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Lower atmospheric pressure affects biologically relevant physical parameters such as gas partial pressure and concentration, leading to increased water vapor diffusivity and greater soil water content loss through evapotranspiration. This might impact plant photosynthetic activity, resource allocation, water relations, and growth. However, the direct impact of low air pressure on plant physiology is largely unknown. This study examined the effects of low air pressure, alone and combined with two water inputs, on different functional traits of three plant species transplanted from montane grasslands at 1,500 m a.s.l. during the first four weeks of their early phenological stage: Trifolium pratense, Hieracium pilosella, and Brachypodium rupestre. Using the terraXcube Ecotron facility which can simulate different climatic conditions, we isolated the effect of air pressure from those of other, related environmental factors (temperature, humidity, and solar radiation) by simulating three different elevations with corresponding air pressures: 1,500 m a.s.l. (85 kPa, control scenario), 2,500 m a.s.l. (75 kPa), and 4,000 m a.s.l. (62 kPa) and we used two different water regimes to observe the combined effect of low air pressure and the impact of varying water inputs on plants. In T. pratense and H. pilosella, we observed an increase in stomatal conductance but a reduction in aboveground biomass at the lowest pressure compared to the control scenario after four weeks of incubation. Contrastingly, B. rupestre showed an interactive effect of air pressure and water treatment on chlorophyll and biomass nitrogen content, which were reduced under higher soil water conditions at 85kPa. This study serves as an initial step in isolating the specific impact of air pressure on plant physiology, demonstrating the potential of the facility for future research. The mixed response patterns across species highlight that atmospheric pressure could be a driving factor to consider when assessing plant responses along elevational gradient. [ABSTRACT FROM AUTHOR]

Background: Prucalopride (1 or 2 mg once daily) is approved for treating adults with chronic idiopathic constipation (CIC). Objectives: We determined the effect of age, body mass index (BMI), and renal function on the efficacy and safety of prucalopride in adults with CIC. Design: Data were pooled from six 12-week, phase III–IV clinical studies in adults who received prucalopride (1 or 2 mg once daily) or placebo for CIC. Methods: Adults were stratified by age (<50; 50–64; ⩾65 years), BMI (underweight/healthy weight, <25 kg/m2; overweight, 25 to <30 kg/m2; obese, ⩾30 kg/m2), and renal function (normal renal function, estimated glomerular filtration rate (eGFR) ⩾90 mL/min/1.73 m2; mild renal impairment, eGFR 60 to <90 mL/min/1.73 m2; moderate renal impairment, eGFR 30 to <60 mL/min/1.73 m2). The primary efficacy endpoint was the proportion of patients with a mean of ⩾3 complete spontaneous bowel movements/week over 12 weeks. Safety data were evaluated descriptively. Results: Of 2484 patients stratified by age (prucalopride, n = 1237; placebo, n = 1247), 1402, 708, and 374 were aged <50, 50–64, and ⩾65 years, respectively. Of 2482 patients stratified by BMI (prucalopride, n = 1237; placebo, n = 1245), 1425, 713, and 344 were underweight/healthy weight, overweight, and obese, respectively. Of 2474 patients stratified by renal function (prucalopride, n = 1233; placebo, n = 1241), 1444, 869, and 161 had normal renal function, mild renal impairment, and moderate renal impairment, respectively. More prucalopride-treated than placebo-treated patients achieved the primary efficacy endpoint. The difference was significant for all subgroups, except for the obese and moderate renal impairment subgroups. More prucalopride-treated than placebo-treated patients reported treatment-related adverse events in most subgroups. Conclusion: Prucalopride demonstrated efficacy in adults with CIC, irrespective of age, BMI, and renal function. No unexpected safety concerns were identified. Trial registration: ClinicalTrials.gov identifiers (https://clinicaltrials.gov/): NCT01147926, NCT01424228, NCT01116206, NCT00483886, NCT00485940, NCT00488137. [ABSTRACT FROM AUTHOR]

The article discusses a workshop on Rossby waves, heat waves, and compound extreme events held in Italy in November 2023. Experts from various fields gathered to discuss research, challenges, and networking opportunities related to the interplay between atmospheric dynamics, Rossby waves, and heat waves. The workshop highlighted the need for collaboration across disciplines to advance understanding of the complex interactions between atmospheric Rossby waves and spatially compounding extreme events, such as heat waves. Key scientific questions and challenges were identified, including the predictability of heat waves, the role of blocking and topography, and the statistical treatment of spatially compounding extreme events. The workshop emphasized the importance of integrating different methodologies and metrics for characterizing Rossby waves and extreme events to enhance predictability and advance climate modeling efforts. [Extracted from the article]

Porphyrins belong to a peculiar class of natural molecules involved in many different biological processes of paramount importance, from photosynthesis in green plants, to the oxygen binding and transportation in breathing and to the oxidation reactions catalyzed by the enzymatic family of cytochromes P450. This versatility is due to the tight structure/properties relationship of these macrocycles. Many different synthetic strategies have been used to modify the porphyrin core by connecting electro- and photo-active moieties in both meso- and beta-pyrrole positions. Among them all, C–C bond formation still remains one of the most useful approaches to ensure fine control over the chemical–physics properties of porphyrins. In this work we successfully tested the catalytic system Pd(dba)2/AsPh3 in the Heck cross-coupling reaction between β-monobrominated tetraphenylporphyrin and ferrocenyl-alkene derivatives, avoiding the use of excess alkene and Ni(II) or Zn(II) porphyrinate complexes. The preferential formation of the alpha- versus trans-isomer was observed when vinylferrocene was used as the starting alkene, compared to styrene and 4-ferrocenylstyrene, either at lower (60 °C) or higher (90 °C) reaction temperature. Subsequent electrochemical and photochemical studies on ferrocene–porphyrin dyads pointed out the importance of the type of β-C–C bond between the two chromophores in modulating/affecting the electron-transfer processes. Such studies can be useful for the realization of highly sensible fluorescent-redox switches or even in the development of highly efficient ferrocene/porphyrin-based chemodynamic therapy agents. [ABSTRACT FROM AUTHOR]

Introduction: Delay in arterial hypertension (AH) diagnosis and late therapy initiation may affect progression towards hypertensive-mediated organ damage (HMOD) and blood pressure (BP) control. Aim: We aimed to assess the impact of time-to-therapy on BP control and HMOD in patients receiving AH diagnosis. Methods: We analysed data from the Campania Salute Network, a prospective registry of hypertensive patients (NCT02211365). At baseline visit, time-to-therapy was defined as the interval between the first occurrence of BP values exceeding guidelines-directed thresholds and therapy initiation; HMOD included left ventricular hypertrophy (LVH), carotid plaque, or chronic kidney disease. Optimal BP control was considered for average values < 140/90 mmHg. Low-risk profile was defined as grade I AH without additional cardiovascular risk factors. Results: From 14,161 hypertensive patients, we selected 1,627 participants who were not on antihypertensive therapy. This population was divided into two groups based on the median time-to-therapy (≤ 2 years n = 1,009, > 2 years n = 618). Patients with a time-to-therapy > 2 years had higher risk of HMOD (adjusted odds ratio, aOR:1.51, 95%, CI:1.19–1.93, p < 0.001) due to increased risks of LVH (aOR:1.43, CI:1.12–1.82, p = 0.004), carotid plaques (aOR:1.29, CI:1.00-1.65, p = 0.047), and chronic kidney disease (aOR:1.68, CI:1.08–2.62, p = 0.022). Time-to-therapy > 2 years was significantly associated with uncontrolled BP values (aOR:1.49, CI:1.18–1.88, p < 0.001) and higher number of antihypertensive drugs (aOR:1.68, CI:1.36–2.08, p < 0.001) during follow-up. In low-risk subgroup, time-to-therapy > 2 years did not impact on BP control and number of drugs. Conclusions: In hypertensive patients, a time-to-therapy > 2 years is associated with HMOD and uncontrolled BP. [ABSTRACT FROM AUTHOR]

Summary: Background: There is little information on the effectiveness of therapies for severe chronic constipation. In a phase 3 trial, we previously demonstrated that a vibrating capsule was significantly more efficacious than a placebo in chronic constipation. Aim: To examine the effects of a vibrating capsule and placebo on symptoms and health‐related quality of life (HRQoL) in patients with severe chronic constipation. Methods: We performed a post hoc analysis of phase 3, multicentre, randomised, double‐blind, and placebo‐controlled 8‐week clinical trial of a vibrating capsule to specifically assess outcomes among subjects who reported 0 complete spontaneous bowel movements (CSBMs) during the 2‐week baseline period. We assessed effects of treatment on bowel symptoms, patient satisfaction, and HRQoL. CSBM responders were defined as subjects with increases of ≥1 or ≥2 or ≥3 weekly CSBMs (CSBM1 or CSBM2, CSBM3, respectively) over baseline for ≥6 out of 8 weeks of treatment. Results: The severe chronic constipation subgroup comprised 175 (56%) of the 312 subjects. Significantly more subjects with severe chronic constipation who received the vibrating capsule than those who received the placebo were CSBM1 (44.9% vs. 20.9%, p = 0.007), CSBM2 (29.2% vs. 11.6%, p = 0.004), and CSBM3 (19.10% vs 6.98%, p = 0.017) responders. Straining effort, stool consistency, patient satisfaction, and HRQoL significantly improved in the severe chronic constipation subgroup. A mild vibrating sensation was reported in 10%. Conclusion: The vibrating capsule significantly improved constipation‐related symptoms and HRQoL in patients with severe constipation, affirming its efficacy and safety across the spectrum of chronic constipation. [ABSTRACT FROM AUTHOR]

Background Objectives Materials and Methods Results Conclusions Facial (FP) and genital psoriasis (GP) significantly affect patients' quality of life. Despite the advances in treatments, limited data on efficacy and safety are available on these difficult‐to‐treat areas. Guselkumab is an interleukin (IL)‐23 inhibitor which has been proven effective in treating patients with moderate‐to‐severe plaque psoriasis.The aim of this interim analysis was to report the efficacy and safety of guselkumab in the treatment of patients with FP and/or GP.GULLIVER is a 52‐week Italian observational study to evaluate the effectiveness and safety of guselkumab in a real‐life setting in patients with FP and/or GP. Adult patients with facial and/or genital moderate‐to‐severe psoriasis (sPGA score ≥ 3) were included. The primary endpoint of this analysis was the percentage of patients achieving a facial or genital sPGA score of 0 (clear) or 1 (almost clear), at Week 12. The change in the score of the facial or genital sPGA components in patients with a score ≥3 for each sPGA component was assessed. PASI score in patients with a baseline PASI above or below 10 was evaluated.Overall, 351 patients were included in the study; 83.3% of FP and 76.5% of GP patients achieved the primary endpoint. Similar response rates were observed for the facial or genital sPGA components in patients with a baseline facial or genital sPGA score ≥3 in each component. Among patients with a baseline PASI score >10, mean PASI score improved from 19.0 (SD 8.3) to 2.2 (SD 4.8). Forty‐four AEs were observed in 32 patients; two mild and transient AEs (fatigue and nausea) were considered treatment related. No SAEs were observed.Guselkumab, showing to be effective and safe in treating FP and GP, may be a valid therapeutic option for patients with psoriasis localized in these difficult‐to‐treat areas. [ABSTRACT FROM AUTHOR]

Background: Multisystem inflammatory syndrome in children (MIS-C) shows a significant overlap of symptoms with other hyper-inflammatory diseases such as Kawasaki disease (KD), but the real difference of the two conditions is still matter of debate. Coronary artery lesions (CAL) are the most relevant complication in KD. Nonetheless, CAL, myocarditis, pericarditis, arrhythmia are the main cardiovascular complications in MIS-C. A close clinical assessment is mandatory, both at the diagnosis and during the follow-up, by ECG and echocardiography. Cardiac magnetic resonance (MRI) adds important data to ultrasound findings. However, cardiac MRI studies in MIS-C are limited to a small number of cohorts. Methods: We enrolled 20 children (age:1–16 years; 11 F; 9 M) with cardiac involvement secondary to MIS-C, all evaluated by cardiac MRI. Results: 8 children showed pathological cardiac MRI: 2 showed pericardial effusion; 2 showed myocardial oedema; 1 showed aortic insufficiency; 3 showed delayed enhancement (one for acute myocarditis with oedema; 2 for myocardial fibrosis). Delayed enhancement was reduced significantly 5.6-9 months after the first MRI evaluation. 25% of patients with pathological MRI had CAL associated with valvular insufficiency of 2 valves. 17% of patients with normal MRI had CAL, associated with valvular insufficiency of 1 valve in 1 patient. The correlations between haematological, clinical, cardiologic parameters, treatment, did not reach the statistical significance. 4 patients were treated with anakinra. Among those, 2 patients showed a normal cardiac MRI. Cardiac lesions resolved in all the patients during the follow-up. Some patients with pathological cardiac MRI could not underwent a control with MRI, for the low compliance. However, echocardiography and ECG, documented the resolution of the pathological data in these cases. Conclusions: A higher risk of CAL was documented in patients with an association of other cardiac lesions. Cardiac MRI is difficult to perform routinely; however, it is useful for evaluating the acute myocardial damage and the outcome of patients with MIS-C. [ABSTRACT FROM AUTHOR]

INTRODUCTION: This post hoc analysis evaluated the efficacy of tenapanor on abdominal symptoms in patients with irritable bowel syndrome with constipation. Abdominal symptoms assessed included pain, discomfort, bloating, cramping, and fullness. METHODS: The abdominal symptomdata were pooled from3 randomized controlled trials (NCT01923428, T3MPO- 1 [NCT02621892], and T3MPO-2 [NCT02686138]).Weekly scoreswere calculated for each abdominal symptom, and the Abdominal Score (AS) was derived as the average of weekly scores for abdominal pain, discomfort, and bloating. The overall change from baseline during the 12 weeks was assessed for each symptom weekly score and the AS. The AS 6/12-week and 9/12-week response rates (AS improvement of ‡2 points for ‡6/12- or ‡9/12-week) were also evaluated. The association of weekly AS response status (reduction of‡30%) withweekly complete spontaneous bowelmovement (CSBM)status (50and>0)was assessed. RESULTS: Among 1,372 patients (684 tenapanor [50 mg twice a day] and 688 placebo), the least squares mean change frombaseline in AS was22.66 for tenapanor vs22.09 for placebo (P < 0.0001). The 6/12-week AS response rate was 44.4% for tenapanor vs 32.4% for placebo (P < 0.0001), and for 9/12-week AS, 30.6%for tenapanor vs20.5%for placebo (P <0.0001).Asignificant association betweenweeklyCSBM status and weekly AS response status was observed each week (P < 0.0001), with a greater proportion achieving an AS reduction in patients with >0 CSBMs in a week. DISCUSSION: Tenapanor significantly reduced abdominal symptoms in patients with irritable bowel syndrome with constipation, particularly pain, discomfort, and bloating measured by AS, compared with placebo. [ABSTRACT FROM AUTHOR]

Aim: Transcatheter closure of the patent ductus arteriosus (TCPDA) is increasingly used in preterm infants as an alternative to surgical ligation. However, clinically ill preterm infants are at risk of contrast nephropathy due to the angiography contrast agents used during the procedure. Methods: We performed a single‐centre before‐and‐after comparative study in VLBW infants to compare the kinetics of serum creatinine during the first 4 days after TCPDA with or without angiography. Results: 69 patients were included and divided into two groups: TCPDA with (contrast+; n = 37) and without (contrast−, n = 32) use of contrast agent. The median dose [range] of contrast agent was 1.0 mL/kg [0.6–2.4 mL/kg]. The change in serum creatinine level between day 2 to 4 after TCPCA and baseline decreased in the contrast‐ group (−17% [−46%; 18%]), while it increased in the contrast+ group (7% [−24%; 202%] p = 0.002). Comparison of blood urea levels between groups showed similar significant differences. The change in serum creatinine between day 2 to 4 and baseline was significantly correlated with the dose of contrast agent (r2 = 0.682; p < 0.001). Conclusion: The use of contrast agents during TCPDA can potentially harm the renal function of very preterm infants. Therefore, we advise minimising or avoiding the use of contrast agents. [ABSTRACT FROM AUTHOR]

This document provides a short summary of the T3MPO-3 study, which was published in Neurogastroenterology and Motility in September 2023. At the end of this summary, there are links to websites where you can find more information about this study. Tenapanor (IBSRELA®) is a newly available medicine in the United States. It is used to treat irritable bowel syndrome with constipation (IBS-C) in people aged 18 years and older. In 2 large clinical trials, tenapanor was shown to improve the symptoms of IBS-C. People with IBS-C often need to take long-term medicines to keep their symptoms under control. As a result, this study, called T3MPO-3, was undertaken to investigate whether there are any possible side effects associated with the long-term use of tenapanor in adults with IBS-C. There were 312 people who had taken part in either of the original 2 trials and took part in this study, with 90 receiving tenapanor for at least 1 year. Loose or watery stool (diarrhea) was the most common side effect, and most cases were mild or moderate. No people died in any of these studies. [ABSTRACT FROM AUTHOR]

The T3MPO-3 study investigated the long-term safety of tenapanor, a medicine used to treat irritable bowel syndrome with constipation (IBS-C) in adults. The study included 312 participants, with 90 receiving tenapanor for at least 1 year. The most common side effect was diarrhea, which was mostly mild or moderate. No deaths occurred during the study. The results support the use of tenapanor as a long-term treatment for IBS-C. More information about the study can be found in the original article published in Neurogastroenterology and Motility. [Extracted from the article]

Simple Summary: One of the main challenges faced by cancer immunotherapy is the emergence of resistance against monotherapies, mediated by several immune escape mechanisms, which are able to impair therapy outcomes. Here, we investigated the biological properties of two novel bispecific constructs, known as tribodies, previously generated in our laboratory. These two bispecific molecules, named TR0304 and TR0506, are able to bind simultaneously to two immune checkpoints, i.e., LAG-3 and PD-L1 or LAG-3 and PD-1, respectively. After testing their effects on lymphocytes and on co-cultures of immune and tumor cells by comparing them to the monoclonal antibodies currently approved for clinical use, we found that these new constructs were able to activate the hPBMCs more efficiently than clinically validated mAbs, leading to stronger tumor cell lysis and, thus, showing their therapeutic potential for monotherapy-resistant tumors. Many advances in antitumor therapies have been achieved with antagonistic antibodies targeting the programmed cell death protein 1 (PD-1) or its ligand (PD-L1); however, many cancer patients still develop resistance to anti–PD-1/PD-L1 treatments often associated with the upregulation of other immune checkpoints such as Lymphocyte Activation Gene-3 (LAG-3). In order to verify whether it is possible to overcome these limits, we analyzed and compared the effects of combinations of the clinically validated anti-LAG-3 mAb (Relatlimab) with anti-PD-1 (Pembrolizumab) or anti-PD-L1 (Atezolizumab) monoclonal antibodies (mAbs) with those of novel bispecific tribodies (TRs), called TR0304 and TR0506, previously generated in our lab by combining the binding moieties of novel human antibodies targeting the same ICs of the mentioned mAbs. In particular, TR0304, made up of a Fab derived from an anti-PD-L1 mAb and two single-chain variable fragments (scFvs) derived from an anti-LAG-3 mAb, was tested in comparison with Relatlimab plus Atezolizumab, and TR0506, made up of an antigen-binding fragment (Fab) derived from the same anti-LAG-3 mAb and two scFvs derived from an anti-PD-1 mAb, was tested in comparison with Relatlimab and Pembrolizumab. We found that the two novel TRs showed similar binding affinity to the targets with respect to validated mAbs, even though they recognized distinct or only partially overlapping epitopes. When tested for their functional properties, they showed an increased ability to induce lymphocyte activation and stronger in vitro cytotoxicity against tumor cells compared to combinatorial treatments of clinically validated mAbs. Considering that tribodies also have other advantages with respect to combinatorial treatments, such as reduced production costs and lower dose requirements, we think that these novel immunomodulatory TRs could be used for therapeutic applications, particularly in monotherapy-resistant cancer patients. [ABSTRACT FROM AUTHOR]

Background: Tenapanor, a first‐in‐class, minimally systemic inhibitor of intestinal sodium/hydrogen exchanger isoform 3 (NHE3), is approved for the treatment of irritable bowel syndrome with constipation (IBS‐C) in adults based on two randomized, placebo‐controlled, phase III studies (T3MPO‐1 [NCT02621892], T3MPO‐2 [NCT02686138]). The open‐label T3MPO‐3 extension study (NCT02727751) enrolled patients who completed these studies to investigate long‐term safety and tolerability of tenapanor. Methods: Patients who completed T3MPO‐1 (16 weeks) or T3MPO‐2 (26 weeks) were eligible for enrollment in T3MPO‐3. Patients in T3MPO‐3 received open‐label tenapanor 50 mg twice a day for up to an additional 39 (T3MPO‐1) or 26 (T3MPO‐2) weeks. Treatment‐emergent adverse events (TEAEs) were evaluated in the entire T3MPO‐3 safety population and in patients who received a total of ≥52 weeks of tenapanor. Key Results: A total of 312 patients were enrolled in T3MPO‐3; 90 received ≥52 weeks of tenapanor. TEAEs were reported in 117 (37.5%) patients in the safety population and in 52 (57.8%) patients who received ≥52 weeks of tenapanor. Diarrhea was the most common TEAE, occurring in 10.6% of the safety population and in 11.1% of patients who received ≥52 weeks of tenapanor. Most cases were mild or moderate in severity, with only two severe cases reported in the safety population. No deaths occurred during the T3MPO‐3 study. Conclusions: Tenapanor was tolerable over ≥52 weeks of treatment and showed similar safety to that seen in shorter studies. Combined results of the T3MPO studies indicate that tenapanor is a valuable new treatment option for patients with IBS‐C. [ABSTRACT FROM AUTHOR]

Bullying at school affects the health and development of children and adolescents. This study aimed to describe evidence about the characteristics of boys and girls identified as bullies in bullying situations. This is a review of publications from 2015 to 2020, operationalized in SciELO, Scopus, Web of Science, and PsycINFO. Data were independently extracted by two reviewers and submitted to methodological quality assessment. The corpus was composed of 27 primary studies. It was found that boys do more bullying and are more engaged in physical aggression. Girls engage more in verbal or psychological type violence. Social/cultural issues are factors consistently associated with such differences. Regarding the consequences of the aggression perpetrated, bullies, regardless of gender, may also have mental health problems. This study gathers quantitative evidence on the characteristics of boys and girls who engage in bullying at school. Differences/similarities should be considered in anti-bullying intervention programs. [ABSTRACT FROM AUTHOR]

This article explores the role of AU-binding factor 1 (AUF-1) in chronic inflammatory skin conditions such as atopic dermatitis (AD) and psoriasis. The study examines the expression of AUF-1 in skin biopsies of AD and psoriasis patients and investigates the modulation of AUF-1 in vitro using human keratinocyte cell cultures. The results show a different pattern of AUF-1 expression in AD compared to psoriasis, suggesting a potential role of AUF-1 in chronic immune-driven skin inflammation. The findings highlight the importance of understanding endogenous mechanisms involved in resolving AD and identifying new therapeutic targets. [Extracted from the article]

This article discusses a case of a severe relapse of pemphigus vulgaris (PV) after receiving the SARS-CoV-2 vaccine. The patient, a 56-year-old female with a previous diagnosis of PV, experienced multiple erythematous erosions on her body, including her eyelids, after receiving the Moderna mRNA-1273 vaccine. The patient had been in remission for 18 months prior to the relapse. Treatment with intravenous corticosteroids and rituximab resulted in an improvement in the patient's condition. The article suggests that SARS-CoV-2 vaccines may trigger relapses in autoimmune skin diseases and further studies are needed to understand the association. [Extracted from the article]

This study evaluated different strategies to increase gas–liquid mass transfer in a randomly packed gas stirred tank reactor (GSTR) continuously fed with second cheese whey (SCW), at thermophilic condition (55 °C), for the purpose of carrying out in situ biogas upgrading. Two different H2 addition rates (1.18 and 1.47 LH2 LR−1 d−1) and three different biogas recirculation rates (118, 176 and 235 L LR−1 d−1) were applied. The higher recirculation rate showed the best upgrading performance; H2 utilization efficiency averaged 88%, and the CH4 concentration in biogas increased from 49.3% during conventional anaerobic digestion to 75%, with a methane evolution rate of 0.37 LCH4 LR−1 d−1. The microbial community samples were collected at the end of each experimental phase, as well as one of the thermophilic sludge used as inoculum; metanogenomic analysis was performed using Illumina-based 16S sequencing. The whole microbial community composition was kept quite stable throughout the conventional anaerobic digestion (AD) and during the H2 addition experimental phases (UP1, UP2, UP3, UP4). On the contrary, the methanogens community was deeply modified by the addition of H2 to the GSTR. Methanogens of the Methanoculleus genus progressively increased in UP1 (47%) and UP2 (51%) until they became dominant in UP3 (94%) and UP4 (77%). At the same time, members of Methanotermobacter genus decreased to 19%, 23%, 3% and 10% in UP1, UP2, UP3 and UP4, respectively. In addition, members of the Methanosarcina genus decreased during the hydrogen addition phases. [ABSTRACT FROM AUTHOR]

In the panorama of New Testament writings, the 1Thessalonians assumes a central role in creating a language appropriate to the novelty of the Gospel. In this epistle, the first writing of the New Testament, Paul must take into account two elements: he writes down the kerygma announced in Thessalonica in relation to some particular issues experienced by the community and has to deal with addresses mostly of ethnic-Christian extraction. For these reasons Paul takes on an important linguistic challenge, committing to resume, redefine and introduce words in relation to the addressees’ understanding and to the message that the epistle intends communicating. This attempt allows Paul to compose a letter in which the vocabulary is both the heritage of the Thessalonians and the expression of the novelty of that Gospel of which the apostle is the undisputed witness. [ABSTRACT FROM AUTHOR]

Psoriasis and psoriatic arthritis (PsA) are interrelated inflammatory diseases. Psoriasis usually precedes PsA onset and represents a well‐established risk factor for PsA development. Bone erosion is a hallmark of PsA, and the contribution of cutaneous psoriatic inflammation in this process has been demonstrated. However, little is still known on the pathogenetic mechanisms that link psoriatic skin to joint damage. Clinical features of psoriatic disease, including specific body site involvement, seem to be important risk predictors of PsA. The aim of this pilot research study was to investigate if psoriatic cutaneous inflammation, affecting these anatomical predictive sites for PsA, could be linked to osteoclast differentiation and activity. Our results showed that psoriasis skin localizations were positively related to the osteoclastogenic profile in psoriatic patients. These results provide new insights into the fascinating skin‐joint axis concept. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy of a myopia control spectacle lens (DIMS) at slowing the progression of myopia in a population of European children in comparison with 0.01% atropine and combined DIMS and atropine. Methods: The study was a non-randomised experimenter-masked prospective controlled observational study of individuals aged 6–18 years with progressing myopia but no ocular pathology. Participants were allocated, according to patient/parent choice, to receive 0.01% atropine eyedrops, DIMS (Hoya® MiyoSmart®) spectacles, combined atropine+DIMS or single vision spectacle lenses (control group). The key outcome variables, cycloplegic autorefraction spherical equivalent refraction (SER) and axial length (AL), were measured at baseline and after three, six, and 12 months. Results: Of the 146 participants (mean age 10.3y ±3.2), 53 received atropine, 30 DIMS spectacles, 31 atropine+DIMS, and 32 single vision control spectacles. Generalized linear mixed model analysis revealed for SER, whilst controlling for age and SER at baseline, at each stage all treatment groups had significantly reduced progression compared with the control group (p<0.016). For AL, whilst controlling for baseline age and AL, at 6 and 12 months all treatment groups had significantly less progression than the control group (p<0.005). For SER only, in pairwise comparisons at 12 months the atropine+DIMS group had significantly reduced progression compared with the DIMS only and Atropine only groups (p<0.001). Conclusion: In a European population, DIMS and atropine are effective at reducing myopia progression and axial elongation in progressing myopia and are most successful at reducing myopia progression when used in combination. [ABSTRACT FROM AUTHOR]

Summary: Background: MD‐7246, a delayed‐release formulation of linaclotide, is designed to target the ileocaecal junction and caecum with the aim of relieving abdominal pain independently of bowel function. Aims: To evaluate the efficacy, safety and dose–response of MD‐7246 in patients with irritable bowel syndrome with diarrhoea (IBS‐D). Methods: A randomised, double‐blind, phase 2 clinical trial enrolled adult patients with IBS‐D (Rome IV criteria). Patients were randomised to placebo or once‐daily oral MD‐7246 300, 600 or 1200 μg for 12 weeks. Abdominal and bowel symptoms were assessed daily. Key efficacy endpoints were change from baseline in abdominal pain and responder rates for a 30% reduction in abdominal pain in 6/12 weeks. Additional abdominal pain responder and exploratory bowel function endpoints were also assessed. Results: Among the 388 randomised patients, there was no significant difference in mean change from baseline in abdominal pain between the MD‐7246 300 μg, 600 μg and 1200 μg groups and placebo (−1.93, −1.58, −1.95 and − 2.01, respectively; p > 0.05 for each group vs placebo). The abdominal pain responder rates in the MD‐7246 groups were similar to or lower than those in the placebo group. All doses of MD‐7246 had a minimal effect on bowel function and were generally well tolerated. Conclusions: MD‐7246 at the doses studied did not improve abdominal pain relative to placebo in an IBS‐D patient population. Similarly, most additional efficacy endpoints showed no improvement with MD‐7246 relative to placebo. [ABSTRACT FROM AUTHOR]

Similarly, as outlined above, the articles in this special section emphasize how the different song practices and experiences of song they present offer different understandings and I ways of knowing i that offer creative potentials for destabilizing logocentric understandings of language, and consequently of speech/song and text, in anthropology. Makeba insists that not only do the words matter in her songs but that "without language, there would be no song; without song, African music would not exist. As Robinson ([50]) shows, even when Indigenous people are invited to sing their own songs without attention to the structures those songs are embedded in may lead to further extractivism, let alone if anthropologists began singing their collaborators' songs. "To change settler colonial perception requires reorienting the form by which we share knowledge, the way we convey sound, song and music." Stéphane Aubinet's article presents the Indigenous singing practice of the Sámi, the yoik, as a way of knowing that entwines humans, the landscape, animals, and other aspects of experience through a process of making the other present through song. [Extracted from the article]

Simple Summary: T cells have been considered, for a long time, key players in anti-cancer responses triggered by treatment with immune checkpoint inhibitors, but our recent studies also revealed the critical role of NK cells, due to the expression of ICs, such as PD-L1 and CTLA-4, on these immune cells also. Here, we investigated whether anti-PD-L1 or anti-CTLA-4 antibodies could modulate the effector functions of NK and T cell subpopulations differently in co-cultures with triple negative breast cancer cells. We found that the novel immunomodulatory antibodies, previously generated in our laboratory, more efficiently activate NK cells than the antibodies in clinical use, such as atezolizumab and ipilimumab. These results indicate that antibodies targeting different epitopes can have differential effects on different lymphocytes subpopulations and that novel combinations of mAbs could be suitable for therapeutic approaches aimed at activating not only T cells but also NK cells, especially for tumors lacking MHC. Antibody-based cancer immunotherapy includes monoclonals against immune checkpoints (ICs), to modulate specific T cell responses against cancer. NK cells are a newly emerging target for immune checkpoint receptor inhibition in cancer immunotherapy, as ICs are also expressed on NK cells in various cancers. The latter cells are becoming attractive targets for cancer immunotherapy, as they are effector cells similar to CTLs, exerting natural cytotoxicity against primary tumor cells and metastasis, and they are able to distinguish tumor cells from healthy ones, leading to more specific anti-tumor cytotoxicity and reduced off-target effects. Thus, we decided to test the effects on isolated NK cells and T cell subpopulations of novel immunomodulatory mAbs, recently generated in our lab, in comparison with those in clinical use, such as ipilimumab and atezolizumab. Interestingly, we found that the novel anti-CTLA-4 (ID-1) and anti-PD-L1 (PD-L1_1) antibodies are able to induce NK cell activation and exert anti-tumor effects on TNBC cells co-cultured with NK cells more efficiently than the clinically validated ones, either when used as single agents or in combinatorial treatments. On the other hand, ipilimumab was found to be more effective in activating T cells with respect to ID-1. These findings indicate that antibodies targeting different epitopes can have differential effects on different lymphocytes subpopulations and that novel combinations of mAbs could be suitable for therapeutic approaches aimed at activating not only T cells but also NK cells, especially for tumors lacking MHC. [ABSTRACT FROM AUTHOR]

Objective: Scrotal degloving injuries are rare and constitute a challenge for reconstructive surgeons. The authors describe their successful experience with a combined reconstruction protocol using an acellular dermal matrix (ADM), negative pressure wound therapy (NPWT) and a split-thickness skin graft (STSG), and the retrospective assessment of overall morbidity and esthetic outcomes. Methods: Five consecutive patients underwent a wide excision of necrotic scrotal skin and a reconstruction procedure using a combined protocol with NPWT, Pelnac®, and STSG. The efficacy of this treatment was determined by assessing overall morbidity and esthetic outcomes with the Vancouver Scar Scale (VSS). Results: The combined protocol made it possible to create an environment that promoted wound healing, improved graft intake, and gage the reconstructed site a more natural look. No significant problems were observed. Satisfactory cosmetic and functional results were obtained in all patients as shown by VSS scores obtained. Conclusions: We believe that this combined protocol is a reliable alternative to flaps and should be considered an excellent option in scrotal reconstruction, especially in critical patients. [ABSTRACT FROM AUTHOR]

This study aimed at evaluating the economic performances of and carbon footprint associated with innovative systems for the energetic valorization of second cheese whey (SCW), a by-product of whey cheese manufacture, through anaerobic digestion processes. Three systems were modeled: a conventional single-stage anaerobic digester (FAD), located at about 50 km from the dairy factory; an on-site conventional single-stage anaerobic digester (CAD), located at the dairy industry; and an on-site two-stage anaerobic digester (TAD). The TAD technology enables the simultaneous production of hydrogen and methane on site. The biogases produced were combusted in combined heat and power plants (CHP), but only the onsite systems provided process heat to the dairy factory. In the specific conditions assumed, TAD configuration exhibited a higher energy output, which led to a GHG emission reduction of about 60% compared to FAD, mostly thanks to the additional hydrogen (H2) production and the improved engine performances. A detailed cost analysis confirmed the results of the environmental analysis, pointing to the TAD solution as the most economically viable, with a payback period of 9 years, while the CAD had a payback time of 12 years. The results here presented aim at providing the dairy industry with a robust economic analysis on the opportunity of building an innovative system for SCW valorization, as well as providing policymakers with environmental reliable data to support the promotion of this technology. [ABSTRACT FROM AUTHOR]

Pharmacologic therapy of FI In the general population, two-thirds of FI episodes are associated with loose stool or diarrhea ([43]). The topics of diarrhea and fecal incontinence (FI) in pregnancy receive less attention in the GI literature, with diarrhea being less common than constipation in pregnancy and FI being often at the intersection of GI and obstetrics. MANAGEMENT OF FI Assessing for prior obstetric anal sphincter injury Anticipating and proactively managing FI and discussing future delivery in pregnant people with 1 or more prior obstetric anal sphincter injury (OASIS) is important because the risk of FI with prior OASIS and the risk of another OASIS in those with a history of OASIS are significantly increased ([[29], [31]]). Gastrointestinal (GI) symptoms are common during pregnancy, with the most common reports being nausea and vomiting, reflux, and constipation. [Extracted from the article]

Arterial hypertension (AH) is a major risk factor for the development of heart failure (HF) which represents one of the leading causes of mortality and morbidity worldwide. The chronic hemodynamic overload induced by AH is responsible for different types of functional and morphological adaptation of the cardiovascular system, defined as hypertensive mediated target organ damage (HMOD), whose identification is of fundamental importance for diagnostic and prognostic purposes. Among HMODs, left ventricular hypertrophy (LVH), coronary microvascular dysfunction (CMVD), and subclinical systolic dysfunction have been shown to play a role in the pathogenesis of HF and represent promising therapeutic targets. Furthermore, LVH represents a strong predictor of cardiovascular events in hypertensive patients, influencing per se the development of CMVD and systolic dysfunction. Clinical evidence suggests considering LVH as a diagnostic marker for HF with preserved ejection fraction (HFpEF). Several studies have also shown that microalbuminuria, a parameter of abnormal renal function, is implicated in the development of HFpEF and in predicting the prognosis of patients with HF. The present review highlights recent evidence on the main HMOD, focusing in particular on LVH, CMD, subclinical systolic dysfunction, and microalbuminuria leading to HFpEF. [ABSTRACT FROM AUTHOR]

Glycosylation is the most prominent modification important for vaccines and its specific pattern depends on several factors that need to be considered when developing a new biopharmaceutical. Tailor-made glycosylation can be exploited to develop more effective and safer vaccines; for this reason, a deep understanding of both glycoengineering strategies and glycans structures and functions is required. In this review we discuss the recent advances concerning glycoprotein expression systems and the explanation of glycans immunomodulation mechanisms. Furthermore, we highlight how glycans tune the immunological properties among different vaccines platforms (whole virus, recombinant protein, nucleic acid), also comparing commercially available formulations and describing the state-of-the-art analytical technologies for glycosylation analysis. The whole review stresses the aspect of glycoprotein glycans as a potential tool to overcome nowadays medical needs in vaccine field. [Display omitted] [ABSTRACT FROM AUTHOR]

Controlled Query Evaluation (CQE) is a framework for the protection of confidential data, where a policy given in terms of logic formulae indicates which information must be kept private. Functions called censors filter query answering so that no answers are returned that may lead a user to infer data protected by the policy. The preferred censors, called optimal censors, are the ones that conceal only what is necessary, thus maximizing the returned answers. Typically, given a policy over a data or knowledge base, several optimal censors exist. Our research on CQE is based on the following intuition: confidential data are those that violate the logical assertions specifying the policy, and thus censoring them in query answering is similar to processing queries in the presence of inconsistent data as studied in Consistent Query Answering (CQA). In this paper, we investigate the relationship between CQE and CQA in the context of Description Logic ontologies. We borrow the idea from CQA that query answering is a form of skeptical reasoning that takes into account all possible optimal censors. This approach leads to a revised notion of CQE, which allows us to avoid making an arbitrary choice on the censor to be selected, as done by previous research on the topic. We then study the data complexity of query answering in our CQE framework, for conjunctive queries issued over ontologies specified in the popular Description Logics DL-Lite R and EL ⊥. In our analysis, we consider some variants of the censor language, which is the language used by the censor to enforce the policy. Whereas the problem is in general intractable for simple censor languages, we show that for DL-Lite R ontologies it is first-order rewritable, and thus in AC0 in data complexity, for the most expressive censor language we propose. [ABSTRACT FROM AUTHOR]

The climate is a nonequilibrium system undergoing the continuous action of forcing and dissipation. Under the effect of a spatially inhomogeneous absorption of solar energy, all the climate components dynamically respond until an approximate steady state (or attractor) is reached. However, multiple steady states can coexist for a given forcing and with the same boundary conditions. Here, we apply the Thermodynamic Diagnostic Tool (TheDiaTo) to investigate the statistical properties of five coexisting climates, ranging from a snowball to an ice-free aquaplanet, obtained in MITgcm coupled simulations. The aim is to explore the multistability of the climate model setup by highlighting differences in competing steady states and their characteristic signatures regarding the meridional transport of heat and water mass, the Lorenz energy cycle, and the material entropy production. We also investigate how such attractors change when the model configuration is varied. We consider, in particular, the effect of changing the representation of the cloud albedo, and of implementing an improved closure of the energy budget. We find that, even if the dynamics remain on the same attractor, state variables are modified. The set of metrics in TheDiaTo quantifies such modifications and represents a valuable tool for model evaluation. [ABSTRACT FROM AUTHOR]

This article is a response to Stephen Vaisey's (2021) article, "Welcome to the Real World: Escaping the Sociology of Culture and Cognition." [ABSTRACT FROM AUTHOR]

Background: The current Coronavirus disease pandemic reveals political and structural inequities of the world's poorest people who have little or no access to health care and yet the largest burdens of poor health. This is in parallel to a more persistent but silent global health crisis, antimicrobial resistance (AMR). We explore the fundamental challenges of health care in humans and animals in relation to AMR in Tanzania. Methods: We conducted 57 individual interviews and focus groups with providers and patients in high, middle and lower tier health care facilities and communities across three regions of Tanzania between April 2019 and February 2020. We covered topics from health infrastructure and prescribing practices to health communication and patient experiences. Results: Three interconnected themes emerged about systemic issues impacting health. First, there are challenges around infrastructure and availability of vital resources such as healthcare staff and supplies. Second, health outcomes are predicated on patient and provider access to services as well as social determinants of health. Third, health communication is critical in defining trusted sources of information, and narratives of blame emerge around health outcomes with the onus of responsibility for action falling on individuals. Conclusion: Entanglements between infrastructure, access and communication exist while constraints in the health system lead to poor health outcomes even in 'normal' circumstances. These are likely to be relevant across the globe and highly topical for addressing pressing global health challenges. Redressing structural health inequities can better equip countries and their citizens to not only face pandemics but also day-to-day health challenges. [ABSTRACT FROM AUTHOR]

Summary: Background: Irritable bowel syndrome‐diarrhoea (IBS‐D) and IBS‐mixed stool pattern (IBS‐M) are disorders of gut‐brain interaction characterised by abdominal pain associated with diarrhoea or both diarrhoea and constipation respectively. The pathophysiology of IBS‐D/M is multifactorial and not completely understood; thus, treatment is aimed at multiple mechanisms such as altering gut microbiota, visceral hypersensitivity, intestinal permeability, gut‐brain interaction and psychological strategies. Aim: The goal of this article was to provide an up‐to‐date review of the current evidence for both non‐pharmacological and pharmacological treatment options in IBS‐D and IBS‐M. Future treatments for IBS‐D and IBS‐M will also be discussed. Methods: Medline and Embase database searches (through April 30 2021) to identify clinical studies in subjects with IBS‐D in which dietary modification, alternative treatments (probiotics, acupuncture, exercise) as well as FDA‐approved medications were used. Results: Dietary modification is often the first line of therapy. Furthermore, lifestyle treatments include complementary alternative medications (CAM), probiotics and peppermint oil are useful adjuncts but have not specifically been described in IBS‐D/M. Evidence strongly supports psychotherapy in the treatment of IBS. Beyond over‐the counter anti‐diarrhoeals, anti‐spasmodics and anti‐depressants, pharmacological treatment now includes treating for bile acid malabsorption and the FDA‐approved medications rifaximin, eluxadoline and alosetron. Conclusions: The treatment of IBS‐D/M ideally involves a multidisciplinary approach of primary care, gastroenterologist and psychologist. Treatment often involves both non‐pharmacological and pharmacological therapies. Future therapies may include faecal microbial transplant, Crofelemer and serotonin antagonists, but further studies are needed. [ABSTRACT FROM AUTHOR]

The atmospheric circulation is driven by heat transport from the tropics to the polar regions, embedding energy conversions between available potential and kinetic energy through various mechanisms. The processes of energy transformations related to the dynamics of the atmosphere can be quantitatively investigated through the Lorenz energy cycle formalism. Here we examine these variations and the impacts of modes of climate variability on the Lorenz energy cycle by using reanalysis data from the Japanese Meteorological Agency (JRA-55). We show that the atmospheric circulation is overall becoming more energetic and efficient. For instance, we find a statistically significant trend in the eddy available potential energy, especially in the transient eddy available potential energy in the Southern Hemisphere. We find significant trends in the conversion rates between zonal available potential and kinetic energy, consistent with an expansion of the Hadley cell, and in the conversion rates between eddy available potential and kinetic energy, suggesting an increase in mid-latitudinal baroclinic instability. We also show that planetary-scale waves dominate the stationary eddy energy, while synoptic-scale waves dominate the transient eddy energy with a significant increasing trend. Our results suggest that interannual variability of the Lorenz energy cycle is determined by modes of climate variability. We find that significant global and hemispheric energy fluctuations are caused by the El Nino-Southern Oscillation, the Arctic Oscillation, the Southern Annular Mode, and the meridional temperature gradient over the Southern Hemisphere. [ABSTRACT FROM AUTHOR]

Abstract: It is commonly believed that blinding to treatment assignment is necessary for placebos to have an effect. However, placebos administered without concealment (ie, open-label placebos [OLPs]) have recently been shown to be effective in some conditions. This study had 2 objectives: first, to determine whether OLP treatment is superior to no-pill control (NPC) in irritable bowel syndrome (IBS) and, second, to compare the efficacy of OLP against double-blind placebo (DBP). In a 6-week, 3-arm, randomized clinical trial, participants were randomized in equal proportions to 3 arms: OLP, DBP, or NPC. Two hundred sixty-two adults (72.9% women), with a mean age of 42.0 (SD = 18.1) years, participated in the primary study. The mean improvement on the IBS Severity Scoring System from baseline to the 6-week end point was significantly greater in OLP compared with that in NPC (90.6 vs 52.3, P = 0.038). Open-label placebo and DBP did not differ significantly on IBS Severity Scoring System improvement (100.3 vs 90.6, P = 0.485). Standardized effect sizes were moderate for OLP vs NPC (d = 0.43) and small for OLP vs DBP (d = 0.10). Participants treated with OLP reported clinically meaningful improvements in IBS symptoms that were significantly greater than those on NPC. Open-label placebo and DBP had similar effects that did not differ significantly, suggesting that blinding may not be necessary for placebos to be effective and that OLP could play a role in the management of patients with refractory IBS. [ABSTRACT FROM AUTHOR]

• Isotopic and geochronological data evidence three units in the Sierra de El Gigante. • First evidence of a Grenville-age basement in the Sierra de El Gigante. • Some units of Sierra de El Gigante and Sierra de Pie de Palo are correlatables. The southwestern paleo-margin of Gondwana is interpreted as an accretionary margin that was active from the late Neoproterozoic to the late Paleozoic. The basement of this paleo-margin is widely exposed in the central-western part of Argentina (Sierras Pampeanas area), where a protracted evolution from the Mesoproterozoic to the late Paleozoic is recorded. Part of this evolution is preserved in the El Gigante Metamorphic Complex (Sierra de El Gigante; Western Sierras Pampeanas), a small rotated block within the Valle Fértil Lineament fault zone that separates the Western and Eastern Sierras Pampeanas. The complex is composed of medium-grade meta-siliciclastic and meta-carbonate rocks and medium- to high-grade meta-igneous rocks, affected by tight to isoclinal folds and a pervasive east–west foliation resulting from the Famatinian orogeny (broadly late Cambrian to early Devonian). Later events include localized ductile shear zones. The isotopic and geochronological data from El Gigante Metamorphic Complex reveal at least three distinct lithological assemblages: (1) metamorphosed felsic igneous rocks of ca. 1.11 Ga, i.e., late Mesoproterozoic, (2) a Neoproterozoic metasedimentary succession composed of quartzites and mica-schists, (3) possibly mid- to late-Cambrian marble and graphite-schist. The Grenvillian assemblage (1) was part of a large reworked Paleoproterozoic continental block called MARA (acronym of Maz-Arequipa-Río Apa) and was the basement over which the Neoproterozoic and Cambrian sedimentary successions were deposited. Based on U-Pb zircon ages, lithological similarities and Sr-isotope data, the three lithological assemblages of the El Gigante Metamorphic Complex can be correlated with similar ones in the nearby geologically better-known Sierra de Pie de Palo. The Neoproterozoic and the Cambrian metasedimentary successions are respectively equivalent to the Difunta Correa Metasedimentary Sequence and the Nikizanga-Caucete Groups, which are recognized throughout the Sierras Pampeanas, east and west of the Valle Fértil Lineament. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Tenapanor is a first-in-class, minimally absorbed, small-molecule inhibitor of the gastrointestinal sodium/hydrogen exchanger isoform 3. This phase 3 trial assessed the long-termefficacy and safety of tenapanor 50 mg b.i.d. for the treatment of patients with irritable bowel syndrome with constipation (IBS-C). METHODS: In this randomized double-blind study (ClinicalTrials.gov identifier: NCT02686138), patients with IBS-C received tenapanor 50 mg b.i.d. or placebo b.i.d. for 26 weeks. The primary endpoint was the proportion of patients who had a reduction of ≥30.0% in average weekly worst abdominal pain and an increase of ≥1 weekly complete spontaneous bowelmovement from baseline, both in the same week, for ≥6 of the first 12 treatment weeks (6/12-week combined responder). RESULTS: Of the 620 randomized patients with IBS-C, 593 (95.6%)were included in the intention-to-treat analysis set (tenapanor: n = 293; placebo: n = 300) and 481 patients (77.6%) completed the 26-week treatment period. In the intention-to-treat analysis set (mean age: 45.4 years; 82.1% women), a significantly greater proportion of patients treated with tenapanor were 6/12-week combined responders than those treated with placebo (36.5% vs 23.7%; P < 0.001). Abdominal symptoms and global symptoms of IBS were significantly improved with tenapanor compared with placebo. Diarrhea, themost common adverse event, was typically transient and mild to moderate in severity. Diarrhea led to study drug discontinuation for 19 (6.5%)and2 patients (0.7%) receiving tenapanor and placebo, respectively. DISCUSSION: Tenapanor 50 mg b.i.d. improved IBS-C symptoms over 26 weeks and was generally well tolerated, offering a potential new long-term treatment option for patients with IBS-C (see Visual abstract, Supplementary Digital Content 1, http://links.lww.com/AJG/B797). [ABSTRACT FROM AUTHOR]

The article discusses the role of abdominal ultrasonography in diagnosing acute diverticulitis. While ultrasonography has similar sensitivity and specificity to CT scans in diagnosing acute diverticulitis, it may be less accurate in identifying complications and alternative diagnoses. European guidelines recommend CT as the first-line investigative tool, with ultrasonography as an alternative. The authors agree that further research is needed to determine the appropriate role of ultrasonography in suspected cases of acute diverticulitis. [Extracted from the article]

Background: Dermatofibrosarcoma protuberans (DFSP) is a rare skin fibroblastic tumor, with a high rate of recurrence. The treatment of DFSP is generally surgical, and wide local excision is the mainstay of surgical treatment. Therefore, complete assessment of all surgical margins is fundamental before definitive reconstruction. The reconstruction is a challenge for plastic surgeons, especially in particular anatomical areas (for aesthetic or functional problems) or in patients who are not candidates for more complex surgical treatments. We describe an alternative approach for reconstructive treatment of the lumbar area after wide excision of DFSP (without fresh-frozen sections) in a young obese woman with a history of smoking, using a new type of acellular dermal matrix (ADM) in a combined management protocol. The benefits of ADM are numerous: immediate wound closure and prevention of infections and excessive drying; minimal donor site morbidity; and good functional and aesthetic outcomes. Moreover, it is a temporary cover while the anatomical specimen is histologically analyzed, without donor site morbidity or prevention of any future surgery (if the margins are not tumor-free) or radiotherapy.Case Presentation: In October 2019, a 34-year old obese Caucasian Woman with a history of smoking came to our institute for a multinodular growing polypoid mass in her lumbar region. An incisional biopsy diagnosed DFSP. The patient underwent proper staging. A wide local excision with 3 cm clinically healthy tissue margins down to the muscle fascia was performed and the defect was repaired using a combined approach with a new artificial bilaminar dermal template (Pelnac®, Gunze Ltd., Osaka, Japan) and a negative-pressure wound therapy system (V.A.C.®, KCI, San Antonio, USA). After the final histological examination revealed tumor-free margins, a split-thickness graft was harvested from the right gluteus and fixed to the new derma with negative-pressure wound therapy. Postoperative radiotherapy was not necessary. After 15 days, the wound had healed without complications, with satisfactory aesthetic outcome and with no limitation of back motion or pain. After 6 months of follow-up, the patient was free from disease.Conclusions: This is the first reported case of Pelnac® use in DFSP reconstruction of the lumbar region. We believe that the multistep approach described herein may be a good alternative approach in selected patients with wide resections in particular anatomical areas, especially when frozen sections (with Mohs micrographic surgery) are not available. [ABSTRACT FROM AUTHOR]