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Purpose: The aim of the study was to analyze the modification of total and regional body composition in early breast cancer patients treated with aromatase inhibitors (AIs). Methods: This is a prospective, single-center, observational, longitudinal study. Four-hundred and twenty-eight patients treated with adjuvant aromatase inhibitors were enrolled at the Medical Oncology and Breast Unit of Spedali Civili Hospital in Brescia from September 2014 to June 2022. Several body composition parameters including total and regional fat and lean body mass were investigated with dual-energy X-ray absorptiometry (DXA) scan at baseline and after 18 months of treatment with aromatase inhibitors. Results: A significant increase in fat body mass (mean + 7.2%, 95% confidence interval [CI]: 5.5;8.9%) and a reduction in lean body mass (mean −3.1%, 95% CI −3.9; −2.4) were documented in this population. The changes in fat and lean body mass varied considerably according to different body districts ranging between + 3.2% to + 10.9% and from−1.3% to −3.9%, respectively. Conclusion: Aromatase inhibitor adjuvant therapy in early breast cancer is associated with changes in body composition, with a wide variability among different body districts, leading to a risk of sarcopenic obesity. Supervised physical exercise that focuses on single body parts that may display detrimental variations may be beneficial for AIs treated patients.

Introduction: Focal therapy (FT) is a promising alternative with curative intent for Low- to Intermediate-risk localized Prostate Cancer (PCa), claiming better functional outcomes and safety profile than standard whole-gland treatments. Ten different FT modalities have been described in the literature. The objective of our narrative review is to evaluate the safety profile and functional outcomes of these different modalities and the current most used tools of assessment for those outcomes. Material and methods: Literature search was performed on 21st February 2023 using PubMed, EMBASE, and Scopus, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA). Articles reporting whole-gland treatments were excluded. All articles reporting functional outcomes were included. Results: One-hundred-seven studies, reporting data on 6933 patients, were included (26 on High Intensity Focal Ultrasound, 22 on Focal Cryotherapy, 14 on Irreversible Electroporation, 11 on Focal brachytherapy, 10 on Focal Laser Ablation, 8 on Photodynamic Therapy, 3 on Microwave ablation, 3 on Robotic Partial Prostatectomy, 2 on bipolar Radio Frequency Ablation, 1 on Prostatic Artery Embolization, and 7 studies comparing different FTs). Post-operative pad-free rate ranged between 92.3–100%. Greater heterogeneity exists considering the Change in Erectile Function, with Changing in Erectile function- rates ranging between 0–94.4% (Cryotherapy). The most used Patient-Reported Outcome Measures (PROMs) were the International Prostate Symptom Score and the International Index of Erectile Function for incontinence/urinary function and potency, respectively. The most common reported complications were hematuria, infections, and urethral strictures, with rates widely ranging among different treatments. The Clavien–Dindo Classification was the most used (40/88 papers) to describe adverse events. Conclusion: FT is a promising treatment for localized PCa, achieving excellent results in terms of safety and functional outcomes. There is a wide heterogeneity in the definition of PROMS and time of collection between studies. High quality comparative studies with standard treatments are needed to reinforce these findings.

Introduction: Focal therapy (FT) is a promising alternative to whole-gland treatments for Localized Prostate Cancer. Ten different FT modalities have been described in literature. However, FT is not yet recommended by the International Guidelines, due to the lack of robust data on Oncological Outcomes. The objective of our Narrative Review is to evaluate the oncological profile of the available FT modalities and to offer a comprehensive overview of the definitions of Cancer Control for FT. Material and methods: Literature search was performed on 21stFebruary 2023 using PubMed, EMBASE, and Scopus, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA). Articles reporting whole gland-treatments were excluded. All articles reporting oncological outcomes were included. Results: One-hundred-twenty-four studies, reporting data on more than 8000 patients treated with FT, were included. Overall, 40 papers were on High Intensity Focal Ultrasound (HIFU), 24 on Focal Cryotherapy, 13 on Irreversible Electroporation (IRE), 11 on Focal brachytherapy, 10 on Focal Laser Ablation (FLA), 8 on Photo-Dynamic Therapy (PDT), 3 on Microwave ablation, 3 on Robotic Partial Prostatectomy, 2 on bipolar Radio Frequency Ablation (bRFA), 1 on Prostatic Artery Embolization (PAE) and 9 comparative papers. Overall, the Biochemical Recurrence (BCR) rate ranged from 0% (Focal Brachytherapy) to 67.5% (HIFU); the Salvage treatment rate ranged from 1% (IRE) to 54% (HIFU) considering re-treatment with FT and from 0% (Focal Brachytherapy) to 66.7% considering standard Radical Treatments. There is no univocal definition of Cancer Control, however the “Phoenix criteria” for BCR were the most commonly used. Conclusions: FT is a promising alternative treatment for localized prostate cancer in terms of Oncological Outcomes, however there is a wide heterogeneity in the definition of cancer control, the reporting of oncological outcomes and a lack of high-quality clinical trials. Solid comparative studies with standard treatments and an unambiguous consensus on how to describe Cancer Control in the field of Focal Therapy are needed.

Pleurotin is a meroterpenoid specialized metabolite made by the fungus Hohenbuehelia grisea, and it is a lead anticancer molecule due to its irreversible inhibition of the thioredoxin-thioredoxin reductase system. Total synthesis of pleurotin has been achieved, including through a stereoselective route; however, its biosynthesis has not been characterized. In this study, we used isotope-labeled precursor feeding to show that the nonterpenoid quinone ring of pleurotin and its congeners is derived from phenylalanine. We sequenced the genome of H. griseaand used comparative transcriptomics to identify putative genes involved in pleurotin biosynthesis. We heterologously expressed a UbiA-like prenyltransferase from H. griseathat led to the accumulation of the first predicted pleurotin biosynthetic intermediate, 3-farnesyl-4-hydroxybenzoic acid. This work sets the foundation to fully elucidate the biosynthesis of pleurotin and its congeners, with long-term potential to optimize their production for therapeutic use and engineer the pathway toward the biosynthesis of valuable analogues.

Background: Axillary vein in the brachial tract or Basilic vein in the proximal third of the arm has got usually an enough diameter to receive a catheter of 4 or 5 Fr. In this case the exit site should be too proximal to the axilla with an higher risk of infection. Pseudo-tunneling procedure can create an exit site at the middle of the arm without using tunnelers during insertion of Peripherally Inserted Central Catheters and Midlines in patients who present deep veins of the arm too small to receive a catheter to consent infusion and blood samples.Aim: The aim of this study is to present our experience with pseudo-tunneling procedure, also using a particular variation of the technique.Methods: From January 2014 to August 2022 150 Peripherally Inserted Central Catheters and 221 Midlines were insert in pediatric and adults patients with too small deep veins at the middle third of the arm with this technique by the same trained team of Vascular Access Unit at ASST Spedali Civili Hospital of Brescia.Results: All procedures were successfully performed at the first or at the second attempt. No insertion related complications were observed.Conclusions: Our data suggest pseudo-tunneling technique is a safe and effective procedure for of Peripherally Inserted Central Catheters and Midline insertion avoiding central venous catheterization even in patient with small vein at the arms.

This work presents an innovative optical chemical sensing approach, which considers a molecularly imprinted polymer (MIP) as the core of an optical waveguide. More specifically, a channel was achieved into an FR4 substrate through a CNC machine. As proof of concept, a MIP prepolymeric mixture for furfural (2-FAL) detection was poured into the channel and then polymerized to obtain the waveguide’s core. The optical-chemical platform was interrogated through two plastic optical fibers (POFs) integrated into the system itself. The idea was to create a core with a refractive index (RI) variable as a function of the analyte-receptor binding interaction. First, the optical chemical sensor response was numerically evaluated by finite element method (FEM) simulations. Then, the sensor platform was tested by using two different experimental setups, both including two channels: the sensor channel consisting of the MIP-core based waveguide and the reference channel, consisting of another waveguide having a core of not imprinted polymer (NIP). The introduction of a reference channel in the experimental setup allowed to eliminate several factors of irreproducibility and noise, due to external conditions (e.g., temperature) or light source fluctuations. Moreover, selectivity tests were carried out to confirm the good selectivity of the proposed optical-chemical sensor system. The results obtained by the two experimental setups are comparable in terms of the limit of detection (LOD), which is equal to around 0.003 mg L−1. The achieved results paved the way for this innovative, low-cost, and selective sensing methodology.

New generations of SiC power devices require to be fabricated on very thin substrates, in order to significantly reduce the series resistance of the device. The role of thinning process on the formation of backside ohmic contact has been investigated in this work. Three different mechanical grinding processes have been adopted, resulting in different amounts of defectivity and surface roughness values. An excimer UV laser has been used to form a Ni-silicide based ohmic contact on the backside of the wafers. The reacted layer has been studied by means of Atomic Force Microscopy (AFM), Transmission Electron Microscopy (TEM) and X-Ray Diffraction (XRD) analyses, as a function of grinding process parameters and laser annealing conditions. The ohmic contact has been evaluated by measuring the Sheet Resistance (Rs) of silicided layers and the Vf at nominal current of Schottky Barrier Diode (SBD) devices, fabricated on 150 mm-diameter 4H-SiC wafers. A strong relationship has been found between the crystal damage, induced by thinning process, and the structural, morphological and electrical properties of silicided ohmic contact, formed by UV laser annealing, revealing that the silicide reaction is moved forward, at fixed annealing conditions, by the increasing of crystal defectivity and surface roughness of SiC.

Previous studies of maternal docosahexaenoic acid (DHA) supplementation during pregnancy have controversial and contrasting results on the short and long‐term effects on early child growth. The impact of this nutritional intervention on the postnatal growth patterns in the offspring of women with pregestational overweight/obesity (PGO) also remains controversial. To analyze the postnatal growth patterns during the first 4 months of life in the offspring of women with PGO randomly supplemented with 800 mg/day (PGO‐800) compared with normative doses of 200 mg/day (PGO‐200) of DHA during pregnancy (<15 weeks of gestation until delivery). This study evaluated the growth patterns during the first 4 months of life of 169 infants of the women that participated in the MIGHT study (NCT02574767). We included the infants of women from the PGO‐200 (n= 81) and PGO‐800 group (n= 88). The growth patterns (weight, length, and head circumference) and change in z‐score (World health Organization charts) were evaluated. Throughout the first 4 months of life, the infants of the PGO‐800 group had lower weight‐for‐length z‐score (coef. −0.65, 95% confidence interval [CI] −1.07, −0.22, p= 0.003) and lower body mass index‐for‐age z‐score (coef. −0.56, 95% CI −0.99, −0.12, p= 0.012) compared with the PGO‐200 group adjusted by maternal body mass index, gestational weight gain, gestational age, insulin in cord blood and infant feeding (exclusive breastfed, not breastfed, and partially breastfed). Maternal supplementation with DHA during pregnancy could beneficially limit the offspring's postnatal weight gain during the first 4 months of life. Pregestational maternal overweight/obesity is one of the most relevant perinatal factors leading to high birth weight and childhood obesity.In Western diets, the n‐6/n‐3 ratio is usually 15:1 to 16.7:1, rather than 1:1 or 2:1 to achieve health benefits.Studies show intrauterine exposure to docosahexaenoic acid (DHA) is associated with healthier newborn body composition. Pregestational maternal overweight/obesity is one of the most relevant perinatal factors leading to high birth weight and childhood obesity. In Western diets, the n‐6/n‐3 ratio is usually 15:1 to 16.7:1, rather than 1:1 or 2:1 to achieve health benefits. Studies show intrauterine exposure to docosahexaenoic acid (DHA) is associated with healthier newborn body composition. DHA supplementation during pregnancy in women with pregestational overweight/obesity may limit infant weight gain during the first 4 months of life.Maternal supplementation with 800 versus 200 mg DHA/day during pregnancy in a population with high risk of infant obesity reduced both the weight‐for‐length and body mass index‐for‐age z‐scores in the first 4 months of life.New strategies such as DHA supplementation during pregnancy could reduce the exposure to a chronic inflammatory state secondary to maternal obesity and generate a healthier growth rate in the offspring. DHA supplementation during pregnancy in women with pregestational overweight/obesity may limit infant weight gain during the first 4 months of life. Maternal supplementation with 800 versus 200 mg DHA/day during pregnancy in a population with high risk of infant obesity reduced both the weight‐for‐length and body mass index‐for‐age z‐scores in the first 4 months of life. New strategies such as DHA supplementation during pregnancy could reduce the exposure to a chronic inflammatory state secondary to maternal obesity and generate a healthier growth rate in the offspring.

Using apples as a raw material and its by-products, such as pomace, in the development of innovative products and drinks, contributes to the production chain of this fruit. The objective of this research was to evaluate physicochemical characteristics, phenolic and profile sensory in aged apple liqueur, prepared with different formulations. Liqueurs were produced using depectinized apple juice, integral apple juice, pectinolytic enzyme and dehydrated apple pomace, all with a final sugar concentration of 100 g/L and an alcohol content of 20% v/v. All received chips (1 cm³) of untoasted oak wood (5 g/L), for maturation for 120 days. The use of an ultrasonic probe was tested in the pre-treatment of wood chips as well as dehydrated apple pomace. Analyzes of acidity, pH, density, total sugar, individual compound profile, total phenols, antioxidant activity and color parameters were carried out. Sensory analysis was applied using the JAR methodology along with acceptability. The results showed that liqueurs made with depectinized juice presented the highest values of total phenols (191.03 mg EAC/L) and antioxidant activity (1001.32 µmol TE/L by DPPH, 1376.70 by FRAP and 1857.41 by ABTS). The liqueurs that received pomace, at the end of the maturation period, showed high luminosity (L* = 96.1) and a light-yellow tone (b* = 35.31). The action of the ultrasonic probe under the wood chips was evidenced with a 3% increase in total phenols and a 5% increase in antioxidant activity. The liqueur that used integral juice and pectinolytic enzyme in the formulation had greater color intensity (C* = 42.6) and a more prominent shade of yellow (b*= 42.66). Finally, formulating the liqueurs with depectinized juice contributes to greater color intensity and maturing the liqueurs with wood chips pre-treated with an ultrasonic device contributed to the incorporation of compounds, improving the concentration of total phenols, and increasing antioxidant activity.

The Spiti Shale Formation in the Spiti and Zanskar regions of the Himalayas has yielded several ammonites collected systematically from ten localities. The ammonites from Zanskar are poorly preserved compared to those from Spiti due to intense tectonic activity. Nevertheless, the single specimen of Malagasites cf. subfrequens indicated the Tithonian age for the Rangdum section in Zanskar. In the Spiti area, 15 genera represented by 30 taxa have been identified, described and illustrated. The majority of the specimens belong to the subfamilies Paraboliceratinae, Virgatosphinctinae, and Himalayitinae. Taramelliceratinae, Streblitinae, and Berriasellinae are less common, whereas Mayaitinae are particularly rare. The oldest ammonites were collected from Oxfordian strata around Chichim and Langza section (Spiti region) and identified as Mayaites and Epimayaites. The Kimmeridgian strata is either absent/not exposed or insignificant and require future work. The base of the Lower Tithonian is marked by Kossmatia, which co-occurs with Paraboliceras Metauhligites Nepalites Uhligites Aulacosphinctoides and Indodichotomoceras biplicatus. This record is succeeded by Virgatosphinctes and Malagasites. The Upper Tithonian is marked by Aulacosphinctes mainly recorded from the Demul area (Spiti region). The majority of Upper Tithonian in the Spiti region is characterized by Aulacosphinctes Paraboliceras Himalayites and Blanfordiceras. The record of ammonite taxa from the present study reveals low taxonomic biodiversity in the Spiti Shale Formation.

Purpose: This study reports the outcomes from a Multicenter Registry on unibody stent-graft system for the treatment of spontaneous infrarenal acute aortic syndrome (MURUSSIAS registry).Materials and methods: The retrospective MURUSSIAS registry included spontaneous infrarenal acute aortic dissection (IAAS) managed with the unibody stent-graft system (AFX endovascular AAA system; Endologix Inc., Irvine, California) outside the current instruction for use. IAAS considered aortic dissection (AD), intramural hematoma (IMH), and penetrating aortic ulcer (PAU). Indications to IAAS treatment were symptoms, associated dilated abdominal aorta (>3 cm), rapidly-growing (>0.5 cm/6 months) aorta, IAAS disease progression. Measured results were technical success, early (within 30 days) and midterm outcomes (after 30 days), including mortality, complications, symptoms recurrence, type I/III endoleak occurrence, stent-graft patency, survival, and freedom from reintervention. The mean follow-up was 22.12 ± 17 months.Results: The MURUSSIAS registry included 83 patients from 7 participating centers. IAAS indication to treatment were symptoms in 42 (51%). In 14 (17%) patients, the infrarenal aortic length was <80 mm, and in 28 (34%), the aortic bifurcation diameter was <16 mm. Technical success was 100%. Mortality occurred early in 1 (1%) and at the midterm in 3 (4%) patients. Complications occurred early in 10 (12%) patients (1 severe, 3 moderates, and 6 mild) and at midterm in 2 (2%) (2 moderate). No symptoms’ recurrence or type I/III endoleaks were registered. The 36-month estimated survival and freedom from reinterventions were 89% and 92%, respectively.Conclusions: The MURUSSIAS registry is the largest collection of spontaneous IAAS managed endovascularly using the AFX endovascular AAA system. The IAAS peculiar anatomic features were fitted with the used technique with excellent results. This treatment strategy might be considered in IAAS unless specifically-designed endovascular solutions will be available also in the emergent setting. Further studies are required to assess the longer-term performances and the stability of the reported technique.Clinical Impact The lack of specifically designed devices for infrarenal acute aortic syndrome (IAAS) disease remains an issue principally for its specific anatomic features. The MURUSSIAS registry retrospectively examined the outcomes of spontaneous IAAS treated using the unibody stent-graft system in a spontaneous national study; and reports the largest available data on this topic. The use of the unibody stent-graft system showed to fit the anatomic peculiarities of IAAS with excellent outcomes. This IAAS treatment strategy should be considered unless specifically designed endovascular solutions will be available.

The variability in the magnetic activity of the Sun is the main source of the observed changes in the plasma and electromagnetic environments within the heliosphere. The primary way in which solar activity affects the Earth’s environment is via the solar wind and its transients. However, the relationship between solar activity and solar wind is not the same at the Space Weather and Space Climate time scales. In this work, we investigate this relationship exploiting five solar cycles data of Ca II K index and solar wind parameters, by taking advantage of the Hilbert–Huang Transform, which allows to separate the contribution at the different time scales. By filtering out the high-frequency components and looking at decennial time scales, we confirm the presence of a delayed response of solar wind to Ca II K index variations, with a time lag of ∼3.1-year for the speed and ∼3.4-year for the dynamic pressure. To assess the results in a stronger framework, we make use of a Transfer Entropy approach to investigate the information flow between the quantities and to test the causality of the relation. The time lag results from the latter are consistent with the cross-correlation ones, pointing out the presence of a statistical significant information flow from Ca II K index to solar wind dynamic pressure that peaks at time lag of 3.6-year. Such a result could be of relevance to build up a predictive model in a Space Climate context.

The Extracorporeal Life Support Organization (ELSO) maintains the world’s largest extracorporeal membrane oxygenation (ECMO) registry by volume, center participation, and international scope. This 2022 ELSO Registry Report describes the program characteristics of ECMO centers, processes of ECMO care, and reported outcomes. Neonates (0–28 days), children (29 days–17 years), and adults (≥18 years) supported with ECMO from 2009 through 2022 and reported to the ELSO Registry were included. This report describes adjunctive therapies, support modes, treatments, complications, and survival outcomes. Data are presented descriptively as counts and percent or median and interquartile range (IQR) by year, group, or level. Missing values were excluded before calculating descriptive statistics. Complications are reported per 1,000 ECMO hours. From 2009 to 2022, 154,568 ECMO runs were entered into the ELSO Registry. Seven hundred and eighty centers submitted data during this time (557 in 2022). Since 2009, the median annual number of adult ECMO runs per center per year increased from 4 to 15, whereas for pediatric and neonatal runs, the rate decreased from 12 to 7. Over 50% of patients were transferred to the reporting ECMO center; 20% of these patients were transported with ECMO. The use of prone positioning before respiratory ECMO increased from 15% (2019) to 44% (2021) for adults during the coronavirus disease-2019 (COVID-19) pandemic. Survival to hospital discharge was greatest at 68.5% for neonatal respiratory support and lowest at 29.5% for ECPR delivered to adults. By 2022, the Registry had enrolled its 200,000th ECMO patient and 100,000th patient discharged alive. Since its inception, the ELSO Registry has helped centers measure and compare outcomes across its member centers and strategies of care. Continued growth and development of the Registry will aim to bolster its utility to patients and centers.

Fostered by the top power conversion efficiencies (PCEs) of lab-scale devices, industrialization of perovskite solar cells is underway. Nevertheless, the intrinsically poor stability of these materials still represents a major concern. Herein, inspired by Nature, the use of β-carotene in perovskite solar cells is proposed to mimic its role as a protective pigment, as occurs in natural photosynthesis. Laser-mediated photostability (LMPS) assessment, Fourier-transform infrared spectra analysis acquired in attenuate total reflectance (ATR-FTIR), spectroscopy ellipsometry (SE), and time-resolved photoluminescence (TRPL) measurements under stress conditions prove that the inclusion of a thin β-carotene interlayer promotes a high improvement in the photostability of the perovskite films against photooxidation. Importantly, this is accompanied by an improvement of the solar cell PCE that approaches 20% efficiency with no hysteresis, which is among the highest values reported for a mixed halide (I-Br) perovskite with a band gap of 1.74 eV, relevant for coupling with silicon in tandem cells.

This study evaluated yerba mate (Ilex paraguariensis) and purple pitanga (Eugenia uniflora) as substrates for kombucha fermentation, focusing on their effects on microbial growth and bioactive properties of the resulting beverage. Simultaneous optimization revealed that the optimal fermentation conditions are 11.5 g/L of yerba mate, 130.0 g/L of sucrose at 25 °C. The beverage produced with yerba mate reached a pH of approximately 2.5 and an optimal concentration of bioactive components after 10 days, while the mixture of yerba mate and pitanga juice reached the same levels after 7 days of fermentation. The count of bacteria and yeast in the yerba mate was 0.5 log CFU/mL higher than that observed in the mixture containing purple pitanga, which indicates the presence of antimicrobial properties in the juice. Fermentation produces a kombucha that is considered low in caffeine. After 10 days of fermentation, the concentration of glucuronic acid was 1.21 ± 0.01 g/L, which is 86% higher than in the kombucha containing pitanga nectar. However, the levels of ascorbic acid were higher in the pitanga kombucha (0.8 g/L) compared to the yerba mate kombucha (0.33 g/L). Replacing part of the yerba mate infusion with pitanga nectar before fermentation incorporated anthocyanins, enhancing the antioxidant activity, antimicrobial effectiveness against pathogens and anti-glycemic activity of the beverages. These findings indicate the potential to produce fermented beverages containing bioactive compounds through the combined use of yerba mate, pitanga nectar, and kombucha microorganisms.

Objectives: People with neuro-motor impairment, lack of speech and general passivity live in a marginalized and isolating condition. This study used a technology-aided program to help three of these people achieve basic activity (i.e., accessing music videos and listening to stories and/or answering questions) and communication (i.e., video calling or sending messages to preferred partners). Methods: The study was carried out according to a non-concurrent multiple baseline design across participants. During the intervention, the participants were provided with the technology system that entailed a tablet and two touch or two optic sensors. Within each session, the tablet presented the participants with choice periods (i.e., periods in which they could choose between music videos and communication with distant partners) interspersed with stories plus questions or questions periods. Results: During the baseline (without the technology system), the participants were not able to make choices (failing to access music videos or communication events) or to answer questions. During the intervention sessions, all participants used the technology successfully to access music videos and communication events and to answer questions independently. Conclusions: The results suggest that simple technology can be adapted to help people like the participants of this study achieve basic forms of functional activity and communication.

A summary of the present stage of our knowledge on the Jurassic sedimentary succession of the basins along the western and northern shelf areas of the Indian craton is presented with a particular focus on the progress in the last four years (2019–2023). Concerning the Jurassic lithostratigraphy of the Kachchh and Jaisalmer basins along the western margin of the Indian craton and the Spiti area of the Indian Himalayas along the southern margin of the Neo-Tethys several improvements have been achieved. Biostratigraphic and palaeoecological studies in these areas still require more attention. There is no limit for palaeontological studies: the more we record, the more information we have on environments and ecosystems in the geological past.