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The Russian invasion of Ukraine has implemented legitimate fears of a global crisis and further and inevitably aggravating existing food-security challenges. The international community is being called upon to take targeted action to address the rapidly-evolving, resultant scenarios, making it essential to go beyond immediate interim measures and to re-examine the agricultural and energy policies that underpin our global economy. This article, without any claim to exhaustiveness, examines the inevitable link between war and the dynamics related to food security. In the first instance, a theoretical-interpretative key of the logics of violent conflicts that generate a relevant impact on global food supplies and food (in)security is provided, within the broader framework of the dynamics related to the instability of international relations which hinder the supply of energy resources and determine the volatility of general price levels. In the concluding section, there is refl ection crossed reference to the ongoing Russia/Ukraine conflict as well as the devastating consequences on global food systems, already put under stress by the COVID-19 pandemic.

Objective With the aim of standardizing and improving the use of ultrasound-guided PLA on PTMC, a panel of experts from China and Italy, jointly issued this expert consensus on the clinical use of PLA for low-risk PTMC.Methods This expert consensus was developed by Chinese and Italian experts who have specific competence and expertise in this area. An evidence-based approach combining the knowledge and practical experience of the panelists was utilized.Results Twenty-six expert consensus recommendations were developed, spanning topics including the indications and contraindications of PLA for PTMC, physician training, preoperative preparation of patients, intraoperative technical procedures, possible complications, efficacy assessment, follow-up strategy, the approach to new PTMC and metastatic lymph nodes after treatment, thyroid-stimulating hormone inhibition therapy, and quality control of the entire procedure.Conclusion We summarized practical recommendations about standardized and improved PLA treatment for PTMC.

Transport systems play a pivotal role in bacterial physiology and represent potential targets for medical and biotechnological applications. However, even in well-studied organisms like Escherichia coli, a notable proportion of transporters, exceeding as many as 30%, remain classified as orphans due to their lack of known substrates. This study leveraged high-resolution LC-MS-based untargeted metabolomics to identify candidate substrates for these orphan transporters. Human serum, including a diverse array of biologically relevant molecules, served as an unbiased source for substrate exposure. The analysis encompassed 26 paired transporter mutant contrasts (i.e., knockout vs. overexpression), compared with the wild type, revealing distinct patterns of substrate uptake and excretion across various mutants. The convergence of candidate substrates across mutant scenarios provided robust validation, shedding light on novel transporter-substrate relationships, including those involving yeaV, hsrA, ydjE, and yddA. Furthermore, several substrates were contingent upon the specific mutants employed. This investigation underscores the utility of untargeted metabolomics for substrate identification in the absence of prior knowledge and lays the groundwork for subsequent validation experiments, holding significant implications for both medical and biotechnological advancements.

Partial nephrectomy (PN) is the primary surgical method for renal tumor treatment, typically involving clamping the renal artery during tumor removal, leading to warm ischemia and potential renal function impairment. Off-clamp approaches have been explored to mitigate organ damage, yet few results have emerged about the possible effects on hemoglobin loss. Most evidence comes from retrospective studies using propensity score matching, known to be sensitive to PS model misspecification. The energy balancing weights (EBW) method offers an alternative method to address bias by focusing on balancing all the characteristics of covariate distribution. We aimed to compare on- vs. off-clamp techniques in PN using EB-weighted retrospective patient data. Out of 333 consecutive PNs (275/58 on/off-clamp ratio), the EBW method achieved balanced variables, notably tumor anatomy and staging. No significant differences were observed in the operative endpoints between on- and off-clamp techniques, although off-clamp PNs showed slight reductions in hemoglobin loss and renal function decline, albeit with slightly higher perioperative blood loss. Our findings support previous evidence, indicating comparable surgical outcomes between standard and off-clamp procedures, with the EBW method proving effective in balancing baseline variables in observational studies comparing interventions.

Abstract Chronic lymphocytic leukemia (CLL) is the most common type of leukemia in western countries. The association between CLL and glomerular disease (GD) is rare. The most frequent GD associated with CLL is membranoproliferative membranous glomerulonephritis (GN) (MPGN) (45%) types I and II, followed by membranous glomerulonephritis, with the same reports of immunotactoid glomerulopathy (ITG). We report a case of ITG diagnosed on kidney biopsy in a CLL patient and the response of renal parameters to drug treatment for CLL. The patient was treated with several lines of therapies with a good response.

A quercetin derivative with remarkable biological performance was successfully synthesized by chemical modification of the flavonoid with docosahexaenoic acid to synthesize 2-(2,2-diphenylbenzo[d][1,3]dioxol-5-yl)-5,7-dihydroxy-4-oxo-4H-chromen-3-yl-(4Z,7Z,10Z,13Z,16Z,19Z)-docosa-4,7,10,13,16,19-hexaenoate (3), deeply characterized by NMR spetroscopy. Modified quercetin and pectin were involved in a grafting process by an ecofriendly radical procedure able to preserve the biological features of the quercetin derivative. Antioxidant performances of the conjugate were evaluated both in term of total phenolic amount and scavenger activity in organic and aqueous environments. Additionally, in vitro acute oral toxicity was also tested against Caco-2 cells and 3T3 fibroblasts, confirming that pectin conjugate does not have any effect on cell viability at the dietary use concentrations. Finally, in vitro experiments highlighted the ability of the conjugate to counteract the migratory properties of Caco-2 and HepG2 cells, indicating its feature in the reduction of the migration of tumour cells. These data showed that the covalent binding of the quercetin derivative to the pectin chain represents a very interesting strategy to improve the bioavailability of the quercetin, representing an effective means of protecting and to transporting polyphenol molecules.

Metabolic reprogramming is an emerging hallmark of cancer, involving the overexpression of metabolism-related proteins, such as glucose and monocarboxylate transporters and intracellular glycolytic enzymes. The biology of testicular germ cell tumors (TGCTs) is very complex, and although their metabolic profile has been scantily explored, some authors have recently reported that the metabolic rewiring of cancer cells resulted in an association with aggressive clinicopathological characteristics. In this study we have investigated, by immunohistochemical analysis, the expression of key proteins sustaining the hyperglycolytic phenotype in pure seminoma (SE, nr. 35), pure embryonal carcinoma (EC, nr. 17) tissues samples, and normal testes (nr. 5). GLUT1, CD44, PFK-1, MCT1, MCT4, LDH-A, and PDH resulted in more expression in EC cells compared to SE cells. TOM20 was more expressed in SE than in EC. GLUT1, MCT1, and MCT4 expression showed a statistically significant association with SE histology, while for EC, the association resulted in being significant only for GLUT1 and MCT4. Finally, we observed that EC resulted as negative for p53, suggesting that the GLUT1 and MTC overexpression observed in EC could be also attributed to p53 downregulation. In conclusion, our findings evidenced that EC exhibits a higher expression of markers of active aerobic glycolysis compared to SE, suggesting that the aggressive phenotype is associated with a higher glycolytic rate. These data corroborate the emerging evidence on the involvement of metabolic reprogramming in testicular malignancies as well, highlighting that the metabolic players should be explored in the future as promising therapeutic targets.

The therapeutic management of premature lifelong ejaculation (PE) ranges from behavioral therapy to pharmacological and surgical treatments. Hyaluronic Acid (HA) injection into the glans penis is a non-surgical procedure, intended to reduce glans hypersensitivity, improving the intravaginal ejaculation latency time (IELT). HA injection can be performed through different techniques that, although safe and effective, rarely can cause local complications. In this pilot uncontrolled study, we tested the effectiveness of a new technique based on a single HA injection into the frenulum of the glans, to improve IELT in a sample of patients affected by PE. We observed a significant increase of the IELT after one (median 73.3, IQR 66.2–79.9 s) and two months (66.2, 63.1–73.9) that gradually decreased at three months, remaining still significantly higher than at baseline (34.8, 30.9–37.4). PEDT and IIEF questionnaires significantly improved compared to baseline in the first two months of follow-up (p < 0.001). In conclusion, the preliminary results emerging from this pilot uncontrolled study, highlight the effectiveness of this one-shot HA injection approach, although a larger sample and longer follow-up time are needed to standardize the procedure.

Grazia Lazzari,1 Renato Giua,2 Elisabetta Verdolino,3 Angela Pia Solazzo,1 Ilaria Benevento,1 Antonietta Montagna,1 Giovanni Castaldo,1 Luciana Rago,1 Giovanni Silvano3 1Radiation Oncology Unit -IRCCS –CROB, Rionero in Vulture, PZ, Italy; 2Pneumology Unit - Perrino Hospital, Brindisi, BR, Italy; 3Radiation Oncology Unit -San Giuseppe Moscati Hospital, Statte, TA, ItalyCorrespondence: Grazia Lazzari, Radiation Oncology Unit, IRCCS –CROB, Via Padre Pio 1, Rionero in Vulture, PZ, 85028, Italy, Tel +39 0972 729740, Email lazzarigrazia@gmail.comAbstract: The COVID-19 pandemic has opened several new disease scenarios, yielding novel syndromes that have never been seen before and resurrecting old inflammatory phenomena that are no longer recorded, such as radiation recall (RR) syndromes. Radiation recall syndrome is a limited field inflammatory reaction that occurs in a volume that was irradiated several months or years previously before being induced by a triggering factor. The most frequently reported phenomena are skin reactions; however, other organs could be involved, such as the lungs in radiation recall pneumonitis (RRP). It is a well-described inflammatory reaction that occurs within a pulmonary volume that was irradiated several months or years previously via radiotherapy (RT), triggered by factors such as drugs, including chemotherapy agents, immunotherapy, or vaccination. Indeed, during the COVID-19 pandemic, RRP following anti-COVID-19 vaccination or SARS-CoV2 infection was recently reported. ACE receptor-rich tissues such as lung or skin tissues were mainly involved. Herein, we present a case of RRP triggered by COVID-19 pulmonary infection in a woman who previously underwent adjuvant breast cancer radiotherapy. Although symptoms were typical, pulmonary CT findings depicted a unique distribution of ground-glass opacities (GGOs) throughout the previous radiation portals and mirror-like the radiation fields. Anamnesis and radiation plan evaluation were crucial in the diagnosis of RRP.Keywords: recall syndromes, adjuvant radiotherapy, immune memory, ACE receptors

BACKGROUND: Ectopic pregnancy (EP) is a serious obstetric condition that can be life-threatening, with various risk factors contributing to its development. In particular, in vitro fertilization (IVF) techniques may lead to an increased rate EP. Additionally, also endometriosis seems to be related to this particular obstetrical condition. CASE REPORT: We report a rare case of ectopic pregnancy on the uterosacral ligament (USL) along with a suspected coexisting tubal ectopic pregnancy following IVF. The patient is a 48-year-old woman in menopause, with a history of pelvic endometriosis, who experienced sudden abdominal pain and vomiting at eight weeks of amenorrhea after undergoing a double heterologous frozen embryo transfer. Thorough examination and pelvic ultrasound, we diagnosed a hemoperitoneum due to a suspected heterotopic EP on the left USL and contralateral tube. Due to the sudden worsening of the patient's condition, we opted for a surgical procedure. An urgent laparotomy revealed a severe hemoperitoneum caused by an EP implanted on the left USL and a malacic, bleeding contralateral tube, both of which were removed, and hemostasis was then guaranteed. The histopathologic exam confirmed the EP on the left USL and an edematous tube without product of conception (POC). CONCLUSIONS: Comparing our case with others reported in the current literature, it appears that the etiopathogenetic mechanisms leading to this urgent obstetrical condition are various and not fully understood. Despite those circumstances, the present case highlights the importance of considering non-tubal ectopic pregnancies in the context of risk factors, including IVF techniques, endometriosis, and advanced age, in cases of abdominal pain and hemoperitoneum after a single or double embryo transfer. The treatment, which involves different professional figures, should be executed as soon as possible, with the aim of preserving the patient's life and any future desire for pregnancies. [ABSTRACT FROM AUTHOR]

In the ELOQUENT-3 trial, the combination of elotuzumab, pomalidomide and dexamethasone (EloPd) proved to have a superior clinical benefit over pomalidomide and dexamethasone with a manageable toxicity profile, leading to its approval for the treatment of patients with relapsed/refractory multiple myeloma (RRMM) who have received at least two prior therapies, including lenalidomide and a proteasome inhibitor. We report here a real-world experience of 200 cases of RRMM treated with EloPd in 35 Italian centers outside of clinical trials. In our dataset, the median number of prior lines of therapy was two, with 51% of cases undergoing autologous stem cell transplant and 73% having been exposed to daratumumab. After a median follow-up of 9 months, 126 patients had stopped EloPd, most of them (88.9%) because of disease progression. The overall response rate was 55.4%, a finding in line with the pivotal trial results. Regarding adverse events, the toxicity profile in our cohort was similar to that in the ELOQUENT-3 trial, with no significant differences between younger (

BackgroundThere are little data on remote monitoring (RM) of implantable loop recorders (ILRs) in patients with unexplained syncope and whether it confers enhanced diagnostic power.ObjectiveTo evaluate the effect of RM in ILR recipients for unexplained syncope for early detection of clinically relevant arrhythmias by comparison with a historical cohort with no RM.MethodsSyncRM is a propensity score (PS)-matched study prospectively including 133 consecutive patients with unexplained syncope and ILR followed up by RM (RM-ON group). A historical cohort of 108 consecutive ILR patients with biannual in-hospital follow-up visits was used as control group (RM-OFF group). The primary endpoint was the time to the clinician's evaluation of clinically relevant arrhythmias (types 1, 2, and 4 of the ISSUE classification).ResultsThe primary endpoint of arrhythmia evaluation was reached in 38 patients (28.6%) of the RM-ON group after a median time of 46 days (interquartile range, 13–106) and in 22 patients (20.4%) of the RM-OFF group after 92 days (25–368). The PS-matched adjusted ratio of rates of arrhythmia evaluation was 2.53 (95% confidence interval, 1.32–4.86) in the RM-ON vs. RM-OFF group (p = 0.005).ConclusionIn our PS-matched comparison with a historical cohort, RM of ILR patients with unexplained syncope was associated with a 2.5-fold higher chance of evaluations of clinically relevant arrhythmias as compared with biannual in-office follow-up visits.

Las enfermedades son el principal problema sanitario del maní (Arachis hypogaea L.), siendo viruela (Cercospora arachidicola Hori y Cercosporidium personatum (Berck. & Curt Deighton)) la más importante del mundo, y la que mayores pérdidas produce en nuestra región. Su manejo es a través del control químico, siendo importante evaluar los nuevos fungicidas que se registran en el cultivo. El objetivo de este estudio fue evaluar el efecto de nuevos fungicidas sobre la intensidad de viruela y el rendimiento de maní. El estudio se realizó en 2015/16 y 2016/17, en General Cabrera y Vicuña Mackenna, Córdoba. Se probaron los tratamientos: T1) Pyraclostrobin(13,3%)+epoxiconazole(5%)(750cc/ha), T2) Trifloxistrobin(18,75%)+prothioconazole(17,5%)(700cc/ha), T3) Azoxistrobina (20%)+difenoconazole(12,5%) (500cc/ha), T4) Difenoconazole(25%)(400cc/ha), T5) Clorotalonil(72%)(1400cc/ha), T6) Fluxapyroxad(5%)+epoxyconazole(5%) + pyraclostrobin(8,1%)(1200cc/ha), T7) Penthiopirad(10%)+picoxystrobin(10%) (800cc/ha), T8) Benzovindiflupyr(15%)+azoxistrobina(30%)(200grs/ha) y T9) Testigo sin fungicida. La evaluación de viruela se realizó cada 15 días desde la primera aplicación considerando su incidencia (% de folíolos afectados) y severidad total (% de área foliar perdida). La producción se evaluó en 2 m2 de cada parcela, determinándose el rendimiento en vainas, granos y granos tamaño confitería. La comparación entre tratamientos se realizó a través de un modelo lineal mixto y test de comparación de medias DGC (p

We aimed to quantify training load (TL) and intensity during practice sessions according to game-related contextual variables (game outcome, opponent standard, game location) in an elite male ice hockey team. Practice data were collected using a wearable 200-Hz accelerometer, heart rate (HR) recording, and session-rating of perceived exertion (s-RPE) throughout 23 sessions (n = 306 files). The reference team performed a greater number of accelerations, decelerations, spent longer time > 85% maximum HR (t85%HR max ) and reported greater s-RPE after losing a game compared to a win (r = 0.13–0.19). Moreover, a lower number of accelerations, decelerations, t85%HR max and s-RPE (r = 0.15–0.45) were found before playing against a top-ranked opponent. In contrast, more accelerations, decelerations, longer 85%HR max and greater s-RPE were observed after playing against a top-ranked team opponent (r = 0.15–0.41). The players performed more accelerations/min, spent more t85%HR max and reported greater s-RPE before playing an away game (r = 0.13–0.22). Weekly TL seems to slightly increase after losing a game, when preparing a game against a weaker opponent, after playing against a stronger opponent, and when preparing an away game. On the other hand, training intensity seems not to be affected by game-related contextual variables. Thus, ice hockey practitioners involved with TL monitoring should consider the interplay of the numerous variables that influence the volume of prescribed training and the actual training responses in each individual player.