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The eastern equatorial Atlantic (EEA) seasonal cycle and interannual variability strongly influence the climate of the surrounding continents. It is thus crucial that models used in both climate predictions and future climate projections are able to simulate them accurately. In that context, the EEA monthly climatology and interannual variability are evaluated over the period 1985–2004 for models participating in the Ocean Model Intercomparison Project Phases 1 and 2 (OMIP1 and OMIP2). The main difference between OMIP1 and OMIP2 simulations is their atmospheric forcing: CORE-II and JRA55-do, respectively. Monthly climatologies of the equatorial Atlantic zonal wind, sea level anomaly, and sea surface temperature in OMIP1 and OMIP2 are comparable to reanalysis products. Yet, some discrepancies exist in both OMIP ensembles: the thermocline is too diffusive, and there is a lack of cooling during the development of the Atlantic cold tongue. The EEA interannual sea surface temperature variability during May–June–July in the OMIP1 ensemble mean is found to be 51 % larger (0.62 ± 0.04 °C) than that in the OMIP2 ensemble mean (0.41 ± 0.03 °C). Likewise, the May–June–July interannual sea surface height variability in the EEA is 33 % larger in the OMIP1 ensemble mean (0.02 ± 0.002 m) than in the OMIP2 ensemble mean (0.015 ± 0.002 m). Sensitivity experiments demonstrate that the discrepancies in interannual sea surface temperatures and sea surface height variabilities between OMIP1 and OMIP2 are mainly attributable to their wind forcings and, specifically, to their variability. While the April–May–June zonal wind variability in the western equatorial Atlantic is similar in both forcings, the zonal wind variability peaks in April for JRA55-do and in May for CORE-II.

In this paper, we first describe the main features of a new version of the International Centre for Theoretical Physics global atmospheric model (SPEEDY) with improved simulation of surface fluxes and the formulation of a three-layer thermodynamic ocean model (TOM3) suitable to explore the coupled extratropical response to tropical ocean variability. Then, we present results on the atmospheric model climatology, highlighting the impact of the modifications introduced in the model code, and show how important features of interdecadal and interannual variability are simulated in a “pacemaker” coupled ensemble of 70-year runs, where portions of the tropical Indo-Pacific are constrained to follow the observed variability. Despite the very basic representation of variations in greenhouse forcing and heat transport to the deep ocean (below the 300 m domain of the TOM3 model), the coupled ensemble reproduces the variations in surface temperature over land and sea with very good accuracy, confirming the role of the Indo-Pacific as a “pacemaker” for the natural fluctuations of global-mean surface temperatures found in earlier studies. Atmospheric zonal-mean temperature trends over 50 years are also realistically simulated in the extratropical lower troposphere and up to 100 hPa in the tropics. On the interannual scale, sea-surface temperature (SST) variability in sub-tropical and tropical regions not affected by SST relaxation is underestimated (mostly because of the absence of dynamically induced variability), while extratropical SST variability during the cold seasons is comparable to that observed. Atmospheric teleconnection patterns and their connections with SST are reproduced with high fidelity, although with local differences in the amplitude of regional features (such as a larger-than-observed response of extratropical SST to North Atlantic Oscillation variability). The SPEEDY-TOM3 model also reproduces the observed connection between averages of surface heat fluxes over the oceans and land surface air temperature in the wintertime northern extratropics. Overall, as in earlier versions of SPEEDY, the fidelity of the simulations (both in terms of climatological means and variability) is higher near the surface and in the lower troposphere, while the negative impacts of the coarse vertical resolution and simplified parameterizations are mostly felt in the stratosphere. However, the improved simulation of surface heat fluxes and their impact on extratropical SST variability in this model version (obtained at a very modest computational cost) make the SPEEDY-TOM3 model a suitable tool to investigate the coupled response of the extratropical circulation to interannual and inter-decadal changes of tropical SST in ensemble experiments.

Introduction. Yersinia enterocolitica (Ye) species is divided into 6 biotypes (BT), 1A, 1B, 2, 3, 4, 5 classified based on biochemical reactions and about 70 serotypes, classified based on the structure of the lipopolysaccharide O-antigen. The BT1A is considered non-pathogenic, while the BT 1B-5 are considered pathogenic. Methods. Evaluate the distribution of eleven chromosomal and plasmid virulence genes, ail, ystA, ystB, myfA, hreP, fes, fepD, ymoA, sat, virF and yadA, in 87 Ye strains isolated from food, animals and humans, using two SYBR Green real-time PCR platforms. Results. The main results showed the presence of the ail and ystA genes in all the pathogenic bioserotypes analyzed. The ystB, on the other hand, was identified in all non-pathogenic strains biotype 1A. The target fes, fepD, sat and hreP were found in both pathogenic biotypes and in BT1A strains. The myfA gene was found in all pathogenic biotype and in some Ye BT1A strains. The virF and yadA plasmid genes were mainly detected in bioserotype 4/O:3 and 2/O:9, while ymoA was identified in all strains. Conclusions. The two molecular platforms could be used to better define some specific molecular targets for the characterization and rapid detection of Ye in different sources which important implications for food safety and animal and human health.

As the climate warms, the grounded ice sheet and floating ice shelves surrounding Antarctica are melting and releasing additional freshwater into the Southern Ocean. Nonetheless, almost all existing coupled climate models have fixed ice sheets and lack the physics required to represent the dominant sources of Antarctic melt. These missing ice dynamics represent a key uncertainty that is typically unaccounted for in current global climate change projections. Previous modelling studies that have imposed additional Antarctic meltwater have demonstrated regional impacts on Southern Ocean stratification, circulation, and sea ice, as well as remote changes in atmospheric circulation, tropical precipitation, and global temperature. However, these previous studies have used widely varying rates of freshwater forcing, have been conducted using different climate models and configurations, and have reached differing conclusions on the magnitude of meltwater–climate feedbacks. The Southern Ocean Freshwater Input from Antarctica (SOFIA) initiative brings together a team of scientists to quantify the climate system response to Antarctic meltwater input along with key aspects of the uncertainty. In this paper, we summarize the state of knowledge on meltwater discharge from the Antarctic ice sheet and ice shelves to the Southern Ocean and explain the scientific objectives of our initiative. We propose a series of coupled and ocean–sea ice model experiments, including idealized meltwater experiments, historical experiments with observationally consistent meltwater input, and future scenarios driven by meltwater inputs derived from stand-alone ice sheet models. Through coordinating a multi-model ensemble of simulations using a common experimental design, open data archiving, and facilitating scientific collaboration, SOFIA aims to move the community toward better constraining our understanding of the climate system response to Antarctic melt.

Consumption of raw or undercooked wild boar (WB) meat is considered an important risk factor for hepatitis E virus (HEV) infection in humans. The possibility of HEV contamination during the slaughtering practices may pose an additional risk. Based on these assumptions, we evaluated HEV contamination of WB meat hunted in Umbria (central Italy) during the 2022–2023 hunting season by real-time RT-PCR. Herein, we show that 10.8% of livers from slaughtered WB were positive for HEV RNA, thus providing an estimate of HEV infection in WB in the Umbria region. Then, by evaluating paired liver–muscle samples from both HEV-positive and HEV-negative animals, we found evidence of muscle HEV contamination in 33% and 14% of cases, respectively. This is the first report on the detection of HEV in WB meat in Umbria, an Italian region with diffuse WB hunting and consumption. The evidence of contamination provided by our study underscores the importance of adopting good hygienic practices in the processing stages of hunted WB carcasses to significantly reduce meat contamination and the risk posed for the final consumer.

In Italy, free vaccinations for Herpes Zoster (HZ), pneumococcal (PCV), and influenza (FLU) are recommended each year for individuals turning 65. Despite this, achieving optimal vaccination coverage remains challenging. This study assesses coverage rates for HZ, PCV, and FLU in Forlì, Northern Italy, and examines how altitude, urban planning, and health organization variables (such as the presence of a vaccination center) impact vaccine uptake. Vaccination coverages were calculated for birth cohorts between 1952 and 1958 for each municipality in the Forlì area as of 1 March 2024. The geographical factors influencing the vaccination uptake were extracted from the Italian National Institute of Statistics (ISTAT) records and evaluated through a multivariate analysis. The sample analyzed included 15,272 vaccine campaign targets from Forlì’s province (185,525 citizens); the vaccine uptake rates for HZ, PCV, and FLU were 26.9%, 36.7%, and 43.5%, respectively. Gender did not appear to influence vaccine uptake. Living in a flat area appeared to increase vaccine uptake in a statistically significant way for all the vaccinations when compared to a mountainous area (HZ: OR: 1.50, PCV: OR: 1.33, FLU: OR: 1.67). The presence of a vaccine service in low-urbanized areas was shown to increase vaccine uptake for all vaccinations (HZ: OR: 1.65, PCV: OR: 1.93, FLU: OR: 1.53) compared with low-urbanized areas without a vaccination center or more urbanized areas with a vaccination center. This study emphasizes the significance of the territorial context, along with the ease of access to vaccinations and geographic barriers, as key determinants in achieving vaccination targets. Local health authorities should consider these factors when implementing vaccination campaigns.

Abstract Sources of uncertainty (i.e., internal variability, model and scenario) in Atlantic Niño variability projections were quantified in 49 models participating in the Coupled Model Intercomparison Phases 5 (CMIP5) and 6 (CMIP6). By the end of the twenty‐first century, the ensemble mean change in Atlantic Niño variability is −0.07 ± 0.10˚C, with 80% of CMIP models projecting a decrease, and representing a 16% reduction relative to the 1981–2005 ensemble mean. Models' projections depict a large spread, with variability changes ranging from 0.23˚C to −0.50˚C. Internal variability is the main source of uncertainty until 2045 but model uncertainty dominates thereafter, eventually explaining up to 80% of the total uncertainty. The scenario uncertainty remains low (

Abstract Atlantic climate displays an oscillatory mode at a period of 10–15 years described as pan-Atlantic decadal oscillation. Prevailing theories on the mode are based on thermodynamic air-sea interactions and the role of ocean circulation remains uncertain. Here we uncover ocean circulation variability associated with the pan-Atlantic decadal oscillation using observational datasets from 1900–2009. Specifically, a sea level-derived index of ocean circulation also exhibits 10-15 year periodicity and leads the surface climate oscillation. The underlying ocean circulation links the extratropical and tropical Atlantic, where the maximum variance in surface-ocean temperature feeds back on the North Atlantic Oscillation (the leading mode of atmospheric variability over the North Atlantic region). Our findings imply that, rather than a passive role postulated by the thermodynamic paradigm, ocean circulation across the Atlantic plays an active role for the pan-Atlantic decadal climate oscillation.

BackgroundThe phenomenon violence against health professionals has received increasing attention in recent years because of its frequency and significant impact on victims’ mental health and disruption of health services. Despite this attention, little is known about the incidence of workplace violence in the highly politicized immunization services. Therefore, we decided to examine the prevalence of workplace violence in the COVID-19 immunization campaign, the risk and protective factors, and the impact on victims’ mental health.MethodsBetween March and April 2022, we conducted an anonymous online survey among health professionals working in COVID-19 vaccination centers in the Friuli-Venezia Giulia Region (Italy). We used the Questionnaire for Workplace Violence in Healthcare Settings and the Impact of Event Scale–Revised.ResultsOf the 200 participants, 93 (46.5%) reported being victims of an act of violence during the vaccination campaign, 60 of them verbally and 7 physically. In 35.5% of cases, the IES score indicated a possible post-traumatic stress reaction in the victim. Opinions on measures to prevent violence and support workers in the workplace differed according to the sex of the health professional, with women emphasizing the need for self-defense training and improvement of security arrangements (p

The provision of quality healthcare relies on scales and measures with robust evidence of their psychometric properties. Using measurement instruments with poor reliability, validity, or feasibility, or those that are not appropriate for the target diagnostic group or construct/dimension under consideration, may be unfavorable for patients, unproductive, and hinder empirical advancement. Resources from the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) group can assist in identifying and developing psychometrically sound measures. The COSMIN initiative is the only international, research-based practice taxonomy and methodological guidelines for measurement in healthcare. This manuscript aims to provide an accessible introduction to theories, principles and practices of psychometrics, instrument properties, and scale development, with applied examples from the COSMIN recommendations. It describes why measurement in healthcare is critical to good practice, explains the concepts of the latent variable and hypothetical construct and their importance in healthcare assessments, explores issues of flawed measurement and briefly explains key theories relevant to psychometrics. The paper also outlines a ten-step process to develop and validate a new measurement instrument, with examples drawn from a recently developed visuoperceptual measure for analysis of disordered swallowing to demonstrate key concepts and provides a guide for understanding properties of and terminology related to measurement instruments. This manuscript serves as a resource for healthcare clinicians, educators, and researchers who seek to develop and validate new measurement instruments or improve the properties of existing ones. It highlights the importance of using psychometrically sound measurement instruments to ensure high-quality healthcare assessments.

Aim: The management of a complicated duplex kidney remains a challenge for paediatric urologists. The aim of this study is to report a 10-year experience of the surgical management of complicated duplex kidney in a single tertiary care paediatric referring hospital. Materials and Methods: Clinical records of all children who undergone a surgical procedure for complicated duplex systems between January 2009 and March 2019 at our institution were retrospectively reviewed. Clinical manifestations, surgical procedures, complications and follow-up were collected and analysed. Logistic regression was performed to explore if any patient's characteristic or underlying associated comorbidity (ureterocoele, ectopic ureter, obstruction, etc.,) could be positively linked to the chance to develop recurrent urinary tract infections (UTIs). Results: We have identified 95 children who received a surgical treatment for 102 complicated duplex kidneys. The presence of an ureterocoele was recorded in 41 (43.2%) patients, an ectopic ureter in 25 (26.3%), a vesicoureteral reflux (VUR) in 40 (42.1%), a vesicoureteric junction obstruction in 24 (25.3%) and an ureteropelvic junction obstruction in 3 (3.2%). An invasive approach such as an heminephrectomy (71.6%) was required in the majority of cases. Higher risk of developing a UTI has been demonstrated in children diagnosed postnatally (P < 0.001) and in those with an associated obstruction (P < 0.05). Conclusions: No standardised management could be recommended for the surgical treatment of complicated duplex kidney. Children without antenatal diagnosis and with either an upper tract obstruction or VUR are at greater risk to develop UTI and need to be looked after more closely.

Purpose: In our institution, stereotactic radiosurgery of multiple brain metastases is performed with the CyberKnife® (CK) device, using fixed/Iris collimators. In this study, nineteen fixed/Iris plans were recalculated with the multileaf collimator (MLC), to assess if it is possible to produce plans with comparable dosimetric overall quality. Materials and Methods: For consistent comparisons, MLC plans were re-optimized and re-normalized in order to achieve the same minimum dose for the total planning target volume (PTVtot). Conformation number (CN), homogeneity index (HI) and dose gradient index (DGI) metrics were evaluated. The dose to the brain was evaluated as the volume receiving 12 Gy (V12) and as the integral dose (ID). The normal tissue complication probability (NTCP) for brain radionecrosis was calculated as a function of V12. Results: The reoptimized plans were reviewed by the radiation oncologist and were found clinically acceptable according to the The American Association of Physicists in Medicine (AAPM) Task Group-101 protocol. However, fixed/Iris plans provided significantly higher CN (+8.6%), HI (+2.2%), and DGI (+44.0%) values, and significantly lower ID values (−35.9%). For PTVtot less than the median value of 2.58cc, fixed/Iris plans provided significantly lower NTCP values. On the other side, MLC plans provided significantly lower treatment times (−18.4%), number of monitor units (−33.3%), beams (−46.0%) and nodes (−21.3%). Conclusions: CK-MLC plans for the stereotactic treatment of brain multi metastases could provide an important advantage in terms of treatment duration. However, to contain the increased risk for brain radionecrosis, it could be useful to calculate MLC plans only for patients with large PTVtot.

The Tropical Pacific Ocean plays an important role in setting the global ocean heat content and redistribution. We examined the role of the shallow and deep circulations in the tropical Pacific in unperturbed and transient climate change conditions in a global ocean model. We found that, in the Control state, the shallow circulation is by far the largest contributor to the overall balance of the column, where the balance is set as the residual between advective cooling and warming by vertical diffusive mixing. Subject to surface flux perturbations, changes in the tropical Pacific ocean heat budget can be explained by shallow wind-driven overturning circulation changes. For wind stress anomalies, the shallow ocean heat budget imbalance is directly related to overturning circulation changes, whereas under heat flux perturbations, warming of the shallow ocean is related to strengthened mid-latitude subduction and weakened dense water production at higher latitudes.

Abstract The Atlantic meridional overturning circulation (AMOC) is central to the climate of the Atlantic by redistributing mass, heat, and freshwater. Hydrographic sections help monitor its strength at different latitudes, and inverse box models provide estimates of AMOC, heat, and freshwater transports. We have used all available hydrographic zonal sections at 24.5°N and 30°S over the last 30 years to conclude that single section inverse models agree with monthly outputs from an ocean general circulation model at the time of the cruise. In contrast, inverse models using multiple sections at different latitudes and times of the year for each of the last three decades are more consistent with decadal averages from the same model. Therefore, solutions of inverse models with single sections are affected by aliasing and represent the state of the ocean at the time of cruise. However, aliasing is greatly reduced when using multiple sections to assess low‐frequency variability.

Background: To assess the pattern of response of presumed local lesions at dynamic contrast enhancement magnetic resonance imaging (DCE-MRI) after salvage radiotherapy (sRT). Methods: This is a prospective study conducted at a single Institution accruing patients with one or more local failures at DCE-MRI after radical prostatectomy between August 2017 and June 2020. Patients underwent exclusive sRT delivering 66–69 Gy and 73.5 Gy in 30 fractions to the whole prostatic fossa and to the local failure(s) seen at DCE-MRI, respectively.Patients were offered DCE-MRI at 3 months intervals after sRT until complete disappearance (CR) of the lesion(s) or up to a maximum of 4 revaluations. Results: 62 patients with 72 nodules were enrolled. All patients underwent the 1st revaluation, and 33 patients (53.2%) showed a CR. The median time to CR was 4.7 months. Four patients did not undergo further testing before achieving a CR and even considering these patients as no responses, the vast majority (87.1%, 95%CI: 78.5–94.4%) of lesions would have completely disappeared by 12 months from the end of sRT.The volume of the lesion at pre-sRT DCE-MRI was an independent predictor of CR at the 1st revaluation (OR: 0.076, 95%CI: 0.009–0.667; p = 0.020) along with time elapsed from sRT (OR: 3.399, 95% CI: 1.156–9.993, p = 0.026). Conclusions: The present study documents the complete disappearance of the vast majority of local lesions after dose-escalated sRT though this requires several months after sRT; timing of CR is at least in part predictable based on the volume of the lesion.Trial registration: Clinicaltrials.gov NCT04703543, registered July 15 2020, retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04703543.

Abstract State-of-the-art climate models simulate warmer than observed sea surface temperatures (SST) in eastern boundary upwelling systems (EBUS), generating biases with profound implications for the simulation of present-day climate and its future projections. Amongst all EBUS, the bias is largest in the southeastern tropical Atlantic (SETA). Here, we provide a comprehensive evaluation of the performance in the SETA of the Coupled Model Intercomparison Project phase 6 (CMIP6), including fine resolution (HighResMIP) and ocean-forced (OMIP) models. We show that biases in the SETA remain large in CMIP6 models but are reduced in HighResMIP, with OMIP models giving the best performance. The analysis suggests that, once local forcing errors have been reduced, the major source of the SETA biases lies in the equatorial Atlantic. This study shows that finer model resolution has helped reduce the local origin of the SETA SST bias but further developments of model physics schemes will be required to make progress.

The application of direct-injection mass spectrometric (DI-MS) techniques, like Proton Transfer Reaction Time of Flight Mass Spectrometry (PTR-ToF-MS) has been suggested as a reliable phenotyping tool for fruit volatilome assessment in both genetic and quality-related studies. In this study the complexity of raspberry aroma was investigated by a comprehensive untargeted VOC analysis, done by combining SPME-GC-MS and PTR-ToF-MS assessments with multi-block discriminant analysis using the DIABLO mixOmics framework. The aim was to acquire an exhaustive characterization of the raspberry volatilome according to different fruit ripening stages (pink, ripe, and overripe) and genetic variances (50 accessions), as well as to investigate the potential of PTR-ToF-MS as a rapid and high throughput VOC phenotyping tool to address issues related to raspberry fruit quality. Results of this study demonstrated the complementarity between SPME-GC-MS and PTR-ToF-MS techniques to evaluate the raspberry aroma composition. PTR-ToF-MS generates reliable raspberry VOC fingerprints mainly due to a reduced compound fragmentation and precise content estimation. In addition, the high collinearity between isomers of monoterpenes and norisoprenoids, discovered by GC analysis, reduces the main analytic limitation of PTR-ToF-MS of not being able to separate isomeric molecules. The high similarity between the VOC matrices obtained by applying PTR-ToF-MS and SPME-GC-MS confirmed the possibility of using PTR-ToF-MS as a reliable high throughput phenotyping tool for raspberry volatiolome assessment. In addition, results provided by the germplasm collection investigation enabled to distinguish the best performing accessions, based on VOCs composition, to be used as superior parental lines for future breeding programs.

Yersinia enterocolitica represents one of the main foodborne pathogens in Europe and the evaluation of possible sources of contamination and its prevalence in food is of considerable interest for risk analysis approach. The results of the search for Yersinia enterocolitica in food samples taken in Umbria region (central Italy) were evaluated during the years 2015-2018. Different types of foods were considered, both ready-to-eat (meat products, dairy products, and raw vegetables) and meat preparations to be eaten after cooking. Samples were assayed by molecular screening for the species indicator gene ompF. Screening positives were subjected to isolation and characterization by searching for specific virulence marker genes, including the ail gene responsible for invasiveness and the ystB gene for the production of enterotoxin. The total prevalence of positive samples for Yersinia enterocolitica was 16.86% with a higher percentage of positive samples in meat preparations (19.35%), followed by ready-to-eat vegetables (11.76%). Poultry meat samples had a higher prevalence than pork and beef samples. Neither positive samples were found in meat products and dairy, nor seasonality in positivity was observed. All isolated strains of Yersinia enterocolitica were biotype 1A, with absence of the ail virulence gene but presence of ystB gene. Since the strains isolated from human patients appear to be primarily biotypes that possess the ail marker, future investigations would be needed regarding the real role of biotype 1A in human disease. In this context, attention should certainly be paid to ready-to-eat vegetables and to careful cooking of meat preparations.

Background: Sutureless aortic bioprostheses are increasingly being used to provide shorter cross-clamp time and facilitate minimally invasive aortic valve replacement. As the use of sutureless valves has increased over the past decade, we begin to encounter their degeneration. We describe clinical outcomes and technical aspects in patients with degenerated sutureless Perceval (CorCym, Italy) aortic bioprosthesis treated with valve-in-valve transcatheter aortic valve replacement (VIV-TAVR). Methods: Between March 2011 and March 2023, 1310 patients underwent aortic valve replacement (AVR) with Perceval bioprosthesis implantation. Severe bioprosthesis degeneration treated with VIV-TAVR occurred in 32 patients with a mean of 6.4 ± 1.9 years (range: 2–10 years) after first implantation. Mean EuroSCORE II was 9.5 ± 6.4% (range: 1.9–35.1%). Results: Thirty of thirty-two (94%) VIV-TAVR were performed via transfemoral and two (6%) via transapical approach. Vascular complications occurred in two patients (6%), and mean hospital stay was 4.6 ± 2.4 days. At mean follow-up of 16.7 ± 15.2 months (range: 1–50 months), survival was 100%, and mean transvalvular pressure gradient was 18.7 ± 5.3 mmHg. Conclusion: VIV-TAVR is a useful option for degenerated Perceval and appears safe and effective. This procedure is associated with good clinical results and excellent hemodynamic performance in our largest single-center experience.

Proton transfer reaction mass spectrometry (PTR-MS) has been developed for the direct, high sensitivity and high time resolution monitoring of volatile organic compounds (VOCs). Although PTR-MS development was not guided by greenness goals, most of its features perfectly fit within the green analytical chemistry (GAC) principles, making PTR-MS an intrinsically green analytical technique. Indeed, in its basic implementation, it does not require solvents or non-renewable carrier gases and, in principle, distilled water, used to feed the source where precursors ions are formed, is the only consumable.Food science and technology and agroindustry are amongst the fields where PTR-MS has been successfully exploited. Here we review and discuss, with emphasis on the GAC requirements, the potential of PTR-MS as a tool for both fundamental research and industrial applications in different food-related themes: i) food consumption and sensory, ii) bioprocess monitoring, iii) traceability, iv) quality control, and v) high-throughput food volatilome phenotyping.The outcome of all these related studies indicates PTR-MS both as a complementary tool to gas chromatographic methods and as a valuable technique when reduced analysis time, high sensitivity and/or on-line measurement are required.

Visuoperceptual evaluation of fiberoptic endoscopic evaluation of swallowing (FEES) is a commonly used assessment in dysphagia or swallowing disorders. Currently, no international consensus exists regarding which visuoperceptual measures to use for the analysis of FEES recordings. Moreover, existing visuoperceptual FEES measures are limited by poor and incomplete psychometric data, identifying an urgent need for developing a visuoperceptual measure to interpret FEES recordings. Following the COSMIN group’s (COnsensus-based Standards for the selection of health Measurement INstruments) psychometric taxonomy and guidelines, this study aimed to establish the content validity of a new visuoperceptual FEES (V-FEES) measure in adults with oropharyngeal dysphagia. Using the Delphi technique, international consensus was achieved among dysphagia experts across 21 countries, resulting in a new prototype measure for V-FEES, comprising 30 items, 8 function testing items (i.e., specific tasks performed by patients while observing and rating items), and 36 unique operationalisations (i.e., defining items into measurable factors that could be measured empirically using visuoperceptual observation). This study supports good content validity for V-FEES, including participants’ feedback on the relevance, comprehensiveness, and comprehensibility of the included items. Future studies will continue the instrument development process and determine the remaining psychometric properties using both the classic test theory (CTT) and item response theory (IRT) models.

Abstract Purpose The purpose of this study is to evaluate inter- and intra-fraction organ motion as well as to quantify clinical target volume (CTV) to planning target volume (PTV) margins to be adopted in the stereotactic treatment of early stage glottic cancer. Methods and materials Stereotactic body radiotherapy (SBRT) to 36 Gy in 3 fractions was administered to 23 patients with early glottic cancer T1N0M0. Patients were irradiated with a volumetric intensity modulated arc technique delivered with 6 MV FFF energy. Each patient underwent a pre-treatment cone beam computed tomography (CBCT) to correct the setup based on the thyroid cartilage position. Imaging was repeated if displacement exceeded 2 mm in any direction. CBCT imaging was also performed after each treatment arc as well as at the end of the delivery. Swallowing was allowed only during the beam-off time between arcs. CBCT images were reviewed to evaluate inter- and intra-fraction organ motion. The relationships between selected treatment characteristics, both beam-on and delivery times as well as organ motion were investigated. Results For the population systematic (Ʃ) and random (σ) inter-fraction errors were 0.9, 1.3 and 0.6 mm and 1.1, 1.3 and 0.7 mm in the left-right (X), cranio-caudal (Y) and antero-posterior (Z) directions, respectively. From the analysis of CBCT images acquired after treatment, systematic (Ʃ) and random (σ) intra-fraction errors resulted 0.7, 1.6 and 0.7 mm and 1.0, 1.5 and 0.6 mm in the X, Y and Z directions, respectively. Margins calculated from the intra-fraction errors were 2.4, 5.1 and 2.2 mm in the X, Y and Z directions respectively. A statistically significant difference was found for the displacement in the Z direction between patients irradiated with > 2 arcs versus ≤ 2 arcs, (MW test, p = 0.038). When analyzing mean data from CBCT images for the whole treatment, a significant correlation was found between the time of delivery and the three dimensional displacement vector (r = 0.489, p = 0.055), the displacement in the Y direction (r = 0.553, p = 0.026) and the subsequent margins to be adopted (r = 0.626, p = 0.009). Finally, displacements and the subsequent margins to be adopted in Y direction were significantly greater for treatments with more than 2 arcs (MW test p = 0.037 and p = 0.019, respectively). Conclusions In the setting of controlled swallowing during treatment delivery, intra-fraction motion still needs to be taken into account when planning with estimated CTV to PTV margins of 3, 5 and 3 mm in the X, Y and Z directions, respectively. Selected treatments may require additional margins.

Gambling disorder (GD) is a behavioral addiction that severely impacts individuals’ functioning, leading to high socioeconomic costs. Non-invasive brain stimulation (NiBS) has received attention for treating psychiatric and neurological conditions in recent decades, but there is no recommendation for its use for GD. Therefore, this study aimed to systematically review and analyze the available literature to determine the effectiveness of NiBS in treating GD. Following the PRISMA guidelines, we screened four electronic databases up to July 2022 and selected relevant English-written original articles. We included ten papers in the systematic review and seven in the meta-analysis. As only two studies employed a sham-controlled design, the pre–post standardized mean change (SMCC) was computed as effect size only for real stimulation. The results showed a significant effect of NiBS in reducing craving scores (SMCC = −0.69; 95% CI = [−1.2, −0.2], p = 0.010). Moreover, considering the GD’s frequent comorbidity with mood disorders, we ran an exploratory analysis of the effects of NiBS on depressive symptoms, which showed significant decreases in post-treatment scores (SMCC = −0.71; 95% CI = [−1.1, −0.3], p < 0.001). These results provide initial evidence for developing NiBS as a feasible therapy for GD symptoms but further comprehensive research is needed to validate these findings. The limitations of the available literature are critically discussed.

Background: To investigate the predictive role of dynamic contrast-enhanced-magnetic resonance imaging (DCE-MRI) findings before salvage radiotherapy after radical prostatectomy (RP). Methods: This retrospective study selected patients with biochemical failure (BF) after RP restaged with DCE-MRI. Patients underwent sRT in 30 fractions delivering 66–69 Gy and 73.5 Gy to the prostatic fossa and to the local failure as per DCE-MRI, respectively. Pelvic nodes were treated to 54 Gy in selected patients. The endpoint was BF after sRT. Results: In total, 236 patients were analyzed and 146 (61.9%) had presumed local failure at DCE-MRI: 54.8%, 23.8% and 21.4% were found at the vesico-urethral anastomosis (VUA), the bladder neck and the retro-vesical space, respectively. The presence of a local failure at DCE-MRI halved the risk of BF; VUA-only location and lesion volume were independently correlated with survival without evidence of biochemical failure (bNED) at multivariable analysis. For patients with VUA-only disease up to 0.4 cc, the 4-year-bNED was 94.6% (95%CI: 80.2–98.6%) as opposed to 80.9% (95%CI: 71.6–87.4%) and 73.7% (95%CI: 63.1–81.8%) for other lesions and no macrodisease, respectively. Conclusions: DCE-MRI at restaging for BF after RP provides predictive and therapeutic information. Patients with small lesions at the VUA have an excellent prognosis after sRT.

The ripening of climacteric fruits, such as apple, is represented by a series of genetically programmed events orchestrated by the action of several hormones. In this study, we investigated the existence of a hormonal crosstalk between ethylene and auxin during the post-harvest ripening of three internationally known apple cultivars: 'Golden Delicious', 'Granny Smith' and 'Fuji'. The normal climacteric ripening was impaired by the exogenous application of 1-methylcyclopropene (1-MCP) that affected the production of ethylene and the physiological behaviour of specific ethylene-related quality traits, such as fruit texture and the production of volatile organic compounds. The application of 1-MCP induced, moreover, a de-novo accumulation of auxin. The RNA-Seq wide-transcriptome analysis evidenced as the competition at the level of the ethylene receptors induced a cultivar-dependent transcriptional re-programming. The DEGs annotation carried out through the KEGG database identified as most genes were assigned to the plant hormone signaling transduction category, and specifically related to auxin and ethylene. The interplay between these two hormones was further assessed through a candidate gene analysis that highlighted a specific activation of GH3 and ILL genes, encoding key steps in the process of the auxin homeostasis mechanism. Our results showed that a compromised ethylene metabolism at the onset of the climacteric ripening in apple can stimulate, in a cultivar-dependent fashion, an initial de-novo synthesis and de-conjugation of auxin as a tentative to restore a normal ripening progression.

Ethylene, produced endogenously by plants and their organs, can induce a wide array of physiological responses even at very low concentrations. Nevertheless, the role of ethylene in regulating blueberry (Vaccinium spp.) ripening and storability is still unclear although an increase in ethylene production has been observed in several studies during blueberry ripening. To overcome this issue, we evaluated the endogenous ethylene production of a Vaccinium germplasm selection at different fruit ripening stages and after cold storage, considering also textural modifications. Ethylene and texture were further assessed also on a bi-parental full-sib population of 124 accessions obtained by the crossing between “Draper” and “Biloxi”, two cultivars characterized by a different chilling requirement and storability performances. Our results were compared with an extensive literature research, carried out to collect all accessible information on published works related to Vaccinium ethylene production and sensitivity. Results of this study illustrate a likely role of ethylene in regulating blueberry shelf life. However, a generalisation valid for all Vaccinium species is not attainable because of the high variability in ethylene production between genotypes, which is strictly genotype-specific. These differences in ethylene production are related with blueberry fruit storage performances based on textural alterations. Specifically, blueberry accessions characterized by the highest ethylene production had a more severe texture decay during storage. Our results support the possibility of tailoring ad hoc preharvest and postharvest strategies to extend blueberry shelf life and quality according with the endogenous ethylene production level of each cultivar.