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Lava tubes are powerful heat insulators, allowing lava to practically keep the initial temperature and travel longer distances than when freely flowing on the ground surface. It is thus extremely important to recognize how, when and where these structures form within a lava flow field for hazard assessment purposes, in order to plan possible interventions should a lava flow approach inhabited areas. Often being formed within thick and complex lava flow fields, lava tubes are difficult to detect, study and explore. In this study, we analyse the 1792–93 Etna lava flow field emplaced on a steep slope (>4°) which comprises several lava tubes located at different distances from the eruptive fissure, at different levels within the lava flow field, and showing various inner morphologies, with peculiar inner features related to their maturity and eruptive history. Our aim is to verify whether it is possible to connect the underground features with features observed on the lava flow surface in order to reconstruct the extension of the tube network and unravel the genetic processes. Our results show that, in the studied lava flow field, a clear correspondence is possible between shallow tubes emplaced late during the lava flow field growth and surface textures. In addition, vertical and horizontal tube capture is very widespread, and might be the primary process for lava tube persistence and long life. Our results might be applicable to other lava tubes on Earth and other rocky planets.

Background: Uncontained morcellation of myoma during laparoscopic surgery has been discouraged because of unknown malignancy. Even the safety of contained morcellation has been questioned because muscle cells have been detected in washings obtained during laparoscopic procedures. The possibility of myoma cell dissemination has been observed in open abdominal surgery, even after hysterectomy. Thus myomectomy would be unsafe from an oncological point of view, regardless of surgical approach. Methods: This is an observational cohort study involving 30 patients who underwent open abdominal myomectomy. Peritoneal abdominal washings were obtained two times during the open abdominal myomectomy: before uterus incision and after the myomectomy itself. Cytological, cell block, and immunohistochemical evaluations were performed. Results: All washings obtained immediately after abdominal peritoneal cavity opening were negative for fibroid cells. Both the first and second washings were free of myoma cells. Cytologic evaluation did not reveal any smooth muscle cells. The results of desmin and smooth muscle actin staining, performed on the pre- and post-myomectomy samples, were negative. Conclusion: Our results demonstrated, for the first time to our knowledge, that there is no dissemination of myoma cells during conservative abdominal surgery. It could represent an additional oncological safety. Further data are needed.

Active geological processes often generate a ground surface response such as uplift, subsidence and faulting/fracturing. Nowadays remote sensing represents a key tool for the evaluation and monitoring of natural hazards. The use of unmanned aerial vehicles (UAVs) in relation to observations of natural hazards encompasses three main stages: pre- and post-event data acquisition, monitoring, and risk assessment. The mud volcano of Santa Barbara (Municipality of Caltanissetta, Italy) represents a dangerous site because on 11 August 2008 a paroxysmal event caused serious damage to infrastructures within a range of about 2 km. The main precursors to mud volcano paroxysmal events are uplift and the development of structural features with dimensions ranging from centimeters to decimeters. Here we present a methodology for monitoring deformation processes that may be precursory to paroxysmal events at the Santa Barbara mud volcano. This methodology is based on (i) the data collection, (ii) the structure from motion (SfM) processing chain and (iii) the M3C2-PM algorithm for the comparison between point clouds and uncertainty analysis with a statistical approach. The objective of this methodology is to detect precursory activity by monitoring deformation processes with centimeter-scale precision and a temporal frequency of 1–2 months.

On 24 August 2016 a strong earthquake (Mw = 6.0) affected central Italy and an intense seismic sequence started. Field observations, DInSAR (Differential INterferometry Synthetic-Aperture Radar) analyses and preliminary focal mechanisms, as well as the distribution of aftershocks, suggested the reactivation of the northern sector of the Laga fault, the southern part of which was already rebooted during the 2009 L'Aquila sequence, and of the southern segment of the Mt Vettore fault system (MVFS). Based on this preliminary information and following the stress-triggering concept (Stein, 1999; Steacy et al., 2005), we tentatively identified a potential fault zone that is very vulnerable to future seismic events just north of the earlier epicentral area. Accordingly, we planned a local geodetic network consisting of five new GNSS (Global Navigation Satellite System) stations located a few kilometres away from both sides of the MVFS. This network was devoted to working out, at least partially but in some detail, the possible northward propagation of the crustal network ruptures. The building of the stations and a first set of measurements were carried out during a first campaign (30 September and 2 October 2016). On 26 October 2016, immediately north of the epicentral area of the 24 August event, another earthquake (Mw = 5.9) occurred, followed 4 days later (30 October) by the main shock (Mw = 6.5) of the whole 2016 summer–autumn seismic sequence. Our local geodetic network was fully affected by the new events and therefore we performed a second campaign soon after (11–13 November 2016). In this brief note, we provide the results of our geodetic measurements that registered the co-seismic and immediately post-seismic deformation of the two major October shocks, documenting in some detail the surface deformation close to the fault trace. We also compare our results with the available surface deformation field of the broader area, obtained on the basis of the DInSAR technique, and show an overall good fit.

Abstract Climate and crop yield variability associated with El NioSouthern Oscillation (ENSO) are now predictable within limits. This predictability suggests a potential to tailor agricultural management to mitigate impacts of adverse conditions and to take advantage of favorable conditions. However, improved climate predictions may benefit society only with parallel advances in our ability to use this knowledge. We show that the value that will accrue to any given actor from an ENSO phase forecast should be viewed not as a known number but instead as a random draw from a distribution, even when the forecast is always correct. Forecast value depends on the highly variable contexts in which forecasts are used. Randomness in forecast value has significant implications for choices made by forecasters, forecast users and policy makers. To show randomness, we estimate potential economic values of ENSO forecasts for agricultural producers based on two realistic assumptions: the crop prices farmers receive are uncertain; and within an ENSO phase, the actual climate is variable in ways that affect profits. The use of synthetic weather and crop price series, with crop simulation models, helps show the range and likelihood of climate forecast value. [ABSTRACT FROM AUTHOR]

Abstract Europe imports large amounts of soybean that are predominantly used for livestock feed, mainly sourced from Brazil, USA and Argentina. In addition, the demand for GM-free soybean for human consumption is project to increase. Soybean has higher protein quality and digestibility than other legumes, along with high concentrations of isoflavones, phytosterols and minerals that enhance the nutritional value as a human food ingredient. Here, we examine the potential to increase soybean production across Europe for livestock feed and direct human consumption, and review possible effects on the environment and human health. Simulations and field data indicate rainfed soybean yields of 3.1 ± 1.2 t ha−1 from southern UK through to southern Europe (compared to a 3.5 t ha−1 average from North America). Drought-prone southern regions and cooler northern regions require breeding to incorporate stress-tolerance traits. Literature synthesized in this work evidenced soybean properties important to human nutrition, health, and traits related to food processing compared to alternative protein sources. While acknowledging the uncertainties inherent in any modelling exercise, our findings suggest that further integrating soybean into European agriculture could reduce GHG emissions by 37–291 Mt CO2e year−1 and fertiliser N use by 0.6–1.2 Mt year−1, concurrently improving human health and nutrition.

The availability of high-dimensional genomic data and advancements in genome-based prediction models (GP) have revolutionized and contributed to accelerated genetic gains in soybean breeding programs. GP-based sparse testing is a promising concept that allows increasing the testing capacity of genotypes in environments, of genotypes or environments at a fixed cost, or a substantial reduction of costs at a fixed testing capacity. This study represents the first attempt to implement GP-based sparse testing in soybeans by evaluating different training set compositions going from non-overlapped RILs until almost the other extreme of having same set of genotypes observed across environments for different training set sizes. A total of 1,755 recombinant inbred lines (RILs) tested in nine environments were used in this study. RILs were derived from 39 bi-parental populations of the Soybean Nested Association Mapping (NAM) project. The predictive abilities of various models and training set sizes and compositions were investigated. Training compositions included a range of ratios of overlapping (O-RILs) and non-overlapping (NO-RILs) RILs across environments, as well as a methodology to maximize or minimize the genetic diversity in a fixed-size sample. Reducing the training set size compromised predictive ability in most training set compositions. Overall, maximizing the genetic diversity within the training set and the inclusion of O-RILs increased prediction accuracy given a fixed training set size; however, the most complex model was less affected by these factors. More testing environments in the early stages of the breeding pipeline can provide a more comprehensive assessment of genotype stability and adaptation which are fundamental for the precise selection of superior genotypes adapted to a wide range of environments.

IntroductionWhile globally appreciated for reliable, intensification-friendly phenotypes, modern corn (Zea mays L.) genotypes retain crop plasticity potential. For example, weather and heterogeneous field conditions can overcome phenotype uniformity and facilitate tiller expression. Such plasticity may be of interest in restrictive or otherwise variable environments around the world, where corn production is steadily expanding. No substantial effort has been made in available literature to predict tiller development in field scenarios, which could provide insight on corn plasticity capabilities and drivers. Therefore, the objectives of this investigation are as follows: 1) identify environment, management, or combinations of these factors key to accurately predict tiller density dynamics in corn; and 2) test outof-season prediction accuracy for identified factors.MethodsReplicated field trials were conducted in 17 diverse site-years in Kansas (United States) during the 2019, 2020, and 2021 seasons. Two modern corn genotypes were evaluated with target plant densities of 25000, 42000, and 60000 plants ha -1. Environmental, phenological, and morphological data were recorded and evaluated with generalized additive models.ResultsPlant density interactions with cumulative growing degree days, photothermal quotient, mean minimum and maximum daily temperatures, cumulative vapor pressure deficit, soil nitrate, and soil phosphorus were identified as important predictive factors of tiller density. Many of these factors had stark non-limiting thresholds. Factors impacting growth rates and photosynthesis (specifically vapor pressure deficit and maximum temperatures) were most sensitive to changes in plant density. Out-of-season prediction errors were seasonally variable, highlighting model limitations due to training datasets.DiscussionThis study demonstrates that tillering is a predictable plasticity mechanism in corn, and therefore could be incorporated into decision tools for restrictive growing regions. While useful for diagnostics, these models are limited in forecast utility and should be coupled with appropriate decision theory and risk assessments for producers in climatically and socioeconomically vulnerable environments.

IntroductionDynamic crop growth models are an important tool to predict complex traits, like crop yield, for modern and future genotypes in their current and evolving environments, as those occurring under climate change. Phenotypic traits are the result of interactions between genetic, environmental, and management factors, and dynamic models are designed to generate the interactions producing phenotypic changes over the growing season. Crop phenotype data are becoming increasingly available at various levels of granularity, both spatially (landscape) and temporally (longitudinal, time-series) from proximal and remote sensing technologies.MethodsHere we propose four phenomenological process models of limited complexity based on differential equations for a coarse description of focal crop traits and environmental conditions during the growing season. Each of these models defines interactions between environmental drivers and crop growth (logistic growth, with implicit growth restriction, or explicit restriction by irradiance, temperature, or water availability) as a minimal set of constraints without resorting to strongly mechanistic interpretations of the parameters. Differences between individual genotypes are conceptualized as differences in crop growth parameter values.ResultsWe demonstrate the utility of such low-complexity models with few parameters by fitting them to longitudinal datasets from the simulation platform APSIM-Wheat involving in silico biomass development of 199 genotypes and data of environmental variables over the course of the growing season at four Australian locations over 31 years. While each of the four models fits well to particular combinations of genotype and trial, none of them provides the best fit across the full set of genotypes by trials because different environmental drivers will limit crop growth in different trials and genotypes in any specific trial will not necessarily experience the same environmental limitation.DiscussionA combination of low-complexity phenomenological models covering a small set of major limiting environmental factors may be a useful forecasting tool for crop growth under genotypic and environmental variation.

IntroductionCrop plasticity is fundamental to sustainability discussions in production agriculture. Modern corn (Zea mays L.) genetics can compensate yield determinants to a small degree, but plasticity mechanisms have been masked by breeder selection and plant density management preferences. While tillers are a well-known source of plasticity in cereal crops, the functional trade-offs of tiller expression to the hierarchical yield formation process in corn are unknown. This investigation aimed to further dissect the consequences of tiller expression on corn yield component determination and plasticity in a range of environments from two plant fraction perspectives – i) main stalks only, considering potential functional trade-offs due to tiller expression; and ii) comprehensive (main stalk plus tillers). MethodsThis multi-seasonal study considered a dataset of 17 site-years across Kansas, United States. Replicated field trials evaluated tiller presence (removed or intact) in two hybrids (P0657AM and P0805AM) at three target plant densities (25000, 42000, and 60000 plants ha-1). Record of ears and kernels per unit area and kernel weight were collected separately for both main stalks and tillers in each plot. ResultsIndicated tiller contributions impacted the plasticity of yield components in evaluated genotypes. Ear number and kernel number per area were less dependent on plant density, but kernel number remained key to yield stability. Although ear number was less related to yield stability, ear source and type were significant yield predictors, with tiller axillary ears as stronger contributors than main stalk secondary ears in high-yielding environments. DiscussionsCertainly, managing for the most main stalk primary ears possible – that is, optimizing the plant density (which consequently reduces tiller expression), is desirable to maximize yields. However, the demonstrated escape from the deterministic hierarchy of corn yield formation may offer avenues to reduce corn management dependence on a seasonally variable optimum plant density, which cannot be remediated mid-season.

Environmental characterization for defining the target population of environments (TPE) is critical to improve the efficiency of breeding programs in crops, such as sorghum (Sorghum bicolor L.). The aim of this study was to characterize the spatial and temporal variation for a TPE for sorghum within the United States. APSIM-sorghum, included in the Agricultural Production Systems sIMulator software platform, was used to quantify water-deficit and heat patterns for 15 sites in the sorghum belt. Historical weather data (∼35 years) was used to identify water (WSP) and heat (HSP) stress patterns to develop water–heat clusters. Four WSPs were identified with large differences in the timing of onset, intensity, and duration of the stress. In the western region of Kansas, Oklahoma, and Texas, the most frequent WSP (∼35%) was stress during grain filling with late recovery. For northeast Kansas, WSP frequencies were more evenly distributed, suggesting large temporal variation. Three HSPs were defined, with the low HSP being most frequent (∼68%). Field data from Kansas State University sorghum hybrid yield performance trials (2006–2013 period, 6 hybrids, 10 sites, 46 site × year combinations) were classified into the previously defined WSP and HSP clusters. As the intensity of the environmental stress increased, there was a clear reduction on grain yield. Both simulated and observed yield data showed similar yield trends when the level of heat or water stressed increased. Field yield data clearly separated contrasting clusters for both water and heat patterns (with vs. without stress). Thus, the patterns were regrouped into four categories, which account for the observed genotype by environment interaction (GxE) and can be applied in a breeding program. A better definition of TPE to improve predictability of GxE could accelerate genetic gains and help bridge the gap between breeders, agronomists, and farmers.

Crop yield results from the complex interaction between genotype, management, and environment. While farmers have control over what genotype to plant and how to manage it, their decisions are often sub-optimal due to climate variability. Sub-seasonal climate predictions embrace the great potential to improve risk analysis and decision-making. However, adequate frameworks integrating future weather uncertainty to predict crop outcomes are lacking. Maize (Zea mays L.) yields are highly sensitive to weather anomalies, and very responsive to plant density (plants m ^−2 ). Thus, economic optimal plat density is conditional to the seasonal weather conditions and can be anticipated with seasonal prospects. The aims of this study were to (i) design a model that describes the yield-to-plant density relationship (herein termed as yield–density) as a function of weather variables, and provides probabilistic forecasts for the economic optimum plant density (EOPD), and (ii) analyze the model predictive performance and sources of uncertainty. We present a novel approach to enable decision-making in agriculture using sub-seasonal climate predictions and Bayesian modeling. This model may inform crop management recommendations and accounts for various sources of uncertainty. A Bayesian hierarchical shrinkage model was fitted to the response of maize yield–density trials performed during the 2010–2019 period across seven states in the United States, identifying the relative importance of key weather, crop, and soil variables. Tercile forecasts of precipitation and temperature from the International Research Institute were used to forecast EOPD before the start of the season. The variables with the greatest influence on the yield–density relationship were weather anomalies, especially those variables indicating months with above-normal temperatures. Improvements on climate forecasting may also improve forecasts on yield responses to management, as we found reduced bias and error (by a factor >10), and greater precision (e.g. R ^2 increased from 0.26 to 0.32) for cases where weather forecasts matched observations. This study may contribute to the development of decision-support tools that can trigger discussions between farmers and consultants about management strategies and their associated risks.

The diverse consequences of genotype-by-environment (GxE) interactions determine trait phenotypes across levels of biological organization for crops, challenging our ambition to predict trait phenotypes from genomic information alone. GxE interactions have many implications for optimizing both genetic gain through plant breeding and crop productivity through on-farm agronomic management. Advances in genomics technologies have provided many suitable predictors for the genotype dimension of GxE interactions. Emerging advances in high-throughput proximal and remote sensor technologies have stimulated the development of “enviromics” as a community of practice, which has the potential to provide suitable predictors for the environment dimension of GxE interactions. Recently, several bespoke examples have emerged demonstrating the nascent potential for enhancing the prediction of yield and other complex trait phenotypes of crop plants through including effects of GxE interactions within prediction models. These encouraging results motivate the development of new prediction methods to accelerate crop improvement. If we can automate methods to identify and harness suitable sets of coordinated genotypic and environmental predictors, this will open new opportunities to upscale and operationalize prediction of the consequences of GxE interactions. This would provide a foundation for accelerating crop improvement through integrating the contributions of both breeding and agronomy. Here we draw on our experience from improvement of maize productivity for the range of water-driven environments across the US corn-belt. We provide perspectives from the maize case study to prioritize promising opportunities to further develop and automate “enviromics” methodologies to accelerate crop improvement through integrated breeding and agronomic approaches for a wider range of crops and environmental targets.

Genomic selection (GS) has revolutionized breeding strategies by predicting the rank performance of post-harvest traits via implementing genomic prediction (GP) models. However, predicting pre-harvest traits in unobserved environments might produce serious biases. In soybean, days to maturity (DTM) represents a crucial stage with a significant impact on yield potential; thus, genotypes must be carefully selected to ensure latitudinal adaptation in this photoperiod-sensitive crop species. This research assessed the use of daylength for predicting DTM in unobserved environments (CV00). A soybean dataset comprising 367 genotypes spanning nine families of the Soybean Nested Association Mapping Panel (SoyNAM) and tested in 11 environments (year-by-location combinations) was considered in this study. The proposed method (CB) returned a root-mean-square error (RMSE) of 5.2 days, a Pearson correlation (PC) of 0.66, and the predicted vs. observed difference in the environmental means (PODEM) ranged from −3.3 to 4.5 days; however, in the absence of daylength data, the conventional GP implementation produced an RMSE of 9 days, a PC of 0.66, and a PODEM range from −14.7 to 7.9 days. These results highlight the importance of dissecting phenotypic variability (G × E) based on photoperiod data and non-predictable environmental stimuli for improving the predictive ability and accuracy of DTM in soybeans.

The vast wealth of cultural artifacts and ancient biological samples can today be investigated using a great variety of methods and technologies. The result is a growing diffusion of studies on DNA, isotopes and morphometrics, and the exponential growth of publications and bio-archaeological discoveries of inestimable value for different areas of interpretation, such as phylogeny, history and archaeology. This paper describes the morphological and molecular study of a rare specimen of Felis from an Early Bronze Age horizon. The report offers the opportunity for a brief discussion on cat taming, on the origin of this practice and on the archaeological importance of this specimen for the reconstruction of taming practices in the Western Mediterranean Basin.

Introduction. An intimate relationship between osteoporosis and sarcopenia has been established. At present, there are few epidemiological studies about osteosarcopenia due to the recent use of this term, especially in Latin America. Objective. To study the association between osteoporosis and sarcopenia and determine the prevalence of osteosarcopenia in patients who attended a rheumatology center in Ecuador. Methods. A cross-sectional study was conducted in a population of patients who had a densitometric study. The diagnosis of sarcopenia was determined by the DXA standard gold test, screening, and conventional methods (bioimpedance, anthropometric measurements, SARC-F, muscle function, and gait test). Results. A total of 92 patients were studied. The median age was 66 ± 10, 90% females. Using the criteria of SMI, 65% had sarcopenia of which 9% had only sarcopenia and 56% had osteosarcopenia; 22% had only osteopenia/osteoporosis; and 13% none of these conditions. The prevalence of sarcopenia according to handgrip strength was 60%, gait speed 45%, and SARC-F score 40%. The prevalence of osteosarcopenia according to handgrip strength was 51%, gait speed 34%, and SARC-F score 32%. Osteoporosis was associated with a higher prevalence of sarcopenia using the criteria of SMI since 40% had sarcopenia in the normal DXA group, 64% in the osteopenia group, and 76% in the osteoporosis group (p=0.017). Of the women, 69% had sarcopenia compared to 33% of the men (p=0.034). The BMI was lower in the group with sarcopenia (25.1 ± 4.1 kg/m2) compared to the group without sarcopenia (29.4 ± 4.1 kg/m2, p

We present two recent cases of toddlers who developed malignant cerebellar edema subsequent to accidental ingestion of prescription opioids. Both children presented acute neurological decline, hydrocephalus, and tonsillar herniation requiring emergent ventricular drain placement, suboccipital craniectomy, and partial cerebellectomy. Together with several other reports, these cases suggest the existence of an uncommon yet severe syndrome of acute opioid-induced malignant cerebellar edema. We hypothesize that the condition results from a combination of primary opioid receptor-mediated changes in neuronal metabolism that are exacerbated by secondary hypoxic insult. If recognized promptly, this syndrome can be treated with emergent neurosurgical intervention with good clinical outcomes. These cases also illustrate the unintended consequences and innocent victims of the spiraling prescription opioid epidemic, which will likely increase in prevalence. Recognition of this syndrome by clinicians is thus critical.

Genomic selection, enabled by whole genome prediction (WGP) methods, is revolutionizing plant breeding. Existing WGP methods have been shown to deliver accurate predictions in the most common settings, such as prediction of across environment performance for traits with additive gene effects. However, prediction of traits with non-additive gene effects and prediction of genotype by environment interaction (G×E), continues to be challenging. Previous attempts to increase prediction accuracy for these particularly difficult tasks employed prediction methods that are purely statistical in nature. Augmenting the statistical methods with biological knowledge has been largely overlooked thus far. Crop growth models (CGMs) attempt to represent the impact of functional relationships between plant physiology and the environment in the formation of yield and similar output traits of interest. Thus, they can explain the impact of G×E and certain types of non-additive gene effects on the expressed phenotype. Approximate Bayesian computation (ABC), a novel and powerful computational procedure, allows the incorporation of CGMs directly into the estimation of whole genome marker effects in WGP. Here we provide a proof of concept study for this novel approach and demonstrate its use with synthetic data sets. We show that this novel approach can be considerably more accurate than the benchmark WGP method GBLUP in predicting performance in environments represented in the estimation set as well as in previously unobserved environments for traits determined by non-additive gene effects. We conclude that this proof of concept demonstrates that using ABC for incorporating biological knowledge in the form of CGMs into WGP is a very promising and novel approach to improving prediction accuracy for some of the most challenging scenarios in plant breeding and applied genetics.

We test the robustness of the self-controlled risk interval (SCRI) design in a setting where time between doses may introduce time-varying confounding, using both negative control outcomes (NCOs) and quantitative bias analysis (QBA). All vaccinated cases identified from 5 European databases between September 1, 2020, and end of data availability were included. Exposures were doses 1-3 of the Pfizer, Moderna, AstraZeneca, and Janssen COVID-19 vaccines; outcomes were myocarditis and, as the NCO, otitis externa. The SCRI used a 60-day control window and dose-specific 28-day risk windows, stratified by vaccine brand and adjusted for calendar time. The QBA included two scenarios: (1) baseline probability of the confounder was higher in the control window and (2) vice versa. The NCO was not associated with any of the COVID-19 vaccine types or doses except Moderna dose 1 (IRR = 1.09; 95% CI 1.01-1.09). The QBA suggested that even the strongest literature-reported confounder (COVID-19; RR for myocarditis = 18.3) could only explain away part of the observed effect, from IRR = 3 to IRR = 1.40. The SCRI seems robust to unmeasured confounding in the COVID-19 setting, although a strong unmeasured confounder could bias the observed effect upward. Replication of our findings for other safety signals would strengthen this conclusion. This article is part of a Special Collection on Pharmacoepidemiology., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.)

We aim to estimate the incidence rates (IRs) of SARS-CoV-2 infections stratified by disease severity and comorbidities in pediatric population and to describe the COVID-19 vaccination coverage in children with and without comorbidities. A population-based cohort study was conducted in 6 electronic healthcare records databases from Italy, Spain, and Norway. The study lasted from 1 January 2020 to the latest databases' available data in each site, i.e., in Italian ARS Tuscany and PEDIANET: December 2021, in Spanish BIFAP: February 2022; SIDIAP: June 2022, and VID: December 2021. Finally, in Norwegian Health Registries: December 2021. Children and adolescents were included and stratified into three age categories (< 5, 5- < 12, and 12- < 18 years old). IRs (95% confidence intervals) per 100 person-years (PY) for non-severe (positive SARS-CoV-2 test or diagnosis without hospitalization) and severe COVID-19 (hospitalization, intensive care unit admission, and death after COVID-19) are reported. The cumulative COVID-19 vaccination rollout was stratified by population with and without comorbidities. The study population comprised 5,654,040 individuals < 18 years of age (51% females) across the six European databases (median age: 6 years), with 1.4 to 8.5% of them having at least one at-risk comorbidity for severe COVID-19. Incidence rates of severe COVID-19 were low (0-1 per 100 PY) but 3 to 4 times higher among children and adolescents with comorbidities during Omicron BA.1-2 wave in December 2021-January 2022. Percentages of vaccination rollout in the general population were between 13% in PEDIANET-IT and 64% in BIFAP-ICU-ES. In ARS-IT and SIDIAP-IT, vaccination rate in children with comorbidities was slightly lower than that in the general population., Conclusion: Severe COVID-19 was rare across databases, but up to 3 to 4 times higher in children with comorbidities during the predominance of Omicron BA.1-2 variant in winter 2021-2022. COVID-19 vaccination coverage was slightly lower in children with comorbidities in ARS (Tuscany) and SIDIAP (Catalonia) data sources. Our findings will inform future public policies aimed to protect the pediatric population, both within these countries and globally., What Is Known: • Pediatric population is susceptible to SARS-CoV-2 infection. • COVID-19 severity rates in children vary across study settings and context., What Is New: • This study confirms the low severity rates of COVID-19 in the pediatric population based on a large cohort of children and adolescents residing in Spain, Italy, and Norway. • Incidence of severe COVID-19 in children and adolescents with comorbidities was up to 3 to 4 times higher than in the general pediatric population during the SARS-CoV-2 high transmission wave of Omicron BA.1-2 variant in winter 2021-2022 in Italy and Spain., Competing Interests: Declarations Ethics approval Most data partners that provided data for the herein-presented results had passed the local ethical review process for the whole COVID-19 Vaccine Monitor study (EUPAS42467); Norwegian data (NHR): Regional Committee for Research Ethics (approval number 155294/REK Nord) and the Data Protection Officer at the University of Oslo (approval number 523275); Valencian data (VID): Comité Ético de Investigación con Medicamentos del Hospital General Universitario de Elche (approval number: PI-90/2021); Catalonian data (SIDIAP): Comitè Ètic d'Investigació amb medicaments (CEIm) de l'IDIAP Jordi Gol (approval number: 21/199-PCV); and BIFAP (several Spanish regions): Comité de Ética de la Investigación con Medicamentos del Hospital Universitario de la Princesa and Comité Científico de BIFAP (approval number: CEIm 14/21). There was no need of ethical committee approval for Italian databases (ARS and PEDIANET). This research adhered to the rules and principles of the European Network of Centers of Pharmacoepidemiology and Pharmacovigilance (ENCePP) Code of Conduct. Consent to participate This research was conducted using secondary heathcare data. Informed consent to participate was not obtained. The whole COVID-19 Vaccine Monitor study (EUPAS42467) was conducted following the ENCePP Code of Conduct. Competing interests The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Chemoradiation therapy (CRT) is a treatment for muscle-invasive bladder cancer (MIBC). Using a novel transcriptomic profiling panel, we validated prognostic immune biomarkers to CRT using 70 pretreatment tumor samples from prospective trials of MIBC (NRG/RTOG 0524 and 0712). Disease-free survival (DFS) and overall survival (OS) were estimated via the Kaplan-Meier method and stratified by genes correlated with immune cell activation. Cox proportional-hazards models were used to assess group differences. Clustering of gene expression profiles revealed that the cluster with high immune cell content was associated with longer DFS (hazard ratio [HR] 0.53, 95% confidence interval [CI] 0.26-1.10; p = 0.071) and OS (HR 0.48, 95% CI 0.24-0.97; p = 0.040) than the cluster with low immune cell content. Higher expression of T-cell infiltration genes (CD8A and ICOS) was associated with longer DFS (HR 0.40, 95% CI 0.21-0.75; p = 0.005) and OS (HR 0.49, 95% CI 0.25-0.94; p = 0.033). Higher IDO1 expression (IFNγ signature) was also associated with longer DFS (HR 0.44, 95% CI 0.24-0.88; p = 0.021) and OS (HR 0.49, 95% CI 0.24-0.99; p = 0.048). These findings should be validated in prospective CRT trials that include biomarkers, particularly for trials incorporating immunotherapy for MIBC. PATIENT SUMMARY: We analyzed patient samples from two clinical trials (NRG/RTOG 0524 and 0712) of chemoradiation for muscle-invasive bladder cancer using a novel method to assess immune cells in the tumor microenvironment. Higher expression of genes associated with immune activation and high overall immune-cell content were associated with better disease-free survival and overall survival for patients treated with chemoradiation., (Copyright © 2024 European Association of Urology. Published by Elsevier B.V. All rights reserved.)

Pasteurellosis, a disease caused by Pasteurella multocida , is responsible for economic losses in rabbit industrial farms due to rhinitis, conjunctivitis, pneumonia, metritis, mastitis, orchitis, subcutaneous abscesses, otitis, encephalitis, and septicaemic forms. Although the occurrence of the disease is conditioned by predisposing factors that affect the rabbit immune response, the strains of P. multocida involved in the infection may have a different pathogenic ability. Therefore, typing of strains spread among the rabbits is important to assess their pathogenic potential. The aim of this study is to investigate the P. multocida strains responsible for disease in rabbit industrial farms. A total of 114 strains identified from different lesions were serotyped. Additionally, the presence of virulence-associated genes was investigated using three PCR (polymerase chain reaction) protocols. Capsular type A was prevalently found in strains from respiratory lesions while types D and F in those from metritis, mastitis, and other lesions. Different associations between some virulence-associated genes and both capsular type and lesions found in rabbits were detected. The presence of 8 virulence-associated genes seems to increase the occurrence of metritis. In addition, strains belonging to capsular type A and responsible for respiratory disorders especially, were found equipped with 10 and 11 virulence-associated genes. Nevertheless, the presence of strains responsible only for rhinitis was also detected among the latter, suggesting that the pathogenic ability of the bacteria depends on the expression rather than the presence of a gene.

Introduction: The aim of this study was to assess the possible extent of bias due to violation of a core assumption (event-dependent exposures) when using self-controlled designs to analyse the association between COVID-19 vaccines and myocarditis., Methods: We used data from five European databases (Spain: BIFAP, FISABIO VID, and SIDIAP; Italy: ARS-Tuscany; England: CPRD Aurum) converted to the ConcePTION Common Data Model. Individuals who experienced both myocarditis and were vaccinated against COVID-19 between 1 September 2020 and the end of data availability in each country were included. We compared a self-controlled risk interval study (SCRI) using a pre-vaccination control window, an SCRI using a post-vaccination control window, a standard SCCS and an extension of the SCCS designed to handle violations of the assumption of event-dependent exposures., Results: We included 1,757 cases of myocarditis. For analyses of the first dose of the Pfizer vaccine, to which all databases contributed information, we found results consistent with a null effect in both of the SCRI and extended SCCS, but some indication of a harmful effect in a standard SCCS. For the second dose, we found evidence of a harmful association for all study designs, with relatively similar effect sizes (SCRI pre = 1.99, 1.40 - 2.82; SCRI post 2.13, 95 %CI - 1.43, 3.18; standard SCCS 1.79, 95 %CI 1.31 - 2.44, extended SCCS 1.52, 95 %CI = 1.08 - 2.15). Adjustment for calendar time did not change these conclusions. Findings using all designs were also consistent with a harmful effect following a second dose of the Moderna vaccine., Conclusions: In the context of the known association between COVID-19 vaccines and myocarditis, we have demonstrated that two forms of SCRI and two forms of SCCS led to largely comparable results, possibly because of limited violation of the assumption of event-dependent exposures., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: University Medical Center Utrecht in collaboration with the Vaccine Monitoring Collaboration for Europe network (VAC4EU). reports financial support was provided by European Medicines Agency. Anna Schultze reports a relationship with GSK that includes: funding grants. Ian Douglas reports a relationship with GSK that includes: equity or stocks and funding grants. Fabio Riefolo reports a relationship with TEAMIT Institute, a research management organisation that participates in financially supported studies for the European Medicines Agency and related healthcare authorities, pharmaceutical companies, and the European Union that includes: employment. Felipe Villalobos, Meritxell Palleja-Millan, Carlo Alberto Bissacco and Elena Segundo reports a relationship with IDIAPJGol, which receives institutional research funding from public and private partners, pharmaceutical companies and regulatory agencies that includes: employment. Miriam Sturkenboom reports a relationship with University Medical Center Utrecht, which conducts studies for the European Medicines Agency, the European Commission and medicine manufacturers, all according to the ENCePP code of conduct that includes: employment. Carlos E. Duran reports a relationship with University Medical Center Utrecht, which receives institutional research funding from pharmaceutical companies and regulatory agencies that includes: employment. Rosa Gini and Davide Messina reports a relationship with ARS Tuscany, which reports funding from the Innovative Medicines Initiative, RTI, PHARMO, University of Southern Denmark, University of Utrecht, Eli Lilly, Pfizer, Novartis, AstraZeneca, Galapagos, and LeoPharma that includes: employment. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier India Pvt Ltd. All rights reserved.)

Background : Adolescent idiopathic scoliosis (AIS) is a spinal pathology affecting 0.47-5.2% of the population, often requiring surgical intervention to control deformity progression. Posterior spinal instrumentation and fusion with pedicle screw fixation are standard procedures for AIS curve correction; however, implant failure remains a significant complication, especially in multi-level fusions. This retrospective cohort study aims to compare the failure rates between conventional pedicle screws (CPSs) and fenestrated pedicle screws (FPSs) in AIS treatment, with a focus on investigating potential causes of these failures. Methods : This study, conducted from January 2016 to December 2020, involves a two-center retrospective analysis of AIS patients undergoing posterior instrumented fusion. Results : Data from a total of 162 patients (122 females and 40 males) revealed a mean age of 14.95 years (range: 11-18). The CPS group consisted of 80 patients (56 females and 24 males), whereas the FPS group consisted of 82 patients (66 females and 16 males) stratified by Risser grade and Lenke Classification. Radiological assessments, clinical outcomes, and SRS-22 scores were evaluated pre-operatively, at 6 months, and post-operatively (minimum follow-up of 2 years). Conclusions : Fenestrated pedicle screws (FPSs) pose concerns due to their lower mechanical strength compared to solid screws. Understanding their limitations and optimizing their application in AIS treatment is essential.

Using 4 data-sources (Spain, Italy, United Kingdom) data and a 1:1 matched cohort study, we aimed to estimate vaccine effectiveness (VE) in preventing SARS-CoV-2 infections with hospitalisations (±30 days) and death (±56 days) in general population and clinical subgroups with homologous/heterologous booster schedules (Comirnaty-BNT and Spikevax-MOD original COVID-19 vaccines) by comparison with unboosted individuals, during Delta and beginning of Omicron variants. Hazard Ratio (HR, by Cox models) and VE ([1-HR]*100) were calculated by inverse probability weights. Between December 2020-February 2022, in adults without prior SARS-CoV-2 infection, we matched 5.5 million people (>1 million with immunodeficiency, 343,727 with cancer) with a booster (3rd) dose by considering doses 1 and 2 vaccine brands and calendar time, age, sex, region, and comorbidities (immunodeficiency, cancer, severe renal disease, transplant recipient, Down Syndrome). We studied booster doses of BNT and MOD administered after doses 1 and 2 with BNT, MOD, or Oxford-AstraZeneca during a median follow-up between 9 and 16 weeks. BNT or MOD showed VE ranging from 70 to 86% across data sources as heterologous 3rd doses, whereas it was 42-88% as homologous 3rd doses. Depending on the severity and available follow-up, 3rd-dose effectiveness lasted between 1 and 5 months. In people with immunodeficiency and cancer, protection across data sources was detected with both heterologous (VE = 54-83%) and homologous (VE = 49-80%) 3rd doses. Overall, both heterologous and homologous 3rd doses with BTN or MOD showed additional protection against the severe effects of SARS-CoV-2 infections for the general population and for patients at potentially high risk of severe COVID-19 (elderly, people with immunodeficiency and cancer) in comparison with two doses schemes during Delta or early Omicron periods. The early VE after vaccination may be due to less testing among vaccinated pairs and unknown confounders, deserving cautious interpretation. The VE wane over time needs further in-depth research to properly envisage when or whether a booster of those vaccines should be administered., Competing Interests: Declaration of Competing Interest All the authors declare financial support was provided by European Medicines Agency and the following financial interests/personal relationships which may be considered as potential competing interests: Elisa Martin Merino (corresponding author): Agencia Española de Medicamentos y Productos Sanitarios (AEMPS) and Agencia Española de Cooperación Internacional para el Desarrollo (AECID) paid a presentation in a course ‘Farmacovigilancia de las vacunas frente a la COVID-19’; Unpaid collaboration in observational studies with Agencia Española de Medicamentos y Productos Sanitarios (AEMPS) for the “Grupo de Trabajo de Efectividad Vacunación COVID-19. Spanish Ministry of Health. ISCIII.CNE. Spanish Agency of Medicines and Medical Devices.” Riefolo Fabio is an employee of TEAMIT Institute, consulting research company that participates in financially supported studies for European Medicines Agency and related healthcare authorities, pharmaceutical companies, and the European Union. Ylenia Ingrasciotta is the CEO of the academic spin-off “INSPIRE srl” of the University of Messina, which has received funding for conducting observational studies from contract research organizations (RTI Health Solutions, Pharmo Institute N.V.) and from pharmaceutical Companies (Chiesi Italia, Kyowa Kirin s.r.l., Daiichi Sankyo Italia S.p.A.). Karin Swart-Polinder is an employee of the PHARMO Institute for Drug Outcomes Research. This independent research institute performs financially supported studies for the government and related healthcare authorities and several pharmaceutical companies., (Copyright © 2023. Published by Elsevier Ltd.)

Introduction: Childhood obesity is a social health problem in the Western World and an important goal is to analyze and correct risk factors. However, part of the problem could be determined by a different perception of the weight., Material and Methods: In October 2019, we conducted a cross-sectional study in which a questionnaire was administered to the parents of primary and secondary school children in South-East Tuscany, Italy. The aim was to determine the association between children's Body Mass Index (BMI) and the parent's perception., Results: Analysis was carried out on 1,405 complete questionnaires. We found that most parents wrongly perceive the weight of their children. 88.3% of parents with obese children believe that their children are of normal weight or only "a little overweight". 67.6% of parents who have overweight children think that their children are of normal weight (p < 0.001)., Conclusions: Our results show a misperception of the weight of the children in the parents eyes. The acquisition of healthy behaviour during childhood is extremely important for health in adulthood and for avoiding the onset of associated diseases. Therefore, food education becomes a crucial objective. Children and parents need to increase consciousness of the correct weight and diseases resulting from bad nutrition., Competing Interests: sCOOL FOOD program was financed by the Monte dei Paschi Foundation. The authors did not receive any personal funds for the research. Monte dei Paschi Foundation had no role in the test design, data collection or analysis, decision to publish, or preparation and discussion of the test results in the manuscript., (©2023 Pacini Editore SRL, Pisa, Italy.)

Purpose: Trabecular bone score (TBS) is a grey-level textural measurement acquired from dual-energy X-ray absorptiometry lumbar spine images and is a validated index of bone microarchitecture. In 2015, a Working Group of the European Society on Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) published a review of the TBS literature, concluding that TBS predicts hip and major osteoporotic fracture, at least partly independent of bone mineral density (BMD) and clinical risk factors. It was also concluded that TBS is potentially amenable to change as a result of pharmacological therapy. Further evidence on the utility of TBS has since accumulated in both primary and secondary osteoporosis, and the introduction of FRAX and BMD T-score adjustment for TBS has accelerated adoption. This position paper therefore presents a review of the updated scientific literature and provides expert consensus statements and corresponding operational guidelines for the use of TBS., Methods: An Expert Working Group was convened by the ESCEO and a systematic review of the evidence undertaken, with defined search strategies for four key topics with respect to the potential use of TBS: (1) fracture prediction in men and women; (2) initiating and monitoring treatment in postmenopausal osteoporosis; (3) fracture prediction in secondary osteoporosis; and (4) treatment monitoring in secondary osteoporosis. Statements to guide the clinical use of TBS were derived from the review and graded by consensus using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach., Results: A total of 96 articles were reviewed and included data on the use of TBS for fracture prediction in men and women, from over 20 countries. The updated evidence shows that TBS enhances fracture risk prediction in both primary and secondary osteoporosis, and can, when taken with BMD and clinical risk factors, inform treatment initiation and the choice of antiosteoporosis treatment. Evidence also indicates that TBS provides useful adjunctive information in monitoring treatment with long-term denosumab and anabolic agents. All expert consensus statements were voted as strongly recommended., Conclusion: The addition of TBS assessment to FRAX and/or BMD enhances fracture risk prediction in primary and secondary osteoporosis, adding useful information for treatment decision-making and monitoring. The expert consensus statements provided in this paper can be used to guide the integration of TBS in clinical practice for the assessment and management of osteoporosis. An example of an operational approach is provided in the appendix. This position paper presents an up-to-date review of the evidence base, synthesised through expert consensus statements, which informs the implementation of Trabecular Bone Score in clinical practice., (© 2023. The Author(s).)

Background: Direct observation is important, yet medical residents are rarely observed. We implemented and evaluated a direct observation program in resident clinics to increase the frequency of observation and feedback and improve perceptions about direct observation., Methods: We assigned faculty as observers in our resident clinics between June 2019 and February 2020. We surveyed residents and faculty before and after the program. Faculty completed a form for each observation performed. We analyzed surveys to examine changes in barriers, frequency and type of observations and feedback, and attitudes toward observation. The analytical sample included 38 and 37 pre- and postresident surveys, respectively, and 20 and 25 pre- and postfaculty surveys, respectively., Results: Resident survey response rates were 32.3% (40/124) pre- and 30.7% (39/127) postintervention. Most residents (76% [pre], 86% [post], P = 0.258) reported being observed in at least one of the four areas: history, examination, counseling, or wrap-up. We received observation tracking forms on 68% of eligible residents. Observed history taking increased from 30% to 79% after the program (P = 0.0010). Survey response rates for faculty were 64.7% (22/34) pre- and 67.5% (25/37) postintervention. Fewer faculty reported time (80% [pre], 52% [post], P = 0.051) and competing demands (65% [pre], 52% [post], P = 0.380) as barriers postintervention. Fewer faculty postintervention viewed observation as a valuable teaching tool (100% [pre], 79% [post], P = 0.0534). All faculty who did not view observation as valuable were the least experienced., Discussion: Assigning faculty as observers can increase observation, especially in history taking, though data suggest an increase in negative perceptions of observation by faculty., (Copyright © 2023 Copyright: © 2023 Education for Health.)

Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor and non-motor alterations. Typical motor symptoms include resting tremors, bradykinesia (hypokinesia or akinesia), muscular stiffness, gait alterations, and postural instability. In this context, neurorehabilitation may have a pivotal role in slowing the progression of PD, using both conventional and innovative rehabilitation approaches. Thirty patients (15 males and 15 females) affected by PD were enrolled in our study. We randomly divided the patients into two groups, an experimental group (EG) and a control group (CG). In particular, the EG performed gait and balance training using the Rysen system, which is an innovative body weight support (BWS) system, whilst the CG received conventional physiotherapy. Both groups underwent 20 sessions, five times weekly, with each session lasting about 40 min. At the end of the training sessions (T1), we found that both groups (EG and CG) achieved clinical improvements, although the EG showed better scores for post-treatment regarding global motor functioning and postural stability compared to the CG. In conclusion, our results suggest that the Rysen system, which is an innovative BWS tool, could be considered a valid device for improving postural control and global motor functions, when compared to conventional gait training, in patients affected by PD.

Background: Human, animal, and environmental health are increasingly threatened by the emergence and spread of antibiotic resistance. Inappropriate use of antibiotic treatments commonly contributes to this threat, but it is also becoming apparent that multiple, interconnected environmental factors can play a significant role. Thus, a One Health approach is required for a comprehensive understanding of the environmental dimensions of antibiotic resistance and inform science-based decisions and actions. The broad and multidisciplinary nature of the problem poses several open questions drawing upon a wide heterogeneous range of studies., Objective: This study seeks to collect and catalogue the evidence of the potential effects of environmental factors on the abundance or detection of antibiotic resistance determinants in the outdoor environment, i.e., antibiotic resistant bacteria and mobile genetic elements carrying antibiotic resistance genes, and the effect on those caused by local environmental conditions of either natural or anthropogenic origin., Methods: Here, we describe the protocol for a systematic evidence map to address this, which will be performed in adherence to best practice guidelines. We will search the literature from 1990 to present, using the following electronic databases: MEDLINE, Embase, and the Web of Science Core Collection as well as the grey literature. We shall include full-text, scientific articles published in English. Reviewers will work in pairs to screen title, abstract and keywords first and then full-text documents. Data extraction will adhere to a code book purposely designed. Risk of bias assessment will not be conducted as part of this SEM. We will combine tables, graphs, and other suitable visualisation techniques to compile a database i) of studies investigating the factors associated with the prevalence of antibiotic resistance in the environment and ii) map the distribution, network, cross-disciplinarity, impact and trends in the literature., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Percutaneous cement discoplasty (PCD) is a minimally invasive surgical procedure that can provide a segmental stabilizing and indirect decompression effect in the case of severely degenerated discs characterized by vacuum phenomenon. This systematic review aims to analyze the available literature relating to correct indications and clinical and radiologic efficacy of PCD in patients affected by advanced degenerative spine conditions., Methods: The search was conducted according to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guideline. Comprehensive research of PubMed, Scopus, and OVID databases was made using the following Mesh terms: ((cement) AND (discoplasty) AND ((vertebral) OR (spinal) OR (spine))). Modal distribution was used to assess the most frequent levels of PCD per patient. Quality assessment of each article was performed according to the Oxford Level of Evidence, Methodological Index for Non-Randomized studies, and Risk of Bias in Non-Randomized Studies score by 2 authors., Results: After the databases search, 5 full-text articles were included in the systematic review for a total of 291 patients (218 females and 73 males). Median PCD levels were 2.2. Despite promising clinical results, the methodologic index showed poor Methodological Index for Non-Randomized and Risk of Bias in Non-Randomized Studies scores., Conclusions: PCD provides good clinical results in elderly patients, especially for pain relief. However, the current literature is poor and the article included in the systematic review showed a poor methodologic score, which could affect the conclusions., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background: Estimates of the association between COVID-19 vaccines and myo-/pericarditis risk vary widely across studies due to scarcity of events, especially in age- and sex-stratified analyses. Methods: Population-based cohort study with nested self-controlled risk interval (SCRI) using healthcare data from five European databases. Individuals were followed from 01/01/2020 until end of data availability (31/12/2021 latest). Outcome was first myo-/pericarditis diagnosis. Exposures were first and second dose of Pfizer, AstraZeneca, Moderna, and Janssen COVID-19 vaccines. Baseline incidence rates (IRs), and vaccine- and dose-specific IRs and rate differences were calculated from the cohort The SCRI calculated calendar time-adjusted IR ratios (IRR), using a 60-day pre-vaccination control period and dose-specific 28-day risk windows. IRRs were pooled using random effects meta-analysis. Findings: Over 35 million individuals (49·2% women, median age 39-49 years) were included, of which 57·4% received at least one COVID-19 vaccine dose. Baseline incidence of myocarditis was low. Myocarditis IRRs were elevated after vaccination in those aged < 30 years, after both Pfizer vaccine doses (IRR = 3·3, 95%CI 1·2-9.4; 7·8, 95%CI 2·6-23·5, respectively) and Moderna vaccine dose 2 (IRR = 6·1, 95%CI 1·1-33·5). An effect of AstraZeneca vaccine dose 2 could not be excluded (IRR = 2·42, 95%CI 0·96-6·07). Pericarditis was not associated with vaccination. Interpretation: mRNA-based COVID-19 vaccines and potentially AstraZeneca are associated with increased myocarditis risk in younger individuals, although absolute incidence remains low. More data on children (≤ 11 years) are needed., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Bots, Riera-Arnau, Belitser, Messina, Aragón, Alsina, Douglas, Durán, García-Poza, Gini, Herings, Huerta, Sisay, Martín-Pérez, Martin, Overbeek, Paoletti, Pallejà-Millán, Schultze, Souverein, Swart, Villalobos, Klungel and Sturkenboom.)

The ischemia/reperfusion mechanism is believed to be responsible for parenchymal damage caused by temporary hypoperfusion and worsened by the subsequent attempt of reperfusion. This represents a true challenge for physicians of several fields, including neurosurgeons. A limited number of papers have shed the light on a rare pathologic condition that affects patients experiencing an unexplained neurologic deficit after spine surgery, the so-called "white cord syndrome." This entity is believed to be caused by an "ischemia/reperfusion" injury on the spinal cord, documented by a postoperative intramedullary hyperintensity on T2-weighted magnetic resonance imaging sequences. To date, the cases of white cord syndrome reported in literature mostly refer to cervical spine surgery. However, the analysis of several reviews focusing on spine surgery outcome suggests postoperative neurologic deficits of new onset could be charged to a mechanism of ischemia/reperfusion, even if the physiopathology of this event is seldom explored or at least discussed. The same neuroradiologic finding can suggest mechanical damage due to inappropriate surgical manipulation. On this purpose, we performed a systematic review of the literature with the aim to identify and analyze all the factors potentially contributing to ischemic/reperfusion damage of the spinal cord that may potentially complicate any spinal surgery, without distinction between cervical or thoracic segments. Finally, we believe that postoperative neurologic deficit after spinal surgery constituting the "white cord syndrome" could be under-reported; both neurosurgeons and patients should be fully aware of this rare but potentially devasting complication burdening cervical and thoracic spine surgery., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Toxoplasma gondii is a major foodborne pathogen capable of infecting all warm-blooded animals, including humans. Although oocyst-associated toxoplasmosis outbreaks have been documented, the relevance of the environmental transmission route remains poorly investigated. Thus, we carried out an extensive systematic review on T. gondii oocyst contamination of soil, water, fresh produce, and mollusk bivalves, following the PRISMA guidelines. Studies published up to the end of 2020 were searched for in public databases and screened. The reference sections of the selected articles were examined to identify additional studies. A total of 102 out of 3201 articles were selected: 34 articles focused on soil, 40 focused on water, 23 focused on fresh produce (vegetables/fruits), and 21 focused on bivalve mollusks. Toxoplasma gondii oocysts were found in all matrices worldwide, with detection rates ranging from 0.09% (1/1109) to 100% (8/8) using bioassay or PCR-based detection methods. There was a high heterogeneity (I 2 = 98.9%), which was influenced by both the sampling strategy (e.g., sampling site and sample type, sample composition, sample origin, season, number of samples, cat presence) and methodology (recovery and detection methods). Harmonized approaches are needed for the detection of T. gondii in different environmental matrices in order to obtain robust and comparable results.

Spine is a frequent site of bone metastases, with a 8.5 months median survival time after diagnosis. In most cases treatment is only palliative. Several advanced techniques can ensure a better Quality of Life (QoL) and increase life expectancy. Radiofrequency ablation (RFA) uses alternating current to produce local heating and necrosis of the spinal lesion, preserving the healthy bone. RFA is supported by vertebral reinforcement through kyphoplasty and vertebroplasty in order to stabilize the fracture with polymethylmethacrylate (PMMA) injection, restoring vertebral body height and reducing the weakness of healthy bone. The aim of this study is to demonstrate the efficacy and advantages of RFA plus vertebral reinforcement through PMMA vertebroplasty and fixation in patients affected by bone spinal metastases. We retrospectively analyzed 54 patients with thoraco-lumbar metastatic vertebral fractures admitted to our Unit between January 2014 and June 2020. Each patient underwent RFA followed by PMMA vertebroplasty and transpedicle fixation. We evaluated pain relief through the Visual Analogue Scale (VAS) Score and PMMA vertebral filling based on the mean Saliou filling score. Analysis of variance (ANOVA) was used to test pain relief with statistical significance for p<0.05. A total of 54 patients (median age 63,44 years; range 34-86 years), with a total of 63 infiltrated vertebrae, were treated with RFA, PMMA vertebroplasty and transpedicular screw fixation; average operative time was 60.4 min (range 51-72). The preoperative average VAS score decreased significantly from 7.81 to 2.50 (p < 0.05) after 12 months. Based on Saliou filling score, filling was satisfactory (12-18) in 20 vertebrae (31,7%), mediocre (6-11) in 33 vertebrae (52,4%), inadequate (0-5) in 10 vertebrae (15,9%). A consistent PMMA filling of vertebral bodies was successfully achieved with significant pain relief. Concomitant RFA, PMMA vertebroplasty and pedicle screw fixation represent a safe and effective technique for the management of spinal metastases, improving clinical outcome and pain control., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Giammalva, Costanzo, Paolini, Benigno, Porzio, Brunasso, Basile, Gulì, Pino, Gerardi, Messina, Umana, Palmisciano, Scalia, Graziano, Visocchi, Iacopino and Maugeri.)

Bridges constitute important elements of the transportation network. A vast part of the Italian existing infrastructural system dates to around 60 years ago, which implies that the related bridge structures were constructed according to past design guidelines and underwent a probable state of material deterioration (e.g., steel corrosion, concrete degradation), especially in those cases in which proper maintenance plans have not been periodically performed over the structural lifetime. Consequently, elaborating rapid yet effective safety assessment strategies for existing bridge structures represents a topical research line. This contribution presents a systematic experimental-numerical approach for assessing the load-bearing capacity of existing prestressed concrete (PC) bridge decks. This methodology is applied to the Longano PC viaduct (southern Italy) as a case study. Initially, natural frequencies and mode shapes of the bridge deck are experimentally identified from vibration data collected in situ through Operational Modal Analysis (OMA), based on which a numerical finite element (FE) model is developed and calibrated. In situ static load tests are then carried out to investigate the static deflections under maximum allowed serviceability loads, which are compared to values provided by the FE model for further validation. Since prestressing strands appear corroded in some portions of the main girders, numerical static nonlinear analysis with a concentrated plasticity approach is finally conducted to quantify the effects of various corrosion scenarios on the resulting load-bearing capacity of the bridge at ultimate limit states. The proposed methodology, encompassing both serviceability and ultimate conditions, can be used to identify critical parts of a large infrastructure network prior to performing widespread and expensive material test campaigns, to gain preliminary insight on the structural health of existing bridges and to plan a priority list of possible repairing actions in a reasonable, safe, and costly effective manner.

The laterally positioned flap (LPF) has been proposed as a promising treatment for isolated gingival recessions (GRs) in mandibular incisors. Several modifications have been proposed to reduce the risk of gingival recession (GR) at the donor tooth site. Therefore, the aim of this was to describe a modified one-stage procedure of performing the LPF associated with the subepithelial connective tissue graft (LPF + SCTG) with the modifications for the treatment of deep isolated GR in mandibular incisors. The modified one-stage technique (LPF + SCTG) is unique because it was presented being bilaminar with tunneled connective tissue graft (CTG) in the adjacent tooth and extended to the flap donor site, without a submarginal incision in the adjacent tooth, taking the entire band of the keratinized tissue (KT) into the flap. In addition, 3 clinical cases were described using this surgical technique. Three healthy patients with Cairo RT1 or RT2 GRs on teeth 31 or 41 were treated with the LPF + SCTG technique. Probing depth (PD), clinical attachment level (CAL), complete root coverage (CRC), mean root coverage (MRC), recession depth (RD), and keratinized tissue width (KTW) were assessed at baseline and in the follow-up periods of 18, 24, and 48 months, in the cases 1, 2, and 3, respectively. The LPF + SCTG with the modifications presented is a predictable approach for the treatment of deep isolated RT1 and RT2 GRs in mandibular incisors that are well positioned in the bone envelope with the presence of KTW adjacent to GR and adequate vestibule depth in the donor area of the flap., Competing Interests: The authors have no current or potential conflicts of interest to declare., (Copyright © 2021 Alvaro Francisco Bosco et al.)

Voxel-wise group analysis is presented as a novel feature selection (FS) technique for a deep learning (DL) approach to brain imaging data classification. The method, based on a voxel-wise two-sample t -test and denoted as t -masking, is integrated into the learning procedure as a data-driven FS strategy. t-Masking has been introduced in a convolutional neural network (CNN) for the test bench of binary classification of very-mild Alzheimer's disease vs. normal control, using a structural magnetic resonance imaging dataset of 180 subjects. To better characterize the t -masking impact on CNN classification performance, six different experimental configurations were designed. Moreover, the performances of the presented FS method were compared to those of similar machine learning (ML) models that relied on different FS approaches. Overall, our results show an enhancement of about 6% in performance when t -masking was applied. Moreover, the reported performance enhancement was higher with respect to similar FS-based ML models. In addition, evaluation of the impact of t -masking on various selection rates has been provided, serving as a useful characterization for future insights. The proposed approach is also highly generalizable to other DL architectures, neuroimaging modalities, and brain pathologies., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Messina, Borrelli, Russo, Salvatore and Aiello.)

Brain gliomas require a deep knowledge of their effects on brain connectivity. Understanding the complex relationship between tumor and functional brain is the preliminary and fundamental step for the subsequent surgery. The extent of resection (EOR) is an independent variable of surgical effectiveness and it correlates with the overall survival. Until now, great efforts have been made to achieve gross total resection (GTR) as the standard of care of brain tumor patients. However, high and low-grade gliomas have an infiltrative behavior and peritumoral white matter is often infiltrated by tumoral cells. According to these evidences, many efforts have been made to push the boundary of the resection beyond the contrast-enhanced lesion core on T1w MRI, in the so called supratotal resection (SpTR). SpTR is aimed to maximize the extent of resection and thus the overall survival. SpTR of primary brain tumors is a feasible technique and its safety is improved by intraoperative neuromonitoring and advanced neuroimaging. Only transient cognitive impairments have been reported in SpTR patients compared to GTR patients. Moreover, SpTR is related to a longer overall and progression-free survival along with preserving neuro-cognitive functions and quality of life., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Giammalva, Brunasso, Costanzo, Paolini, Umana, Scalia, Gagliardo, Gerardi, Basile, Graziano, Gulì, Messina, Pino, Feraco, Tumbiolo, Midiri, Iacopino and Maugeri.)

Transcranial MR-guided Focused ultrasound (tcMRgFUS) is a surgical procedure that adopts focused ultrasounds beam towards a specific therapeutic target through the intact skull. The convergence of focused ultrasound beams onto the target produces tissue effects through released energy. Regarding neurosurgical applications, tcMRgFUS has been successfully adopted as a non-invasive procedure for ablative purposes such as thalamotomy, pallidotomy, and subthalamotomy for movement disorders. Several studies confirmed the effectiveness of tcMRgFUS in the treatment of several neurological conditions, ranging from motor disorders to psychiatric disorders. Moreover, using low-frequencies tcMRgFUS systems temporarily disrupts the blood-brain barrier, making this procedure suitable in neuro-oncology and neurodegenerative disease for controlled drug delivery. Nowadays, tcMRgFUS represents one of the most promising and fascinating technologies in neuroscience. Since it is an emerging technology, tcMRgFUS is still the subject of countless disparate studies, even if its effectiveness has been already proven in many experimental and therapeutic fields. Therefore, although many studies have been carried out, many others are still needed to increase the degree of knowledge of the innumerable potentials of tcMRgFUS and thus expand the future fields of application of this technology.

Objective: in elderly patients reduction and fixation of acetabular fractures showed poor outcomes in fracture patterns where cartilage comminution/impaction and/or femoral head dislocation are present; acute arthroplasty with standard uncemented hemispherical cups and posterior plating has been recently proposed, we report on its safety and effectiveness., Methods: we used this technique to manage 67 displaced acetabular fracture but both column in patients older than 65 years old., Results: fractures of posterior column and/or wall with severe cartilage involvement may be treated safely with acute THA., Conclusions: Good results in complex fracture patterns may also be achieved., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2020 Published by Elsevier B.V. on behalf of Professor P K Surendran Memorial Education Foundation.)