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In 2019, the Deep Submergence Support Vessel Pressure Drop embarked on the third leg of the Five Deeps Expedition. Over the course of 10 days, the full ocean depth submersible Deep Submergence Vehicle Limiting Factor made a record five dives to the bottom of the Mariana Trench: four to the Challenger Deep, one to the Sirena Deep. The submersible was supported by three scientific landers, one of which became stuck on the seafloor at 10,925 m depth. Here we describe how, during the third dive of the campaign, the expedition utilized the submersible to rescue this lost asset from full ocean depth. The expedition was not only significant for its operational jump from single full ocean depth dives to multiple dives in a short space of time, but demonstrated that assets lost in the deepest 45% of the oceans are no longer irretrievable.

Transcatheter aortic valve implantation (TAVI) has been adopted as an alternative to surgery in severe aortic stenosis treatment, even in low-intermediate risk. The aim of this study is to retrospectively report our single-centre 13-year TAVI experience with emphasis on learning curve, referral indication and trends in outcomes over time.We included 361 consecutive patients who underwent TAVI from January 2008 to December 2020, grouped according to similar per-year volume of procedures: G1 (2008-2014), G2 (2015-2017) and G3 (2018-2020).The number of procedures increased (group size: 59Favourable trends were observed across the groups, with an improvement in periprocedural outcomes and cardiovascular mortality at 1-year. These improvements could depend on increased expertise because mortality reduction was noted only after reaching a significant procedure volume. A trend towards lower risk patients selection was present in our cohort, as previously described worldwide.

We deduce that charged liquid droplets minimizing Debye-H\"uckel-type free energy are spherical in the small charge regime. The variational model was proposed by Muratov and Novaga in 2016 to avoid the ill-posedness of the classical one. By combining a recent (partial) regularity result with Selection Principle of Cicalese and Leonardi, we prove that the ball is the unique minimizer in the small charge regime.

The Perrot spring (1305 m a.s.l.), located on the right side of the Chalamy Stream, inside the Monte Avic Natural Park (Aosta Valley, NW Italy), is an important source of drinking water for Champdepraz municipality.The spring is placed on a large slope characterized by the presence of debris covers of various origin (glacial, fluvial and landslide) above the bedrock (serpentinised peridotites and metabasites of the Zermatt-Saas Zone, Penninic Domain) which crops out only in the upper part of the basin.The water source is fed by rainwater infiltrating and flowing into the shallow deposits, with a permeability by porosity, and into the most fractured portion of the substrate. The water emerges at the contact between the topographic surface and impermeable or semi-permeable basal lithologies (unfractured crystalline rocks and glacio-lacustrine deposits).The aim of this study is to delineate the recharge processes of the spring and the definition of the recharge area extension that is very important for its conservation.In this view, an analysis of groundwater spring parameters (e.g. daily discharge, temperature and electrical conductivity) were conducted for the years 2018-2020.The flow rate ranges between 22 and 47 L/s with two maxima, one in spring and one in autumn; the electrolytic conductivity varies between 60 and 75 S/cm. The variation of groundwater temperature is very low, between 4.9°C and 5.5°C. The low discharge and temperature variations suggest a relatively high average share of the supply area and a sufficiently deep flow circuit.The analysis of these data shows the presence of two contributions to the spring supply: a spring contribution from snowmelt, characterized by a low INCREASE in flow rate, and an autumn contribution from rainwater infiltration.Moreover, sampling campaigns were also carried out in the entire Chalamy stream basin in August 2021 and January, July, September 2022. In particular, water from lakes, rivers, spring and rainwater was sampled.During the field campaigns, pH, electrical conductivity and temperature were measured in situ. Chemical analysis of major ions and stable isotopes (δ2H and δ18O) were then conducted on water samples.The chemical analyses show a groundwater chemistry coherent with the regional geology: the hydrochemical facies is bicarbonate-sodium, the main cations are Ca2+ and Mg2+ and the anions HCO3-. Finally, isotopic analyses of precipitation and spring water suggest a recharge elevation of around 2,500 m a.s.l.

Communicative gaze (e.g., mutual or averted) has been shown to affect attentional orienting. However, no study to date has clearly separated the neural basis of the pure social component that modulates attentional orienting in response to communicative gaze from other processes that might be a combination of attentional and social effects. We used Transcranial Magnetic Stimulation (TMS) to isolate the purely social effects of communicative gaze on attentional orienting. Participants completed a gaze-cueing task with a humanoid robot who engaged either in mutual or in averted gaze prior to shifting its gaze. Before the task, participants received either Sham stimulation (baseline), stimulation of right temporoparietal junction (rTPJ) or dorso-medial prefrontal cortex (dmPFC). Results showed, as expected, that communicative gaze affected attentional orienting in baseline condition. This effect was not evident for rTPJ stimulation. Interestingly, stimulation to rTPJ also canceled out attentional orienting altogether. On the other hand, dmPFC stimulation eliminated the socially-driven difference in attention orienting between the two gaze conditions while maintaining the basic general attentional orienting effect. Thus, our results allowed for separation of the pure social effect of communicative gaze on attentional orienting from other processes that are a combination of social and generic attentional components.

Antegrade wiring using only antegrade guiding catheter without contralateral injection (defined as "blind antegrade wiring") may represent a valid initial treatment strategy for selected chronic coronary total occlusions (CTOs) due to the potentially lower risk of vascular complications. A careful selection of lesions eligible for this strategy as well as an accurate balance between the likelihood of success and failure is paramount. The aim of the study is to determine the rate of successful revascularization, the potential predictors of failure and the incidence of major complications, when using a "blind antegrade wiring" technique.In this multicentric study, consecutive patients with CTO undergoing percutaneous coronary intervention (PCI) were retrospectively screened. All cases approached using "blind antegrade wiring" technique were included.Out of 155 consecutive CTO-PCIs, 94 involved initial "blind antegrade wiring" strategy. Successful revascularization by means of "blind antegrade wiring" technique was achieved in 73 (78%) patients. Final successful revascularization was obtained in 19 of the remaining 21 procedures with "blind antegrade wiring" failure using other techniques (by adding a second contralateral guiding catheter; 98% total successful revascularization). Logistic regression analysis identified higher J-CTO score as the only predictor of "blind antegrade wiring" failure. One complication occurred (wire-based coronary perforation)."Blind antegrade wiring" may be considered as initial strategy for selected CTO-PCI, mainly for CTOs with low J-CTO score. This strategy would allow in a substantial number of cases to avoid "a priori" dual injection, keeping it as secondary strategy in case of "blind antegrade wiring" failure.

Tsunami building damage estimates are critical to post-disaster supply logistics and disaster management. Likewise, accurate damage estimates in a digital twin framework (Koshimura et al., 2023) enable more effective responses to disaster emergencies. However, meaningful results from an eventual disaster digital twin would be contingent on real-time inputs, at best. Hence, any practical implementation of a model that performs tsunami building damage estimates precludes reliance on post-disaster data, such as current damage detection models. By embedding physical representations of both the inundated environment and the tsunami, we propose to circumvent the limitations of optical imagery-based deep learning models. We aim to curtail the reliance on post-event data during evaluation, limit the constraints associated with the observation angle, and learn multi-level damage representations based on spatial and geophysical context. Our purpose is to learn these representations by training on physical parameters rather than optical imagery. Thus, we adapt deep learning architectures, initially developed for computer vision tasks, to take in a larger input tensor. Then, we extend and combine remotely sensed data, such as digital elevation models, land use, and cadastral maps. These extra layers embed the physical and spatial context relevant to tsunami inundation in the input. Finally, we test our modified architecture and benchmark the results against a random forest baseline.

The long range electronic modulations recently discovered in the geometrically frustrated kagome lattice have opened new avenues to explore the effect of correlations in materials with topological electron flat bands. The observation of the lattice response to the emergent new phases of matter, a soft phonon mode, has remained elusive and the microscopic origin of charge density waves (CDWs) is still unknown. Here, we show, for the first time, a complete melting of the ScV$_ 6$Sn$_ 6$ (166) kagome lattice. The low energy phonon with propagation vector $\frac{1}{3} \frac{1}{3} \frac{1}{2}$ collapses at 98 K, without the emergence of long-range charge order, which sets in with a propagation vector $\frac{1}{3} \frac{1}{3} \frac{1}{3}$. The CDW is driven (but locks at a different vector) by the softening of an overdamped phonon flat plane at k$_z$=$\pi$. We observe broad phonon anomalies in momentum space, pointing to (1) the existence of approximately flat phonon bands which gain some dispersion due to electron renormalization, and (2) the effects of the momentum dependent electron-phonon interaction in the CDW formation. Ab initio and analytical calculations corroborate the experimental findings to indicate that the weak leading order phonon instability is located at the wave vector $\frac{1}{3} \frac{1}{3} \frac{1}{2}$ of a rather flat collapsed mode. We analytically compute the phonon frequency renormalization from high temperatures to the soft mode, and relate it to a peak in the orbital-resolved susceptibility, obtaining an excellent match with both ab initio and experimental results, and explaining the origin of the approximately flat phonon dispersion. Our data report the first example of the collapse of a softening of a flat phonon plane and promote the 166 compounds of the kagome family as primary candidates to explore correlated flat phonon-topological flat electron physics., Comment: 10 pages, 4 figures

Dirac semimetals show nontrivial physical properties and can host exotic quantum states like Weyl semimetals and topological insulators under suitable external conditions. Here, by combining angle-resolved photoemission spectroscopy measurements (ARPES) and first-principle calculations, we demonstrate that Zintl-phase compound SmMg$_2$Bi$_2$ belongs to the close proximity to a topological Dirac semimetallic state. ARPES results show a Dirac-like band crossing at the zone-center near the Fermi level ($E_\mathrm {F}$) which is further confirmed by first-principle calculations. Theoretical studies also reveal that SmMg$_2$Bi$_2$ belongs to a $Z_2$ topological class and hosts spin-polarized states around the $E_\mathrm {F}$. Zintl's theory predicts that the valence state of Sm in this material should be Sm$^{2+}$, however we detect many Sm-4$f$ multiplet states (flat-bands) whose energy positions suggest the presence of both Sm$^{2+}$ and Sm$^{3+}$. It is also evident that these flat-bands and other dispersive states are strongly hybridized when they cross each other. Due to the presence of Sm$^{3+}$ ions, the temperature dependence of magnetic susceptibility $\chi(T)$ shows Curie-Weiss-like contribution in the low temperature region, in addition to the Van Vleck-like behaviour expected for the Sm$^{2+}$ ions. The present study will help in better understanding of the electronic structure, magnetism and transport properties of related materials., Comment: 11 pages, 7 figures

Iatrogenic coronary artery dissections (ICAD) are rare but potentially devastating complications during coronary angiography and percutaneous coronary interventions (PCI). Intima media complex separation may be produced either by the catheter tip or during PCI. Patient characteristics and procedure related risk factors are intimately linked to catheter induced ICAD over diagnostic angiography. Moreover, the increasing complexity of patients undergoing PCI, which frequently involves treatment of heavily calcified or occluded vessels, has increased the likelihood of dissections during PCI. A prompt recognition, along with a prompt management (either percutaneous, surgical or even careful watching), are key in preventing catastrophic consequences of ICAD, such as left ventricular dysfunction, cardiogenic shock, periprocedural myocardial infarction (MI) or cardiac death. This review aims to summarize the main updates concerning the pathophysiology, highlight key risk factors and suggest recommendations in management and treatment of ICAD.

Vascular access-related complications are one of the most frequent issues following percutaneous interventions of chronic total occlusions (CTO) because of the traditional use of large introducer sheaths for more back-up catheter support, and the need for multiple access sites, often including femoral access. In current practice, many operators still approach the revascularisation of CTO through femoral access despite the demonstrated advantage of radial procedures, mostly in terms of incidence of bleeding complications. Recently, an alternative strategy to deal with CTO, with the aim to minimise the number of access-related complications without affecting the successful revascularisation rate, has been proposed: the ‘minimalistic hybrid approach’ algorithm. This approach consists of the use of classic ‘hybrid algorithm’ techniques, but also aims to minimise the number of access sites, the size of the catheters used, and the adoption of the femoral access.

Functional constipation (FC) is one of the most common disorders in childhood and has a neg-ative impact on the quality of life of children. Scientific evidence regarding a causal relation-ship between FC and cow’s milk allergy is controversial, as it is also reported by the latest European Society for Paediatric Gastroenterology, Hepatology and Nutrition-North American Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN–NASPGHAN) rec-ommendations. In the case of FC, routine allergometric tests are not recommended and the cows’ milk-free diet is only proposed in the case of laxative-resistant constipation and only following the advice of an expert. Instead, after a careful review of the literature and in view of the many clinical cases encountered in our clinical practice, we believe that it is useful to propose cows’ milk-free diet as first line for the treatment of FC at least in pre-school children and in children with a personal or family history of atopy or with a previous diagnosis of cow’s milk protein allergy.

Background: Whether concomitant administration of anticancer agents influences the efficacy and safety of oral anticoagulants in patients treated for cancer-associated venous thromboembolism (VTE) is undefined. The pharmacological interaction between anticancer agents and direct oral anticoagulants is perceived as a concern.Methods: We evaluated the effects of concomitant administration of anticancer agents on recurrent VTE, major bleeding and death in patients with cancer-associated VTE randomised to receive apixaban or dalteparin in the Caravaggio study.Results: Anticancer agents were concomitantly given to 336 patients (58.3%) treated with apixaban and to 332 patients (57.3%) treated with dalteparin. In patients treated with apixaban, recurrent VTE occurred in 20 (6.0%) and 12 (5.0%) among patients treated or not treated with anticancer agents, respectively (hazard ratio [HR] = 1.14; 0.55-2.38); major bleeding occurred in 12 (3.6%) and 10 (4.2%) patients , respectively (HR = 0.79; 0.34-1.82), and death occurred in 74 (22.0%) and 61 (25.4%) patients , respectively (HR = 0.71; 0.51-1. 00). In patients treated with dalteparin, recurrent VTE occurred in 24 (7.2%) and 22 (8.9%) among patients treated or not treated with anticancer agents, respectively (HR = 0.71; 0.40-1.28); major bleeding occurred in 16 (4.8%) and 7 (2.8%) patients, respectively (HR = 1.78; 0.66-4.79 ), and death occurred in 87 (26.2% ) and 66 (26.7 %) patients, respectively (HR = 0.85; 0.62-1.18). The comparative efficacy and safety of apixaban and dalteparin was not different in patients treated or not treated with anticancer agents. No effect on recurrent VTE, major bleeding or death was observed with inhibitors or inducers of P-glycoprotein and/or CYP3A4.Conclusion: In our study, concomitant administration of anticancer agents had no effect on the risk of VTE recurrence or major bleeding in patients treated with apixaban or dalteparin for cancer-associated VTE.(c) 2021 Elsevier Ltd. All rights reserved.

The minimalistic hybrid approach (MHA) is an algorithm to perform chronic total occlusion (CTO) percutaneous coronary intervention (PCI). The current study aims to evaluate the distribution of patients among the five different treatment strategies, the different techniques used in each strategy, the overall procedural success, and the safety of the MHA algorithm.Data from a consecutive series of patients with a CTO who underwent elective PCI between February 2019 and July 2021 were prospectively collected and retrospectively analyzed.One hundred and forty-three CTOPCI in 135 patients were approached according to the MHA algorithm: 134 CTO (93.7%) were successfully recanalized and 9 procedures failed. About half of the procedures (48.3%) were approached using strategy A: antegrade "blind wiring" with contralateral retrograde options, making this the most popular strategy. A total of 89 procedures (62.2%) were completed with a single guiding catheter; in 86 (96.6%) a forearm approach was used. The remaining 54 cases were performed with dual access; in the majority of these patients (90.7%), a bilateral forearm approach was used. The only reason to use the femoral access was inadequate forearm access. One hundred and fifty-four out of 197 (78.2%) access sites were 6 French sheaths.MHA is a stepwise approach focused on the forearm approach to reduce the number of access sites and catheter size used in CTOPCI while maintaining proficiency and safety. Operators should be warned that this approach should be adopted only by experienced CTO operators who master all the strategies of the classic hybrid algorithm and the forearm approach.

Background: Recent research highlighted the potential role of circulating cell-free DNA (cfDNA), resulted by apoptosis or cell necrosis, as a prognostic marker in the setting of different clinical conditions. Cardiorenal syndrome type 1 (CRS type 1) is characterized by a rapid worsening of cardiac function leading to acute kidney injury (AKI). Apoptosis of renal epithelial cells is proposed as a mechanism involved in CRS type 1. In this study, we investigated cfDNA levels in patients with acute heart failure (AHF) and CRS type 1 and the possible correlation between cfDNA levels and inflammatory and apoptotic parameters. Methods: We enrolled 17 AHF patients and 15 CRS type 1 who exhibited AKI at the time of admission (caused by AHF) or developed AKI during the first 48 h from admission. cfDNA was extracted from plasma and quantified by real-time polymerase chain reaction. Plasma levels of NGAL, tumor necrosis factor-α, interleukin (IL)-6, IL-18, and caspase-3 were measured. Results: We observed significantly higher levels of cfDNA in patients with CRS type 1 than patients with AHF. Caspase-3, IL-6, IL-18, and NGAL levels resulted significantly increased in patients with CRS type 1. Moreover, a positive correlation between cfDNA levels and caspase-3 levels was found, as well as between cfDNA levels and IL-6 and renal parameters. Conclusion: Our study explores the premise of cfDNA as a marker for apoptosis and inflammation in CRS type 1 patients. cfDNA could potentially serve as an index for noninvasive monitoring of tissue damage and apoptosis in patients with AKI induced by AHF.

Arsenic (As) is a chemical element that is widely distributed in the environment. The high content of As in groundwater represents a major public health problem in many regions of the world. Accord...

El presente trabajo analiza el Espacio de Juego de una Sala de Internación pediátrica para revalorizar la importancia y efectos de habitar el juego no sólo para el niño y la niña que allí se internan. Para ello, se recorre la historia del dispositivo, su momento instituyente; y viñetas donde no sólo la infancia atraviesa el jugar, también las personas adultas, acompañantes de la internación y el equipo de salud y sus prácticas.. El Espacio creaba las condiciones para la ficción, para entrar en otra escena, suspender el malestar y construir lazos. Ubicaba cuestiones diagnósticas y propiciaba operaciones subjetivas inaugurales. Constituido como otra escena para la institución, en una tercera zona, transformó la situación de internación hospitalaria en ocasión y oportunidad para la clínica y abrió camino al juego en todas sus dimensiones, en niños y niñas , en adultos referentes –generalmente, madres– y las prácticas. Se revaloriza el jugar en sí mismo y la dimensión lúdica de las intervenciones y de la posición analítica. ------------------------ *El presente artículo fue reescrito sobre la base del Trabajo Integrador Final de la Carrera de Especialización en Psicología Clínica Institucional y Comunitaria (cohorte 2004 – 2005) “El Espacio de Juego de la Sala de Internación Pediátrica del Hospital Provincial de Rosario. Relatos y experiencias” (año 2009) del que soy autora y fue dirigido por la Dra. Ana Bloj.

The improvement in childhood cancer treatments resulted in a marked improvement in the survival of pediatric cancer patients. However, as survival increased, it was also possible to observe the long-term side effects of cancer therapies. Among these, metabolic syndrome is one of the most frequent long-term side effects, and causes high mortality and morbidity. Consequently, it is necessary to identify strategies that allow for early diagnosis. In this review, the pathogenetic mechanisms of metabolic syndrome and the potential new biomarkers that can facilitate its diagnosis in survivors of pediatric tumors are analyzed.

We aimed to assess which bifurcation technique performs best in unprotected left-main (LM) percutaneous coronary intervention (PCI).Provisional stenting was considered the preferred technique for LM bifurcation PCI due to the supposed lower risks of thrombosis and restenosis. However, recent studies showed potential advantages of double kissing (DK)-crush technique over the other strategies.We performed a frequentist network meta-analysis comparing different stenting techniques in the setting of LM bifurcation. PubMed, Embase, the Cochrane Central Register of Controlled Trials, and Clinicaltrials.gov were searched. Both randomized clinical trials and non-randomized clinical trials were considered eligible for inclusion. Incidence rate ratios (IRRs) were computed using a random-effects model for death, cardiac death, myocardial infarction, target-vessel revascularization, target-lesion revascularization, and stent thrombosis, including 95% confidence intervals (CIs).A total of 10 studies (2364 patients) were included. Compared with provisional stenting, DK-crush was associated with fewer cardiac deaths (IRR, 0.34; 95% CI, 0.17-0.70; P.01), myocardial infarctions (IRR, 0.19; 95% CI, 0.08-0.44; P.001), stent thromboses (IRR, 0.31; 95% CI, 0.14-0.69; P.01), target-vessel revascularizations (IRR, 0.25; 95% CI, 0.14-0.46; P.001), and target-lesion revascularizations (IRR, 0.25; 95% CI, 0.14-0.46; P.001). DK-crush was also associated with a lower risk of myocardial infarction (IRR, 0.19; 95% CI, 0.05-0.76; P=.02) when compared with standard crush and lower risk of target-lesion revascularization when compared with culotte (IRR, 0.32; 95% CI, 0.12-0.83; P=.02) and crush (IRR, 0.07; 95% CI, 0.02-0.28; P.001).DK-crush is the best technique for unprotected LM bifurcation PCI.

Controlling the density of electrons inside an insulator via the chemical potential is a cornerstone of modern electronics, enabling the electrical conductivity of semiconductors and the emergence of fascinating new properties linked with electronic correlations. The compound SmB6 has drawn widespread attention in recent years as the first insulator to feature both strong electronic correlations and topological quantum order1-7, potentially enabling a host of new phenomenologies as charge density is modified. However, chemical potential has not been experimentally controlled in studies to date of the electronic structure. Here we present an angle-resolved photoemission spectromicroscopy (μ-ARPES) study of SmB6 alloys, using the natural inhomogeneity of sample surfaces to create the analogue of a multi-dimensional doping series. The role of electronic correlations is observed in the interplay of the topologically ordered conducting states with one another and with the chemical potential. Higher doping is found to result in the transformation of these interdependencies as the disorder from impurities erodes quantum coherence. These findings set the stage for a holistic understanding of the interplay between strong correlations and topological features in the electron system. Moreover, they validate recent analyses suggesting that the electronic structure of SmB6 can present the key hallmarks of conventional electron doping, such as a Fermi surface, while nonetheless preserving long-range insulating character in electrical transport measurements8-10.

Axial spondyloarthritis (axial-SpA) is a multifactorial disease characterized by inflammation in sacroiliac joints and spine, bone reabsorption, and aberrant bone deposition, which may lead to ankylosis. Disease pathogenesis depends on genetic, immunological, mechanical, and bioenvironmental factors. HLA-B27 represents the most important genetic factor, although the disease may also develop in its absence. This MHC class I molecule has been deeply studied from a molecular point of view. Different theories, including the arthritogenic peptide, the unfolded protein response, and HLA-B27 homodimers formation, have been proposed to explain its role. From an immunological point of view, a complex interplay between the innate and adaptive immune system is involved in disease onset. Unlike other systemic autoimmune diseases, the innate immune system in axial-SpA has a crucial role marked by abnormal activity of innate immune cells, including γδ T cells, type 3 innate lymphoid cells, neutrophils, and mucosal-associated invariant T cells, at tissue-specific sites prone to the disease. On the other hand, a T cell adaptive response would seem involved in axial-SpA pathogenesis as emphasized by several studies focusing on TCR low clonal heterogeneity and clonal expansions as well as an interindividual sharing of CD4/8 T cell receptors. As a result of this immune dysregulation, several proinflammatory molecules are produced following the activation of tangled intracellular pathways involved in pathomechanisms of axial-SpA. This review aims to expand the current understanding of axial-SpA pathogenesis, pointing out novel molecular mechanisms leading to disease development and to further investigate potential therapeutic targets.

Introduction: Football was the first sport to resume competitions after the coronavirus disease 2019 (COVID-19) lockdown and promptly the hypothesis was raised of a potential relationship between the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and musculoskeletal injuries in athletes. This study aimed to confirm the association between SARS-CoV-2 infection and muscle strain injury in a large population of elite football players and to investigate if the COVID-19 severity level could affect the risk of injury. Methods: A retrospective cohort study involving 15 Italian professional male football teams was performed during the Italian Serie A 2020–2021 season. Injuries and SARS-CoV-2 positivity data were collected by team doctors through an online database. Results: Of the 433 included players, we observed 173 SARS-CoV-2 infections and 332 indirect muscle strains. COVID-19 episodes mostly belonged to severity level I and II. The injury risk significantly increased after a COVID-19 event, by 36% (HR = 1.36, CI95% 1.05; 1.77, p-value = 0.02). The injury burden demonstrated an 86% increase (ratio = 1.86, CI95% 1.21; 2.86, p-value = 0.005) in the COVID-19 severity level II/III versus players without a previous SARS-CoV-2 infection, while level I (asymptomatic) patients showed a similar average burden (ratio = 0.92, CI95% 0.54; 1.58, p-value = 0.77). A significantly higher proportion of muscle–tendon junction injuries (40.6% vs. 27.1%, difference = 13.5%, CI95% 0.002%; 26.9%, p-value = 0.047) was found when comparing level II/III versus Non-COVID-19. Conclusions: This study confirms the correlation between SARS-CoV-2 infection and indirect muscle injuries and highlights how the severity of the infection would represent an additional risk factor.

The aim of this study was to examine the impact of two different post-match training interventions on the subsequent recovery of perceptual and biochemical parameters after the game. In a crossover design, eight sub-elite players underwent a soccer-specific training (SST) and an active recovery (AR) regimen on the second day after a match (+48 h). Muscle soreness as well as muscle damage (creatine kinase, CK), inflammatory (C-reactive protein and interleukin 6), immunological (e.g., lymphocytes, neutrophils, and monocytes), and endocrine (cortisol) markers were obtained at baseline (−72 h), immediately after (0 h), and 72 h post-match (+72 h). AR promoted a higher restoration of muscle soreness values (P = 0.004, η2p = 0.49) together with a better restoration of CK within 72 h post-match compared with SST (P = 0.04, η2p = 0.36). Conversely, no significant (P > 0.05, η2p < 0.91) differences were observed in the recovery timeframe of inflammatory, immunological, and endocrine responses between SST and AR. Overall, AR elicited a quicker muscle soreness and CK restoration compared to SST intervention at 72 h post-match. Such information provides novel evidence-based findings on the appropriateness of different recovery strategies and may aid to improve the practitioners’ decision-making process when two consecutive games are played within 3 days.

Background: Several instruments have been proposed to investigate restricted, repetitive behaviors (RRBs) in individuals with Autism Spectrum Disorder (ASD). Systematic video observations may overcome questionnaire and interview limitations to investigate RRBs. This study aimed to analyze stereotypic patterns through video recordings and to determine the correlation between the number and appearance of RRBs to ASD severity. Methods: Twenty health professionals wearing a body cam recorded 780 specific RRBs during everyday activities of 67 individuals with ASD (mean age: 14.2 ± 3.72 years) for three months. Each stereotypy was classified according to its complexity pattern (i.e., simple or complex) based on body parts and sensory channels involved. Results: The RRBs spectrum for each subject ranged from one to 33 different patterns (mean: 11.6 ± 6.82). Individuals with a lower number of stereotypies shown a lower ASD severity compared to subjects with a higher number of stereotypies (p = 0.044). No significant differences were observed between individuals exhibiting simple (n = 40) and complex patterns (n = 27) of stereotypies on ASD severity, age, sex, and the number of stereotypes. Conclusions: This study represents the first attempt to systematically document expression patterns of RRBs with a data-driven approach. This may provide a better understanding of the pathophysiology and management of RRBs.

Since 2018, important changes in the treatment of drug-resistant tuberculosis have been produced in the light of new evidence. The discovery of new anti-tuberculosis drugs, such as bedaquiline and nitroimidazopirane derivatives, as well as the use of repurposed drugs, led to international organizations to recommend new, totally oral, treatment regimens for mono-resistant and multidrug-resistant tuberculosis, leaving aside the prolonged use of injectables, with their inherent toxicity and discomfort. Some definitions of drug-resistant tuberculosis have changed. The duration of treatment is also under review, leading some new regimens under study, such as BPaL (bedaquiline, pretomanid and linezolid), to a duration similar to that for treating susceptible tuberculosis. In this narrative review, we describe the new definitions, some basic diagnostic aspects, the pharmacological aspects, and the new classification of drugs to be used in the treatment of drug-resistant tuberculosis as well as the currently proposed schemes to treat it available within the Argentinean context. Finally, we include a brief review of ongoing clinical trials on new shortened treatments.Desde 2018 han surgido a la luz de la evidencia importantes cambios en el tratamiento de la tuberculosis drogorresistente. El descubrimiento de nuevas drogas antituberculosis, como la bedaquilina y los derivados de nitroimidazopiranos, así como la utilización de drogas repropuestas, llevó a la recomendación de organismos internacionales de nuevos esquemas de tratamiento de la tuberculosis monorresistente y multidrogorresistente que son totalmente orales y así dejan de lado el uso prolongado de inyectables, con su inherente toxicidad e incomodidad. Algunas de las definiciones de tuberculosis drogorresistente han cambiado. También está en revisión el tiempo de su tratamiento y con algunos nuevos esquemas en estudio, como el BpaL (bedaquilina, pretomanid y linezolid), se ha logrado una duración similar a la del tratamiento de la tuberculosis pansensible. En esta revisión bibliográfica narrativa describimos las nuevas definiciones, algunos aspectos diagnósticos básicos, los aspectos farmacológicos y la nueva clasificación de las drogas a utilizar en el tratamiento de la tuberculosis drogorresistente, así como los esquemas actualmente propuestos para tratarla, contextualizados con la realidad nacional. Finalizamos con una breve reseña de los estudios clínicos en curso de nuevos esquemas acortados de tratamiento.

The intertwining between spin, charge, and lattice degrees of freedom can give rise to unusual macroscopic quantum states, including high-temperature superconductivity and quantum anomalous Hall effects. Recently, a charge density wave (CDW) is observed in the kagome antiferromagnet FeGe, indicative of possible intertwining physics. An outstanding question is that whether magnetic correlation is fundamental for the spontaneous spatial symmetry breaking orders. Here, utilizing elastic and high-resolution inelastic x-ray scattering, we discover a charge dimerization superlattice that coexists with the 2$\times$2$\times$1 CDW in the kagome sublattice. Most interestingly, between the magnetic and CDW transition temperature, the phonon dynamical structure factor shows a giant phonon-energy hardening and a substantial phonon linewidth broadening near the charge-dimerization wavevectors, both signaling the spin-phonon coupling. By first principles calculations, we show that both the static and dynamic spin excitations intertwine with the phonon to drive the spatial symmetry breaking., Comment: The data that support the findings of this study are available from the corresponding author on reasonable request

Here, our angle resolved photoemission spectroscopy experiment reveled that the surface band structure of the 1T-VSe2 host electronic states that was not predicted or probed before. Earlier claims to support charge density wave phase can be all explained in terms of these new findings. Its Fermi surface found to be not gaped at any point of the Brillouin zone and warping effect on the electronic structure, attributed to the lattice distortion previously, is due to the different dispersion of the multiple bands. Based on these new findings and interpretations, charge density wave induced modification on the electronic structure of 1T-VSe2 needs to be reconstructed in the future studies., Comment: 4

Destructive interference of electron hopping on the frustrated kagome lattice generates Dirac nodes, saddle points, and flat bands in the electronic structure. The latter provides the narrow bands and a peak in the density of states that can generate correlated electron behavior when the Fermi level lies within them. In the kagome metal CoSn, this alignment is not realized, and the compound is a Pauli paramagnet. Here we show that replacing part of the tin with indium (CoSn1-xInx) moves the Fermi energy into the flat band region, with support from band structure calculations, heat capacity measurements, and angle resolved photoemission spectroscopy. The associated instability results in the emergence of itinerant antiferromagnetism with a Neel temperature up to 30K. Long range magnetic order is confirmed by neutron diffraction measurements, which indicate an ordered magnetic moment of 0.1-0.2 Bohr magnetons per Co (for x = 0.4). Thus, CoSn1-xInx provides a rare example of an itinerant antiferromagnet with a small ordered moment. This work provides clear evidence that flat bands arising from frustrated lattices in bulk crystals represent a viable route to new physics, evidenced here by the emergence of magnetic order upon introducing a non-magnetic dopant into a non-magnetic kagome metal.

Habitat restoration and recolonisation of benthic communities after physical perturbation in the deep sea has long been thought to be extremely slow. This study reports on a serendipitous opportunity to survey the current state of a large mechanical disturbance of sediments at 6460 m in the Pacific Ocean. The impact was caused 77 years ago by the sinking of the USS Johnston. The surrounding debris field had little impact on the sedimentary habitat, other than in the provision of artificial hard substrates, while the troughs that formed as the ship impacted the seafloor and slid down the slope of the Philippine Trench were still completely void of animal tracks and burrows, or any observable epifauna, and in some areas subsurface stratification was still exposed at the surface. This suggests that mechanical perturbations of sediments in the deep Pacific may remain ecologically significant for, at the very least, 100 years.

A careful angiographic assessment of a chronic total occlusion (CTO) is essential for optimal procedural planning. In the classic Hybrid Approach, the insertion of two guiding catheters at the beginning of the intervention is recommended. This is fundamental to perform simultaneous double injection, to achieve complete visualization of the coronary circulation and to choose the best starting strategy between antegrade wire escalation (AWE), antegrade dissection and re-entry (ADR) and the retrograde techniques (retrograde wire escalation [RWE] and retrograde dissection and re-entry [RDR]). In the Hybrid Algorithm the set-up is the same, regardless of the chosen first strategy, and therefore routinely uses double access. Because revascularizations of CTOs commonly require large bore catheters (7-8 French) to ensure high back up support, the femoral arterial access is preferred by most of the operators. However, the use of a double access, large introducer sheaths and femoral approach are associated with a greater risk of access-related complications and even the occurrence of major adverse cardiovascular events. We have previously proposed an algorithm, called "Minimalistic Hybrid Approach", which aims to limit the routine use of dual injection, and to favour the use of trans-radial access and smaller (6-7 French) guiding catheters. In this algorithm the chosen starting strategy depends on the complexity of the lesion assessed by J-CTO score and on the presence of favourable contralateral interventional collateral circulation. However, this novel algorithm proved to have some limitations, such as the non-specific evaluation of CTOs with ipsilateral collateral circulation and the too arbitrary choice of the starting strategy based on a J-CTO score cut-off. These considerations led to the development of an "updated" Minimalistic Hybrid Approach algorithm that takes into account the type of collaterals (ipsilateral or contralateral) and the "a priori" choice of the hybrid technique, with the highest chance of success in that specific CTO lesion (independently from the J-CTO score). One important aspect that makes this algorithm unique is its "dynamicity": not only for the technique to be used, as in the classic hybrid algorithm (shifting between AWE, ADR, RWE and RDR), but also for the set-up, with access site and French size to be adapted during the PCI to the technique adopted. We believe that this novel approach could further improve the safety of CTO-PCI without losing its current efficacy.

The data reported in this article are related to the paper entitle “Stem cells transplantation positively modulates the heart-kidney cross talk in Cardiorenal Syndrome Type II” (Vescovo et al., 2019), which analyzed the impact of stem cells injection in cardiorenal syndrome type II. The dataset contains detailed information on apoptosis and cytokines milieu modification after injection of c-Kit–selected human amniotic fluid stem cells (hAFS) or rats vascular progenitor cells (rSVC-GFP group) in an experimental model of CRSII. The data can be useful for clarifying the paracrine effects exerted by the injected cells.

In this letter, a simple and fast method is presented for improving the linear array radiation patterns produced by the existing synthesis algorithms. Given a linear aperiodic array with elements lying at specified positions, having uniform distribution of the excitations and radiating a pencil beam in the broadside direction, the proposed approach iteratively modifies the positions of the elements in order to reduce the power radiated in the sidelobe region. Numerical examples show the effectiveness of the method, and the effects of the sidelobe power reduction on other parameters of the antenna are examined.

Solitary fibrous tumor (SFT), a rare mesenchymal neoplasm of fibroblastic origin, was initially discovered in the mediastinal pleura and then described in many extra-pleural sites.The reports of primary solitary fibrous tumor of bone are extremely rare and only a few cases have been previously mentioned in the literature, most of which in flat and short bones.Here we present the case of a 53-year-old female, who was referred to the emergency department of a peripheral hospital after an accidental fall. Imaging studies revealed an intertrochanteric fracture with an underlying intramedullary lytic lesion. A biopsy was performed and a diagnosis of Ewing sarcoma was initially suggested. She arrived at our hospital where we reevaluated the case. The biopsy was reviewed and a diagnosis of intraosseous SFT was proposed. She underwent en-block resection of the proximal right femur.Primary SFTs of the bone are, like in our case, easily misdiagnosed due to the low specificity of the imaging studies and the extreme rarity of the localization. An accurate diagnosis and early resection are very important and with careful long-term follow-up is essential, particularly in those who with malignant behavior, for the early detection of possible recurrence or metastasis.