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Little is known about the dermatologic manifestations of multisystem inflammatory syndrome in children (MIS-C) in children and adolescents.

Macrophages make up a substantial portion of the stromal compartment of the heart in health and disease. In the past decade, the origins of these cardiac macrophages have been established as two broad populations derived from either embryonic or definitive haematopoiesis and that can be distinguished by the expression of CC-motif chemokine receptor 2 (CCR2). These cardiac macrophage populations are transcriptionally distinct and have differing cell surface markers and divergent roles in cardiac homeostasis and disease. Embryonic-derived CCR2−macrophages are a tissue-resident population that participates in tissue development, repair and maintenance, whereas CCR2+macrophages are derived from definitive haematopoiesis and contribute to inflammation and tissue damage. Studies from the past 5 years have leveraged single-cell RNA sequencing technologies to expand our understanding of cardiac macrophage diversity, particularly of the monocyte-derived macrophage populations that reside in the injured and diseased heart. Emerging technologies in spatial transcriptomics have enabled the identification of distinct disease-associated cellular neighbourhoods consisting of macrophages, other immune cells and fibroblasts, highlighting the involvement of macrophages in cell–cell communication. Together, these discoveries lend new insights into the role of specific macrophage populations in the pathogenesis of cardiac disease, which can pave the way for the identification of new therapeutic targets and the development of diagnostic tools. In this Review, we discuss the developmental origin of cardiac macrophages and describe newly identified cell states and associated cellular neighbourhoods in the steady state and injury settings. We also discuss various contributions and effector functions of cardiac macrophages in homeostasis and disease.

La coincidencia en un paciente de espasmo hemifacial (EHF) y de neuralgia trigeminal (NT) no es frecuente. Se presenta un caso con el objetivo de mostrar esta asociación por la activación anormal del reflejo trigémino-facial.

The recent SmartGraph platform facilitates the execution of complex drug-discovery workflows with ease in the network-pharmacology paradigm. However, at the time of its publication we identified the need for the development of an Application Programming Interface (API) that could promote biomedical data integration and hypothesis generation in an automated manner. This need was magnified at the time of the COVID-19 pandemic. This study addresses the absence of such an API. Accordingly, most functionalities of the original platform were implemented within the SmartGraph API. We demonstrate that by using the API it is possible to transform the original semiautomated workflow behind the Neo4COVID19 database to a fully automated one. The availability of the SmartGraph API lends a significant improvement to the programmatic integration of network-pharmacology-oriented knowledge graphs and analytics, as well as predictive functionalities and workflows.

In the search for more sustainable remediation strategies for PAH-contaminated soils, an integrated application of thermal remediation and bioremediation (TEB) may allow the use of less impacting temperatures by associating heating to biological degradation. However, the influence of heating on soil microbiota remains poorly understood, especially in soils from tropical regions. This work investigated the effects of low-temperature heating on creosote-contaminated soil bacteria. We used culture-dependent and 16 S rRNA sequencing methods to compare the microbial community of soil samples heated to 60 and 100 oC for 1 h in microcosms. Heating to 60 °C reduced the density of cultivable heterotrophic bacteria compared to control soil (p< 0.05), and exposure to 100 °C inactivated the viable heterotrophic community. Burkholderia-Caballeronia-Paraburkholderia(BCP) group and Sphingobiumwere the predominant genera. Temperature and incubation time affected the Bray-Curtis dissimilarity index (p< 0.05). At 60 °C and 30 days incubation, the relative abundance of Sphingobiumdecreased and BCP increased dominance. The network of heated soil after 30 days of incubation showed fewer nodes and edges but maintained its density and complexity. Both main genera are associated with PAH degradation, suggesting functional redundancy and a likely potential of soil microbiota to maintain biodegradation ability after exposure to higher temperatures. We concluded that TEB can be considered as a potential strategy to bioremediate creosote-contaminated soils, allowing biodegradation in temperature ranges where thermal remediation does not completely remove contaminants. However, we recommend further research to determine degradation rates with this technology.

Purpose:: This article aims to comprehensively analyze the unique challenges in managing patients with metastatic Differentiated Thyroid Cancer (DTC) that develop radioiodine-refractory disease, especially in developing countries in Latin America. We discuss key contentious aspects of their treatment, such as the optimal timing for initiating systemic therapy, the choice of first-line medications, the appropriate timing for requesting molecular interrogation, and the challenges associated with accessing these drugs and molecular panels. Methods:: To illustrate these challenges and enhance understanding, we present five real clinical cases from the authors’ experiences. Results:: Patients with Differentiated Thyroid Cancer (DTC) generally have an excellent prognosis, with an overall 10-year survival rate exceeding 97%. However, approximately 5% of DTC patients, especially those with distant metastases, may develop radioiodine-refractory disease, reducing survival rates. Access to medications remains difficult and time-consuming, particularly for patients within the public healthcare system. Urgent discussions on drug pricing involving all stakeholders are imperative. To break free from complacency, stakeholders must prioritize patient well-being by advocating for evidence-based drug pricing, increased participation in clinical trials, and streamlined regulatory processes. Conclusion:: Beyond the recognized need for prospective randomized clinical trials to determine the optimal first-line drug and the timing of molecular testing, this type of manuscript plays a pivotal role in stimulating discussions and disseminating comprehensive knowledge about the challenges associated with treating and monitoring patients with radioiodine-refractory thyroid carcinoma, especially in developing countries.

Inflammation and tissue fibrosis co-exist and are causally linked to organ dysfunction1,2. However, the molecular mechanisms driving immune–fibroblast cell communication in human cardiac disease remain unexplored and there are at present no approved treatments that directly target cardiac fibrosis3,4. Here we performed multiomic single-cell gene expression, epitope mapping and chromatin accessibility profiling in 45 healthy donor, acutely infarcted and chronically failing human hearts. We identified a disease-associated fibroblast trajectory that diverged into distinct populations reminiscent of myofibroblasts and matrifibrocytes, the latter expressing fibroblast activator protein (FAP) and periostin (POSTN). Genetic lineage tracing of FAP+fibroblasts in vivo showed that they contribute to the POSTN lineage but not the myofibroblast lineage. We assessed the applicability of experimental systems to model cardiac fibroblasts and demonstrated that three different in vivo mouse models of cardiac injury were superior compared with cultured human heart and dermal fibroblasts in recapitulating the human disease phenotype. Ligand–receptor analysis and spatial transcriptomics predicted that interactions between C-C chemokine receptor type 2 (CCR2) macrophages and fibroblasts mediated by interleukin-1β (IL-1β) signalling drove the emergence of FAP/POSTN fibroblasts within spatially defined niches. In vivo, we deleted the IL-1 receptor on fibroblasts and the IL-1β ligand in CCR2+monocytes and macrophages, and inhibited IL-1β signalling using a monoclonal antibody, and showed reduced FAP/POSTN fibroblasts, diminished myocardial fibrosis and improved cardiac function. These findings highlight the broader therapeutic potential of targeting inflammation to treat tissue fibrosis and preserve organ function.

Le Comité de cancérologie de l’Association française d’urologie propose une mise à jour des recommandations dans la prise en charge du cancer de la prostate (CaP) récidivé et/ou métastatique.

Le but du comité de cancérologie de l’Association française d’urologie est de proposer une mise à jour des recommandations dans le diagnostic et la prise en charge du cancer de la prostate (CaP) localisé.

Despite a comparable overall detection rate, this trial fails to show noninferiority of transperineal targeted biopsies over transrectal significant cancer detection.

The overall performance of the tested computer-aided diagnosis (CADx) system was similar to that of the Prostate Imaging Reporting and Data System version 2 score assigned prospectively at the time of biopsy. The CADx predefined diagnostic thresholds, which provided 90% sensitivity in the training dataset, yielded sensitivity of 86% (95% confidence interval: 76–94) and specificity of 64% (95% confidence interval: 55–74) in the test dataset. The CADx score could help stratify the risk of clinically significant prostate cancer in patients with positive magnetic resonance imaging and negative prostate-specific antigen density.

Staphylococcus pseudintermedius, which is part of the skin microbiome of dogs, causes a variety of opportunistic infections. These infections may become more difficult to treat due to the formation of biofilm. The capacity of S. pseudintermediusto form biofilm, as well as the associated genes, has not been elucidated. This study evaluated the production and composition of S. pseudintermediusbiofilm. Samples were collected from both infected dogs and asymptomatic dogs. Isolates were identified using mass spectrometry and Multiplex-PCR. Biofilm production and composition were assessed using a quantitative microtiter plate assay. The presence of icaoperon genes and spsgenes was investigated using conventional PCR. The investigation of Agr type and virulence genes was conducted in silico on 24 sequenced samples. All strains could produce strong biofilms, with most of the isolates presenting a polysaccharide biofilm. 63.6% of the isolates carried the complete icaoperon (ADBC). All samples showed the presence of the genes spsK, spsA, and spsL, while the distribution of other genes varied. Agr type III was the most prevalent (52.2%). All sequenced samples carried the cytotoxins hlb, luk-S, luk-F, as well as the exfoliative toxins sietand se_int. No isolate displayed other exfoliative toxins. Only LB1733 presented a set of different enterotoxins (sea, seb, sec_canine, seh, sek, sel, and seq). Our findings suggest that S. pseudintermediusis a strong producer of biofilm and carries virulence genes.

The article provides an overview of the progress and success of Major League Cricket (MLC) in the United States. MLC has completed two seasons and is considered the most successful professional franchise set-up in American cricket history. The league attracts top-tier players from around the world with its high salaries and has gained recognition and support from American fans. However, there is a need for a third venue to accommodate the growing demand, and MLC is in talks with the ECB to avoid scheduling conflicts with The Hundred. The league aims to establish a clear window in the cricket calendar and expand its presence in the American market. [Extracted from the article]

ABSTRACTThe flip chip package (FCP) based integrated circuits supports millimetre wave frequency range (30 - 300 GHz), analysing the conditions for optimal signal transmission between the integrated circuits for FCP type being the primary essence of this article. The effective signal transmission occurs through a dielectric-coated conductor structure based on the surface wave communication phenomenon, known as a surface wave communication-based wave guide (SWW). The article focuses primarily on design considerations to build SWW for FCP applications at millimetre wave frequency ranges. The efficiency of the proposed waveguide was investigated in terms of power transmission capacity, voltage standing wave ratio (VSWR) and signal attenuation. The analysis comprises examining these parameters at the frequency range of 50 GHz to 150 GHz while taking into account varied degrees of waveguide dimensions and surface reactance. The measured results show that at the signal frequency of 100 GHz with dielectric and conductor thickness of 0.2 mm and surface reactance of 100 Ω, the suggested waveguide provides efficient signal transmission with approximately 0 dB signal attenuation, ideal high-power flow of 41,000 ${{VA} \over {{m^2}}}$VAm2and VSWR of 1.2. Overall, this article provides insights on the design and performance of SWW for FCP applications at millimetre wave frequency band.

Esistono diversi tumori testicolari, il più comune dei quali è il cancro testicolare, che è relativamente raro, e il 98% di essi è rappresentato da tumori a cellule germinali. Tuttavia, è il tumore maligno più frequente negli uomini di età compresa tra i 15 e i 35 anni, responsabile del 12% dei decessi in questa fascia d’età. Diagnosticato il più delle volte mediante esame obiettivo, la sua caratteristica principale risiede nel suo carattere il più delle volte curabile, grazie alla combinazione di procedure diagnostiche rapide, di marcatori tumorali discriminanti e di protocolli terapeutici efficaci, tanto che il tasso di sopravvivenza a 5 anni è superiore al 95%. Infatti, la palpazione clinica o il rilevamento ecografico di una massa testicolare giustificano l’orchiectomia inguinale allargata, una procedura diagnostica e terapeutica. I trattamenti adiuvanti variano a seconda del tipo istologico, tra tumori a cellule germinali non seminomatosi (TGNS), che sono chemiosensibili e rapidamente progressivi, e tumori a cellule germinali seminomatosi (TGS), che sono radiosensibili e lentamente progressivi. La prognosi delle forme metastatiche dipende dalla massa tumorale. La polichemioterapia a base di platino è efficace nei TGNS, con oltre l’80% di remissione completa a 5 anni. È efficace anche nei TGS e sostituisce la radioterapia esterna negli stadi metastatici. In questi soggetti giovani, la cui guarigione è praticamente assicurata, la futura paternità è una preoccupazione che giustifica la conservazione dello sperma prima dell’orchiectomia.

Owing to their unique luminescent properties and photosensitizing capability, cyanoruthenium(II) complexes with diimine ligands are the subject of intense research striving for routes for tuning their electronic properties and improving their emission quantum yield. In this work, we describe a heterometallic d-fcyanide-bridged Ru(II)–Er(III) assembly obtained by the direct reaction of trivalent erbium salt with the neutral [Ru(bipy)2(CN)2] (bipy = 2,2'-bipyridine) metalloligand. This strategy allows for accommodating inorganic negatively charged anions such as nitrate and oxalate in the coordination sphere of the lanthanide ion. As a result, a dimeric tetranuclear discrete molecular architecture is obtained, where the two constituting monomeric Ru(II)-CN-Er(III) units are bridged by an oxalate anion coordinating two Er(III) ions in a bis-bidentate fashion. Strikingly, this heterometallic compound shows intense dual emission in the visible and near-infrared spectral ranges under single-wavelength excitation in both solution and the crystalline state. The effect of Er(III) coordination through a cyanide bridge is thoroughly discussed, also with the support of DFT calculations, to highlight the factors that induce the observed spectral hypsochromism and, more importantly, the remarkable 10-fold-increased emission quantum yield of the [Ru(bipy)2(CN)2] moiety in the visible range. We show that the described coordination mode induces an energy raise of the emissive triplet metal-to-ligand charge transfer (3MLCT) state and even a more pronounced lifting of the nonemissive Ru(II) triplet metal-centered (3MC) states, suppressing thermal deactivation channels. Furthermore, owing to the reduced number of water molecules and quenching groups surrounding the lanthanide ion in the molecular architecture, relatively intense erbium emission at 1.5 µm telecom wavelength is detected through sensitization from the Ru(II) metalloligand. We suggest that this compound can find applications as an efficient solid-state dual emitter.

ABSTRACTIn this paper, a dataset collecting the results of in-plane cyclic tests on unreinforced masonry piers, carried out within different research projects, is presented. The dataset includes brick and block [...]

Background: Prostate cancer remains the most frequently diagnosed cancer among men. High-Intensity Focused Ultrasound (HIFU) has emerged as a thermal ablative technique for partial-gland-ablation (PGA), aiming to minimize collateral damage while maximizing tumor control. Monitoring after HIFU PGA relies on serial PSA testing, multiparametric-MRI, and biopsies. The diagnostic accuracy of MRI for clinically-significant cancer(csPCa) recurrence is challenging. Objective: This systematic review and meta-analysis aim to evaluate the accuracy of MRI in detecting early recurrence of localized prostate cancer following HIFU PGA. Methods: Adhering to PRISMA guidelines, a comprehensive literature search was conducted until May 8th2024 using MEDLINE and Scopus. The inclusion criteria encompassed randomized controlled trials and cohort studies involving men diagnosed with localized prostate cancer who had as primary treatment HIFU PGA. The primary outcome measures included the sensitivity, specificity, positive-predictive value (PPV), and negative-predictive value (NPV) of MRI for csPCa(ISUP ≥ 2) based on biopsy results. We pooled data from studies with sufficient csPCa and csPCa-free patients (≥5) post HIFU for statistical analysis. Results: Fifteen studies meet the inclusion criteria, encompassing 1093 patients and 12 studies were eligible for meta-analysis. MRI sensitivity in detecting clinically-significant prostate cancer (csPCa) recurrence post HIFU PGA varied widely (0–89%), with a pooled sensitivity of 0.52 (95% CI:0.36–0.68). Specificity ranged from 44% to 100%, with a pooled specificity of 0.81 (95% CI:0.68–0.91). The pooled NPV was 0.82 (95% CI:0.72–0.90), and the pooled PPV was 0.50 (95% CI:0.35–0.65). Three studies reported in-field diagnostic performance with sensitivities ranging from 0.42 to 0.80 and specificities from 0.45 to 0.97. Conclusion: MRI accuracy for clinically-significant recurrence after partial gland ablation with HIFU for localized prostate cancer shows low diagnostic performance in the treated lobe with pooled sensitivity of 0.52 (95% CI:0.36–0.68) and specificity of 0.81 (95% CI:0.68–0.91). Limits of this review include the low number of studies reporting about site of recurrence in or out of the treated lobe.

ObjectiveSelected populations of patients with chronic hepatitis B (CHB) may benefit from a combined use of pegylated interferon-alpha (pegIFN-α) and nucleos(t)ides (NUCs). The aim of our study was to assess the immunomodulatory effect of pegIFN-α on T and natural killer (NK) cell responses in NUC-suppressed patients to identify cellular and/or serological parameters to predict better T cell-restoring effect and better control of infection in response to pegIFN-α for a tailored application of IFN-α add-on.Design53 HBeAg-negative NUC-treated patients with CHB were randomised at a 1:1 ratio to receive pegIFN-α-2a for 48 weeks, or to continue NUC therapy and then followed up for at least 6 months maintaining NUCs. Serum hepatitis B surface antigen (HBsAg) and hepatitis B core‐related antigen (HBcrAg) levels as well as peripheral blood NK cell phenotype and function and HBV-specific T cell responses upon in vitro stimulation with overlapping HBV peptides were measured longitudinally before, during and after pegIFN-α therapy.ResultsTwo cohorts of pegIFN-α treated patients were identified according to HBsAg decline greater or less than 0.5 log at week 24 post-treatment. PegIFN-α add-on did not significantly improve HBV-specific T cell responses during therapy but elicited a significant multispecific and polyfunctional T cell improvement at week 24 post-pegIFN-α treatment compared with baseline. This improvement was maximal in patients who had a higher drop in serum HBsAg levels and a lower basal HBcrAg values.ConclusionsPegIFN-α treatment can induce greater functional T cell improvement and HBsAg decline in patients with lower baseline HBcrAg levels. Thus, HBcrAg may represent an easily and reliably applicable parameter to select patients who are more likely to achieve better response to pegIFN-α add-on to virally suppressed patients.

The concept of in situ multisatellite altimetry calibration and validation in the absolute sense using ocean autonomous surface vehicles as global navigation satellite systems (GNSS) platforms is demonstrated through an experiment in the North Sea during 2016. A Wave Glider (WG) equipped with geodetic GNSS traveled to locations ranging from 21 to 78 km from the coast to be directly under four Jason-series tracks and two CryoSat-2 tracks. 5-Hz sea surface heights (SSHs) were estimated from precise point positioning (PPP) mode processing of GPS+GLONASS data, together with hourly zenith wet tropospheric delays (ZWDs), and used as reference values for altimetry satellite measured SSH, tropospheric delay, and significant wave height (SWH). SSH biases obtained were −30 to −8 mm for Jason-2 using geophysical data record (GDR)-D products, −40 to +1 mm for Jason-3 using GDR-F products, and −29 and +18 mm for CryoSat-2 using SAR mode GOP baseline C products. These biases are almost commensurate with results from previous studies in other regions that used GNSS buoys or onshore GNSS reference stations with geoid and tide extrapolation. The Jason-2 and Jason-3 microwave radiometer (MWR)-measured ZWDs differed, respectively, by −15 and −10 mm on average from those measured by the GNSS WG. Root-mean-square SWH differences of 2–6 cm were obtained between Jason-2/3 and the co-located GNSS WG, and equivalent differences of 19–21 cm for CryoSat-2.

The aim of the article is to reveal the level of problematic smartphone use (PSU) among young people, with an additional aim being to diagnose the level of use of applications offering ready access to popular social networks (SNS—e.g. Facebook, Instagram, Snapchat, TikTok, Pinterest). The text fills a gap related to the scale and mechanisms of PSUs. The research was conducted in Bosnia and Herzegovina in 2022, and is the first study of its kind in the country. A total of 1,024 young people participated in the study (age range 14–19 years; Female 627, Male 397). From the data collected, it was noted that: 1) Loss of control of the duration of smartphone use is the most common symptom of PSU; 2) Around 40% of respondents report having problems with self-control of duration of smartphone use; 3) 17.19% of the sample have high intensity of almost all diagnostic criteria of PSU; 4) About 1/3 of respondents declare no symptoms of PSU; 5) High intensity of PSU is more common in girls than in boys; 6) Instagram and TikTok are the most frequently used applications on smartphones; 7) More than half of the respondents use Instagram software constantly or almost constantly during the day, while less than 40% use TikTok-enabled software; 8) Girls are slightly more likely to use Instagram-enabled and TikTok-enabled software on smartphones; 9) Frequency of use of SNS software on smartphones is a poor predictor of PSU rates.

ABSTRACTBirds generally produce vocalisations in specific daily temporal windows. Describing diel-calling activity patterns along with taxonomic group and guild membership increase the knowledge about potential factors shaping the behaviour of these animals. This information is also highly relevant for the enhancement of monitoring plans for conservation. We performed a passive acoustic monitoring to describe the diel calling activity patterns of a bird assemblage within the Valdivian temperate rainforest, associating the patterns to taxonomic group and diet guild, and also aiming to contribute to the enhancement of ecological monitoring within this biodiversity hotspot. Our results indicate that high richness levels are detected around sunrise and sunset. Also, within the bird assemblage studied, most birds show diurnal vocal activity, among which several were also active during crepuscular periods, and only two species had nocturnal vocal activity. Among diurnal birds with enough number of detections to perform a detailed description of diel calling patterns, our results did not show clear trends considering diet guild or taxonomic group. We expect that this information encourages future research to increase the understanding on the factors influencing vocal activity patterns, as well as population and community trends from this biodiversity hotspot.

Small non‐coding (snc)RNAs, including microRNAs and P‐element induced wimpy testis (PIWI)‐interacting‐RNAs (piRNAs), crucially regulate gene expression in both physiological and pathological conditions. In particular, some muscle‐specific microRNAs (myomiRs) have been involved in the pathogenesis of cancer‐induced muscle wasting. The aims of the present study were (i) to profile sncRNAs in both skeletal muscle and plasma of gastrointestinal cancer patients and (ii) to investigate the association among differentially expressed sncRNAs and the level of muscularity at body composition analysis. Surgical patients with gastrointestinal cancer or benign disease were recruited. Blood samples and muscle biopsies (rectus abdominis) were collected during surgery. Low muscularity patients were those at the lowest tertile of skeletal muscle index (SMI; CT‐scan), whereas moderate/high muscularity patients were in the middle and highest SMI tertiles. SncRNAs in the muscle were assessed by RNAseq, circulating microRNAs were evaluated by qPCR. Cancer patients (n= 25; 13 females, 52%) showed a mean age of 71.6 ± 11.2 years, a median body weight loss of 4.2% and a mean BMI of 27.0 ± 3.2 kg/m2. Control group (n= 15; 9 females, 60%) showed a mean age 58.1 ± 13.9 years and a mean BMI of 28.0 ± 4.3 kg/m2. In cancer patients, the median L3‐SMI (cm2/m2) was 42.52 (34.42; 49.07). Males showed a median L3‐SMI of 46.08 (41.17–51.79) and females a median L3‐SMI of 40.77 (33.73–42.87). Moderate‐high and low muscularity groups included 17 and 8 patients, respectively. As for circulating microRNAs, miR‐21‐5p and miR‐133a‐3p were up‐regulated in patients compared with controls, whereas miR‐15b‐5p resulted down‐regulated in the same comparison (about 30% of control values). Sample clustering by muscularity and sex revealed increased miR‐133a‐3p and miR‐206 only in moderate‐high muscularity males. SncRNA profiling in the muscle identified 373 microRNAs and 190 piRNAs (72.5% and 18.7% of raw reads, respectively). As for microRNAs, 10 were up‐regulated, and 56 were down‐regulated in cancer patients versus controls. Among the 24 dysregulated piRNAs, the majority were down‐regulated, including the top two most expressed piRNAs in the muscle (piR‐12790 and piR‐2106). Network analysis on validated mRNA targets of down‐regulated microRNAs revealed miR‐15b‐5p, miR‐106a‐5p and miR‐106b‐5p as main interactors of genes related to ubiquitin ligase/transferase activities. These results show dysregulation of both muscle microRNAs and piRNAs in cancer patients compared with controls, the former following a sex‐specific pattern. Changes in circulating microRNAs are associated with the degree of muscularity rather than body weight loss.

The natural history of hepatitis B virus (HBV) infection is closely dependent on the dynamic interplay between the host immune response and viral replication. Spontaneous HBV clearance in acute self-limited infection is the result of an adequate and efficient antiviral immune response. Instead, it is widely recognized that in chronic HBV infection, immunologic dysfunction contributes to viral persistence. Long-lasting exposure to high viral antigens, upregulation of multiple co-inhibitory receptors, dysfunctional intracellular signaling pathways and metabolic alterations, and intrahepatic regulatory mechanisms have been described as features ultimately leading to a hierarchical loss of effector functions up to full T-cell exhaustion.

The Diverticular Inflammation and Complication Assessment (DICA) classification and the Combined Overview on Diverticular Assessment (CODA) were found to be effective in predicting the outcomes of Diverticular Disease (DD). We ascertain whether fecal calprotectin (FC) can further aid in improving risk stratification. A three‐year international, multicentre, prospective cohort study was conducted involving 43 Gastroenterology and Endoscopy centres. Survival methods for censored observations were used to estimate the risk of acute diverticulitis (AD) in newly diagnosed DD patients according to basal FC, DICA, and CODA. The net benefit of management strategies based on DICA, CODA and FC in addition to CODA was assessed with decision curve analysis, which incorporates the harms and benefits of using a prognostic model for clinical decisions. At the first diagnosis of diverticulosis/DD, 871 participants underwent FC measurement. FC was associated with the risk of AD at 3 years (HR per each base 10 logarithm increase: 3.29; 95% confidence interval, 2.13–5.10) and showed moderate discrimination (c‐statistic: 0.685; 0.614–0.756). DICA and CODA were more accurate predictors of AD than FC. However, FC showed high discrimination capacity to predict AD at 3 months, which was not maintained at longer follow‐up times. The decision curve analysis comparing the combination of FC and CODA with CODA alone did not clearly indicate a larger net benefit of one strategy over the other. FC measurement could be used as a complementary tool to assess the immediate risk of AD. In all other cases, treatment strategies based on the CODA score alone should be recommended.

ABSTRACT Experimental campaigns carried out in the past showed that the presence of truss bed-joint reinforcement provides a general improvement to the performance of masonry panels subjected to horizontal actions. [...]

In this contemporary study integrating functional imaging data, we found potential efficacy of salvage radiotherapy with dose escalation for macroscopic relapse in the prostate bed, with an acceptable toxicity profile.

Lysergic acid diethylamide (LSD) is an atypical psychedelic compound that exerts its effects through pleiotropic actions, mainly involving 1A/2A serotoninergic (5-HT) receptor subtypes. However, the mechanisms by which LSD promotes a reorganization of the brain’s functional activity and connectivity are still partially unknown.

Terzo tumore urologico dopo quello della prostata e della vescica, il tumore renale comprende un insieme di situazioni istologiche variegate, che vanno dalle cisti benigne ai tumori maligni metastatici. La TC è l’esame che ha radicalmente rivoluzionato la diagnosi e la stadiazione preterapeutica del carcinoma renale. L’iter diagnostico si basa su una serie di dati raccolti alla TC. L’analisi anatomopatologica conferma la diagnosi. La realizzazione di biopsie renali è un contributo diagnostico le cui indicazioni devono ancora essere specificate. Il trattamento curativo di prima intenzione di uno stadio localizzato è l’escissione chirurgica, favorendo la nefrectomia parziale piuttosto che la nefrectomia totale. I trattamenti ablativi come la crioterapia, la radiofrequenza o la radioterapia stereotassica sono in costante aumento, ma resta da valutare il loro ruolo nell’approccio terapeutico. Infine, la prognosi dei tumori renali metastatici è migliorata grazie agli antiangiogenici e alle nuove immunoterapie.

Traditionally, as the load on the distribution system grows, additional infrastructure must be provided to increase the capacity of the local substation. However, with the proliferation of distributed energy resources, [...]

Abstract: Cutaneous perianal recurrence is rare after anterior resection for rectal cancer. In most cases, exfoliated tumor cells almost certainly seeded onto an area of anal canal that was injured by the head of the stapling gun used for the fashion of stapled colorectal anastomosis. The first two cases of cutaneous perineal recurrence on the site of a Lone Star Retractor™ after handsewn J-pouch coloanal anastomosis for rectal cancer are presented. In two cases, recurrence occurred on the scars induced by elastic stay hook of Lone Star retractor. Both cases were treated by local excision alone. At one year of follow-up, there were no signs of local recurrence.

Conventional dental care is often impossible in patients with Autism Spectrum Disorder (ASD). Non-collaborative behaviors, sometimes associated with aggressiveness, are usual justifications for premedication in this population. Thereby, this research focuses on the effects of oral midazolam versus oral ketamine plus midazolam as preanesthetic medication in ASD.

ABSTRACTBackgroundVedolizumab (VDZ) can be used to treat refractory ulcerative colitis (UC) and Crohn’s disease (CD). We assessed whether there are differences in treating UC vs CD with VDZ.Research design and methods Mayo score in UC and the Harvey-Bradshaw Index (HBI) in CD scored the clinical activity. Achievement and maintenance of clinical remission during the follow-up, and safety were the primary endpoints.Results729 patients (475 with UC and 254 with CD), median follow-up of 18 (IQR 6-36) months, were enrolled. Clinical remission at the 6thmonth of treatment was achieved in 488 (66.9%) patients (74.4% in CD vs 62.9% in UC, p<0.002) while, during the follow-up, no difference was found (81.5% in the UC group and 81.5% pts in the CD group; p=0.537). The clinical remission at the 6thmonth of treatment (p=0.001) and being naïve to biologics (p<0.0001) were significantly associated with prolonged clinical remission. The clinical response was significantly higher in UC (90.1%) vs CD (84.3%) (p=0.023), and surgery occurred more frequently in CD (1.9% in UC vs 5.1% in CD, p=0.016).ConclusionWe found differences when using VDZ in UC vs CD in real life. These parameters can help the physician predict this drug’s longterm efficacy.