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The development and calibration of a measurement system designed for assessing the performance of the avalanche photodiodes (APDs) used in the Compton scattering polarimeter of the CUSP project is discussed in this work. The designed system is able to characterize the APD gain G A P D and energy resolution across a wide range of temperatures T (from −20 °C to +60 °C) and bias voltages V b i a s (from 260 V to 410 V). The primary goal was to experimentally determine the G A P D dependence on the T and V b i a s in order to establish a strategy for stabilizing G A P D by compensating for T fluctuations, acting on V b i a s . The results demonstrate the system capability to accurately characterize APD behavior and develop feedback mechanisms to ensure its stable operation. This work provides a robust framework for calibrating APDs for space environments. It is essential for the successful implementation of spaceborne polarimeters such as the Compton scattering polarimeter foreseen aboard the CUbeSat Solar Polarimeter (CUSP) mission under development to perform solar flare X-ray polarimetry. [ABSTRACT FROM AUTHOR]

Overtraffic is one of the main keys to air pollution in urban areas. The aim of the present work is to review the approaches and explore the potentiality of AI in reducing traffic pollution in urban areas, ranging over three main areas: the optimization of traffic lights timing to reduce delays, the use of AI-powered drones to monitor pollution levels in real-time, and the use of fixed AI-based sensors to detect the levels of pollutants in the air with the use of AI models to identify patterns in the collected data and predict air quality in near-real time. Some attention was also dedicated to possible problems arising from privacy protection and data security, and the case study of the Piemonte area and of the city of Turin in the north–west of Italy is presented: the current situation is depicted, and possible local future applications of AI are explored. The use of AI has proven to be very promising in all three areas, particularly in the field of optimization of traffic lights' timing and coordination in increasingly larger traffic networks. [ABSTRACT FROM AUTHOR]

Using a novel joint inversion approach, this study tackles the challenge of accurately characterizing subsurface electrical resistivity in vineyards, a critical and strategic aspect of precision viticulture. For the first time, we integrate 3D Galvanic Contact Resistivity with multi-2D Capacitively Coupled Resistivity data. Conducted in a prestigious Sangiovese vineyard in Montalcino (Tuscany, Italy), the data are analyzed utilizing a single algorithm capable of inverting Capacitively Coupled Resistivity, Galvanic Contact Resistivity, and joint datasets. This approach combines data sensitive to different depths and spatial resolutions, resulting in a comprehensive analysis of soil resistivity variations and moisture distribution, thus providing a detailed and coherent subsurface model. The joint inversion produced a high spatial resolution 3D resistivity model with a density of 20.21 data/m3. This model significantly enhances subsurface characterization, delineating root systems and correlating water distribution with resistivity patterns, showing relative variations sometimes greater than 50%. This method reduced data misfit more effectively than individual inversions and identified a low-resistivity volume (<20 Ω·m), extending from northeast to south, indicating the presence of subsurface water. The systematic alternation of high and low resistivity across vineyard rows highlights the impact of soil management activities on resistivity and supports targeted interventions for vineyard health. [ABSTRACT FROM AUTHOR]

Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disorder characterized by the predisposition to develop tumors such as malignant peripheral nerve sheath tumors (MPNSTs) which represents the primary cause of death for NF1-affected patients. Regardless of the high incidence and mortality, the molecular mechanisms underneath MPNST growth and metastatic progression remain poorly understood. In this proof-of-concept study, we performed somatic whole-exome sequencing (WES) to profile the genomic alterations in four samples from a patient with NF1-associated MPNST, consisting of a benign plexiform neurofibroma, a primary MPNST, and metastases from lung and skin tissues. By comparing genomic patterns, we identified a high level of variability across samples with distinctive genetic changes which allow for the definition of profiles of the early phase with respect to the late metastatic stages. Pathogenic and likely pathogenic variants were abundant in the primary tumor, whereas the metastatic samples exhibited a high level of copy-number variations (CNVs), highlighting a possible genomic instability in the late phases. The most known MPNST-related genes, such as TP53 and SUZ12, were identified in CNVs observed within the primary tumor. Pathway analysis of altered early genes in MPNST pointed to a potential role in cell motility, division and metabolism. Moreover, we employed survival analysis with the TCGA sarcoma genomic dataset on 262 affected patients, in order to corroborate the predictive significance of the identified early and metastatic MPNST driver genes. Specifically, the expression changes related to the mutated genes, such as in RBMX, PNPLA6 and AGAP2, were associated with reduced patient survival, distinguishing them as potential prognostic biomarkers. This study underlines the relevance of integrating genomic results with clinical information for early diagnosis and prognostic understanding of tumor aggressiveness. [ABSTRACT FROM AUTHOR]

Spontaneous cleavage reactions normally occur in vivo on amino acid peptide backbones, leading to fragmentation products that can have different physiological roles and toxicity, particularly when the substrate of the hydrolytic processes are neuronal peptides and proteins highly related to neurodegeneration. We report a hydrolytic study performed with the HPLC-MS technique at different temperatures (4 °C and 37 °C) on peptide fragments of different neuronal proteins (amyloid-β, tau, and α-synuclein) in physiological conditions in the presence of Cu2+ and Zn2+ ions, two metal ions found at millimolar concentrations in amyloid plaques. The coordination of these metal ions with these peptides significantly protects their backbones toward hydrolytic degradation, preserving the entire sequences over two weeks in solution, while the free peptides in the same buffer are fully fragmented after the same or even shorter incubation period. Our data show that peptide cleavage is not only ruled by the chemical sensitivity of amino acids, but the peptide conformation changes induced by metal coordination influence hydrolytic reactions. The enhanced stability of neuronal peptides provided by metal coordination can increase local levels of amyloidogenic species capable of seeding fibril growth, resulting in aberrant protein depositions and deficits in neuronal activity. [ABSTRACT FROM AUTHOR]

This study investigates the biorefinery approach to extracting blood–brain barrier (BBB)-permeable compounds from Eucalyptus globulus Labill. and Salvia officinalis L. for neuroprotective purposes. A sequential extraction process was applied, starting with supercritical CO2 extraction (SC-CO2) to obtain non-polar terpenoids, followed by pressurized natural deep eutectic solvent extraction (PLE-NaDES) to recover phenolic compounds from the SC-CO2 residue. PLE-NaDES extracts exhibited higher antioxidant and anticholinergic capacities than SC-CO2 extracts for both plants, with S. officinalis extracts being more bioactive than E. globulus extracts. A total of 21 terpenoids were identified using gas chromatography–mass spectrometry from E. globulus while 24 were detected from S. officinalis SC-CO2 extracts. In addition, 25 different phenolic compounds were identified in both plants using high-performance liquid chromatography coupled with mass spectrometry from PLE-NaDES extracts. The study of the permeability across the BBB showed limited permeability for non-polar compounds obtained by SC-CO2 from both plants; however, the more polar compounds obtained by PLE-NaDES showed high permeability, particularly for flavonoids in E. globulus and rosmarinic acid in S. officinalis. This study revealed, for the first time, the antioxidant and neuroprotective potential of S. officinalis and E. globulus extracts obtained using SC-CO2 followed by PLE-NaDES, as well as the high permeability of PLE-NaDES extracts when crossing the BBB to exert their protective effects. This research opens a new pathway for exploring alternatives to current drugs used in treating neurodegenerative diseases. [ABSTRACT FROM AUTHOR]

The integration of energy generation and consumption is one of the most effective ways to reduce energy-system-related waste, costs, and emissions in cities. This paper considers a university district consisting of 32 buildings where electrical demand is currently met by the national grid, and 31% of thermal demand is supplied by a centralized heating station through a district heating network; the remainder is covered by small, dedicated boilers. Starting from the present system, the goal is to identify "retrofit" design solutions to reduce cost, environmental impact, and the primary energy consumption of the district. To this end, three new configurations of the multi-energy system (MES) of the district are proposed considering (i) the installation of new energy conversion and storage units, (ii) the enlargement of the existing district heating network, and (iii) the inclusion of new branches of the electrical and heating network. The configurations differ in increasing levels of integration through the energy networks. The results show that the installation of cogeneration engines leads to significant benefits in both economic (up to −12.3% of total annual costs) and energy (up to −10.2% of the primary energy consumption) terms; these benefits increase as the level of integration increases. On the other hand, the limited availability of space for photovoltaics results in increased CO2 emissions when only total cost minimization is considered. However, by accepting a cost increase of 8.4% over the least expensive solution, a significant reduction in CO2 (−23.9%) can be achieved while still keeping total costs lower than the existing MES. [ABSTRACT FROM AUTHOR]

A growing interest in offshore wind energy in the Mediterranean Sea has been recently observed thanks to the potential for scale-up and recent advances in floating technologies and dynamic cables: in the Italian panorama, the offshore wind connection requests to the National Transmission Grid (NTG) reached almost 84 GW at the end of September 2024. Starting from a realistic estimate of the offshore wind power plants (OWPPs) to be realized off the southern coasts in a very long-term scenario, this paper presents a novel optimization procedure for meshed AC offshore network configuration, aiming at minimizing the offshore wind generation curtailment based on the DC optimal power flow approximation, assessing the security condition of the whole onshore and offshore networks. The reactive power compensation aspects are also considered in the optimization procedure: the optimal compensation sizing for export cables and collecting stations is evaluated via the AC optimal power flow (OPF) approach, considering a combined voltage profile and minimum short circuit power constraint for the onshore extra-high voltage (EHV) nodes. The simulation results demonstrate that the obtained meshed network configuration and attendant re-active compensation allow most of the offshore wind generation to be evacuated even in the worst-case scenario, i.e., the N1 network, full offshore wind generation output, and summer line rating, testifying to the relevance of the proposed methodology for real applications. [ABSTRACT FROM AUTHOR]

This paper explores the development and testing of two Internet of Things (IoT) applications designed to leverage Vehicle-to-Infrastructure (V2I) communication for managing intelligent intersections. The first scenario focuses on enabling the rapid and safe passage of emergency vehicles through intersections by notifying approaching drivers via a mobile application. The second scenario enhances pedestrian safety by alerting drivers, through the same application, about the presence of pedestrians detected at crosswalks by a traffic sensor equipped with neural network capabilities. Both scenarios were tested at two distinct intelligent intersections in Lioni, Avellino, Italy, and demonstrated notable effectiveness. Results show a significant reduction in emergency vehicle response times and a measurable increase in driver awareness of pedestrians at crossings. The findings underscore the potential of V2I technologies to improve traffic flow, reduce risks for vulnerable road users, and contribute to the advancement of safer and smarter urban transportation systems. [ABSTRACT FROM AUTHOR]

Background: Cardiogenic shock (CS) is the most frequent cause of in-hospital mortality after ST-elevation myocardial infarction (STEMI). Data about CS in very elderly (age ≥ 85 years) STEMI patients are scarce. We sought to assess the prognostic factors and the short- and mid-term impact of CS in this population. Methods: Consecutive very elderly STEMI patients undergoing invasive treatment were included in a retrospective multicenter registry. Results: Among 608 patients, 72 (11.8%) fulfilled experienced CS. Peripheral artery disease (PAD) (OR: 2.25, 95% CI: 1.29–3.92, p < 0.01) and cardiac arrest at presentation (OR: 4.36, 95% CI: 2.32–8.21, p < 0.01) were the major independent predictors of CS. Age (HR: 1.07, 95% CI: 1.03–1.11, p < 0.001), PAD (HR: 1.29, 95% CI: 1.01–1.66, p = 0.045), previous MI (HR: 2.16, 95% CI: 1.32–3.55, p = 0.002), and cardiac arrest at presentation (HR: 1.59, 95% CI: 1.29–1.96, p < 0.001) were the major independent predictors of death. CS was associated with a higher risk of mortality at 30 days (adjusted HR: 4.21, 95% CI: 2.19 to 7.78, p < 0.01) mostly driven by higher intraprocedural and in-hospital mortality. Among patients who survived the acute phase and hospitalization, CS at presentation was not associated with a higher mortality risk during the remaining follow-up period (log-rank p = 0.78). Conclusions: At short-term follow-up, very elderly STEMI patients presenting with CS had a higher risk of mortality when compared to non-CS patients. Interestingly, CS patients surviving the acute phase showed a similar survival rate to non-CS patients after discharge. [ABSTRACT FROM AUTHOR]

Background: The evolution of technology has continuously redefined the landscape of rehabilitation medicine. Researchers have long incorporated virtual reality (VR) as a promising intervention, providing immersive therapeutic environments for patients. The emergence of the metaverse has recently further expanded the potential applications of VR to augment the possibilities in rehabilitation. Rehabilitation is a crucial aspect of healthcare, and technological advancements have allowed new approaches to aid in this process. One such approach is the metaverse, a virtual world where users can interact with each other and their surroundings in a simulated environment. This comprehensive review aimed to analyze the scientific evidence using the term "metaverse" in rehabilitation and its potential patient benefits. Methods: We conducted a comprehensive literature search from the inception to September 2024 in PubMed, Scopus, Web of Science, and Cochrane Database to identify studies investigating the term "metaverse" and its role in rehabilitation. We then assessed these studies based on their methodology, patient population, technology used, and therapeutic outcomes. Results: Out of 81 articles, 55 remained after removing duplicates. After screening the title, abstract, and full text, we included five articles. Conclusions: Results from these studies suggested potential benefits in various rehabilitative areas, such as cerebral palsy, intellectual disabilities, pain management, and physical performance improvement among the elderly. The metaverse presents promising avenues for enhancing rehabilitation outcomes. While VR's effectiveness is well established, the metaverse, being a newer concept, necessitates further studies for a more comprehensive understanding. [ABSTRACT FROM AUTHOR]

Background: Crohn's disease (CD) is an inflammatory bowel disease (IBD) that also affects pediatric patients. It frequently presents as a localized disease, affecting the ileocecal area, ileum, or colon. It requires targeted therapy to achieve a good quality of life and long-term control of disease activity. Despite multiple medical therapies available, several patients benefit from surgical treatment. The aim of our study is to demonstrate how an early surgical approach can bring an improvement in disease activity, evaluating the Simple Endoscopic Score for Crohn's Disease (SES-CD) and the Pediatric Crohn's Disease Activity Index (PCDAI). Methods: A retrospective multicenter study was carried out from 2008 to 2023, including 29 patients, affected by localized CD. These data were analyzed: demographics, SES-CD, and PCDAI, before and after surgery. The differences between groups were analyzed using Student's t-test for continuous variables, and Pearson's Chi-squared test or Fisher's exact test for categorical variables. Results: The SES-CD significantly decreased from 12 (median, range 1–15) to 0 (median, range 0–6) (p < 0.0001) and the PCDAI decreased from 30 (median, range 10–50) to 0 (median, range 0–15) (p < 0.0001). The rate of patients receiving enteral nutrition decreased from 51.7% preoperatively to 0% postoperatively (p = 0.0001). The rate of antibiotic use decreased from 13.8% to 0% (p = 0.0001). The rate of patients receiving ≥2 drugs decreased from 10.3% to 0% (p = 0.0001). Conclusions: The early surgical approach can be considered an excellent therapeutic strategy in patients with localized CD. Both parameters examined, SES-CD and PCDAI, demonstrated a clear improvement in the endoscopic images and in disease activity. [ABSTRACT FROM AUTHOR]

In this paper, we present a molecular dynamics study of the structural and dynamical properties of γ-valerolactone (GVL) both as a standalone solvent and in electrolyte formulations for electrochemistry applications. This study involves developing a new parameterization of a polarizable forcefield and applying it to simulate pure GVL and selected salt solutions. The forcefield was validated with experimental bulk data and quantum mechanical calculations, with excellent agreement obtained in both cases. Specifically, two 1M electrolyte solutions of lithium bis(fluorosulfonyl)imide and lithium bis(oxalate)borate in GVL were simulated, focusing on their ionic transport and highlighting ion solvation structure. Ion pairing in the electrolytes was also investigated through enhanced sampling molecular dynamics, obtaining a detailed picture of the ion dynamics in the GVL solution. [ABSTRACT FROM AUTHOR]

Simple Summary: Basaloid thymic carcinoma (BTC) is an extremely rare tumor, and very little data are available on its clinical behavior, drug sensibility, and patients' outcome. We retrospectively collected demographical, clinical, and pathological data of all consecutive patients previously diagnosed with BTC at TYME-referral institutes from 2008 to 2023. Twenty-eight patients with BTC were identified. A total of 22/28 patients were included in this analysis. BTC is generally diagnosed as a localized disease, and no alterations in actionable targets or microsatellite instability were identified. Patients with stage I–III BTC can achieve long-term DFS, and efforts should be made to perform radical surgical resection, combined with perioperative treatment when appropriate. Patients with advanced disease progression have shown a high response rate to systemic treatments, but they have a poor prognosis. Background: thymic basaloid carcinoma (BTC) is an extremely rare tumor, and very little data are available on BTC's biology, clinical behavior, drug sensitivity, and patient outcomes. Methods: We performed a retrospective observational study on patients diagnosed with BTC in 11 referral centers of TYME. All BTC diagnoses were reviewed by the referring pathologist. Results: Twenty-eight patients were identified. A total of 22/28 patients were included. Eighteen patients had TNM stage I–III disease, and all underwent surgery; three patients received preoperative chemotherapy, and 10 patients received adjuvant radiotherapy. With a median follow-up of 46 (1–133) months, median overall survival (mOS) and median relapse-free survival were not reached. At 48 months, OS was 77% (95%CI 43–92), and DFS was 63% (95%CI 30–83). The median OS of the 4 patients diagnosed with metastatic disease was 7 months. Six patients received first-line systemic treatment for metastatic disease, and all showed tumor responses. Anti-tumor activity was also observed with an anti-VEGFR TKI and a multi-TKI inhibitor combined with an anti-PD1 antibody. Next-generation sequencing performed in three tumor samples did not identify actionable alterations or microsatellite instability. Conclusions: BTC is an extremely rare tumor that usually presents as a localized disease. Patients diagnosed with stage I–III disease can achieve long-term DFS, and efforts should be made to perform radical surgical resection combined with perioperative treatment whenever appropriate. Patients with advanced disease progression have a poor prognosis despite a high response rate to systemic treatments. [ABSTRACT FROM AUTHOR]

Pathogenic variants in DNM1L, encoding dynamin-like protein-1 (DRP1), cause a lethal encephalopathy. DRP1 defective function results in altered mitochondrial networks, characterized by elongated/spaghetti-like, highly interconnected mitochondria. We validated in yeast the pathogenicity of a de novo DNM1L variant identified by whole exome sequencing performed more than 10 years after the patient's death. Meanwhile, we reviewed the broadness and specificities of DNM1L-related phenotype. The patient, who exhibited developmental delay in her third year, developed a therapy-refractory myoclonic status epilepticus, followed by neurological deterioration with brain atrophy and refractory epilepsy. She died of heart failure due to hypertrophic cardiomyopathy. She was found to be heterozygous for the DNM1L variant (NM_ 012062.5):c.1201G>A, p.(Gly401Ser). We demonstrated its deleterious impact and dominant negative effect by assessing haploid and diploid mutant yeast strains, oxidative growth, oxygen consumption, frequency of petite, and architecture of the mitochondrial network. Structural modeling of p.(Gly401Ser) predicted the interference of the mutant protein in the self-oligomerization of the DRP1 active complex. DNM1L-related phenotypes include static or (early) lethal encephalopathy and neurodevelopmental disorders. In addition, there may be ophthalmological impairment, peripheral neuropathy, ataxia, dystonia, spasticity, myoclonus, and myopathy. The clinical presentations vary depending on mutations in different DRP1 domains. Few pathogenic variants, the p.(Gly401Ser) included, cause an encephalocardiomyopathy with refractory status epilepticus. [ABSTRACT FROM AUTHOR]

Marfan syndrome (MFS) is a genetic disorder affecting connective tissue, often leading to cardiovascular complications such as aortic aneurysms and mitral valve prolapse. Cardiovascular multimodality imaging plays a crucial role in the diagnosis, monitoring, and management of MFS patients. This review explores the advancements in echocardiography, cardiovascular magnetic resonance (CMR), cardiac computed tomography (CCT), and nuclear medicine techniques in MFS. Echocardiography remains the first-line tool, essential for assessing aortic root, mitral valve abnormalities, and cardiac function. CMR provides detailed anatomical and functional assessments without radiation exposure, making it ideal for long-term follow-up. CT offers high-resolution imaging of the aorta, crucial for surgical planning, despite its ionizing radiation. Emerging nuclear medicine techniques, though less common, show promise in evaluating myocardial involvement and inflammatory conditions. This review underscores the importance of a comprehensive imaging approach to improve outcomes and guide interventions in MFS patients. It also introduces novel aspects of multimodality approaches, emphasizing their impact on early detection and management of cardiovascular complications in MFS. [ABSTRACT FROM AUTHOR]

Adipose-derived mesenchymal stem cells (ASCs) are commonly employed in clinical treatment for various diseases due to their ability to differentiate into multi-lineage and anti-inflammatory/immunomodulatory properties. Preclinical studies support their use for bone regeneration, healing, and the improvement of functional outcomes. However, a deeper understanding of the molecular mechanisms underlying ASC biology is crucial to identifying key regulatory pathways that influence differentiation and enhance regenerative potential. In this study, we employed the NanoString nCounter technology, an advanced multiplexed digital counting method of RNA molecules, to comprehensively characterize differentially expressed transcripts involved in metabolic pathways at distinct time points in osteogenically differentiating ASCs treated with or without the pan-DNMT inhibitor RG108. In silico annotation and gene ontology analysis highlighted the activation of ethanol oxidation, ROS regulation, retinoic acid metabolism, and steroid hormone metabolism, as well as in the metabolism of lipids, amino acids, and nucleotides, and pinpointed potential new osteogenic drivers like AOX1 and ADH1A. RG108-treated cells, in addition to the upregulation of the osteogenesis-related markers RUNX2 and ALPL, showed statistically significant alterations in genes implicated in transcriptional control (MYCN, MYB, TP63, and IRF1), ethanol oxidation (ADH1C, ADH4, ADH6, and ADH7), and glucose metabolism (SLC2A3). These findings highlight the complex interplay of the metabolic, structural, and signaling pathways that orchestrate osteogenic differentiation. Furthermore, this study underscores the potential of epigenetic drugs like RG108 to enhance ASC properties, paving the way for more effective and personalized cell-based therapies for bone regeneration. [ABSTRACT FROM AUTHOR]

This paper presents a holistic assessment framework for the impacts of water distribution pipe breaks to promote environmentally sustainable and socially resilient cities. This framework considers social, environmental, and economic vulnerabilities as well as probabilities associated with pipe failure. The integration of these features provides a comprehensive approach to understanding infrastructure risks. Taking the city of Vancouver as a case study, the social vulnerability index (SVI) is obtained following the application of a cross-correlation matrix and principal component analysis (PCA) to identify the most influential among 33 selected variables from the 2021 census of the Canadian population. The Environmental Vulnerability Index (EVI) is evaluated by considering the park and floodplain areas. The Economic Vulnerability Index (ECI) is derived from the replacement cost of pipes. These indices offer valuable insights into the spatial distribution of vulnerabilities (consequences) across urban areas. Subsequently, the Consequence of Failure (COF) is computed by aggregating the three vulnerabilities with equal weights. Pipe probability of failure (POF) is evaluated by a Weibull model calibrated on real break data as a function of pipe age. This approach enables a dynamic evaluation of pipe deterioration over time. Risk is finally assessed by combining COF and POF for prioritizing pipe replacement and rehabilitation, with the final objective of mitigating the adverse impacts of infrastructure failure. The findings show the significant impact of ethnicity, socioeconomic indices, and education on the social vulnerability index. Moreover, the areas close to English Bay and Fraser River are more environmentally vulnerable. The pipes with high economic vulnerability are primarily concrete pipes, due to their expensive replacement costs. Finally, the risk framework resulting from the vulnerabilities and pipe break probabilities is used to rank the Vancouver City water distribution network pipes. This ranking system highlights critical areas requiring different levels of attention for infrastructure improvements. All the pipes and corresponding risks are illustrated in Vancouver maps, highlighting that the pipes associated with a very high level of risk are mostly in the south and north of Vancouver. [ABSTRACT FROM AUTHOR]

Skin ulcers are open wounds on the skin characterized by the loss of epidermal tissue. Skin ulcers can be acute or chronic, with chronic ulcers persisting for over six weeks and often being difficult to heal. Treating chronic wounds involves periodic visual inspections to control infection and maintain moisture balance, with edge and size analysis used to track wound evolution. This condition mostly affects individuals over 65 years old and is often associated with chronic conditions such as diabetes, vascular issues, heart diseases, and obesity. Early detection, assessment, and treatment are crucial for recovery. This study introduces a method for automatically detecting and segmenting skin ulcers using a Convolutional Neural Network and two-dimensional images. Additionally, a three-dimensional image analysis is employed to extract key clinical parameters for patient assessment. The developed system aims to equip specialists and healthcare providers with an objective tool for assessing and monitoring skin ulcers. An interactive graphical interface, implemented in Unity3D, allows healthcare operators to interact with the system and visualize the extracted parameters of the ulcer. This approach seeks to address the need for precise and efficient monitoring tools in managing chronic wounds, providing a significant advancement in the field by automating and improving the accuracy of ulcer assessment. [ABSTRACT FROM AUTHOR]

Simple Summary: Cancer signatures are very popular and support inference when reproducible and generalizable. However, every approach derives them differently, often in a context-specific way. Depending on the available experiments and data, computational methods used to obtain the signatures may vary. A few relevant questions motivated this research, one being the significance of collating signatures in terms of the outcomes, another being the synergistic meaning of a meta or super signature, and finally, whether some effective operational strategy exists to reduce the complexity of a signature set. There are numerous ways of portraying cancer complexity based on combining multiple types of data. A common approach involves developing signatures from gene expression profiles to highlight a few key reproducible features that provide insight into cancer risk, progression, or recurrence. Normally, a selection of such features is made through relevance or significance, given a reference context. In the case of highly metastatic cancers, numerous gene signatures have been published with varying levels of validation. Then, integrating the signatures could potentially lead to a more comprehensive view of the connection between cancer and its phenotypes by covering annotations not fully explored in individual studies. This broader understanding of disease phenotypes would improve the predictive accuracy of statistical models used to identify meaningful associations. We present an example of this approach by reconciling a great number of published signatures into meta-signatures relevant to Osteosarcoma (OS) metastasis. We generate a well-annotated and interpretable interactome network from integrated OS gene expression signatures and identify key nodes that regulate essential aspects of metastasis. While the connected signatures link diverse prognostic measurements for OS, the proposed approach is applicable to any type of cancer. [ABSTRACT FROM AUTHOR]

Background: According to current guidelines, patients with heart valve disease should be followed by Heart Valve Clinics (HVCs). Regular quality analysis is a major prerequisite of an HVC's program, but few data have been reported so far. Methods: We retrospectively collected patients with isolated, native aortic valve stenosis who had been visited in our HVC at least once between 2021 and 2024. For each outpatient visit, symptoms, physical examination, echocardiographic data, complementary tests, and indications were acquired. Also, adverse events (hospitalization, unplanned procedures, and death) were retrieved. Results: A total of 320 patients were included. Mean visits/patient ratio was 1.2. At the first visit, 69.7% already had severe aortic stenosis, and severe symptoms (NYHA ≥ III) were evident in 24.4%. In addition, 26.5%, 59.1%, 12.8%, and 1.6% were in Généreux stage I, II, III, and IV, respectively. Overall, 197 (78.5%) and 54 (21.5%) patients received an indication for transcatheter AVR and surgical AVR, respectively. AVR-free survival was 46%, 23%, and 6% at 6, 12, and 24 months, respectively (mean 8.8 months CI95% 7.7–9.9). Adverse event-free survival was 97.2%, 95.5%, and 85% at 3, 6, and 12 months, respectively. Conclusions: Patients referred to our HVC already had an advanced disease with cardiac damage. Transcatheter AVR was mostly indicated, and it showed excellent short-term results. A low rate of adverse events was seen among patients in follow-up, but the odds of receiving AVR were high and driven by Généreux's stage. Despite these favorable results, further efforts to sensitize earlier patient referral should be made. [ABSTRACT FROM AUTHOR]

Background: Cangrelor provides rapid platelet inhibition, making it a potential option for out-of-hospital cardiac arrest (OHCA) survivors undergoing percutaneous coronary intervention (PCI). However, clinical data on its use after OHCA are limited. This study investigates in-hospital outcomes of cangrelor use in this population. Methods: We conducted a prospective, observational study involving OHCA patients from the Lombardia CARe Registry (January 2015–December 2022) who underwent PCI in seven centers in Northern Italy. Propensity score (PS) matching compared patients who received cangrelor to those who did not. Logistic regression tested associations between cangrelor and discharge outcomes. Results: Of 612 OHCA patients admitted, 414 (67.4%) underwent PCI with known antithrombotic therapy, of whom 34 (8.2%) received cangrelor. Radial access was more common in the cangrelor group, which also had a higher troponin peak and a final TIMI flow grade of 3. Survival at discharge was 82.4% in the cangrelor group, compared to 65.3% in the no-cangrelor group (p = 0.043). Univariable logistic regression showed that cangrelor use was associated with higher survival at discharge (OR 2.5; 95% CI: 1.1–6.1, p = 0.049). After multiple PS matchings, cangrelor remained associated with better survival (OR 2.07; 95% CI: 1.16–2.98). Major bleeding rates were higher in the cangrelor group, even after adjusting for baseline bleeding risk (OR: 7.0; 95% CI: 2.9–17.0; p < 0.001). Conclusions: In OHCA patients undergoing PCI, cangrelor use was linked to improved in-hospital survival but higher major bleeding, suggesting a potential net clinical benefit. [ABSTRACT FROM AUTHOR]

Background/Objectives: B3 breast lesions, characterized by uncertain malignant potential, pose a significant challenge for clinicians. With the increasing use of preoperative biopsies, there is a need for careful management strategies, including watchful waiting, vacuum-assisted excision (VAE), and surgery. This study aims to assess the concordance between preoperative biopsy findings and postoperative histology, with a focus on evaluating the positive predictive value (PPV) for malignancy in B3 lesions. Methods: Over a seven-year period, 305 patients preoperatively diagnosed with B3 lesions were treated at the Multidisciplinary Breast Center of "Fondazione Policlinico Universitario Agostino Gemelli IRCCS" in Rome. All cases were reviewed at multidisciplinary meetings involving surgeons, radiologists, histopathologists, and oncologists. Preoperative diagnoses were obtained by ultrasound-guided core needle biopsies (CNBs) or stereotactic-guided vacuum-assisted biopsies (VABs). The radiological features were assessed using the Breast Imaging Reporting and Data System (BIRADS), and discrepancies between radiological and pathological findings were recorded. The biopsy results were compared with the postoperative histological findings to calculate the PPV for malignancy. Results: Of the 305 B3 lesions biopsied, 242 were confirmed as B3 on the final histological examination, resulting in a concordance rate of 79.3%. A total of 63 cases were upgraded to malignancy on postoperative histology, yielding a cumulative upgrade rate of 20.7%. The PPV for malignancy was 31.5% for atypical ductal hyperplasia (ADH), 27.6% for lobular neoplasia (LN), 22.9% for papillary lesions (PLs), 12.1% for flat epithelial atypia (FEA), 10.4% for radial scar (RS), and 10.3% for phyllodes tumors (PTs). Conclusions: Our findings demonstrate that the cumulative PPV for B3 lesions, as well as the PPV for each subtype, are consistent with the existing literature. The factors influencing the PPV include the use of CNB versus VAB, discordance between the BIRADS and biopsy results, the presence of atypia in the biopsy sample, the presence of microcalcifications on mammography, mass lesions identified on MRI, and the extent of the lesion. These factors should be considered in the personalized management of B3 lesions, potentially leading to more targeted and less invasive approaches in the future. [ABSTRACT FROM AUTHOR]

Background/Objectives: Mummy studies allow to reconstruct the characteristic of a population in a specific spatiotemporal context, in terms of living conditions, pathologies and death. Radiology represents an efficient diagnostic technique able to establish the preservation state of mummified organs and to estimate the patient's pathological conditions. However, the radiological approach shows some limitations. Although bone structures are easy to differentiate, soft tissue components are much more challenging, especially when they overlap. For this reason, computed tomography, a well-established approach that achieves optimal image contrast and three-dimensional reconstruction, has been introduced. This original article focuses attention on the role of virtual dissection as a promising technology for exploring human mummy anatomy and considers the potential of environmental scanning electron microscopy and X-ray spectroscopy as complementary approaches useful to understand the state of preservation of mummified remains. Methods: Ancient mummy corps have been analyzed through Anatomage Table 10 and environmental scanning electron microscope equipped with X-ray spectrometer; Results: Anatomage Table 10 through various volumetric renderings allows us to describe spine alteration due to osteoarthritis, dental state, and other clinical-pathological characteristics of different mummies. Environmental scanning electron microscope, with the advantage of observing mummified samples without prior specimen preparation, details on the state of tissue fragments. Skin, tendon and muscle show a preserved morphology and keratinocytes, collagen fibers and tendon structures are easily recognizable. Furthermore, X-ray spectrometer reveals in our tissue remains, the presence of compounds related to soil contamination. This investigation identifies a plethora of organic and inorganic substances where the mummies were found, providing crucial information about the mummification environment. Conclusions: These morphological and analytical techniques make it possible to study mummified bodies and describe their anatomical details in real size, in a non-invasive and innovative way, demonstrating that these interdisciplinary approaches could have great potential for improving knowledge in the study of ancient corpses. [ABSTRACT FROM AUTHOR]

Design optimization through the integration of multiple functions into a single part is a highly effective strategy to reduce costs, simplify assembly, improve performance, and reduce weight. Additive manufacturing facilitates the production of complex structures by allowing parts consolidation, resulting in optimized designs, where multiple functions are integrated into a single component. This study presents a design for additive manufacturing method for integrating multiple lattice structures to achieve thermal management and shock absorption functions. The method follows modeling and simulation phases for dimensioning and optimizing solutions to deliver the design functions at different macro- and mesoscale levels. Hierarchical complexity was leveraged to design the two-levels structure in a single part, each delivering a specific function. Specifically, the external layer addresses energy absorption and thermal insulation, while the internal layer acts as a thermal battery by incorporating a phase change material. The design of a container carried by an unmanned aerial vehicle for the transport of healthcare and biological materials is presented. The container is shock-resistant and can maintain the content at 4 ± 2 °C for at least 1 h. As it operates passively without the need for additional energy-consuming devices, it is easy to operate and contributes to increased flight autonomy. A flight mission experiment for urgent transport of blood bags confirmed the capability of the container to preserve blood integrity. This case study demonstrates that the two-layer lattice structure design represents a highly efficient approach to multifunctional design optimization. [ABSTRACT FROM AUTHOR]

Physical inactivity is a major global public health concern, and table tennis offers a low-impact, engaging way to promote physical activity across various age groups. However, many beginners struggle to maintain effective participation due to their lower skill levels. Therefore, the development and reinforcement of stable grip techniques is crucial because it will help beginners achieve sustainable improvements in performance. This will provide additional opportunities to increase physical activity, and therefore overall health, across all age groups. Thus, in this study, we investigate the effects of a prototype table tennis handle on the racket angle and performance of beginners. The prototype handle features a 20° tilt to assist the player in maintaining a stable topspin forehand grip during play. The participants were randomized into three groups, Groups A, B, and C, which used the prototype handle, standard handle, and practiced with the prototype but performed tests with the standard handle, respectively. The participants executed topspin forehand strokes in approximately 30 min of practice, and data on racket angles, swing mechanics, success rates, and ball landing positions were collected. The results showed that Group A exhibited a larger racket open angle and a smaller racket face Angle than the other groups. However, the groups showed no significant differences in hit positions or overall success rates. Our results suggest that although the prototype handle can influence racket angles and some performance aspects, individual differences and swing mechanics should be considered. [ABSTRACT FROM AUTHOR]

Objectives: The intricate relationship between malocclusions and speech sound disorders (SSDs) is yet to be fully understood. This is particularly true for pediatric patients during the deciduous and mixed dentition stages. Employing a methodical scoping review approach, this study scrutinizes the recent literature to elucidate how these dental misalignments impact speech articulation and phonetic clarity. Methods: The present scoping review has been conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. The selected articles have been found using PubMed, Scopus, Web of Science, and The Cochrane Library; the scope was limited to studies describing cases of patients in the deciduous or mixed dentition stage and the presence of both malocclusion and SSDs. Results: Out of the 1880 articles found, 44 passed the initial screening and 12 met the eligibility criteria and have been included in this review. Conclusions: The analysis reveals that while there is a consensus on the influence of malocclusions on speech production, the extent and specific nature of these effects vary across studies. anterior open bite is frequently associated with speech disorders, affecting phonemes by altering airflow and tongue placement. The review highlights the need for multidisciplinary approaches for effective treatment and calls for further investigation into the causative relationships between malocclusions and SSDs. [ABSTRACT FROM AUTHOR]

Background: Despite kidney transplantation being a life-saving procedure, patients experience a high risk of developing fungal infections (FIs), with an increased risk of both morbidity and mortality, especially during the first year after transplant. Methods: We herein conducted a narrative review of the most common FIs in kidney transplant recipients (KTRs), with a focus on prevalence, risk factors, mortality, and prevention strategies. Results: The most common fungal pathogens in KTRs include Candida species (up to 70% of the overall FIs), Aspergillus species, Pneumocystis jiroveci, and Cryptococcus species. Fungal colonization, diabetes mellitus, chronic liver disease, malnutrition, and pre-existing lung conditions should all be acknowledged as possible predisposing risk factors. The mortality rate can vary from 25 to 50% and according to different settings and the types of FIs. Preventive strategies are critical for reducing the incidence of FIs in this population. These include antifungal prophylaxis, environmental precautions, and infection control measures. The use of novel tools (such as PCR-based molecular assays and NGS) for rapid and accurate diagnosis may play an important role. Conclusions: Early recognition, the appropriate use of antifungal therapy, and preventive strategies are essential for improving graft loss and fatal outcomes in this vulnerable population. Future research is needed to optimize diagnostic tools, identify novel antifungal agents, and develop better prophylactic strategies for high-risk transplant recipients. [ABSTRACT FROM AUTHOR]

2,8-Dithia-5-aza-2,6-pyridinophane (L1) has been used as a receptor unit in the construction of the conjugated redox chemosensor 5-ferrocenylmethyl-2,8-dithia-5-aza-2,6-pyridinophane (L3). In order to further explore the coordination chemistry of L1, and comparatively, that of its structural analogue 2,11-dithia-5,8-diaza-2,6-pyridinophane (L2), featuring two secondary nitrogen atoms in the macrocyclic unit, the crystal structures of the new synthesised complexes [Pb(L1)(ClO4)2]·½CH3CN, [Cu(L2)](ClO4)2·CH3CN and [Cd(L2)(NO3)]NO3 were determined by X-ray diffraction analysis. The electrochemical response of L3 towards the metal ions Cu2+, Zn2+, Cd2+, Hg2+, and Pb2+ was investigated by cyclic voltammetry (CV) in CH2Cl2/CH3CN 0.25:1 (v/v) mixture. Upon addition to L3 of increasing amounts of the aforementioned metal cations, the wave corresponding to the Fc+/Fc redox couple of the un-complexed L3 was gradually replaced by a new reversible wave at more positive potentials and corresponding to the Fc+/Fc redox couple of the complexed ligand. The maximum anodic shift of the ferrocene oxidation wave is observed in the presence of Pb2+ (230 mV), to which corresponds a reaction coupling efficiency (RCE) value as large as 7.9 × 103. The response selectivity of L3 is discussed in reference to the optical selectivity observed for conjugated chemosensors featuring L1 as receptor unit and different fluorogenic fragments as signalling units. [ABSTRACT FROM AUTHOR]

Simple Summary: Congenital dermatofibrosarcoma protuberans (DFSP) is a rare skin cancer in infants that often mimics benign lesions such as birthmarks or hemangiomas, leading to misdiagnosis and treatment delays. Early biopsy and accurate diagnosis are essential to prevent aggressive growth and recurrence. Multidisciplinary management and clinician awareness are essential to improve outcomes in affected children. Dermatofibrosarcoma protuberans (DFSP) is a rare low-grade soft tissue sarcoma. Its congenital form poses distinct diagnostic and therapeutic challenges, often resembling benign entities like hemangiomas or vascular malformations, which can lead to misdiagnosis and treatment delays. This review delves into the epidemiology, clinical manifestations, and diagnostic strategies for DFSP, with an emphasis on the use of advanced molecular techniques, such as FISH and RT-PCR, for the detection of the COL1A1-PDGFB fusion gene, a definitive marker of DFSP. We also explore emerging non-invasive imaging technologies, including multispectral and optical coherence, which, while promising, still require further validation. This review underscores the importance of differential diagnosis from similar conditions, such as medallion-like dermal dendritic hamartoma (MLDDH), through an integrated approach that combines histopathology, immunohistochemistry, and molecular testing. Surgical excision, particularly using Mohs micrographic surgery, is preferred to achieve oncologic safety while preserving aesthetic and functional results in pediatric cases. Furthermore, we discuss the potential of adjuvant therapies like tyrosine kinase inhibitors in treating advanced or inoperable cases. Highlighting the critical role of early detection and a collaborative treatment strategy, this review aims to enhance diagnostic precision and access to innovative treatments, ensuring optimal management for this severe, yet rare, condition. [ABSTRACT FROM AUTHOR]

Simple Summary: This study investigates background parenchymal enhancement (BPE) in contrast-enhanced mammography (CEM) and its association with breast density, menopausal status, and breast cancer (BC) characteristics. Conducted retrospectively on 116 patients with invasive BC, the research reveals that BPE is higher in pre-menopausal women and those with greater breast density. These findings align with observations in MRI studies. However, BPE intensity showed no correlation with tumor subtype or grade, suggesting it does not reflect poorer prognostic indicators. This study highlights the potential of BPE as a risk biomarker, particularly for preventive follow-up in high-density or pre-menopausal patients. Further multicentric and prospective studies are recommended to validate these findings and explore the role of BPE in CEM diagnostics. Background: Contrast-enhanced mammography (CEM) has recently gained recognition as an effective alternative to breast magnetic resonance imaging (MRI) for assessing breast lesions, offering both morphological and functional imaging capabilities. However, the phenomenon of background parenchymal enhancement (BPE) remains a critical consideration, as it can affect the interpretation of images by obscuring or mimicking lesions. While the impact of BPE has been well-documented in MRI, limited data are available regarding the factors influencing BPE in CEM and its relationship with breast cancer (BC) characteristics. Materials: This retrospective study included 116 patients with confirmed invasive BC who underwent CEM prior to biopsy and surgery. Data collected included patient age, breast density, receptor status, tumor grading, and the Ki-67 proliferation index. BPE was evaluated by two radiologists using the 2022 ACR BI-RADS lexicon for CEM. Statistical analyses were conducted to assess the relationship between BPE, patient demographics, and tumor characteristics. Results: The study found a significant association between higher levels of BPE and specific patient characteristics. In particular, increased BPE was more commonly observed in patients with higher breast density (p < 0.001) and those who were pre-menopausal (p = 0.029). Among patients categorized under density level B, the majority exhibited minimal BPE, while those in categories C and D showed progressively higher levels of BPE, indicating a clear trend correlating higher breast density with increased enhancement. Additionally, pre-menopausal patients demonstrated a higher likelihood of moderate to marked BPE compared to post-menopausal patients. Despite these significant associations, the analysis did not reveal a meaningful correlation between BPE intensity and tumor subtypes (p = 0.77) or tumor grade (p = 0.73). The inter-reader agreement for BPE assessment was substantial, as indicated by a weighted kappa of 0.78 (95% CI: 0.68–0.89), demonstrating consistent evaluation between radiologists. Conclusions: These findings suggest that BPE in CEM is influenced by factors like breast density and age, aligning with patterns observed in MRI studies. However, BPE intensity was not associated with tumor subtypes or grades, indicating a poorer prognosis. These insights highlight the potential of BPE as a risk biomarker in preventive follow-up, particularly for patients with high breast density and pre-menopausal status. Further multicentric and prospective studies are needed to validate these results and deepen the understanding of BPE's role in CEM diagnostics. [ABSTRACT FROM AUTHOR]

Background/Objectives: Managing type 2 diabetes mellitus (T2DM) and obesity requires a multidimensional, patient-centered approach including nutritional interventions (NIs) and physical activity. Changes in the gut microbiota (GM) have been linked to obesity and the metabolic alterations typical of T2DM and obesity, and they are strongly influenced by diet. However, few studies have evaluated the effects on the GM of a very-low-calorie ketogenic diet (VLCKD) in patients with T2DM, especially in the mid-term and long-term. This longitudinal study is aimed at evaluating the mid-term and long-term impact of the VLCKD and Mediterranean diet (MD) on the GM and on the anthropometric, metabolic, and lifestyle parameters of 11 patients with T2DM and obesity (diabesity). This study extends previously published results evaluating the short-term (three months) impact of these NIs on the same patients. Methods: At baseline, patients were randomly assigned to either a VLCKD (KETO group) or a Mediterranean diet (MEDI group). After two months, the KETO group gradually shifted to a Mediterranean diet (VLCKD-MD), according to current VLCKD guidelines. From the fourth month until the end of the study both groups followed a similar MD. Previous published results showed that VLCKD had a more beneficial impact than MD on several variables for 3 months of NI. In this study, the analyses were extended until six (T6) and twelve months (T12) of NI by comparing data prospectively and against baseline (T0). The GM analysis was performed through next-generation sequencing. Results: Improvements in anthropometric and metabolic parameters were more pronounced in the KETO group at T6, particularly for body mass index (−5.8 vs. −1.7 kg/m2; p = 0.006) and waist circumference (−15.9 vs. −5.2 cm; p = 0.011). At T6, a significant improvement in HbA1c (6.7% vs. 5.5% p = 0.02) and triglyceride (158 vs. 95 mg/dL p = 0.04) values compared to T0 was observed only in the KETO group, which maintained the results achieved at T3. The VLCKD-MD had a more beneficial impact than the MD on the GM phenotype. A substantial positive modulatory effect was observed especially up to the sixth month of the NI in KETO due to the progressive increase in bacterial markers of human health. After the sixth month, most markers of human health decreased, though they were still increased compared with baseline. Among them, the Verrucomicrobiota phylum was identified as the main biomarker in the KETO group, together with its members Verrucomicrobiae, Akkermansiaceae, Verrucomicrobiales, and Akkermansia at T6 compared with baseline. Conclusions: Both dietary approaches ameliorated health status, but VLCKD, in support of the MD, has shown greater improvements on anthropometric and metabolic parameters, as well as on GM profile, especially up to T6 of NI. [ABSTRACT FROM AUTHOR]

Background/Objectives: Next-generation sequencing (NGS) can explain how genetics influence morbidity and mortality in children. However, it is unclear whether health providers will perceive and use such treatments. We conducted a discrete choice experiment (DCE) to understand Italian health professionals' preferences for NGS to improve the diagnosis of paediatric genetic diseases. Methods: The DCE was administered online to 125 health professionals in Italy. We documented attributes influencing professionals' decisions of NGS, including higher diagnostic yield, shorter counselling periods, cost, turnaround time, and the identification of fewer variants of unknown significance. Results: Results show that factors such as higher diagnostic yield, shorter counselling periods, lower costs, and faster turnaround times positively influenced the adoption of NGS tests. Willingness to pay (WTP) estimates varied from EUR 387 (95% CI, 271.8–502.9) for 7% increase in the diagnostic yield to EUR 469 (95% CI, 287.2–744.9) for a decrease of one week in the turnaround time. Responders would reduce diagnostic yield by 7% to decrease the turnaround time by one week in both the preference and the willingness to trade (WTT) spaces. Respondents prioritised diagnostic yield (RI = 50.36%; 95% CI 40.2–67.2%) compared to other attributes. Conclusions: therefore, health professionals value NGS for allowing earlier, more accurate genetic diagnoses. [ABSTRACT FROM AUTHOR]

B3 breast lesions, classified as lesions of uncertain malignant potential, present a significant diagnostic and therapeutic challenge due to their heterogeneous nature and variable risk of progression to malignancy. These lesions, which include atypical ductal hyperplasia (ADH), papillary lesions (PLs), flat epithelial atypia (FEA), radial scars (RSs), lobular neoplasia (LN), and phyllodes tumors (PTs), occupy a "grey zone" between benign and malignant pathologies, making their management complex and often controversial. This article explores the diagnostic difficulties associated with B3 lesions, focusing on the limitations of current imaging techniques, including mammography, ultrasound, and magnetic resonance imaging (MRI), as well as the challenges in histopathological interpretation. Core needle biopsy (CNB) and vacuum-assisted biopsy (VAB) are widely used for diagnosis, but both methods have inherent limitations, including sampling errors and the inability to determine malignancy in some cases definitively. The therapeutic approach to B3 lesions is nuanced, with treatment decisions strongly influenced by factors such as the lesion size, radiological findings, histopathological characteristics, and patient factors. While some lesions can be safely monitored with watchful waiting, others may require vacuum-assisted excision (VAE) or surgical excision to rule out malignancy. The decision-making process is further complicated by the discordance between the BI-RADS score and biopsy results, as well as the presence of additional risk factors, such as microcalcifications. This review provides an in-depth analysis of the current diagnostic challenges and treatment strategies for B3 lesions, emphasizing the importance of a multidisciplinary approach to management. By synthesizing the most recent research, this article aims to provide clinicians with a clearer understanding of the complexities involved in diagnosing and treating B3 breast lesions while highlighting areas for future research, such as artificial intelligence and genomics, to improve the diagnostic accuracy and patient outcomes. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) remains one of the leading causes of death. Because of the individual nature of the trauma (brain, circumstances and forces), humans experience individual TBIs. This makes it difficult to generalise therapies. Clinical management issues such as whether intracranial pressure (ICP), cerebral perfusion pressure (CPP) or decompressive craniectomy improve patient outcome remain partly unanswered. Experimental drug approaches for the treatment of secondary brain injury (SBI) have not found clinical application. The complex, cellular and molecular pathways of SBI remain incompletely understood, and there are insufficient experimental (animal) models that reflect the pathophysiology of human TBI to develop translational therapeutic approaches. Therefore, we investigated different injury patterns after acute subdural hematoma (ASDH) as TBI in a post-hoc approach to assess the impact on SBI in a long-term, human-sized porcine TBI animal model. Post-mortem brain tissue analysis, after ASDH, bilateral ICP, CPP, cerebral oxygenation and temperature monitoring, and biomarker analysis were performed. Extracerebral, intraparenchymal–extraventricular and intraventricular blood, combined with brainstem and basal ganglia injury, influenced the experiment and its outcome. Basal ganglia injury affects the duration of the experiment. Recognition of these different injury patterns is important for translational interpretation of results in this animal model of SBI after TBI. [ABSTRACT FROM AUTHOR]

Background/Objectives: Ventriculoperitoneal shunting is a validated procedure for the treatment of idiopathic normal-pressure hydrocephalus. To select shunt-responsive patients, infusion and tap tests can be used. Only gait is evaluated after the procedure to establish a potential improvement. In this study, we present our Hydro-Real-Time Neuropsychological Testing protocol to assess the feasibility of performing an ultra-fast assessment of patients during the infusion and tap test. Methods: We tested 57 patients during the infusion and tap test to obtain real-time feedback on their cognitive status. Data were obtained immediately before the infusion phase (T0), when the pressure plateau was reached (T1), and immediately after cerebrospinal fluid subtraction (T2). Based on cerebrospinal fluid dynamics, 63.15% of the patients presented a resistance to outflow > 12 mmHg/mL/min, while 88% had a positive tap test response. Results: Compared to T0, cerebrospinal fluid removal significantly improved performance on tasks exploring executive functions (counting backward, p < 0.001; verbal fluency, p < 0.001). Patients were significantly faster at counting backward at T2 vs. T1 (p < 0.05) and at T2 vs. T0 (p < 0.001) and were significantly faster at counting forward at T2 vs. T1 (p < 0.005), suggesting an improvement in speed at T2. There was a significantly smaller index at T1 vs. T0 (p = 0.005) and at T2 vs. T0 (p < 0.001), suggesting a more marked improvement in patients' executive abilities at T2 and a smaller improvement at T1. Regarding verbal fluency, patients were worse at T1 vs. T0 (p < 0.001) and at T2 vs. T0 (p < 0.001). Conclusions: Patients' performance can be monitored during the infusion and tap test as significant changes in executive functions are observable. In future, this protocol might help improve patients' selection for surgery. [ABSTRACT FROM AUTHOR]

Background/Objectives: Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by the loss of dopaminergic neurons leading to debilitating motor and non-motor symptoms. Beyond its well-known neurological features, emerging evidence underscores the pivotal role of the gut–brain axis and gastrointestinal microbiota in PD pathogenesis. Dysbiosis has been strongly linked to PD and is associated with increased intestinal permeability, chronic inflammation, and the production of neurotoxic metabolites that may exacerbate neuronal damage. Methods: This review delves into the complex interplay between PD and dysbiosis, shedding light on two peculiar subsets of dysbiosis, Helicobacter pylori infection and small-intestinal bacterial overgrowth. These conditions may not only contribute to PD progression but also influence therapeutic responses such as L-dopa efficacy. Conclusions: The potential to modulate gut microbiota through probiotics, prebiotics, and synbiotics; fecal microbiota transplantation; and antibiotics represents a promising frontier for innovative PD treatments. Despite this potential, the current evidence is limited by small sample sizes and methodological variability across studies. Rigorous, large-scale, randomized placebo-controlled trials with standardized treatments in terms of composition, dosage, and duration are urgently needed to validate these findings and pave the way for microbiota-based therapeutic strategies in PD management. [ABSTRACT FROM AUTHOR]

Patients with mental illnesses adhere to organized cancer screening programs less frequently than the general population. This systematic review aims to examine the literature to identify studies that evaluate interventions designed to increase cancer screening adherence in people with mental disorders. The review protocol was registered (CRD42024510431) and Pubmed and Scopus were searched up to January 2024. Breast, colorectal, or cervical cancer screening were considered. We adhered to the PROSPERO guidelines. Study quality was assessed. Overall, six articles were included: two RCT studies, two before–after studies, and two cohort studies. Four interventions were conducted in the USA, one in Canada, and one in Japan. Two studies evaluated all three cancer screening programs, two studies evaluated breast cancer screenings, and two studies evaluated colorectal cancer screenings. The proposed interventions included patient navigation, case management, and support from staff members along with educational modules, decision counselling sessions, and enhanced primary care. The most consistent improvements in screening adherence were observed in breast and colorectal cancer screenings compared to usual care, particularly through interventions like patient navigation (colorectal cancer: 47.1% vs. 11.8%, p < 0.001) and case management. Further evaluations of interventions and their costs are still needed. [ABSTRACT FROM AUTHOR]

Surgery is the cornerstone of vulvar cancer treatment, but it is associated with a significant risk of complications that may impact prognosis, particularly in older patients with multiple comorbidities. The objective of this study was to evaluate the role of age, comorbidities, and frailty in predicting postoperative complications after vulvar cancer surgery and to develop a predictive nomogram. A retrospective cohort study was conducted, including patients who underwent surgery for vulvar cancer at two Italian institutions from January 2018 to December 2023. A logistic regression model for the rate of Clavien-Dindo 2+ 30-days complications was run, considering the age-adjusted Charlson Comorbidity Index (AACCI), body mass index (BMI), and frailty as exposures. Lesion characteristics and surgical procedures were considered as confounders. Among the 225 included patients, 50 (22.2%) had a grade 2+ complication. The predictive score of the nomogram ranged from 44 to 140. The AACCI (0–64 points) and BMI (0–100 points) were independently associated with a risk of complications. A nomogram including the AACCI and BMI predicts the risk of complications for patients undergoing surgery for vulvar cancer. The preoperative determination of the risk of complications enables surgical planning and allows a tailored peri- and postoperative management plan. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study investigates the preparation of coamorphous systems composed entirely of active pharmaceutical ingredients (APIs), namely praziquantel, niclosamide, and mebendazole. The objective was to formulate and characterize binary and ternary coamorphous systems to evaluate their structural, thermal, and stability properties. Methods: Ten different mixtures (binary and ternary) were designed through a mixture design approach and prepared using a sustainable, one-step neat grinding process in a lab-scale vibrational mill. The systems were prepared reproducibly within 4 h across the entire experimental domain. Structural characterization was performed using PXRD and FTIR to confirm the absence of crystalline domains and the presence of molecular interactions. The glass transition temperature (Tg) was theoretically calculated using the Gordon–Taylor equation for three-component systems and determined experimentally via DSC. Stability studies were conducted on seven systems under different storage conditions (−30 °C, 5 °C, 25 °C, and 40 °C) for six months. Results: PXRD analysis confirmed the formation of coamorphous systems with no crystalline phases. DSC revealed a single Tg for most systems, indicating homogeneity. Stability studies demonstrated that five out of seven systems adhered to the "Tg—50 °C" stability rule, remaining physically stable over six months. Recrystallization studies indicated diverse pathways: some systems reverted to their original crystalline phases, while others formed new entities such as cocrystals. Conclusions: This study highlights the feasibility of coamorphous systems composed of multiple APIs using a simple, solvent-free grinding approach. The findings underscore the importance of molecular interactions in determining stability and recrystallization behavior, offering insights for designing robust coamorphous formulations. [ABSTRACT FROM AUTHOR]

(1) Background: Targeted alpha therapy is an emerging field in nuclear medicine driven by two advantages: overcoming resistance in cancer-suffering patients to beta therapies and the practical application of lower activities of 212Pb- and 225Ac-labelled peptides to achieve the same doses compared to beta therapy due to the highly cytotoxic nature of alpha particles. However, quality control of the 212Pb/225Ac-radiopharmaceuticals remains a challenge due to the low activity levels used for therapy (100 kBq/kg) and the formation of several free daughter nuclides immediately after the formulation of patient doses; (2) Methods: The routine alpha detection on thin-layer chromatograms (TLC) of 212Pb- and 225Ac-labelled peptides using a MiniScanPRO+ scanner combined with an alpha detector head was compared with detection using an AR-2000 scanner equipped with an open proportional counter tube. Measurement time, resolution and validity were compared for both scanners; (3) Results: For 225Ac, the quality control values of the radiochemical purity (RCP) were within the acceptance criteria 2 h after TLC development, regardless of when the TLC probe was taken. That is, if the TLC probe was taken 24 h after radiosynthesis, the true value of the RCP was not measured until 5 h after TLC development. For 212Pb-labelled peptides, the probe sampling did not have a high impact on the value of the RCP for the MiniScanPRO+ and AR-2000. A difference was observed when measuring TLC with the AR-2000 in different modes; (4) Conclusions: The MiniScanPRO+ is fast, does not require additional equipment and can also measure the gamma spectrum, which may be important for some radiopharmaceutical production sites and regulatory authorities. The AR-2000 has a better signal-to-noise ratio, and this eliminates the need for additional waiting time after TLC development. [ABSTRACT FROM AUTHOR]

Background: The orthodontist can play an important role in the early detection of sleep-disordered breathing (SDB), aiding in the prevention of dentoskeletal complications and systemic issues. Early intervention supports proper pediatric development, emphasizing the need for SDB screening in orthodontics. SDB involves abnormal breathing during sleep, with obstructive sleep apnea (OSA) in children presenting unique diagnostic challenges compared to adults. Aim: This study aimed to identify children at risk for SDB through a validated screening questionnaire during orthodontic evaluations. Methods: This prospective study recruited children under 12 years of age between July 2023 and July 2024. The Sleep Clinical Record was used to screen for SDB indicators. Results: Among the 48 participants (31 females, 17 males) aged 5–12 years, 69% were identified as being at risk for SDB. Risk factors included oral breathing, nasal obstruction, tonsillar hypertrophy, malocclusion, high Friedman scores, narrow palates, and positive Brouillette phenotypes, all showing significant correlations (p < 0.05). Conclusion: The findings underline the critical importance of early SDB screening in orthodontic settings. These preliminary results encourage further research on larger cohorts to refine diagnostic tools and interventions. Early recognition and management of SDB can significantly enhance systemic health and craniofacial outcomes in pediatric patients. [ABSTRACT FROM AUTHOR]

PEA 46 is a biobased polymer with promising properties for sustainable packaging applications, which can be obtained via polymerization of a furan 2,5-dicarboxylic acid (2,5-FDCA) derivative and a diol monomer containing internal amide bonds (46 amido diol). In the literature, PEA 46 showed a complex series of thermal transitions during DSC scans. For this reason, in this initial exploratory study PEA 46 was subjected to compression molding and the melting behavior of film samples was investigated with parallel DSC and WAXS analyses. At room temperature, a mesomorph phase was the only one observed. Subjecting the samples to heating scans led to the formation of phase α, caused by a sequence of partially overlapping melting and recrystallization phenomena. An additional melting and recrystallization phenomenon resulted in the development of a phase β, which melted at approximately 173 °C, the temperature after which the material was completely amorphous and isotropic. Phase α could be enhanced via thermal annealing, whereas phase β could be enhanced via a melt crystallization treatment. [ABSTRACT FROM AUTHOR]

The optimization of the energy system serving users' aggregations at urban level, such as Energy Communities, is commonly addressed by optimizing separately the set of energy conversion and storage systems from the scheduling of energy demand. Conversely, this paper proposes an integrated approach to include the demand side in the design and operation optimization of the energy system of an Energy Community. The goal is to evaluate the economic, energetic, and environmental benefits when users with different demands are aggregated, and different degrees of flexibility of their electricity demand are considered. The optimization is based on a Mixed-Integer Linear Programming approach and is solved multiple times by varying (i) the share of each type of user (residential, commercial, and office), (ii) the allowed variation of the hourly electricity demand, and (iii) the maximum permitted CO2 emissions. Results show that an hourly flexibility of up to 50% in electricity demand reduces the overall system cost and the amount of energy withdrawn from the grid by up to 25% and 31%, respectively, compared to a non-flexible system. Moreover, the aggregation of users whose demands match well with electricity generation from renewable sources can reduce CO2 emissions by up to 30%. [ABSTRACT FROM AUTHOR]

Understanding the deterioration processes in wooden artefacts is essential for accurately assessing their conservation status and developing effective preservation strategies. Advanced imaging techniques are currently being explored to study the impact of chemical changes on the structural and mechanical properties of wood. Nonlinear optical modalities, including second harmonic generation (SHG) and two-photon excited fluorescence (TPEF), combined with fluorescence lifetime imaging microscopy (FLIM), offer a promising non-destructive diagnostic method for evaluating lignocellulose-based materials. In this study, we employed a nonlinear multimodal approach to examine the effects of artificially induced delignification on samples of Norway spruce (Picea abies) and European beech (Fagus sylvatica) subjected to increasing treatment durations. The integration of SHG/TPEF imaging and multi-component fluorescence lifetime analysis enabled the detection of localized variations in nonlinear signals and τ-phase of key biopolymers within wood cell walls. This methodology provides a powerful tool for early detection of wood deterioration, facilitating proactive conservation efforts of wooden artefacts. [ABSTRACT FROM AUTHOR]

Pulmonary embolism (PE) is a life-threatening medical condition caused by the thrombotic occlusion of one or more branches of the lung vasculature, which represents the third most common cause of cardiovascular mortality after myocardial infarction and stroke. PE treatment requires a tailored approach based on accurate risk stratification and personalized treatment decision-making. Anticoagulation is the cornerstone of PE management, yet patients at higher clinical risk may require more rapid reperfusion therapies. In recent years, transcatheter treatment has emerged as a valuable option for patients with intermediate–high or high-risk PE who have contraindications to systemic thrombolysis. Recent advancements in catheter-directed therapies, such as catheter-directed thrombolysis (CDT) and catheter-directed mechanical thrombectomy (CDMT), provide minimally invasive options for swift symptom relief and hemodynamic stabilization. This review aims to provide a practical approach for optimal patient selection and management for PE percutaneous therapies, supported by a thorough evaluation of the current evidence base supporting these procedures. A focus on post-procedural management, the prevention of recurrence, and monitoring for long-term complications such as chronic pulmonary hypertension and post-PE syndrome is also specifically tackled. [ABSTRACT FROM AUTHOR]

Objectives: To determine whether a closed dressing protocol reduces the surgical site infections (SSI) rate compared to conventional closing techniques. Methods: Patients who underwent lumbar spine surgery at two neurosurgical centers were retrospectively included from June 2015 to December 2019. Data on patients, general risk factors, and surgical risk factors for SSI were collected. Patients were subdivided into two groups: a Closed Protocol where the Dermabond® ± Prineo® dressing system was used, and a Conventional Protocol, namely sutures or staples. Statistical analysis was undertaken to compare the infection rates among the different closure techniques. Results: Altogether, 672 patients were included. In the whole cohort, 157 (23.36%) underwent skin closure with staples, 122 (18.15%) with sutures, 98 (14.58%) with intracutaneous sutures, 78 (11.61%) with Dermabond®, and 217 (32.29%) with Demabond® + Prineo®. The overall infection rate was 2.23% (n = 15). Skin suture had the highest infection rate (4.10%), while the lowest was Dermabond® (1.28%) and Dermabond® + Prineo® (1.4%), though the difference was not significant. Risk factors for SSI included higher BMI (29.46 kg/m2 vs. 26.96 kg/m2, p = 0.044), other sites infection (20.00% vs. 2.38%, p = 0.004), and a higher national nosocomial infections surveillance score (p = 0.003). Conclusions: This study showed that a closed protocol with the use of adhesive dressing with or without mesh had a slight tendency to lower infection rates compared to conventional protocol with sutures or staples, although no statistically significant difference was found between the closure techniques. Larger randomized studies are needed to investigate this potential benefit avoiding selection bias. [ABSTRACT FROM AUTHOR]