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Background: The indications of preoperative chemotherapy, for initially resectable synchronous colorectal liver metastases, remain controversial. This meta-analysis aimed to assess the efficacy and safety of preoperative chemotherapy in such patients. Methods: Six retrospective studies were included in the meta-analysis with 1036 patients. Some 554 patients were allocated to the preoperative group, and 482 others were allocated to the surgery group. Results: Major hepatectomy was more common in the preoperative group than in the surgery group (43.1% vs. 28.8%, p < 0.001). Furthermore, the percentage of patients with more than three liver metastases was higher in the preoperative group compared to the surgery group (12.6% vs. 5.4%, p < 0.002). Preoperative chemotherapy showed no statistically significant impact on overall survival. Combined disease free/relapse survival analysis of patients with high disease burden (liver metastases > 3, maximum diameter > 5 cm, clinical risk score ≥ 3) demonstrated that there is a 12% lower risk of recurrence in favor of preoperative chemotherapy. Combined analysis showed a statistically significant (77% higher probability) of postoperative morbidity in patients who received preoperative chemotherapy (p = 0.002). Conclusions: Preoperative chemotherapy should be suggested in patients with high disease burden. The number of cycles of preoperative chemotherapy should be low (3–4) to avoid increased postoperative morbidity. However more prospective studies are needed to clarify the exact role of preoperative chemotherapy in patients with synchronous resectable colorectal liver metastases.

We identify the need for enhanced pedestrian–vehicle simulation tools and build such a tool to explore the interaction among pedestrian “players” and virtual human- and automated-vehicles for different scenarios taking place in an urban environment. We first present contemporary research tools and then propose the design and development of a new desktop application that facilitates pedestrian-point-of-view research. We then conduct a three-step user experience experiment, in which a small number of participants answer questions before and after using the application to interact with virtual human and automated vehicles in diverse road-crossing scenarios. Behavioral results observed in virtuality, especially when motivated by consequence, tend to simulate real life sufficiently well to inform design choices. From the simulation, we observed valuable insights into human–vehicle interactions. Upon completing this preliminary testing, we iterated the tool’s design and ultimately conducted an 89-participant study of human–vehicle interactions for three scenarios taking place in a virtual environment. Our tool raised participant awareness of autonomous vehicles and their capabilities and limitations, which is an important step in overcoming public distrust of AVs. We additionally saw that participants trust humans and technology less as drivers than in other contexts, and that pedestrians feel safer around vehicles with autonomy indicators. Further, we note that study participants increasingly feel safe with automated vehicles with increased exposure. These preliminary results, as well as the efficacy of the tool’s design, may inform future socio-technical design for automated vehicles and their human interactions.

Broader understanding of waste management has the potential to bring about broad societal change impacting the climate crisis and public health. We present existing waste management tools and commercially-available games involving waste management, highlighting the strengths and opportunities left unaddressed by these tools in educational contexts and planning use cases. A survey motivates the need for enhanced interactive tools providing clear feedback through quick-visibility performance indicators. After identifying an opportunity to build upon highly-detailed multi-criteria simulation tools, we explore the need for easy-to-read performance metrics that will bring to the field of waste management easily identifiable and measurable key performance indicators (KPIs) that vary alongside factors affecting waste management policies. Such metrics are introduced and detailed as part of a unified waste management model. We then develop a representative gamified educational tool based upon this model to be used by students, decision makers planning real-world policies, and the public. This simulator is built upon the Unity Game Engine and emulates waste management techniques and resulting KPIs within the context of a virtual city.

Mass population movements have altered the epidemiology of tinea capitis (TC) in countries receiving refugees. Periodic monitoring of the local pathogen profiles may serve as a basis for both the selection of appropriate empirical antifungal therapy and the implementation of preventive actions. Therefore, we investigated the impact of an unprecedented immigration wave occurring in Greece since 2015 on the epidemiological trends of TC. All microbiologically confirmed TC cases diagnosed during the period 2012–2019 in a referral academic hospital for dermatological disorders in Athens, Greece, were retrospectively reviewed. A total of 583 patients were recorded, where 348 (60%) were male, 547 (94%) were children and 160 (27%) were immigrants from Balkan, Middle Eastern, Asian as well as African countries. The overall annual incidence of TC was 0.49, with a significant increase over the years (p = 0.007). M. canis was the predominant causative agent (74%), followed by T. violaceum (12%), T. tonsurans (7%) and other rare dermatophyte species (7%). M. canis prevalence decreased from 2014 to 2019 (84% to 67%, p = 0.021) in parallel with a three-fold increase in T. violaceum plus T. tonsurans rates (10% to 32%, p = 0.002). An increasing incidence of TC with a shift towards anthropophilic Trichophyton spp. in Greece could be linked to the immigration flows from different socioeconomic backgrounds.

In the midst of a persistent pandemic of a probable zoonotic origin, one needs to constantly evaluate the interplay of SARS-CoV-2 (severe acute respiratory syndrome-related coronavirus-2) with animal populations. Animals can get infected from humans, and certain species, including mink and white-tailed deer, exhibit considerable animal-to-animal transmission resulting in potential endemicity, mutation pressure, and possible secondary spillover to humans. We attempt a comprehensive review of the available data on animal species infected by SARS-CoV-2, as presented in the scientific literature and official reports of relevant organizations. We further evaluate the lessons humans should learn from mink outbreaks, white-tailed deer endemicity, zoo outbreaks, the threat for certain species conservation, the possible implication of rodents in the evolution of novel variants such as Omicron, and the potential role of pets as animal reservoirs of the virus. Finally, we outline the need for a broader approach to the pandemic and epidemics, in general, incorporating the principles of One Health and Planetary Health.

This work compares two design methodologies, emulating both AgCl electrode and skin tissue Cole models for testing and verification of electrical bio-impedance circuits and systems. The models are based on fractional-order elements, are implemented with active components, and capture bio-impedance behaviors up to 10 kHz. Contrary to passive-elements realizations, both architectures using analog filters coupled with adjustable transconductors offer tunability of the fractional capacitors’ parameters. The main objective is to build a tunable active integrated circuitry block that is able to approximate the models’ behavior and can be utilized as a Subject Under Test (SUT) and electrode equivalent in bio-impedance measurement applications. A tetrapolar impedance setup, typical in bio-impedance measurements, is used to demonstrate the performance and accuracy of the presented architectures via Spectre Monte-Carlo simulation. Circuit and post-layout simulations are carried out in 90-nm CMOS process, using the Cadence IC suite.