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Objective. To analyze the use of the Pressure Recording Analytical Method (PRAM), an hemodynamic monitoring system, in evaluating intraoperative and postoperative hemodynamic instability in patients undergoing endovascular repair for abdominal aortic aneurysm, and to evaluate if the decision to refer patients to a ordinary ward or to a Cardiac Step-Down Unit (CSDU) after the intervention on the basis of intraoperative hemodynamic monitoring could be more cost-effective. Materials and Methods. After preoperative clinical evaluation, 44 patients were divided in this non-randomised study into two groups according to their postoperative destination: Group 1-ward (N=22) and Group 2-CSDU (N=22). All patients underwent monitoring with PRAM during the intervention and in the 24 postoperative hours, measuring several indices of myocardial contractility and other hemodynamic variables. Results. According to the variability of two parameters, Stroke Volume Variation and Pulse Pressure Variation, patients were classified as stable or unstable. Unstable patients showed a significant alteration in several hemodynamic indices, in comparison to stable ones. According to the intraoperative monitoring, eight high risk patients could have been sent to an ordinary ward due to their stability, with a reduction in the improper use of CSDU and, consequently, in costs. Conclusions. Hemodynamic monitoring with PRAM can be useful in these patients, both for intraoperative management and for the choice of the more appropriate postoperative setting, possibly reducing the improper use of CSDU for hemodynamically stable patients who are judged to be at high risk preoperatively, and re-evaluating low surgical risk patients with an unstable intraoperative pattern, with a possible reduction in costs. [ABSTRACT FROM AUTHOR]

Mobile phone operators need to work together to make sure the experience of using new services lives up to users' expectations. [ABSTRACT FROM AUTHOR]

• Data from both the MA-XRF and HIS have been informative to investigate ancient over-paintings and the painting underneath. • The evolution of the depicted devotees during different phases of the painting has been elucidated. • A significant contribution to the exploration of the painting technique of Marco d'Oggiono has been obtained. Two panels by Marco d'Oggiono – a painter who was active at the end of the 15th century in Leonardo's workshop in Milan – were investigated by Macro X-ray fluorescence spectroscopy and VNIR hyperspectral imaging. The paintings depict St. Francis and St. Anthony of Padua, each presenting a devotee, and are part of the permanent collection of the Pinacoteca di Brera in Milan. They are two of the five still known compartments of the Maleo polyptich, which originally consisted of ten panels. Preliminarily analyses suggested the presence of ancient over-paintings that modified the arrangement of the hair of one devotee and partially changed the dress of the other one. The paper reports the results obtained by investigating the repainted areas by a new mobile apparatus for MA-XRF and by an innovative compact VNIR hyperspectral camera. The aim is to obtain information on the materials and – possibly – on the original appearance of the modified representations. The two instrumental approaches produced images related to the different superimposed painting layers, which supported the interpretation of the subsequent phases of the production of the paintings and highlighted the evolution of the appearance of the subjects. [ABSTRACT FROM AUTHOR]

Incorporating consumer electronics into the operating room, we evaluated the Apple Vision Pro (AVP) during limb preservation surgeries, just as we evaluated Google Glass and FaceTime more than a decade ago. Although AVP's real-time mixed-reality data overlay and controls offer potential enhancements to surgical precision and team communication, our assessment recognized limitations in adapting consumer technology to clinical environments. The initial use facilitated intraoperative decision-making and educational interactions with trainees. The current mixed-reality pass-through resolution allows for input but not for highly dexterous surgical interactions. These early observations indicate that while AVP may soon improve aspects of surgical performance and education, further iteration, evaluation, and experience are needed to fully understand its impact on patient outcomes and to refine its integration into clinical practice., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Starch is a renewable biopolymer that can be sourced from agricultural waste and used to produce nanoparticles (SNPs). In particular, amorphous SNPs have potential application in numerous fields, including the consolidation of weakened paintings in the cultural heritage preservation. Starch dissolution followed by nanoprecipitation in nonsolvents is an advantageous synthetic route, but new methodologies are needed to feasibly control the physicochemical properties of the SNPs. Here, we explored nanoprecipitation by nonsolvency using a set of "green" solvents to obtain amorphous SNPs, rather than starch nanocrystals already reported in the literature. The effect of the nonsolvent on the ordering of polymer chains in the obtained SNPs was studied. The recovery of local order (e.g., isolated V-type helices) after dissolution was shown to depend on the type of solvents used in the dissolution and precipitation steps, while long-range order (extended arrays of helices) is lost. Aqueous dispersions of the SNPs provided effective consolidation of powdery painted layers, showing that the selection of particle synthetic routes can be dictated by sustainability and scalability criteria. These "green" formulations are candidates as new consolidants in art preservation, and the possibility of tuning local order in amorphous starch assemblies might also impact fields like food chemistry, pharmaceutics, and nanocomposites, where SNPs with tunable amorphousness are more advantageous than nanocrystals.

Hypothesis: The development of gels capable to adapt and act at the interface of rough surfaces is a central topic in modern science for Cultural Heritage preservation. To overcome the limitations of solvents or polymer solutions, commonly used in the restoration practice, poly(vinyl alcohol) (PVA) "twin-chain" polymer networks (TC-PNs) have been recently proposed. The properties of this new class of gels, that are the most performing gels available for Cultural Heritage preservation, are mostly unexplored. This paper investigates how chemical modifications affect gels' structure and their rheological behavior, producing new gelled systems with enhanced and tunable properties for challenging applications, not restricted to Cultural Heritage preservation., Experiments: In this study, the PVA-TC-PNs structural and functional properties were changed by functionalization with sebacic acid into a new class of TC-PNs. Functionalization affects the porosity and nanostructure of the network, changing its uptake/release of fluids and favoring the uptake of organic solvents with various polarity, a crucial feature to boost the versatility of TC-PNs in practical applications., Findings: The functionalized gels exhibited unprecedented performances during the cleaning of contemporary paintings from the Peggy Gugghenheim collection (Venice), whose restoration with traditional solvents and swabs would be difficult to avoid possible disfigurements to the painted layers. These results candidate the functionalized TC-PNs as a new, highly promising class of gels in art preservation., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

The location and the conformational changes of proteins/enzymes immobilized within Metal Organic Frameworks (MOFs) are still poorly investigated and understood. Bovine serum albumin (BSA), used as a model protein, was immobilized within two different zeolitic imidazolate frameworks (ZIF-zni and ZIF-8). Pristine ZIFs and BSA@ZIFs were characterized by X-ray diffraction, small-angle X-ray scattering, scanning electron microscopy, confocal laser scanning microscopy, thermogravimetric analysis, micro-FTIR and confocal Raman spectroscopy to characterize MOFs structure and the protein location in the materials. Moreover, the secondary structure and conformation changes of BSA after immobilization on both ZIFs were studied with FTIR. BSA is located both in the inner and on the outer surface of MOFs, forming domains that span from the micro- to the nanoscale. BSA crystallinity (β-sheets + α-helices) increases up to 25 % and 40 % due to immobilization within ZIF-zni and ZIF-8, respectively, with a consequent reduction of β-turns., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

This work illustrates a novel prototype of a transmittance hyperspectral imaging (HSI) scanner, operating in the 400-900 nm range, and designed on purpose for non-invasive analysis of photographic materials, such as negatives, films and slides. The instrument provides high-quality spectral data and high-definition spectral images on targets of small size (e.g., 35 mm film strips) and is the first example of HSI instrumentation specifically designed for applications in the photographic conservation field. The instrument was tested in laboratory and on a set of specimens selected from a damaged photographic archive. This experimentation, though preliminary, demonstrated the soundness of a technical approach based on HSI for large-scale spectroscopic characterization of photographic archival materials. The obtained results encourage the continuation of experimentation of HSI as an advanced tool for photography conservation.

The objective of these Guidelines was to revise and update the previous 2016 Italian Guidelines on Abdominal Aortic Aneurysm Disease, in accordance with the National Guidelines System (SNLG), to guide every practitioner toward the most correct management pathway for this pathology. The methodology applied in this update was the GRADE-SIGN version methodology, following the instructions of the AGREE quality of reporting checklist as well. The first methodological step was the formulation of clinical questions structured according to the PICO (Population, Intervention, Comparison, Outcome) model according to which the Recommendations were issued. Then, systematic reviews of the Literature were carried out for each PICO question or for homogeneous groups of questions, followed by the selection of the articles and the assessment of the methodological quality for each of them using qualitative checklists. Finally, a Considered Judgment form was filled in for each clinical question, in which the features of the evidence as a whole are assessed to establish the transition from the level of evidence to the direction and strength of the recommendations. These guidelines outline the correct management of patients with abdominal aortic aneurysm in terms of screening and surveillance. Medical management and indication for surgery are discussed, as well as preoperative assessment regarding patients' background and surgical risk evaluation. Once the indication for surgery has been established, the options for traditional open and endovascular surgery are described and compared, focusing specifically on patients with ruptured abdominal aortic aneurysms as well. Finally, indications for early and late postoperative follow-up are explained. The most recent evidence in the Literature has been able to confirm and possibly modify the previous recommendations updating them, likewise to propose new recommendations on prospectively relevant topics.

Background: Erectile dysfunction (ED) is a prevalent health problem that seriously impacts men's quality of life. The potential treatment of ED by percutaneous approach has emerged with valid angiographic results and a significant improvement in symptoms and quality of life. In addition, cell-based regenerative therapies aiming at enhancing neovascularization have been successfully performed with peripheral blood mononuclear cells (PBMNCs) in diabetic patients affected by critical limb ischaemia., Case Summary: We report a case of a young insulin dependent (ID) diabetic patients who suffered of severe vasculogenic erectile dysfunction associated with a poor response for more than 1 year to oral phosphodiesterase-5 inhibitors (PDE5i) and intracavernous (IC) phosphodiesterase type 1 (PDE1) therapy. At selective angiography of the pelvic district, a severe atherosclerotic disease of the internal iliac and pudendal artery was evident with absence of distal vascularization of the cavernous bodies. The patient was treated by mechanical revascularization with drug-coated balloon and drug-eluting stent placement associated with IC injection of autologous PBMNCs. Immediate and 1-year clinical and angiographic follow-up are described., Discussion: Percutaneous revascularization with drug-coated balloon and drug-eluting stent associated with IC autologous PBMNCs cells injection is a safe and effective procedure to restore normal erectile function in diabetic patients affected by severe vasculogenic ED not responding to conventional oral drug therapies., (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.)

The diabetic foot represents one of the most dangerous complications of diabetic disease, and it is characterized by the presence of infection, ulceration, or necrosis of the foot tissues associated with various degrees of neuropathy or ischemia. If not correctly and promptly treated, it leads to high rates of major amputations. Although in Italy diabetics are about 5% of the population, more than 50% of major amputations are performed in diabetic patients. Compared to non-diabetic patients, diabetic peripheral artery disease localizes more distally, mostly in the below-the-knee vessels, is typically bilateral with multi-level involvement, and presents earlier onset and more aggressive course. The primary target of revascularization, either surgical or percutaneous, is the reconstitution of a direct flow line up to the suffering tissues, essential condition for healing. Revascularization alone, however, is not sufficient, it must be integrated in a multidisciplinary context, where the internal, infectious, surgical and orthopedic aspects of treatment can drive the patient on a personalized route towards limb salvage and recovery of walking.