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Background: Peri-electrode edema after deep brain stimulation (DBS) surgery for Parkinson Disease (PD) has been reported in up to 100% of cases. The clinical significance of this finding is unclear, with most papers suggesting a benign course. The risk factors are also poorly defined. We aimed at defining the incidence rate, the clinical significance and the predictive factors of peri-electrode edema in patients undergoing DBS for PD. Methods: We reviewed data of 119 patients treated with frameless stereotactic DBS for PD between 2012 and 2022 at our Institution. A mixed-technique targeting was adopted. Awake surgery was used in 64.7% cases; in most cases, microelectrode recording (MER) was adopted. The target was the subthalamic nucleus (STN) in 91.2% cases. Results: Ninety patients were included. Postoperative edema related to lead placement was noticed in 40% patients after a median time of 2 days since surgery; in 88.9% of these cases, it was limited to subcortical white matter. Symptomatic edema was registered only in one case (1.1%), confirming previous reports on the benign clinical course. The only independent predictive factor for edema onset was asleep surgery (p = 0.0451). Notably, the use of directional electrodes was not associated with an increased risk of edema at multivariable analysis. Clinical parameters including age, and timing of CT scanning, did not affect edema onset. Conclusions: We confirmed the very low rate of symptomatic edema in DBS for PD. When feasible, awake DBS using MER is the ideal technique to reduce the risk of radiologic postoperative edema. [ABSTRACT FROM AUTHOR]

This study explores the potential of glass polishing waste (GPW) in improving clayey soil from the Guabirotuba formation. The research stands out by developing a novel geomaterial and proposing equations to predict mechanical behavior, focusing on the effects of porosity (η), GPW content, and cement on unconfined compressive strength (qu), splitting tensile strength (qt), and durability through accumulated loss of mass (ALM). This research contributes to understanding the parameters that influence the mechanical strength and durability of soil–cement, and soil–cement-GPW blends through the adequacy of the porosity/cement content (η/Civ) and porosity/binder content (η/Biv) indices on qu, qt, and ALM. Soil–cement-GPW blends and a control group (soil–cement) were analyzed, and the microstructure of the best blends was evaluated using scanning electron microscopy (SEM). The results showed that the soil–cement-GPW blends exhibited superior mechanical strengths compared to the soil–cement blends, reaching a maximum value of qu = 3176 kPa and qt = 946 kPa after 90 days in the soil + 8%cement + 15%GPW blends compacted at the modified effort. Soil–cement specimens showed higher ALM (soil + 8%cement; ALM = 8.1%) than the blends with GPW (soil + 8%cement + 15%GPW; ALM = 2.5%). The qu of specimens in durability tests decreased by 15% to 49.5% compared to those in qu tests after 28 days of curing, with the highest losses in blends with lower cement content and no GPW. The results of qu, qt, and ALM were successfully correlated with the η/Civ and η/Biv indices in power-type relationships. These indices proved effective for predicting qu, qt, and ALM, replacing conventional trial-and-error strategies that are typically labor-intensive and time-consuming. [ABSTRACT FROM AUTHOR]

BPV1, BPV2, BPV13, and BPV14 are all genotypes of bovine delta papillomaviruses (δPV), of which the first three cause infections in horses and are associated with equine sarcoids. However, BPV14 infection has never been reported in equine species. In this study, we examined 58 fresh and thawed commercial semen samples from healthy stallions. In 34 (58.6%), bovine δPV DNA was detected and quantified using droplet digital polymerase chain reaction (ddPCR). Real time quantitative PCR (qPCR) was able to identify bovine δPV DNA in 5 samples (8.6%). Of the BPV-infected semen samples, 15 were positive for BPV2 (~ 44.1%) on ddPCR and 4 (~ 11.7%) on qPCR; 12 (~ 35.3%) for BPV14 on ddPCR and 1 (~ 3%) by qPCR; 4 (~ 11.7%) for BPV1 on ddPCR, whereas qPCR failed to reveal this infection; 3 (~ 8.8%) for BPV13 on ddPCR; and BPV13 infection was not detected by qPCR. Our study showed for the first time that BPV14 is an additional infectious agent potentially responsible for infection in horses, as its transcripts were detected and quantified in some semen samples. Large-scale BPV14 screening is necessary to provide substantial data on the molecular epidemiology for a better understanding of the geographical divergence of BPV14 prevalence in different areas and how widespread BPV14 is among equids. [ABSTRACT FROM AUTHOR]

High-resolution absorption spectroscopy toward bright background sources has had a paramount role in understanding early galaxy formation, the evolution of the intergalactic medium and the reionisation of the Universe. However, these studies are now approaching the boundaries of what can be achieved at ground-based 8-10m class telescopes. The identification of primeval systems at the highest redshifts, within the reionisation epoch and even into the dark ages, and of the products of the first generation of stars and the chemical enrichment of the early Universe, requires observing very faint targets with a signal-to-noise ratio high enough to detect very weak spectral signatures. In this paper, we describe the giant leap forward that will be enabled by ANDES, the high-resolution spectrograph for the ELT, in these key science fields, together with a brief, non-exhaustive overview of other extragalactic research topics that will be pursued by this instrument, and its synergistic use with other facilities that will become available in the early 2030s. [ABSTRACT FROM AUTHOR]

Modified Patankar schemes are linearly implicit time integration methods designed to be unconditionally positive and conservative. In the present work we extend the Patankar-type approach to linear multistep methods and prove that the resulting discretizations retain, with no restrictions on the step size, the positivity of the solution and the linear invariant of the continuous-time system. Moreover, we provide results on arbitrarily high order of convergence and we introduce an embedding technique for the Patankar weights denominators to achieve it. [ABSTRACT FROM AUTHOR]

In bioarchaeology, funerary taphonomy and preservation become part of the biocultural narrative of the dead. We evaluate the role of these factors in reconstructing the identities of those buried in an emerging deathway, the ventrally placed legs flexed (VPLF) burial position, during the Terminal Classic (750–900/1000 CE) period at the Maya polity of Lower Dover in western Belize. The term “VPLF” describes a divergent burial practice which may have resulted from intentional binding prior to burial. In our analysis of VPLF burials (n = 12), we use a two-step process to reconstruct the social identities and potential meaning of the burial pattern: (1) interpretation of the archaeological context based on excavation observations and biogeochemistry and (2) osteological analysis of curated individuals to reconstruct their biological profiles and post-mortem/post-excavation histories. Osteological analyses included age and sex estimation, paleopathological assessment of frailty and trauma, and skeletal modifications from cultural and taphonomic forces. Radiocarbon dating and ceramic analyses were used to date the burials. Stable and radiogenic isotopic analyses were applied to reconstruct diet and mobility for a subset of the VPLF burials. Our results show that individuals were buried in the VPLF position irrespective of age, sex, or social status, consistent with patterns at other Terminal Classic and Postclassic Maya sites, although VPLF interment may have been practiced earlier at Lower Dover. We hypothesize that the appearance of VPLF burials in the Terminal Classic period signified an ideological shift in light of emerging social and environmental pressures in the region. [ABSTRACT FROM AUTHOR]

Background: The first post-COVID-19 pandemic year demonstrated an unusual bronchiolitis epidemic in both hemispheres and has been attributed to the removal of barriers implemented during SARS-CoV-2 infection. Several countries reported an increase in respiratory syncytial virus (RSV) bronchiolitis, with more hospitalizations and a greater need for respiratory support. We aimed to evaluate the consequences of the COVID-19 pandemic on the epidemiology and management of severe bronchiolitis in pediatric intensive care units (PICUs) in Italy. Methods: Multicenter, retrospective, cohort database analysis. All children younger than 24 months admitted to 7 PICUs from October 2017 to April 2023 diagnosed with bronchiolitis were included. We compared patients from pre-COVID and post-COVID eras, excluding patients from the 2020–2021 season due to low numbers. Logistic regression models were used to assess the impact of the pre-/post-COVID period on the need for invasive ventilation. Results: Seven hundred fifteen patients were admitted to PICU during the study period, 451 patients pre-COVID and 251 patients post-COVID. Patients in the post-COVID group were older, had more comorbidities, and had higher Pediatric Index of Mortality scores at admission but the need for respiratory support was not significantly different. There was high variability in bronchiolitis management across centers. Presenting pre-COVID was protective against the risk of mechanical ventilation, adjusted for age and disease severity at admission (OR 0.38, 95% CI 0.16–0.89), while RSV infection increased the risk of intubation (OR 2.49, 95% CI 1.1–5.63). Conclusions: PICUs have faced an unexpected peak of significantly more severe cases of bronchiolitis after the COVID-19 pandemic, which did not require increased respiratory support. [ABSTRACT FROM AUTHOR]

Glioma associated macrophages/microglia (GAMs) play an important role in glioblastoma (GBM) progression, due to their massive recruitment to the tumor site and polarization to a tumor promoting phenotype. GAMs secrete a variety of cytokines, which facilitate tumor cell growth and invasion, and prevent other immune cells from mounting an immune response against the tumor. Here, we demonstrate that zinc finger and BTB containing domain 18 (ZBTB18), a transcriptional repressor with tumor suppressive function in glioblastoma, impairs the production of key cytokines, which function as chemoattractant for GAMs. Consistently, we observe a reduced migration of GAMs when ZBTB18 is expressed by glioblastoma cells, both in cell culture and in vivo experiments. Moreover, RNA sequencing analysis shows that the presence of ZBTB18 in glioblastoma cells alters the commitment of conditioned microglia, suggesting the loss of the immune-suppressive phenotype and the acquisition of pro-inflammatory features. Thus, therapeutic approaches to increase ZBTB18 expression in GBM cells could represent an effective adjuvant to immune therapy in GBM. In vitro, in vivo and in silico studies identify the transcriptional repressor ZBTB18 as a negative regulator of tumor associated macrophage recruitment and of their tumor promoting phenotype in glioblastoma [ABSTRACT FROM AUTHOR]

Introduction: Delay in arterial hypertension (AH) diagnosis and late therapy initiation may affect progression towards hypertensive-mediated organ damage (HMOD) and blood pressure (BP) control. Aim: We aimed to assess the impact of time-to-therapy on BP control and HMOD in patients receiving AH diagnosis. Methods: We analysed data from the Campania Salute Network, a prospective registry of hypertensive patients (NCT02211365). At baseline visit, time-to-therapy was defined as the interval between the first occurrence of BP values exceeding guidelines-directed thresholds and therapy initiation; HMOD included left ventricular hypertrophy (LVH), carotid plaque, or chronic kidney disease. Optimal BP control was considered for average values < 140/90 mmHg. Low-risk profile was defined as grade I AH without additional cardiovascular risk factors. Results: From 14,161 hypertensive patients, we selected 1,627 participants who were not on antihypertensive therapy. This population was divided into two groups based on the median time-to-therapy (≤ 2 years n = 1,009, > 2 years n = 618). Patients with a time-to-therapy > 2 years had higher risk of HMOD (adjusted odds ratio, aOR:1.51, 95%, CI:1.19–1.93, p < 0.001) due to increased risks of LVH (aOR:1.43, CI:1.12–1.82, p = 0.004), carotid plaques (aOR:1.29, CI:1.00-1.65, p = 0.047), and chronic kidney disease (aOR:1.68, CI:1.08–2.62, p = 0.022). Time-to-therapy > 2 years was significantly associated with uncontrolled BP values (aOR:1.49, CI:1.18–1.88, p < 0.001) and higher number of antihypertensive drugs (aOR:1.68, CI:1.36–2.08, p < 0.001) during follow-up. In low-risk subgroup, time-to-therapy > 2 years did not impact on BP control and number of drugs. Conclusions: In hypertensive patients, a time-to-therapy > 2 years is associated with HMOD and uncontrolled BP. [ABSTRACT FROM AUTHOR]

During the Roman age, the southern promontory of the gulf of Baia was the perfect location for the construction of villae maritimae for the Roman élite that decided to spend their summer residences by the sea. One of these residences is now located in the military fortress of the Castello Aragonese di Baia, built in 1495 CE during the Aragonese period (15th century). Here, during restoration works, the ruins of the residential sector of the villa, which historical sources ascribe to Caesar, were unearthed. The most representative evidence of this is the outstanding in situ remain of mosaics, decorated plasters and finely frescoed surfaces decorated according to the repertoire of the II style. This research aims to investigate the polychromy of a wall decoration representing a perspective depiction of architectural scenes en trompe l'oeil analysed by means of a multi-analytical, non-destructive approach performed in situ. The combined use of spectroscopic techniques (portable X-ray fluorescence, Raman and Fourier Transform Infrared Spectroscopy) points out the use of a characteristic Roman palette, quantitatively assessed by colorimetric measurements. It consists of red and yellow ochre, calcite, hematite, organic black pigments, precious materials such as cinnabar and Egyptian blue, green copper compounds. Fourier Transform Infrared Spectroscopy also revealed the presence of synthetic resins, likely used for the conservation of mural paintings. These are, however, damaged by atmospheric humidity, as detected by Infrared Thermography. Gypsum has been identified as the main weathering product. [ABSTRACT FROM AUTHOR]

Acute diverticulitis (AD) is associated with relevant morbidity/mortality and is increasing worldwide, thus becoming a major issue for national health systems. AD may be challenging, as clinical relevance varies widely, ranging from asymptomatic picture to life-threatening conditions, with continuously evolving diagnostic tools, classifications, and management. A 33-item-questionnaire was administered to residents and surgeons to analyze the actual clinical practice and to verify the real spread of recent recommendations, also by stratifying surgeons by experience. CT-scan remains the mainstay of AD assessment, including cases presenting with recurrent mild episodes or women of child-bearing age. Outpatient management of mild AD is slowly gaining acceptance. A conservative management is preferred in non-severe cases with extradigestive air or small/non-radiologically drainable abscesses. In severe cases, a laparoscopic approach is preferred, with a non-negligible number of surgeons confident in performing emergency complex procedures. Surgeons are seemingly aware of several options during emergency surgery for AD, since the rate of Hartmann procedures does not exceed 50% in most environments and damage control surgery is spreading in life-threatening cases. Quality of life and history of complicated AD are the main indications for delayed colectomy, which is mostly performed avoiding the proximal vessel ligation, mobilizing the splenic flexure and performing a colorectal anastomosis. ICG is spreading to check anastomotic stumps' vascularization. Differences between the two experience groups were found about the type of investigation to exclude colon cancer (considering the experience only in terms of number of colectomies performed), the size of the peritoneal abscess to be drained, practice of damage control surgery and the attitude towards colovesical fistula. [ABSTRACT FROM AUTHOR]

Compacted soils are vital in constructing unpaved roads and embankments for infrastructure projects, requiring a thorough understanding of how different soil properties influence erosion. This research examined the influence of suction on the mass loss of clayey soil from the Guabirotuba Formation, compacted at various degrees of saturation and densities. The study involved initial physical–chemical, mineralogical, and morphological soil characterization. Tests were then conducted to determine the soil water characteristic curve, hydraulic conductivity, and erodibility using the filter paper method, permeability tests, and the Inderbitzen test. Samples were compacted to dry unit weights of 14.55 kN/m3, 15.42 kN/m3, and 16.28 kN/m3 with saturation levels of 20%, 50%, 91.08%, 93.49%, and 95.60%. Results showed that variations in soil density altered the soil water characteristic curve, tending towards a unimodal shape with reduced void ratios. Soil permeability decreased in the desaturation zone of the curve. The study determined that soil mass loss is primarily influenced by saturation degree and density, with saturation emerging as the most crucial factor. Erosion resistance was observed to be lowest at 50% saturation compared to both 20% and optimal saturation levels, which was associated with a reduction in the unsaturated permeability coefficient. It has been found that the influence of slope is negligible. Therefore, soil saturation levels significantly affect erosion resistance, making the soil more susceptible to disruption when air continuously occupies the pore space. [ABSTRACT FROM AUTHOR]

Context: Growth hormone (GH) deficiency in a child with short stature is diagnosed by GH secretion provocative tests. When the test response is considered adequate, the short stature is considered idiopathic (ISS). Objective: To determine the effect of GH provocative tests on the growth rate in children with idiopathic short stature. Design: Children with short stature with a normal response to at least one GH provocative test were enrolled. Height and growth velocity were measured prior to and after stimulus tests during the follow-up. Methods: Height, mid-parental height, body weight, and body mass index were measured. The height and growth rate were converted to percentiles and Standard Deviation Scores (SDS) using reference ranges standardized by age and sex. GH provocative tests employed arginine or clonidine as secretagogues. Results: Fourty-six children of both genders were enrolled. In thirty-six children, height was measured at the time of testing and on an average time prior to and after the tests of 210 days and 180 days respectively. After testing the children displayed a 3.4-fold increase in their estimated 90-day growth rate. The median (inter-quartile range, IQR) 90 days growth of children pre-and post-tests were 0.7 (0.2–1.0) cm and 2.4 (1.7–3.1) cm respectively with a mean 3,4-fold increase (p < 0.0001). The median (IQR) 90 days growth of children pre- and post-tests calculated as standard deviation scores (SDS) were −4.0 (−5.4–−2.1) SDS and 0.1 (−1.9–1.4) SDS respectively (p < 0.0001). Ten children with ISS were observed for about 5 months before the GH provocative tests. A small increase in the growth rate was seen only in 2 out of 10 children before testing while it increased in all of them after the tests. The difference in the median growth rate at the first and the second observation was not significant (p = 0.219). Conclusions: Two sequential somatotropic axis provocative tests increase the growth rate in children with idiopathic short stature. The duration of this effect is yet to be determined. [ABSTRACT FROM AUTHOR]

Background: The study of central nervous system (CNS) tumors is particularly relevant in the pediatric population because of their relatively high frequency in this demographic and the significant impact on disease- and treatment-related morbidity and mortality. While both morphological and non-morphological magnetic resonance imaging techniques can give important information concerning tumor characterization, grading, and patient prognosis, increasing evidence in recent years has highlighted the need for personalized treatment and the development of quantitative imaging parameters that can predict the nature of the lesion and its possible evolution. For this purpose, radiomics and the use of artificial intelligence software, aimed at obtaining valuable data from images beyond mere visual observation, are gaining increasing importance. This brief review illustrates the current state of the art of this new imaging approach and its contributions to understanding CNS tumors in children. Data sources: We searched the PubMed, Scopus, and Web of Science databases using the following key search terms: ("radiomics" AND/OR "artificial intelligence") AND ("pediatric AND brain tumors"). Basic and clinical research literature related to the above key research terms, i.e., studies assessing the key factors, challenges, or problems of using radiomics and artificial intelligence in pediatric brain tumors management, was collected. Results: A total of 63 articles were included. The included ones were published between 2008 and 2024. Central nervous tumors are crucial in pediatrics due to their high frequency and impact on disease and treatment. MRI serves as the cornerstone of neuroimaging, providing cellular, vascular, and functional information in addition to morphological features for brain malignancies. Radiomics can provide a quantitative approach to medical imaging analysis, aimed at increasing the information obtainable from the pixels/voxel grey-level values and their interrelationships. The "radiomic workflow" involves a series of iterative steps for reproducible and consistent extraction of imaging data. These steps include image acquisition for tumor segmentation, feature extraction, and feature selection. Finally, the selected features, via training predictive model (CNN), are used to test the final model. Conclusions: In the field of personalized medicine, the application of radiomics and artificial intelligence (AI) algorithms brings up new and significant possibilities. Neuroimaging yields enormous amounts of data that are significantly more than what can be gained from visual studies that radiologists can undertake on their own. Thus, new partnerships with other specialized experts, such as big data analysts and AI specialists, are desperately needed. We believe that radiomics and AI algorithms have the potential to move beyond their restricted use in research to clinical applications in the diagnosis, treatment, and follow-up of pediatric patients with brain tumors, despite the limitations set out. [ABSTRACT FROM AUTHOR]

The present study aims to assess the effect of using recycled aggregates (RA) derived from construction and demolition waste (CDW) on the development of the unconfined compressive strength (UCS) of a silty-cement soil from the Guabirotuba Formation, located in the southern region of Brazil. Was considered the influence of various parameters, including RA content, compaction effort, maximum dry specific mass, and porosity/volume cement content (η/Civ). RA contents of 10%, 20%, and 30%, combined with 5% cement by dry soil weight, are studied at curing times of 0, 7, 14, and 28 days, using standard, intermediate, and modified compaction efforts. The results reveal that the addition of RA leads to an increase in the maximum dry specific mass, directly correlating with an increase in the rate of compressive strength gain over time. In the case of the modified compaction effort, the UCS value for the mixture with 30% RA at 28 days of curing reaches 2318 kPa, which is 35% higher compared to the mixture without RA, which has an RCS value of 1711 kPa. Equations establishing a relationship between η/Civ and UCS show that smaller η/Civ values result in greater UCS. Furthermore, a correlation between η/Civ and RA content with UCS suggests that η/Civ has a stronger influence on UCS than RA content. Lastly, Scanning Electron Microscopy (SEM) indicates that incorporating 30% RA reduces the number of pores as well as their size, which enhances the soil structure and its increases stability, resulting in a more compact structure. [ABSTRACT FROM AUTHOR]

The use of microelectrode recording (MER) during deep brain stimulation (DBS) for Parkinson Disease is controversial. Furthermore, in asleep DBS anesthesia can impair the ability to record single-cell electric activity. The purpose of this study was to describe our surgical and anesthesiologic protocol for MER assessment during asleep subthalamic nucleus (STN) DBS and to put our findings in the context of a systematic review of the literature. Sixty-three STN electrodes were implanted in 32 patients under general anesthesia. A frameless technique using O-Arm scanning was adopted in all cases. Total intravenous anesthesia, monitored with bispectral index, was administered using a target controlled infusion of both propofol and remifentanil. A systematic review of the literature with metanalysis on MER in asleep vs awake STN DBS for Parkinson Disease was performed. In our series, MER could be reliably recorded in all cases, impacting profoundly on electrode positioning: the final position was located within 2 mm from the planned target only in 42.9% cases. Depth modification > 2 mm was necessary in 21 cases (33.3%), while in 15 cases (23.8%) a different track was used. At 1-year follow-up we observed a significant reduction in LEDD, UPDRS Part III score off-medications, and UPDRS Part III score on medications, as compared to baseline. The systematic review of the literature yielded 23 papers; adding the cases here reported, overall 1258 asleep DBS cases using MER are described. This technique was safe and effective: metanalysis showed similar, if not better, outcome of asleep vs awake patients operated using MER. MER are a useful and reliable tool during asleep STN DBS, leading to a fine tuning of electrode position in the majority of cases. Collaboration between neurosurgeon, neurophysiologist and neuroanesthesiologist is crucial, since slight modifications of sedation level can impact profoundly on MER reliability. [ABSTRACT FROM AUTHOR]

Introduction: No data are available on the diagnostic algorithms recommended by guidelines for the assessment of diastolic dysfunction (DD) in patients with arterial hypertension. Aim: To fill this gap, we evaluated diastolic function in hypertensive patients with and without LVH matched with healthy subjects by applying 2016 American Society of Echocardiography-European Association of Cardiovascular Imaging Guidelines for the evaluation of LV diastolic function. Methods: 717 healthy and hypertensives with normal LV ejection fraction and with and without LV hypertrophy (LVH), matched 1:1:1 from two prospective registries, represented the study population. Results: By applying algorithm A, indeterminate pattern was found in 0.4% of healthy, in 6.3% of hypertensives without LVH, and in 21% with LVH (overall p < 0.05 vs. healthy). DD was absent in healthy, however present in 2 and 8% of hypertensives without and with LVH (p = 0.06 and p = 0.001 vs. healthy, respectively). By applying algorithm B, no cases of indeterminate pattern were found. DD was observed in 2.9% of healthy, 7 and 10.5% of hypertensives without and with LVH (p < 0.05 vs. healthy). Conclusions: The use of algorithm A should be limited only to truly normal subjects, whereas algorithm B should be applied to all patients with hypertension, even without comorbidities and irrespective of LVH. [ABSTRACT FROM AUTHOR]

Introduction: Several observational studies have been conducted to assess the prevalence of cardiovascular risk factors in hypertensive patients; however, none has yet investigated prevalence, clustering, and current management of cardiovascular risk factors upon first referral to hypertension specialists, which is the aim of the present study. Methods: Consecutive adult outpatients with essential/secondary hypertension were included at the time of their first referral to hypertension specialists at 13 Italian centers in the period April 2022–2023 if they had at least one additional major cardiovascular risk factor among LDL-hypercholesterolemia, type 2 diabetes, and cigarette smoking. Prevalence, degree of control, and current management strategies of cardiovascular risk factors were assessed. Results: A total of 255 individuals were included, 40.2% women and 98.4% Caucasian. Mean age was 60.3±13.3 years and mean blood pressure [BP] was 140.3±17.9/84.8±12.3 mmHg). Most participants were smokers (55.3%), had a sedentary lifestyle (75.7%), suffered from overweight/obesity (51%) or high LDL-cholesterol (41.6%), had never adopted strategies to lose weight (55.7%), and were not on a low-salt diet (57.4%). Only a minority of patients reported receiving specialist counseling, and 27.9% had never received recommendations to correct unhealthy lifestyle habits. Nearly 90% of individuals with an estimated high/very high cardiovascular risk profile did not achieve recommended LDL-cholesterol targets. Conclusions: In patients with hypertension, both pharmacological and lifestyle therapeutic advice are yet to improve before referral to hypertension specialists. This should be considered in the primary care setting in order to optimize cardiovascular risk management strategies. [ABSTRACT FROM AUTHOR]

Purpose: To describe fetal brain Magnetic Resonance Imaging (MRI) findings in a large series of monochorionic (MC) pregnancies complicated by Twin Anemia-Polycythemia Sequence (TAPS) prenatally diagnosed, so to characterize the potential intracranial complications associated with this condition, their frequency and potential treatment options. Methods: This is a retrospective study of MC twin pregnancies complicated by TAPS and undergone fetal MRI in a single institution from 2006 to 2023. MRI control was performed and post-natal ultrasound (US) or MRI were available. Results: 1250 MC pregnancies were evaluated in our institution. 50 pregnancies (4%) were diagnosed with TAPS, 29 underwent a fetal brain MRI. 13/29 pregnancies (44.8%) demonstrated brain findings at MRI in at least a twin. Neuroradiological findings were detected in 14/57 twins (24.6%). We detected four main categories of findings: hemorrhagic lesions, T2-weighted white-matter hyperintensities (WMH), brain edema-swelling and venous congestion. Nineteen findings were present in the anemic and three in the polycythemic twins, with a statistically significant ratio between the two groups (p-value = 0.01). Intrauterine MRI follow-up demonstrated the sequalae of hemorrhagic lesions. A complete regression of brain swelling, veins prominence and T2-WMHs was demonstrated after treatment. Postnatal imaging confirmed prenatal features. Conclusions: Our work demonstrates that TAPS-related MRI anomalies consisted in edematous/hemorrhagic lesions that occur mostly in anemic rather than in polycythemic twins. Fetoscopic laser surgery could have a potential decongestant role. Therefore, prenatal MRI may help in counselling and management in TAPS pregnancies, especially for the planning of therapy and the monitoring of its efficacy. [ABSTRACT FROM AUTHOR]

Purpose: To assess the efficacy of machine learning and radiomics analysis by computed tomography (CT) in presurgical setting, to predict RAS mutational status in colorectal liver metastases. Methods: Patient selection in a retrospective study was carried out from January 2018 to May 2021 considering the following inclusion criteria: patients subjected to surgical resection for liver metastases; proven pathological liver metastases; patients subjected to enhanced CT examination in the presurgical setting with a good quality of images; and RAS assessment as standard reference. A total of 851 radiomics features were extracted using the PyRadiomics Python package from the Slicer 3D image computing platform after slice-by-slice segmentation on CT portal phase by two expert radiologists of each individual liver metastasis performed first independently by the individual reader and then in consensus. Balancing technique was performed, and inter- and intraclass correlation coefficients were calculated to assess the between-observer and within-observer reproducibility of features. Receiver operating characteristics (ROC) analysis with the calculation of area under the ROC curve (AUC), sensitivity (SENS), specificity (SPEC), positive predictive value (PPV), negative predictive value (NPV) and accuracy (ACC) were assessed for each parameter. Linear and non-logistic regression model (LRM and NLRM) and different machine learning-based classifiers were considered. Moreover, features selection was performed before and after a normalized procedure using two different methods (3-sigma and z-score). Results: Seventy-seven liver metastases in 28 patients with a mean age of 60 years (range 40–80 years) were analyzed. The best predictors, at univariate analysis for both normalized procedures, were original_shape_Maximum2DDiameter and wavelet_HLL_glcm_InverseVariance that reached an accuracy of 80%, an AUC ≥ 0.75, a sensitivity ≥ 80% and a specificity ≥ 70% (p value < < 0.01). However, a multivariate analysis significantly increased the accuracy in RAS prediction when a linear regression model (LRM) was used. The best performance was obtained using a LRM combining linearly 12 robust features after a z-score normalization procedure: AUC of 0.953, accuracy 98%, sensitivity 96%, specificity of 100%, PPV 100% and NPV 96% (p value < < 0.01). No statistically significant increase was obtained considering the tested machine learning both without normalization and with normalization methods. Conclusions: Normalized approach in CT radiomics analysis allows to predict RAS mutational status in colorectal liver metastases patients. [ABSTRACT FROM AUTHOR]

Paper bookbindings have been disregarded for centuries by scholars since they were only considered temporary covering materials for manuscripts and books. Recently, there is a willingness to reconsider these bindings and to evaluate their role. Thanks to the collaboration with the Marciana National Library in Venice, which stores an impressive collection of 849 detached bindings, the current research provides a chemical-physical elucidation about the composition and the manufacture of paper bookbindings realized between the 16th and the eighteenth century in the Venetian area. A selection of bookbindings was analysed by the means of complementary methods (thickness measurements, Attenuated Total Reflection—Fourier-Transform Infrared Spectroscopy (ATR-FTIR), Pyrolysis–Gas Chromatography–Mass Spectrometry (Py-GC–MS) and X-Ray Fluorescence (XRF)). Data evidence the presence of cellulose as the main component of paper pulp; hemicellulose and lignin were identified too, probably related to the presence of linen/hemp rags in the paper production. Gelatine was detected muck likely related to paper sizing; among inorganic additives CaCO3 was found in all samples. The presence of waxy material may be due to past undocumented conservation treatments. [ABSTRACT FROM AUTHOR]

Aim of the present study was to conduct a comprehensive review of surgical strategies that can be offered to patients with trigeminal neuralgia undergoing microvascular decompression (MVD) surgery and without intraoperative evidence of neurovascular conflict, with a high pre-operative suspicion of conflict lacking intraoperative confirmation, or individuals experiencing recurrence after previous treatment. This systematic review followed established guidelines (PRISMA) to identify and critically appraise relevant studies. The review question was formulated according to the PICO (P: patients; I: intervention; C: comparison; O: outcomes) framework as follows. For patients with trigeminal neuralgia (P) undergoing MVD surgery (I) without demonstrable preoperative neurovascular conflict, high suspicion of conflict but no intraoperative confirmation or recurrence after previous treatment (C), do additional surgical techniques (nerve combing, neurapraxia, arachnoid lysis) (O) improve pain relief outcomes (O)? The search of the literature yielded a total of 221 results. Duplicate records were then removed (n = [76]). A total of 143 papers was screened, and 117 records were excluded via title and abstract screening; 26 studies were found to be relevant to our research question and were assessed for eligibility. Upon full-text review, 17 articles were included in the review, describing the following techniques; (1) internal neurolysis (n = 6) (2) arachnoid lysis/adhesiolysis (n = 2) (3) neurapraxia (n = 3) (4) partial rhizotomy of the sensory root (n = 4) (5) pontine descending tractotomy (n = 2). The risk of bias was assessed using the ROBINS-I (Risk of Bias in Non-randomized Studies - of Interventions) assessment tool. While the described techniques hold promise, further research is warranted to establish standardized protocols, refine surgical approaches, and comprehensively evaluate long-term outcomes. [ABSTRACT FROM AUTHOR]

The study of film-formation processes of oil paints has been extensively addressed over the last decade and the influence of metal ions in the drying and degradation stages of oil paints has been demonstrated. This research aimed to determine a suitable methodology for monitoring the early drying stages of selected commercial oil paint films and to gain an insight into the migration mechanisms of material degradation taking place between adjacent paint films, with special attention to the influence of the lead white. For this purpose, a hybrid approach was adopted to characterize the composition of the paint and highlight failure mechanisms in the paint films through a wide range of time. The methods included scribe tests, percentage weight variation (ΔW%), attenuated reflectance Fourier transform infrared spectrophotometry (ATR-FTIR), gas chromatography-mass spectrometry (GC-MS), and thermal analysis with differential scanning calorimetry (TG-DSC). The results show how metal ions interact with the oil binder and the pigment in the adjacent paint film: the transverse migration of lead white is shown to affect the reactivity of polyunsaturated triglycerides, increasing the rate of oxygen uptake and promoting the formation of radicals and bonds between polymer chains, depending on the pigment with which it interacts. [ABSTRACT FROM AUTHOR]

Cannabidiol (CBD) has gained significant attention as a complementary and alternative medicine due to its promising therapeutic properties. However, CBD faces obstacles when administered orally due to its poor solubility in water, leading to limited absorption into the bloodstream and low and variable bioavailability. Therefore, the development of innovative delivery approaches that can enhance CBD's bioavailability, facilitate administration, and promote patient adherence is crucial. We propose a new approach for buccal delivery of CBD based on a self-assembling nanoemulsion (NE) made of a mixture of surfactants (Tween 80 and Labrasol) and medium chain triglycerides (MCTs). The NE formulation showed properties suitable for buccal administration, including appropriate size, CBD content, and surface properties, and, if compared to a CBD-MCT solution, it exhibited better control of administered doses, faster dissolution in buccal medium, and enhanced stability. The CBD-NE effectively released its active load within 5 h, remained stable even when diluted in simulated buccal fluids, and could be easily administered through a commercially available spray, providing consistent and reproducible doses of NE with optimized properties. In vitro permeation studies demonstrated that the CBD-NE facilitated swift and consistent permeation through the buccal mucosa, resulting in a higher concentration in the acceptor compartment compared to CBD-MCT. Furthermore, the in vivo study in mice showed that a single buccal administration of CBD-NE led to a quicker onset of action than a CBD solution in MCT, while maintaining the same plasma levels over time and leading to typically higher plasma concentrations compared to those usually achieved through oral administration. In conclusion, our CBD-NE represents a promising alternative formulation strategy for buccal CBD administration, overcoming the challenges associated with conventional formulations such as variable bioavailability and low control of administered doses. [ABSTRACT FROM AUTHOR]

Research on happiness in preadolescence and adolescence has been limited regarding the sources of happiness. The present study aims to explore such sources in preadolescents and adolescents through a multi-method and multi-informant approach. Semi-structured interviews were conducted with 77 family triads: children (age range: 11–19; M = 13.90, SD = 2.70; 61% female), mothers (M = 47.50, SD = 4.35), and fathers (M = 50.53, SD = 5.30). The triads were asked to define happiness from children's perspective, describe what makes children happy, and indicate children's levels of happiness. Using quantitative data, preadolescents exhibited higher individual happiness levels than adolescents, and fathers reported higher levels of children's happiness than mothers. Through Thematic Analysis, five primary sources of happiness emerged: Social relationships, Family relationships, Personal interests, Achievement, and Entertainment. Social relationships was the most recurring theme across the narratives of both preadolescents/adolescents and parents. The second most recurring theme was Personal interests for preadolescents/adolescents and Family relationships for parents. Parents notably more frequently mentioned Achievement than children. Males displayed a higher propensity to report the Entertainment theme than females, while females reported the Family relationships and Social relationships themes more frequently. Preadolescents exhibited a higher occurrence of the Entertainment and Family relationships themes than adolescents. Regarding the concordance of themes between children and their parents, low overall levels of agreement were observed, all below 40%. The highest levels of concordance were found between mothers and fathers rather than between parents and children. The results could provide valuable insights to parents and educators on how to help youth promote their happiness. [ABSTRACT FROM AUTHOR]

Vestibular paroxysmia (VP) is a rare condition. The pathogenesis is linked to a neurovascular conflict (NVC) between an abnormal arterial loop and the VII/VIII cranial nerve complex in the cerebello-pontine angle. Due to its rarity, intraoperative findings are only anecdotally reported. Here we reported on a case of VP, showing the radiological images and the intraoperative surgical video of microvascular decompression (MVD). Further we discussed our findings considering the pertinent literature. We think that in case of VP the concordance between the side of tinnitus/hypoacusia and the side of NVC on magnetic resonance imaging should be always looked for before considering MVD as a therapeutic option. [ABSTRACT FROM AUTHOR]

In somatic tissue differentiation, chromatin accessibility changes govern priming and precursor commitment towards cellular fates1–3. Therefore, somatic mutations are likely to alter chromatin accessibility patterns, as they disrupt differentiation topologies leading to abnormal clonal outgrowth. However, defining the impact of somatic mutations on the epigenome in human samples is challenging due to admixed mutated and wild-type cells. Here, to chart how somatic mutations disrupt epigenetic landscapes in human clonal outgrowths, we developed genotyping of targeted loci with single-cell chromatin accessibility (GoT–ChA). This high-throughput platform links genotypes to chromatin accessibility at single-cell resolution across thousands of cells within a single assay. We applied GoT–ChA to CD34+ cells from patients with myeloproliferative neoplasms with JAK2V617F-mutated haematopoiesis. Differential accessibility analysis between wild-type and JAK2V617F-mutant progenitors revealed both cell-intrinsic and cell-state-specific shifts within mutant haematopoietic precursors, including cell-intrinsic pro-inflammatory signatures in haematopoietic stem cells, and a distinct profibrotic inflammatory chromatin landscape in megakaryocytic progenitors. Integration of mitochondrial genome profiling and cell-surface protein expression measurement allowed expansion of genotyping onto DOGMA-seq through imputation, enabling single-cell capture of genotypes, chromatin accessibility, RNA expression and cell-surface protein expression. Collectively, we show that the JAK2V617F mutation leads to epigenetic rewiring in a cell-intrinsic and cell type-specific manner, influencing inflammation states and differentiation trajectories. We envision that GoT–ChA will empower broad future investigations of the critical link between somatic mutations and epigenetic alterations across clonal populations in malignant and non-malignant contexts.The JAK2V617F mutation leads to epigenetic rewiring in a cell-intrinsic and cell-type-specific manner, influencing inflammation states and differentiation trajectories in patients with myeloproliferative neoplasms. [ABSTRACT FROM AUTHOR]

Aims/hypothesis: Type 1 diabetes is an autoimmune disorder that is characterised by destruction of pancreatic beta cells by autoreactive T lymphocytes. Although islet autoantibodies (AAb) are an indicator of disease progression, specific immune biomarkers that can be used as target molecules to halt development of type 1 diabetes have not been discovered. Soluble immune checkpoint molecules (sICM) play a pivotal role in counteracting excessive lymphocyte responses, but their role in type 1 diabetes is unexplored. In this longitudinal study, we measured sICM levels in AAb-positive (AAb+) children to identify molecules related to type 1 diabetes progression. Methods: We measured the levels of 14 sICM in the sera of AAb+ children (n=57) compared to those with recent-onset type 1 diabetes (n=79) and healthy children (n=44), obtained from two cohorts. AAb+ children were followed up and divided based on their progression to type 1 diabetes (AAbP) or not (AAbNP) (if they lost islet autoimmunity and did not develop disease in subsequent years). sICM were also measured in the sample taken at the visit closest to disease onset in AAbP children. Results: We found that AAb+ children had a distinct sICM profile compared with healthy children and those with recent-onset type 1 diabetes. In addition, AAb+ children who progressed to type 1 diabetes (AAbP) had higher sICM concentrations than non-progressors (AAbNP). Further, sICM levels decreased in AAbP children close to disease onset. Application of Cox regression models highlighted that high concentrations of soluble programmed cell death protein 1 (sPD-1) are associated with type 1 diabetes progression (HR 1.71; 95% CI 1.16, 2.51; p=0.007). Conclusions/interpretation: This study reveals an sICM profile that is dysregulated during the preclinical stage of type 1 diabetes, and identifies sPD-1 as a pathophysiologically-relevant molecule that is associated with disease progression, offering a potential target for early interventions in autoimmune diabetes. [ABSTRACT FROM AUTHOR]

Background and purpose: While HCC is an inflammation-associated cancer, CRLM develops on permissive healthy liver microenvironment. To evaluate the immune aspects of these two different environments, peripheral blood-(PB), peritumoral-(PT) and tumoral tissues-(TT) from HCC and CRLM patients were evaluated. Methods: 40 HCC and 34 CRLM were enrolled and freshly TT, PT and PB were collected at the surgery. PB-, PT- and TT-derived CD4+CD25+ Tregs, M/PMN-MDSC and PB-derived CD4+CD25− T-effector cells (Teffs) were isolated and characterized. Tregs' function was also evaluated in the presence of the CXCR4 inhibitor, peptide-R29, AMD3100 or anti-PD1. RNA was extracted from PB/PT/TT tissues and tested for FOXP3, CXCL12, CXCR4, CCL5, IL-15, CXCL5, Arg-1, N-cad, Vim, CXCL8, TGFβ and VEGF-A expression. Results: In HCC/CRLM-PB, higher number of functional Tregs, CD4+CD25hiFOXP3+ was detected, although PB-HCC Tregs exert a more suppressive function as compared to CRLM Tregs. In HCC/CRLM-TT, Tregs were highly represented with activated/ENTPD-1+Tregs prevalent in HCC. As compared to CRLM, HCC overexpressed CXCR4 and N-cadherin/vimentin in a contest rich in arginase and CCL5. Monocytic MDSCs were highly represented in HCC/CRLM, while high polymorphonuclear MDSCs were detected only in HCC. Interestingly, the function of CXCR4-PB-Tregs was impaired in HCC/CRLM by the CXCR4 inhibitor R29. Conclusion: In HCC and CRLM, peripheral blood, peritumoral and tumoral tissues Tregs are highly represented and functional. Nevertheless, HCC displays a more immunosuppressive TME due to Tregs, MDSCs, intrinsic tumor features (CXCR4, CCL5, arginase) and the contest in which it develops. As CXCR4 is overexpressed in HCC/CRLM tumor/TME cells, CXCR4 inhibitors may be considered for double hit therapy in liver cancer patients. [ABSTRACT FROM AUTHOR]

Research interest in children’s happiness has increasingly grown in recent years. Studies of children’s happiness have shown that happiness promotes greater social and emotional well-being during childhood. The present study explores the different perspectives of children and their parents on happy moments spent together, examining potential discrepancies in points of view. Semi-structured interviews were conducted with 154 children (6–13 years old: Mage=8.72, SD = 2.00; 57% girls), their mothers (Mage=42.30, SD = 4.50), and their fathers (Mage=45.47, SD = 5.42). Children were asked to indicate their level of happiness using a single item and to recount their happy moments spent with their fathers and mothers. Parents were asked to evaluate their children’s happiness and to identify what they thought was the happiest moment their children had experienced with them. The data was analyzed using Thematic Analysis. Six main themes related to children’s happy moments emerged from the transcripts: (1) Activities outside the home; (2) Shared activities between parents and children; (3) Happy moments of play between parents and children; (4) Parent-child moments of affection; (5) Relevance of material gifts; (6) Non-specified happy moments. Emotional interactions characterized the happiest moments reported with mothers, while those with fathers were more frequently playful and fun situations. Results showed that parents and children disagree on children’s happiness levels and tend to identify different episodes as the happiest moments spent together. The study examined parent-child interactions in the context of family happiness, considering the protective role of a child’s happiness against negative psychological symptoms. It aimed to identify components of happier moments as potential indicators of family well-being, given the family’s role in psychological development. [ABSTRACT FROM AUTHOR]

Inefficient knock-in of transgene cargos limits the potential of cell-based medicines. In this study, we used a CRISPR nuclease that targets a site within an exon of an essential gene and designed a cargo template so that correct knock-in would retain essential gene function while also integrating the transgene(s) of interest. Cells with non-productive insertions and deletions would undergo negative selection. This technology, called SLEEK (SeLection by Essential-gene Exon Knock-in), achieved knock-in efficiencies of more than 90% in clinically relevant cell types without impacting long-term viability or expansion. SLEEK knock-in rates in T cells are more efficient than state-of-the-art TRAC knock-in with AAV6 and surpass more than 90% efficiency even with non-viral DNA cargos. As a clinical application, natural killer cells generated from induced pluripotent stem cells containing SLEEK knock-in of CD16 and mbIL-15 show substantially improved tumor killing and persistence in vivo. Transgene knock-ins into housekeeping genes lead to high efficiency of cell selection. [ABSTRACT FROM AUTHOR]

Purpose: To assess the efficacy of radiomics features, obtained by magnetic resonance imaging (MRI) with hepatospecific contrast agent, in pre-surgical setting, to predict RAS mutational status in liver metastases. Methods: Patients with MRI in pre-surgical setting were enrolled in a retrospective study. Manual segmentation was made by means 3D Slicer image computing, and 851 radiomics features were extracted as median values using the PyRadiomics Python package. The features were extracted considering the agreement with the Imaging Biomarker Standardization Initiative (IBSI). Balancing was performed through synthesis of samples for the underrepresented classes using the self-adaptive synthetic oversampling (SASYNO) approach. Inter- and intraclass correlation coefficients (ICC) were calculated to assess the between-observer and within-observer reproducibility of all radiomics characteristics. For continuous variables, nonparametric Wilcoxon–Mann–Whitney test was utilized. Benjamini and Hochberg's false discovery rate (FDR) adjustment for multiple testing was used. Receiver operating characteristics (ROC) analysis with the calculation of area under the ROC curve (AUC), sensitivity (SENS), specificity (SPEC), positive predictive value (PPV), negative predictive value (NPV) and accuracy (ACC) were assessed for each parameter. Linear and non-logistic regression model (LRM and NLRM) and different machine learning-based classifiers including decision tree (DT), k-nearest neighbor (KNN) and support vector machine (SVM) were considered. Moreover, features selection were performed before and after a normalized procedure using two different methods (3-sigma and z-score). McNemar test was used to assess differences statistically significant between dichotomic tables. All statistical procedures were done using MATLAB R2021b Statistics and Machine Toolbox (MathWorks, Natick, MA, USA). Results: Seven normalized radiomics features, extracted from arterial phase, 11 normalized radiomics features, from portal phase, 12 normalized radiomics features from hepatobiliary phase and 12 normalized features from T2-W SPACE sequence were robust predictors of RAS mutational status. The multivariate analysis increased significantly the accuracy in RAS prediction when a LRM was used, combining 12 robust normalized features extracted by VIBE hepatobiliary phase reaching an accuracy of 99%, a sensitivity 97%, a specificity of 100%, a PPV of 100% and a NPV of 98%. No statistically significant increase was obtained, considering the tested classifiers DT, KNN and SVM, both without normalization and with normalization methods. Conclusions: Normalized approach in MRI radiomics analysis allows to predict RAS mutational status. [ABSTRACT FROM AUTHOR]

The mergers of binary compact objects such as neutron stars and black holes are of central interest to several areas of astrophysics, including as the progenitors of gamma-ray bursts (GRBs)1, sources of high-frequency gravitational waves (GWs)2 and likely production sites for heavy-element nucleosynthesis by means of rapid neutron capture (the r-process)3. Here we present observations of the exceptionally bright GRB 230307A. We show that GRB 230307A belongs to the class of long-duration GRBs associated with compact object mergers4–6 and contains a kilonova similar to AT2017gfo, associated with the GW merger GW170817 (refs. 7–12). We obtained James Webb Space Telescope (JWST) mid-infrared imaging and spectroscopy 29 and 61 days after the burst. The spectroscopy shows an emission line at 2.15 microns, which we interpret as tellurium (atomic mass A = 130) and a very red source, emitting most of its light in the mid-infrared owing to the production of lanthanides. These observations demonstrate that nucleosynthesis in GRBs can create r-process elements across a broad atomic mass range and play a central role in heavy-element nucleosynthesis across the Universe.Observations from the JWST of the second brightest GRB ever detected, GRB 230307A, indicate that it belongs to the class of long-duration GRBs resulting from compact object mergers, with the decay of lanthanides powering the longlasting optical and infrared emission. [ABSTRACT FROM AUTHOR]

Background: Bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) is standard of care for Parkinson's disease (PD) patients and a correct lead placement is crucial to obtain good clinical outcomes. Evidence demonstrating the targeting accuracy of the frameless technique for DBS, along with the advantages for patients and clinicians, is solid, while data reporting long-term clinical outcomes for PD patients are still lacking. Objectives: The study aims to assess the clinical safety and efficacy of frameless bilateral STN-DBS in PD patients at 5 years from surgery. Methods: Consecutive PD patients undergoing bilateral STN-DBS with a frameless system were included in this single-center retrospective study. Clinical features, including the Unified Parkinson's Disease Rating Scale (UPDRS) in its total motor score and axial sub-scores, and pharmacological regimen were assessed at baseline, 1 year, 3 years, and 5 years after surgery. The adverse events related to the procedure, stimulation, or the presence of the hardware were systematically collected. Results: Forty-one PD patients undergone bilateral STN-DBS implantation were included in the study and fifteen patients already completed the 5-year observation. No complications occurred during surgery and the perioperative phase, and no unexpected serious adverse event occurred during the entire follow-up period. At 5 years from surgery, there was a sustained motor efficacy of STN stimulation: STN-DBS significantly improved the off-stim UPDRS III score at 5 years by 37.6% (P < 0.001), while the dopaminergic medications remained significantly reduced compared to baseline (− 21.6% versus baseline LEDD; P = 0.036). Conclusions: Our data support the use of the frameless system for STN-DBS in PD patients, as a safe and well-tolerated technique, with long-term clinical benefits and persistent motor efficacy at 5 years from the surgery. [ABSTRACT FROM AUTHOR]

Understanding the response of plants to varied gravitational conditions is vital for developing effective food production in space bioregenerative life support systems. This study examines the impact of altered gravity conditions on the growth and morphological responses of Wolffia globosa (commonly known as "water lentils" or "duckweed"), assessing its potential as a space crop. Although an experiment testing the effect of simulated microgravity on Wolffia globosa has been previously conducted, for the first time, we investigated the effect of multiple gravity levels on the growth and morphological traits of Wolffia globosa plants. The plant responses to simulated microgravity, simulated partial gravity (Moon), and hypergravity environments were evaluated using random positioning machines and the large-diameter centrifuge. As hypothesized, we observed a slight reaction to different gravitational levels in the growth and morphological traits of Wolffia globosa. The relative growth rates (RGR) of plants subjected to simulated microgravity and partial gravity were reduced when compared to those in other gravity levels. The morphological analysis revealed differences in plant dimensions and frond length-to-width ratios under diverse gravity conditions. Our findings showed that Wolffia globosa is responsive to gravitational changes, with its growth and morphological adaptations being slightly influenced by varying gravitational environments. As for other crop species, growth was reduced by the microgravity conditions; however, RGR remained substantial at 0.33 a day. In conclusion, this study underscores the potential of Wolffia globosa as a space crop and its adaptability to diverse gravitational conditions, contributing to the development of sustainable food production and bioregenerative life support systems for future space exploration missions. [ABSTRACT FROM AUTHOR]

Problematic soils, such as expansive clay-rich soils, need geological and geotechnical assessments before commencing any construction project. The mineralogical composition of the soil plays a crucial role in determining its physical and chemical behavior, ultimately affecting its stability and susceptibility to erosion. This study analyzed the variability of chemical, mineralogical, and morphological attributes of five soils of the Guabirotuba formation. Samples in different areas of Curitiba and the metropolitan region were collected. Chemical composition by X-ray fluorescence spectrometry (XRF), mineralogical composition by X-ray diffraction (XRD), and microstructure by scanning electron microscopy (SEM) were determined. The results showed that the five soils have a similar chemical composition, with silicon dioxide and aluminum oxide being the main constituents. The mineralogical composition varied in all analyzed soils. However, they belong to the same geological formation, and certain conditions, such as weathering, pressure, cation exchange, and climate, may differ in their mineralogy. Four of the five soils analyzed showed low expansion capacity due to kaolinite, characterized by low swelling potential and water adsorption capacity. On the other hand, one of the soils presented expansive potential because it did not have the presence of kaolinite in its mineralogical composition. Finally, the variability of soil characteristics changes from one place to another. Although they have similar chemical compositions, the cation exchange and mineralogical composition contribute to the development of several behaviors that can be useful for decision-making about the destination of said soil. [ABSTRACT FROM AUTHOR]

Over time, fetal MR neuro-imaging has undergone continuous improvement; presently, it plays a pivotal role in the diagnosis of an expanding array of complex neurological conditions. Within this pictorial essay, our focus will be exclusively directed towards those cutting-edge clinical applications, which currently yield valuable diagnostic insights on a single case basis. Specifically, the pictorial examples will center on some abnormal entities and their features at an earlier fetal stage. [ABSTRACT FROM AUTHOR]

Environmental pollution in considered an established determinant of non-communicable illness, including cardiovascular diseases (CVDs). Air pollution is the result of a complex combination of chemical, physical, and biological agents, and represents one of the main causes of mortality and morbidity in the world population. It is responsible for 7.6% of global mortality. In this regard, it has been documented that it increases the risk of CVDs and major adverse cardiovascular and cerebrovascular events. In northern regions of China, long-term exposures to the particulate matter < 2.5 µm (PM2.5) increase in the risk of ischemic heart disease by almost two-folds. Similarly, the additional risk for stroke, increases by almost 10% for long-term exposure to PM2.5. The detrimental effects of air pollution on cardiovascular system are particularly manifest in vulnerable subjects, such as the elderly, patients with heart disease, and obese individuals. Therefore, nowadays, cardiovascular prevention strategies, in addition to controlling traditional risk factors, should also include measures to improve the environment. This goal can be achieved by the implementation of the health surveillance in occupational medicine and by the extensive application of the national and international legislative measures. In fact, the health surveillance represents a crucial preventive measure for workers exposed to health risks (chemical, physical agents, etc.) that may lead to occupational diseases after long-term exposure. On the other hand, since environmental pollution does not recognize well-defined boundaries, only the implementation of regulations among large territorial areas can be useful to improve the quality of environment. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was the evaluation radiomics analysis efficacy performed using computed tomography (CT) and magnetic resonance imaging in the prediction of colorectal liver metastases patterns linked to patient prognosis: tumor growth front; grade; tumor budding; mucinous type. Moreover, the prediction of liver recurrence was also evaluated. Methods: The retrospective study included an internal and validation dataset; the first was composed by 119 liver metastases from 49 patients while the second consisted to 28 patients with single lesion. Radiomic features were extracted using PyRadiomics. Univariate and multivariate approaches including machine learning algorithms were employed. Results: The best predictor to identify tumor growth was the Wavelet_HLH_glcm_MaximumProbability with an accuracy of 84% and to detect recurrence the best predictor was wavelet_HLH_ngtdm_Complexity with an accuracy of 90%, both extracted by T1-weigthed arterial phase sequence. The best predictor to detect tumor budding was the wavelet_LLH_glcm_Imc1 with an accuracy of 88% and to identify mucinous type was wavelet_LLH_glcm_JointEntropy with an accuracy of 92%, both calculated on T2-weigthed sequence. An increase statistically significant of accuracy (90%) was obtained using a linear weighted combination of 15 predictors extracted by T2-weigthed images to detect tumor front growth. An increase statistically significant of accuracy at 93% was obtained using a linear weighted combination of 11 predictors by the T1-weigthed arterial phase sequence to classify tumor budding. An increase statistically significant of accuracy at 97% was obtained using a linear weighted combination of 16 predictors extracted on CT to detect recurrence. An increase statistically significant of accuracy was obtained in the tumor budding identification considering a K-nearest neighbors and the 11 significant features extracted T1-weigthed arterial phase sequence. Conclusions: The results confirmed the Radiomics capacity to recognize clinical and histopathological prognostic features that should influence the choice of treatments in colorectal liver metastases patients to obtain a more personalized therapy. [ABSTRACT FROM AUTHOR]

Ankle arthrodesis is commonly performed to treat end-stage ankle osteoarthritis. The aim of this study was to determine whether the use of fibular autograft might increase the fusion rate and decrease the complication rate in ankle arthrodesis (AA) fixed using cannulated screws. To perform this PRISMA-compliant proportional meta-analysis, multiple databases were searched for studies in which patients undergone AA (using exclusively cannulated screws and augmented with fibular bone graft) were followed. The characteristics of the cohort, the study design, surgical details, the nonunion and complication rate at the longest follow-up were extracted and recorded. The modified Coleman Methodology Score (mCMS) was applied to appraise the quality of studies. Two groups were built: arthrodeses fixed with screws combined with cancellous autograft (G1) and arthrodeses fixed with screws combined with cancellous autograft and augmented with a lateral fibular onlay (G2). A third group (arthrodeses fixed with screws and no graft, G3) was extracted from previous literature for a further comparison. Overall, we included 306 ankles (296 patients) from ten series (ten studies). In G1 and G2 there were 118 ankles (111 patients) and 188 ankles (185 patients), respectively. In patients where cancellous autograft was used, a further augmentation with a fibular lateral strut autograft did not change significantly the nonunion (4% [95% CI 1–9] in G1 vs. 2% [95% CI 0–5) in G2, p = 0.99) nor the complication rate (18% [95% CI 0–36] in G1 vs. 13% [95% CI 6–21) in G2, p = 0.71). Upon comparison with 667 ankles (659 patients, G3) in which arthrodeses had been performed without grafting, the nonunion and complication rates did not differ significantly either (pooled estimates: 3% [95% CI 1–3) in G1 + G2 vs. 3% [95% CI 2–4] in G3, p = 0.73 for nonunion; 15% [8–23] in G1 + G2 vs. 13% [95% CI 9–17] in G3, p = 0.93 for complications). In ankle arthrodesis fixed with cannulated screws combined with cancellous autograft at the fusion site, a construct augmentation with a distal fibular onlay strut graft positioned laterally at the ankle joint does not reduce the risk of nonunion or complication. In general, the use of bone graft does not influence significantly the nonunion nor the complication rate as compared to non-grafted screw-fixed ankle arthrodeses.Kindly check and confirm the corresponding author mail id is correctly identified.It's all correct [ABSTRACT FROM AUTHOR]

High blood pressure is the leading cause of death and disability globally and an important treatable risk factor for cardiovascular, cerebrovascular and chronic kidney diseases. Digital technology, including mobile health solutions and digital therapy, is expanding rapidly in clinical medicine and has the potential to improve the quality of care and effectiveness of drug treatment by making medical interventions timely, tailored to hypertensive patients' needs and by improving treatment adherence. Thus, the systematic application of digital technologies could support diagnosis and awareness of hypertension and its complications, ultimately leading to improved BP control at the population level. The progressive implementation of digital medicine in the national health systems must be accompanied by the supervision and guidance of health authorities and scientific societies to ensure the correct use of these new technologies with consequent maximization of the potential benefits. The role of scientific societies in relation to the rapid adoption of digital technologies, therefore, should encompass the entire spectrum of activities pertaining to their institutional role: information, training, promotion of research, scientific collaboration and advice, evaluation and validation of technological tools, and collaboration with regulatory and health authorities. [ABSTRACT FROM AUTHOR]

Anal diseases are very common and, in most of the cases, require surgery of minor or medium complexity, and, therefore, are among the most accessible diseases for surgeons in training. Aim of this study is to investigate the status of the training in proctology in Italy. A 31-items questionnaire was administered to residents and young specialists (≤ 2 years) in general surgery, using mailing lists, and the social media accounts of the Italian Society of Colorectal Surgery. Answers from 338 respondents (53.8% males) were included in the final analysis. Overall, 252 respondents (74.5%) were residents and 86 (25.5%) young specialists. Two hundred and fifty-five (75.4%) respondents practiced proctology for the first time early on during their postgraduate training, but only 19.5% did it continuously for ≥ 24 months. Almost all respondents (334; 98.8%) had the chance to participate in proctological procedures, 205 (60.5%) as first surgeon. This percentage decreases according to the complexity of the surgery. In fact, only 11 (3.3%) and 24 (7.1%) of the respondents were allowed to be the first surgeon in more complex proctological diseases such as surgery for rectal prolapse and fecal incontinence. The present survey suggests that, in Italy, most surgeons in training deal with anal diseases. However, only few of them could achieve sufficient professional skills in the management of proctological diseases to be able to practice autonomously as young specialists. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 epidemic and its lockdown dramatically impacted the general well-being of the population and affected sociosexual experiences, thus modifying sexual behavior, desire, and well-being. Clustering analysis has not yet been applied to research and data investigating sociosexuality. The cluster analysis method could be a valid support for clinicians in investigating the condition of a population with respect to problems related to sociosexuality. The aim of the present study was to analyze the different perceptions of the sociosexual experiences in southern population during the COVID-19 pandemic. Methods: We enrolled 734 (450 female) participants with a carried out anonymous web-based survey from the 16th of April 2020 to the 3rd June of 2020. The revised Sociosexual Orientation Inventory (SOI-R) is a self-report test assessing three theoretically meaningful facets of sociosexual orientation (behavior, attitude, and desire). Results: We found eleven clusters, and the findings showed, for the first time, an intra- and inter-diagnostic heterogeneity in the sexual profile of participants. Theoretically, we identified subtype clusters whose sexual attitude was to avoid sexual promiscuity with significant gender differences. Women show a greater propensity for attitude and desire facet than men. Conclusions: Our new method of unsupervised learning could represent a reliable tool to support socio-cultural analysis studies on issues influenced by cultural mechanisms in a quick and explanatory way, as in the case of sexual orientation and attitude differences between men and women. Social and Policy Implications: Understanding these gaps is fundamental for policy makers, managers of social networks, those who deal with engaged couples and families, and sexuality starting from the very youngest adolescents. We claim to devise a strategy to measure how much a sexist culture implicitly and explicitly limits the freedom of sexual expression and how this can affect psycho-sexual well-being in a society. [ABSTRACT FROM AUTHOR]

Construction and demolition wastes (CDW) are a concern in urban areas, in addition, it is well understood that soft soils are inappropriate for paving designs. Therefore, this paper presents an alternative solution combining CDW and a soft silty soil, aiming to overcome the soft soil drawbacks by repeated loadings. For this purpose, a laboratory study was developed, comprising both resilient modulus (MR) and unconfined compressive strength (UCS) tests over soil and soil-CDW compacted blends, to evaluate the mechanical properties of the proposed stabilization. Also, three compaction efforts (standard, intermediate, and modified) and a curing time of up to 90 days were used. The UCS of blends was also measured with the identical specimens with which the resilience tests were carried out. The results indicated that incorporating CDW (size sand and gravel materials) into the soil improves the qu and MR for all compaction energies, and the Resilient Modulus test affects the UCS of all blends, increasing its effect with the decrease in compaction effort. Repeated loads caused a decrease in the specimen's voids whereby the density increased and, therefore, qu. Finally, the results conclude that the compacted mixtures in the intermediate effort and 40–60% CDW by weight are potentially applicable in pavements compared to the traditional soil–cement base/subbase. [ABSTRACT FROM AUTHOR]

Advancements in plant space biology are required for the realization of human space exploration missions, where the re-supply of resources from Earth is not feasible. Until a few decades ago, space life science was focused on the impact of the space environment on the human body. More recently, the interest in plant space biology has increased because plants are key organisms in Bioregenerative Life Support Systems (BLSS) for the regeneration of resources and fresh food production. Moreover, plants play an important role in psychological support for astronauts. The definition of cultivation requirements for the design, realization, and successful operation of BLSS must consider the effects of space factors on plants. Altered gravitational fields and radiation exposure are the main space factors inducing changes in gene expression, cell proliferation and differentiation, signalling and physiological processes with possible consequences on tissue organization and organogenesis, thus on the whole plant functioning. Interestingly, the changes at the cellular and molecular levels do not always result in organismic or developmental changes. This apparent paradox is a current research challenge. In this paper, the main findings of gravity- and radiation-related research on higher plants are summarized, highlighting the knowledge gaps that are still necessary to fill. Existing experimental facilities to simulate the effect of space factors, as well as requirements for future facilities for possible experiments to achieve fundamental biology goals are considered. Finally, the need for making synergies among disciplines and for establishing global standard operating procedures for analyses and data collection in space experiments is highlighted. [ABSTRACT FROM AUTHOR]