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Abstract The SARS-CoV-2 coronavirus emerged in 2019 causing a COVID-19 pandemic that resulted in 7 million deaths out of 770 million reported cases over the next 4 years. The global health emergency called for unprecedented efforts to monitor and reduce the rate of infection, pushing the study of new diagnostic methods. In this paper, we introduce a cheap, fast, and non-invasive COVID-19 detection system, which exploits only exhaled breath. Specifically, provided an air sample, the mass spectra in the 10–351 mass-to-charge range are measured using an original micro and nano-sampling device coupled with a high-precision spectrometer; then, the raw spectra are processed by custom software algorithms; the clean and augmented data are eventually classified using state-of-the-art machine-learning algorithms. An uncontrolled clinical trial was conducted between 2021 and 2022 on 302 subjects who were concerned about being infected, either due to exhibiting symptoms or having recently recovered from illness. Despite the simplicity of use, our system showed a performance comparable to the traditional polymerase-chain-reaction and antigen testing in identifying cases of COVID-19 (that is, 95% accuracy, 94% recall, 96% specificity, and 92% $$F_1$$ -score). In light of these outcomes, we think that the proposed system holds the potential for substantial contributions to routine screenings and expedited responses during future epidemics, as it yields results comparable to state-of-the-art methods, providing them in a more rapid and less invasive manner.

Despite the advent of robotics and the decreasing rate of complications after radical cystectomy, several factors are renowned to impair the early outcomes of this procedure. The aim of this paper is to provide a multivariate analysis (MVA) of patient and surgical procedure-related variables likely to affect postoperative course and 30-day complication rate. Fifty-five robotic-assisted radical cystectomies (RARCs) performed at a single center from July 2021 to March 2023 were enrolled. Baseline demographics, comorbidities, and intraoperative and postoperative data were collected. Uni- and multivariate analyses were performed to evaluate the relationship with Clavien ≥ II complications arising within 30 days of surgery. A postoperative Clavien ≥ II complication was evident in 15 patients (28%), whereas Clavien ≥ III occurred only in 5 (9%). At MVA, the only independent predictor of Clavien ≥ II complications was a prior neoadjuvant chemotherapy (OR 5.6; 95% CI 1.22–25.3, p = 0.026). Recognized the small sample size, patients who received a prior NAC should deserve special care within the postoperative course.

O referencial freireano vem sendo empregado em investigações de diferentes campos da educação, incluindo pesquisas na área do Ensino de Ciências. Com o objetivo de identificar as contribuições de Paulo Freire em relação aos conhecimentos científicos e tecnológicos para a educação em ciências da natureza, foram analisadas fontes primárias por meio de uma pesquisa bibliográfica. Dentre os livros mais citados do autor, dez foram selecionados para a análise, incluindo: I) Pedagogia do Oprimido; II) Pedagogia da Esperança: um reencontro com a Pedagogia do Oprimido; III) Pedagogia da Autonomia; IV) Educação como prática da liberdade; V) A importância do ato de ler; VI) Educação e mudança; VII) Extensão ou comunicação; VIII) Política e educação; IX) Conscientização; X) Pedagogia da Indignação. O tratamento analítico se deu por meio da enumeração, categorização e decodificação oriundas das técnicas de análise de conteúdo de Bardin. As unidades de análise foram selecionadas a partir dos seguintes termos e radicais: Ciência; Científic-; Tecno; e Técnic-. Os resultados identificados e analisados pelo estudo buscam ampliar o conhecimento da comunidade de pesquisadores e de professores acerca da contribuição da obra do autor para o ensino de ciências da natureza, além de propiciar debates e futuras investigações sobre a dimensão instrumental do conhecimento científico por meio de uma perspectiva dialógica, humanista e igualitária.

Objective: To conduct a thorough examination of the current understanding of the effect of maternal depression exposure on the executive functions (EFs) of offspring. Methods: Following the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) statement, a comprehensive search for peer-reviewed cohort studies was performed on the MEDLINE (via PubMed), ScienceDirect, LILACS, PsycINFO, and SciELO databases. Study quality was assessed using the National Heart, Lung, and Blood Institute (NHLBI) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. The evidence was evaluated using the Grading of Recommendation, Assessment, Development, and Evaluation framework. Results: Thirty-three cohort studies from different countries, enrolling a total of 38,981 participants, were analyzed. Twenty-four studies confirmed the hypothesis of a harmful effect of maternal depressive symptoms on offspring EF. However, high heterogeneity among studies was found, and meta-analysis was not feasible. Fetal programming, genetics, and parental practices have been identified as potential mechanisms that can affect the EFs of children born to mothers who have experienced depressive symptoms. Conclusion: Our findings suggest a negative association between maternal depressive symptoms and offspring EF. Further studies on the effects of chronicity/severity of maternal symptoms and changes in EFs in different sensitive periods are needed. Registration number: PROSPERO CRD42020221193.

BackgroundSurgery is still the standard treatment for breast lesions such as in situ ductal carcinoma (DCIS); however, its survival benefit is minimal, particularly for low-grade DCIS. Surgical complications and related depression status can adversely affect patients’ quality of life. Approximately 25% of breast cancer (BC) cases are in situ forms, with DCIS making up 90% of these. Low and intermediate-grade DCIS often grow slowly and do not always progress clinically significant diseases. Identifying non-invasive lesions could help prevent overtreatment. In this context, new diagnostic tools like vacuum-assisted excision (VAE) could enhance the management of these conditions.MethodsThe prospective VACIS study explores the role of VAE in ensuring the absence of pathology at subsequent surgery and reducing the diagnostic underestimation of breast biopsies for microcalcifications. Patients with suspicious breast microcalcifications up to 15 mm, who are candidates for stereotactic biopsy, will be enrolled and randomised into two groups. The control group will complete the biopsy with typical sampling, aiming to collect some microcalcifications from the target, while the experimental group will focus on the complete removal of the biopsy target (confirmed by mammography on the biopsy table), followed by a second sequence of cleaning samples. Radiograms will confirm lesion removal. Pathologic outcomes at surgery will be compared between the groups, and the percentage of underestimation will be assessed. The sample size is calculated to be 70 patients per group, using statistical tests and multivariate logistic models to detect a significant difference in the absence of pathology. Data collected will include patient age, lesion characteristics, and details of the biopsy, pathology and surgery.DiscussionCurrent surgical treatments for low-and sometimes intermediate-grade DCIS offer limited survival benefits and may hurt patients’ quality of life due to surgery-related complications and associated depression. These lesions often grow slowly and might not become clinically significant, suggesting a need to avoid overtreatment. Improved diagnostics procedures, such as VAE, could help distinguish non-invasive from potentially invasive lesions, reduce biopsy underestimation, enable personalised management and optimise treatment strategies. This study hypothesises that VAE could be a viable alternative to surgery, capable of removing pathology during the biopsy procedure.Clinical trial registrationClinicaltrials.gov, identifier NCT05932758.

In this paper we introduce a bulk-surface reaction-diffusion (BS-RD) model in three space dimensions (3D) that extends the so-called DIB morphochemical model to account for the electrolyte contribution in the application, in order to study structure formation during discharge-charge processes in batteries. Here we propose to approximate the model by the bulk-surface virtual element method (BS-VEM) on a tailor-made mesh that proves to be competitive with fast bespoke methods for PDEs on Cartesian grids. We present a selection of numerical simulations that accurately match the classical morphologies found in experiments. Finally, we compare the Turing patterns obtained by the coupled 3D BS-RD model with those obtained with the original 2D version.

Abstract Objectives To compare surgical and functional outcomes between off‐clamp robot‐assisted partial nephrectomy with indocyanine‐green tumour marking through preliminary superselective embolization and on‐clamp robot‐assisted partial nephrectomy with intraoperative ultrasound identification of the renal mass. Material and methods One hundred and forty patients with a single renal mass underwent indocyanine‐green fluorescence‐guided off‐clamp robot‐assisted partial nephrectomy with preoperative superselective embolization (Group A, 70 patients) versus intraoperative ultrasound‐guided on‐clamp robot‐assisted partial nephrectomy without embolization (Group B, 70 patients). We assessed operative time, intraoperative blood loss, complications, length of stay, renal function, need for ancillary procedures and blood transfusions. Results Mean tumour size was 24 versus 25 mm in Group A versus Group B (p = 0.19). Mean operative time was 86.5 versus 121.8 min (p = 0.02), mean blood loss was 72.8 versus 214.2 mL (p = 0.02), and mean haemoglobin drop on postoperative day 1 was 1.1 versus 2.6 g/dL (p = 0.04) in Group A versus Group B. One‐month creatinine, hospital stay and enucleated tumour volume were comparable. Ten postoperative complications occurred in Group A (13.3%) and 11 in Group B (15.3%). Following superselective embolization, no patients required blood transfusions versus two patients in Group B. Postoperative selective renal embolization was needed in one case per group. Conclusions Preoperative superselective embolization of a renal mass with indocyanine‐green before off‐clamp robot‐assisted partial nephrectomy significantly reduces operative time and intraoperative blood loss compared to on‐clamp intraoperative ultrasound‐guided robot‐assisted partial nephrectomy. A longer follow‐up is needed to establish the effect on renal function.

Abstract Background CLAD (Chronic Lung Allograft Dysfunction) remains a serious complication following lung transplantation. Some evidence shows that portions of Extracorporeal Photopheresis (ECP)-treated patients improve/stabilize their graft function. In spite of that, data concerning molecular mechanisms are still lacking. Aims of our study were to assess whether ECP effects are mediated by Mononuclear Cells (MNCs) modulation in term of microRNAs (miRNAs) expression and growth factors release. Methods Cells from leukapheresis of 16 CLAD patients, at time 0 and 6-months (10 cycles), were cultured for 48h ± PHA (10 ug/ml) or LPS (2 ug/ml). Expression levels of miR-146a-5p, miR-155-5p, miR-31-5p, miR181a-5p, miR-142-3p, miR-16-5p and miR-23b-5p in MNCs-exosomes were evaluated by qRT-PCR, while ELISA assessed different growth factors levels on culture supernatants. Results Our result showed miR-142-3p down-regulation (p = 0.02) in MNCs of ECP-patients after the 10 cycles and after LPS stimulation (p = 0.005). We also find miR-146a-5p up-regulation in cells after the 10 cycles stimulated with LPS (p = 0.03). Connective tissue growth factor (CTGF) levels significantly decreased in MNCs supernatant (p = 0.04). The effect of ECP is translated into frequency changes of Dendritic Cell (DC) subpopulations and a slight increase in T regulatory cells (Treg) number and a significant decrease in CTGF release. Conclusions ECP might affect regulatory T cell functions, since both miR-142 and miR-146a have been shown to be involved in the regulation of suppressor regulatory T cell functions and DCs. On the other side ECP, possibly by regulating macrophage activation, is able to significantly down modulate CTGF release.

Abstract While alkaline Zn batteries, like traditional rechargeable aqueous batteries, boast an advantage in terms of energy density, their progress has been hampered by concerns related to the anode. These concerns include issues like Zn dendrites, self‐corrosion, passivation, shape change, and the hydrogen evolution reaction (HER). To tackle these challenges, we have introduced a nanostructuring approach for the anode, employing carbon‐coated ZnO nanoparticles (ZnO@C) as the active material. In this study, we synthesized ZnO@C nanoparticles in an environmentally sustainable and scalable manner to address passivation and dissolution issues jointly. Nanoscale ZnO particles effectively prevent passivation, while carbon shell slows down the dissolution of zincate. The Zn anode exhibits a significant performance boost when compared to Zn foil and bare ZnO nanoparticles, even when subjected to demanding conditions (without the use of ZnO‐saturated electrolyte). This rechargeable Zn anode marks a significant step toward the realization of practical, high‐energy rechargeable aqueous batteries, such as Zn‐air batteries.

IntroductionEuropean forests face increasing threats due to climate change-induced stressors, which create the perfect conditions for bark beetle outbreaks. The most important spruce forest pest in Europe is the European Spruce Bark Beetle (Ips typographus L.). Effective management of I. typographus outbreaks necessitates the timely detection of recently attacked spruce trees, which is challenging given the difficulty in spotting symptoms on infested tree crowns. Bark beetle population density is one of many factors that can affect infestation rate and symptoms development. This study compares the appearance of early symptoms in endemic and epidemic bark beetle populations using highresolution Unmanned Aerial Vehicles (UAV) multispectral imagery.MethodsIn spring of 2022, host colonization by bark beetles was induced on groups of spruce trees growing in 10 sites in the Southern Alps, characterized by different population density (5 epidemic and 5 endemic). A multispectral sensor mounted on a drone captured images once every 2 weeks, from May to August 2022. The analyses of a set of vegetational indices allowed the actual infested trees’ reflectance features and symptoms appearance to be observed at each site, comparing them with those of unattacked trees.ResultsResults show that high bark beetles population density triggers a more rapid and intense response regarding the emergence of symptoms. Infested trees were detected at least 1 month before symptoms became evident to the human eye (red phase) in epidemic sites, while this was not possible in endemic sites. Key performing vegetation indices included NDVI (Normalized Difference Vegetation Index), SAVI (Soil Adjust Vegetation Index, with a correction factor of 0.44), and NDRE (Normalized Difference Red Edge index).DiscussionThis early-detection approach could allow automatic diagnosis of bark beetles’ infestations and provide useful guidance for the management of areas suffering pest outbreaks.

Abstract Contrast-enhanced mammography (CEM) is a relatively recent diagnostic technique increasingly being utilized in clinical practice. Until recently, there was a lack of standardized reporting for CEM findings. However, this has changed with the publication of a supplement in the Breast Imaging Reporting and Data System (BI-RADS). A comprehensive understanding of CEM is essential for further enhancing its role in both screening and managing patients with breast malignancies. CEM can also be beneficial for problem-solving, improving the management of uncertain breast findings. Practitioners in this field should become more cognizant of how and when to employ this technique and interpret the various CEM findings. This paper aims to outline the key findings in the updated version of the BI-RADS specifically dedicated to CEM. Additionally, it will present some clinical cases commonly encountered in clinical practice. Critical relevance statement Standardized reporting and a thorough understanding of CEM findings are pivotal for advancing the role of CEM in screening and managing breast cancer patients. This standardization contributes significantly to integrating CEM as an essential component of daily clinical practice. Key points • A complete knowledge and understanding of the findings outlined in the new BI-RADS CEM are necessary for accurate reporting. • BI-RADS CEM supplement is intuitive and practical to use. • Standardization of the CEM findings enables more accurate patient management. Graphical Abstract

Legume crops play a key role in hastening both the agroecological and protein transition and improving the sustainability of cropping systems. Among legumes, chickpea (Cicer arietinum L.) is a valuable source of protein, fibers, and nutraceutical compounds, providing important agri-environmental effects. Nevertheless, few studies have explored the effect of genetic characteristics on production and quality traits in chickpea. Chickpea landraces seem particularly interesting for their positive agronomic and quality characteristics, opening the door for innovation in sustainable food systems. Thus, the present study aimed to characterize two chickpea Tuscan landraces (Rugoso della Maremma and Cappuccio della Valtiberina) in comparison with widely distributed commercial chickpea varieties (Ares, Maragià, Pascià, Principe, Reale, Sultano, and Vittoria). Our findings highlighted positive agronomic traits of landraces in terms of seed yield and yield components, demonstrating performance that is either superior or comparable to commercial varieties. Notably, Cappuccio della Valtiberina showed the highest 1000-seed weight (425.50 g), followed by Maragià (432.92 g), Principe (392.32 g), and Reale (382.79 g), and the highest harvest index (0.55), similar to Reale (0.55). Overall, landraces achieved 18.75% higher yields than commercial varieties. Regarding chickpea quality, landraces exhibited profiles comparable to those of commercial genotypes in terms of protein and oil content, as well as nutraceuticals. Interestingly, the two landraces had the most favorable ω-6/ω-3 ratios (Cappuccio della Valtiberina, 12.45; Rugoso della Maremma, 13.71) among the genotypes except for Maragià (11.78), indicating better nutritional quality compared to commercial varieties (>14.00). These results demonstrated that landraces could offer promising prospects for future chickpea breeding programs, aiding in the selection of genotypes capable of adapting to changing growing conditions and supporting the development of sustainable food systems.

Expanding uterine masses can be the cause of pregnancy loss and add technical difficulties to uterus evacuation due to the intense anatomical distortion of the endocervical canal and uterine cavity. The literature is scarce in the peculiarities of the management of missed abortions in uterus with important distorted anatomies. We report a case of a primigravida patient who presented a rapid and expressive increase of abdominal volume due to a giant uterine mass, evolving to miscarriage. Ultrasound can be a useful tool, allowing visualization of the endocervical path and uterine cavity, helping to perform uterine evacuation in the presence of anatomical distortion without compromising the reproductive future. To the best of our knowledge, no such case has been previously reported.

Anemia is common in cancer patients and impacts on quality of life and prognosis. It is typically multifactorial, often involving different pathophysiological mechanisms, making treatment a difficult task. In patients undergoing active anticancer treatments like chemotherapy, decreased red blood cell (RBC) production due to myelosuppression generally predominates, but absolute or functional iron deficiency frequently coexists. Current treatments for chemotherapy-related anemia include blood transfusions, erythropoiesis-stimulating agents, and iron supplementation. Each option has limitations, and there is an urgent need for novel approaches. After decades of relative immobilism, several promising anti-anemic drugs are now entering the clinical scenario. Emerging novel classes of anti-anemic drugs recently introduced or in development for other types of anemia include activin receptor ligand traps, hypoxia-inducible factor-prolyl hydroxylase inhibitors, and hepcidin antagonists. Here, we discuss their possible role in the treatment of anemia observed in patients receiving anticancer therapies.

Abstract Key message During pest outbreaks, mapping tools play an important role. Participatory projects can provide useful ground data, which have a high accuracy in detecting early-stage infestations and small spots of the European spruce bark beetle Ips typographus. However, satellite approaches are fundamental to clearly estimate infestation occurrence because ground data are spatially biased. Here, we show how a participatory approach involving nonspecialized staff and based on GIS-based app may contribute ground truth data that are fully complementary to satellite data. Context In Europe, bark beetle outbreaks were recently triggered by windstorms and heat waves, with the European spruce bark beetle Ips typographus. as the most important pest species. Huge efforts are needed for continuous mapping and monitoring of affected areas, especially during an incipient large-scale infestation. This is particularly difficult in mountain landscapes because of the rugged topography. Aims In addition to the use of remote sensing techniques, ground surveys are still an important source of data, providing detailed information on the symptoms of the affected trees and the stage of the attacks. Unfortunately, these surveys are extremely time demanding and require intensive field work. We wanted to assess how a participatory approach based on nonspecialized staff may contribute to data collection. Methods Georeferenced outbreak data were collected in the field in the Southern Alps (Italy) using a smartphone application based on ArcGIS platform. The survey was based on a participatory approach on a voluntary basis, involving citizens aware of forest practices. Visual analysis of satellite images was performed monthly to assess the visibility of reported infestations. Using a binomial model, we tested how the type of report (i.e., on-site/off-site), size of spot, stage of infestation, and their interactions affect detectability. In addition, spot occurrences within a study area were mapped for comparison with ground surveillance. Closeness to roads was tested between reported and unreported spots. Results WebGIS platform allowed us to retrieve near real-time information on bark beetle outbreaks and to compare the results with satellite imagery. Using visual analysis of satellite images, we detected only ~ 50% of the spots observed in the field, and detectability decreased dramatically for smaller and early-stage spots. Field observations were mostly concentrated near roads and covered only ~ 10% of the spots detected on satellite images. Conclusion The participatory approach is particularly helpful in mapping early-stage and small infestations, while satellite images are better suited at covering large areas and detect large and advanced-stage spots. The integration of those approaches is promising, and it can greatly improve the overall understanding of bark beetle outbreaks under emergency situations. A greater effort in developing smart applications for ground detection will benefit future monitoring of forest pests.

ObjectivesPostoperative haematuria is a feared complication following prostate enucleation, and it may occur even weeks after discharge. We evaluated the risk of bleeding after discharge and its predictive factors in patients who underwent Thulium laser enucleation of the prostate (ThuLEP). MethodsBetween January 2015 and December 2018, patients with surgical indication for benign prostatic hyperplasia underwent ThuLEP in 4 urology departments. All procedures were performed by experienced urologists. Postoperative haematuria was defined as macroscopic haematuria occurring 7 days after discharge. Readmission rate due to macroscopic haematuria was assessed. Logistic regression models tested for predictors of postoperative bleeding requiring readmission. ResultsOverall, 748 patients were included, and 52 (6.9%) of them were readmitted after discharge because of macroscopic haematuria. No cases of deep venous thrombosis or pulmonary embolism were diagnosed. Mean length of stay for surgical treatment was 2.1 days, and mean hospitalization for readmission was 5.6 days. None of the readmitted patients required reintervention, while 46.1% of them required blood transfusions. Diabetes mellitus (P < 0.05), a long bridge of oral anticoagulant drugs with low molecular weight heparin (LMWH) (P < 0.05) and history of constipation (P < 0.05) were significant predictors of readmission after discharge due to macroscopic haematuria. ConclusionsPatients with a clinical history of diabetes mellitus or constipation and patients who undergo a long bridge of oral anticoagulant therapy with LMWH are at higher risk of bleeding requiring readmission after ThuLEP.