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Purpose: Adrenocortical carcinoma (ACC) is a rare, aggressive pediatric malignancy. Advanced ACC requires multimodal treatment, including surgery and systemic chemotherapy including cisplatin, etoposide, doxorubicin, and mitotane. This is associated with significant gastrointestinal toxicity, resulting in many patients being unable to complete scheduled therapy. Often, supplemental nutrition is required if oral intake during treatment is poor. We assessed the frequency of nutritional supplement use in pediatric patients treated for advanced ACC. Methods: This was a retrospective observational study of patients with ACC treated at St. Jude Children’s Research Hospital over 10 years (2012–2022). Patient demographics, treatment received, and the need for supplemental enteral or parenteral nutrition were reviewed. Results: A total of 18 patients with ACC were treated from 2012 to 2022, with 11 having advanced ACC. 54.5% of patients required supplemental nutrition, both enteral and parenteral. All patients requiring supplemental nutrition were intolerant of oral intake, with a mean weight loss of 13.8% (range: 5.9–35%). Mean duration of nutritional support was 362 ± 337 days. Patients requiring supplemental nutrition tended to be younger than others (mean age: 4.45 ± 3.63 vs. 9.14 ± 4.59 years; median age: 3.35 vs. 8.40 years; range: 0.90–11.0 vs. 3.30–15.1 years) (p = 0.082). Conclusions: Most patients with stage IV ACC require nutritional support during their treatment course, especially younger patients. Preemptive feeding tube placement should be considered to avoid delays in treatment. [ABSTRACT FROM AUTHOR]

The increasing age of patients with end-stage renal disease raises the issue of hostile arterial access for transplantation, with technical difficulties associated with clamping and suturing the iliac artery. Some of these patients - who theoretically represent those who would benefit the most from transplantation in terms of mortality - are contraindicated because of anatomical and medical issues. In this context, a specific endovascular device called EndoPreKiT (Endovascular Preparation for Kidney Transplantation) has been designed, enabling arterial access for transplantation via a mini-invasive procedure. It consists of a woven Dacron supported by self-expanding nitinol rings, ensuring anchorage and allowing arterial clamping. The middle part of the anterior face of the device is stentless, enabling the anastomosis directly onto the Dacron once the calcified artery wall has been removed. After a cadaveric study validating its technical feasibility, such device was successfully implanted in 10 patients considered unfit for transplantation due to severe wall calcification. Two of them have been successfully transplanted with excellent outcomes after 13 and 3 months of follow-up. EndoPreKiT device may be a significant breakthrough in transplant surgery, that could expand the horizon of eligibility to include even the most fragile patients with challenging arterial access. [ABSTRACT FROM AUTHOR]

Background: multilocular thymic cysts are uncommon acquired cysts in the anterior mediastinum caused by incomplete thymic involution. They may be associated with autoimmune diseases, such as rheumatoid arthritis and systemic sclerosis. Methods: a 61-year-old man with a history of rheumatoid arthritis for 8 years was referred to our unit because of a multiloculated mass in the anterior mediastinum with a high F18 fluorodeoxyglucose uptake at PET-CT scan. Histology showed a multilocular thymic cyst with lymphoid tissue, organized in germinal centers and internodal areas. Results: rheumatoid arthritis-related symptoms progressively disappeared after the excision of the mass. Conclusions: to our knowledge, this is the first report in the English language of rheumatoid arthritis symptoms improvement after multilocular thymic cyst surgical removal. [ABSTRACT FROM AUTHOR]

Two 3D-printed crown materials (Crown and Ceramic Crown) were examined to determine the best surface treatment and primers for bonding. Discs of the two materials were printed and mounted with their "intaglio" surfaces untouched. Half the specimens from each group were sandblasted with 50 µm alumina. Then, specimens were divided into four groups (n = 10): Gr1—no further treatment; Gr2—one coat of silane; Gr3—one coat of universal adhesive; Gr4—one coat of silane, then one coat of universal adhesive. Bond strength specimens were prepared with an Ultradent shear bond strength apparatus using Filtek Supreme composite. Specimens were stored for 8 weeks in 37 °C water. The specimens were debonded with a circular notched-edge blade applied at 1 mm/min, and the shear bond strength was calculated. The data were compared with a two-way ANOVA (factors: surface treatment and primer) and a Tukey post hoc analysis for both materials independently, with p < 0.01 considered meaningful. The filler content (burned ash) and resin content (FTIR) of the materials were determined. For both materials, factors surface treatment and primer were significant (p < 0.01), but their interaction was not (p = 0.43 for Crown and p = 0.34 for Ceramic Crown). Alumina air particle abrasion improved the bond strength for both materials. The Tukey post hoc analysis grouped primer treatments into the same statistically different groups for both materials: Gr1 and Gr2 < Gr3 and Gr4. The filler percentage of Crown was 32.7% and Ceramic Crown was 48.2%. Resin content was similar for both materials. The most effective method to bond to 3D-printed crowns (regardless of filler percentage) was to sandblast with 50 µm alumina and apply a layer of adhesive (with or without previous application of silane). [ABSTRACT FROM AUTHOR]

Preference tests are commonly used to assess fish behavior and cognition in several research fields. This study aimed to investigate how fish perform in a preference test involving extended habituation to the apparatus, which was expected to reduce stress. We contrasted the choice between a sector of the apparatus with natural vegetation, expected to be the preferred stimulus, and a barren sector. Initially, we demonstrated that guppies' preference for the sector with vegetation increased after a 5‐day habituation period (Experiment 1). Subsequent experiments systematically modified the testing paradigm to observe effects on the preference. Experiment 2 introduced a physical separation between sectors to facilitate discrete choices, Experiment 3 tested groups of fish, and Experiment 4 used wild guppies. Only the modification in Experiment 3 impacted preference scores: guppies tested in groups showed a higher preference for the vegetation stimulus and spent less time in the central, no‐choice sector of the testing apparatus. Overall, this study supports the importance of methodological details in preference tests and highlights the benefits of extended habituation and group testing. Researchers should consider these factors when designing experiments to evaluate cognitive abilities or behavioral preferences in fish. Tailoring testing paradigms to specific research goals can improve the reliability and comparability of results, contributing to a deeper understanding of fish behavior and welfare. [ABSTRACT FROM AUTHOR]

Background/Objectives: Male infertility is influenced by physiological factors like age, as well as lifestyle factors, including physical activity. However, the specific impact of sport activity on semen parameters, and thus on male fertility, remains unclear. Specifically, the aim of this systematic review is to evaluate how an intense regime of training may affect sperm parameters in professional and non-profession athletes. Methods: Studies reporting sperm parameters associated with high training load were included. In April 2024, three electronic databases and literature sources (PubMed, Scopus, and Web of Science) were searched. Quality appraisal was performed independently by three authors using the National Heart, Lung, and Blood Institute Quality Assessment Tools (NHLBI-QAT). Results: Four studies met the inclusion criteria, reporting a total of 156 participants. Sixteen weeks of intensive cycling training produced a significant decrease in seminal volume, sperm concentration, sperm motility, and morphology, with a return to their initial levels, except for sperm morphology and sperm concentration, after at least one week of rest. In addition, in athletes with varicocele, a 6-month stop from sports activity went a long way toward improving sperm concentration and sperm motility. However, DNA fragmentation, a greater presence of round cells, and high numbers of active macrophages were described. At least 30 days improve semen parameters in professional and non-professional athletes. Conclusions: Intensive training could worsen seminal parameters and, consequently, male fertility. However, certainty of evidence is very low, and the results should be interpreted with caution. [ABSTRACT FROM AUTHOR]

Pulicaria species are used as herbal medicine and in the preparation of decoctions in several Asian and African regions. Among them, the plant Pulicaria burchardii is known for its medicinal properties, but comprehensive studies on its biological activity are still limited. This study examined the properties of the essential oil (EO) extracted by P. burchiardii and collected in Morocco during the flowering period. The focus was on its antimicrobial, anti-germinative, antioxidant, and antiviral activities, with the aim of evaluating its potential use in food preservation and beyond. The EO was subjected to various analyses to determine its chemical composition and biological efficacy. Specifically, GCMS and NMR analyses revealed that the EO is rich in oxygenated sesquiterpenes (72.59%), with 1-oxo-bisabolone being the predominant component (65.09%). The antimicrobial activity was tested against various Gram-positive and Gram-negative bacteria, demonstrating a significant inhibition of bacterial growth, particularly against Bacillus subtilis (MIC value of 0.6 mg/mL). The anti-germinative property was evaluated on spores of B. subtilis and other bacilli, such as Bacillus cereus, revealing a notable ability to prevent germination. For antiviral activity, the EO was tested against several pathogenic viruses including SARS-CoV-2 and HSV-1, showing an effective broad-spectrum reduction in viral replication in vitro. This study demonstrated that P. burchardii essential oil had excellent antibacterial and antiviral capabilities. The future challenge will focus mainly on the principal compound, 1-oxo-bisabolone, to demonstrate its real effectiveness as an antibacterial and/or antiviral. [ABSTRACT FROM AUTHOR]

Background: Alzheimer's disease (AD) is the most common neurodegenerative dementia, with diagnosis traditionally reliant on clinical criteria. Cerebrospinal fluid (CSF) biomarkers like pTau181 and Aβ42/Aβ40 ratio significantly improve diagnostic accuracy but are invasive. Plasma biomarkers measured by automated assays offer a non-invasive alternative. Objective: To evaluate the diagnostic performance of plasma pTau181, Aβ42/Aβ40, and pTau181/Aβ42 ratios in predicting CSF amyloid status in a real-life clinical setting. Methods: Data from consecutive patients whose plasma and CSF samples sent to our laboratory between March and October 2022, were retrospectively analyzed. Plasma and CSF pTau181, Aβ42, and Aβ40 levels were measured using the Lumipulse G600II platform. CSF amyloid status was classified as amyloid-positive (A+) or amyloid-negative (A-) based on the Aβ42/Aβ40 ratio. Statistical analyses included Spearman correlation, receiver operating characteristic (ROC) curves, and multivariate logistic regression to evaluate biomarker performance. Results: Among 165 individuals (83 females), 29.1% were classified as A+. Significant correlations were found between plasma and CSF biomarkers, with the highest for the pTau181/Aβ42 ratio (ρ=0.620, p < 0.0001). ROC analysis showed the pTau181/Aβ42 ratio had the highest diagnostic performance (AUC 0.818), followed by pTau181 (AUC 0.794) and Aβ42/Aβ40 (AUC 0.775). Combining plasma biomarkers in age-adjusted models improved diagnostic accuracy (AUC up to 0.846). Conclusions: Plasma biomarkers measured by the Lumipulse G600II platform show strong potential in predicting CSF amyloid status and possibly reduces the need for lumbar punctures. These findings support the potential use of plasma assays in the early diagnosis of AD. Anyway, further validations in larger multicenter cohorts are mandatory. [ABSTRACT FROM AUTHOR]

Lateral ankle soft tissue defects pose challenges, especially in cases due to chronic pressure from cross-legged sitting, which usually present with a large dead space, small skin opening that often accompanies an open joint. Traditional reconstruction methods using fasciocutaneous flaps may result in donor site morbidity such as delayed wound healing or nerve injury. In this article, we present a case of diabetes-related lateral ankle defect successfully treated using adiposal layer only flap, also known as pure fat flap. The anatomy and the surgical technique of adiposal layer only flap were reviewed. These flaps preserve the subdermal plexus and deep fascia while obliterating dead space and providing a gliding surface for proper ankle movement. A perforator-based adiposal layer only flap was elevated from the peroneal artery and used to cover the defect. Flap perfusion was confirmed using indocyanine green video angiography and color duplex ultrasound. Patient had a successful recovery with minimal donor site morbidity. The technique expands the reconstructive microsurgeon's options for complex ankle coverage, ensuring optimal wound healing and functional outcomes. [ABSTRACT FROM AUTHOR]

In the realm of chemical processing, particularly at the industrial scale, safety is of utmost importance. A predominant factor causing accidents within the chemical industry is runaway phenomena, primarily initiated by uncontrolled exothermic reactions. This review critically examines the often‐overlooked decomposition mechanisms as a significant contributor to thermal energy release, necessitating a comprehensive revision and understanding of both experimental and theoretical strategies for assessing thermal degradation. Key to this discourse is the explication of calorimetry as the principal experimental technique, alongside ab initio quantum chemistry simulations as a robust theoretical framework for quantifying the most relevant properties. However, more than mere cognisance of these methodologies is required for a meticulous thermal stability assessment. The review emphasizes identifying and quantifying fundamental parameters through experimental and theoretical investigations. Only upon acquiring these parameters, including kinetic, thermodynamic, onset, and peak characteristics of the exothermic decomposition reactions, can one effectively mitigate risks and hazards in designing and optimizing chemical processes and apparatus. Furthermore, this review delineates qualitative and quantitative methodologies for hazard assessment, proffering strategies for estimating safe operational conditions and sizing relief devices. The paper culminates in exploring future trajectories in thermal stability assessments, focusing on emerging applications in lithium‐ion batteries, electrolyzers, electrified reactors, ionic liquids, artificial intelligence and machine learning approaches. Thus, the paper underlines the evolving landscape of thermal risk management in contemporary and future chemical industries. [ABSTRACT FROM AUTHOR]

Ketamine provides the highest safety profile among sedatives for procedural sedation and analgesia in the pediatric emergency setting. However, it can cause vomiting and recovery agitation. No studies have examined epigenetic factors, such as microRNAs, for predicting the occurrence of these adverse events. Neuronal‐derived extracellular vesicle microRNA profiles were studied to predict the occurrence of ketamine‐induced vomiting and recovery agitation in children. For this aim, a single‐center prospective pharmacoepigenetic study was performed and 50 children who underwent procedural sedation with intravenous ketamine as the only sedative drug were enrolled between October 2019 and November 2022. MiRNA profiling in plasma neural‐derived extracellular vesicles was analyzed through next‐generation sequencing and measured before treatment with ketamine. Twenty‐two patients experienced vomiting or recovery agitation. Among the 16 differentially expressed microRNAs, the upregulated miR‐15a‐5p and miR‐484 targeted genes related to N‐methyl‐D‐aspartate (NMDA) receptor activity, including glutamate ionotropic receptor NMDA type subunit 2A (GRIN2A). Preliminary data confirmed lower GRIN2A levels in patients who developed these events. Downregulated miR‐126‐3p and miR‐24‐3p targeted AMPA receptor‐associated genes. Functional analyses of gene targets revealed the enrichment of glutamatergic and neurotrophins signaling. Recovery agitation was associated with this network. Vomiting was related to dopaminergic and cholinergic systems. Three miRNAs (miR‐18a‐3p, miR‐484, and miR‐548az‐5p) were identified as predictive biomarkers (AUC 0.814; 95% CI: 0.632–0.956) for ketamine‐induced vomiting and recovery agitation. MicroRNA profiles can predict the development of ketamine‐induced vomiting or recovery agitation in children. This study contributes to the understanding of the mechanisms underlying ketamine‐induced adverse events. [ABSTRACT FROM AUTHOR]

DCoffset faults of phase current sensors in AC Permanent Magnet Synchronous Machines (PMSMs) are widely studied in the literature since they can lead to heavy torque oscillations and thermal instability of the drive. This paper presents the experimental implementation of an algorithm for the real time estimation and compensation of these faults in PMSM drives controlled by Field Oriented Control (FOC). The method uses equations derived from the analytically closed form solution of the steady-state d-q axes model of PMSM, taking into account the full FOC dynamics and DC offset faults of the phase current sensors. The algorithm allows for detecting, isolating, and estimating the fault conditions by identifying the phase current offsets, both when using three sensors and two current sensors. The real time compensation is based on the developed model, does not require additional hardware, and uses only a digital filter of the measured phase currents for compensating online the offset fault. Experimental results and sensitivity analysis to the motor parameters variations are presented to validate the proposed algorithm.

Sliding mode controllers (SMCs) are commonly used in permanent-magnet synchronous machines (PMSMs) for current control due to their robustness and simplicity. However, high gains used in traditional discontinuous SMC implementations can induce chattering. To address this, disturbance observers are employed to maintain robustness without resorting to high gains. This article introduces a novel continuous asymptotic SMC method for PMSM currents that avoids the need for disturbance observers, resulting in reduced complexity and tuning efforts. The control laws of the two $dq$-axes currents are obtained through the sensitivity of the tracking errors with respect to the controller outputs. The robustness and convergence properties of the proposed control laws are theoretically studied using the Lyapunov approach. Numerical simulations are used to evaluate the performance and robustness of the proposed controller, followed by experiments to compare it to a discontinuous terminal SMC with and without a disturbance observer. The results clearly demonstrate the superiority of the proposed controller that ensures fast convergence, low chattering, and high robustness to parameter variations without requiring the design of additional disturbance observers.

ABSTRACT Background Medical images play an important role in diagnosis and treatment of pediatric solid tumors. The field of radiology, pathology, and other image‐based diagnostics are getting increasingly important and advanced. This indicates a need for advanced image processing technology such as Deep Learning (DL). Aim Our review focused on the use of DL in multidisciplinary imaging in pediatric surgical oncology. Methods A search was conducted within three databases (Pubmed, Embase, and Scopus), and 2056 articles were identified. Three separate screenings were performed for each identified subfield. Results In total, we identified 36 articles, divided between radiology (n = 22), pathology (n = 9), and other image‐based diagnostics (n = 5). Four types of tasks were identified in our review: classification, prediction, segmentation, and synthesis. General statements about the studies'’ performance could not be made due to the inhomogeneity of the included studies. To implement DL in pediatric clinical practice, both technical validation and clinical validation are of uttermost importance. Conclusion In conclusion, our review provided an overview of all DL research in the field of pediatric surgical oncology. The more advanced status of DL in adults should be used as guide to move the field of DL in pediatric oncology further, to keep improving the outcomes of children with cancer.