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This paper presents research in the field of optimization in maritime passenger traffic that can ensure the long-term sustainability of coastal maritime passenger lines system. For the purpose of the research contained in this paper, it has been hypothesized that the optimal arrangement of boats within a coastal maritime passenger lines system will reduce the consumption of propulsion energy, the emission of harmful gasses and operating costs. The aim of this paper is to present an efficient algorithm for a reduction in propulsion energy consumption in coastal maritime passenger lines systems by reassigning boats to lines that they service. The problem is modeled using a bipartite graph and the solution is obtained by searching for optimal matching using Edmonds' algorithm. The authors apply, for the first time, Edmonds' algorithm to the problems of the optimization of assignments of boats to lines. The research results were confirmed by tests on a representative example. The optimization results on only 10 ships in the given example show yearly savings of 91,097.30 L of fuel (lowering costs by EUR 69,233.95) and reducing CO2 by 243.59 tons, which proves that this algorithm found a much more efficient arrangement that could result in a significant reduction in propulsion energy consumption, thus providing economic and ecological benefits. [ABSTRACT FROM AUTHOR]

Diarrhoea is one of the top five causes of death among paediatric and geriatric population in India. Bacterial, viral and protozoal pathogens contaminating the food and water, or even opportunistic commensal microbes can lead to diarrhoeal infections. A number of anti-infective and antiparasitic agents are available for treating these infections. However, they come along with their distinct side effects. Alternative systems of medicine suggest treatments that come from natural sources like plants, minerals and animals. Bovine colostrum is one such animal-derived product recommended by Ayurveda to boost immunity and treat infections in human beings. is a rich source of immunoglobulins such as IgG1, IgG2, IgA and IgM. These antibodies along with other immune factors such as lactoferrin, lactoperoxidase, lysozymes, lactalbumins, oligosaccharides present in colostrum provide an excellent passive protection against infections of bacterial, viral and protozoal origin. A long track record of safe use and several in vitro, preclinical and clinical studies have established bovine colostrum as a safe and effective remedy in the prevention and treatment of diarrhoea. We present a mechanistic review of application of bovine colostrum against primary and secondary diarrhoeal infections. [ABSTRACT FROM AUTHOR]

Membrane-bound replication organelles (ROs) are a unifying feature among diverse positive-strand RNA viruses. These compartments, formed as alterations of various host organelles, provide a protective niche for viral genome replication. Some ROs are characterised by a membrane-spanning pore formed by viral proteins. The RO membrane separates the interior from immune sensors in the cytoplasm. Recent advances in imaging techniques have revealed striking diversity in RO morphology and origin across virus families. Nevertheless, ROs share core features such as interactions with host proteins for their biogenesis and for lipid and energy transfer. The restructuring of host membranes for RO biogenesis and maintenance requires coordinated action of viral and host factors, including membrane-bending proteins, lipid-modifying enzymes and tethers for interorganellar contacts. In this Cell Science at a Glance article and the accompanying poster, we highlight ROs as a universal feature of positive-strand RNA viruses reliant on virus-host interplay, and we discuss ROs in the context of extensive research focusing on their potential as promising targets for antiviral therapies and their role as models for understanding fundamental principles of cell biology [ABSTRACT FROM AUTHOR]

Since electric vehicles (EVs) have definite benefits over gasoline vehicles, the vehicle market could be dominated by EVs in the future. This paper focuses on the new valet charging service to send staffs to replace users for charging their EVs, which can largely reduce charging anxiety. In this study, the location of charging stations and the allocation of charging demands to charging stations are optimized simultaneously due to the interaction of these decisions. The queueing behavior at the charging station is incorporated into the model, and the average charging waiting time is derived. We construct a mixed integer nonlinear optimization model based on the characteristics of valet charge service and an infinite-source queuing model. The objective is to minimize a total cost of the construction of charging facilities and valet charge service launching (i.e., charging staffs' road service, round-trip time, and the charging waiting time). The planning problem for valet charging service in this paper contributes to the existing literature on self-charging way where the users of EVs drive at charging stations to recharge their EVs by themselves. An improved genetic algorithm is developed to obtain deployment and operation plans for large-scale instances constructed based a real case in Shanghai. The improved genetic algorithm shows high performance in convergence and solution quality, which provide the service providers an efficient decision support tool. Meaningful managerial insights are also provided, which can help the service provider make better cost-effective design of charging location and allocation plans. For example, the charging station location decisions are not as much as sensitive to critical variables (such as demand level, charging capacities, and the value of time) than the overall cost to those. This means that partial location decisions remain unchanged when the key parameters vary. [ABSTRACT FROM AUTHOR]

Viral infections usually induce the rearrangement of cellular cytoskeletal proteins and organelle membrane structures, thus creating independent compartments [termed replication organelles (ROs)] to facilitate viral genome replication. Within the ROs, viral replicases, including polymerases, helicases, and ligases, play functional roles during viral replication. These viral replicases are pivotal in the virus life cycle, and numerous studies have demonstrated that the viral replicases could be the potential targets for drugs development. Here, we summarize primarily the key replicases within viral ROs and emphasize the advancements of antiviral drugs targeting crucial viral replicases, providing novel insights into the future development of antiviral strategies. [ABSTRACT FROM AUTHOR]

Background: 3D printers have gained prominence in rapid prototyping and viable in creating dimensionally accurate objects that are both safe within a Magnetic Resonance Imaging (MRI) environment and visible in MRI scans. A challenge when making MRI-visible objects using 3D printing is that hard plastics are invisible in standard MRI scans, while fluids are not. So typically, a hollow object will be printed and filled with a liquid that will be visible in MRI scans. This poses an engineering challenge however since objects created using traditional Fused Deposition Modeling (FDM) 3D-printing techniques are prone to leakage. Digital Light Processing (DLP) is a relatively modern and affordable 3D-printing technique using UV-hardened resin, capable of creating objects that are inherently liquid-tight. When printing hollow parts using DLP printers, one typically requires adding drainage holes for uncured liquid resin to escape during the printing process. If this is not done liquid resin will remain inside the object, which in our application is the desired outcome. Purpose: We devised a method to produce an inherently MRI-visible accessory using DLP technology with low dimensional tolerance to facilitate MRI-guided breast biopsies. Methods: By hollowing out the object without adding drainage holes and tuning printing parameters such as z-lift distance to retain as much uncured liquid resin inside as possible through surface tension, objects that are inherently visible in MRI scans can be created without further post-processing treatment. Results: Objects created through our method are simple and inexpensive to recreate, have minimal manufacturing steps, and are shown to be dimensionally exact and inherently MRI visible to be directly used in various applications without further treatment. Conclusion: Our proposed method of manufacturing objects that are inherently both MRI safe, and MRI visible. The proposed process is simple and does not require additional materials and tools beyond a DLP 3D-printer. With only an inexpensive DLP 3D-printer kit and basic cleaning and sanitation materials found in the hospital, we have demonstrated the viability of our process by successfully creating an object containing fine structures with low spatial tolerances used for MRI-guided breast biopsies. [ABSTRACT FROM AUTHOR]

Plasma membranes appear as deformable systems wherein molecules are free to move and diffuse giving rise to condensed microdomains (composed of ordered lipids, transmembrane proteins and cholesterol) surrounded by disordered lipid molecules. Such denser and thicker regions, namely lipid rafts, are important communication hubs for cells. Indeed, recent experiments revealed how the most of active signaling proteins co-localize on such domains, thereby intensifying the biochemical trafficking of substances. From a material standpoint, it is reasonable to assume the bilayer as a visco-elastic body accounting for both in-plane fluidity and elasticity. Consequently, lipid rafts contribute to membrane heterogeneity by typically exhibiting higher stiffness and viscosity and by locally altering the bilayer dynamics and proteins activity. A chemo-mechanical model of lipid bilayer coupled with interspecific dynamics among the resident species (typically transmembrane receptors and trasporters) has been recently formulated to explain and predict how proteins regulate the dynamic heterogeneity of membrane. However, the explicit inclusion of the membrane viscosity in the model was not considered. To this aim, the present work enriches the constitutive description of the bilayer by modeling its visco-elastic behavior. This is done through a strain-level dependent viscosity able to theoretically trace back the alteration of membrane fluidity experimentally observed in lipid phase transitions. This provides new insights into how the quasi-solid and fluid components of lipid membrane response interact with the evolution of resident proteins by affecting the activity of raft domains, with effects on cell mechano-signaling. [ABSTRACT FROM AUTHOR]

Background: Primary Health Care (PHC) systems are pivotal in delivering essential health services during crises, as demonstrated during the COVID-19 pandemic. With varied global strategies to reinforce PHC systems, this scoping review consolidates these efforts, identifying and categorizing key resilience-building strategies. Methods: Adopting Arksey and O'Malley's scoping review framework, this study synthesized literature across five databases and Google Scholar, encompassing studies up to December 31st, 2022. We focused on English and Persian studies that addressed interventions to strengthen PHC amidst COVID-19. Data were analyzed through thematic framework analysis employing MAXQDA 10 software. Results: Our review encapsulated 167 studies from 48 countries, revealing 194 interventions to strengthen PHC resilience, categorized into governance and leadership, financing, workforce, infrastructures, information systems, and service delivery. Notable strategies included telemedicine, workforce training, psychological support, and enhanced health information systems. The diversity of the interventions reflects a robust global response, emphasizing the adaptability of strategies across different health systems. Conclusions: The study underscored the need for well-resourced, managed, and adaptable PHC systems, capable of maintaining continuity in health services during emergencies. The identified interventions suggested a roadmap for integrating resilience into PHC, essential for global health security. This collective knowledge offered a strategic framework to enhance PHC systems' readiness for future health challenges, contributing to the overall sustainability and effectiveness of global health systems. [ABSTRACT FROM AUTHOR]

Scheduling problems are a fundamental aspect of various industries, wherein the effective allocation of resources and time management play a crucial role in optimizing operational processes. These problems can arise in any industry that requires the scheduling of resources, from manufacturing to healthcare and transportation. Despite the extensive scope of service system scheduling problems in the literature, research has yet to examine the bibliometric variables in this area. Based on bibliometric criteria, this research offers a picture of the structure, evolution, and potential future directions of studies on scheduling in service systems. With the application of the bibliometric analysis software VOSviewer and CiteSpace, 1991 publications related to service scheduling were identified from the Web of Science database between 1982 and 2023 and used in the analysis of this paper. This review used several bibliometric approaches, such as performance analysis and a scientific mapping of service scheduling. Several bibliometric variables, such as h-index, productivity, and citations, were included in the performance evaluation. Science mapping has used co-citations, bibliographic coupling, and the concurrency of keywords. Also, this paper introduces a novel and comprehensive framework for classifying scheduling models in service systems based on their characteristics. The highly cited implementation papers in the literature have demonstrated that scheduling problems in health care have been heavily utilized in the scholarly literature. This review which is the first bibliometric analysis in the service scheduling field provides a summary reference for scholars entering the subject for future research. [ABSTRACT FROM AUTHOR]

Despite advancements in pediatric burn care, the profound hypermetabolic response associated with severe burns remains a multifaceted challenge throughout the continuum of care. Understanding the various physiologic disturbances that constitute hypermetabolism is crucial for a thorough evaluation and for implementing appropriate surgical and nonsurgical interventions. In this article, we describe the pathophysiology and treatment of hypermetabolism in pediatric burn patients with a focus on reducing resting energy requirements, minimizing infection, and optimizing nutrition for patients undergoing frequent surgical intervention. [ABSTRACT FROM AUTHOR]

Cell membranes, mediator of many biological mechanisms from adhesion and metabolism up to mutation and infection, are highly dynamic and heterogeneous environments exhibiting a strong coupling between biochemical events and structural re-organisation. This involves conformational changes induced, at lower scales, by lipid order transitions and by the micro-mechanical interplay of lipids with transmembrane proteins and molecular diffusion. Particular attention is focused on lipid rafts, ordered lipid microdomains rich of signalling proteins, that co-localise to enhance substance trafficking and activate different intracellular biochemical pathways. In this framework, the theoretical modelling of the dynamic clustering of lipid rafts implies a full multiphysics coupling between the kinetics of phase changes and the mechanical work performed by transmembrane proteins on lipids, involving the bilayer elasticity. This mechanism produces complex interspecific dynamics in which membrane stresses and chemical potentials do compete by determining different morphological arrangements, alteration in diffusive walkways and coalescence phenomena, with a consequent influence on both signalling potential and intracellular processes. Therefore, after identifying the leading chemo-mechanical interactions, the present work investigates from a modelling perspective the spatio-temporal evolution of raft domains to theoretically explain co-localisation and synergy between proteins' activation and raft formation, by coupling diffusive and mechanical phenomena to observe different morphological patterns and clustering of ordered lipids. This could help to gain new insights into the remodelling of cell membranes and could potentially suggest mechanically based strategies to control their selectivity, by orienting intracellular functions and mechanotransduction. [ABSTRACT FROM AUTHOR]

Background: COVID-19 rapidly spread through South Asian countries and overwhelmed the health systems that were unprepared for such an outbreak. Evidence from high-income countries showed that COVID-19 impacted healthcare utilization, including medication use, but empirical evidence is lacking in South Asia. This study aimed to investigate the effect of COVID-19 on healthcare utilization and medication use in South Asia. Method: The current study used longitudinal data from the ‘Premise Health Service Disruption Survey’ 2020 and 2021. The countries of interest were limited to Afghanistan, Bangladesh, and India. In these surveys, data related to healthcare utilization and medication use were collected for three-time points; ‘Pre-COVID phase’, ‘Initial phase of COVID-19 outbreak’, and ‘One year of COVID-19 outbreak’. Generalized estimating equation (GEE) along with McNemar’s test, Kruskal–Wallis test and χ2 test were applied in this study following the conceptualization of Andersen’s healthcare utilization model. Result: The use of healthcare and medication was unevenly impacted by the COVID-19 epidemic in Afghanistan, Bangladesh, and India. Immediately after the COVID-19 outbreak, respondents in Bangladesh reported around four times higher incomplete healthcare utilization compared to pre-COVID phase. In contrast, respondents in Afghanistan reported lower incomplete utilization of healthcare in a similar context. In the post COVID-19 outbreak, non-adherence to medication use was significantly higher in Afghanistan (OR:1.7; 95%CI:1.6,1.9) and India (OR:1.3; 95%CI:1.1,1.7) compared to pre-COVID phase. Respondents of all three countries who sought assistance to manage non-communicable diseases (NCDs) had higher odds (Afghanistan: OR:1.5; 95%CI:1.3,1.8; Bangladesh: OR: 3.7; 95%CI:1.9,7.3; India: OR: 2.3; 95% CI: 1.4,3.6) of non-adherence to medication use after the COVID-19 outbreak compared to pre-COVID phase. Conclusion: The present study documented important evidence of the influence of COVID-19 epidemic on healthcare utilization and medication use in three countries of South Asia. Lessons learned from this study can feed into policy responses to the crisis and preparedness for future pandemics. [ABSTRACT FROM AUTHOR]

Background: Magnetic resonance imaging (MRI)-guided vacuum-assisted breast biopsy (VABB) is an increasingly requested procedure, but it implies training and experience both in its execution and in determining radiological-pathological concordance and is therefore performed in dedicated breast centers. The purpose of this study is to evaluate the diagnostic performance of MRI-guided vacuum-assisted biopsy and to determine the upgrade rate after surgery or follow-up., Methods: We retrospectively evaluated all consecutive patients with suspicious MRI findings without corresponding mammographic and ultrasonographic findings who underwent MRI-guided vacuum-assisted breast biopsy (VABB) at our Institution from November 2020 to March 2023. We determined the sensitivity (SE), specificity (SP), positive predictive value (PPV), negative predictive value (NPV) and accuracy of the procedure; we also assessed upgrade rate to malignancies using surgery or at least 1-year negative follow-up as reference standard. Fisher's exact test was used to evaluate the correlation between enhancement size and type (mass/non-mass) and histological outcomes., Results: A total of 121 patients with 122 suspicious breast lesions have been included. 29.5% (n = 36) of these lesions were classified as malignant (B5), 23% (n = 28) were lesions with uncertain malignant potential (B3 lesions), and 47.5% (n =58) were benign (B2). Among B5 lesions, 47.22% (n =17) were ductal carcinomas in situ (DCIS) and 52.77% (n = 19) were invasive carcinomas. Among patients with already diagnosed breast cancer (n = 36), MRI-guided VABB identified additional foci of disease in 36.1% (n = 13) of the cases, specifically 10 foci on the same breast and 3 in the contralateral breast. Accuracy of MRI-guided VABB was 96.7%, SE was 90%, SP was 100%, PPV was 100%, and NPV was 95.3%. 4 benign lesions (B2 and B3) were upgraded to B5 lesions after surgery or follow-up; the upgrade rate to malignancies was 3.28%. Fisher's exact test showed a significant association between enhancement size and histological outcomes (OR = 2.38, p = 0.046), while enhancement type was not significantly correlated (OR = 0.88, p = 0.841). No major complications have been reported., Conclusions: MRI-guided VABB has proven to be a mini-invasive, safe, and accurate procedure for the diagnostic work-up of suspected breast lesions, which can help in the management of patients aiding in the correct surgical decisional process., Competing Interests: Declarations. Competing interests: The authors have no relevant financial or non-financial interests to disclose. Ethical approval: This study was approved by the institutional review board. All procedures performed in the studies involving human participants were in accordance with the ethical standards of the Institution “Fondazione IRCCS Istituto Nazionale dei Tumori” of Milan and with the 1964 Helsinki Declaration and its later amendments. Consent to participate: Informed consent was obtained from all individual participants included in the study., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Introduction: The COVID-19 pandemic has exerted devastating effects on healthcare delivery systems, specifically those for pregnant women. The aim of this review was to determine the maternal perception of antenatal health care services during the COVID-19 pandemic critical phase. Methods: Scopus, Web of Science, SAGE, and Ovid were systematically searched using the keywords "maternal", "COVID-19 pandemic", "maternal health service", and "maternal perception". Articles were eligible for inclusion if they were original articles, written in English, and published between January 1, 2020, and December 12, 2022. This review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eligible articles were assessed using the Mixed Methods Appraisal Tool. Thematic analysis was used for data synthesis. Results: Of 2683 articles identified, 13 fulfilled the inclusion criteria and were included in the narrative synthesis. Five themes emerged regarding the determinants of maternal perception of antenatal healthcare services during the COVID-19 pandemic critical phase: lack of psychosocial support, poor maternal healthcare quality, poor opinion of virtual consultation, health structure adaptation failure to meet women's needs, and satisfaction with maternal health services. Conclusion: Maternal perception, specifically pregnant women's psychosocial and maternal health needs, should be focused on the continuation of maternal care during the COVID-19 pandemic. It is critical to identify the maternal perception of maternal health services during the pandemic to ensure health service equity in the "new normal" future. [ABSTRACT FROM AUTHOR]

Background: CEM-guided breast biopsy is an advanced diagnostic procedure that takes advantage of the ability of CEM to enhance suspicious breast lesions. The aim pf this paper is to describe a single-center retrospective experience on CEM-guided breast biopsy in terms of procedural features and histological outcomes. Methods: 69 patients underwent the procedure. Patient age, breast density, presentation, dimensions, and lesion target enhancement were recorded. All the biopsy procedures were performed using a 7- or 10-gauge (G) vacuum-assisted biopsy needle. The procedural approach (horizontal or vertical) and the decubitus of the patient (lateral or in a sitting position) were noted. Results: A total of 69 patients underwent a CEM-guided biopsy. Suspicious lesions presented as mass enhancement in 35% of cases and non-mass enhancement in 65% of cases. The median size of the target lesions was 20 mm. The median procedural time for each biopsy was 10 ± 4 min. The patients were placed in a lateral decubitus position in 52% of cases and seated in 48% of cases. The most common approach was horizontal (57%). The mean AGD was 14.8 mGy. At histology, cancer detection rate was 28% (20/71). Conclusions: CEM-guided biopsy was feasible, with high procedure success rates and high tolerance by the patients. [ABSTRACT FROM AUTHOR]

Executive functions (EFs) in early childhood are predictors of later developmental outcomes and school readiness. Much of the research on EFs and their psychosocial correlates has been conducted in high-income, minority world countries, which represent a small and biased portion of children globally. The aim of this study is to examine EFs among children aged 3-5 years in two African countries, South Africa (SA) and The Gambia (GM), and to explore shared and distinct predictors of EFs in these settings. The SA sample (N = 243, 51.9% female) was recruited from low-income communities within the Cape Town Metropolitan area. In GM, participants (N = 171, 49.7% female) were recruited from the rural West Kiang region. EFs, working memory (WM), inhibitory control (IC) and cognitive flexibility (CF), were measured using tablet-based tasks. Associations between EF task performance and indicators of socioeconomic status (household assets, caregiver education) and family enrichment factors (enrichment activities, diversity of caregivers) were assessed. Participants in SA scored higher on all EF tasks, but children in both sites predominantly scored within the expected range for their age. There were no associations between EFs and household or familial variables in SA, except for a trend-level association between caregiver education and CF. Patterns were similar in GM, where there was a trend-level association between WM and enrichment activities but no other relationships. We challenge the postulation that children in low-income settings have poorer EFs, simply due to lower socioeconomic status, but highlight the need to identify predictors of EFs in diverse, global settings. RESEARCH HIGHLIGHTS: Assessed Executive Functioning (EF) skills and their psychosocial predictors among pre-school aged children (aged 3-5 years) in two African settings (The Gambia and South Africa). On average, children within each setting performed within the expected range for their age, although children in South Africa had higher scores across tasks. There was little evidence of any association between socioeconomic variables and EFs in either site. Enrichment activities were marginally associated with better working memory in The Gambia, and caregiver education with cognitive flexibility in South Africa, both associations were trend-level significance., (© 2023 The Authors. Developmental Science published by John Wiley & Sons Ltd.)

Introduction: New therapies for resistant hypertension (RH), including renal denervation (RDN), have been studied., Aim: Access the safety and effectiveness of radiofrequency-based RDN vs pharmacological treatment for RH., Methods: A thorough literature search was conducted across PubMed, EMBASE, and the Cochrane databases, focusing on studies that compared the effects of radiofrequency-based RDN versus pharmacological treatment for RH. Treatment effects for binary and continuous endpoints were pooled and used, respectively, odds-ratio (OR) and mean differences (MD) with 95% confidence intervals (CI) to analyze continuous outcomes., Results: In the 10 included studies, involving 1.182 patients, 682 received radiofrequency-based RDN. The follow-up period ranged from 6 to 84 months. Analysis revealed that the RDN group had a significant reduction in office systolic blood pressure (BP) (MD - 9.5 mmHg; 95% CI - 16.81 to - 2.29; P = 0.01), office diastolic BP (MD - 5.1 mmHg; 95% CI - 8.42 to - 2.80; P < 0.001), 24 h systolic BP (MD - 4.8 mmHg; 95% CI - 7.26 to - 2.42; P < 0.001). For 24 h diastolic BP RDN did not have a significant reduction (MD - 2.3 mmHg; 95% CI - 4.19 to - 0.52; P = 0.012). The heterogeneity between the studies was high, visible in the funnel and Baujat plots. The OR was non-significant for non-serious adverse events, but also clinically significant for hypertensive crises and strokes for the RDN group., Conclusions: While the pharmacological regimen of 3 or more anti-hypertensive, including a diuretic, still be the first-line option for RH treatment, our results support that radiofrequency-based RDN is superior in reducing global BP and is safe., (© 2024. The Author(s).)

Background: Excision is routinely recommended for atypical ductal hyperplasia (ADH) found on core biopsy given cancer upstage rates of near 20%. Identifying a cohort at low-risk for upstage may avoid low-value surgery. Objectives were to elucidate factors predictive of upstage in ADH, specifically near-complete core sampling, to potentially define a group at low upstage risk., Patients and Methods: This retrospective, cross-sectional, multi-institutional study from 2015 to 2019 of 221 ADH lesions in 216 patients who underwent excision or active observation (≥ 12 months imaging surveillance, mean follow-up 32.6 months) evaluated clinical, radiologic, pathologic, and procedural factors for association with upstage. Radiologists prospectively examined imaging for lesional size and sampling proportion., Results: Upstage occurred in 37 (16.7%) lesions, 25 (67.6%) to ductal carcinoma in situ (DCIS) and 12 (32.4%) to invasive cancer. Factors independently predictive of upstage were lesion size ≥ 10 mm (OR 5.47, 95% CI 2.03-14.77, p < 0.001), pathologic suspicion for DCIS (OR 12.29, 95% CI 3.24-46.56, p < 0.001), and calcification distribution pattern (OR 8.08, 95% CI 2.04-32.00, p = 0.003, "regional"; OR 19.28, 95% CI 3.47-106.97, p < 0.001, "linear"). Near-complete sampling was not correlated with upstage (p = 0.64). All three significant predictors were absent in 65 (29.4%) cases, with a 1.5% upstage rate., Conclusions: The upstage rate among 221 ADH lesions was 16.7%, highest in lesions ≥ 10 mm, with pathologic suspicion of DCIS, and linear/regional calcifications on mammography. Conversely, 30% of the cohort exhibited all low-risk factors, with an upstage rate < 2%, suggesting that active surveillance may be permissible in lieu of surgery., (© 2024. The Author(s).)

Resistant hypertension is associated with an exceedingly high cardiovascular risk and there remains an unmet therapeutic need driven by pathophysiologic pathways unaddressed by guideline-recommended therapy. While spironolactone is widely considered as the preferable fourth-line drug, its broad application is limited by its side effect profile, especially off-target steroid receptor-mediated effects and hyperkalaemia in at-risk subpopulations. Recent landmark trials have reported promising safety and efficacy results for a number of novel compounds targeting relevant pathophysiologic pathways that remain unopposed by contemporary drugs. These include the dual endothelin receptor antagonist, aprocitentan, the aldosterone synthase inhibitor, baxdrostat and the nonsteroidal mineralocorticoid receptor antagonist finerenone. Furthermore, the evidence base for consideration of catheter-based renal denervation as a safe and effective adjunct therapeutic approach across the clinical spectrum of hypertension has been further substantiated. This review will summarise the recently published evidence on novel antihypertensive drugs and renal denervation in the context of resistant hypertension., (© 2023 The Authors. British Journal of Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.)

The Coronavirus pandemic has affected millions of people due to the spread of the Severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) virus. Pregnant individuals and infants are most vulnerable given the increased risk of developing severe complications from SARS-CoV-2 infection. Recently, COVID-19 vaccination is recommended for pregnant women and infants starting at 6 months of age to prevent disease contraction and minimize disease severity. We conducted a review of the literature on COVID-19 vaccination to discuss vaccine safety and efficacy, immunity after maternal vaccination, transplacental transfer and persistence of antibodies, and public health implications. Current evidence supports the safety and efficacy of vaccination during pregnancy. Maternal vaccination provides greater antibody persistence in infants compared to immunity from natural infection. Furthermore, vaccination has demonstrated an increased rate of passive antibody transfer through the placenta and breast milk. Public health interventions are important in achieving herd immunity and ultimately ending the pandemic. IMPACT: This article highlights the benefits of COVID-19 vaccination during pregnancy with a review of the data describing safety and efficacy, passive and active immunity after maternal immunization, trans-placental transfer and persistence of protective antibodies, and public health implications. With this information, healthcare providers can provide up-to-date knowledge to their pregnant patients to help them form an informed decision on vaccination and combat vaccine hesitancy., (© 2023. The Author(s), under exclusive licence to Springer Nature America, Inc.)