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Computer-mediated communication (CMC) via Facebook as social media could support a relaxed and non-threatening learning atmosphere, augmenting EFL learners' engagement through increasing social interaction. To maximize the potential of CMC for English language learning outside of classroom activities, an understanding of communication flow through the lens of Social Presence indicators using Facebook group chats is needed to measure such indicators among EFL learners with a limited access to the real-life use of English. This can help enhance the quality of learning through rich interaction and increased engagement among them. The purpose of this paper was to identify Social Presence indicators used by these EFL learners in their Facebook group chats. The data were collected for eight weeks from 52 Thai undergraduate students taking an English for Conversation course in a Thai university. Using the Social Presence categories by Rourke et al. (1999) and Swan and Shih (2005), quantitative coding was used to analyze the exchanged Facebook group text messages. The results showed that the Interactive Category garnered the highest percentage compared to the Affective and Cohesive Category, suggesting that CMC with Facebook group chats engendered relationship building and sustainability among Thai EFL learners with CMC community members. Pedagogical implications are discussed on the significance of Social Presence for developing an effective CMC environment on Facebook among EFL learners.

Background: Development of secondary esophageal cancer after hematopoietic stem cell transplantation has been described; however, there is little consensus on treatment and surveillance for these patients. The objective of this study was to describe our experience treating patients with secondary esophageal cancer. Methods: A retrospective chart review of prospectively collected data was performed to identify patients who underwent hematopoietic stem cell transplantation from 1997 to 2012 and in whom esophageal cancer developed later. Results: A total of 5066 patients underwent hematopoietic stem cell transplantation, and esophageal cancer developed in 11 (0.2%) of these patients. The median time to diagnosis of esophageal cancer after hematopoietic stem cell transplantation was 11 years (interquartile range, 8.5 to 14 years). Four patients received a diagnosis of stage III or IV disease. Seven patients underwent esophagectomy, 6 patients after neoadjuvant treatment. Three patients experienced adverse events postoperatively, all grades II and IIIa. Two surgical patients died of distant recurrence 2 years and 3 years, respectively, after their esophageal cancer diagnosis. The other 5 surgical patients have not experienced recurrence of their esophageal cancer. Conclusions: For patients with secondary esophageal cancer, esophagectomy after neoadjuvant treatment has acceptable morbidity and may be a viable option for this cohort.

ObjectiveThe Philippines experienced one of the longest restriction periods during the COVID-19 pandemic. This study aimed to provide a developmental profile of 18–25 month-old children and identify factors associated with their development during their early years being born and raised during the pandemic.MethodsThe study population was recruited through convenience sampling among families living in proximity to the daycare centers in Cainta, Rizal, Philippines. 116 children qualified to participate and underwent developmental screening using the Early Childhood Care and Development (ECCD) Checklist and their parents were interviewed related to demographic and social factors.ResultsThe mean score of the children’s Overall Development is 106.47 (SD = 13.43) indicating that children’s skills were within the expected range of 80–119. Girls had significantly higher mean scores compared to boys [MGirl = 111.23, SDGirl = 9.95 vs. MBoy = 101.18, SDBoy = 14.83 t(114) = −4.32 p

The introduction of CFTR modulator drugs like elexacaftor-tezacaftor-ivacaftor (ETI) has transformed the management of cystic fibrosis (CF), significantly improving symptoms, lung function, and quality of life, while reducing reliance on intravenous antibiotics. However, respiratory exacerbations in the CFTR modulators era remain poorly understood from both pathophysiological and clinical perspectives.We present the case of a 20-year-old Caucasian woman with CF (F508del/L1077P) who, after three years of ETI treatment, experienced a severe episode of hemoptysis, despite being almost asymptomatic in the weeks leading up to admission, requiring bronchial artery embolization. Following ETI treatment, auscultatory findings and FEV1 changes may be less significant, making the detection of respiratory exacerbation more challenging. This highlights the need for heightened vigilance in managing such cases and underscores the challenge of diagnosing and managing exacerbations in the era of modulators. Long term real-world studies are essential to comprehend the evolving course of the disease during ETI treatment.

Wringinsongo Village, Tumpang Subdistrict, Malang Regency maintains a clean environment through environmentally friendly waste management. One of Wringinsongo's BUMDes (Village-Owned Enterprises) is the Waste Bank, which uses waste as a potential sector. It needs to get special attention related to its governance because the recording is still less effective and there are often calculation errors caused by the recording system using paper. Based on these conditions, it is necessary to develop an application to help record transaction activities at the Waste Bank. The Wringinsongo Village Waste Bank application can be accessed on both the web platform and Android mobile devices, based on the ease of access to the system by village managers and officials. After developing the application, socialization, and training were conducted to the Waste Bank manager and village officials to provide information on how to use the application. After three months of use, feedback was taken to get responses related to the use of the application. The result is that BUMDes managers find it easy to record and obtain accurate and faster calculation results.

Introduction: Gynecological malignancies are one of the most common cancers in women. Morbidity, in this case, can occur in patients with advanced cancer, and one of the causes is hydronephrosis. In the development of this case, a double-J stent (DJS) is usually used to treat urinary diversion. This research aimed to analyze the comparison of hydronephrosis patients from gynecologic oncology treated with DJS and without DJS. Methods: Retrospective research was conducted by reviewing 115 medical record data. Patients with hydronephrosis related to gynecologic oncology at a referral hospital in Surabaya, Indonesia, from January to August 2023 were included in this study. Data were analyzed using the Chi-square test for categorical data. For numerical data, they were analyzed using the Mann–Whitney test. Results: Cervical cancer was found in almost half of the total patients. Most patients undergo a DJS procedure. Nearly half of the patients experienced moderate category hydronephrosis before treatment and mild category after treatment. More than half of patients experience hydronephrosis on one side. The statistical test results of patients who underwent DJS installation and those who were not installed with DJS regarding the length of treatment (length of stay), prediversion creatinine, postdiversion creatinine, cancer stage, side of hydronephrosis, and length of operation showed P < 0.05. Conclusions: The use of urinary diversion in cases of gynecological malignancies can support the management of hydronephrosis in gynecological cancer patients. There are differences between patients who undergo DJS installation and those who do not undergo DJS installation, which show specific indications.

Abstract Introduction COXPD23 is a rare mitochondrial disease caused by biallelic pathogenic variants in GTPBP3. We report on two siblings with a mild phenotype. Case reports The young boy presented with global developmental delay, ataxic gait and upper limbs tremor, and the older sister with absence seizures and hypertrophic cardiomyopathy. Respiratory chain impairment was confirmed in muscle. Discussion Reviewed cases point toward clustering around two prevalent phenotypes: an early‐onset presentation with severe fatal encephalopathy and a late milder presentation with global developmental delay/ID and cardiopathy, with the latter as, is the main feature. Our patients showed an intermediate phenotype with intrafamilial variability.

Diabetes mellitus (DM) is one of the most prevalent cardiovascular risk factors in the general population, being associated with high morbidity and socioeconomic burden. Diabetic cardiomyopathy (DCM) is a non-negligible complication of DM, whose pathophysiological fundaments are the altered cardiac metabolism, the hyperglycemia-triggered formation of advanced glycation end-products (AGEs) and the inflammatory milieu which are typical in diabetic patients. These metabolic abnormalities lead to cardiomyocytes apoptosis, interstitial fibrosis and mechanical cardiac dysfunction, which can be identified with non-invasive imaging techniques, like echocardiography and cardiac magnetic resonance. This review aims to: 1) describe the major imaging features of DCM; 2) highlight how early identification of DCM-related anatomical and functional remodeling might allow patients’ therapy optimization and prognosis improvement.

BackgroundMitochondria adjust their shape in response to the different energetic and metabolic requirements of the cell, through extremely dynamic fusion and fission events. Several highly conserved dynamin-like GTPases are involved in these processes and, among those, the OPA1 protein is a key player in the fusion of inner mitochondrial membranes. Hundreds of monoallelic or biallelic pathogenic gene variants have been described in OPA1, all associated with a plethora of clinical phenotypes without a straightforward genotype-phenotype correlation.MethodsHere we report two patients harboring novel de novo variants in OPA1. DNA of two patients was analyzed using NGS technology and the pathogenicity has been evaluated through biochemical and morphological studies in patient’s derived fibroblasts and in yeast model.ResultsThe two patients here reported manifest with neurological signs resembling Leigh syndrome, thus further expanding the clinical spectrum associated with variants in OPA1. In cultured skin fibroblasts we observed a reduced amount of mitochondrial DNA (mtDNA) and altered mitochondrial network characterized by more fragmented mitochondria. Modeling in yeast allowed to define the deleterious mechanism and the pathogenicity of the identified gene mutations.ConclusionWe have described two novel-single OPA1 mutations in two patients characterized by early-onset neurological signs, never documented, thus expanding the clinical spectrum of this complex syndrome. Moreover, both yeast model and patients derived fibroblasts showed mitochondrial defects, including decreased mtDNA maintenance, correlating with patients’ clinical phenotypes.

La lettura di questo caso clinico ha stimolato molto il nostro gruppo formato da psicologhe e psicoterapeute ad orientamento sistemico: esistiamo come tali all’interno di un gruppo di psicoterapeute più ampio con orientamenti diversi, del consultorio diffuso dell’Associazione ‘Progetto SUM’ nella sede di Torino. Nella nostra formazione dedichiamo diverse risorse per apprendere a collaborare in contesti co-terapici e d’equipe. Il nostro contributo teorico e pratico sarà guidato dall’attenzione alla complessità del sistema, al paziente designato fino ad arrivare alle emozioni del terapeuta, strumento indispensabile per la buona riuscita di un percorso terapeutico. Il nostro modello di riferimento si basa su un approccio di osservazione dell’individuo nei diversi sottosistemi di cui lo stesso è parte, in primis la famiglia. Quest’ultima è in continua trasformazione e governata da regole che evolvono nel tempo in interazione con l’ambiente circostante. I terapeuti quando incontrano i pazienti nella stanza di terapia diventano parte del sistema, generandone uno più complesso e ampio, indispensabile nel processo di cura.[...]

Background Mitral regurgitation (MR) is frequent in patients with aortic stenosis (AS). Although primary MR is an established negative prognostic factor, whether different mechanisms of MR have different effects on outcome is currently unknown. The aim of this study was to evaluate the impact of the MR mechanism in patients undergoing transcatheter aortic valve replacement (TAVR). Methods and Results This is a retrospective observational study of patients who underwent TAVR for severe aortic stenosis in a high‐volume tertiary care center. Echocardiographic comprehensive MR assessment was performed at baseline and within 3 months post TAVR. The study population was divided into 4 groups according to MR mechanism: Group I: fibro‐calcific leaflet degeneration; Group II: prolapse/flail; Group III: ventricular secondary MR (functional MR); and Group IV: atrial functional MR. The study end point was a combination of death from cardiovascular cause and heart failure–related hospitalization. The study population included 427 patients (mean age 81.7±6.5 years; 71% primary MR; 62% ≥moderate MR). At 3‐year follow‐up, survival free from the composite end point significantly differs according to MR mechanism: it was higher in group IV (atrial functional MR, 96.6%) compared with group I (80.4%, P=0.002) and group II patients (60.7%, P=0.001), and group III (84.8%, P=0.037); patients with MR due to leaflet prolapse showed poorer prognosis compared with patients with functional MR (group III, P=0.023 and group IV, P=0.001) and with group I (P=0.040). Overall, severe MR after TAVR identified patients with poorer prognosis and was significantly more frequent in group II (46.4%, P=0.001). Conclusions In patients undergoing TAVR, preprocedural identification of MR mechanism and mechanism provides prognostic insights.

Abstract Cigarette smoking is a major preventable cause of morbidity and mortality. While quitting smoking is the best option, switching from cigarettes to non-combustible alternatives (NCAs) such as e-vapor products is a viable harm reduction approach for smokers who would otherwise continue to smoke. A key challenge for the clinical assessment of NCAs is that self-reported product use can be unreliable, compromising the proper evaluation of their risk reduction potential. In this cross-sectional study of 205 healthy volunteers, we combined comprehensive exposure characterization with in-depth multi-omics profiling to compare effects across four study groups: cigarette smokers (CS), e-vapor users (EV), former smokers (FS), and never smokers (NS). Multi-omics analyses included metabolomics, transcriptomics, DNA methylomics, proteomics, and lipidomics. Comparison of the molecular effects between CS and NS recapitulated several previous observations, such as increased inflammatory markers in CS. Generally, FS and EV demonstrated intermediate molecular effects between the NS and CS groups. Stratification of the FS and EV by combustion exposure markers suggested that this position on the spectrum between CS and NS was partially driven by non-compliance/dual use. Overall, this study highlights the importance of in-depth exposure characterization before biological effect characterization for any NCA assessment study.

Abstract Background Postoperative atrial fibrillation (POAF) is the most common arrhythmia following cardiac surgery (CS). It may occur between the 1st and the 4th postoperative day as acute POAF or between the 5th and the 30th as subacute (sPOAF). sPOAF is associated with higher thromboembolic risk, which consistently increase patients' morbidity. Neutrophil‐to‐lymphocyte ratio (NLR) is a low‐cost inflammatory index proposed as possible POAF predictor. Identification of patients' risk categories might lead to improved postoperative outcomes. Methods The aim was to assess the incidence of sPOAF and to identify possible predictors in patients performing cardiovascular rehabilitation (CR) after CS. A single‐center cohort study was performed on 737 post‐surgical patients admitted to CR on sinus rhythm. Continuous monitoring with 12‐lead ECG telemetry was performed. We evaluated the predictive role of anamnestic, clinical, and laboratory data, including baseline NLR. Results Subacute POAF was documented in 170 cases (23.1%). At the multivariate analysis, age (OR 1.03; p = .001), mitral valve surgery (OR 1.77; p = .012), acute POAF (OR 2.97; p

Abstract Purkinje cells in the cerebellum are among the largest neurons in the brain and have been extensively investigated in rodents. However, their morphological and physiological properties remain poorly understood in humans. In this study, we utilized high-resolution morphological reconstructions and unique electrophysiological recordings of human Purkinje cells ex vivo to generate computational models and estimate computational capacity. An inter-species comparison showed that human Purkinje cell had similar fractal structures but were larger than those of mouse Purkinje cells. Consequently, given a similar spine density (2/μm), human Purkinje cell hosted approximately 7.5 times more dendritic spines than those of mice. Moreover, human Purkinje cells had a higher dendritic complexity than mouse Purkinje cells and usually emitted 2–3 main dendritic trunks instead of one. Intrinsic electro-responsiveness was similar between the two species, but model simulations revealed that the dendrites could process ~6.5 times (n = 51 vs. n = 8) more input patterns in human Purkinje cells than in mouse Purkinje cells. Thus, while human Purkinje cells maintained spike discharge properties similar to those of rodents during evolution, they developed more complex dendrites, enhancing computational capacity.

Penelitian ini bertujuan untuk mengidentifikasi faktor-faktor yang berkontribusi terhadap konsumsi minuman keras pada remaja d Nagari Pasar Tapan, Kecamatan Basa Ampek Balai, Kabupaten Pesisir Selatan, Sumatera Barat, Indonesia. Metode penelitian yang digunakan adalah metode kualitatif, proses pengumpulan data dilakukan dengan teknik observasi, wawancara mendalam dan dokumentasi. Unit analisis pada penelitian ini adalah unit analisis individu, yaitu remaja yang mengonsumsi minuman keras di Nagari Pasar Tapan. Dalam menganalisis data, peneliti menggunakan teknik analisis kualitatif. Teori yang digunakan dalam penelitian ini adalah teori kontrol sosial yang dikemukakan oleh Travis Hirschi. Hasil penelitian menjelaskan bahwa faktor penyebab remaja konsumsi minuman keras, diantaranya: (1) faktor kontrol internal yang meliputi; lemahnya ikatan attachment remaja dengan orang tua, rendahnya komitmen (commitment) remaja, dan kuatnya keterlibatan (involvement) remaja dengan teman sebaya yang juga mengonsumsi minuman keras. (2) kegagalan penegak hukum dalam mengikat remaja untuk tidak mengonsumsi minuman keras di nagari pasar tapan. (3) faktor lingkungan tempat tinggal dalam mempengaruhi pengkonsumsian minuman keras pada remaja yang ditandai oleh ketersediaan minuman keras yang murah dan mudah diakses, serta adanya tempat berkumpul yang terpencil dan minim pencahayaan.

Improper processing of soymilk, such as soybean raw materials, use of well water, and use of cooking vessels, produces soymilk that does not meet SNI standards. These conditions can contaminate soymilk with harmful metals. The purpose of this study was to measure the nutritional quality and metal content of soymilk produced using aluminum and stainless steel cooking vessels. The research was descriptive and was conducted in July 2022. Analytical tests were carried out by comparing the nutritional content in the form of total protein, fat, lactose, and solid non-fat (SNF), and analyzing the heavy metal content. The results showed that the contents of Pb, Cu, and Hg in soy milk processed with stainless steel were lower than those of aluminum, from 11,494 ppm to 2,706 ppm, 114,612 ppm to 10,211 ppm, and 0,372 ppm to 0,012 ppm, respectively. The contents of Zn and As in soymilk with stainless steel were higher than those treated with aluminum, from 884,585 ppm to 73,616 ppm and from 0,107 ppm to 0,079 ppm, respectively. Cooking water also contributed 0,055; 0,044; 0,028, and 0,156 ppm to the heavy metal content of Pb, Cu, Zn, Hg, and As, respectively. In conclusion, the use of stainless steel in soymilk processing resulted in better nutritional quality and lower heavy metal content compared to aluminum.

Background: This study aims to identify a metabolomic signature that facilitates the classification of syncope and the categorization of the unexplained syncope (US) to aid in its management. Methods: We compared a control group (CTRL, n = 10) with a transient loss of consciousness (TLC) group divided into the OH group (n = 23) for orthostatic syncope, the NMS group (n = 26) for neuromediated syncope, the CS group (n = 9) for cardiological syncope, and the US group (n = 27) for US defined as syncope without a precise categorization after first- and second-level diagnostic approaches. Results: The CTRL and the TLC groups significantly differed in metabolic profile. A new logistic regression model has been developed to predict how the US will be clustered. Using differences in lysophosphatidylcholine with 22 carbon atom (C22:0-LPC) levels, 96% of the US belongs to the NMS and 4% to the CS subgroup. Differences in glutamine and lysine (GLN/LYS) levels clustered 95% of the US in the NMS and 5% in the CS subgroup. Conclusions: We hypothesize a possible role of C22:0 LPC and GLN/LYS in re-classifying US and differentiating it from cardiological syncope.

Agriculture faces great challenges to overcome global warming and improve system sustainability, requiring access to novel genetic diversity. So far, wild populations and local landraces remain poorly explored. This is notably the case for the two diploid species, Brassica oleracea L. (CC, 2n=2x=18) and B. rapa L. (AA, 2n=2x=20). In order to explore the genetic diversity in both species, we have collected populations in their centre of origin, the Mediterranean basin, on a large contrasting climatic and soil gradient from northern Europe to southern sub-Saharan regions. In these areas, we also collected 14 populations belonging to five B. oleracea closely related species. Our objective was to ensure the absence of species misidentification at the seedling stage among the populations collected and to describe thereafter their origins. We combined flow cytometry, sequencing of a species-specific chloroplast genomic region, as well as cytogenetic analyses in case of unexpected results for taxonomic verification. Out of the 112 B. oleracea and 154 B. rapa populations collected, 103 and 146, respectively, presented a good germination rate and eighteen populations were misidentified. The most frequent mistake was the confusion of these diploid species with B. napus. Additionally for B. rapa, two autotetraploid populations were observed. Habitats of the collected and confirmed wild populations and landraces are described in this study. The unique plant material described here will serve to investigate the genomic regions involved in adaptation to climate and microbiota within the framework of the H2020 Prima project ‘BrasExplor’.

Background: To limit the progression of disease, people with cystic fibrosis (pwCF) perform daily respiratory physiotherapy, which is perceived as the most burdensome routine in managing their condition. The elexacaftor–tezacaftor–ivacaftor (ETI) combination has changed respiratory management. Objective: To investigate how the perceived treatment burden changed in 1 year of treatment with ETI. Design: Prospective observational study. Methods: Ad hoc questionnaires for the pwCF and for the caregivers of pwCF

Penetrating aortic ulcer (PAU) represents a subset of acute aortic syndromes characterized by high rupture risk and management challenges, particularly in elderly patients with significant comorbidities. This case report showcases a 75-year-old patient with a history of coronary artery bypass graft (CABG) and with multiple PAUs involving the aortic arch, deemed unfit for conventional open surgery. A branched aortic endograft with a pre-cannulated side component for the left subclavian artery (LSA) was employed to preserve the patency of the previous CABG. Two computational fluid dynamics (CFD) simulations and a morphological analysis were performed on the pre- and post-intervention aortic configurations to evaluate changes in flow rate and pressure drop at LSA level and differences in the lumen size. The results revealed a decrease in the flow rate equal to 2.38% after the intervention and an increase in pressure drop of 4.48 mmHg, while the maximum differences in LSA cross-sectional areas and diameters were 1.49 cm2 and 0.64 cm, respectively. Minimal alteration in LSA blood flow due to the chosen intervention approach confirmed the effectiveness of the selected unibody design endograft with LSA preservation, ensuring myocardial perfusion. Therefore, CFD simulations demonstrate to be a powerful tool to evaluate the hemodynamic consequences of interventions by accurately estimating the main fluid dynamic parameters.

Abstract Aging is the basis for several unfavorable conditions, including cardiovascular diseases (CVDs). In this sense, regular physical activity (regular PA) has been proven to delay cellular aging and prevent endothelial dysfunction related to CVDs. Despite numerous studies involving athletes, little is known about cellular and molecular mechanisms of regular PA among master athletes. The present study aimed at evaluating the effects of regular PA on local microcirculatory functions in elderly athletes as compared to age-matched sedentary controls. Moreover, molecular/epigenetic mechanisms (nitric oxide, oxidative stress, PGC-1α, SIRT1 and miR29) were also assessed. The results of the present study showed that regular PA significantly increased local blood flow in post-ischemia and post-heating conditions, as well as NO plasma concentrations, denoting a better endothelial function/microcirculatory efficiency. Moreover, athletes presented a greater plasma antioxidant and increased transcriptional levels of the metabolism regulator PGC-1α. Finally, regular PA enhanced plasma level of SIRT1 and miR29, suggested as epigenetic regulators of redox balance and cellular metabolism. In addition, stimulated local blood flow was directly related to plasma antioxidant capacity, and SIRT1 and miR29 levels. Overall, our data confirm the beneficial effects of regular PA on the cardiovascular profile in elderly athletes and shed light on molecular signals involved in the positive adaptations to exercise.

This study analyses the trends of total aerosol and the main aerosol species over nine capitals in the Baltic Sea basin from 1989 to 2019 based on the Modern-Era Retrospective Analysis for Research and Applications, Version 2 Reanalysis. Aerosol speciation includes mineral dust, sea salt, sulphate (SO4), organic carbon (OC), and black carbon (BC). The mean total aerosol optical depth (AOD) values were the highest (up to 0.216) over the continental capitals (i.e., Warsaw, Berlin, and Vilnius). For each capital, the mean SO4 AOD was the main aerosol species, with a trend specular to total AOD. Apart from Warsaw, the mean BC AOD was the aerosol species with the lowest level. The composition of aerosols changed with respect to the species of anthropogenic origins (i.e., SO4, OC, and BC), with the percentage contribution to the total AOD decreasing for the SO4 AOD and increasing for the BC AOD. Also, the OC AOD showed an increase in the percentage contribution to total AOD for Copenhagen, Oslo, Stockholm, and the continental capitals. Anthropogenic aerosols contributed up to 90.3% of the total AOD, with the highest values over the continental capitals. For each capital, the minimum in the percentage contribution of anthropogenic AOD was between 2007 and 2008, likely due to the global financial crisis. Anthropogenic AOD as a percentage of the total AOD decreased from 1989 to 2008. Both the total and the SO4 AODs decreased over each capital. By contrast, the BC AOD increased over Stockholm, and both the OC and BC AODs increased over Berlin, Copenhagen, and Oslo. The decoupling of carbonaceous aerosols and the SO4 AOD trends was likely due to concurrent factors such as biomass burning and low-sulphur fuel policies. From 2000 to 2019, the inverse relationships between gross domestic products and SO4 AODs suggest a relative decoupling of economic growth from fossil fuels for Oslo, Stockholm, Tallinn, and Vilnius.

Graft steatosis has been associated with inferior outcomes after liver transplantation. Given the rising prevalence of obesity and fatty liver disease, strategies allowing safe and successful utilization of fatty liver grafts are needed. Liver preservation by normothermic machine perfusion (NMP) allows reducing ischemia-reperfusion injury, extending preservation time and assessing graft viability prior to implantation into the recipient. NMP can be initiated at the donor hospital using a transportable device (referred to as upfront NMP or normothermic machine preservation) or after a period of cold ischemia (known as back-to-base). In this report, we present the case of a graft from an HCV-positive DBD donor with 70% macrovesicular steatosis, which was successfully preserved and transplanted using upfront NMP. This approach was key to minimize initial injury to the graft and allowed assessing its viability before transplantation, while improving transplant logistics. Upfront NMP represents a promising approach to enhance the transplantation of fatty liver grafts.

Abstract Background The role of left atrial appendage occlusion (LAAO) for atrial fibrillation patients that during oral anticoagulant therapy (OAC) suffer from ischemic events or present LAA sludge, and the best postinterventional anticoagulant regimen, need to be defined. We present our experience with a hybrid approach of LAAO+ lifelong OAC therapy in this cohort of patients. Methods Out of 425 patients treated with LAAO, 102 underwent LAAO because, despite OAC, suffered from ischemic events or presented with LAA sludge. Patients without high bleeding risk were discharged with the aim of maintaining lifelong OAC. This cohort was then matched to a population who underwent LAAO in primary ischemic events prevention. The primary endpoint was the composite of all‐cause death and major adverse cardiovascular events consisting of ischemic stroke, systemic embolism (SE), and major bleeding. Results Procedural success was 98%, and 70% of patients were discharged with anticoagulant therapy. After a median follow‐up of 47.2 months, the primary endpoint occurred in 27 patients (26%). At multivariate analyses, coronary artery disease (OR 5.1, CI 1.89–14.27, p = .003) and OAC at discharge (OR 0.29, CI 0.11–0.80, p = .017) were associated with the primary endpoint. After propensity score matching, no significant difference was found in the survival free from the primary endpoint according to the indication for LAAO (p = .19). Conclusions In this high‐ischemic risk cohort, LAAO + OAC seem a long‐term safe and effective therapeutical approach, with no difference in the survival free from the primary endpoint according to the indication for LAAO in a matched cohort.

The increased availability of genetic technologies has significantly improved the detection of novel germline variants conferring a predisposition to tumor development in patients with malignant disease. The identification of variants of uncertain significance (VUS) represents a challenge for the clinician, leading to difficulties in decision-making regarding medical management, the surveillance program, and genetic counseling. Moreover, it can generate confusion and anxiety for patients and their family members. Herein, we report a 5-year-old girl carrying a VUS in the Succinate Dehydrogenase Complex Subunit C (SHDC) gene who had been previously treated for high-risk neuroblastoma and subsequently followed by the development of secondary acute myeloid leukemia. In this context, we describe how functional studies can provide additional insight on gene function determining whether the variant interferes with normal protein function or stability.

The use of enzymes in Indonesia is increasing rapidly and is used in various industries, especially FCMG. One of the enzymes that is widely used is xylanase, which is an extracellular enzyme that can hydrolyze xylan into xylose and xylo-oligosaccharides. This research aims to determine the optimum conditions for the xylanase production process from coffee cherry processing waste (CCPW) using Trichoderma viride through solid fermentation. The research method used was experimental using central composite design (CCD) in Design Expert 13.0 software. The treatment designs used were fermentation times of 24 hours, 48 ​​hours, and 72 hours; and substrate concentrations of 25%, 50%, and 75%. The experimental response analysis design was enzyme activity, protein content, and specific activity. The results of the research show that the optimum conditions for xylanase production are at a substrate concentration of 75% and a fermentation time of 24 hours with a desirability value of 0.742, which produces an enzyme activity value of 36.388 U/mL and a dissolved protein content of 0.494 mg/mL with a specific activity of 73.660. U/mg. The verification results show conformity with the formula predicted by the Design Expert 13.0 software, namely enzyme activity of 36,292 U/mL and protein content of 0.488 mg/mL with a specific activity of 74,369 U/mg

Background and aimsSince Type 1 Diabetes (T1D) onset usually occurs at a young age, a relevant number of affected people attend school for most of their time; it is necessary that school personnel receive appropriate education and training. We aimed to evaluate the effectiveness of the online training program offered by IRCCS Istituto Giannina Gaslini during and after COVID-19 pandemic.MethodsThe Institute’s Diabetes team offered an online training program to school staff of the Region during COVID-19 pandemic. A validated questionnaire was proposed to all the schools in which training meetings were held in the previous 2 years (2020–2021 and 2021–2022). The questionnaire consisted of four sections: Section 1 (Socio-demographical data), Section 2 (Theoretical knowledge on T1D), Section 3 (Confidence in handling T1D), and Section 4 (Practical skills and Glucagon Administration). To evaluate the effectiveness of the online training program, the answers between participants (Group A) and non-participants (Group B) were then compared.Results225 subjects from 19 schools participated in the survey. People who participated to the training (Group A, n = 53) demonstrated better T1D theoretical knowledge compared to non-participants (Group B, n = 154; p

Castanopsis spp., also known as berangan in Acehnese, is a chestnut species that is still used and well-known by the people of Indonesia. However, it is currently very rare and is becoming less well-known to today's younger generation. This research aims to study and understand how people in Nagan Raya process and use Castanopsis spp. species. Data were collected using two methods: ethnobotanical data and population data. The participatory rural appraisal (PRA) method was used in direct interviews to collect ethnobotanical data. Purposive sampling was used to obtain the Castanopsis spp. the population as much as local informants could show. There were 48 people from three groups of respondents who provided ethnobotanical data: traditional figures, farmers, and villagers who Castanopsis spp. species. The respondents in this study were divided into three groups based on their age, education, and occupation. There are 2 types of Castanopsis spp. that have been found in the Nagan Raya district, Castanopsis inermis and Castanopsis costata. They were discovered in forest areas, plantations, office/home yards, and roadside areas. Castanopsis spp fruits are commonly used as food, while the wood are usually used as carpentry/furniture wood and firewood. Kata Kunci: ethnobotany, berangan, chestnut, Castanopsis spp.