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Background: Parkinson’s, a degenerative disease characterized by motor and non-motor symptoms, gradually leads to disability and affects ordinary gestures, including patients’ home oral hygiene. Given that poor oral conditions, with decayed teeth, halitosis, and periodontal inflammation, can represent a critical issue in patients with low compliance in oral hygiene, the aim of this review was to investigate overall oral health in patients with Parkinson’s disease (PD). Methods: A search on PubMed, Cochrane Library and Scopus databases was conducted to identify relevant publications: studies concerning patients with PD, their oral health conditions, and oral hygiene, also in terms of inflammation and plaque control, were included. Risk of bias analysis and qualitative analysis were performed. Results: Of 226 records found through the electronic search, a total of 16 studies were finally included in the systematic review. Outcomes without consistent differences between PD patients and healthy patients (control group) mainly regarded: the frequency of brushing (at least twice a day), the brushing methods (generally variable) and the frequency of dental visits (mostly regular for both groups). In patients with PD, use of interdental devices was lower, and presence of plaque was higher: due to self-reported difficulties, 15–29% of them need help for oral care, against the 1% in the healthy group. Furthermore, the longer duration and higher severity of PD seem to adversely affect overall oral health conditions. Discussion: Since poor oral conditions of patients with PD are associated with their disability in conducting proper home procedures, it is necessary for dental practitioners to focus on specific and personalized instructions, to be easily delivered to caregivers.

Autologous platelet-rich plasma (aPRP) and autologous platelet-rich fibrin (aPRF) are blood-derived biomaterials that potentially enhance wound healing. Rosuvastatin (RSV), a lipidlowering statin, exhibits pleiotropic effects that may promote tissue repair, warranting investigation into its use alone or combined with biomaterials for wound healing. This study aims to evaluate the wound repair effects of aPRP and aPRF, with or without adding 1.2% rosuvastatin. Sixteen clinically healthy adult male New Zealand rabbits were randomly assigned to two groups of eight, each receiving one of the biomaterials either with or without 1.2% rosuvastatin. The biomaterials used were of autologous origin, specifically aPRP and aPRF. Surgical wounds were induced and treated with biomaterials and 1.2% rosuvastatin over 17 days. Macroscopic assessments of wound area and epithelial gap distance were conducted, supplemented by histological analysis. A significant inverse correlation was observed between wound area and epithelial thickness with the use of aPRF (r = -0.5500). No significant difference was found in epithelial thickness between treatment groups (p > 0.05). In terms of the wound area, aPRP alone (p = 0.001), aPRF alone (p = 0.021), and aPRP+RSV (p = 0.016) treatments yielded smaller wound areas compared to aPRF+RSV at 14 days post-treatment. These findings suggest that the addition of 1.2% rosuvastatin to aPRP resulting in a smaller wound area compared to aPRF, enhances wound repair.

Climate change presents substantial challenges for the aviation sector, particularly concerning the assessment and management of risks to airport infrastructure and operations. Effective climate risk assessment is crucial for implementing prioritized adaptation strategies that enhance airport resilience. This paper introduces an innovative matrix-based co-design approach to evaluate climate risks for airports, illustrated by a case study of Bologna Airport, located in Emilia-Romagna, Italy. The matrix-based approach, distinguished by its integration of climate hazard, exposure and vulnerability data, proves to be both robust and replicable, especially when key stakeholders actively participate in the process. The approach offers a systematic framework for identifying and assessing climate risks, facilitating the development of effective adaptation strategies. The Bologna Airport case study highlights the approach’s practical application, demonstrating its effectiveness in risk assessment and its potential to guide decision-making for more resilient airport management. The findings underscore the importance of early and equitable preventive actions and support, making vulnerability analysis a critical component in developing effective adaptation strategies. This research advances resilience planning in the aviation sector and offers valuable insights for other airports facing similar climate challenges.

Objetivos: Conhecer as justificativas de familiares para a não autorização da doação de órgãos e tecidos. Métodos: Trata-se de um estudo documental. Analisaram-se os registros de entrevistas familiares de potenciais doadores, realizadas em 2022 por uma Organização de Procura de Órgãos e Tecidos (OPO) do estado do Rio Grande do Sul. Foram incluídos no estudo os registros referentes às negativas para a doação. Registros incompletos ou que careciam da justificativa dos familiares foram excluídos. Os dados foram coletados em março e abril de 2024 e analisados por meio de estatística descritiva simples. O projeto de pesquisa foi aprovado pelo Comitê de Ética em Pesquisa. Resultados: Durante 2022, a OPO pesquisada realizou 121 entrevistas com familiares de potenciais doadores de órgãos; desse total, houve 33 autorizações, 65 negativas e 23 casos de contraindicação médica para a doação. Quanto às negativas dos familiares, dos 65 registros analisados, 39 foram excluídos, pois estavam com informações incompletas ou não continham a justificativa para a não doação. A amostra final foi constituída por 26 registros de entrevistas. Os argumentos mais comuns para a negativa à doação foram paciente não era doador em vida, desconhecimento da família sobre o desejo do falecido quanto à doação e manifestação contrária da família. Conclusão: Entre as justificativas observadas estão a pessoa falecida ter se declarado não doadora em vida, a falta de consenso familiar acerca da doação, o desejo da família em preservar a integridade do corpo, o tempo de espera para a devolução do corpo, aspectos religiosos, o desconhecimento quanto ao desejo do falecido acerca da doação e a família ser contrária à doação. Os resultados poderão ser utilizados por profissionais em diferentes serviços de saúde para a criação de estratégias de mitigação das negativas dos familiares.

The effect of juvenile stress on brain morphology, and especially white matter, is poorly understood. The present study aimed to evaluate the effects of two models of stress, physical and psychological, in the juvenile phase of male rats and their long-term impact on the integrity of the brain white matter. Morphological analysis was based on two major pathways of brain connection and myelin concentration, corpus callosum (CC) and fornix. Animals were randomly assigned to three groups: Control (C), Immobilization Stress (IS), and Predator Exposure Stress (PES). The stress procedures occurred for three consecutive days from d95 of postnatal life (P25 to P27). For long-term evaluation, in adulthood (P90-P95), the brains were collected, fixed, and processed by the Klüver-Barrera technique. The collected material was evaluated using image capture and analysis in the ImageJ Software. Both models of stress studied produced no changes in body and brain weight, and all regions analyzed (genu, body, and splenium of the corpus callosum and the fornix) showed no changes in optical integrity. Thus, this study suggests that short-term juvenile stress does not cause lasting morphological effects on white matter structure, and this adaptation, in which neither reductive nor protective changes occurred, can be considered a positive adaptation.

Resumo Objetivo identificar a percepção de familiares e da equipe de enfermagem sobre a implementação de um diário de Unidade de Terapia Intensiva à rotina de cuidados do paciente crítico. Método estudo descritivo, qualitativo, realizado em uma Unidade de Terapia Intensiva (UTI) adulto, entre julho e outubro de 2022. Implementou-se um diário, com registros de familiares e da equipe de enfermagem. A percepção dos familiares foi identificada através de entrevistas, e a da equipe, por meio de roda de conversa. Utilizou-se análise temática de Minayo. O estudo foi aprovado por Comitê de Ética em Pesquisa. Resultados participaram nove familiares; emergiram as seguintes categorias: Benefícios da utilização do diário de UTI e Fatores que podem influenciar no uso do diário de UTI”. A partir da roda de conversa, com cinco profissionais de enfermagem, evidenciaram-se as categorias: Melhora da conexão com paciente e família; O diário como fonte de informações e Aspectos éticos relacionados aos registros. Considerações finais e implicações para a prática os familiares e os profissionais de enfermagem consideraram o instrumento benéfico, tanto para familiares quanto para pacientes. Para sua implementação, fluxos bem estabelecidos sobre o uso e a aproximação da família são essenciais para subsidiar o processo e obter a adesão das partes envolvidas.

Abstract In supramolecular chemistry, the pursuit of highly efficient molecular recognition systems holds paramount significance. This study introduces new [2.2]paracyclophanes (PCP) as exceptional guest molecules for cucurbit[8]uril (CB8). This well‐matched host‐guest interaction is marked by ultra‐high binding affinities (Ka up to 1015 M−1 in water) accompanied by unprecedented exothermic contributions (ΔH up to −20.6 kcal mol−1) observed in CB8 binding, rivaling the exceptional affinities of cucurbit[7]uril (CB7), which has until now been recognized as the gold standard for high‐affinity binding in water. The PCPs demonstrate an excellent fit within the CB8 cavity without structural deformation of the host. Our research methodology incorporates organic synthesis, NMR, fluorescence titration, and isothermal titration calorimetry (ITC) experiments, as well as quantum mechanical simulations, to systematically examine the binding characteristics of fluorescent mono‐ and dicationic PCP guests within the CB8 cavity. This study not only corroborates but also critically reevaluates certain aspects of the “high‐energy water release model” for cucurbit[n]uril systems. Furthermore, the ease of modifying PCP compounds, combined with their superior water solubility compared to di‐ and triamantanes, and their characteristic fluorescent response in forming and disassembling host‐guest complexes, elevates PCPs as promising candidates for the creation of advanced supramolecular CB8‐functional materials and sensing assays.

Evaluation of conduction intervals to predict success of resynchronization in biventricular pacing(BiVP) or Conduction System Pacing(CSP) is not spread in clinical practice. A right ventricle-to-left ventricle intrinsic conduction interval (RVs–LVs) > 70 ms or prolonged RVpaced – LVs(RVp-LVs)interval can predict Cardiac Resynchronization Therapy (CRT)response.This paper describes a case of cardiac resynchronization guided by spontaneous and paced interventricular conduction delays (IVCD) obtained in BiVP that led to changing intraoperative approach. A strategy for cardiac resynchronization based on the CSP/BiVP approach according to the IVCD could represent a viable and reliable solution to obtain a narrow paced QRS and to improve the CRT response.

Abstract Aims Mechanical circulatory support (MCS) systems are increasingly employed in cardiogenic shock and advanced heart failure. A thorough understanding of the complex interactions occurring among heart, vasculature, and device is essential to optimize patient's management. The aim of this study is to explore non‐invasive haemodynamic profiling of patients undergoing MCS based on pressure–strain (PS) analysis. Methods Clinical and echocardiographic data from consecutive patients undergoing different MCS systems positioning/implantation admitted to the third level cardiological intensive care unit of Siena Hospital from August 2021 to November 2021 were retrospectively reviewed. Patients without a useful echocardiographic exam or without arterial blood pressure recording at the time of echocardiography were excluded. Myocardial work analysis was performed in the included patients. Results We reviewed 18 patients, of which nine were excluded. Included patients were three patients with intra‐aortic balloon pump (IABP), two patients with durable left ventricular assist device (dLVAD), two patients with Impella®, one patient with extracorporeal membrane oxygenation (ECMO), and one patient with ECMO and IABP. Myocardial work analysis was feasible in each included patient. The use of IABP shifted the PS curve rightward and downward. Global work index (GWI) and global wasted work (GWW) decreased after IABP positioning, whereas global work efficiency (GWE) increased. The use of continuous‐flow pumps, whether temporaneous (Impella®) or long term (dLVAD), induced a change in the PS loop morphology, with a shift towards a triangular shape. ECMO positioning alone resulted in a narrowing of the PS loop, with a decrease in GWI and GWE and an increase in GWW and mean arterial pressure. The combined used of IABP with ECMO widened the PS loop and improved GWI and GWE. Conclusions PS loops analysis in patients undergoing MCS seems to be feasible and may unveil MCS‐induced haemodynamic variations. Myocardial work could be used to monitor ventricular–arterial–device coupling and guide tailored MCS management.

Endothelial dysfunction plays a central role in the severity of COVID-19, since the respiratory, thrombotic and myocardial complications of the disease are closely linked to vascular endothelial damage. To address this issue, we evaluate here the effect of conditioned media from spike S1-activated macrophages (CM_S1) on the proliferation of human umbilical endothelial cells (HUVECs), focusing on the specific role of interleukin-1-beta (IL-1β), interleukin-6 (IL-6), interferon-gamma (IFN-γ) and tumor necrosis factor-alpha (TNF-α). Results obtained demonstrate that the incubation with CM_S1 for 72 h hinders endothelial cell proliferation and induces signs of cytotoxicity. Comparable results are obtained upon exposure to IFN-γ + TNF-α, which are thus postulated to play a pivotal role in the effects observed. These events are associated with an increase in p21 protein and a decrease in Rb phosphorylation, as well as with the activation of IRF-1 and NF-kB transcription factors. Overall, these findings further sustain the pivotal role of a hypersecretion of inflammatory cytokines as a trigger for endothelial activation and injury in the immune-mediated effects of COVID-19.

Pulmonary vein isolation (PVI) with catheter ablation (CA) represents an effective therapy for atrial fibrillation (AF). Unfortunately, it is still not exempt from severe complications. The balance of risks and benefits should be assessed, and a patient-tailored approach is desirable. So far, several clinical and cardiac imaging parameters have been evaluated to investigate pre- and post-procedural features that could help clinicians in the selection of patients at high risk of a poor outcome after CA. This clinical and systematic review analyses the potential role of new LA parameters, such as LA reservoir strain, to predict AF recurrence after CA therapy. Notably, LA reservoir strain gains substantial clinical importance in patients with paroxysmal AF and when a low CHADS2-VASc score is retrieved. LA reservoir strain provides data concerning the risk of AF recurrence after PVI and, thus, in the management of long-term medical therapy in this patient’s group.

Objetivo: descrever a percepção do técnico de enfermagem e a sua atuação no bundle de prevenção de pneumonia, associada à ventilação mecânica em Unidade de Terapia Intensiva. Metodologia: estudo descritivo e qualitativo, realizado com técnicos de enfermagem de uma Unidade de Terapia Intensiva Adulto de Porto Alegre. Coleta dos dados realizada por meio de entrevistas gravadas, seguindo roteiro semiestruturado. Dados analisados sob a ótica da análise temática de Minayo. Resultados: participaram 40 técnicos de enfermagem, em queemergiram quatro categorias: a) atuação do Técnico de Enfermagem no bundle de prevenção de Pneumonia Associada à Ventilação Mecânica (PAVM); b) itens que compõem o bundle de prevenção de PAVM; c) fragilidades na implantação do bundle de prevenção de PAVM; d) educação continuada sobre PAVM. Considerações finais: participantes conhecem as medidas de prevenção, reconhecem sua importância e as executam direta e indiretamente. A equipe utiliza um mnemônico próprio para memorização dos itens do bundle. Descritores: Enfermagem. Cuidado de Enfermagem. Unidade de Terapia Intensiva. Pneumonia Associada à Ventilação Mecânica. Educação Continuada.

Faba bean (Vicia faba) is a temperate grain legume of major importance for food and feed. Powdery mildews are an important group of diseases in many crops, although in faba bean, it is still considered to be of only minor and local relevance. Here, we report the occurrence of powdery mildew in southern Spain, which was identified through ITS sequencing as Erysiphe trifolii. Resistance screenings allowed the identification of a wide range of responses to the disease, with accessions BPL-710 and ILB-4708 outstanding due to their high levels of resistance. Histological studies showed that the mechanisms of resistance may involve the inhibition of germination and impairment of fungal development, as shown by a limited number of primary and secondary hyphae compared to those of the susceptible accessions. This work permitted a better understanding of the interaction of faba bean and powdery mildew, laying the ground for breeding programs for resistance if needed in the future.

BackgroundCardiac resynchronization therapy (CRT) is an established treatment in selected patients suffering from heart failure with reduced ejection fraction (HFrEF). It has been proposed that myocardial fibrosis and inflammation could influence CRT “response” and outcome. Our study investigated the long-term prognostic significance of cardiac biomarkers in HFrEF patients with an indication for CRT.MethodsConsecutive patients referred for CRT implantation were retrospectively evaluated. The soluble suppression of tumorigenicity 2 (sST2), galectin-3 (Gal-3), N-terminal portion of the B-type natriuretic peptide (NT-proBNP), and estimated glomerular filtration rate (eGFR) were measured at baseline and after 1 year of follow-up. Multivariate analyses were performed to evaluate their correlation with the primary composite outcome of cardiovascular mortality and heart failure hospitalizations at a mean follow-up of 9 ± 2 years.ResultsAmong the 86 patients enrolled, 44% experienced the primary outcome. In this group, the mean baseline values of NT-proBNP, Gal-3, and sST2 were significantly higher compared with the patients without cardiovascular events. At the multivariate analyses, baseline Gal-3 [cut-off: 16.6 ng/ml, AUC: 0.91, p

Ascochyta blight, caused by Ascochyta fabae, poses a significant threat to faba bean and other legumes worldwide. Necrotic lesions on stems, leaves, and pods characterize the disease. Given the economic impact of this pathogen and the potential involvement of secondary metabolites in symptom development, a study was conducted to investigate the fungus’s ability to produce bioactive metabolites that might contribute to its pathogenicity. For this investigation, the fungus was cultured in three substrates (Czapek-Dox, PDB, and rice). The produced metabolites were analyzed by NMR and LC-HRMS methods, resulting in the dereplication of seven metabolites, which varied with the cultural substrates. Ascochlorin, ascofuranol, and (R)-mevalonolactone were isolated from the Czapek-Dox extract; ascosalipyrone, benzoic acid, and tyrosol from the PDB extract; and ascosalitoxin and ascosalipyrone from the rice extract. The phytotoxicity of the pure metabolites was assessed at different concentrations on their primary hosts and related legumes. The fungal exudates displayed varying degrees of phytotoxicity, with the Czapek-Dox medium’s exudate exhibiting the highest activity across almost all legumes tested. The species belonging to the genus Vicia spp. were the most susceptible, with faba bean being susceptible to all metabolites, at least at the highest concentration tested, as expected. In particular, ascosalitoxin and benzoic acid were the most phytotoxic in the tested condition and, as a consequence, expected to play an important role on necrosis’s appearance.

Background. In COVID-19, an uncontrolled inflammatory response might worsen lung damage, leading to acute respiratory distress syndrome (ARDS). Recent evidence points to the induction of inducible nitric oxide synthase (NOS2/iNOS) as a component of inflammatory response since NOS2 is upregulated in critical COVID-19 patients. Here, we explore the mechanisms underlying the modulation of iNOS expression in human alveolar cells. Methods. A549 WT and IRF1 KO cells were exposed to a conditioned medium of macrophages treated with SARS-CoV-2 spike S1. Additionally, the effect of IFNγ, IL-1β, IL-6, and TNFα, either alone or combined, was addressed. iNOS expression was assessed with RT-qPCR and Western blot. The effect of baricitinib and CAPE, inhibitors of JAK/STAT and NF-kB, respectively, was also investigated. Results. Treatment with a conditioned medium caused a marked induction of iNOS in A549 WT and a weak stimulation in IRF1 KO. IFNγ induced NOS2 and synergistically cooperated with IL-1β and TNFα. The inhibitory pattern of baricitinb and CAPE indicates that cytokines activate both IRF1 and NF-κB through the JAK/STAT1 pathway. Conclusions. Cytokines secreted by S1-activated macrophages markedly induce iNOS, whose expression is suppressed by baricitinib. Our findings sustain the therapeutic efficacy of this drug in COVID-19 since, besides limiting the cytokine storm, it also prevents NOS2 induction.

Pea (Pisum sativum) stands out as one of the most significant and productive cool-season pulse crops cultivated worldwide. Dealing with biotic stresses remains a critical challenge in fully harnessing pea’s potential productivity. As such, dedicated research and developmental efforts are necessary to make use of omic resources and advanced breeding techniques. These approaches are crucial in facilitating the rapid and timely development of high-yielding varieties that can tolerate and resist multiple stresses. The availability of advanced genomic tools, such as comprehensive genetic maps and reliable DNA markers, holds immense promise for integrating resistance genes from diverse sources. This integration helps accelerate genetic gains in pea crops. This review provides an overview of recent accomplishments in the genetic and genomic resource development of peas. It also covers the inheritance of genes controlling various biotic stress responses, genes that control pathogenesis in disease-causing organisms, the mapping of genes/QTLs, as well as transcriptomic and proteomic advancements. By combining conventional and modern omics-enabled breeding strategies, genetic gains can be significantly enhanced.

ObjectivesThis study aimed to explore the correlation between left ventricular (LV) myocardial work (MW) indices and invasively-derived LV stroke work index (SWI) in a cohort of patients with advanced heart failure (AHF) considered for heart transplantation.BackgroundLeft ventricular MW has emerged as a promising tool for diagnostic and prognostic purposes in heart failure (HF) but its relationship with hemodynamic data derived from right heart catheterization (RHC) has not been assessed in patients with advanced heart failure yet.Materials and methodsConsecutive patients with AHF considered for heart transplantation from 2016 to 2021 performing RHC and echocardiography as part of the workup were included. Conventional LV functional parameters and LV MW indices, including LV global work index (GWI), LV global constructive work (GCW), LV global wasted work (GWW), LV global work efficiency (GWE), and other were calculated and compared with invasively-measured LV SWI.ResultsThe population included 44 patients. Median time between RHC and echocardiography was 0 days (IQR: 0–24). Median age was 60 years (IQR: 54–63). For the most part, etiology of HF was non-ischemic (61.4%) and all patients were either on class NYHA II (61.4%) or III (27.3%). Median left ventricular ejection fraction was 25% (IQR: 22.3–32.3), median NT-proBNP 1,377 pg/ml (IQR: 646–2570). LV global longitudinal strain (GLS) significantly correlated with LV SWI (r = –0.337; p = 0.031), whereas, LV ejection fraction (EF) did not (r = 0.308; p = 0.050). With regard to LV MW indices, some of them demonstrated correlation with LV SWI, particularly LV GWI (r = 0.425; p = 0.006), LV GCW (r = 0.506; p = 0.001), LV global positive work (LV GPW; r = 0.464; p = 0.003) and LV global systolic constructive work (GSCW; r = 0.471; p = 0.002).ConclusionAmong LV MW indices, LV GCW correlated better with invasively-derived SWI, potentially representing a powerful tool for a more comprehensive evaluation of myocardial function.

Heart transplant (HTx) still represents the most effective therapy for end-stage heart failure, with a median survival time of 10 years. The transplanted heart shows peculiar physiology due to the profound alterations induced by the operation, which inevitably influences several echocardiographic parameters assessed during these patients’ follow-ups. With these premises, the diastolic function is one of the main aspects to take into consideration. The left atrium (LA) plays a key role in this matter, and that same chamber is significantly impaired with the transplant, with different degrees of altered function based on the surgical technique. Therefore, the traditional echocardiographic evaluation of diastolic function applied to the general population might not properly reflect the physiology of the graft. This review attempts to provide current evidence on diastolic function in HTx starting from defining its different physiology and how the standard echocardiographic parameters might be affected to its prognostic role. Furthermore, based on the experience of our center and the available evidence, we proposed an algorithm that might help clinicians distinguish from actual diastolic dysfunction from a normal diastolic pattern in HTx population.

Introdução: Entre os membros que compõem as Comissões Intra- Hospitalares de Doação de Órgãos e Tecidos para Transplantes (Cihdott), o enfermeiro é o profissional que tem o maior contato com possíveis doadores e seus familiares por causa dos cuidados prestados aos pacientes nas unidades de tratamento intensivo, tornando-se, assim, uma referência para a família. Sua atuação como membro da Cihdott tem sido reconhecida e relacionada ao sucesso da doação de órgãos. Objetivo: Identificar as competências do enfermeiro membro da Cihdott. Método: Estudo descritivo, com abordagem qualitativa. Foram incluídos enfermeiros membros da Cihdott havia, pelo menos, seis meses, que aceitaram participar da pesquisa, selecionados por meio da técnica snowball. Foram realizadas entrevistas semiestruturadas, e a análise dos dados ocorreu por agrupamento temático, utilizando referencial de Minayo. Resultados: Participaram do estudo dez enfermeiros, com idades entre 32 e 50 anos e tempo de atuação na Cihdott de quatro a 11 anos. Da análise dos dados, emergiram quatro categorias: “O protagonismo do enfermeiro do início ao fim do processo de doação”; “Competências e atribuições do enfermeiro da Cihdott”; “Qualidades pessoais que influenciam no âmbito profissional”; e “Fatores limitadores para a atuação do enfermeiro”. Considerações finais: O enfermeiro membro da Cihdott atua em diversas atividades no processo de doação e transplante, entre elas: realização de busca ativa, entrevista familiar, manutenção do doador, acompanhamento no processo de retirada e transplante de órgãos e tecidos, acondicionamento dos órgãos para transplante, acompanhamento da reconstituição do corpo e devolução do corpo à família doadora, realização de capacitações com as equipes. Além disso, atribuições administrativas e burocráticas fazem parte da rotina do enfermeiro da Cihdott.

Abstract Transcatheter aortic valve replacement (TAVR) has shown to reduce mortality compared to surgical aortic valve replacement (sAVR). However, it is unknown which procedure is associated with better post-procedural valvular function. We conducted a meta-analysis of randomized clinical trials that compared TAVR to sAVR for at least 2 years. The primary outcome was post-procedural patient-prosthesis-mismatch (PPM). Secondary outcomes were post-procedural and 2-year: effective orifice area (EOA), paravalvular gradient (PVG) and moderate/severe paravalvular leak (PVL). We identified 6 trials with a total of 7022 participants with severe aortic stenosis. TAVR was associated with 37% (95% CI [0.51–0.78) mean RR reduction of post-procedural PPM, a decrease that was not affected by the surgical risk at inclusion, neither by the transcatheter heart valve system. Postprocedural changes in gradient and EOA were also in favor of TAVR as there was a pooled mean difference decrease of 0.56 (95% CI [0.73–0.38]) in gradient and an increase of 0.47 (95% CI [0.38–0.56]) in EOA. Additionally, self-expandable valves were associated with a higher decrease in gradient than balloon ones (beta = 0.38; 95% CI [0.12–0.64]). However, TAVR was associated with a higher risk of moderate/severe PVL (pooled RR: 9.54, 95% CI [5.53–16.46]). All results were sustainable at 2 years.

Societal Impact Statement Lentil is a staple in many diets around the world and growing in popularity as a quick‐cooking, nutritious, plant‐based source of protein in the human diet. Lentil varieties are usually grown close to where they were bred. Future climate change scenarios will result in increased temperatures and shifts in lentil crop production areas, necessitating expanded breeding efforts. We show how we can use a daylength and temperature model to identify varieties most likely to succeed in these new environments, expand genetic diversity, and give plant breeders additional knowledge and tools to help mitigate these changes for lentil producers. Summary Lentil (Lens culinaris Medik.) is cultivated under a wide range of environmental conditions, which has led to diverse phenological adaptations and resulted in a decrease in genetic variability within breeding programs due to reluctance in using genotypes from other environments. We phenotyped 324 genotypes across nine locations over three years to assess their phenological response to the environment of major lentil production regions and to predict days from sowing to flowering (DTF) using a photothermal model. DTF was highly influenced by the environment and is sufficient to explain adaptation. We were able to predict DTF reliably in most environments using a simple photothermal model, however, in certain site‐years, results suggest there may be additional environmental factors at play. Hierarchical clustering of principal components revealed the presence of eight groups based on the responses of DTF to contrasting environments. These groups are associated with the coefficients of the photothermal model and revealed differences in temperature and photoperiod sensitivity. Future climate change scenarios will result in increased temperature and/or shifts in production areas. The ability to use the photothermal model to identify genotypes most likely to succeed in these new environments has important social impacts with respect to traditional cropping systems.