnosis of metastatic disease; median number of previous lines of therapies was 4 (range: 1-12) and of chemotherapies was 4 (range: 1-10). 2 (6%) pts had HER2-positive disease, 13 (37%) HR-positive/HER2-negative disease, and 20 (20%) had triple-negative breast cancer (TNBC). TILs and PD-L1 CPS were < 1 in 15 (43%) pts; 20 pts (57%) were eligible for CPS and/or TILs criteria: 16 (43%) were both PD-L1 positive and TILs positive, 4 only PD-L1 positive. Median PD-L1 CPS score was 5 (range: 0-80%) in the overall population and 17 (range: 2-80%) in eligible patients; 16/35 pts (43%) had CPS≥10. Median TILs score was 0% (range: 0-55%) in the overall population, 0% (range: 0-40%) in the HER2-negative (n=16), 0% (range 0-20%) in the HER2-low (n=18), and 37.5% (range 20-55%) in the HER2-positive (n=2). No significant differences in baseline characteristics were found between positive and negative biopsies (Table). Considering only the TILs, a statistically significant correlation between HER2-positive status and TILs score was demonstrated (p< 0.001); no other correlations between receptor status (estrogen receptor, progesterone receptor, HER2) and PD-L1 CPS or TILs emerged. Conclusions: 57% of patients with chest wall BC have skin metastases positive for PD-L1 CPS and/or TILs score ≥1%. To our knowledge, these are the first prospective data on the prevalence of PD-L1 and TILs in metastatic BC with lymphangitic spread to the chest wall, highlighting potential actionability through therapeutic strategies with new immune-oncology agents in this setting. Table: Characteristics of patients included in the biomarker analysis (n=35) *Calculated with T test or Fisher’s exact test, as appropriate. Keys: BC, breast cancer; CPS, combined positive score; CT, chemotherapy; HR; hormone receptor; n, number; NA; not available; PD-L1, Programmed cell death ligand protein 1; TILs, tumor infiltrating lymphocytes; TNBC, triple negative breast cancer. Citation Format: Carmine Valenza, Pier Paolo Maria Berton Giachetti, Paola Zagami, Eleonora Nicolò, Dario Trapani, Laura Boldrini, Beatrice Taurelli Salimbeni, Liliana Ascione, Gabriele Antonarelli, Chiara Corti, Angela Esposito, Carmen Criscitiello, Nicola Fusco, Giuseppe Curigliano. Pembrolizumab and Oral Metronomic Cyclophosphamide in Patients with Chest Wall Breast Cancer (PERICLES): an immune-biomarker analysis of tumor infiltrating lymphocytes (TILs) and programmed cell death ligand protein 1 (PD-L1) [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P1-14-05.

Survival rates for many forms of thoracic malignancies have improved over the past few decades, however, many survivors are coping with the side effects of cancer treatment for longer. Physical activity (PA) has been proposed as a therapeutic strategy to combat the effects of treatment in cancer survivors and eHealth could be a good way to encourage patients to practice it.To explore the effects of eHealth in the promotion of PA among thoracic malignancies.Suitable articles were searched using PubMed, Web of Science and Scopus databases using a combination of medical subject headings.In total, 4781 articles were identified, of which ten met eligibility criteria. Different eHealth interventions were described in these studies: mobile application (app) (n = 3), website (n = 2), email (n = 2), web and mobile application (n = 1), telephone counseling (n = 1) and online sheet (n = 1). All studies reported improvements in PA, with 8/10 studies reporting statistically significant changes.Our results show that eHealth programs are useful to promote PA in malignancy thoracic survivors, compared to no intervention, conventional treatment or a dietary approach. Moreover, the meta-analysis also revealed eHealth is a good way to improve the level of PA in thoracic malignancies survivors.

Noise can be modeled as a sequence of random variables defined on a probability space that may add to a given dynamical system T that is a map on a phase space. In the nontrivial case of dynamical noise {εn}n, where εn ∈ N(0, σ2) and the system output is xn = T(xn−1, xn−2, ..., x0)+εn, without any specific knowledge/assumption on T, the quantitative estimation of noise power σ2 is a challenge. Here, we introduce a formal method, based on nonlinear entropy profile, to estimate the dynamical noise power σ2 without knowledge on the specific T function. Time-series generated from Logistic maps and Pomeau-Manneville systems under different conditions are used to test the correctness of the method. Results demonstrate that the proposed estimation algorithm properly discerns different noise levels with no a priori information. Numerical simluations, including sereis generation, are performed with MATLAB.

The impact of the COVID-19 pandemic influences of COPD patients. The worsening of their health status may contribute to a higher pain prevalence.The aim of this study was to analyze the pain-related variables before and during the COVID-19 pandemic in patients with chronic obstructive pulmonary disease.In this cross-sectional case-control study, stable patients with chronic obstructive pulmonary disease without a COVID-19 diagnosis were evaluated before and during the pandemic. The main outcomes were the pronociceptive pain profile (general pain sensitivity, pain intensity, pain interference, and pressure pain sensitivity) and the psychological vulnerability (perceived health status, anxiety, and depression).Our results showed that patients with chronic obstructive pulmonary disease during COVID-19 pandemic experienced higher general pain sensitivity and intensity with statistical differences in pain interference (p.001), being the overall perceived health status lower than before the pandemic (p.05).We concluded that patients with chronic obstructive pulmonary disease during the COVID-19 pandemic showed a rise the pronociceptive pain profile accompanied by increased psychological vulnerability.

People with Down syndrome(DS) present neurophysiological problems that could be alleviated with the systematic practice of Physical Education(PE). However, there are questions regarding laboratory assessments for the prescription of exercises, as there are no adequate equipment or protocols for this group, the difficulty of the individual with DS concerning the proposed tests, and difficulty in controlling emotions when in a laboratory environment because they present intellectual disability. The objective of this study was to report approach procedures for the data collection in a laboratory environment developed in research on muscle strength, body composition, and hemodynamics in adolescents with Down syndrome, from the use of Henri Wallon's theory of emotions and his considerations about emotional manifestations. Considering this theory and what we can call a greater humanization of the process of evaluating people with DS in the laboratory, the participants, who were unable to perform the proposed tests, were encouraged to participate in the study at another time.

Stress represents a main risk factor for psychiatric disorders. Whereas it is known that even a single trauma may induce psychiatric disorders in humans, the mechanisms of vulnerability to acute stressors have been little investigated. In this study, we generated a new animal model of resilience/vulnerability to acute footshock (FS) stress in rats and analyzed early functional, molecular, and morphological determinants of stress vulnerability at tripartite glutamate synapses in the prefrontal cortex (PFC). We found that adult male rats subjected to FS can be deemed resilient (FS-R) or vulnerable (FS-V), based on their anhedonic phenotype 24 h after stress exposure, and that these two populations are phenotypically distinguishable up to two weeks afterwards. Basal presynaptic glutamate release was increased in the PFC of FS-V rats, while depolarization-evoked glutamate release and synapsin I phosphorylation at Ser9 were increased in both FS-R and FS-V. In FS-R and FS-V rats the synaptic expression of GluN2A and apical dendritic length of prelimbic PFC layers II–III pyramidal neurons were decreased, while BDNF expression was selectively reduced in FS-V. Depolarization-evoked (carrier-mediated) glutamate release from astroglia perisynaptic processes (gliosomes) was selectively increased in the PFC of FS-V rats, while GLT1 and xCt levels were higher and GS expression reduced in purified PFC gliosomes from FS-R. Overall, we show for the first time that the application of the sucrose intake test to rats exposed to acute FS led to the generation of a novel animal model of resilience/vulnerability to acute stress, which we used to identify early determinants of maladaptive response related to behavioral vulnerability to stress.

Donation after cardiac death (DCD) donors are still subject of studies. In this prospective cohort trial, we compared outcomes after lung transplantation (LT) of subjects receiving lungs from DCD donors with those of subjects receiving lungs from donation after brain death (DBD) donors (ClinicalTrial.gov: NCT02061462). Lungs from DCD donors were preserved in-vivo through normothermic ventilation, as per our protocol. We enrolled candidates for bilateral LT ≥14 years. Candidates for multi-organ or re-LT, donors aged ≥65 years, DCD category I or IV donors were excluded. We recorded clinical data on donors and recipients. Primary endpoint was 30-day mortality. Secondary endpoints were: duration of mechanical ventilation (MV), intensive care unit (ICU) length of stay, severe primary graft dysfunction (PGD3) and chronic lung allograft dysfunction (CLAD). 121 patients (110 DBD Group, 11 DCD Group) were enrolled. 30-day mortality and CLAD prevalence were nil in the DCD Group. DCD Group patients required longer MV (DCD Group: 2 days, DBD Group: 1 day, p = 0.011). ICU length of stay and PGD3 rate were higher in DCD Group but did not significantly differ. LT with DCD grafts procured with our protocols appears safe, despite prolonged ischemia times.

Introduction: Pulmonary embolism (PE) can be diagnosed by perfusion lung scintigra-phy using human albumin macroaggregates labelled 99mTc (99mTc-MAA). When PE is suspected, subcutaneous Low Molecular Weight Heparin (LMWH) should be administered even before the results of the PE diagnostic flowchart. In our study, we aimed to evaluate a possible interaction (in vitro interference) between 99mTc-MAA and LMWH. Materials and Methods: The reconstitution of MAA kit was performed according to the manufac-turer's instruction. After labelling, we carried out the following preparations: a standard dose of 99mTc-MAA alone, as control; 99mTc-MAA and enoxaparin at different ratios. According to the manufacturer's instruction, the radiochemical purity was performed and evaluated immediately (T0), after 15 and 30 minutes after incubation (T15 and T30). Results: We compared the radiochemical purity of 99mTc-MAA with: (i) radiochemical purity of 99mTc-MAA and enoxaparin (11 ratio), (ii) radiochemical purity of 99mTc-MAA and enoxaparin (0.5 ratio), and (iii) radiochemical purity of 99mTc-MAA and enoxaparin (ratio 2). No significant differ-ences were found between all the measured parameters at each time point for each ratio. We also tested the stability of 99mTc-MAA in physiological conditions (at 37°C in PBS): the initial radio-chemical purity of 99mTc-MAA was 99.78%. The values of 99mTc-MAA radiochemical purity were high in all conditions of possible interaction with LMWH, with values ranging from 98.00% at T0 to 95% at T30. Conclusion: We found no statistically significant change in the in vitro stability of 99mTc-MAA in the presence of enoxaparin, excluding a possible direct interference. Future studies will be needed to check the 99mTc-MAA stability under physiological conditions.

International audience

Several antibody-drug conjugates (ADCs) have been recently approved to treat solid tumours. Since ADCs seem to have activity in multiple malignancies sharing the expression of a specific antigen, they may be mirroring the experience of histology-agnostic-targeted treatments. So, the possibility to interpret the activity of some ADCs across different cancer types in a biomarker-driven perspective arises. However, relevant biological, methodological, and regulatory challenges should be highlighted and addressed, in order to grant ADCs biomarker-driven regulatory approvals in the next future. In this review, we discuss challenges and opportunities posed by the pan-histological expansion of ADCs in solid tumours. In particular, we provide an overview about technological and manufacturing advancements; we offer up-to-date highlights of the current evidence from clinical trials investigating ADCs in solid tumours; we discuss the need for the identification of optimal predictive biomarkers, as well as major methodological, statistical, and regulatory considerations for a biomarker-driven histology-agnostic approach.

The treatment landscape of early triple-negative breast cancer (TNBC) has recently expanded after the Food and Drug Administration (FDA) approval of pembrolizumab in combination with neoadjuvant chemotherapy. The addition of this immune checkpoint inhibitor (ICI) has shown significantly increased pathological complete response (pCR) rate and event-free survival (EFS) in the KEYNOTE-522 phase III trial. Several additional studies are ongoing with the goal of further improving the outcomes and achieving an optimal integration of ICIs in the treatment of TNBC.The article examines pCR and survival rates in TNBC. It appraises clinical trials investigating neoadjuvant ICIs for TNBC and the improvement of pCR rates (biomarker-driven escalation of treatment, optimization of chemotherapy backbone, and addition of locoregional treatments or innovative agents). Insights into the role of pCR as a surrogate endpoint and the possibility of enhancing pCR rates for women affected by early TNBC are offered.The pharmacopoeia of early TNBC is growing and becoming more heterogeneous with the advent of ICIs; to enhance the clinical benefit of patients, it is necessary to develop response endpoints that consider the mechanism of action of experimental drugs, to optimize patient selection through validated biomarkers, and to compare the most promising treatment strategies in randomized clinical trials.

Resumo Objetivo Analisar a incidência da necrose avascular da epífise no tratamento do escorregamento da epífise proximal do fêmur pela técnica de Dunn modificada, correlacionando-a com outras variáveis. Como objetivo secundário, descrevemos outras complicações encontradas. Métodos Estudo retrospectivo com 20 pacientes tratados entre 2009 e 2019, com seguimento de 2 a 12 anos, tratados pela mesma equipe cirúrgica. A análise incluiu características gerais, tempo entre apresentação e procedimento cirúrgico, classificação, presença de perfusão sanguínea intraoperatória da epífise, avaliação das complicações e seus respectivos tratamentos. Resultados Todos os casos eram graves, 65% crônicos agudizados e 55% dos escorregamentos eram instáveis. Nossa taxa de complicações foi de 45%, sendo 5 casos de necrose avascular, 2 de infecção profunda, uma falha do material e uma instabilidade articular. Pacientes operados com maior tempo após a internação e os sem perfusão intraoperatória da epífise tiveram maior risco de necrose na análise estatística. Considerando o tempo do estudo, tivemos 4 casos de necrose nos primeiros 5 anos e 1 caso nos últimos 5 anos. Conclusão Nosso estudo demonstrou que a necrose foi a complicação mais comum e que o atraso para a realização da cirurgia e a ausência de perfusão da epífise no intraoperatório podem predispor à necrose avascular. Embora não estatisticamente significante, a instabilidade coxofemoral foi observada na forma de apresentação crônica e a fixação cirúrgica com fios rosqueados se mostrou menos eficaz que a fixação com parafuso canulado.Este procedimento deve ser reservado para casos graves nos quais outras técnicas não sejam possíveis e realizado por equipe experiente, treinada e capacitada.

Patients with HER2-positive breast cancer account for approximately 15% to 20% of all breast cancers and represent one of the most aggressive breast cancer subtypes. Survival rates of patients with metastatic disease have improved dramatically and progressively. Many new agents have been developed, and long-term follow-up from trials of anti-HER2 agents has shown long-term responses. The availability of novel, highly active anti-HER2 treatments, together with the ongoing development of promising diagnostic tools, will offer the unprecedented opportunity to raise cure rates. Our ultimate goal is to tailor treatment intensity to disease and patient characteristics, hopefully increasing the fraction of cured patients while minimizing the risk for overtreatment. If conducted rationally and carefully, this plan has the potential to break a decades-long paradigm, leading to a new, precise era of treatment of HER2-positive breast cancer.

Floods determine river behaviour in time and space. Yet quantitative measures of discharge variability from geological stratigraphy are sparse, even though they are critical to understand landscape sensitivity to past and future environmental change. Here we show how storm-driven river floods in the geologic past can be quantified, using Carboniferous stratigraphy as an exemplar. The geometries of dune cross-sets demonstrate that discharge-driven disequilibrium dynamics dominated fluvial deposition in the Pennant Formation of South Wales. Based on bedform preservation theory, we quantify dune turnover timescales and hence the magnitude and duration of flow variability, showing that rivers were perennial but prone to flashy floods lasting 4-16 hours. This disequilibrium bedform preservation is consistent across 4 Ma of stratigraphy, and coincides with facies-based markers of flooding, such as mass-preservation of woody debris. We suggest that it is now possible to quantify climate-driven sedimentation events in the geologic past, and reconstruct discharge variability from the rock record on a uniquely short (daily) timescale, revealing a formation dominated by flashy floods in perennial rivers.

If depressive symptoms are not caused by the physiological effects of a substance or other medical or neurological conditions, they are generally classified as mental disorders that target the central nervous system. However, recent evidence suggests that peripheral neural dynamics on cardiovascular control play a causal role in regulating and processing emotions. In this perspective, we explore the dynamics of the Central-Autonomic Network (CAN) and related brain-heart interplay (BHI), highlighting their psychophysiological correlates and clinical symptoms of depression. Thus, we suggest that depression may arise from dysregulated cardiac vagal and sympathovagal dynamics that lead to CAN and BHI dysfunctions. Therefore, treatments for depression should target the nervous system as a whole, with particular emphasis on regulating vagal and BHI dynamics.

Background Worldwide, prostate cancer is both the second-most diagnosed cancer and most common solid tumor in men. Prostate cancer patients present with a symptom burden that is compounded by the impact of medical oncology treatment, affecting different domains of their perceived health status. Education active techniques are a key role in chronic disease to increase participation in their recovery. Purpose The purpose of the current review was to examine the efficacy of education-enhanced in urinary symptom burden, psychological distress, and self-efficacy in patients diagnosed with prostate cancer. Methods A wide search of the literature was conducted for articles from their inception to June 2022. Only randomized controlled trials were included. Data extraction and methodologic quality assessment of the studies were carried out by two reviewers. We previously registered the protocol of this systematic review on PROSPERO (CRD42022331954). Results A total of six studies were included in the study. After education-enhanced intervention showed significant improvements in any of perceived urinary symptom burden, one in psychological distress, and one in self-efficacy in the experimental group. The meta-analysis showed that education-enhanced interventions have a significant effect on depression. Conclusion Education-enhanced could have positive effects on urinary symptom burden, psychological distress, and selfefficacy in prostate cancer survivors. Our review was unable to demonstrate the best timing to apply education-enhanced strategies., Universidad de Granada/ CBUA, FPU (Formación Profesorado Universitario), The Spanish Ministry of Education (Spain) (FPU: 21/00451, FPU 20/01670, and FPU 19/02609).

Background: Systemic sclerosis (SSc) is an autoimmune rheumatic disease. Individuals with a diagnosis of SSc describe repercussions on their activities of daily living and instrumental activities of daily living that affect their everyday functional capacity. The objective of this systematic review was to explore the effectiveness of nonpharmacological interventions to improve hand function and the ability to perform activities of daily living. Methods: A systematic review was conducted on the Cochrane Library, Medline/ PubMed, OTseeker, PEDro, Scopus, Web of Science up to September 10, 2022. Inclusion criteria were defined following PICOS recommendations (Populations, Intervention, Comparison and Outcome measures). Methodological quality was assessed with the Downs and Black Scale and risk of bias was assessed using version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2). A meta-analysis of each outcome was performed. Results: A total of 8 studies met the inclusion criteria, providing data on 487 individuals with SSc. The non-pharmacological intervention applied the most was exercise. The effects of non-pharmacological interventions were better than those of the waiting list or no treatment control conditions in both outcomes – hand function (mean difference [MD] = −6.98; 95% CI [−11.45, − 2.50], P= 0.002, I 2= 0%) and performance of daily activities (MD = −0.19; 95% CI [−0.33, − 0.04], P= 0.01, I 2= 0%). Moderate risk of bias was found in the majority of the studies included. Conclusion: There is emerging evidence that non-pharmacological interventions can improve hand function and performance of daily activities in individuals with a diagnosis of SSc. Given the moderate risk of bias found in the studies included, the results should be considered with caution., University of Granada, Spain

Unconventional hydrocarbon assets represent a rapidly expanding proportion of North American oil and gas production. Similar to the incipient phase of conventional oil production at the turn of the twentieth century, there are ample opportunities to improve production efficiency. In this work we demonstrate that pressure dependent permeability degradation exhibited by unconventional reservoir materials is due to the mechanical response of a few commonly encountered microstructural constituents. In particular, the mechanical response of unconventional reservoir materials may be conceptualized as the superposed deformation of matrix (or ~ cylindrical/spherical), and compliant (or slit) pores. The former are representative of pores in a granular medium or a cemented sandstone, while the latter represent pores in an aligned clay compact or a microcrack. As a result of this simplicity, we demonstrate that permeability degradation is accounted for through a weighted superposition of conventional permeability models for these pore architectures. This approach permits us to conclude that the most severe pressure dependence is due to imperceptible bedding parallel delamination cracks in the oil bearing argillaceous (clay-rich) mudstones. Finally, we demonstrate that these delaminations tend to populate layers that are enriched with organic carbon. These findings are a basis for improving recovery factors through the development of new completion techniques to exploit, then mitigate pressure dependent permeability in practice.

Inflammatory Bowel Disease (IBD) patients on biological therapy are receiving vaccines against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). However, it is unclear if IBD therapy could influence the response to this vaccine. In a case-control study, we assessed the antibody profiling after anti-SARS-CoV-2 BNT162b2 vaccine in IBD patients on biological therapy.We analyzed seroprevalence and antibody titer, after 14 weeks from the first BNT162b2 vaccine dose, in IBD patients on biological therapy and Health Care Workers (HCWs). In IBD patients, medical history and disease data were recorded.Eighty-two subjects were enrolled in this study. Among them, 40 were IBD patients on biological therapy and 42 were HCWs. All subjects developed an IgG anti-Spike antibody titer above the cut-off. IBD patients on biological therapy developed a lower antibody titer than HCWs (P0.00001). No differences were reported in patients who received at least one dose of the vaccine within a period of 7 days from the last biological drug administration, compared to all other IBD patients. A difference was found between patients who were on concomitant immunosuppressive therapy and patients on sole biological therapy (P = 0.0287). Patients with presence of any sign of disease activity (clinical, endoscopic or laboratory) showed a higher development of antibody titer compared to those in complete disease remission (P = 0,0468).Our data indicate that in IBD patients, treatment with biological therapies do not affect the seroprevalence but leads to a lower antibody titer development after anti-SARS-CoV-2 BNT162b2 vaccine.

To investigate the efficacy of self-management interventions on quality of life and/or self-efficacy in patients diagnosed with prostate cancer through a systematic review with meta-analysis.A search was conducted from database inception to March 2022 across three databases. Randomized controlled trials were included. Two reviewers performed independent data extraction and methodologic quality assessment of the studies.A total of fifteen studies were included in the study. Self-management interventions were identified by the Practical Reviews in Self-Management Support. The meta-analysis showed that self-management interventions have a significant effect on self-efficacy CONCLUSION: Self-management programs could have positive effects on quality of life and improve self-efficacy in prostate cancer patients.Self-management components may be heterogeneous but show positive results in improving self-efficacy in prostate cancer survivors. Including self-management components in the rehabilitation of prostate survivors can improve their quality of life.

The rarely witnessed process of river avulsion repositions channels across floodplains, which influences floodplain geomorphology and stratigraphic architecture. The way avulsions redirect water and sediment is typically generalized into one of two styles. Avulsions proceeding through rapid channel switching and producing little to no floodplain disturbance are annexational, while those that involve sequential phases of crevassing, flooding, and eventual development of a new channel are progradational. We test the validity of these avulsion style categories by mapping and characterizing 14 avulsion events in Andean, Himalayan, and New Guinean foreland basins. We use Landsat data to identify how avulsions proceed and interpret the possible products of these processes in terms of geomorphic features and stratigraphy. We show that during annexation the avulsion channel widens, changes its meander wavelength and amplitude, or increases channel thread count. During progradation, avulsion channels are constructed from evolving distributary networks. Often beginning as crevasse splays, these networks migrate down the floodplain gradient and frequently create and fill ponds during the process. We also see evidence for a recently defined third avulsion style. Retrogradation involves overbank flow, like progradation, but is marked by an upstream-migrating abandonment and infilling of the parent channel. Avulsion belts in this study range from 5 to 60 km in length, and from 1 to 50 km in width. On average, these events demonstrate annexational style over 22.4% of their length. Eleven of 13 events either begin or end with annexation, and seven both begin and end with annexation. Only one event exhibited progradation over the entire avulsion-belt length. While there are many documented examples of purely annexational avulsions, we see little evidence for completely progradational or retrogradational avulsions, and instead suggest that a given avulsion is better envisioned as a series of spatiotemporal phases of annexation, progradation, and retrogradation. Such hybrid avulsions likely produce significantly greater stratigraphic variability than that predicted by the traditional end-member model. We suggest that a time-averaged, formation-scale consideration of avulsion products will yield more accurate characterizations of avulsion dynamics in ancient fluvial systems.

PurposeThe field of scientific research on small and medium-sized family businesses has been growing exponentially and the aim of this paper is to systematize the body of knowledge to develop an agenda for the future.Design/methodology/approachAdopting comparative bibliometric analyses on 155 articles (from 1989 until 2018) the authors provide a systematic assessment of the scientific research about small family firms, unveiling the structure and evolution of the field. Bibliographic coupling, co-citation analysis and co-occurrence analysis are adopted to identify the most influential studies and themes.FindingsFour clusters of research are reviewed: succession in family SMEs, performances of family SMEs, internationalization of family SMEs and organizational culture of family SMEs.Originality/valueThis paper contributes to the field of family SMEs by providing a systematic analysis of the scientific knowledge. Reviewing those clusters allows to providing avenues and reflections for future research and further practice.

To evaluate the short- and medium-term effects of an 8-week individualized comprehensive rehabilitation program in women with chronic knee osteoarthritis as regards functionality, physical performance, and perceived health status.Women with chronic knee osteoarthritis were randomly assigned to the aquatic training group or to the individualized comprehensive rehabilitation (ICR) group. The main outcomes were functionality assessed with the Western Ontario and McMaster Universities Osteoarthritis Index, physical performance assessed with the Timed Up and Go test and the Stair Climbing Test, and perceived health status evaluated with the European Quality of Life- 5 Dimensions questionnaire. Participants were assessed after the treatment and at 3-month follow-up.Forty participants were included in the study. After the treatment, there were no significant between- group differences. At 3-month follow-up, there were significant between-group differences in functionality (stiffness P = 0.049, function P = 0.005, and total subscores P = 0.048) and physical performance (Timed Up and Go P = 0.031 and Stair Climbing Test P = 0.046) in favor of the ICR group.An 8-week ICR program improved functionality, physical performance, and perceived health status compared with an aquatic training program in women with chronic knee osteoarthritis.

A challenge of studying information-seeking behavior in open web systems is the unpredictability of those systems. One solution to counteract this issue is employing a simulation to ensure experimental control. However, concerns arise over the realism of such an environment. This paper assesses the realism of a behavioral simulation used to study the evaluation behavior of 175 students from fourth grade through graduate school. We assess realism through the examination of targeted participant feedback about what would have made the simulated environment and tasks more realistic to these participants. Based on this feedback, we reflect on decisions made in designing the simulation and offer recommendations for future studies interested in incorporating behavioral simulation in their research design. We find that a thoughtfully designed simulation can elicit naturalistic behavior when the controlled environment is designed to be realistic in meaningful ways. Because the simulation does not have to perfectly match reality to elicit these behaviors, designing a simulation that is real enough is an effective method to study information-seeking behavior.

The process of river avulsion builds floodplains and fills alluvial basins. We report on a new style of river avulsion identified in the Landsat satellite record. We found 69 examples of retrogradational avulsions on rivers of densely forested fluvial fans in the Andean and New Guinean alluvial basins. Retrogradational avulsions are initiated by a channel blockage, e.g., a logjam, that fills the channel with sediment and forces water overbank (dechannelization), which creates a chevron-shaped flooding pattern. Dechannelization waves travel upstream at a median rate of 387 m/yr and last on average for 13 yr; many rivers show multiple dechannelizing events on the same reach. Dechannelization ends and the avulsion is complete when the river finds a new flow path. We simulate upstream-migrating dechannelization with a one-dimensional morphodynamic model for open channel flow. Observations are consistent with model results and show that channel blockages can cause dechannelization on steep (10−2 to 10−3), low-discharge (~101 m3 s−1) rivers. This illustrates a new style of floodplain sedimentation that is unaccounted for in ecologic and stratigraphic models.

Dynamical information exchange between central and autonomic nervous systems, as referred to functional brain-heart interplay, occurs during emotional and physical arousal. It is well documented that physical and mental stress lead to sympathetic activation. Nevertheless, the role of autonomic inputs in nervous system-wise communication under mental stress is yet unknown. In this study, we estimated the causal and bidirectional neural modulations between electroencephalogram (EEG) oscillations and peripheral sympathetic and parasympathetic activities using a recently proposed computational framework for a functional brain-heart interplay assessment, namely the sympathovagal synthetic data generation model. Mental stress was elicited in 37 healthy volunteers by increasing their cognitive demands throughout three tasks associated with increased stress levels. Stress elicitation induced an increased variability in sympathovagal markers, as well as increased variability in the directional brain-heart interplay. The observed heart-to-brain interplay was primarily from sympathetic activity targeting a wide range of EEG oscillations, whereas variability in the efferent direction seemed mainly related to EEG oscillations in the γ band. These findings extend current knowledge on stress physiology, which mainly referred to top-down neural dynamics. Our results suggest that mental stress may not cause an increase in sympathetic activity exclusively as it initiates a dynamic fluctuation within brain-body networks including bidirectional interactions at a brain-heart level. We conclude that directional brain-heart interplay measurements may provide suitable biomarkers for a quantitative stress assessment and bodily feedback may modulate the perceived stress caused by increased cognitive demand.

Importance: Autism spectrum disorder (ASD) is one of the most prevalent neurodevelopmental disorders and is characterized by compromised social interactions, reduced verbal communication, stereotyped repetitive behaviors, restricted interests, and sensory abnormalities. Yet absent from the knowledge base is information about sensory abnormalities related to pain experiences. Exploring the pain experiences of people with ASD may provide occupational therapy practitioners with a baseline to determine areas of need and effective interventions. Objective: To conduct a systematic review of the literature to summarize current evidence from case–control studies comparing sensory abnormalities with regard to pain experiences of people diagnosed and not diagnosed with ASD. Data Sources: A systematic literature search of the CINAHL, Cochrane, MEDLINE (PubMed), OTseeker, and Web of Science databases, using MeSH terms and broad keywords. Study Selection and Data Collection: A search was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The Newcastle–Ottawa Scale was used to evaluate the risk of bias of the included studies. Findings: A total of 27 case–control studies involving 865 people with ASD and 864 control participants were included. Several methods were used to explore pain experiences, such as threshold detection or pain threshold. Conclusion and Relevance: The results indicate that people with ASD may have an abnormal sensory experience with regard to pain sensitivity. Occupational therapy practitioners should develop an intervention to focus on pain. What This Article Adds: This study adds to the body of literature indicating that people with ASD have sensory abnormalities with regard to pain experiences. Results highlight the need for occupational therapy interventions to focus on pain experiences.

Falsification is the basis for testing existing hypotheses, and a great danger is posed when results incorrectly reject our prior notions (false positives). Though nonparametric and nonlinear exploratory methods of uncovering coupling provide a flexible framework to study network configurations and discover causal graphs, multiple comparisons analyses make false positives more likely, exacerbating the need for their control. We aim to robustify the Gaussian Processes Convergent Cross-Mapping (GP-CCM) method through Variational Bayesian Gaussian Process modeling (VGP-CCM). We alleviate computational costs of integrating with conditional hyperparameter distributions through mean field approximations. This approximation model, in conjunction with permutation sampling of the null distribution, permits significance statistics that are more robust than permutation sampling with point hyperparameters. Simulated unidirectional Lorenz-Rossler systems as well as mechanistic models of neurovascular systems are used to evaluate the method. The results demonstrate that the proposed method yields improved specificity, showing promise to combat false positives, Submitted to The 11th International Conference on Complex Networks and their Applications (CNA2022), 12 pages