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The detection of genetic alterations in patients with acute leukemias is essential for the targeting of more specific and effective therapies. Therefore, the aim of this study was to compare the sensitivity of Nested-PCR and RT-qPCR techniques in the detection of genetic alterations in patients with acute leukemias. This study included samples from 117 patients treated at the Fortaleza General Hospital. All samples were submitted to analysis using the Nested-PCR and the RT-qPCR techniques. Acute Myeloid Leukemia (AML) patients’ samples were submitted to the analysis of the following alterations: FLT3-ITD, RUNX1::RUNX1T1, CBFB::MYH11 and PML::RARA; meanwhile, BCR::ABL1, TCF3::PBX1, KMT2A::AFF1, ETV6::RUNX1, and STIL::TAL1 fusions were investigated in the Acute Lymphoblastic Leukemia (ALL) patients’ samples. Throughout the study, 77 patients were diagnosed with AML and 40 with ALL. Among the 77 AML patients, FLT3-ITD, RUNX1::RUNX1T1, PML::RARA, and CBFB::MYH11 were detected in 4, 7, 10 and 8 patients, respectively. Among the 40 ALL patients, the presence of 23 patients with BCR::ABL1 translocation and 9 patients with TCF3::PBX1 translocation was observed through the RT-qPCR methodology. Overall, the present study demonstrated that the RT-qPCR technique presented a higher sensitivity when compared to the Nested-PCR technique at the time of diagnosis of the acute leukemia samples studied.

The Sorrento Peninsula is characterized by a significant occurrence of examples of vernacular architecture, which exhibit distinctive morphological and constructive features. These have been the subject of numerous studies. However, some buildings have undergone a process of transformation over time, the details of which have yet to be investigated. Architectures that initially held a rural character were enlarged and ennobled, thereby becoming what could be termed as “villas of delights”. However, these clearly manifest their origin based on the permanence of some vernacular features. This paper focuses on the analysis of a case study, Villa Murat, which is exemplary in illustrating this process. This thorough interdisciplinary research combines historical investigation, based mainly on archival documents, with a direct examination of the Villa. This has enabled the retracing of the building’s evolution and of the events that occurred in it. An integrated survey, which employed photogrammetry and laser scanning, enabled the assessment of the current state of conservation. The ultimate objective of this research is to propose conservative interventions which, in conjunction with the suggested new intended use, could ensure the preservation of the Villa.

Coronavirus disease 2019 (COVID-19) is an infection characterized by the dysregulation of systemic cytokine levels. The measurement of serum levels of inflammatory cyto-/chemokines has been suggested as a tool in the management of COVID-19. The aim of this study is to highlight the significance of measured levels of interleukin (IL)-1α, IL-1β, IL-6, IL-8, IL-10, IL-12(p70), IL-27, interferon (IFN)γ, interferon gamma-induced protein (IP)-10, monocyte chemoattractant protein (MCP)-1, and tumor necrosis factor (TNF)-α in serum samples from infected and recovered subjects, possibly predictive of severity and/or duration of the disease. Serum samples from healthy (HD), positive at hospital admittance (T0), and recovered subjects (T1, 31–60, or 70–200 days post-negativization) were collected and tested through a bead-based cytometric assay and confirmed through ELISA. IL-10 levels were increased in the T0 group compared to both HD and T1. IL-27 significantly decreased in the 31–60 group. IL-1β significantly increased in the 70–200 day group. TNF-α significantly decreased in T0 compared to HD and in the 31–60 group versus HD. IP-10 significantly increased in T0 compared to HD. These results suggest that IP-10 could represent an early marker of clinical worsening, whereas IL-10 might be indicative of the possible onset of post-COVID-19 long syndrome.

Background: Airway clearance impairment has a significant impact on self-care and quality of life. Identifying clinical data, nursing diagnoses, and nursing interventions is essential to clinical reasoning and enhancing nursing care. This study aims to map the existing evidence on clinical data, nursing diagnoses, and nursing interventions addressing the nursing focus on “airway clearance”. Methods: Research was conducted based on Joanna Briggs’s Scoping Review Methodology. We searched four databases for published studies until December 2023. Results: From the initial 1854 studies identified, 123 were included in the review. The findings highlighted two areas of nursing attention: one related to signs and symptom management, and the other related to education and coping strategies. The data that led to nursing diagnoses were divided into cognitive and clinical data. The nursing diagnoses were mostly related to secretion retention, excessive mucus production, and airway obstruction. The most commonly identified nursing interventions were educational interventions assembled into predesigned education programs rather than patient-tailored programs. Conclusions: Findings can add substantial value for systematizing the nursing process related to “airway clearance”, improving nursing decision-making and care quality. This study was prospectively registered with the Open Science Framework (OSF) on 02 December 2022, with the registration number wx5ze.

This article analyzes the effect of the rehydration method on the physical–mechanical properties of accelerated carbonation-cured magnesium-based fiber cement boards. The rehydration process of the boards was analyzed in conjunction with the analysis of the pre-curing time before accelerated carbonation (24, 48, and 72 h before carbonation), resulting in eight different curing parameters used in this investigation. The physical–mechanical performance and microstructural characteristics of magnesium oxysulfate boards before and after carbonation were investigated by water absorption, apparent porosity, and bulk density using the four-point bending test, X-ray diffraction, thermogravimetric analysis, and scanning electron microscopy. According to the results, the accelerated carbonation process improved the mechanical properties of the boards. The samples that carbonated after 48 h showed a higher modulus of rupture. The rehydration process of the composites before carbonation led to enhancements in the pre-cured boards for 48 and 72 h, demonstrating that carbonation occurred more effectively after water rehydration. The mechanical improvements were associated with the formation of hydration products, which preferentially formed in the pores and voids of the fiber cement matrix. These carbonation products altered the physical properties of the composites, increasing the density of the boards and reducing the void volume. The decomposition of the formed carbonates was confirmed by thermogravimetric analysis, which indicated that the rehydration process favored the carbonation of the composites.

Brackish water can promote physicochemical changes in the soil. Aiming to mitigate the effect of excess salts in the soil, the use of organic matter promotes restructuring. The aim was to evaluate the productive and nutritional characteristics of cactus pear under different brackish water depths (ID) and levels of organic matter (OM). A factorial arrangement of 4 × 4 × 4 with four replications was utilized. Plots consisted of ID (0, 12, 20, and 28% reference evapotranspiration—ETo), and subplots were composed of OM levels (0, 15, 30, and 45 t/ha) and days after planting (DAP; 180, 270, 360, and 450 days). The growth, yield, and chemical composition of cactus pear were affected by ID and OM and/or by their interaction. The regular and increasing application of ID from 192 to 456 mm/year and a rainfall of 110 mm/year in cactus pear crops in biosaline systems improves the growth, freshness, dry matter yields, accumulation capacity per unit area, and chemical composition of cactus pear. The increase in OM up to the range from 30 to 45 Mg/ha linearly increases the agronomic performance of cactus pear. Biosaline systems with cactus pear should be adopted with the combined use of regular supplementary ID and OM, measuring at 304 mm/year and 45 Mg/ha, respectively.

In recent decades, the poultry farming industry has assumed a pivotal role in meeting the global demand for affordable animal proteins. While poultry farming makes a substantial contribution to food security and nutrition, it also presents environmental and public health challenges. The use of poultry litter as fertilizer for agricultural soils raises concerns about the transfer of pathogens and drug-resistant microorganisms from poultry farms to crop production areas. On the other hand, according to the Food and Agriculture Organization of the United Nations (FAO), fungicides represent the second most used chemical group in agricultural practices. In this context, agricultural soils receive the application of both poultry litter as a fertilizer and fungicides used in agricultural production. This practice can result in fungal contamination of the soil and the development of antifungal resistance. This article explores the necessity of monitoring antifungal resistance, particularly in food production areas with co-application of poultry litter and fungicides. It also highlights the role of fungi in ecosystems, decomposition, and mutualistic plant associations. We call for interdisciplinary research to comprehensively understand fungal resistance to fungicides in the environment. This approach seeks to promote sustainability in the realms of human health, agriculture, and the environment, aligning seamlessly with the One Health concept.

Pelvic organ prolapse (POP) occurs due to inadequate support of female pelvic organs and is often treated with synthetic implants. However, complications like infections, mesh shrinkage, and tissue erosion can arise due to biomechanical incompatibilities with native tissue. This study aimed to optimize the melt electrowriting process using medical-grade biodegradable Poly(ε-caprolactone) (PCL) with a pellet extruder to print meshes that mimic the mechanical properties of vaginal tissue. Square and diagonal mesh designs with filament diameters of 80 µm, 160 µm, and 240 µm were produced and evaluated through mechanical testing, comparing them to a commercial mesh and sheep vaginal tissue. The results showed that when comparing medical-grade with non-medical-grade square meshes, there was a 54% difference in the Secant modulus, with the non-medical-grade meshes falling short of matching the properties of vaginal tissue. The square-shaped medical-grade PCL mesh closely approximated vaginal tissue, showing only a 13.7% higher Secant modulus and a maximum stress of 0.29 MPa, indicating strong performance. Although the diagonal-shaped mesh exhibited a 14% stress difference, its larger Secant modulus discrepancy of 45% rendered it less suitable. In contrast, the commercial mesh was significantly stiffer, measuring 77.5% higher than vaginal tissue. The diagonal-shaped mesh may better match the stress–strain characteristics of vaginal tissue, but the square-shaped mesh offers stronger support due to its higher stress–strain curve. Overall, meshes printed with medical-grade PCL show superior performance compared to non-medical-grade meshes, suggesting that they are a promising avenue for future advancements in the field of POP repair.

The objective was to evaluate the agronomic and production characteristics and the quality of forage sorghum for silage production, using a moisture-retaining polymer (MRP) in the soil during the agricultural off-season. To assess the agronomic characteristics of the forage sorghum, four treatments were used, represented by the MRP hydration intervals (Control, 0, 5, and 10 days) and four replications. The qualitative characteristics of the silage were evaluated in a 4 × 2 factorial scheme, and the same MRP hydration intervals were used for the agronomic assessment, with and without the concentrate mixture at the time of ensiling, both in a randomized block design. There were differences (p < 0.05) for all morphological variables, agronomic variables, and weight constituents of forage sorghum. There was an interaction effect (p < 0.05) between the MRP hydration intervals and the concentrate mixture at the time of ensiling for gas losses, silage dry matter recovery, and ether extract. There was an effect (p < 0.05) due to the addition of the concentrate mixture at the time of ensiling for in vitro dry matter digestibility and total digestible nutrients. When using MRP at planting and the concentrate mixture at the time of forage sorghum ensiling, a hydration interval of every 5 days is recommended.

The advent of Artificial Intelligence (AI) has in just a few years supplied multiple areas of knowledge, including in the medical and scientific fields. An increasing number of AI-based applications have been developed, among which conversational AI has emerged. Regarding the latter, ChatGPT has risen to the headlines, scientific and otherwise, for its distinct propensity to simulate a ‘real’ discussion with its interlocutor, based on appropriate prompts. Although several clinical studies using ChatGPT have already been published in the literature, very little has yet been written about its potential application in human pathology. We conduct a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, using PubMed, Scopus and the Web of Science (WoS) as databases, with the following keywords: ChatGPT OR Chat GPT, in combination with each of the following: pathology, diagnostic pathology, anatomic pathology, before 31 July 2023. A total of 103 records were initially identified in the literature search, of which 19 were duplicates. After screening for eligibility and inclusion criteria, only five publications were ultimately included. The majority of publications were original articles (n = 2), followed by a case report (n = 1), letter to the editor (n = 1) and review (n = 1). Furthermore, we performed a ‘query session’ with ChatGPT regarding pathologies such as pigmented skin lesions, malignant melanoma and variants, Gleason’s score of prostate adenocarcinoma, differential diagnosis between germ cell tumors and high grade serous carcinoma of the ovary, pleural mesothelioma and pediatric diffuse midline glioma. Although the premises are exciting and ChatGPT is able to co-advise the pathologist in providing large amounts of scientific data for use in routine microscopic diagnostic practice, there are many limitations (such as data of training, amount of data available, ‘hallucination’ phenomena) that need to be addressed and resolved, with the caveat that an AI-driven system should always provide support and never a decision-making motive during the histopathological diagnostic process.

Background—Pregnancy represents a nutritional challenge, since macro- and micronutrients intake can affect mother’ health and influence negative outcomes. The aim of this retrospective pilot study is to evidence whether the oral supplementation with high molecular weight hyaluronic acid (HMWHA), in association with alpha lipoic acid (ALA), magnesium, vitamin B6 and vitamin D, in pregnant women, could reduce adverse effects, such as PTB, pelvic pain, contraction and hospitalization. Methods—Data were collected from n = 200 women treated daily with oral supplements of 200 mg HMWHA, 100 mg ALA, 450 mg magnesium, 2.6 mg vitamin B6 and 50 mcg vitamin D (treatment group) and from n = 50 women taking with oral supplements of 400 mg magnesium (control group). In both groups, supplementation started from the 7th gestational week until delivery. Results—Oral treatment with HMWHA, in association with ALA, magnesium, vitamin B6 and vitamin D in pregnant women, significantly reduced adverse events, such as PTB (p < 0.01), pelvic pain and contractions (p < 0.0001), miscarriages (p < 0.05) and admission to ER/hospitalization (p < 0.0001) compared with the control group. Conclusions—Despite HMWHA having been poorly used as a food supplement in pregnant women, our results open a reassuring scenario regarding its oral administration during pregnancy.

The translational research community, in general, and the Clinical and Translational Science Awards (CTSA) community, in particular, share the vision of repurposing EHRs for research that will improve the quality of clinical practice. Many members of these communities are also aware that electronic health records (EHRs) suffer limitations of data becoming poorly structured, biased, and unusable out of original context. This creates obstacles to the continuity of care, utility, quality improvement, and translational research. Analogous limitations to sharing objective data in other areas of the natural sciences have been successfully overcome by developing and using common ontologies. This White Paper presents the authors’ rationale for the use of ontologies with computable semantics for the improvement of clinical data quality and EHR usability formulated for researchers with a stake in clinical and translational science and who are advocates for the use of information technology in medicine but at the same time are concerned by current major shortfalls. This White Paper outlines pitfalls, opportunities, and solutions and recommends increased investment in research and development of ontologies with computable semantics for a new generation of EHRs.

In the original publication [...]

This article summarizes the history, current status, and future directions of self-determination research across the globe, with a focus on applications to the education of students with intellectual and developmental disabilities and their transition from school to adult life. Research on the development, implementation, and outcomes of self-determination assessments and interventions is explored. Causal Agency Theory, a theoretical framework for understanding the development of self-determination as a psychological construct, is reviewed, along with research on the importance of self-determination for inclusion, psychological growth, and overall well-being. Specific approaches, models, and perspectives for addressing the support needs of students with intellectual and developmental disabilities, particularly during transitions, are discussed. Assessment and intervention aligned with Causal Agency Theory, including the Self-Determination Inventory and the Self-Determined Learning Model of Instruction, are introduced. Future directions and emerging areas of research are summarized, including issues related to cultural validity, integration of strengths-based approaches, emerging technologies, and systemic changes in schools and communities.

Unmanned vehicles (UVs) have become increasingly important in various scenarios of civil and military operations. The present work aims at the conceptual design of a modular Amphibious Unmanned Ground Vehicle (A-UGV) that can be easily adapted for different types of land and/or water missions with low monetary cost (EUR < 5 k, without sensors). Basing the design on the needs highlighted in the 2021 review of the Strategic Directive of the Portuguese Navy, the necessary specifications and requirements are established for two mission scenarios. Then, a market research analysis focused on vehicles currently available and their technological advances is conducted to identify existing UV solutions and respective characteristics/capabilities of interest to the current work. To study and define the geometry of the hull and the configuration of the A-UGV itself, preliminary computational structural and fluid analyses are carried out to ensure it complies with the specifications initially established. As a result, one obtains a fully electric vehicle with approximate dimensions of 1050 × 670 × 450 mm (length–width–height), enabled with 6 × 6 traction capable of reaching 20 km/h on land, which possesses amphibious capabilities of independent propulsion in water up to 8 kts and an estimated autonomy of over 60 min.

Breast cancer risk factors include lifestyle, genetic–hormonal influences, and viral infections. Human papillomavirus (HPV), known primarily as the etiological agent of cervical cancer, also appears active in breast carcinogenesis, as evidenced in our study of 56 patients from northeastern Brazil. We assessed the clinical and sociodemographic characteristics, correlating them with various breast cancer tumor types. HPV detection involved amplifying the L1 region, with viral load measured using the E2/E6 ratio and viral activity indicated by E5 oncogene expression. Predominantly, patients over 56 years of age with healthy lifestyles showed a high incidence of invasive ductal carcinoma and triple-negative breast cancer. HPV was detected in 35.7% of cases, mostly HPV16, which is associated with high viral loads (80 copies per cell) and significant E5 expression. These results hint at a possible link between HPV and breast carcinogenesis, necessitating further studies to explore this association and the underlying viral mechanisms.

Careful cleaning of a milking parlour and its equipment is fundamental to guarantee good raw milk quality and prevent the dissemination of bacteria and improve animal welfare. This study aimed to investigate, using an ATP-bioluminescence assay and bacteriological analysis, the bacterial contamination of milking parlours on milking parlour surfaces of buffalo farms in the Campania Region, evaluating the seasonal dynamics during the year 2022. Eight farms were selected by the Italian ClassyFarm system, which assesses the level of animal welfare and biosecurity according to risk analysis. Before sampling, all dairy farm owners filled out a questionnaire on milking management, animal hygiene, and health. The questionnaires evidenced similar cleaning procedures but an absence of a standardised cleaning protocol among the different farms. ATP bioluminescence results evidenced similar levels of contamination in all the selected buffalo farms, and the season comparison showed no significant differences. A variation in the percentages of bacterial isolates during the different seasons was observed, with a higher prevalence of Enterobacteriaceae (38%) in summer. A small number of samples exhibited an absence of bacterial growth. Identifying bacteria is crucial for understanding the microorganisms present in the milking parlour, yet employing ATP luminometry could offer broad and accurate applications in buffalo milking parlours. In conclusion, the use of ATP bioluminescence for evaluating the hygiene of a buffalo milking parlour could represent a further important advancement in dairy farming technology.

The interaction of programmed death-1 (PD-1) on T lymphocytes with its ligands Programmed Death Ligand 1 (PD-L1) and Programmed Death Ligand 2 (PD-L2) on tumor cells and/or tumor-associated macrophages results in inhibitory signals to the T-cell receptor pathway, consequently causing tumor immune escape. PD-L1/PD-L2 are currently used as predictive tissue biomarkers in clinical practice. Virtually PD-L1 levels expressed by tumor cells are associated with a good response to immune checkpoint blockade therapies targeting the PD-1/PD-L1 axis. These therapies restore T-cell antitumor immune response by releasing T-lymphocytes from the inhibitory effects of tumor cells. Immune checkpoint therapies have completely changed the management of patients with solid cancers. This therapeutic strategy is less used in hematological malignancies, although good results have been achieved in some settings, such as refractory/relapsed classic Hodgkin lymphoma and primary mediastinal large B-cell lymphoma. Variable results have been obtained in diffuse large B-cell lymphoma and T-cell lymphomas. Immunohistochemistry represents the main technique for assessing PD-L1 expression on tumor cells. This review aims to describe the current knowledge of PD-L1 expression in various types of lymphomas, focusing on the principal mechanisms underlying PD-L1 overexpression, its prognostic significance and practical issues concerning the evaluation of PD-L1 immunohistochemical results in lymphomas.

Background and Objective: Interatrial block (IAB) is defined as a conduction delay between the right and left atria. No data are available about the prevalence of both partial IAB and advanced IAB among the different stages of chronic kidney disease. The aim of this study was to describe the prevalence and type of advanced IAB across the spectrum of renal function, including patients on dialysis and the clinical characteristics associated with advanced IAB. Materials and Methods: Retrospective, single-center study of 151 patients consecutively admitted to the Nephrology and Ophthalmology Unit for 3 months. The study population was divided into three groups according to stages of chronic kidney disease. We evaluated the prevalence and pattern of IAB among the groups and the clinical characteristics associated with advanced IAB. Results: The prevalence of partial IAB was significantly lower in end-stage kidney disease (ESKD) group compared to control group (36.7% vs. 59.6%; p = 0.02); in contrast the prevalence of advanced IAB was significantly higher in both chronic kidney disease (CKD) (17.8% vs. 5.3%, p = 0.04) and ESKD group (24.5% vs. 5.3%, p = 0.005) compared to control group. The atypical pattern of advanced IAB was more frequent in both the ESKD and CKD group than in the control group (100% and 75% vs. 33.3%; p = 0.02). Overall, among patients that showed advanced IAB, 17 (73.9%) showed an atypical pattern by morphology and 2 (8.7%) showed an atypical pattern by duration of advanced IAB. The ESKD group was younger than the control group (65.7 ± 12.3 years vs. 71.3 ± 9.9 years; p = 0.01) and showed a higher prevalence of beta blockers (42.9% vs. 19.3%; p = 0.009), as in the CKD group (37.8% vs. 19.3%; p= 0.04). Conclusions: The progressive worsening of renal function was associated with an increasing prevalence of advanced IAB. Advanced IAB may be a sign of uremic cardiomyopathy and may suggest further evaluation with long-term follow-up to investigate its prognostic significance in chronic kidney disease.

Background: Technological advances in pediatric gastrointestinal (GI) endoscopy require highly specialized physicians. Therefore, proper training is fundamental. The aim of this study was to assess the level of competence of pediatric surgery residents to determine areas that should be addressed to design better training programs focused on pediatric GI endoscopy. Methods: An observational study was performed on all Italian pediatric surgery trainees that concluded the training program by the end of 2021, who were asked to answer a questionnaire about the quality of the GI endoscopy education received during their 5 years of residency. Results: 12 out 14 (86%) pediatric surgery trainees answered the questionnaire. A total of 50% (6/12) of the trainees declared they were interested in pediatric GI endoscopy, and 42% (5/12) said that they would be interested in dedicating themselves to this discipline in the future. Only 33% (4/12) of them were in a center equipped with endoscopy simulators. Among them, 17% (2/12) never took part in GI endoscopic procedures while working in centers in which GI endoscopy is performed exclusively by pediatric gastroenterologists, 25% (3/12) had never performed GI endoscopic procedures as a first operator and 17% (2/12) not even as assistant. Overall, 50% (6/12) were not satisfied with the level of education received and only 17% (2/12) declared that they felt confident enough to perform routine endoscopies alone. Conclusions: Our study highlights great inhomogeneity between different schools and some important failings. Better programs should be designed to educate proficient pediatric GI endoscopists.

Amplicon-targeted metagenomics is now the standard approach for the study of the composition and dynamics of food microbial communities. Hundreds of papers on this subject have been published in scientific journals and the information is dispersed in a variety of sources, while raw sequences and their metadata are available in public repositories for some, but not all, of the published studies. A limited number of web resources and databases allow scientists to access this wealth of information but their level of annotation on studies and samples varies. Here, we report on the release of FoodMicrobionet v5, a comprehensive database of metataxonomic studies on bacterial and fungal communities of foods. The current version of the database includes 251 published studies (11 focusing on fungal microbiota, 230 on bacterial microbiota, and 10 providing data for both bacterial and fungal microbiota) and 14,035 samples with data on bacteria and 1114 samples with data on fungi. The new structure of the database is compatible with interactive apps and scripts developed for previous versions and allows scientists, R&D personnel in industries and regulators to access a wealth of information on food microbial communities.

In recent decades several methods have been developed to extract coastlines from remotely sensed images. In fact, this is one of the principal fields of remote sensing research that continues to receive attention, as testified by the thousands of scientific articles present in the main databases, such as SCOPUS, WoS, etc. The main issue is to automatize the whole process or at least a great part of it, so as to minimize the human error connected to photointerpretation and identification of training sites to support the classification of objects (basically soil and water) present in the observed scene. This article proposes a new fully automatic methodological approach for coastline extraction: it is based on the unsupervised classification of the most decorrelated fictitious band derived from Principal Component Analysis (PCA) applied to the satellite images. The experiments are carried out on datasets characterized by images with different geometric resolution, i.e., Landsat 9 Operational Land Imager (OLI) multispectral images (pixel size: 30 m), a Sentinel-2 dataset including blue, green, red and Near Infrared (NIR) bands (pixel size: 10 m) and a Sentinel-2 dataset including red edge, narrow NIR and Short-Wave Infrared (SWIR) bands (pixel size: 20 m). The results are very encouraging, given that the comparison between each extracted coastline and the corresponding real one generates, in all cases, residues that present a Root Mean Squared Error (RMSE) lower than the pixel size of the considered dataset. In addition, the PCA results are better than those achieved with Normalized Difference Water Index (NDWI) and Modified NDWI (MNDWI) applications.

Background: People with Parkinson’s disease (pwPD) present alterations of spatiotemporal gait parameters that impact walking ability. While preliminary studies suggested that dual-task gait training improves spatiotemporal gait parameters, it remains unclear whether dual-task gait training specifically improves dual-task gait performance compared to single-task gait training. The aim of this review is to assess the effect of dual-task training relative to single-task gait training on specific gait parameters during dual-task tests in pwPD. Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs), searching three electronic databases. Two reviewers independently selected RCTs, extracted data, and applied the Cochrane risk-of-bias tool for randomized trials (Version 2) and the GRADE framework for assessing the certainty of evidence. The primary outcomes were dual-task gait speed, stride length, and cadence. Secondary outcomes included dual-task costs on gait speed, balance confidence, and quality of life. Results: We included 14 RCTs (548 patients). Meta-analyses showed effects favoring dual-task training over single-task training in improving dual-task gait speed (standardized mean difference [SMD] = 0.48, 95% confidence interval [CI] = 0.20–0.77; 11 studies; low certainty evidence), stride length (mean difference [MD] = 0.09 m, 95% CI = 0.04–0.14; 4 studies; very low certainty evidence), and cadence (MD = 5.45 steps/min, 95% CI = 3.59–7.31; 5 studies; very low certainty evidence). We also found a significant effect of dual-task training over single-task training on dual-task cost and quality of life, but not on balance confidence. Conclusions: Our findings support the use of dual-task training relative to single-task training to improve dual-task spatiotemporal gait parameters in pwPD. Further studies are encouraged to better define the features of dual-task training and the clinical characteristics of pwPD to identify better responders.

This study assesses the performance of the Weather Research and Forecasting (WRF) model using a high-resolution spatial grid (1 km) with various combinations of physical parameterization packages to simulate a severe event in August 2021 in the southeastern Brazilian coast. After determining the optimal set of physical parameterizations for representing wind patterns during this event, a year-long evaluation was conducted, covering forecast horizons of 24, 48, and 72 h. The simulation results were compared with observational wind data from four weather stations. The findings highlight variations in the efficacy of different physical parameterization sets, with certain sets encountering challenges in accurately depicting the peak of the severe event. The most favorable results were achieved using a combination of Tiedtke (cumulus), Thompson (microphysics), TKE (boundary layer), Monin-Obukhov (surface layer), Unified-NOAH (land surface), and RRTMG (shortwave and longwave radiation). Over the one-year forecasting period, the WRF model effectively represented the overall wind pattern, including forecasts up to three days in advance (72-h forecast horizon). Generally, the statistical metrics indicate robust model performance, even for the 72-h forecast horizon, with correlation coefficients consistently exceeding 0.60 at all analyzed points. While the model proficiently captured wind distribution, it tended to overestimate northeast wind speed and gust intensities. Notably, forecast accuracy decreased as stations approached the ocean, exemplified by the ATPM station.

The accumulation of brown algae from the genus Sargassum has been increasing over the years in coastal regions of the Caribbean, Africa, Brazil, and Mexico. This causes harmful effects to the ecosystem, human health, the economy, and the climate due to gas emissions from its decomposition process. There is the possibility of this biomass being reused in civil construction, and some studies have been carried out on its application to common Portland cement mortar. As such, the objective of this study is to evaluate the potential of sargassum ash as a mineral addition to partially replace fine aggregates in Portland cement mortar. Characterization of the raw materials was carried out through X-ray fluorescence spectroscopy, loss on ignition, particle size distribution, Brunauer–Emmett–Teller (BET) analysis, real density, X-ray diffraction, scanning electron microscopy, and dispersion spectroscopy of electrons. The mortars were prepared by partially replacing the fine aggregate (sand) with sargassum ash at 0%, 5%, 10%, and 20%. Mortar performance was evaluated through water absorption, apparent porosity, apparent specific mass, and compressive strength 7, 28, and 63 days after curing. Lastly, a life cycle assessment was conducted in accordance with ISO standards 14040:2006 and 14044:2006. The results showed that replacing sand with sargassum ash increases water absorption and apparent porosity, and decreases the apparent specific mass and compressive strength as replacement increases. Nevertheless, the compressive strength results after 63 days for 5 and 10% replacement did not differ statistically from reference values. The life cycle assessment indicated that mortars with partial replacement of sand by sargassum ash show positive environmental impacts when compared to reference values for most categories, regardless of the scenario analyzed, especially for mortar with 10% replacement. As such, the use of sargassum ash at 10% does not alter the mortar’s compressive strength values after 63 days, but does reduce its environmental impact. The application of this biomass in civil construction materials provides a destination for this algae, and that can be a solution to mitigate the social, environmental, and economic problems it has been causing.

This study aims to analyze the effect of the curing temperature of nano-reinforcements during the manufacturing process on the mechanical properties of composites involving graphene (GNP), carbon nanofibers (CNFs), and a hybrid mixture of these two nanoparticles. In this context, the type of nanoparticles, their content, their type of resin, and their hybridization were considered. The results showed that both nanoparticles increased the viscosity of the resin suspension, with an increase of between 16.3% and 38.2% for GNP nanoparticles and 45.4% and 74% for CNFs depending on the type of resin. Shrinkage was also affected by the addition of nanoparticles, as the highest results were obtained with GNP nanoparticles, with a 91% increase compared with the neat resin, and the lowest results were obtained with CNFs, with a decrease of 77% compared with the neat resin. A curing temperature of 5 °C promoted the best bending and hardness performance for all composites regardless of the type of resin and reinforcement used, with improvements of up to 24.8% for GNP nanoparticles and 13.52% for CNFs compared with the neat resin at 20 °C. Hybridization led to further improvements in bending properties and hardness compared with single-reinforcement composites due to a synergistic effect. However, the effectiveness of hybridization depends on the type of resin.

Atomic force microscopy (AFM) is a powerful technique to study the nanomechanical properties of a wide range of materials at the piconewton level. AFM force–indentation curves can be fitted with appropriate contact models, enabling the determination of material properties for a given sample. However, the analysis of large datasets comprising thousands of curves using conventional methods presents a time-intensive challenge. As a result, there is an increasing interest in exploring alternative methodologies, such as integrating machine learning (ML) models to streamline and improve the efficiency of this process. In this work, two data-driven regressors were tuned to predict the Young’s modulus and adhesion energy from force–indentation curves of soft samples (Young’s modulus up to 10 kPa). Both models were trained exclusively on synthetic data derived from the contact theories developed by Hertz as well as Johnson, Kendall and Roberts (JKR). The PyTorch library was employed to build and train the models; then, the key hyperparameters were refined by implementing the optimization framework Optuna. The first model was successfully tested with synthetic and experimental curves from AFM nanoindentations, and the second presented promising results on the synthetic data. Our work suggests that experimental data may not be essential for training data-driven models to predict surface properties from AFM nanoindentations. By delivering accurate predictions in a computationally efficient way, our regressors validate the potential of a deep learning approach in exploring AFM nanoindentations and motivate further development of similar strategies to overcome current limitations in AFM postprocessing.

γδ T-cells provide immune surveillance against cancer, straddling both innate and adaptive immunity. G115 is a clonal γδ T-cell receptor (TCR) of the Vγ9Vδ2 subtype which can confer responsiveness to phosphoantigens (PAgs) when genetically introduced into conventional αβ T-cells. Cancer immunotherapy using γδ TCR-engineered T-cells is currently under clinical evaluation. In this study, we sought to broaden the cancer specificity of the G115 γδ TCR by insertion of a tumour-binding peptide into the complementarity-determining region (CDR) three regions of the TCR δ2 chain. Peptides were selected from the foot and mouth disease virus A20 peptide which binds with high affinity and selectivity to αvβ6, an epithelial-selective integrin that is expressed by a range of solid tumours. Insertion of an A20-derived 12mer peptide achieved the best results, enabling the resulting G115 + A12 T-cells to kill both PAg and αvβ6-expressing tumour cells. Cytolytic activity of G115 + A12 T-cells against PAg-presenting K562 target cells was enhanced compared to G115 control cells, in keeping with the critical role of CDR3 δ2 length for optimal PAg recognition. Activation was accompanied by interferon (IFN)-γ release in the presence of either target antigen, providing a novel dual-specificity approach for cancer immunotherapy.

Head and neck cancer, the seventh most common cancer worldwide, often affects the larynx, with a higher incidence in men. Total laryngectomy, a common treatment, results in the loss of phonation, and tracheoesophageal voice rehabilitation is the current rehabilitation method of choice. Despite ongoing debates regarding the timing of tracheoesophageal puncture (TEP), a crucial procedure for voice prosthesis placement, the secondary puncture continues to be the preferred choice in the majority of cases. This underscores the persistent controversy and the absence of consensus in this field. The aim of this manuscript was to define evidence-based recommendations regarding the procedure of primary TEP with voice prosthesis placement, establish the conditions and requirements for performing primary TEP, determine the indications and contraindications of primary TEP, as well as to define the complications and management of primary TEP. A total of 19 statements were formulated, with 78.95% of them having a Level of Evidence 4 and a Grade of Recommendation C. There is not sufficient evidence comparing the outcomes of primary TEP versus secondary TEP. Future studies with robust methodologies are needed to clarify the role of primary and secondary TEP in the rehabilitation of patients undergoing total laryngectomy.

Agricultural management influences the soil ecosystem by affecting its physicochemical properties, residues of pesticides and microbiome. As vineyards grow crops with the highest incidence of pesticides, the aim of this study was to evaluate the impact of conventional and sustainable management systems of vineyards from DOP Ribeiro on the soil’s condition. Samples from soils under three different management systems were collected, and the main soil physicochemical properties were evaluated. A selection of 50 pesticides were investigated by liquid chromatography with tandem mass spectrometry. The bacterial and fungal microbiomes were characterized through amplicon sequencing. The results show that organic agriculture positively influences soil pH and the concentration of some nutrients compared to conventional management. Our microbiome analysis demonstrated that transitioning from conventional to organic management significantly improves several BeCrop® indexes related to key microbial metabolism and soil bio-sustainability. Such a transition does not affect soil alpha diversity, but leads to a higher interconnected microbial network structure. Moreover, differential core genera and species for each management system are observed. In addition, the correlation of the microbiome with geographical distance is evidence of the existence of different microbial terroirs within DOP Ribeiro. Indeed, sustainable management leads to higher nutrient availability and enhances soil health in the short term, while lowering pesticide usage.

Chemotherapy-induced nausea and vomiting (CINV) negatively impact cancer patients’ quality of life and treatment outcomes. This study evaluated the achievement of complete response to CINV prophylaxis during the first five days after chemotherapy in adult outpatient cancer clinics with solid malignant tumours receiving Moderate or Highly Emetogenic Chemotherapy (MEC or HEC) in Portugal. During the study, patients completed three evaluations, and nausea severity and CINV impact on patients’ daily life was assessed. A complete response (no emetic episodes, no use of rescue antiemetic medication, and no more than mild nausea) was observed in 72% of the cycles (N = 161) throughout the five days after chemotherapy. Amongst the patient population, 25% classified their CINV episodes as severe. Though more than half of the patients achieved a complete response, suggesting that a therapeutic effort is being made to minimise this side effect, the overall scenario is barely optimistic. Significantly, new CINV-control measures in MEC/HEC patients should be adopted, specifically avoiding the single use of dexamethasone and 5-HT3 and raising awareness of using NK1-RAs. Thus, it is critical to improve CINV prophylactic treatment and implement practical international antiemetic guidelines in Portuguese clinical practice, envisaging the improvement of supportive care for cancer patients.

Background: Noninvasive ventilation (NIV) in COVID-19 patients outside of intensive care unit (ICU) settings was a feasible support during the pandemic outbreak. The aim of this study was to assess the effectiveness of an “on the job” NIV training program provided to 66 nurses working in 3 COVID-19 wards in an Italian university hospital. Methods: A quasi-experimental longitudinal before–after study was designed. The NIV Team education program, provided by expert ICU nurses, included: 3 h sessions of training on the job during work-shifts about the management of helmet-continuous positive airway pressure (CPAP) Venturi systems, and NIV with oronasal and full-face masks. An eleven-item “brief skills self-report tool” was administered before and after the program to explore the perception of NIV education program attendees about their level of skills. Results: In total, 59 nurses responded to the questionnaire. There was an improvement in the skill levels of the management of Helmet-CPAP (median before training 2, inter-quartile range (IQR) 0–6; median after training 8, IQR 3–9; p < 0.0001), and mask-NIV (median before training 2, IQR 0–6; median after training 8, IQR 3–9; p < 0.0001). Conclusions: Training on the job performed by expert ICU nurses can be a valuable and fast means to implement new Helmet-CPAP and mask-NIV skills outside of ICUs.

The present paper addresses the problem of generating and propagating vibrations induced by low-impact loading on a driven pile. In this context, an experimental test site was selected and characterized, where ground-borne vibrations induced by the application of a low dynamic loading on the pile head were measured using accelerometers placed at the ground surface. At the same time, a new numerical approach, based on a coupled FEM-PML (Finite Element Method-Perfectly Matched Layer) formulation, to model the pile–ground system was presented. A very satisfactory agreement was observed between the experimental data collected in these experiments and the prediction performed by the numerical model. The experimental data can be also used by other authors for the experimental validation of their or other prediction models.

Osteoarthritis (OA) is a degenerative and progressive joint disease. When all three compartments are involved, end-stage OA is treated with a total knee arthroplasty (TKA). Unicompartmental knee arthroplasty (UKA) is a primary treatment for isolated osteoarthritis. UKA has a quicker recovery time than TKA, as well as less morbidity and more tissue sparing. At the time of surgery, 17% of patients have a tricompartmental disease and most patients with a Kellegren–Lawrence grade >3 have an intact anterior cruciate ligament (ACL). Conventional TKA sacrifices the ACL. Patients with concurrent medial and lateral osteoarthritis and a functional ACL may receive a primary bi-unicondylar arthroplasty. Combined partial knee arthroplasty (CPKA) is an established practice either in bicompartmental femoro-tibial OA or in OA progression after UKA, with the addition of another UKA. A conversion of a lateral UKA to a tricompartmental joint replacement has been reported in the literature. In our case report, we describe a one-stage hypoallergenic tricompartmental UKA, with improved clinical score and no sign of early failure at the last follow-up.

Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers. PDAC is characterized by a complex tumor microenvironment (TME), that plays a pivotal role in disease progression and resistance to therapy. Investigating the spatial distribution and interaction of TME cells with the tumor is the basis for understanding the mechanisms underlying disease progression and represents a current challenge in PDAC research. Imaging mass cytometry (IMC) is the major multiplex imaging technology for the spatial analysis of tumor heterogeneity. However, there is a dearth of reports of multiplexed IMC panels for different preclinical mouse models, including pancreatic cancer. We addressed this gap by utilizing two preclinical models of PDAC: the genetically engineered, bearing KRAS–TP53 mutations in pancreatic cells, and the orthotopic, and developed a 28–marker panel for single–cell IMC analysis to assess the abundance, distribution and phenotypes of cells involved in PDAC progression and their reciprocal functional interactions. Herein, we provide an unprecedented definition of the distribution of TME cells in PDAC and compare the diversity between transplanted and genetic disease models. The results obtained represent an important and customizable tool for unraveling the complexities of PDAC and deciphering the mechanisms behind therapy resistance.

Current physical systems are built in more that one coordinate: for example, electrical power systems, aeronautical systems and robotic systems can be modeled in multibond graphs (MBG). However, in these systems, some elements use only one axis or dimension—for example, actuators and controllers—which can be modeled in bond graphs (BG). Therefore, in this paper, modeling of systems in multibond graphs and bond graphs (MBG-BG) is presented. Likewise, the junction structure of systems represented by (MBG-BG) is introduced. From this structure, mathematical modeling in the state space is presented. Likewise, modeling of systems on a platform (MBG-BG) can be seen as symmetric to the mathematical model that represents these systems. Finally, a synchronous generator modeled by (MBG-BG) as a case study is developed, and simulation results using 20-Sim software are shown. Furthermore, an electrical power system connected to the power supply of a DC motor as another case study is explained.

Topology optimization has evidenced its capacity to provide new optimal designs in many different disciplines. However, most novel methods are difficult to apply in commercial software, limiting their use in the academic field and hindering their application in the industry. This article presents a new open methodology for solving geometrically complex non-self-adjoint topology optimization problems, including stress-constrained and stress minimization formulations, using validated FEM commercial software. The methodology was validated by comparing the sensitivity analysis with the results obtained through finite differences and solving two benchmark problems with the following optimizers: Optimality Criteria, Method of Moving Asymptotes, Sequential Least-Squares Quadratic Programming (SLSQP), and Trust-constr optimization algorithms. The SLSQP and Trust-constr optimization algorithms obtained better results in stress-minimization problem statements than the methodology available in ABAQUS®. A Python implementation of this methodology is proposed, working in conjunction with the commercial software ABAQUS® 2023 to allow a straightforward application to new problems while benefiting from a graphic user interface and validated finite element solver.

The non-premixed filtered tabulated chemistry for large eddy simulations employs numerical filtering to resolve a thin flame front on practical LES numerical grids. The flame structure is modified to be coherent with the domain discretization. The first turbulent combustion application of the non-premixed filtered tabulated chemistry approach is presented. A keen comparison of the flamelet filtering transformation in the premixed and non-premixed regimes is carried out. Three distinctive features are outlined: the flame thickness variation, the filtered manifold transformation, and the model activation dependence on the chosen diffusion flamelet configuration for a non-premixed filtered approach. The model performance is assessed on two real turbulent flame configurations, Sandia flames D and E, employing a three-dimensional tabulation strategy, where the numerical grid is coupled with the model by the third parameter, i.e., the computational cell size. The repercussions of the above cited aspects are carefully assessed. The results demonstrate that the formalism coupling with an SGS modeling function can adequately describe wrinkled flame front effects. The predictions for both the major stable species and the minor ones accurately correspond with the underlying physics. It turns out that there is a substantial variation of the filter effect as a function of the strain rate of the flame and the considered species. The varying filter sensitivity along the manifold influences the response of the model correction terms and the retrieved variables. The non-premixed FTACLES formalism possibilities and conditions for the model’s utilization and optimal performance are clearly stated, to confirm the idea that SGS closure in diffusive combustion can be derived based on filtering arguments, and not only based on statistical approaches.

Using by-products added to grass silage in the total mixed ration (TMR) silage form can bring advantages to the ensiling process, raising DM levels, absorbing moisture, and improving the silage’s chemical composition. The aim of this study was to evaluate the effect of babassu by-products’ inclusion substitution for corn in Guinea grass silage in the total mixed ration as an alternative feed for ruminants. The experiment was a completely randomized design with four treatments (silage) and five replications (silo). There was a significant difference in the fermentation profile and losses of silage (p < 0.001), some organic acids (lactic and butyric acids, p < 0.001), and the percentage of lactic acid in fermentation products (LA:FP, p < 0.001). The TGS showed the highest average for the variable’s maximum temperature (p < 0.001) and hours/max temperature (p = 0.011). Babassu by-products could eventually replace 50% of corn in total mixed rations silage containing Guinea grass, meeting the suggestion for the total mixed ration silage.

Zeolites have been successfully applied as catalysts in the pyrolysis of plastics to obtain valuable lower molecular weight hydrocarbon compounds. In the present work, mordenite was directly synthesized and chemically modified from commercial mordenite to increase pore volume. For the first time, the performance of these mordenites was compared with that of an alkali-treated ZSM-5 as catalysts for assisting the pyrolysis of simulated urban plastic waste. The investigated zeolites were: (i) as-supplied synthetic ZSM-5 (ZSM-5/AS); (ii) 0.2 M NaOH treated ZSM-5 (ZSM-5/02); (iii) as-supplied mordenite (MOR/AS); (iv) 0.2 M NaOH treated mordenite (MOR/02); and (v) synthetic lab-developed mordenite (MOR/SD). The modified and synthesized zeolites were individually applied as catalysts in the 700 °C pyrolyzes of combined polyethylene, polypropylene, and polystyrene wastes in a mixture simulating most plastics found in Rio de Janeiro (Brazil) city garbage composition. X-ray diffraction revealed crystallite sizes of all zeolites in a nanometric range from 17 to 43 nm. Textural analysis disclosed the alkali-treated ZSM-5/02 with a superior external surface area, 153 m²/g, and mesopore volume equal to 0.253 cm3/g. Lower values were obtained by MOR/02 (39 m²/g and 0.072 cm3/g). The pyrolysis of the plastic mixture with ZSM-5/02 presented a lower initial degradation temperature, 387 °C, followed by MOR/02, with 417 °C. The ZSM-5/02 catalyst obtained the highest conversion in the pyrolysis of the plastic mixture, totaling 49.2%. However, pyrolysis assisted by the MOR/02 catalyst showed the largest fraction (81.5%) of light hydrocarbons.

Background: balloon cell melanoma represents less than 1% of all histological forms of malignant melanoma and represents a diagnostic challenge for the dermatopathologist. Methods: in this paper we present our cases of BCM found in our daily practice from 1 January 2008 to 31 December 2021, and we conduct a review of the literature relating to this entity in the period from the first description, 1970, to early 2022. Results: four cases of melanoma balloon cell have been extrapolated from our electronic database, while in the review of the literature we have identified 115 cases of patients with primary and/or metastatic BCM. Conclusions: we believe that future studies with numerous case series are essential not only to increase the knowledge of the pathophysiology of this neoplasm but also to correctly evaluate the response of BCM patients to new oncological therapies.

Members of the Paracoccidioides complex are the causative agents of Paracoccidioidomycosis (PCM), a human systemic mycosis endemic in Latin America. Upon initial contact with the host, the pathogen needs to uptake micronutrients. Nitrogen is an essential source for biosynthetic pathways. Adaptation to nutritional stress is a key feature of fungi in host tissues. Fungi utilize nitrogen sources through Nitrogen Catabolite Repression (NCR). NCR ensures the scavenging, uptake and catabolism of alternative nitrogen sources, when preferential ones, such as glutamine or ammonium, are unavailable. The NanoUPLC-MSE proteomic approach was used to investigate the NCR response of Paracoccidioides lutzii after growth on proline or glutamine as a nitrogen source. A total of 338 differentially expressed proteins were identified. P. lutzii demonstrated that gluconeogenesis, β-oxidation, glyoxylate cycle, adhesin-like proteins, stress response and cell wall remodeling were triggered in NCR-proline conditions. In addition, within macrophages, yeast cells trained under NCR-proline conditions showed an increased ability to survive. In general, this study allows a comprehensive understanding of the NCR response employed by the fungus to overcome nutritional starvation, which in the human host is represented by nutritional immunity. In turn, the pathogen requires rapid adaptation to the changing microenvironment induced by macrophages to achieve successful infection.

Encapsulation of Doxorubicin (Dox), a potent cytotoxic agent and immunogenic cell death inducer, in pegylated (Stealth) liposomes, is well known to have major pharmacologic advantages over treatment with free Dox. Reformulation of alendronate (Ald), a potent amino-bisphosphonate, by encapsulation in pegylated liposomes, results in significant immune modulatory effects through interaction with tumor-associated macrophages and activation of a subset of gamma-delta T lymphocytes. We present here recent findings of our research work with a formulation of Dox and Ald co-encapsulated in pegylated liposomes (PLAD) and discuss its pharmacological properties vis-à-vis free Dox and the current clinical formulation of pegylated liposomal Dox. PLAD is a robust formulation with high and reproducible remote loading of Dox and high stability in plasma. Results of biodistribution studies, imaging with radionuclide-labeled liposomes, and therapeutic studies as a single agent and in combination with immune checkpoint inhibitors or gamma-delta T lymphocytes suggest that PLAD is a unique product with distinct tumor microenvironmental interactions and distinct pharmacologic properties when compared with free Dox and the clinical formulation of pegylated liposomal Dox. These results underscore the potential added value of PLAD for chemo-immunotherapy of cancer and the relevance of the co-encapsulation approach in nanomedicine.

Background: The Brazilian National Solid Waste Policy establishes the shared responsibility of all actors involved in e-waste generation and management; however, some conflicts of interest need interventions and approaches for preventing them. Objective: This paper proposes using a graph model for conflict resolution (GMCR) decision support system to simulate the analysis and resolution of realistic e-waste management conflicts. Method: A systematic literature review focused on e-waste management, shared responsibility and conflict management was conducted, and a graph model for conflict resolution (GMCR) decision support system was applied to generate a framework to address this context. Results: The need for commitment agreements promoted by government institutions in partnerships with companies involved in the process is essential since the principle of shared responsibility requires educational actions, favoring efficiency in the reverse logistics recovery procedures for e-waste. Understanding the interconnected causes of conflicts and their facets is crucial for effective resolution and prevention, aiding comprehension, focused interventions, and evidence-based decision-making for transformative change amidst conflicting stakeholder objectives in the case of WEEE management. These results can be helpful for academics and practitioners working in this area.

Background: Foreign body ingestion (FBI) represents the most common cause of emergent gastrointestinal endoscopy in children. FBI’s management can be quite challenging for physicians because of the variability of the clinical presentation, and the decision tree becomes even more intricate because of patient-specific variables that must be considered in the pediatric age range (e.g., age of patients and neuropsychiatric disorders) in addition to the mere characteristics of the foreign body. We present an application for smartphones designed for pediatricians and pediatric surgeons based on the latest guidelines from the official pediatric societies. The app aims to help physicians manage FBI quickly and properly in children. Materials and methods: The latest pediatric FBI management guidelines were reviewed and summarized. The flow chart we obtained guided the development of a smartphone application. A questionnaire was administered to all pediatric surgeon trainees at our institute to test the feasibility and helpfulness of the application. Results: An app for smartphones was obtained and shared for free on the Google Play Store and Apple Store. The app guides the physician step by step in the diagnostic process, analyzing all patient- and foreign body-specific characteristics. The app consultation ends with a suggestion of the most proper decision to make in terms of further radiological investigations and the indication and timing of endoscopy. A questionnaire administered to trainees proved the app to be useful and easy to use. Conclusion: We developed an app able to help pediatricians and pediatric surgeons manage FBI in children, providing standardized and updated recommendations in a smart and easily available way.

The recognition of microbe and extracellular matrix (ECM) is a recurring theme in the humoral innate immune system. Fluid-phase molecules of innate immunity share regulatory roles in ECM. On the other hand, ECM elements have immunological functions. Innate immunity is evolutionary and functionally connected to hemostasis. Staphylococcus aureus (S. aureus) is a major cause of hospital-associated bloodstream infections and the most common cause of several life-threatening conditions such as endocarditis and sepsis through its ability to manipulate hemostasis. Biofilm-related infection and sepsis represent a medical need due to the lack of treatments and the high resistance to antibiotics. We designed a method combining imaging and microfluidics to dissect the role of elements of the ECM and hemostasis in triggering S. aureus biofilm by highlighting an essential role of fibrinogen (FG) in adhesion and formation. Furthermore, we ascertained an important role of the fluid-phase activation of fibrinolysis in inhibiting biofilm of S. aureus and facilitating an antibody-mediated response aimed at pathogen killing. The results define FG as an essential element of hemostasis in the S. aureus biofilm formation and a role of fibrinolysis in its inhibition, while promoting an antibody-mediated response. Understanding host molecular mechanisms influencing biofilm formation and degradation is instrumental for the development of new combined therapeutic approaches to prevent the risk of S. aureus biofilm-associated diseases.