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Abstract Background Surfactant is a well-established therapy for preterm neonates affected by respiratory distress syndrome (RDS). The goals of different methods of surfactant administration are to reduce the duration of mechanical ventilation and the severity of bronchopulmonary dysplasia (BPD); however, the optimal administration method remains unknown. This study compares the effectiveness of the INtubate-RECruit-SURfactant-Extubate (IN-REC-SUR-E) technique with the less-invasive surfactant administration (LISA) technique, in increasing BPD-free survival of preterm infants. This is an international unblinded multicenter randomized controlled study in which preterm infants will be randomized into two groups to receive IN-REC-SUR-E or LISA surfactant administration. Methods In this study, 382 infants born at 24+0–27+6 weeks’ gestation, not intubated in the delivery room and failing nasal continuous positive airway pressure (nCPAP) or nasal intermittent positive pressure ventilation (NIPPV) during the first 24 h of life, will be randomized 1:1 to receive IN-REC-SUR-E or LISA surfactant administration. The primary outcome is a composite outcome of death or BPD at 36 weeks’ postmenstrual age. The secondary outcomes are BPD at 36 weeks’ postmenstrual age; death; pulse oximetry/fraction of inspired oxygen; severe intraventricular hemorrhage; pneumothorax; duration of respiratory support and oxygen therapy; pulmonary hemorrhage; patent ductus arteriosus undergoing treatment; percentage of infants receiving more doses of surfactant; periventricular leukomalacia, severe retinopathy of prematurity, necrotizing enterocolitis, sepsis; total in-hospital stay; systemic postnatal steroids; neurodevelopmental outcomes; and respiratory function testing at 24 months of age. Randomization will be centrally provided using both stratification and permuted blocks with random block sizes and block order. Stratification factors will include center and gestational age (24+0 to 25+6 weeks or 26+0 to 27+6 weeks). Analyses will be conducted in both intention-to-treat and per-protocol populations, utilizing a log-binomial regression model that corrects for stratification factors to estimate the adjusted relative risk (RR). Discussion This trial is designed to provide robust data on the best method of surfactant administration in spontaneously breathing preterm infants born at 24+0–27+6 weeks’ gestation affected by RDS and failing nCPAP or NIPPV during the first 24 h of life, comparing IN-REC-SUR-E to LISA technique, in increasing BPD-free survival at 36 weeks’ postmenstrual age of life. Trial registration ClinicalTrials.gov NCT05711966. Registered on February 3, 2023.

Abstract Background Long-chain acyl-carnitines (ACs) are potential arrhythmogenic metabolites. Their role in atrial fibrillation (AF) remains incompletely understood. Using a systems medicine approach, we assessed the contribution of C18:1AC to AF by analysing its in vitro effects on cardiac electrophysiology and metabolism, and translated our findings into the human setting. Methods and results Human iPSC-derived engineered heart tissue was exposed to C18:1AC. A biphasic effect on contractile force was observed: short exposure enhanced contractile force, but elicited spontaneous contractions and impaired Ca2+ handling. Continuous exposure provoked an impairment of contractile force. In human atrial mitochondria from AF individuals, C18:1AC inhibited respiration. In a population-based cohort as well as a cohort of patients, high C18:1AC serum concentrations were associated with the incidence and prevalence of AF. Conclusion Our data provide evidence for an arrhythmogenic potential of the metabolite C18:1AC. The metabolite interferes with mitochondrial metabolism, thereby contributing to contractile dysfunction and shows predictive potential as novel circulating biomarker for risk of AF.

Extreme political populism has been fiercely spreading climate disinformation for years, contributing to a social divide about climate change. In order to profile how both sides of the climate divide communicate climate change, we collected dissemination materials and analysed the mindset of key actors reaching global audiences. We apply network science to textual content in order to reconstruct and analyse the mindsets of key actors across the climate divide. Here, we show that the emerging mindsets support the identification of emotional patterns – such as hypercritical scepticism masking falsehoods under a trustful promotion of change – linked to a quick and pervasive spread of falsehoods, i.e. an infodemic. We find that, in climate change disinformation, the word “climate” represents a fearsome threat linked to inconsistent science. We show that the word “change” represents a reassuring pattern in climate disinformation, characterised by trust and by low anticipation without risk awareness, except for some fear about policy changes. For climate activism, the word “change” is linked to high levels of negative emotions like anger, disgust, and fear related to a perception of existential threats. Furthermore, the word “children” represents an angering concern in climate disinformation, while climate change activism perceives “children” with trust and joy but also sadness for their anticipated future. Mindset reconstruction has the potential to become a relevant tool for identifying and flagging communication materials linked to disinformation, which amplifies the climate divide and facilitates infodemics.

Introduction: With limited resources for rehabilitation, burn therapists throughout the world rely on local resources, professional creativity and community relationships to create solutions to help their patients recover. The demands of helping a burn survivor achieve an optimal outcome drive the burn therapist to create tools and strategies that effectively solve common problems after burn injury. Methods: The International Society for Burn Injury (ISBI) invited burn therapists from around the world to describe the innovations that they have created to solve burn rehabilitation problems. The submissions were provided through an online form and inclusion of photographs was encouraged. Each submission was reviewed in a blinded manner by an expert panel of three independent rehabilitation therapists from the ISBI Rehabilitation Committee. The submissions were reviewed for originality, utility, quality and safety, then edited and compiled to be shared and disseminated throughout the world. Results: A total of 77 innovations were submitted for review. 71 were accepted for publication (92%) and given the opportunity to publish in Burns Open. Clinicians from 15 countries submitted innovations. The innovations were categorized as: Orthosis, Scar Management, Techniques, Activities of Daily Living Devices, Educational Tools and Prosthesis. Nineteen submissions were translated from Spanish to English. Discussion: Creative and innovative ideas using local resources are turned into patient solutions by experienced burn therapists around the world. However, because such innovations don’t reach widespread investigation or production, the ideas remain in a silo in the local area when they could be of use to therapists in other cultures. This project resulted in a book of “Innovative Solutions in Burn Rehabilitation from Around the World,” that was printed and is now available as this Special Edition in Burns Open. Future work would include expanding on the book with more innovative solutions and translating it into multiple languages to improve access and usability throughout the world.

Introduction: With limited resources for rehabilitation, burn therapists throughout the world rely on local resources, professional creativity and community relationships to create solutions to help their patients recover. The demands of helping a burn survivor achieve an optimal outcome drive the burn therapist to create tools and strategies that effectively solve common problems after burn injury. Methods: The International Society for Burn Injury (ISBI) invited burn therapists from around the world to describe the innovations that they have created to solve burn rehabilitation problems. The submissions were provided through an online form and inclusion of photographs was encouraged. Each submission was reviewed in a blinded manner by an expert panel of three independent rehabilitation therapists from the ISBI Rehabilitation Committee. The submissions were reviewed for originality, utility, quality and safety, then edited and compiled to be shared and disseminated throughout the world. Results: A total of 77 innovations were submitted for review. 71 were accepted for publication (92%) and given the opportunity to publish in Burns Open. Clinicians from 15 countries submitted innovations. The innovations were categorized as: Orthosis, Scar Management, Techniques, Activities of Daily Living Devices, Educational Tools and Prosthesis. Nineteen submissions were translated from Spanish to English. Discussion: Creative and innovative ideas using local resources are turned into patient solutions by experienced burn therapists around the world. However, because such innovations don’t reach widespread investigation or production, the ideas remain in a silo in the local area when they could be of use to therapists in other cultures. This project resulted in a book of “Innovative Solutions in Burn Rehabilitation from Around the World,” that was printed and is now available as this Special Edition in Burns Open. Future work would include expanding on the book with more innovative solutions and translating it into multiple languages to improve access and usability throughout the world.

Abstract Background Malignant pleural mesothelioma (MPM) is a rare and aggressive malignancy that most commonly affects the pleural layers. MPM has a strong association with asbestos, mainly caused by exposure to its biopersistent fibers in at least 80% of cases. Individuals with a chronic exposure to asbestos might develop disease with a 20–40-year latency with few or no symptoms. Such has been the case in the Italian regions of Piedmont and Lombardy, where industrial production of materials laden with asbestos, mainly cements, has been responsible for the onset of a large epidemic. Since 2018, a multidisciplinary team at San Matteo hospital in Pavia has been collecting data on over 100 patients with MPM. The main goal of this project is to define and describe an integrated profile for each MPM case at diagnosis by using data mining and partition analysis. Methods Here we bring together exhaustive epidemiologic, histologic and radiologic data of 88 MPM patients that came to our observation and draw correlations with predictive and prognostic significance. Results The median overall survival (OS) was 15.6 months. Most patients presented with pleural effusion, irrespective of disease stage. Quite unexpectedly, no statistically significant association was demonstrated between OS and TNM disease stage at diagnosis. Although average OS is similar in male and female patients, partition analysis of data underlined a significant differential hierarchy of predictor categories based on patient gender. In females with no smoking history, full chemotherapeutic regimens are associated with better outcomes. Moreover, concerning second line treatments, vinorelbine emerged as the most advantageous choice for female patients, whereas in the male subgroup no statistically significant difference resulted between gemcitabine and vinorelbine. Conclusion A multidisciplinary approach to MPM is mandatory to define better therapeutic approaches, personalize the management and improve patient outcomes.

This study explores the medicinal potential of Pergularia daemia, a perennial vine abundant along Indian roadsides, focusing on its leaves have diverse therapeutic properties in traditional medicine. This research investigates its unexplored potential in application of drug delivery and the synthesis of zinc oxide nano-particles from its leaves. PD mediated Zinc Oxide nanoparticles were synthesized by precipitate method. The qualitative phyto chemical analysis of PD leaves extract was carried out and the extract showed the presence of carbohydrates, phenols, flavanoids, alkaloids and terpenoids. The synthesized zinc oxide nanoparticles were characterized by UV–Visible spectroscopy, Fourier transform Infrared spectroscopy, X-ray diffraction Analysis and scanning electron microscope. The results from characterization suggest that the synthesized compound was ZnO in nano scale which was in oval shape and with high purity. The synthesized zinc oxide nano particle could be a huge application in medical field, pharmaceutical and biotechnology in near future. [ABSTRACT FROM AUTHOR]

Abstract Purpose Accurate dosimetry is essential in radioembolization. To this purpose, an automatic protocol for healthy liver dosimetry based on dual isotope (DI) SPECT imaging, combining holmium-166 (166Ho)-microspheres, and technetium-99 m (99mTc)-colloid was developed: 166Ho-microspheres used as scout and therapeutic particles, and 99mTc-colloid to identify the healthy liver. DI SPECT allows for an automatic and accurate estimation of absorbed doses, introducing true personalized dosimetry. However, photon crosstalk between isotopes can compromise image quality. This study investigates the effect of 99mTc downscatter on 166Ho dosimetry, by comparing 166Ho-SPECT reconstructions of patient scans acquired before (166Ho-only) and after additional administration of 99mTc-colloid (166Ho-DI). Methods The 166Ho-only and 166Ho-DI scans were performed in short succession by injecting 99mTc-colloid on the scanner table. To compensate for 99mTc downscatter, its influence was accounted for in the DI image reconstruction using energy window-based scatter correction methods. The qualitative assessment was performed by independent blinded comparison by two nuclear medicine physicians assessing 65 pairs of SPECT/CT. Inter-observer agreement was tested by Cohen’s kappa coefficient. For the quantitative analysis, two volumes of interest within the liver, VOITUMOR, and VOIHEALTHY were manually delineated on the 166Ho-only reconstruction and transferred to the co-registered 166Ho-DI reconstruction. Absorbed dose within the resulting VOIs, and in the lungs (VOILUNGS), was calculated based on the administered therapeutic activity. Results The qualitative assessment showed no distinct clinical preference for either 166Ho-only or 166Ho-DI SPECT (kappa = 0.093). Quantitative analysis indicated that the mean absorbed dose difference between 166Ho-DI and 166Ho-only was − 2.00 ± 2.84 Gy (median 27 Gy; p value < 0.00001), − 5.27 ± 8.99 Gy (median 116 Gy; p value = 0.00035), and 0.80 ± 1.08 Gy (median 3 Gy; p value < 0.00001) for VOIHEALTHY, VOITUMOR, and VOILUNGS, respectively. The corresponding Pearson’s correlation coefficient between 166Ho-only and 166Ho-DI for absorbed dose was 0.97, 0.99, and 0.82, respectively. Conclusion The DI protocol enables automatic dosimetry with undiminished image quality and accuracy. Clinical trials The clinical study mentioned is registered with Clinicaltrials.gov (NCT02067988) on 20 February 2014.

Abstract Cancer of unknown primary (CUP) is an obscure disease characterized by multiple metastases in the absence of a primary tumor. No consensus has been reached whether CUPs are simply generated from cancers that cannot be detected or whether they are the manifestation of a still unknown nosological entity. Here, we report the complete expression and genetic analysis of multiple synchronous metastases harvested at warm autopsy of a patient with CUP. The expression profiles were remarkably similar and astonishingly singular. The whole exome analysis yielded a high number of mutations present in all metastases (fully shared), additional mutations (partially shared) accumulated one after another in a series, and few private mutations were unique to each metastasis. Surprisingly, the phylogenetic trajectory linking CUP metastases was atypical, depicting a common “stream”, sprouting a series of linear “brooks”, at variance from the extensive branched evolution observed in metastases from most cancers of known origin. The distinctive genetic and evolutionary features depicted suggest that CUP is a novel nosological entity.

Grapes: Wild and cultivated grapevines adapted to different stresses Wild and domesticated grapevine populations display genomic differences that likely arose as a result of evolutionary responses to different environmental pressures. Annarita Marrano of the Edmund Mach Foundation in San Michele All’adige, Italy, and colleagues characterized the genetic diversity found in 44 wild and 48 cultivated accessions of the Eurasian wine grape, Vitis vinifera. They analyzed 54,000 single DNA letters spread across the genome and found evidence that natural wild grapevine populations are on the decline. They also identified several genomic regions related to stress responses that evolved differently in grapes bred to live in vineyards and their wild relatives. The findings suggest the need to conserve wild grapevines, which may harbor genes encoding resilience factors that could aid in the development of hardier wine-producing crops in the future.

A key area of research in hydrologic modeling is the prediction of flood response in complex urban basins with hydraulic structures such as pump stations, canals, culverts, and spillways. The prediction of the basin’s response to heavy rainfall is needed in order to assess the impacts of potential watershed management decisions, especially during high flow periods. In this study, the HEC-HMS model was adopted to predict the accumulated discharges in a small urban basin located in West Palm Beach, Florida, USA. The model was calibrated based on seven flood events and validated using seven independent events spanning a 5-year period. The results show that the accumulated flow of water released from the basin was simulated with high accuracy, and that the model can be used for various management scenarios involving high flow conditions in the south Florida urban basin.

In this research, the physically-based WTS (Water Temperature Simulation) model was developed to predict water temperature changes in a river in eastern Connecticut during the summer. The model was applied and calibrated with a one-hour time step during the summer’s low-flow season on the Fenton River, which is tributary of the Mansfield Hollow Lake. Temperatures were recorded at one-hour intervals during the summer in 2004 and 2005, at various locations along the river to provide data for the model’s calibration. Model results were tested against observed stream temperatures and also compared to the SSTemp (Stream Segment Temperature model) created by Bartholow (2002). Results show that both models can be used to predict changes in stream temperature due to changes in groundwater inflow/outflow, and could be used to assess various water management scenarios.

Stella, J. M., & Warner, G. S. (January-February, 2018). Modelling a hydrologic Black-Box. Water Technology and Sciences (in Spanish), 9(1), 101-112, DOI: 10.24850/j-tyca-2018-01-07. Hydrologic simulation models have become an essential tool in the modern world of water management; they are used extensively and play an important auxiliary role in fulfilling the core tasks of water management, in policy preparation, operational water management and research. A physical based hydrologic Black-Box model was created to simulate the water inflows and outflows of the system that could be used for an educational purpose. Then a mathematical model using Stella® software was created to simulate the Black-Box model. The results of the simulations show that the combination of a physical hydrologic Black-Box model and the mathematical model using the Stella® software can helps students understand the basic hydrologic processes.

The molecular and cellular mechanisms which drive metastatic spread are the topic of constant debate and scientific research due to the potential implications for cancer patients' prognosis. In addition to genetics and environmental factors, mechanics of single cells and physical interaction with the surrounding environment play relevant role in defining invasive phenotype. Reconstructing the physical properties of metastatic clones may help to clarify still open issues in disease progression as well as to lead to new diagnostic and therapeutic approaches. In this perspective cancer of unknown primary origin (CUP) identify the ideal model to study physical interactions and forces involved in the metastatic process. We have previously demonstrated that MET oncogene is mutated with unexpected high frequency in CUPs. We here analyze and discuss how the MET activation by somatic mutation may affect physical properties in giving rise to such a highly malignant syndrome, as that defined by CUP.

Introducción y objetivos: Algunas especies de helechos cheilanthoideos son caracterizados por presentar adaptaciones a hábitats xéricos. Además, presentan la particularidad de enrollar sus láminas frente a condiciones de stress hídrico. Sin embargo, al retornar las condiciones ambientales óptimas las láminas se vuelven a expandir. El objetivo de este trabajo es proporcionar información morfo-anatómica de las frondes y asociar estructuras anatómicas a estos movimientos foliares. M&M: Se estudiaron mediante microscopía óptica y electrónica de barrido la morfo-anatomía de las frondes de cuatro especies: Adiantopsis radiata, Cheilanthes glauca, Doryopteris concolor, y D. pentagona. Además, se analizó la densidad de los estomas y se calculó el índice estomático. Resultados: Se observó mesófilo homogéneo en A. radiata y D. pentagona. Cheilanthes glauca y Doryopteris concolor presentaron mesófilo heterogéneo dorsiventral. Todas las especies mostraron hojas hipoestómaticas y estomas de tipo anomocítico. El índice estomático osciló entre 9,1% (A. radiata) y 14,1% (D. concolor) y el rango de densidad de los estomas fue de 39,7 (D. pentagona) y 57,8 (D. concolor). Conclusiones: El mesófilo observado en A. radiata y D. pentagona refleja la especialización para habitar ambientes mesófilos. El mesófilo heterogéneo dorsiventral de Doryopteris concolor podría ser una ventaja para su hábito epifítico facultativo. Cheilanthes glauca tiene características xeromorfas y mesomorfas, probablemente como resultado de la disponibilidad de agua en el ambiente durante las diferentes estaciones. Se propone como hipótesis que el engrosamiento de las paredes anticlinales de las células epidérmicas podría estar involucrados en los movimientos de las láminas.