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A considerable body of empirical evidence indicates that conflict affects reproductive behaviour, often resulting in an increased fertility rate due to higher child mortality and limited access to healthcare services. However, we know much less about the effect of peace in a post-conflict setting. This study explores how the external provision of security affects fertility by focusing on the UN intervention in Liberia. We combine DHS birth history data with information on road distance to UN military compounds and find that women living in the proximity of peacekeepers have lower fertility rates in the deployment period. This is due to parents prioritizing quality over quantity: peacekeepers improve maternal and child health and encourage family planning by enabling donors and humanitarian actors to deliver infrastructures and services and facilitating citizens’ access to such services. We also provide evidence that the UN mission revitalizes local economic activities, thus increasing the opportunity cost of childbearing.

Civil wars affect the economic conditions of households by disrupting economic transactions and harming their psychological well-being. To restore basic conditions for local economic recovery in conflict-torn regions, the international community has only a limited number of tools at its disposal. We ask whether UN peacekeeping is one instrument to mitigate the negative effect of conflict on households' economic well-being. We argue that, by reducing violence and heightening perceptions of safety, UN missions (i) encourage labor provision and economic exchanges, and (ii) instill confidence by reducing the psychological impact of daily stressors. Combining high-frequency household survey data and information on subnational deployment of UN peacekeepers in South Sudan, we show that peacekeepers' military presence improves security (observed and perceived), which in turn revitalizes local economies and households' subjective well-being. These improvements ultimately boost households' consumption, partially countering the negative effect of ongoing civil wars by keeping local communities' economy afloat.

We explore the relation between immigration, crime, and local government spending on security in Italian municipalities. We find that immigration increases the share of public resources devoted to police protection, particularly when migrants are culturally distant from the native population. We uncover a misalignment between perception and reality, as immigration is associated to fear of future crimes rather than the actual probability of being victim of a crime. We also demonstrate that immigration from culturally distant societies corresponds to a deterioration in civic cooperation and interpersonal trust, which can affect perceptions of safety and the demand for police services.

Purpose: Obesity and pregnancy are strictly related: on the one hand, obesity—one of the most common comorbidities in women of reproductive age—contributes to infertility and obesity-related pregnancy complications, whereas pregnancy is a condition in which, physiologically, the pregnant woman undergoes weight gain. Endoscopic sleeve gastroplasty (ESG) may be used for the treatment of obesity in women of childbearing age. Materials and Methods: A retrospective analysis was conducted to evaluate weight trajectories, the evolution of obesity-related comorbidities, and lifestyle modification in women who became pregnant after ESG. A comparison was made between childbearing-age women who became pregnant after ESG and non-pregnant women. Results: A total of 150 childbearing-age women underwent ESG at a large tertiary medical center. Of these, 11 patients (33.4 ± 6.2 years) became pregnant after the procedure, following a mean time interval of 5.5 ± 3.9 months. Three women (two affected by polycystic ovary syndrome) reported difficulty getting pregnant before undergoing ESG. The mean preconception BMI was 31.9±4.0 kg/m2 (−7.24 ± 4.0 kg/m2 after ESG). Total body weight loss (TBWL, %) was 18.08 ± 8.00, 11.00 ± 11.08, and 12.08 ± 8.49, at the beginning of pregnancy, at the delivery, and at the first follow-up (19.6 ± 7.8 months after ESG). TBWL of at least 5% was achieved before pregnancy in all patients (73% reached a TBWL ≥ 10%). No significant differences in weight loss and QoL were found between the pregnancy and non-pregnancy groups up to 24 months after ESG. Conclusions: Endoscopic sleeve gastroplasty allows for adequate weight loss before and after pregnancy in patients with obesity. Graphical Abstract: [Figure not available: see fulltext.]

Esophageal perforation is a life-threatening condition burdened by high morbidity and mortality. The esophageal perforation can occur spontaneously (such as Boerhaave syndrome) or can be an iatrogenic complication. The diagnostic approach may be difficult as the clinical presentations is often non-specific. However, a proper and early diagnosis is crucial to reduce the mortality rate. Once the diagnosis is obtained, the therapeutic management differs among the different clinical scenarios. In some cases, a wait and watch approach is preferred, in other cases a more aggressive treatment is required. Although surgery was considered the standard of care, nowadays endoscopy is emerging as the first line treatment in esophageal perforations non-responsive to medical treatments. The endoscopic techniques available are the application of through-the-scope clips (TTSCs), over-the-scope clips, esophageal stents, endoscopic suturing techniques, endoluminal vacuum therapy (EVT), and locoregional application of regenerative medicine. The choice of the specific endoscopic technique depends on the injury length, the perforation site, and the presence of fluid collections. The complexity of the diagnostic and therapeutic approach to esophageal perforation imposes a multidisciplinary approach in order to choose the proper treatment in each singular case. The aim of this study is to assess the role of endoscopy in the management of esophageal injuries and to describe the endoscopic techniques nowadays available.

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OBJECTIVE: The Coronavirus Disease 2019 (COVID-19) pandemic mainly involves respiratory symptoms, though gastrointestinal (GI) symptoms are increasingly being recognized. In this context, the presence of comorbidities appears to be associated with adverse outcomes. However, the role of digestive manifestations is not yet well defined. The primary aim of this study was to assess the prevalence of GI symptoms and digestive comorbidities in a cohort of patients with COVID-19 compared to controls. The secondary aim was to determine the association of GI-symptoms and digestive comorbidities with clinical outcomes. PATIENTS AND METHODS: Inpatients with COVID-19 and controls with similar symptoms and/or radiological findings were enrolled. Symptoms at admission and throughout hospitalization were collected as they were comorbidities. The measured clinical outcomes were mortality, intensive care unit admission and cumulative endpoint. RESULTS: A total of 105 patients were included: 34 with COVID-19 and 71 controls. At admission, the prevalence of GI symptoms among COVID-19 patients was 8.8%. During hospitalization, the frequency of GI symptoms was higher in patients with COVID-19 than in controls (p=0.004). Among patients with COVID-19, the mortality and a cumulative endpoint rates of those with GI symptoms were both lower than for those without GI symptoms (p=0.016 and p=0.000, respectively). Finally, we found digestive comorbidities to be associated with a milder course of COVID-19 (p=0.039 for cumulative endpoint). CONCLUSIONS: Our results highlighted the non-negligible frequency of GI symptoms in patients with COVID-19, partly attributable to the therapies implemented. In addition, the presence of GI symptoms and digestive comorbidities is associated with better outcomes. Most likely, digestive comorbidities do not hinder the host's immune response against SARS-COV-2, and the occurrence of GI symptoms might be linked to a faster reduction of the viral load via the faeca

© 2018 SPIE. We have previously introduced a femtosecond laser micromachining-based scheme for the fabrication of anisotropic waveguides and isotropic Bragg reflection gratings in lithium niobate for application in future integrated-optic spatial light modulators. In this paper, we depict progress in fabrication and characterization of anisotropic Bragg reflection gratings fabricated in lithium niobate via Type I femtosecond laser-based permittivity modulation. We furthermore depict an electromagnetic analysis of such multilayer grating structures based around coupled-wave theory for thick holographic gratings., U.S. Army Research Laboratory (Contract FA8650-14-C-6571)

Gallbladder cancer is a rare malignancy burdened by poor prognosis with an estimated 5-year survival of 5% to 13% due to late presentation, early infiltration of surrounding tissues, and lack of successful treatments. The only curative approach is surgery; however, more than 50% of cases are unresectable at the time of diagnosis. Endoscopy represents, together with surgery and chemotherapy, an available palliative option in advanced gallbladder cancers not eligible for curative treatments. Cholangitis, jaundice, gastric outlet obstruction, and pain are common complications of advanced gallbladder cancer that may need endoscopic management in order to improve the overall survival and the patients’ quality of life. Endoscopic biliary drainage is frequently performed to manage cholangitis and jaundice. ERCP is generally the preferred technique allowing the placement of a plastic stent or a self-expandable metal stent depending on the singular clinical case. EUS-guided biliary drainage is an available alternative for patients not amenable to ERCP drainage (e.g., altered anatomy). Gastric outlet obstruction is another rare complication of gallbladder malignancy growing in contact with the duodenal wall and causing its compression. Endoscopy is a less invasive alternative to surgery, offering different options such as an intraluminal self-expandable metal stent or EUS-guided gastroenteroanastomosis. Abdominal pain associated with cancer progression is generally managed with medical treatments; however, for incoercible pain, EUS-guided celiac plexus neurolysis has been described as an effective and safe treatment. Locoregional treatments, such as radiofrequency ablation (RFA), photodynamic therapy (PDT), and intraluminal brachytherapy (IBT), have been described in the control of disease progression; however, their role in daily clinical practice has not been established yet. The aim of this study is to perform a review of the literature in order to assess the role of endos