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This study aimed to identify the link between alloy microstructures and the nanomechanical properties of different orthodontic archwires containing nickel-titanium (NiTi) by sensing sliced areas. Previous studies have focused on analyzing and contrasting physical properties such as microhardness, elasticity modulus, and resistance; therefore, the trend is to consider microstructural characteristics in detail. Thirty archwire samples from 3 different commercial brands, American Orthodontics (AO), 3M Unitek (3M), and Borgatta, were analyzed through scanning electron microscopy and energy-dispersive x-ray spectroscopy, transmission electron microscopy, atomic force microscopy, Berkovich nanoindentation, and microtensile microscopy to determine their chemical-crystallographic characteristics and nanomechanical and bending characteristics. The identified formulations of AO and 3M had averages of 20 wt%, for Ni and 15.4 wt% for Ti, with lower concentrations for Borgatta. Alloys of Ni and Ti were distributed in different concentrates in the matrix of the archwires. The nanomechanical properties showed high values of the elastic modulus (82.8 ± 3.6 GPa) and hardness (6.4 ± 1.2 GPa) and a minor deformation degree of 0.38% for the AO wires, although the bending strength exhibited the highest values for 3M. No corrosion was observed with a prolonged hydrolytic attack on the surface of any of the wires (0.0-0.5 National Bureau of Standards units). The highest nanomechanical properties and bending characteristics were observed for wires with higher NiTi precipitate contents, which were distributed differently in the alloy overall in the matrix. The nanoindentations sensed in different areas evidenced different mechanical properties for NiTi depending on its concentrations of Ti and enucleations. [Display omitted] • Nanomechanical properties of different orthodontic nickel-titanium archwires were studied. • Bending characteristics are evidenced by wires with higher nickel-titanium contents. • No corrosion was observed with a prolonged hydrolytic attack on the surface of all wires. • Chemical-crystallographic characteristics were examined by scanning electron microscopy. • The corrosion did not manifest after a hydrolytic attack of the wires in artificial. [ABSTRACT FROM AUTHOR]

This study explores the evolution of authorship dynamics in Interventional Radiology over a fifteen-year period, with a focus on gender disparities. It aims to illuminate the representation of female authors in high-impact IR journals, highlighting ongoing challenges in achieving gender diversity, especially in leadership roles. A bibliometric analysis was conducted on articles published from 2008 to 2023, systematically assessing trends in female first and last authorships, as well as their overall contribution to total authorship within prominent IR journals. The analysis revealed a fluctuating trajectory in female authorship. Female first authorship peaked in 2011, followed by a decline through 2012-2013, and subsequently rebounded by 2023. Female last authorship exhibited a similar non-linear pattern, with an initial decline from 2008 to 2013, before gradually increasing in recent years. Overall, the presence of female authors in IR publications has steadily grown, with a notable rise in the proportion of publications featuring female authors and an increase in the average number of female contributors per article by 2023. Despite the overall growth in female authorship, significant disparities persist, particularly in senior authorship positions. These findings highlight the need for sustained efforts to address gender inequities in IR, emphasizing the importance of robust policies and support systems to promote women's advancement within the field. [ABSTRACT FROM AUTHOR]

• Graduate nursing students demonstrated high levels of blended learning satisfaction, self-efficacy, and work efficacy. • Graduate nursing students' self-efficacy increases if they are satisfied with the blended learning setup. • Self-efficacy directly influences nursing students' work readiness. • Blended learning satisfaction mediates the influence on nursing students' work readiness via self-efficacy. To determine the relationship between blended learning satisfaction with self-efficacy and the work readiness of nursing graduates. Blended learning is an educational approach to ensuring quality nursing education during the COVID-19 pandemic. However, examining the nursing students' blended learning satisfaction and its association with self-efficacy and work readiness remains underreported during the pandemic. A descriptive-correlational design using a structural equation modeling (SEM) approach. This study was participated by 208 nursing graduates recruited through consecutive sampling. Four self-report tools were used to collect data (Student Learning Satisfaction in a Blended Learning Satisfaction Tool [BLST], Nursing Self-Efficacy Tool [NSET], and Nursing Work Readiness Tool [NWRT]). Data analysis included descriptive statistics and SEM. The results indicated high levels of blended learning satisfaction (M = 2.88; SD = 0.45), self-efficacy (M = 3.25; SD = 0.35), and work readiness (M = 3.34; SD = 0.34). The emerging model demonstrated acceptable model fit indices, with self-efficacy increasing with blended learning satisfaction (p = 0.16) and a direct impact on work readiness (p = 0.73). In addition, blended learning satisfaction does not directly influence work readiness (p = −0.03) but has a mediating effect on work readiness through self-efficacy (p = 0.009). Nursing students who underwent blended learning in their senior year reported high levels of blended learning satisfaction, self-efficacy, and work readiness. Nursing students in a blended learning environment have the potential to be work-ready if they consider themselves self-efficacious and have the support of a suitable blended learning set-up. [ABSTRACT FROM AUTHOR]

The rationale for the Latarjet procedure was described as the "triple blocking" effect. Satisfactory surgical outcomes have been reported after surgery. However, it has been reported that the "triple blocking" effect increases joint stability, but it does not fully restore it. Moreover, the procedure is nonanatomic and concerns remain regarding the effects. The study of scapulohumeral rhythm, which is a clinical parameter used for the functional evaluation of shoulder kinematics, can offer new perspectives on the rationale for the procedure. This study aimed to compare the shoulder kinematics of patients after the Latarjet procedure to the shoulders of a healthy population using magnetic and inertial measurement units with a motion analysis system. A retrospective study with prospective data collection was conducted on 28 patients who underwent the open Latarjet procedure for recurrent shoulder instability. At a minimum 12-month follow-up, each patient was evaluated by assessing the range of motion, the Rowe score, and the Constant-Murley score. Patients were examined using the ShowMotion 3D kinematic tracking system (NCS Lab, Modena, Italy), which uses wireless wearable noninvasive magnetic and inertial measurement units sensors to assess the three-dimensional kinematics of the shoulder. For each plane of elevation (ie, flexion and abduction), the scapulohumeral rhythm was described by three scapulothoracic rotations (ie, protraction–retraction, mediolateral rotation and posterior–anterior tilting) as a function of humeral anteflexion or humeral abduction. The mean time from first shoulder dislocation to surgery was 6.6 ± 3 years (range, 1-12 years). No intraoperative complications occurred, and computed tomography (CT) performed 3 months after surgery showed graft union in all patients. After a mean follow-up time of 32.4 ± 20 months (range, 12-96), the mean Constant-Murley score and Rowe scores were 94.5 ± 4.8 (range, 84-100) and 96.7 ± 3.5 (range, 90-100), respectively. All patients showed no signs of glenohumeral arthritis on X-ray examination. Scapular posterior tilt and scapular internal rotation were significantly greater in the patient group than in the healthy population for the flexion–extension and abduction–adduction movements along the whole shoulder range of motion (all P <.05); no differences were found in upward/downward scapular rotation. A greater scapular posterior tilt and scapular internal rotation were observed after the Latarjet procedure. The modified position of the scapula was maintained during the entire range of motion, suggesting a shoulder-stabilizing kinematic effect in addition to the bony, sling and bumper effects. [ABSTRACT FROM AUTHOR]

For patients with T1b gallbladder cancer or greater, an adequate lymphadenectomy should include at least 6 nodes. Studies comparing short- and long-term outcomes of the open approach with those of laparoscopy and robotic approaches are limited, with small sample sizes, and there are none comparing laparoscopic and robotic approaches. This study compared patients who underwent robotic, laparoscopic, and open resection of gallbladder cancer, evaluating short- and long-term outcomes. We conducted a multicenter retrospective study of patients with T1b gallbladder cancer or greater (excluding combined organ resection and T4) who underwent open, laparoscopic, and robotic liver resection and lymphadenectomy between January 2012 and December 2022. The 3 groups were matched in terms of patient baseline and disease characteristics based on propensity score matching, comparing robotic with open and robotic with laparoscopic groups. We enrolled 575 patients from 37 institutions. After propensity score matching, the median number of harvested nodes was higher in the robotic group than in the open (7 vs 5; P =.0150) and laparoscopic groups (7 vs 4; P <.001). The Pringle maneuver time was shorter with robotic resection than with laparoscopy (38 vs 59 minutes; P =.0034), and the robotic group also had a lower conversion rate (3% vs 14%, respectively; P =.005) and less estimated blood loss than open and laparoscopic resections. The perioperative morbidity and mortality rates did not differ. The robotic and laparoscopic approaches were associated with faster functional recovery than the open group. In the multivariate analysis, the factors related to the retrieval of at least 6 nodes were the robotic approach over open (odds ratio, 5.1529) and over laparoscopy (odds ratio, 6.7289) and the center experience (≥20 minimally invasive liver resections/year) (odds ratio, 4.962). After a mean follow-up of 42.6 months, overall survival and disease-free survival were not different between groups. Compared with open and laparoscopic surgeries, the robotic approach for gallbladder cancer performed in a center with appropriate experience in minimally invasive surgery can provide adequate node retrieval. [ABSTRACT FROM AUTHOR]

To analyze the diagnostic performance of three short magnetic resonance imaging (MRI) protocols for the follow-up of pancratic intraductal papillary mucinous neoplasms (IPMN). Follow-up MRI examinations of 287 patients with IPMN performed in two centers were retrospectively retrieved. Four MRI protocols were identified as follows: T1-weighted (T1w), T2-weighted (T2w), and MRCP sequences (protocol 1); T1w, T2w, MRCP, and diffusion-weighted (DWI) sequences (protocol 2); T1w, T2w, MRCP, and post-contrast T1w-sequences (protocol 3); and a comprehensive protocol including all previous sequences (protocol 4). Three radiologists with different experience in abdominal imaging expressed their opinion upon the optimal patient's management upon the evaluation of each protocol. Intra-and inter-observer agreement and concordance with the clinical decision expressed by a pancreatic surgeon were calculated with Cohen's kappa test. 223 patients were included (66±10 years; 92 men, 131 women). 143 patients had branch-duct-IPMNs, 25 main-duct-IPMNs and 55 mixed-type-IPMNs. 79 patients underwent surgery, resulting in 52 high-grade dysplasia (HGD) and 27 low-grade dysplasia (LGD). Concordance for the expert reader between protocols 1, 2 and 3 and the actual clinical decision were 0.63, 0.72, and 0.74 respectively (95% CI, 0.53–0.73, 0.63–0.81, and 0.65–0.83). Inter-observer agreement between reader 1 and reader 2, reader 1 and reader 3, and reader 2 and reader 3 were: 0.71, 0.50, and 0.75 for protocol 1 (95% CI, 0.63–0.81, 0.40–0.60, and 0.66–0.84);0.68, 0.54, and 0.84 for protocol 2 (95% CI, 0.59–0.77, 0.44–0.64, and 0.76–0.91); and 0.77, 0.65, and 0.86 for protocol 3 (95% CI, 0.69–0.86, 0.55–0.74, and 0.80–0.93). Short MRI protocol is suitable for IPMN surveillance. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Designing incentives to attract the best teachers to low-performing schools has become a fundamental objective in educational equity. We analyze the case of Costa Rica, where the most experienced teachers usually choose to work in the countryʼs Central Region. We carried out a discrete choice experiment with a sample of 400 teachers in 52 schools, aiming to elicit their preferences to work at schools located in disadvantaged regions. The findings suggest that monetary incentives are the most effective to increase the probability of teachers accepting contracts in disadvantaged locations. In particular, economic bonuses show marginal effects between 8 % and 22 %. On the other hand, non-monetary incentives (working with highly qualified peers, direct access to supervisors of educational programs, and provision of material resources) are found to be important complements in the design of incentive packages. Combining monetary and non-monetary incentives, we obtain an acceptance rate to move to disadvantaged regions of more than 30 % of the teachers. These incentive designs are especially relevant in the educational systems of developing countries, which face high internal inequalities and strong financial constraints. [ABSTRACT FROM AUTHOR]

At the end of 2022, the football world championship will be held in Qatar. These types of meetings require a risk analysis. It proposes an approach to determine which health risks should be prioritized. We use a mixed methodology (Hierarchical Process Analysis, World Health Organization STAR and European Commission INFORM) to determine the risk level of a total of 12 health entities. Our analysis identifies 6 health entities with a moderate risk. There are 4 whose valuation is as low risk and 2 as very low. In our work we focus the analysis from a point of view of the route of transmission or presentation of health events, which facilitates a visualization of the preventive measures to be implemented, both organizationally and individually by the attendees. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The anterior iliac crest is one of the most used options; however, pain and other complications have been reported. Other options for bone harvest in the lower extremity, such as the proximal tibia and calcaneus, can be useful sites for bone grafting. Computed tomography angiography images of the lower extremity were analyzed using 3-D Slicer™ medical imaging software, creating an advanced 3-dimensional model. Bone volume (cm3) and bone mineral density (Hounsfield units) were measured from the cancellous bone in the anterior iliac crest, posterior iliac crest, proximal tibia, and the calcaneus. Fifteen studies were included. The total volume measured it was of 61.88 ± 14.15 cm3, 19.35 ± 4.16 cm3, 32.48 ± 7.49 cm3, 26.40 ± 7.18 cm3, for the proximal tibia, anterior and posterior iliac crest, and calcaneus, respectively. Regarding Hounsfield units, the densities were 116 ± 58.77, 232.4 ± 68.65, 214.4 ± 74.45, 170.5 ± 52.32, for proximal tibia, anterior and posterior iliac crest, and calcaneus. The intraclass correlation coefficients were in average >0.94. In conclusion, the proximal tibia has more cancellous bone than the anterior and posterior iliac crest. The calcaneus has more cancellous bone than the anterior iliac crest. Bone mineral density was highest in the anterior iliac crest and in proximal tibia was the lowest value. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Addressing facial palsy (FP) presents intricate challenges in achieving natural expressions. Although free functional muscle transfers (FFMT) offer effective smile restoration, age impacts their efficacy. The optimal FFMT age range of 5–55 years is limited by physical fitness, which extends beyond age boundaries. Unilateral FP demands vary; younger patients require dynamic solutions like FFMT, whereas older individuals prioritize public appearance due to baseline distortion. The aim of this study is to describe and to assess a new static technique combining deep plane facelift and fascia lata graft for FP treatment. We conducted a prospective pilot study enrolling unilateral FP patients aged >55 and declining FFMT. Exclusions encompassed prior FP surgery, recent injections, uncontrolled diabetes cognitive deficits, and patients unable to quit smoking. To evaluate this technique, the Glasgow Benefit Inventory (GBI), along with two objective scales, the Face- and Neck-Lift Objective Photo-Numerical Assessment Scale and the eFACE scale, were used. Interrater reliability and intrarater reliability were assessed. Fifteen patients (mean age: 60.9 years) underwent the procedure. Both static and dynamic symmetry significantly improved (p < 0.05), including check volume and position, oral commissure, and jawline. Notably, eye closure enhancement was observed. GBI scores also significantly increased (p < 0.05). Interrater reliability and intrarater reliability were minimal (p = 0.12 and p = 0.13). This combined approach offers a static FP treatment option, especially for the elderly or FFMT-ineligible patients. The relatively brief procedure yields immediate and satisfactory results, suggesting its potential value in FP management. Further comprehensive studies are encouraged to validate the technique's long-term efficacy and applicability across larger populations. [ABSTRACT FROM AUTHOR]

Survival data after mitral transcatheter edge-to-edge repair (TEER) are scarce, and its impact on predicted life expectancy is unknown. The aim of this study was to estimate the impact of TEER on postprocedural life expectancy among patients enrolled in the MitraSwiss registry through a relative survival (RS) analysis. Consecutive TEER patients 60 to 89 years of age enrolled between 2011 and 2018 (N = 1140) were evaluated. RS was defined as the ratio between post-TEER survival and expected survival in an age-, sex- and calendar period–matched group derived from the Swiss national 2011 to 2019 mortality tables. The primary aim was to assess 5-year survival and RS after TEER. The secondary aim was to assess RS according to the etiology of mitral regurgitation, age class and sustained procedural success over time. Overall, 5-year survival after TEER was 59.3% (95% CI: 54.9%-63.4%), whereas RS reached 80.5% (95% CI: 74.6%-86.0%). RS was 91.1% (95% CI: 82.5%-98.6%) in primary mitral regurgitation (PMR) and 71.5% (95% CI: 63.0%-79.3%) in secondary mitral regurgitation (SMR). Patients 80 to 89 years of age (n = 579) showed high 5-year RS (93.0%; 95% CI: 83.3%-101.9%). In this group, restoration of predicted life expectancy was achieved in PMR with a 5-year RS of 100% (95% CI: 87.9%-110.7%), whereas sustained procedural success increased the RS rate to 90.6% (95% CI: 71.3%-107.3%) in SMR. Mitral TEER in patients 80 to 89 years of age is able to restore predicted life expectancy in PMR, whereas in SMR with sustained procedural success, high RS estimates were observed. Our analysis suggests that successful, sustained mitral regurgitation reduction is key to survival improvement, particularly in patients 80 to 89 years of age. [Display omitted] [ABSTRACT FROM AUTHOR]

Hip hemiarthroplasty dislocation is a devastating complication. Among other preoperative risk factors, acetabular morphology has been rarely studied. The purpose of the study was to evaluate the influence of preoperative native acetabular morphology on hemiarthroplasty dislocation. We retrospectively reviewed 867 patients who underwent hip hemiarthroplasty for femoral neck fracture between January 1, 2014 and January 1, 2019. The 380 included patients were treated with an anterior-based muscle-sparing approach. The central-edge angle (CEA) and acetabular depth-to-width ratio (ADWR) of the fractured hip were measured preoperatively on the anteroposterior pelvic view. Receiver operating characteristic curves were performed to analyze the optimal cutoff for CEA and ADWR. Hemiarthroplasty dislocation occurred in 18 patients (4.7%), and the remaining 362 patients were used as the control group. No significant differences in terms of sex, age, dementia, neuromuscular disease, and body mass index were found between the 2 groups. The 18 patients who had a hip dislocation had significantly smaller mean CEA than the control group (P =.0001) (mean 36.1 ± 7.5° and 43.2 ± 5.6°, respectively) as well as ADWR (mean 34 ± 6 versus 37 ± 4, respectively) (P =.001). Using the receiver operating characteristic analysis, we report significant cutoffs of 38.5° for CEA (P =.0001) and 34.5 for the ADWR (P =.017). Higher rates of hemiarthroplasty dislocation were observed in patients who had a preoperative CEA of less than 38.5° and an ADWR of less than 34.5. Patients who have preoperative acetabular morphological risk factors for dislocation might be better candidates for a total hip arthroplasty. [ABSTRACT FROM AUTHOR]

The arthroscopic remplissage procedure has been described to successfully treat engaging Hill-Sachs lesions and improve shoulder stability. Several variations of this technique have been described, including remplissage with 1 or 2 knotted or knotless anchors, remplissage with double or triple bridging pulleys, and remplissage with or without a subacromial view. However, most techniques use anchors in combination with round sutures. This article describes an all-arthroscopic articular knotless remplissage technique using a strong, flat, double-strand suture tape bridge fixed with 2 small anchors under direct joint visualization and reduction of the capsule and infraspinatus without requiring a subacromial view. [Display omitted] [ABSTRACT FROM AUTHOR]

To evaluate the effects of a high-fat diet during post-weaning growth on intermediate metabolism and retroperitoneal adipose tissue, in adult male rats exposed to adequate or deficient zinc intake during prenatal and postnatal life. Female Wistar rats were fed low- or control-zinc diets from pregnancy to offspring weaning. Male offspring born from control mothers were fed either control or high-fat, control-zinc diets for 60 days. Male offspring born from zinc deficient mothers were fed either low-zinc or high-fat, low-zinc diets for 60 days. At 74 days of life, oral glucose tolerance test was performed. In 81-day-old offspring, blood pressure, lipid profile, plasmatic lipid peroxidation and serum adiponectin level were determined. In retroperitoneal adipose tissue, we evaluated oxidative stress, morphology and adipocytokines mRNA expression. Low-zinc diet induced adipocytes hypertrophy, increased oxidative stress, and decreased adiponectin mRNA expression in adipose tissue. Low-zinc diet increased systolic blood pressure, triglyceridemia, plasmatic lipid peroxidation and glycemia at 3 h after glucose overload. Animals fed high-fat or high-fat, low-zinc diets showed adipocytes hypertrophy, decreased adiponectin mRNA expression, and increased leptin mRNA expression and oxidative stress in adipose tissue. They also exhibited decreased serum adiponectin levels, increased triglyceridemia, plasmatic lipid peroxidation and area under the oral glucose tolerance curve. High-fat, low-zinc diet induced greater alterations in adipocyte hypertrophy, leptin mRNA expression and glucose tolerance test than high-fat diet. Zinc deficiency since early stages of intrauterine life could increase susceptibility to metabolic alterations induced by high-fat diets during postnatal life. • ZD induces adipocytes hypertrophy and alters adiponectin mRNA expression in RPAT. • ZD alters lipid and glucose metabolism and increases oxidative stress in RPAT. • HFD alters intermediate metabolism, oxidative stress and adipokines expression in AT. • ZD heightens changes in adipocyte area, leptin expression and OGTT in rats fed HFD. [ABSTRACT FROM AUTHOR]

Historically, the neogregarine Apicystis bombi was isolated almost exclusively from bumble bees (Bombus spp.) where it disrupts adipose tissue, increasing hosts' mortality rates. Records in solitary bees are scarce worldwide. To check for its presence in carpenter bees (genus Xylocopa), campaigns were performed in Argentina capturing 154 individuals of five species (X. augusti , X. splendidula , X. atamisquensis , X. frontalis , X. nigrocincta). The presence of A. bombi was detected by molecular means in X. augusti , X. atamisquensis, and X. nigrocincta in four of the nine provinces screened. The pathogenesis and eventual impact that A. bombi may cause in individuals or populations of Xylocopa species remain unknown. The presence of A. bombi in northern Argentina would be contradictory to the hypothesis that its occurrence is the exclusive result of its introduction to South America through invasive, infected exotic bumble bees. [Display omitted] • Xylocopa individuals were scrutinized for the neogregarine Apicystis bombi. • Apicystis bombi was found in X. augusti , X. atamisquensis and X. nigrocincta. • The new associations Xylocopa – A. bombi were found in four Argentine provinces. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

• A sequence of competing structural equation models is tested. • Depression partially mediates pain-frailty relationship. • Depression and pain explain 91% of the frailty variance. Frailty is highly prevalent among older adults. This study aims to add evidence to the mediational role of depression in the pain-frailty relationship. Data came from a sample of 2578 Spanish older adults recruited from the Survey of Health, Aging, and Retirement in Europe (SHARE). A set of competing structural equation models were performed: (a) independent prediction, (b) full mediation, and (c) partial mediation. Results showed a better fit for the partial mediation model. This model was extended including covariates. The effects of pain and depression remained relevant in the final model, which explained 91% of the frailty variance. These findings support the relevance of the pain-depression dyad in frailty development. Although the pain shows a direct impact on frailty, this association is partially mediated by depression. The interplay of these conditions could be crucial for treatment effectiveness. [ABSTRACT FROM AUTHOR]

Surgical site occurrences pose a threat to patient health, potentially resulting in significant increases in health care spending caused by using additional resources. The objective of this study was to reach a consensus among a group of experts in incisional negative pressure wound therapy to determine the indications for using this type of treatment prophylactically and to analyze the associated risk factors of surgical site occurrences in abdominal surgery. A group of experts in incisional negative pressure wound therapy from Spain and Portugal was formed among general surgery specialists who frequently perform colorectal, esophagogastric, or abdominal wall surgery. The Coordinating Committee performed a bibliographic search to identify the most relevant publications and to create a summary table to serve as a decision-making protocol regarding the use of prophylactic incisional negative pressure wound therapy based on factors related to the patient and type of procedure. The patient risk factors associated with surgical site occurrence development such as age, immunosuppression, anticoagulation, hypoalbuminemia, smoking, American Society of Anesthesiologists classification, diabetes, obesity, and malnutrition were analyzed. For surgical procedure factors, surgical time, repeated surgeries, organ transplantation, need for blood transfusion, complex abdominal wall reconstruction, surgery at a contaminated site, open abdomen closure, emergency surgery, and hyperthermic intraperitoneal chemotherapy were analyzed. In our experience, this consensus has been achieved on a tailored set of recommendations on patient and surgical aspects that should be considered to reduce the risk of surgical site occurrences with the use of prophylactic incisional negative pressure wound therapy, particularly in areas where the evidence base is controversial or lacking. [Display omitted] [ABSTRACT FROM AUTHOR]

Anterior iliac crest (AIC) is the preferred option for bone grafting; however, pain and complications are reported. Proximal tibia (PT) is a sourceful site for bone grafting with lower complications. MEDLINE, EMBASE, and Scopus were searched to identify studies comparing AIC and PT autograft procedure. The main outcome was pain and complication rate. As well as cadaveric and cell-based studies were analyzed for quantity and quality of AIC and PT autograft. A meta-analysis was performed using the generic inverse variance method with random or fixed effects model depending on heterogeneity between studies. Heterogeneity was tested with the I2 statistic index. Fifteen studies were included in the meta-analysis. Six studies and 248 patients were included for clinical outcomes. A significant pain reduction favoring PT at 24 hours was detected after meta-analysis and corresponding sensitivity analysis. The estimated effect size ranged from -2.31 to -2.93 cm, with confidence intervals aligned to the left indicating a robust steady decrease in pain across studies. This effect was not observed after 1 month. A total of 18 complications were reported, 13 in the AIC group and 5 in the PT group. Four cadaveric studies were included, 3 favored PT on the quantity of bone graft harvested. Five cell-based studies were included, only one study favored AIC for quality of bone graft. Our study concludes that PT bone harvest is a reliable option for bone grafting regarding morbidity, complications, volume graft obtained, and cellular and molecular properties. However, the current evidence is still insufficient to draw definitive conclusions, especially in terms of bone healing. PROSPERO Register: CRD42020198150 [ABSTRACT FROM AUTHOR]

Liver transplantation (LT) represents the best therapeutic option for hepatocellular carcinoma (HCC) and end-stage liver disease (ESLD). Although HIV infection does not seem to lower survival rates, HCV and HCC recurrence appear more harmful. To compare the overall survival after LT; evaluate the impact of anti-HCV direct-acting agents (DAA); assess the rate of HCC recurrence in HIV-positive and negative patients. Subjects with HCV/HBV infection who underwent LT for HCC or ESLD from 2012 to 2019 were retrospectively evaluated. Study population included 299 individuals, 31 (10.4%) were HIV-positive. Overall mortality was similar (16.1% versus 19.0%, p = 0.695). HCC recurrence was observed in 6 HIV-positive (19.4%) and in 17 negative subjects (6.3%, p = 0.022). Time to relapse was 831 days in HIV-positive and 315 days in negative patients (p = 0.046). Cox model found a significant role for HIV in univariate analysis but, after adjusting for variables, extra-hepatic tumor was the only factor associated to recurrence (aHR 56.379, p < 0.001). Post-LT survival improved after DAA availability and HIV has no impact on mortality. A higher and delayed rate of HCC recurrence was observed in co-infected individuals: surveillance protocols should be strengthened along time in this population. [ABSTRACT FROM AUTHOR]

As climate change intensifies, European coastal cities face escalating risks from multiple climate-related hazards. Addressing these challenges requires capturing the multifaceted nature of climate risks adequately. This paper presents a novel multi-hazard risk assessment methodology for European coastal cities, which integrates indicators of hazard, exposure, sensitivity, and adaptive capacity. It advances beyond existing models by incorporating a wide array of climate-related hazards and significant indicators. Applied to six diverse coastal cities across different climatic zones and urbanization levels, the methodology proves robust and versatile, offering a comprehensive approach to understanding climate risks. Findings reveal that Varna has the lowest hazard score compared to other cities. Cork and Viana do Castelo are significantly affected by coastal hazards, while La Spezia exhibits very low coastal hazard scores but high land hazard scores. The exposure component ranges between medium and low values, with a maximum in Klaipeda and a minimum in Viana do Castelo. In terms of vulnerability, Viana do Castelo and Bergen stand out, while Cork exhibits the lowest score. Finally, risk presents a balanced landscape, where cities with the highest scores in hazard and exposure also exhibit the lowest levels of vulnerability and vice versa. The discussion on policy implications advocates for participatory resilience-building, leveraging new technologies and non-traditional indicators to enhance urban adaptive capacity. The granularity and specificity inherent to the proposed methodology offer a tool to compare and identify high-risk cities systematically, allowing for a more informed and targeted approach to resilience building and strategic allocation of often limited resources. • Baseline risk assessment methodology. • Comprehensive set of climate-related hazards. • Wide set of indicators of exposure and vulnerability. • Application to six diverse coastal cities. • Decision support tool for coastal management. [ABSTRACT FROM AUTHOR]

Opioids are the most effective painkillers, but their benefit-risk balance often hinder their therapeutic use. WLB-73502 is a dual, bispecific compound that binds sigma-1 (S1R) and mu-opioid (MOR) receptors. WLB-73502 is an antagonist at the S1R. It behaved as a partial MOR agonist at the G-protein pathway and produced no/unsignificant β -arrestin-2 recruitment, thus demonstrating low intrinsic efficacy on MOR at both signalling pathways. Despite its partial MOR agonism, WLB-73502 exerted full antinociceptive efficacy, with potency superior to morphine and similar to oxycodone against nociceptive, inflammatory and osteoarthritis pain, and superior to both morphine and oxycodone against neuropathic pain. WLB-73502 crosses the blood–brain barrier and binds brain S1R and MOR to an extent consistent with its antinociceptive effect. Contrary to morphine and oxycodone, tolerance to its antinociceptive effect did not develop after repeated 4-week administration. Also, contrary to opioid comparators, WLB-73502 did not inhibit gastrointestinal transit or respiratory function in rats at doses inducing full efficacy, and it was devoid of proemetic effect (retching and vomiting) in ferrets at potentially effective doses. WLB-73502 benefits from its bivalent S1R antagonist and partial MOR agonist nature to provide an improved antinociceptive and safety profile respect to strong opioid therapy. WLB-73502 is a bispecific sigma-1 antagonist and partial mu-opioid agonist (low intrinsic efficacy at G i/o -protein activation and undetectable β -arrestin-2 recruitment) with improved antinociceptive and safety profile respect to strong opioids. [Display omitted] [ABSTRACT FROM AUTHOR]

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In recent decades, medical research has been primarily focused on the inherited aspect of cancers, despite the reality that only 5–10% of tumours discovered are derived from genetic causes. Cancer is a broad term, and therefore it is inaccurate to address it as a purely genetic disease. Understanding cancer cells' behaviour is the first step in countering them. Behind the scenes, there is a complicated network of environmental factors, DNA errors, metabolic shifts, and electrostatic alterations that build over time and lead to the illness's development. This latter aspect has been analyzed in previous studies, but how the different electrical changes integrate and affect each other is rarely examined. Every cell in the human body possesses electrical properties that are essential for proper behaviour both within and outside of the cell itself. It is not yet clear whether these changes correlate with cell mutation in cancer cells, or only with their subsequent development. Either way, these aspects merit further investigation, especially with regards to their causes and consequences. Trying to block changes at various levels of occurrence or assisting in their prevention could be the key to stopping cells from becoming cancerous. Therefore, a comprehensive understanding of the current knowledge regarding the electrical landscape of cells is much needed. We review four essential electrical characteristics of cells, providing a deep understanding of the electrostatic changes in cancer cells compared to their normal counterparts. In particular, we provide an overview of intracellular and extracellular pH modifications, differences in ionic concentrations in the cytoplasm, transmembrane potential variations, and changes within mitochondria. New therapies targeting or exploiting the electrical properties of cells are developed and tested every year, such as pH-dependent carriers and tumour-treating fields. A brief section regarding the state-of-the-art of these therapies can be found at the end of this review. Finally, we highlight how these alterations integrate and potentially yield indications of cells' malignancy or metastatic index. • Every cell of the human body has specific electrical properties. • Cancer cells differ significantly in their electrical properties from normal cells. • Cancer cells exhibit extracellular and intracellular pH alterations. • Cancer cells have a lower transmembrane potential than normal cells and different ionic concentrations. • Electrostatic properties of cancer cells are becoming a focus of new therapies. [ABSTRACT FROM AUTHOR]

In order to translate the FLASH effect in clinical use and to treat deep tumors, Very High Electron Energy irradiations could represent a valid technique. Here, we address the main issues in the design of a VHEE FLASH machine. We present preliminary results for a compact C-band system aiming to reach a high accelerating gradient and high current necessary to deliver a Ultra High Dose Rate with a beam pulse duration of 3 μ s. The proposed system is composed by low energy high current injector linac followed by a high acceleration gradient structure able to reach 60–160 MeV energy range. To obtain the maximum energy, an energy pulse compressor options is considered. CST code was used to define the specifications RF parameters of the linac. To optimize the accelerated current and therefore the delivered dose, beam dynamics simulations was performed using TSTEP and ASTRA codes. The VHEE parameters Linac suitable to satisfy FLASH criteria were simulated. Preliminary results allow to obtain a maximum energy of 160 MeV, with a peak current of 200 mA, which corresponds to a charge of 600 nC. A promising preliminary design of VHEE linac for FLASH RT has been performed. Supplementary studies are on going to complete the characterization of the machine and to manufacture and test the RF prototypes. • Novel modality for radiotherapy reduces healthy tissue toxicities; the FLASH effect. • FLASH irradiation is obtained with ultra-high dose-rate short bursts. • Linear accelerator-based machine is designed for FLASH experiments. • Small footprint laboratory for very-high energy electron for pre-clinical studies. [ABSTRACT FROM AUTHOR]

[Display omitted] • The goal of this contribution is to reduce the number of migrated instances during business process change without affecting the number of instances that satisfy the new requirements. To achive this goal: • We propose the use of the Petri Nets (PNs) formalism and Graph Rewriting Rules (GRRs) to model BPs and their changes, in which a PN is used to model the current BP, and GRRs are used to model the BP change and the instance migration. • Our lazy strategy considers two consistency criteria to ignore the migration of instances that satisfy the new requirements. • We implement our approach in the framework, Flexible (Bouhamed et al., 2021). • We illustrate our approach by means of a running example modeling a real-world scenario where two BP changes are introduced. In addition, we compare our approach with a brute-force approach not only in this example but using five other BPs proposed in the literature as well. Business processes (BPs) are subject to frequent and unpredictable changes caused by new laws or modifications in the business environment, including user requirements. Many running instances are migrated to new BPs during a BP change, even when these instances satisfy the new requirements. We propose a migration strategy to ignore the migration of these instances. We specify the BP using Petri Nets (PNs), and the change including the instance migration using Graph Rewriting Rules (GRRs). We propose two consistency criteria based on the instance execution history and its possible future executions to identify the instances supporting the change. The first criterion ignores the migration of the instances satisfying the new requirements. The second criterion postpones the migration of instances that support the migration until they definitely cannot satisfy the new requirements, where some instances might avoid the states where the migration is mandatory. The proposed approach is implemented through the framework called Flexible and illustrated using two cases of BP changes. Simulation results shows that a large number of instances can be ignored during the migration, 86.34% and 42.35% respectively. The approach is evaluated using five real-life scenarios, where a positive correlation with respect to the complexity is observed. [ABSTRACT FROM AUTHOR]

Liver transplantation has increased in volume and provides substantial survival benefit. However, there remains a need for value-based assessment of this costly procedure. Model for end stage liver disease era adult recipients were identified using United Network for Organ Sharing Standard Transplant Analysis file data (n = 75,988) and compared across time periods (period A: February 2002 to January 2007; B: February 2007 to January 2013; C: February 2013 to January 2019). Liver centers were divided into volume tertiles for each period (small, medium, large). Value for the index transplant episode was defined as percentage graft survival ≥1 year divided by mean posttransplant duration of stay. All centers increased value over time due to ubiquitous improvement in 1-year graft survival. However, large centers demonstrated the most significant value change (large +17% vs small +7.0%, P <. 001) due to a –8.5% reduction in large centers duration of stay from period A to C, while small centers duration of stay remained unchanged (–0.1%). Large centers delivered higher value despite more complex care: older recipients (54.8 ± 10.3 vs 53.0 ± 11.4 years P <. 001), fewer model for end stage liver disease exceptions (34.0% vs 38.2%, P <. 001), higher rates of candidate portal vein thrombosis (10.1% vs 8.5%, P <. 001) and prior abdominal surgery (43.4% vs 37.4%, P <. 001), and more marginal donor utilization (donor risk index 1.45 ± 0.38 vs 1.36 ± 0.33, P <. 001). Mahalanobis metric matching demonstrated that compared with small centers, large centers progressively shortened recipient duration of stay per transplant in each period (A: –0.36 days, P =. 437; B: –2.14 days, P <. 001; C: –2.49 days, P <. 001). There is value in liver transplant volume. Adoption of value-based practices from large centers may allow optimization of health care delivery for this costly procedure. [ABSTRACT FROM AUTHOR]

This study's objective is to determine if the combined use of bone substitutes and collagen membranes is related to worse postoperative outcomes after intra-osseous oral cystectomies. Additional risk factors mentioned in the existing literature were retrospectively analysed by reviewing the medical records and imaging tests of adult patients. Age, gender, smoking habit, cyst location, size, shape, histopathology, perilesional osteosclerosis and associated intracystic third molars were registered. The type of biomaterials applied and the number of bony walls remaining after surgery were also identified. All factors were analysed in relation to wound dehiscence and postoperative infection. Simple and multiple logistic regression analyses were performed to exclude possible confounding effects between the risk factors identified. In a sample of 211 cystectomies, guided bone regeneration was not significantly associated with infection, only the presence of impacted third molars was (p = 0.0219). This finding remained true, even in cysts larger than 25 mm. However, the risk of wound dehiscence was 4.9 times higher when biomaterials were applied (CI 95%, 1.6818–12.8274, p = 0.0014). In accordance with recent studies, these findings suggest that whenever guided bone regeneration might prove useful after cyst enucleation, avoiding chemically cross-linked membranes should be considered. [ABSTRACT FROM AUTHOR]

Facial expression studies in animal communication are essential. However, manual inspection methods are only practical for small datasets. Deep learning techniques can help discriminate facial configurations associated with vocalisations over large datasets. We extracted and labelled frames of different primate species, trained deep-learning models to identify key points on their faces, and computed distances between them to identify facial gestures. We used machine learning algorithms to classify vocalised and non-vocalised gestures across different species. The algorithms showed higher-than-chance correct classification rates, with some exceeding 90 %. Our work employs deep learning to map primate facial gestures and offers an innovative application of pose estimation systems. Our approach facilitates the investigation of facial repertoire across primate species and behavioural contexts, enabling comparative research in primate communication. • Facial gestures are a critical component of primate communication. • DeepLabCut represents a promising tool for quantifying facial movements. • We can automatically discriminate among voiced and unvoiced primate faces. [ABSTRACT FROM AUTHOR]

The intensification of human activities and the impacts of climate change are poised to degrade coastal ecosystems significantly in the future, potentially endangering both human populations and infrastructure. In response, many countries have developed strategies over recent decades to combat coastal erosion and flooding. The wide range of physical, economic, and social characteristics across regions has resulted in diverse management approaches. This research aims to identify which countries have enacted laws compelling governmental action against coastal erosion and flooding, which policies detail coastal protection solutions, and which administration level is most effective in implementing these measures. Through a review of coastal protection policies and an analysis of research developments in this field across ten countries, this study reveals significant variations in legislative frameworks. For instance, Germany has stringent laws requiring coastline protection, whereas countries such as Greece and South Korea rely mainly on management recommendations. Additionally, Germany and Japan include provisions for funding these protective measures in their legislation, which is crucial for mitigating conflicts across different government levels. Generally, regional and/or local administrations are favoured for implementing such policies – such as in the USA, Brazil, and Australia – even though establishing a national regulatory framework could enhance coordination. However, most of these regulations date back to the 20th century and fail to incorporate contemporary scientific advancements and emerging concepts in coastal protection. The insights gained from this research are intended to inform coastal planners about the importance of maintaining updated management plans, ultimately aiming to ensure long-term sustainability of coastlines. • In most developed countries, coastal protection powers are exercised by local bodies. • The usual protection measures combine both hard and soft solutions. • Only 5 of the 10 policies studied were enacted in the 21st century. • Climate change is the most repeated term in coastal protection literature. [ABSTRACT FROM AUTHOR]

In search of a powerful source of bioactive molecules that can be imperative in maintaining health, this paper studies two Corydalis species from the territory of Turkey. Namely, C. erdelii Zucc. and C. solida (L.) Clairv. were extracted with ethanol using homogenized-assisted extraction, and infusions of these two plant species were obtained using water. The obtained extracts and infusions were characterized in terms of chemical composition, namely in terms of the content of total phenols and flavonoids, as well as individual polyphenolic components using the LC-method of analysis. Along with the examination of the chemical composition, their biological activity was also determined using a series of tests that defined their antioxidant, antidiabetic, neuroprotective and cytotoxic activity. The obtained results showed that infusion of C. solida was richer with biomolecules capable to neutralize DPPH, ABTS radicals but also with better reduction power. Ethanolic extracts also showed a higher degree of inhibition of the observed enzymes. Treatment of A549 lung cancer cells with Corydalis extracts, especially ethanol extracts, triggered up-regulation of apoptotic and ER stress pathway genes, potentially attributed to compounds like quercetin and verbascoside. C. erdelii demonstrated superior apoptotic activity compared to C. solida , possibly due to unique compounds. In BEAS-2B cells, Corydalis extracts induced apoptosis while suppressing ER stress, suggesting a mechanism primarily driven by apoptosis. The molecular docking study identified eight compounds from Corydalis extracts with strong inhibitory activity against enzymes. Compounds like kaempferol 3- O -rhamnoside, rhamnocitrin 3-rhamnoside, and verbascoside showed stable interactions with proteins, suggesting their potential for further drug development. [Display omitted] [ABSTRACT FROM AUTHOR]

Carbon ion therapy treatments can be monitored non-invasively with in-beam Positron Emission Tomography (PET). At CNAO the INSIDE in-beam PET scanner has been used in a clinical trial (NCT03662373) to monitor cancer treatments with proton and carbon therapy. In this work we present the analysis results of carbon therapy data, acquired during the first phase of the clinical trial, analyzing data of nine patients treated at CNAO for various malignant tumors in the head-and-neck region. The patient group contained two patients requiring replanning, and seven patients without replanning, based on established protocols. For each patient the PET images acquired along the course of treatment were compared with a reference, applying two analysis methods: the beam-eye-view (BEV) method and the γ -index analysis. Time trends in several parameters were investigated, as well as the agreement with control CTs, if available. Regarding the BEV-method, the average sigma value σ was 3.7 mm of range difference distributions for patients without changes (sensitivity of the INSIDE detector). The 3D-information obtained from the BEV analysis was partly in agreement with what was observed in the control CT. The data quality and quantity was insufficient for a definite interpretation of the time trends. We analyzed carbon therapy data acquired with the INSIDE in-beam PET detector using two analysis methods. The data allowed to evaluate sensitivity of the INSIDE detector for carbon therapy and to make several recommendations for the future. • Nine carbon therapy patients were monitored with in-beam PET (NCT03662373). • Two analysis methods were applied: gamma-index and Beam-Eye-View analysis. • The sensitivity of the INSIDE detector was evaluated for carbon therapy. • More data is needed to verify time trends in the analysis parameters and to relate them to anatomical changes. • The reliability of the 3D information should be studied in the future. [ABSTRACT FROM AUTHOR]

Novel supportive care interventions designed for an aging population with lung cancer are urgently needed. We aimed to determine the feasibility of a novel supportive care physical therapy (PT) plus progressive muscle relaxation (PMR) intervention delivered to older adults with advanced lung cancer in the United States (US). This clinical trial, Resiliency Among Older Adults Receiving Lung Cancer Treatment (ROAR-LCT: NCT04229381), recruited adults aged ≥60 years with unresectable stage III/IV non-small cell (NSCLC) or small cell lung cancer (SCLC) receiving cancer treatment at The James Thoracic Oncology Center (planned enrollment, N = 20). There were no exclusion criteria pertaining to performance status, laboratory values, prior cancer diagnoses, comorbidities, or brain metastases. Participants were evaluated by PT and psychology and given an exercise pedaler, resistance bands, a relaxation voice recording, and instructions at study initiation. Participants were evaluated in-person by PTs and psychologists at the start and end of the 12-session intervention, with the intervening sessions conducted via virtual health. Participants completed self-reported measures of functional status, symptoms, and mood longitudinally with the following instruments: EQ-5D-5L, Patient Health Questionnaire-9, and General Anxiety Disorder-7. PT assessments included the Short Physical Performance Battery (SPPB) and the two-minute walk test. Feasibility was defined as at least 60% of participants completing at least 70% of all intervention sessions. Optional gut microbiome samples and activity monitoring data (ActiGraph®) were also collected. The ROAR-LCT study concluded after consenting 22 patients. Among the 22 consented, 18 (81.8%) started the intervention; 11 participants (61.1%) completed at least 70% of all study sessions. All participants with SCLC completed the intervention. Reasons for withdrawal included progression of disease or hospitalization. The majority (88.9%) of patients who started were able to complete at least one virtual health session. Participants' functional status, SPPB, depression, and anxiety scores were stable from pre- to post-intervention. Participants who withdrew had worse baseline scores across domains. Seven microbiome and six ActiGraph® samples were collected. Discussion: This is one of the first PT + PMR supportive care interventions using virtual health among older adults with advanced lung cancer to achieve feasibility in the US. [ABSTRACT FROM AUTHOR]

Material Jetting (MJ) 3D printing technology is promising for the fabrication of highly realistic surgical simulators, however, the changes in the mechanical properties of MJ materials after post-printing treatments and over time remain quite unknown. In this study, we investigate the effect of different post-printing processes and aging on the mechanical properties of a white opaque and rigid MJ photopolymer, a white flexible MJ photopolymer and on a combination of them. Tensile and Shore hardness tests were conducted on homogeneous 3D-printed specimens: two different post-printing procedures for support removal (dry and water) and further surface treatment (with glycerol solution) were compared. The specimens were tested within 48 h from printing and after aging (30–180 days) in a controlled environment. All groups of specimens treated with different post-printing processes (dry, water, glycerol) exhibited a statistically significant difference in mechanical properties (i.e. elongation at break, elastic modulus, ultimate tensile strength). Particularly, the treatment with glycerol makes the flexible photopolymer more rigid, but then with aging the initial elongation of the material tends to be restored. For the rigid photopolymer, an increase in deformability was observed as a major effect of aging. The hardness tests on the printed specimens highlighted a significant overestimation of the Shore values declared by the manufacturer. The study findings are useful for guiding the material selection and post-printing processing techniques to manufacture realistic and durable models for surgical training. [ABSTRACT FROM AUTHOR]

Higher anti-tumor necrosis factor-α (TNF) drug levels are associated with improved clinical healing of Crohn's perianal fistulas. It is unclear whether this leads to improved healing on radiologic assessment. We aimed to evaluate the association between anti-TNF drug levels and radiologic outcomes in perianal fistulising Crohn's disease. A cross-sectional retrospective multicenter study was undertaken. Patients with perianal fistulising Crohn's disease on maintenance infliximab or adalimumab, with drug levels within 6 months of perianal magnetic resonance imaging were included. Patients receiving dose changes or fistula surgery between drug level and imaging were excluded. Radiologic disease activity was scored using the Van Assche Index, with an inflammatory subscore calculated using indices: T2-weighted imaging hyperintensity, collections >3 mm diameter, rectal wall involvement. Primary endpoint was radiologic healing (inflammatory subscore ≤6). Secondary endpoint was radiologic remission (inflammatory subscore = 0). Of 193 patients (infliximab, n = 117; adalimumab, n = 76), patients with radiologic healing had higher median drug levels compared with those with active disease (infliximab 6.0 vs 3.9 μg/mL; adalimumab 9.1 vs 6.2 μg/mL; both P <.05). Patients with radiologic remission also had higher median drug levels compared with those with active disease (infliximab 7.4 vs 3.9 μg/mL; P <.05; adalimumab 9.8 vs 6.2 μg/mL; P =.07). There was a significant incremental reduction in median inflammatory subscores with higher anti-TNF drug level tertiles. Higher anti-TNF drug levels were associated with improved radiologic outcomes on magnetic resonance imaging in perianal fistulising Crohn's disease, with an incremental improvement at higher drug level tertiles for both infliximab and adalimumab. [Display omitted] [ABSTRACT FROM AUTHOR]

In the last 20 years, mechanical circulatory supports (MCS) have overturned completely the outcomes and the clinical recovery of patients with isolated acute left ventricle failure (iALVF). This usually occurs more frequently than right-sided heart failure or biventricular dysfunction, and it mainly is caused by acute myocardial infarction. The primary role of MCS is to restore the tissue metabolism to preserve the vital organs' function but, on the other hand, they also have to relieve the workload stress on the heart. In this way, they allow not only the heart to recover from the acute event, but MCS also can stabilize the patient toward cardiac transplantation. The short-term MCS devices currently used in clinical practice are the intraaortic balloon pump, the Impella (Abiomed, Danvers, MA), and venoarterial extracorporeal membrane oxygenation (VA-ECMO), but the choice of the right and tailored device for each patient, as well as the timing to use it, is actually one of the most debated topics of MCS management. [ABSTRACT FROM AUTHOR]