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Background: Managing extraintestinal manifestations (EIMs) in inflammatory bowel disease (IBD) patients remains challenging due to considerable heterogeneity in diagnostic criteria and the lack of a standardised definition and validated diagnostic pathways. Delays in recognising and treating EIMs can lead to significant disease progression. Therefore, early detection and treatment are crucial. Objectives: We aimed to assess the effectiveness of a dedicated immune-mediated inflammatory diseases (IMIDs) clinic in reducing EIM diagnostic delays and improving patients' outcomes. Design: A single-centre observational study was conducted, including IBD patients presenting with EIMs red flags. Methods: We compared the EIMs diagnostic delay between patients who attended a multidisciplinary IMID outpatient clinic (IMID-G) and those who attended individual referral specialists representing the standard outpatient clinic group (SOC-G). We further evaluated the impact of diagnostic timing on 18-month clinical outcomes, including therapeutic changes, steroid and immunosuppressant use and biological therapy switch/swap. Results: We enrolled 238 IBD patients, 127 in the IMID-G and 111 in the SOC-G. The average time to EIM diagnosis was 2.48 ± 1.8 and 5.36 ± 2.3 months for the IMID and SOC-Gs (Δ = 2.88 months, p = 0.005). The majority of patients received a diagnosis of peripheral arthritis (IMID-G = 37.5%; SOC-G = 33.7%) and spondyloarthropathy (IMID-G = 32.1%; SOC-G = 33.7%). No significant difference was observed in the rates of EIMs between the two groups (88.2% in IMID-G vs 92.8% in SOC-G, p = 0.27). Regarding therapeutic changes, the IMID-G reported a mean time to the first therapeutic change driven by the specialist referral of 2.96 ± 1.8 months, compared to 6.09 ± 2.5 months in the SOC-G, showing a significant difference (p = 0.007). The IMID-G had a higher frequency of biological therapy switching/swapping and adding immunosuppressive treatment than the SOC-G (p = 0.008 and p = 0.04, respectively). Survival curves revealed a significant reduction in diagnostic delay and time to treatment in the IMID-G compared to the SOC-G (log-rank test, p < 0.001). Conclusion: Attending a dedicated IMID clinic can enhance the diagnostic process for EIMs in IBD patients, thereby reducing diagnostic delays and allowing early interventions to avoid disease progression. Plain language summary: Reducing diagnostic delays for EIMs in IBD: a comparison of multidisciplinary clinics and standard referral practice An outpatient model involving specialists in immune-mediated inflammatory diseases (IMIDs) – gastroenterologists, dermatologists, and rheumatologists – enhances the diagnostic process through early referral strategies and a multidisciplinary approach. This model promotes teamwork and improves communication, reducing diagnostic delays and enabling timely access to effective treatments, potentially minimising the risk of disease progression and thereby improving patient outcomes [ABSTRACT FROM AUTHOR]

In 1960, Dr. William Dock, visiting professor at Yale, discussed the case of a young girl with an unknown liver disease. Dock recommended biopsy, invoking bank robber Willie Sutton's words "that's where the money is." Drs. Petersdorf and Beeson, in attendance that day, included the following in their 1961 publication on fever of unexplained origin, "We are indebted to Dr. William Dock for the term Sutton's Law. It recommends proceeding immediately to the diagnostic test most likely to provide a diagnosis, and deplores the tendency to carry out a battery of 'routine' examinations in conventional sequence." Thereafter, Sutton's Law became an acclaimed aphorism advocating pursuit of tissue, because of its specificity for achieving diagnostic certainty. However, its popularity was fleeting, as formal medical decision-analysis (FMDA) became the standard. In the 1940s and 1950s, pioneers in the field laid the groundwork, and by the 1980s, clinician researchers had introduced the science into everyday clinical practice. The original version of Sutton's Law neglected the reality that FMDA is more than specificity, tissue, and absolute certainty. The newer version encourages clinicians to employ and prioritize their "routine" interview questions, physical examination assessments, and laboratory tests that provide clarity to differentiate between disease and no disease, to influence favorably the patient's management, and to discard those evaluations more likely to provide misleading results. Dock, Petersdorf, and Beeson may not have spoken the language of FMDA, but they were adept at applying its principles. Without them, and the unknown medical student who made the diagnosis of schistosomiasis, there would be no Sutton's Law. For many, it is an obsolete and apocryphal aphorism valuable solely for touting the importance of specificity in tissue diagnosis. For others, it has evolved, remaining relevant as an authentic lesson in decision-analysis, past and present. [ABSTRACT FROM AUTHOR]

People with chronic kidney disease (CKD) are at a high risk of heart disease and end-stage kidney disease. This review describes how new medications, such as glucagon-like peptide-1 receptor agonists (GLP1RA), aldosterone synthase inhibitors (ASi), soluble guanylate cyclase (sGC) and endothelin receptor antagonists (ERA), can lower heart–kidney risk in people with CKD. GLP1RA are already recommended for managing blood sugar in people with CKD and type 2 diabetes and have been shown to lower the risk of developing end-stage kidney disease. GLP1RA will likely soon be included in clinical guidelines, but further research is needed to understand how these medications protect the kidneys. ASi are another new medication that lower the protein found in urine. Larger trials are being done to see how well these medications work in slowing CKD. Lastly, both sGC agonists and ERAs have been shown to relax blood vessels to improve blood flow in the kidney, and reduce the amount of protein found in urine, both of which are critical to protecting kidneys. Larger clinical trials are being done to see if these medications prevent CKD from getting worse. In summary, this review describes the new and promising treatments for CKD. These therapies hold the potential to slow kidney disease and improve the wellbeing of patients. Further research of these new treatments is important for improving CKD care. ABSTRACT Despite recent advancements in the treatment of chronic kidney disease (CKD), identifying novel therapies beyond guideline-directed therapies that reduce residual cardiorenal risk remains imperative. In this review, we highlight the clinical evidence supporting emerging therapies for CKD, including glucagon-like peptide-1 receptor agonists (GLP1RA) and other incretin-based therapies, aldosterone synthase inhibitors (ASI), endothelin receptor antagonists (ERA), soluble guanylate cyclase (sGC) agonists and anti-inflammatory drugs. Long-acting GLP1RA are already recommended for glycemic control in patients with CKD and type 2 diabetes and the large, dedicated kidney outcome trial FLOW was recently stopped early for efficacy. Emerging clinical trial evidence supports the concept that ASI also provide additional benefit on top of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, which remain a cornerstone of CKD treatment. Next, we consider the use of sGC agonists, which target nitric oxide bioavailability and thereby reduce albuminuria. Finally, we explore the therapeutic potential of ERA, which act through hemodynamic and anti-fibrotic mechanisms, thereby addressing a common final pathway in the development of CKD. Accordingly, our review highlights the changing therapeutic landscape for CKD with promising agents to further prevent the progression of kidney disease. [ABSTRACT FROM AUTHOR]

Objective: To evaluate ureteral involvement using transvaginal sonography (TVS) regarding the distortion of the course of the ureters caused by deep endometriosis (DE), which can facilitate predicting the need for ureterolysis during surgery, even in the absence of ureteral stenosis or dilatation. Methods: This is a single‐center, observational, retrospective pilot study of 88 consecutive patients who later underwent surgery for DE that used ultrasound preoperative diagnosis of ureteral medial deviation of one or both ureters between January 2019 and January 2022. At TVS, the course of the ureter was considered medialized if, in longitudinal and transversal section, any distance was detectable between the ureter and the cervix at the point where the ureter crosses the uterine artery. The primary end point was to determine sensitivity, specificity, and positive and negative predictive values of "ureteral medial deviation" diagnosed using TVS, in order to predict the need for ureterolysis. Results: Our series included 88 women with a median age of 39 (interquartile range 33–43) years. Ureteral medialization showed a relatively low false‐positive rate (10.9%), with a specificity of 89.1% (95% confidence interval [CI] 81.4%–96.7%) and a sensitivity of 86.6% (95% CI 80.3%–92.9%), along with a high positive predictive value of 93.3% (95% CI 88.4%–98.1%), and a lower negative predictive value of 79.1% (95% CI 69.8%–88.5%), respectively. Conclusions: This study introduced a new ultrasound sign with a high degree of accuracy to predict ureterolysis and this may have positive implications in the management and surgical planning of patients with ureteral endometriosis. Synopsis: Evaluation of ureteral involvement regarding the distortion of the course of the ureters by deep endometriosis, which can facilitate predicting the need for ureterolysis. [ABSTRACT FROM AUTHOR]

A burst of muscle sympathetic nerve activity (MSNA) induces vasoconstriction that transiently reduces regional vascular conductance and increases systemic blood pressure (BP) over the subsequent 4–8 cardiac cycles. These responses are termed sympathetic neurovascular transduction and sympathetic transduction of BP, respectively. Sympathetic transduction of BP is commonly calculated and interpreted as a proxy measure for regional sympathetic neurovascular transduction despite the systemic nature of BP regulation. The present analysis tested whether the peak change in signal-averaged sympathetic transduction of BP was correlated to the change in regional sympathetic vascular transduction at rest. Fourteen adults (5 females, 23 ± 3 yr) arrived at the laboratory, ate a standardized meal, and rested for 90–120 min. MSNA (fibular nerve microneurography), heart rate (electrocardiography), beat-to-beat BP (finger photoplethysmography), and superficial femoral artery blood flow (Doppler ultrasound) were obtained continuously for 10 min in the supine position. Femoral vascular conductance (FVC) was calculated as blood flow divided by mean arterial BP. The peak change in diastolic BP following a burst of MSNA was correlated to the corresponding nadir change in femoral vascular conductance (r = −0.58 [−0.07 to −0.85], P = 0.03) and superficial femoral artery blood flow (r = −0.54 [−0.17 to −0.83], P = 0.04). The nadir change in diastolic BP in cardiac cycles not following an MSNA burst was correlated to the peak change in femoral vascular conductance (r = −0.42 [−0.83 to 0.00], P = 0.05), but not superficial femoral artery blood flow (r = 0.41 [−0.77 to 0.15], P = 0.14). In conclusion, more commonly assessed sympathetic transduction of BP provides moderate insight into regional sympathetic neurovascular transduction. NEW & NOTEWORTHY: The majority of studies have used signal-averaged sympathetic transduction of blood pressure as a generalized measure of transduction. In this analysis, we show that sympathetic transduction of blood pressure and regional sympathetic vascular transduction were moderately correlated in healthy adults at rest. The moderate strength of this relationship highlights potential differences between regional and systemic assessments of sympathetic transduction and suggests that future work should choose the transduction measure best aligned with the research question. [ABSTRACT FROM AUTHOR]

This work explores the geometry of extremal Kerr-Newman black holes by analyzing their mass/energy relationships and the conditions ensuring black hole existence. Using differential geometry in E 3 , we examine the topology of the event horizon surface and identify two distinct families of extremal black holes, each defined by unique proportionalities between their core parameters: mass (m), charge (Q), angular momentum (L), and the irreducible mass ( m i r ). In the first family, these parameters are proportionally related to the irreducible mass by irrational numbers, with a characteristic flat Gaussian curvature at the poles. In the second family, we uncover a more intriguing structure where m, Q, and L are connected to m i r through coefficients involving the golden ratio − ϕ − . Within this family lies a unique black hole whose physical parameters converge on the golden ratio, including the irreducible mass and polar Gauss curvature. This black hole represents the highest symmetry achievable within the constraints of the Kerr-Newman metric. This remarkable symmetry invites further speculation about its implications, such as the potential determination of the dark energy density parameter Ω Λ for Kerr-Newman-de Sitter black holes. Additionally, we compute the maximum energy that can be extracted through reversible transformations. We have determined that the second, golden-ratio-linked family allows for a greater energy yield than the first. [ABSTRACT FROM AUTHOR]

For early Christian missionaries, Chinese proverbs were an invaluable resource for learning the language, understanding the culture, and carrying out religious evangelization. While existing research has predominantly focused on collections of Chinese proverbs by Protestant missionaries, Catholic missionaries' efforts in gathering Chinese proverbs preceded those of their Protestant counterparts and hold significant linguistic, historical, and cross-cultural value. This study begins by tracing the emergence of Catholic missionaries' interest in Chinese proverbs and then presents a comparative analysis of three representative collections compiled by Joseph de Prémare (1666–1736), Paul Perny (1818–1907), and Joseph Van Oost (1877–1939): Catholic missionaries from different orders and historical periods. It examines the compilation structures, purposes, Chinese proverbs selected, and interpretive approaches in their works, tracing the evolution of Catholic missionaries' Chinese proverb collections. The study interprets this evolution in relation to the Catholic Church's missionary strategies and the personal evangelization philosophies of the missionaries themselves. This research demonstrates the diverse cultural engagement practices of Catholic missionaries in China from the 18th to the early 20th century, offering new insights into the interaction between Catholicism and Chinese culture during this period. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia, a syndrome characterized by age-related loss of muscle mass and function, lacks universally accepted diagnostic criteria, particularly for its role as a prognostic factor in elderly patients with non-small-cell lung cancer (NSCLC). This study aimed to evaluate the prognostic significance of sarcopenia, assessed by psoas muscle size on baseline CT scans, in patients over 70 years of age with metastatic NSCLC. Methods: We retrospectively analyzed 85 elderly patients undergoing palliative radiation therapy between August 2022 and July 2024. Using morphometric analysis of psoas size, we investigated its correlation with overall survival (OS) and progression-free survival (PFS). Results: Our results showed that decreased psoas size was significantly associated with shorter OS and PFS, with median OS of 10 months and PFS of 4 months in sarcopenic patients compared to longer survival times in non-sarcopenic patients. Median survival of non-sarcopenic vs. sarcopenic patients was 21 ± 7 months (muscle area > median) versus 5 ± 2.3 months (muscle area < median). Multivariate analysis confirmed that psoas size, along with ECOG performance status and treatment of primary NSCLC, was a significant predictor of survival. Discussion: These findings suggest that psoas muscle size is a valuable prognostic marker for elderly NSCLC patients, potentially guiding treatment decisions and patient management. Further research is needed to validate these results and refine prognostic models for this population. [ABSTRACT FROM AUTHOR]

The efficiency potential for single‐junction photovoltaics (PV) is described by the detailed balance model, which requires the elimination of nonradiative recombination and perfect minority carrier collection. Improvements in GaAs, Si, and perovskite PV follow this model. It might be more complex for CdTe, a leading thin‐film PV technology. While lifetime, passivation, and doping goals for 25% efficient CdTe solar cells are largely reached, voltage is ≈20% below the detailed balance limit. Why is that? In Se‐alloyed CdSexTe1‐x (Se is required for >20% efficiency) additional losses can occur due to electrostatic and bandgap fluctuations and due to electronic trap states. To understand mechanisms limiting CdSeTe solar cell performance and to suggest improvements, carrier dynamics, and transport in CdSexTe1‐x with variation in Se composition and as doping is analyzed. It is shown that trapping, likely due to anion‐site defects and their complexes, is correlated with low charge carrier mobility of 0.1–0.6 cm2 (Vs)−1. Even with 1000 ns charge carrier lifetimes, carrier diffusion length is less than the absorber thickness, reducing efficiency to ≈23%. Device simulations are used to analyze the performance of CdSexTe1‐x solar cells; thermodynamic models are not sufficient for absorbers with electronic disorder and trapping. [ABSTRACT FROM AUTHOR]

The gap between endoscopy and histology is getting closer with the introduction of sophisticated endoscopic technologies. Furthermore, unprecedented advances in artificial intelligence (AI) have enabled objective assessment of endoscopy and digital pathology, providing accurate, consistent, and reproducible evaluations of endoscopic appearance and histologic activity. These advancements result in improved disease management by predicting treatment response and long-term outcomes. AI will also support endoscopy in raising the standard of clinical trial study design by facilitating patient recruitment and improving the validity of endoscopic readings and endoscopy quality, thus overcoming the subjective variability in scoring. Accordingly, AI will be an ideal adjunct tool for enhancing, complementing, and improving our understanding of ulcerative colitis course. This review explores promising AI applications enabled by endoscopy and histology techniques. We further discuss future directions, envisioning a bright future where AI technology extends the frontiers beyond human limits and boundaries. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Patients with intrathecal catheters for pain medication infusion should be aware of the possible complication of acute flaccid paralysis. While exceedingly rare, it should prompt immediate medical attention to rule out compressive pathology requiring intervention. [ABSTRACT FROM AUTHOR]

The composer, performer, and installation artist Raven Chacon hails from Fort Defiance, in the Navajo Nation. His work has been exhibited in various prestigious venues and he has received numerous awards, including the Pulitzer Prize for Music in 2022. He has also mentored indigenous composers and his works are part of renowned collections. A conversation between Raven Chacon and Michael Nardone explores the listening practices associated with composing scores for performance, shedding light on the cultural and historical contexts of his works. [Extracted from the article]

Objective: We examined whether the emotions that clients experience within session are associated with treatment outcome in dialectical behavior therapy (DBT) for borderline personality disorder (BPD). Method: Participants were 52 adults who met criteria for BPD and were enrolled in a 12-month DBT treatment. The Classification of Affective-Meaning States, an observer-rated measure of discrete emotions, was used to code videos of individual DBT sessions. Raters coded three psychotherapy sessions for each participant: one session from each of the early, working, and late phases of psychotherapy. Self-report measures of BPD symptoms were used to assess treatment outcome. Results: More emotional experience overall during the early phase predicted fewer BPD symptoms at 12-month treatment outcome, explaining 19% of the variance in symptoms. However, increases across treatment in global distress predicted higher levels of BPD (24% of the variance explained) and depression symptoms (15% explained) at termination. Increases in emotional flexibility (i.e., variation between states) from the early to working phase predicted fewer depressive symptoms at termination (14% explained). Self-compassion coded during the working phase also predicted a better treatment outcome (explaining 19%–34%). Conclusions: Clients' in-session emotional experiences predict treatment outcome 8–10 months later. Clients with BPD may benefit from more overall exploration of their emotional experiences early in DBT, as well as expression of self-compassion. Increases in nonspecific, intense negative affect anticipates poor prognosis, whereas increases in emotional flexibility during early treatment anticipates better prognosis. What is the public health significance of this article?: This study highlights the importance of discrete emotional experiences in dialectical behavior therapy for borderline personality disorder. Specific kinds of emotional experience in individual dialectical behavior therapy sessions anticipate treatment outcome. [ABSTRACT FROM AUTHOR]

The integration of multidisciplinary tumor boards (MTBs) is fundamental in delivering state-of-the-art cancer treatment, facilitating collaborative diagnosis and management by a diverse team of specialists. Despite the clear benefits in personalized patient care and improved outcomes, the increasing burden on MTBs due to rising cancer incidence and financial constraints necessitates innovative solutions. The advent of artificial intelligence (AI) in the medical field offers a promising avenue to support clinical decision-making. This review explores the perspectives of clinicians dedicated to the care of cancer patients—surgeons, medical oncologists, and radiation oncologists—on the application of AI within MTBs. Additionally, it examines the role of AI across various clinical specialties involved in cancer diagnosis and treatment. By analyzing both the potential and the challenges, this study underscores how AI can enhance multidisciplinary discussions and optimize treatment plans. The findings highlight the transformative role that AI may play in refining oncology care and sustaining the efficacy of MTBs amidst growing clinical demands. [ABSTRACT FROM AUTHOR]

Volume overload represents a hallmark clinical feature linked to the development and progression of heart failure (HF). Alleviating signs and symptoms of volume overload represents a foundational HF treatment target that is achieved using loop diuretics in the acute and chronic setting. Recent work has provided evidence to support guideline-directed medical therapies, such as sodium glucose cotransporter 2 (SGLT2) inhibitors and mineralocorticoid receptor (MR) antagonists, as important adjunct diuretics that may act synergistically when used with background loop diuretics in people with chronic HF. Furthermore, there is growing interest in understanding the role of SGLT2 inhibitors, carbonic anhydrase inhibitors, thiazide diuretics, and MR antagonists in treating volume overload in patients hospitalized for acute HF, particularly in the setting of loop diuretic resistance. Thus, the current review demonstrates that: (i) SGLT2 inhibitors and MR antagonists confer long-term cardioprotection in chronic HF patients but it is unclear whether natriuresis or diuresis represents the primary mechanisms for this benefit, (ii) SGLT2 inhibitors, carbonic anhydrase inhibitors, and thiazide diuretics increase natriuresis in the acute HF setting, but implications on long-term outcomes remain unclear and warrants further investigation, and (iii) a multi-nephron segment approach, using agents that act on distinct segments of the nephron, potentiate diuresis to alleviate signs and symptoms of volume overload in acute HF. [ABSTRACT FROM AUTHOR]

Adhesive Capsulitis of the shoulder is a painful pathology limiting shoulder movements, commonly known as "Frozen Shoulder". Since this pathology limits movement, it is important to make an early diagnosis. Diagnosing capsulitis relies on clinical assessment, although diagnostic imaging, such as Magnetic Resonance Imaging, can provide predictive or supportive information for specific characteristic signs. However, its diagnosis is not so simple nor so immediate, indeed it remains a difficult topic for many general radiologists and expert musculoskeletal radiologists. This study aims to investigate whether it is possible to use disease signs within a medical image to automatically diagnose Adhesive Capsulitis. To this purpose, we propose an automatic Model Checking-based approach to quickly diagnose the Adhesive Capsulitis taking as input the radiomic feature values from the medical images. Furthermore, we compare the performance achieved by our method with diagnostic results obtained by professional radiologists with different levels of experience. To the best of our knowledge, this is the first method for the automatic diagnosis of Adhesive Capsulitis of the Shoulder. [ABSTRACT FROM AUTHOR]

Acute Severe Ulcerative Colitis (ASUC) is a severe form of ulcerative colitis relapse which requires hospitalization and intensive medical intervention to avoid colectomy. The timely recognition of patients at risk of corticosteroid failure and the early initiation of medical rescue therapy are paramount in the management of ASUC. The choice of medical rescue therapy is influenced by multiple factors, especially patient's prior treatment history. This decision should involve the patient and ideally a multidisciplinary team of healthcare professionals, including gastroenterologists, radiologists, surgeons and enterostomal therapists. Although several predictive models have been developed to predict corticosteroid failure in ASUC, there is no single validated tool that is universally utilized. At present, infliximab and cyclosporine are the only agents systematically evaluated and recommended for medical rescue therapy, with recent reports of off-label utilization of tofacitinib and upadacitinib in small case series. The available evidence regarding the efficacy and safety of these oral small molecules for ASUC is insufficient to provide definitive recommendations. Early decision-making to assess the response to medical rescue therapy is essential, and the decision to pursue surgery in the case of treatment failure should not be delayed. [ABSTRACT FROM AUTHOR]

OSAS and TMDs represent multifactorial nosologic entities, whose central, functional and psycho‐social aspects are gaining growing attention within the scientific community. In our previous commentary, we wanted to point out that structural aspects should not be forgotten in a clinical and research context. The inherent complexity of the matter could make it difficult to quantify the exact contribution of every single factor. The multifaceted nature of OSAS and TMDs pathophysiology could sustain several phenotypes in both conditions, and the anatomic parameters may assume different weights according to each phenotype, possibly justifying literature discrepancies. Thus, a patient with a co‐existing OSAS and TMD (umbrella terms per se, each of them including different pathophysiological and clinical characteristics) represents an even greater challenge to researchers and practitioners. The scientific and therapeutic community should keep on looking for evidence to offer the best possible answers to such daring questions, in the most collaborative and fruitful way. [ABSTRACT FROM AUTHOR]

Investigation of intrinsic defects such as gallium vacancies (VGa) and their interactions with extrinsic defects like Fe in β-Ga2O3 is crucial for the development of devices. Photoinduced electron paramagnetic resonance (photo-EPR) experiments are performed at room temperature and 30 K by illuminating neutron irradiated Fe-doped and unintentionally doped β-Ga2O3 crystals with LEDs from 0.7 to 4.7 eV, and interactions between VGa and other defects such as Fe are investigated. 30 K measurements indicate small photoinduced changes in the amount of V Ga 2 − , but the photothreshold suggests little or no interaction with Fe. Rather, the decrease of V Ga 2 − is accompanied by the emergence of self-trapped holes (STHs), indicating that the stability of the STH is critical to the V Ga 2 − optical transition. We suggest the decrease of V Ga 2 − is due to excitation of electrons from valence band maximum to the defect. The resulting hole is captured at an oxygen atom to form STH. By performing a systematic photo-EPR study of gallium vacancies, we show that the intrinsic defect, VGa, does not interact with extrinsic defects, Fe or Ir. Instead, VGa contributes to the stability of the STH. [ABSTRACT FROM AUTHOR]

Purpose: The surgical approach to bowel endometriosis is still unclear. The aim of the study is to compare TICA to conventional specimen extractions and extra-abdominal insertion of the anvil in terms of both complications and functional outcomes. Methods: This is a single-center, observational, retrospective study conducted enrolling symptomatic women underwent laparoscopic excision of deep endometriosis with segmental bowel resection between September 2019 and June 2022. Women who underwent TICA were compared to classical technique (CT) in terms of intra- and postoperative complications, moreover, functional outcomes relating to the pelvic organs were assessed using validated questionnaires [Knowles-Eccersley-Scott-Symptom (KESS) questionnaire and Gastro-Intestinal Quality of Life Index (GIQLI)] for bowel function. Pain symptoms were assessed using Visual Analogue Scale (VAS) scores. Results: The sample included 64 women. TICA was performed on 31.2% (n = 20) of the women, whereas CT was used on 68.8% (n = 44). None of the patients experienced rectovaginal, vesicovaginal, ureteral or vesical fistula, or ureteral stenosis and uroperitoneum, and in no cases was it necessary to reoperate. Regarding the two surgical approaches, no significant difference was observed in terms of complications. As concerns pain symptoms at 6-month follow-up evaluations on stratified data, except for dysuria, all VAS scales reported showed significant reductions between median values, for both surgery interventions. As well, significant improvements were further observed in KESS scores and overall GIQLI. Only the GIQLI evaluation was significantly smaller in the TICA group compared to CT after the 6-month follow-up. Conclusions: We did not find any significant differences in terms of intra- or post-operative complications compared TICA and CT, but only a slight improvement in the Gastro-Intestinal Quality of Life Index in patients who underwent the CT compared to the TICA technique. [ABSTRACT FROM AUTHOR]

This document, published in the journal Clinical Autonomic Research, explores the relationship between sympathetic vasoconstrictor outflow and endothelial-mediated vasodilation in maintaining blood flow homeostasis. The study investigates whether endothelial ischemic reperfusion injury enhances sympathetic neurovascular transduction. The researchers conducted experiments on 11 healthy participants and found that impairments in endothelial function did not affect sympathetic vasoconstrictor responsiveness. The study suggests that a more robust sympatho-excitatory stimulus may be required to potentiate sympathetic vasoconstrictor transduction in conditions of endothelial dysfunction. [Extracted from the article]

Background: The transition from pediatric to adult healthcare in individuals with inflammatory bowel disease (IBD) poses significant challenges mainly due to the high burden of IBD during adolescence, a critical period of psychosocial development. So far, there are few longitudinal data linking transition readiness to long-term disease outcomes. Objective: We aimed to assess patients' readiness to transition and its impact on clinical outcomes, quality of life, and adherence to therapy. Design: An observational, prospective study was conducted in a tertiary adult and pediatric center, including adolescents aged ⩾17 years with a diagnosis of IBD, who underwent a 'structured transition' program including two joint adult–pediatric visits. Methods: Transition readiness skills were assessed with the Transition Readiness Assessment Questionnaire (TRAQ). All patients completed the TRAQ at the time of recruitment, which occurred during the initial joint adult–pediatric visit, to determine those deemed ready for transition versus those not ready. The Morisky Medication Adherence Scale and the 36-Item Short Form Health Survey Questionnaire (SF-36) were also completed at baseline and after 12 months. Clinical outcomes were collected at the 12-month follow-up. Results: In all, 80 patients were enrolled who had transitioned through a structured transition clinic and completed 12 months of follow-up. In total, 54 patients were ready for the transition, with a mean TRAQ = 3.2 ± 0.5. The number of clinical relapses and hospitalizations at 12 months was lower in ready compared to not-ready patients (p = 0.004 and p = 0.04, respectively). SF-36 did not differ between ready and not-ready patients and pre- and post-transition clinics (p > 0.05). Based on the receiver operating characteristic curve, a TRAQ cutoff ⩾3.16 could predict medication adherence with a sensibility of 77%, a specificity of 82%, and an AUC of 0.81 (0.71–0.91; p < 0.001). Conclusion: Patients ready for transition had better outcomes at 12 months compared to those who were not ready. Therefore, readiness assessment tools should be integrated into transition management to ensure that interventions are targeted, patient-centered, and responsive to individuals' changing needs. Plain language summary: Transition readiness associated with improved clinical outcomes The transition for individuals with inflammatory bowel disease (IBD) is a dynamic and complex process that must be planned and cannot simply be performed once the patient is 18 years old. Since it does not depend solely on the patient's age but also on developmental readiness, it requires preparation and education starting from early adolescence. In the current study, a 'joint-visit' including both pediatric and adult providers yields positive clinical outcomes over 12 months. Patients ready for transition reported fewer relapses, hospitalizations, and improved therapy adherence compared to those not ready. Readiness assessment tools should be integrated into transition clinics to facilitate targeted interventions for IBD patients based on the changing needs of individuals. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus (DM) and osteoporosis are two of the most widespread metabolic diseases in the world. The aim of this study is to investigate the prevalence of DM among patients affected by osteoporosis and fragility fractures, and to search for differences in clinical characteristics. Methods: This is a single-center retrospective, case–controlled study. A total of 589 patients attending CTO Bone Unit between 2 January 2010 and 31 May 2023, due to osteoporosis and fragility fractures, were divided into two groups, according to the diagnosis of DM. The clinical and bone characteristics of patients were compared. Results: Prevalence of DM was 12.7%. Compared to patients without DM, the median age at the time of first fracture was similar: 72 years ± 13.5 interquartile range (IQR) vs. 71 years ± 12 IQR; prevalence of combination of vertebral and hip fractures was higher (p = 0.008), as well as prevalence of males (p = 0.016). Bone mineral density (BMD) at all sites was higher in DM group; trabecular bone score (TBS), instead, was significantly lower (p < 0.001). Conclusions: Patients with fragility fractures and DM more frequently show combination of major fractures with higher BMD levels. In these patients, TBS could be a better indicator of bone health than BMD and, therefore, might be used as a diagnostic tool in clinical practice. [ABSTRACT FROM AUTHOR]

Discharge of postganglionic muscle sympathetic nerve activity (MSNA) is related poorly to blood pressure (BP) in adults. Whether neural measurements beyond the prevailing level of MSNA can account for interindividual differences in BP remains unclear. The current study sought to evaluate the relative contributions of sympathetic-BP transduction and sympathetic barore- flex gain on resting BP in young adults. Data were analyzed from 191 (77 females) young adults (18-39 years) who underwent continuous measurement of beat-to-beat BP (finger photoplethysmography), heart rate (electrocardiography), and fibular nerve MSNA (microneurography). Linear regression analyses were computed to determine associations between sympathetic-BP transduction (signal-averaging) or sympathetic baroreflex gain (threshold technique) and resting BP, before and after controlling for age, body mass index, and MSNA burst frequency. K-mean clustering was used to explore sympathetic phenotypes of BP control and consequential influence on resting BP. Sympathetic-BP transduction was unrelated to BP in males or females (both R² < 0.01; P > 0.67). Sympathetic baroreflex gain was positively associated with BP in males (R² = 0.09, P < 0.01), but not in females (R² < 0.01; P = 0.80), before and after controlling for age, body mass index, and MSNA burst frequency. K-means clustering identified a subset of participants with average resting MSNA, yet lower sympathetic-BP transduction and lower sympathetic baroreflex gain. This distinct subgroup presented with elevated BP in males (P < 0.02), but not in females (P = 0.10). Sympathetic-BP transduction is unrelated to resting BP, while the association between sympathetic baroreflex gain and resting BP in males reveals important sex differences in the sympathetic determination of resting BP. [ABSTRACT FROM AUTHOR]

We propose a new tool for estimating the complexity of a time series: the entropy of difference (ED). The method is based solely on the sign of the difference between neighboring values in a time series. This makes it possible to describe the signal as efficiently as prior proposed parameters, such as permutation entropy (PE) or modified permutation entropy (mPE). Firstly, this method reduces the size of the sample that is necessary to estimate the parameter value, and secondly it enables the use of the Kullback–Leibler divergence to estimate the "distance" between the time series data and random signals. [ABSTRACT FROM AUTHOR]

Objective: Surgical management of bowel endometriosis is still controversial. Recently, many authors have pointed out the potential benefits of preserving the superior rectal artery, thus ensuring better perfusion of the anastomosis. The aim of this study was to evaluate the complication rate and functional outcomes of a bowel resection technique for deep endometriosis (DE) involving a nerve‐ and vascular‐sparing approach. Methods: A single‐center retrospective study was conducted by enrolling patients who underwent segmental resection of the rectus sigmoid for DE in our department between September 2019 and April 2022. Intraoperative and postoperative complications were recorded for each woman, and functional outcomes relating to the pelvic organs were assessed using validated questionnaires (Knowles‐Eccersley‐Scott‐Symptom [KESS] questionnaire and Gastro‐Intestinal Quality of Life Index [GIQLI] for bowel function, Bristol Female Lower Urinary Tract Symptoms [BFLUTS] for urinary function, and Female Sexual Function Index [FSFI] for sexual function). These were evaluated preoperatively and postoperatively after 6 months from surgery. Results: Sixty‐one patients were enrolled. No patients had Clavien‐Dindo grade 3 or 4 complications, there were no rectovaginal fistulas or ureteral lesions, and in no cases was it necessary to reoperate. Temporary bladder voiding deficits were reported in 8.2% of patients, which were treated with self‐catheterizations, always resolving within 45 days of surgery. Gastrointestinal function evaluated by KESS and GIQLI improved significantly after surgery, whereas sexual function appeared to worsen, although without reaching the level of statistically significant validity. Conclusion: Our vascular‐ and nerve‐sparing segmental bowel resection technique for DE had a low intraoperative and postoperative complication rate and produced an improvement in gastrointestinal function after surgery. Synopsis: Our vascular‐ and nerve‐sparing technique for bowel resection for endometriosis is associated with an improvement of gastrointestinal function and a low rate of postoperative complications. [ABSTRACT FROM AUTHOR]

All-back-contact thin-film photovoltaic devices in lattice back contact (LBC) configuration are studied by device simulation to set the requirements for achieving efficiency > --> 20 % with lateral contact spacing > --> 50 μ m. The numerical device model is first validated against published data for an LBC perovskite device and extended to predict the performance of Cd(Se,Te)-based polycrystalline devices. Recent advances in the electronic properties of Cd(Se,Te) films have made high efficiency LBC devices feasible with industrially scalable contact dimensions. Constraints on bulk, interface, and contact properties are quantified and discussed. [ABSTRACT FROM AUTHOR]

In response to the COVID-19 pandemic, San Francisco, California issued a shelter-in-place (SIP) order in March 2020, during which emergency physicians noted a drop in trauma cases, as well as a change in traditional mechanisms of trauma. Our objective was to determine the epidemiology of traumatic brain injury (TBI) pre- and post-COVID-19 SIP. We reviewed the electronic medical record of the only trauma center in the city of San Francisco, to determine the number of and characteristics of patients with a diagnosis of head injury presenting to the emergency department between December 16, 2019 and June 16, 2020. Using chi-squared and Fisher's exact tests when appropriate, we compared pre- and post- COVID-19 lockdown epidemiology. There were 1246 TBI-related visits during the 6-month study period. Bi-weekly TBI cases decreased by 36.64% 2 weeks after the COVID-19 SIP and then increased to near baseline levels by June 2020. TBI patients during SIP were older (mean age: 53.3 years pre-SIP vs. 58.2 post-SIP; p < 0.001), more likely to be male (odds ratio 1.43, 95% confidence interval 1.14–1.81), and less likely to be 17 or younger (8.9% vs. 0.5%, pre- to post-SIP respectively, p = 0.003). Patients were less likely to be Hispanic (27.2% vs. 21.7% pre- to post-SIP, respectively, p = 0.029). The proportion of TBI visits attributable to cycling accidents increased (14.1% to 52.7%, p < 0.001), whereas those attributable to pedestrians involved in road traffic accidents decreased (37.2% to 12.7%, p = 0.003). Understanding the changing epidemiology of TBI during the COVID-19 pandemic can aid in immediate and future disaster resource planning. [ABSTRACT FROM AUTHOR]

This document, published in the journal Clinical Autonomic Research, explores the effects of inhaling cannabis on cardiac autonomic function in humans. The study specifically focuses on the impact of Δ-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), two primary cannabinoids found in cannabis. The researchers found that inhalation of THC-containing cannabis decreased cardiac baroreflex gain and heart rate variability, while CBD did not have the same effect. Additionally, THC increased ventricular repolarization, as indicated by changes in the QT interval. These findings suggest that the physiological effects of cannabis may be influenced by the relative proportions of THC and CBD. [Extracted from the article]

After a focused effort over the last decade, order‐of‐magnitude improvements in doping and electro‐optical characteristics (radiative efficiency, carrier lifetime, and passivation) have been reported for polycrystalline CdSeTe solar cells. Surprisingly, this did not result in higher solar cell voltages regardless of device contacting layers, absorber grading profiles, and other changes in device architecture. From detailed evaluation of radiative emission and carrier dynamics in CdSeTe heterostructures and devices, it is shown that the complexity introduced to the absorber to achieve lifetime and passivation metrics resulted in charge carrier trapping, which now negatively affects CdSeTe absorbers. It is found that the defects with activation energy Ea ≈ 0.14‐0.22 eV dominate radiative emission and carrier dynamics in undoped CdSeTe, and electronic potential fluctuations with the amplitude γ ≈ 45–60 meV are present in As‐doped CdSeTe/CdTe. Because of potential fluctuations, radiative voltage is reduced by ≈ −100 mV, to VOCrad$V_{OC}^{rad}$ = 1020‐1050 mV (for 1.4 eV bandgap). For record‐efficiency solar cells with VOC ≥900 mV, radiative and nonradiative recombination voltage losses are comparable, and future research needs to focus on reducing dopant compensation which causes potential fluctuations. This represents a paradigm shift for CdTe solar cells, with non‐radiative bulk recombination no longer representing a dominant voltage loss pathway. [ABSTRACT FROM AUTHOR]

Objective: Ureteral endometriosis has an incidence of 0.1% to 1%. The type of surgery required is either conservative (ureterolysis) or radical treatment, depending on the degree of ureter infiltration. The incidence of intraoperative and postoperative complications is heterogeneous. Thus, the aim of the current study was to propose a classification of ureterolysis based on the anatomical structure of the ureter and differing complication rates with procedures. Methods: A total of 139 ureterolysis procedures were included in the study. Patients were divided into three groups according to the depth of ureterolysis required. Differences were recorded across the three types of ureterolysis in terms of intraoperative and postoperative complications. Results: The incidence of ureteral fistula was reported in 0.7% of cases, with postoperative ureteral stenosis in 2% of type 2 ureterolysis. In the case of type 3 ureterolysis, after conservative procedures, 52.9% of patients required an ureteroneocystostomy to solve the ureteral stenosis. Conclusion: The risk of ureteral injury and ureteroneocystostomy after conservative procedures appears to be associated with type 3 ureterolysis, probably due to excessive devascularization, secondary to the incision of adventitia. Obviously, these data should be confirmed through a prospective study of a larger number, but our proposed classification can provide the basis for making data from future studies more comparable. Synopsis: The proposed classification of ureterolysis for deep endometriosis differentiates the procedure in terms of rate of complications and need for more radical procedures. [ABSTRACT FROM AUTHOR]

Introduction This study examined user behavior, e-cigarette dependence, and device characteristics on nicotine intake among users of pod-mod e-cigarettes. Aims and Methods In 2019–2020, people who use pod-mods in the San Francisco Bay Area completed questionnaires and provided a urine sample for analysis of total nicotine equivalents (TNE). The relationship between TNE and e-cigarette use, e-cigarette brands, e-liquid nicotine strength, e-cigarette dependence, and urine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), as a measure of combustible cigarette exposure, were examined. Results Of 100 participants (64% male, 71% in the 18–34 age group, 45% white), 53 used JUUL primarily, 12 used Puff Bar primarily, and 35 used other brands, including Suorin; 48 participants reported current cigarette smoking. Participants most often reported use of e-liquid with 4.5%–6.0% nicotine (68%), fruit (35%), tobacco (28%), and menthol or mint flavors (26%), used e-cigarettes on 25.5 (SD = 6.3) days a month, 10.2 (SD = 14.2) times a day, and 40% used 1–2 pods/cartridges per week. In bivariate analysis, urinary TNE was higher with greater frequency (days used) and intensity (number of pods used) of e-cigarette use, e-cigarette dependence, and combustible cigarette use. In multivariable analysis, days of e-cigarette use in the last 30 days, number of pods used per week, and NNAL levels were significantly associated with TNE. There was no significant impact of e-liquid nicotine strength on TNE. Conclusions Nicotine intake among people who used pod-mod e-cigarettes increased with e-cigarette consumption and e-cigarette dependence, but not with e-liquid nicotine strength. Our findings may inform whether FDA adopts a nicotine standard for e-cigarettes. Implications The study examined how device and user characteristics influence nicotine intake among pod-mod e-cigarette users. Nicotine intake increased with frequency (days of e-cigarette use in past 30 days) intensity of use (number of pods used per day) and e-cigarette dependence but not with the flavor or nicotine concentration of the e-liquids. Regulation of nicotine concentration of e-liquids is unlikely to influence nicotine exposure among adult experienced pod-mod users. [ABSTRACT FROM AUTHOR]

These data suggest that augmented transduction may contribute to greater blood pressure fluctuations that could, over time, lead to a pathological cardiovascular phenotype and blood pressure dysregulation. Larger vasoconstrictor responses to MSNA bursts lead to higher pressor responses, which could contribute to greater blood pressure fluctuations (i.e., larger blood pressure variability). Keywords: Sex differences; Muscle sympathetic nerve activity; Pressor responses; Average-real-variability; Blood pressure regulation EN Sex differences Muscle sympathetic nerve activity Pressor responses Average-real-variability Blood pressure regulation 529 532 4 08/22/23 20230801 NES 230801 Supplementary Information The online version contains supplementary material available at https://doi.org/10.1007/s10286-023-00949-7. [Extracted from the article]

Technological development in terms of the power requirement for data acquisition and processing opens new perspectives in the field of environmental monitoring. Near real-time data flow about the sea condition and a possible direct interface with applications and services devoted to marine weather networks would have a significant impact on several aspects, such as, for example, safety and efficiency. In this scenario, the needs of buoy networks have been analyzed, and the estimation of directional wave spectra from buoys' data has been deeply investigated. Two methods have been implemented, namely the truncated Fourier series and the weighted truncated Fourier series, and they have been tested by both simulated and real experimental data, representative of typical Mediterranean Sea conditions. From simulation, the second method proved to be more efficient. From the application to real case studies, it emerged that it works effectively in real conditions, as confirmed by parallel meteorological observations. The estimation of the main propagation direction was possible with a small uncertainty of a few degrees, yet the method exhibits a limited directional resolution, which suggests the need for undertaking further studies, briefly addressed in the conclusions. [ABSTRACT FROM AUTHOR]

Background: Non-small-cell lung cancer (NSCLC) is a common, steady growing lung tumour that is often discovered when a surgical approach is forbidden. For locally advanced inoperable NSCLC, the clinical approach consists of a combination of chemotherapy and radiotherapy, eventually followed by adjuvant immunotherapy, a treatment that is useful but may cause several mild and severe adverse effect. Chest radiotherapy, specifically, may affect the heart and coronary artery, impairing heart function and causing pathologic changes in myocardial tissues. The aim of this study is to evaluate the damage coming from these therapies with the aid of cardiac imaging. Methods: This is a single-centre, prospective clinical trial. Patients with NSCLC who are enrolled will undergo computed tomography (CT) and magnetic resonance imaging (MRI) before chemotherapy 3 months, 6 months, and 9–12 months after the treatment. We expect to enrol 30 patients in 2 years. Conclusions: Our clinical trial will be an opportunity not only to highlight the timing and the radiation dose needed for pathological cardiac tissue changes to happen but will also provide useful data to set new follow-up schedules and strategies, keeping in mind that, more often than not, patients affected by NSCLC may present other heart- and lung-related pathological conditions. [ABSTRACT FROM AUTHOR]

Simple Summary: Patients with inflammatory bowel disease (IBD) are at an increased risk of developing colorectal cancer (CRC), mainly because of chronic intestinal inflammation. Some unique molecular differences occur in colitis-associated CRC, resulting in a different sequence of events, primarily of inflammation–dysplasia–carcinoma, compared to sporadic cases. In this context, the recent and continuous evolution in our understanding of the genetic and molecular mechanisms underlying IBD-associated CRC and the development of new OMIC techniques has opened up new possibilities for personalised and organ-sparing therapies. This review provides an overview of the IBD-related carcinogenesis pathway with a focus on the interaction between microbiota and the gut barrier and the role of currently available therapies for IBD in the inflammation–dysplasia–cancer sequence. Patients affected by inflammatory bowel disease (IBD) have a two-fold higher risk of developing colorectal cancer (CRC) than the general population. IBD-related CRC follows a different genetic and molecular pathogenic pathway than sporadic CRC and can be considered a complication of chronic intestinal inflammation. Since inflammation is recognised as an independent risk factor for neoplastic progression, clinicians strive to modulate and control disease, often using potent therapy agents to achieve mucosal healing and decrease the risk of colorectal cancer in IBD patients. Improved therapeutic control of inflammation, combined with endoscopic advances and early detection of pre-cancerous lesions through surveillance programs, explains the lower incidence rate of IBD-related CRC. In addition, current research is increasingly focused on translating emerging and advanced knowledge in microbiome and metagenomics into personalised, early, and non-invasive CRC screening tools that guide organ-sparing therapy in IBD patients. This review aims to summarise the existing literature on IBD-associated CRC, focusing on new insights into the alteration of the intestinal barrier and the interactions with the gut microbiome as the initial promoter. In addition, the role of OMIC techniques for precision medicine and the impact of the available IBD therapeutic armamentarium on the evolution to CRC will be discussed. [ABSTRACT FROM AUTHOR]

Introduction: Treatment of human papillomavirus (HPV)-related head and neck squamous cell carcinoma (HNSCC) is rapidly evolving. Despite either surgery or radiotherapy (RT), with or without chemotherapy (CT), being acceptable in intermediate and locally advanced diseases, there is uncertainty regarding the best treatment option for these patients. Therefore, we performed a network meta-analysis (NMA) to compare the relative efficacy of different treatments for HPV+ oropharyngeal carcinoma. Material and methods: Randomized clinical trials that enrolled adults with non-metastatic HPV+ oropharynx cancer and provided data about overall survival (OS) and/or progression-free survival (PFS) and/or locoregional control and distant metastases (LRC and DM) were included. Fixed- or random-effects models were fit using a Bayesian approach to NMA. Between-group comparisons were estimated using hazard ratios (HRs) with 95% credible intervals (CrIs). The primary outcome was OS. Results: A total of 844 citations were screened; 11 randomized clinical trials were included (HPV+ stage III–IV cancer, mainly oropharynx carcinomas). Nine treatment arms were compared. Radiotherapy (altered or standard fractionation) + triweekly cisplatin (HR 3.8; 95% CrIs 0.29–65 and 0.3; 95% CrIs 0.03–2.51) was superior to RT in term of OS (P score = 0.42 and 0.16). Radiotherapy with low and high cisplatin doses appeared similar (HR 1.57; 95% CrIs 0.19–12.72). Altered fractionation or standard RT + 3-weekly cisplatin are the 2 highest-ranked options in terms of PFS (P score = 0.35 and 0.34). Conclusions: This meta-analysis confirms the role of cisplatin added to RT as the best option for HPV+ oropharyngeal carcinoma. RT+ 3-weekly cisplatin is likely to be the best radical treatment in terms of OS and PFS. [ABSTRACT FROM AUTHOR]

Background: Mesalazine is among the medications most prescribed by gastroenterologists, with variable and controversial use in different settings. We aimed to explore the use of mesalazine in the clinical practice of young gastroenterologists. Methods: A web-based electronic survey was distributed to all participants of the National Meeting of the Italian Young Gastroenterologist and Endoscopist Association. Results: A total of 101 participants took part in the survey, with a majority (54.4%) being aged >30 years, 63.4% of whom were trainees in academic hospitals, and 69.3% of whom were involved in the clinical management of inflammatory bowel disease (IBD). While both non-dedicated and IBD physicians generally agreed on the appropriate dose of mesalazine for mild ulcerative colitis (UC), significant differences were observed between the two groups for moderate-severe ulcerative colitis (UC). Additionally, in IBD patients who were starting immuno-modulators and/or biologics, 80% of IBD-dedicated physicians continued to prescribe mesalazine, compared to 45.2% of non-dedicated physicians (p = 0.002). Indeed, 48.4% of non-dedicated IBD physicians did not acknowledge mesalazine for colorectal cancer chemoprevention. With regards to Crohn's disease, it is mainly used by 30.1% of IBD physicians for preventing postoperative recurrence of Crohn's disease. Finally, 57.4% used mesalazine for symptomatic uncomplicated diverticular disease, and 84.2% did not recommend its use for irritable bowel syndrome. Conclusions: This survey showed heterogeneous behaviors in the daily use of mesalazine, mainly in the management of IBD. Educational programs and novel studies are needed to clarify its use. [ABSTRACT FROM AUTHOR]

DNA-methylation alterations are common in cancer and display unique characteristics that make them ideal markers for tumor quantification and classification. Here we present MIMESIS, a computational framework exploiting minimal DNA-methylation signatures composed by a few dozen informative DNA-methylation sites to quantify and classify tumor signals in tissue and cell-free DNA samples. Extensive analyses of multiple independent and heterogenous datasets including >7200 samples demonstrate the capability of MIMESIS to provide precise estimations of tumor content and to enable accurate classification of tumor type and molecular subtype. To assess our framework for clinical applications, we designed a MIMESIS-informed assay incorporating the minimal signatures for breast cancer. Using both artificial samples and clinical serial cell-free DNA samples from patients with metastatic breast cancer, we show that our approach provides accurate estimations of tumor content, sensitive detection of tumor signal and the ability to capture clinically relevant molecular subtype in patients' circulation. This study provides evidence that our extremely parsimonious approach can be used to develop cost-effective and highly scalable DNA-methylation assays that could support and facilitate the implementation of precision oncology in clinical practice. [ABSTRACT FROM AUTHOR]

Treatment-induced cardiac toxicity represents an important issue in non-small cell lung cancer (NSCLC) patients, and no biomarkers are currently available in clinical practice. A novel and easy-to-calculate marker is the quantitative analysis of calcium plaque in the coronary, calculated on CT. It is called the Agatston score (or CAD score). At the same time, other potential predictors include cardiac ultrasonography and anamnesis of the patients. Our work aimed to correlate cardiac biomarkers with overall survival (OS) in NSCLC patients. We retrospectively analyzed patients with NSCLC discussed in the Multidisciplinary Tumor Board of our Institute for the present analysis between January 2018 and July 2022. Inclusion criteria were the availability of basal CT imaging of the thorax, cardiac ultrasonography with the calculation of ejection fraction (EF), and complete anamnesis, including assessment of co-pathologies and pharmacological drugs. The clinical data of the patients were retrospectively collected, and the CAD scores was calculated on a CT scan. All of these parameters were correlated with overall survival (OS) with univariate analysis (Kaplan–Meier analysis) and multivariate analysis (Cox regression analysis). Following the above-mentioned inclusion criteria, 173 patients were included in the present analysis. Of those, 120 patients died in the follow-up period (69.6%), and the median overall survival (OS) was 28 months (mean 47.2 months, 95% CI, 36–57 months). In univariate analysis, several parameters that significantly correlated with lower OS were the stage (p < 0.001), the CAD grading (p < 0.001), history of ischemic heart disease (p: 0.034), use of beta blocker drugs (p: 0.036), and cardiac ejection fraction (p: 0.005). In multivariate analysis, the only parameters that remained significant were as follows: CAD score (p: 0.014, OR 1.56, 95% CI: 1.04–1.83), stage (p: 0.016, OR: 1.26, 95% CI: 1.05–1.53), and cardiac ejection fraction (p: 0.011, OR 0.46, 95% CI: 0.25–0.84). Both CAD score and ejection fraction are correlated with survival in NSCLC patients at all stages of the disease. Independently from the treatment choice, a cardiological evaluation is mandatory for patients with NSCLC. [ABSTRACT FROM AUTHOR]

Post‐hypoxia sympathoexcitation does not elicit corresponding changes in vascular tone, suggesting diminished sympathetic signalling. Blunted sympathetic transduction following acute hypoxia, however, has not been confirmed and the effects of hypoxia on the sympathetic transduction of mean arterial pressure (MAP) as a function of action potential (AP) activity is unknown. We hypothesized that MAP changes would be blunted during acute hypoxia but restored in recovery and asynchronous APs would elicit smaller MAP changes than synchronous APs. Seven healthy males (age: 24 (3) years; BMI: 25 (3) kg/m2) underwent 20 min isocapnic hypoxia (PETO2: 47 (2) mmHg) and 30 min recovery. Multi‐unit microneurography (muscle sympathetic nerve activity; MSNA) and continuous wavelet transform with matched mother wavelet was used to detect sympathetic APs during baseline, hypoxia, early (first 7 min) and late (last 7 min) recovery. AP groups were classified as synchronous APs, asynchronous APs (occurring outside an MSNA burst) and no AP activity. Sympathetic transduction of MAP was quantified using signal‐averaging, with ΔMAP tracked following AP group cardiac cycles. Following synchronous APs, ΔMAP was reduced in hypoxia (+1.8 (0.9) mmHg) and early recovery (+1.5 (0.7) mmHg) compared with baseline (+3.1 (2.2) mmHg). AP group‐by‐condition interactions show that at rest asynchronous APs attenuate MAP reductions compared with no AP activity (−0.4 (1.1) vs. −2.2 (1.2) mmHg, respectively), with no difference between AP groups in hypoxia, early or late recovery. Sympathetic transduction of MAP is blunted in hypoxia and early recovery. At rest, asynchronous sympathetic APs contribute to neural regulation of MAP by attenuating nadir pressure responses. Key points: Acute isocapnic hypoxia elicits lasting sympathoexcitation that does not correspond to parallel changes in vascular tone, suggesting blunted sympathetic transduction.Signal‐averaging techniques track the magnitude and temporal cardiovascular responses following integrated muscle sympathetic nerve activity (MSNA) burst and non‐burst cardiac cycles. However, this does not fully characterize the effects of sympathetic action potential (AP) activity on blood pressure control.We show that hypoxia blunts the sympathetic transduction of mean arterial pressure (MAP) following synchronous APs that form integrated MSNA bursts and that sympathetic transduction of MAP remains attenuated into early recovery.At rest, asynchronous APs attenuate the reduction in MAP compared with cardiac cycles following no AP activity, thus asynchronous sympathetic APs appear to contribute to the neural regulation of blood pressure.The results advance our understanding of sympathetic transduction of arterial pressure during and following exposure to acute isocapnic hypoxia in humans. [ABSTRACT FROM AUTHOR]

Objective: There is a lack of information about the normal trend of C‐reactive protein (CRP) blood levels in the postoperative days after gynecological benign surgery. We investigated the impact of different surgical techniques on CRP trend. We performed a comparative analysis between a CRP and white blood cell (WBC) trend in postoperative monitoring. Methods: We studied 207 surgical patients for benign gynecological pathology. We analyzed CRP and WBC levels after surgery in the total number of women and separately by approaches. Results: CRP mean log scores showed a typical behavior. Moreover, results from chi‐square test underline that the proportion of women with this result is independent from the type of surgery they underwent. Log score mean values of CPR differed between all groups and between times. No difference in the mean number of white cells between the second and the third day was found, as observed for CRP. Conclusions: Our study shows a trend reference model in postoperative monitoring of patients with benign gynecological surgery. The comparative analysis between the CRP and WBC trend in the postoperative days provided us data demonstrating the superiority of CRP in postsurgical patient outcomes monitoring. Synopsis: Comparative analysis between the trend of C‐reactive protein blood levels in the postoperative days without complications and white blood cells levels in laparotomic, laparoscopic, and vaginal gynecological surgery. [ABSTRACT FROM AUTHOR]

In this commentary, using existing clinical trial data and FDA approvals we propose that there is currently a critical need for an appropriate balancing between the financial impact of new cancer drugs and their actual benefit for patients. By adopting "pleural mesothelioma" as our clinical model we summarize the most relevant pertinent and available literature on this topic, and use an analysis of the reliability of the trials submitted for registration and/or recently published as a case in point to raise concerns with respect to appropriate trial design, biomarker based stratification and to highlight the ongoing need for balancing the benefit/cost ratio for both patients and healthcare providers. [ABSTRACT FROM AUTHOR]

Despite the significant reduction of both morbidity and mortality after the introduction of many vaccines against COVID‐19, recent reports indicated a worsening skin conditions in particular patients with psoriasis. We extracted the data of 51 patients from 19 papers. The mean age was 56.9 (SD = 16.2) years, with a male prevalence 45%. Of the 51 cases, vaccine types at which psoriasis flare occurred were as the following: Pfizer vaccine (30), AstraZeneca (9), Moderna (8), Coronavac (2) Covishield (1), and Covaxin (1). Exacerbation was common in the second dose of Pfizer, AstraZeneca, Moderna, and Covishield vaccines. Moreover, the onset of psoriasis exacerbation was shorter after the second dose of Pfizer (mean = 12.8 [SD = 15.2]) and AstraZeneca (mean = 7.4 [SD = 3.6]) rather than the first dose of both vaccines, respectively (mean = 19.2 [SD = 21.3]) and (mean = 18.5 [SD = 10.7]). [ABSTRACT FROM AUTHOR]

Advancing optoelectronic and emerging technologies increasingly requires control and design of interfaces between dissimilar materials. However, incommensurate interfaces are notoriously defective and rarely benefit from first-principles predictions, because no explicit atomic-structure models exist. Here, we adopt a bulk crystal structure prediction method to the interface geometry and apply it to SnO2/CdTe heterojunctions without and with the addition of CdCl2, a ubiquitous and beneficial, but abstruse processing step in CdTe photovoltaics. Whereas the direct SnO2/CdTe interface is highly defective, we discover a unique two-dimensional CdCl2 interphase, unrelated to the respective bulk structure. It facilitates a seamless transition from the rutile to zincblende lattices and removes defect-states from the interface bandgap. Implementing the predicted interface electronic structure in device simulations, we demonstrate the theoretical feasibility of bufferless oxide-CdTe heterojunction solar cells approaching the Shockley–Queisser limit. Our results highlight the broader potential of designing atomically thin interlayers to enable defect-free incommensurate interfaces. [ABSTRACT FROM AUTHOR]

Clinicians are reluctant to seek mental health services. They fear loss of livelihood and disciplinary action. The Oregon Wellness Program (OWP) is a state-wide consolidated mental health initiative formally established in 2018 as a physician, physician assistant, acupuncturist, and podiatrist program. OWP is self-referral, not-mandated, strictly confidential, and free. Reporting to oversight bodies is forbidden. Utilization increased from 228 clients to 349 clients (a 53% increase) and 405 visits to 625 visits (a 54% increase) from 2019 to 2020 respectively, coinciding with the first COVID-19 pandemic surge. Between April 2019 and the end of August 2020, 41 of 433 (9.5%) individuals who were provided mental health services returned 77 program evaluation surveys, indicating satisfaction with the program (96%), its helpfulness to them personally (99%), and changes made in their personal lives (80%). The burnout response rate fell with increased visits and reallocation of activities within their practices increased (39%). A survey of mental health professionals corroborated positive results of their clients. The OWP can serve as a model for healthcare professional support programs. Collaboration among healthcare organizations, professional, and oversight bodies is essential. Increasing sustainable funding to pay for expanding services for dentists and nurses, assuring access for rural clinicians, and developing research tools to capture a more robust sample of responses remain priorities. [ABSTRACT FROM AUTHOR]

Despite being usually delivered in oncological patients, radiotherapy can be used as a successful treatment for several non-malignant disorders. Even though this use of radiotherapy has been scarcely investigated since the 1950s, more recent interest has actually shed the light on this approach. Thus, the aim of this narrative review is to analyze the applications of non-oncological radiotherapy in different disorders. Key references were derived from a PubMed query. Hand searching and clinicaltrials.gov were also used. This review contains a narrative report and a critical discussion of non-oncological radiotherapy approaches. In conclusion, non-oncological radiotherapy is a safe and efficacious approach to treat several disorders that needs to be further investigated and used in clinical practice. [ABSTRACT FROM AUTHOR]

Surface enhanced laser desorption/ionization‐time of flight (SELDI‐TOF) mass spectrometry is a variant of the matrix‐assisted laser desorption/ionization‐time of flight (MALDI‐TOF) mass spectrometry. It is used in many cases especially for the analysis of protein profiling and for preliminary screening of biomarkers in complex samples. Unfortunately, these analyses are time consuming and protein identification is generally strictly limited. SELDI‐TOF analysis of mass spectra (SELYMATRA) is a web application (WA) developed to reduce these limitations by (i) automating the identification processes and (ii) introducing the possibility to predict proteins in complex mixtures from cells and tissues. The WA architectural pattern is the model‐view‐controller, commonly used in software development. The WA compares the mass value between two mass spectra (sample vs. control) to extract differences, and, according to the set parameters, it queries a local database to predict most likely proteins based on their masses and different expression amplification. The WA was validated in a cellular model overexpressing a tagged NURR1 receptor, being able to recognize the tagged protein in the profiling of transformed cells. A help page, including a description of parameters for WA use, is available on the website. [ABSTRACT FROM AUTHOR]

Following the M w 3.9 earthquake that occurred in the Ischia island (Naples, southern Italy) on 21 August 2017, the local monitoring seismic network was significantly improved in terms of both number of stations and instrumentation performance. Due to the huge amount of collected seismic ambient noise data, in this paper we present a first 3-D shear wave velocity model of the island retrieved from the inversion of horizontal-to-vertical spectral ratio curves by fixing the shear wave velocities (Vs) and modifying the thicknesses to get the corresponding 1-D Vs models. We are confident about the robustness of the attained models since the inversion process provided a good convergence towards the best-fitting solutions. Then, a first 3-D velocity model was obtained by contouring all the 1-D models obtained for the selected seismic stations to highlight possible lateral variations of the layer thicknesses and to reconstruct the morphology of the deeper interface characterized by a high-impedance contrast. A good correspondence between the 3-D Vs model and the geological features of the island was observed, especially in the northern sector where most of the stations are installed. In particular, the top of the high-impedance contrast interface appears deeper in the northern coastal areas and shallower in the central sector. This result agrees with the structural settings of the island likely due to the resurgence of Mount Epomeo. [ABSTRACT FROM AUTHOR]