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Rossella Siligato,1,2 Guido Gembillo,2,3 Alfredo De Giorgi,4 Alessio Di Maria,1 Laura Maria Scichilone,1 Matteo Capone,1,5 Francesca Maria Vinci,1,5 Simone Nicoletti,1 Marta Bondanelli,5 Cristina Malaventura,5 Alda Storari,1,5 Domenico Santoro,3 Sara Dionisi,6 Fabio Fabbian1,5 1Nephrology Unit, University Hospital of Ferrara, Ferrara, Italy; 2Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, University of Messina, Messina, Italy; 3Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy; 4Internal Medicine, University Hospital of Ferrara, Ferrara, Italy; 5Department of Medical Sciences, University of Ferrara, Ferrara, Italy; 6Nursing, Technical and Rehabilitation, Department DATeR Azienda Unità Sanitaria Locale Di Bologna, Bologna, ItalyCorrespondence: Fabio Fabbian, Department of Medical Sciences, via Luigi Borsari, 46, Ferrara, Italy, I-44124, Tel +39 0532 239385, Email f.fabbian@ospfe.itPurpose: Social determinants of health have been related with kidney diseases and their outcomes. Financial toxicity (FT) refers to the negative impact of health care costs on clinical conditions. This scoping review aimed to evaluate the literature linking FT with renal diseases.Patients and Methods: We Included all studies analyzing FT and renal disease recorded in PubMed, Embase and Google Scholar between 2013 and 2023. The research question was formulated with reference to the acronym PCC (Problem, Concept and Contest). For each included study, we considered the study design, the population and main results from different populations with distinct renal conditions and the results were summarized in four tables.Results: Socioeconomic deprivation was the main cause of FT, and the majority of studies on the relationship between FT and chronic kidney disease (CKD) were conducted in the USA (4 studies evaluated the pediatric population and 6 studies included adults). Three studies reported the impact of FT on nephrolithiasis, and 3 studies analyzed the link between FT and renal tumors. The methods used for detecting FT differed and were based on consultations, questionnaires, expenditures and database records analysis. The COmprehensive Score for financial Toxicity (COST) questionnaire was used in 7 studies (43%), and the prevalence of FT was reported to be high in children and adults.Conclusion: Although the quality of the selected study is limited, due to different populations investigated and heterogeneity in detecting FT, the latter seems to be a frequent finding in people with renal disease. Health care professionals should recognize socioeconomic deprivation as the major cause of FT. Detecting FT could help in prioritizing patient-centered care in populations with renal diseases through the development of strategies aimed at improving care for people with kidney diseases.Plain Language Summary: Social determinants of health, especially poverty, social environmental stressors and psychological factors, are increasingly recognized as significant determinants of kidney diseases and their outcomes. Financial toxicity (FT) refers to the negative impact of health care costs on clinical conditions. The relationship between FT and renal disease is not completely understood. With this scoping review, we evaluated all published papers between 2013 and 2023 on this item. We analyzed 16 studies and found that FT is common in pediatric and adult CKD patients and in patients with nephrolithiasis and renal tumors. For patients with kidney disease, FT represents a significant burden, both through the direct costs of disease management and treatment and through indirect costs such as the loss of income due to missed work and expenses for transportation and accommodations near outpatient clinics. Finally, it should be noted that in different countries, it is difficult for people with kidney disease to obtain health insurance coverage. Health care professionals need to improve their knowledge about the relationship between FT and renal disease; there is a paucity of data regarding the effects of FT on different outcomes, although this nonmedical risk factor can negatively influence kidney health and quality of life. Further studies involving different professionals able to consider environmental, physical and emotional risk factors are needed. Keywords: financial toxicity, financial burden, financial hardship, renal disease, chronic kidney disease

Abstract Macroscopic coherence in quantum fluids allows the observation of interference effects in their wavefunctions, and enables applications such as superconducting quantum interference devices based on Josephson tunneling. The Josephson effect manifests in both fermionic and bosonic systems, and has been well studied in superfluid helium and atomic Bose-Einstein condensates. In exciton-polariton condensates—that offer a path to integrated semiconductor platforms—creating weak links in ring geometries has so far remained challenging. In this work, we realize a Josephson junction in a polariton ring condensate. Using optical control of the barrier, we induce net circulation around the ring and demonstrate both superfluid-hydrodynamic and the Josephson regime characterized by a sinusoidal tunneling current. Our theory in terms of the free-energy landscapes explains the appearance of these regimes using experimental values. These results show that weak links in ring condensates can be explored in optical integrated circuits and hold potential for room-temperature applications.

Swapping visual perspective in virtual reality (VR) provides a unique means for embodying different virtual bodies and for self-distancing. Moreover, this technology is a powerful tool for experiential learning and for simulating realistic scenarios, with broad potential in the training of soft skills. However, there is scarce knowledge on how perspective swapping in VR might benefit the training of soft skills such as those required in a job interview. This article investigates the impact of virtual body swapping on the self-assessment of verbal and nonverbal communication skills, emotional states, and embodiment in a simulated job interview context. Three main conditions were compared: a baseline condition in which the participants practiced a job interview from the first-person perspective of a virtual interviewee (no swap condition); an external point of view condition where, first, the participants answered questions from the interviewee perspective, but then swap visual perspective to re-experience their responses from a nonembodied point of view (out of body condition); and a condition in which, after answering questions from the interviewee perspective, the participants re-experienced their responses from the embodied perspective of the virtual recruiter (recruiter condition). The experimental results indicated that the effectiveness of the out of body and recruiter conditions was superior to the no swap condition to self-assess the communication styles used during a job interview. Moreover, all the conditions led to a high level of embodiment toward the interviewee avatar when seen from the first-person perspective; in the case of the recruiter condition, the participants also felt embodied in the recruiter avatar. No differences in emotional states were found among conditions, with all sharing a positive valence.

Background The prognostic value of the Geriatric 8 (G8) screening score in metastatic renal cell carcinoma (mRCC) patients receiving first-line immunotherapy remains unclear. This study aimed to evaluate the prognostic role of G8 within the context of the Meet-URO classification in mRCC patients treated with first-line ipilimumab-nivolumab. Methods This retrospective multicentre study analysed 106 mRCC patients treated with first-line ipilimumab-nivolumab. G8 and Meet-URO scores were calculated before treatment initiation. Primary endpoint was overall survival (OS), defined as duration from first administration of Nivolumab to death. OS was analysed in relation to age groups, G8 scores, and Meet-URO score categories, with data censored for patients still alive at the last follow-up. The secondary endpoint, progression-free survival (PFS), was measured from initiating Nivolumab to the earliest instance of disease progression or death. OS and PFS were assessed using Kaplan-Meier methods and Cox regression analyses. The reporting of this study conforms to the REMARK guidelines. Results Patients with G8 > 14 had more favorable IMDC and Meet-URO risk classifications and lower neutrophil-to-lymphocyte ratios. While PFS did not differ significantly between G8 ≤ 14 and >14 groups (1-year 29.3% vs 46.2%, p = 0.2), OS was significantly longer in G8 > 14 group (1-year 76.1% vs 58.6%, p = 0.006). In multivariable analysis, G8 ≤ 14 was independently associated with worse OS (HR 2.36, 95% CI 1.06-5.08, p = 0.03) but not PFS. The Meet-URO score was prognostic for both PFS and OS. In patients ≥70 years, G8 lost its prognostic value, while Meet-URO remained prognostic for OS. Conclusions The G8 score is an independent prognostic factor for OS but not PFS in mRCC patients receiving first-line ipilimumab-nivolumab. The Meet-URO score shows consistent prognostic ability for PFS and OS across age groups. These findings suggest that while G8 may be useful for individual patient-level OS prediction, the Meet-URO score may be superior for guiding treatment decisions in clinical practice.

Summary: Background: The health of the marginalized populations is crucial for public health and inequalities. The World Health Organization (WHO) Global Hepatitis Report 2024 stated that over 304 million people were living with Hepatitis B Virus (HBV)/Hepatitis C Virus (HCV) infection in 2022. We performed HBV/HCV screenings among marginalized communities to reveal hidden infections and link-to-care positive participants. Methods: From January 2019 to May 2024, finger-prick tests were used to conduct on-site screenings at non-profit organizations in Tuscany, Italy. Positive participants were referred to the closest outpatient clinic. Findings: Eighty/1812 (4.4%) participants were Hepatitis B surface Antigen (HBsAg)+, mostly men (p

Background: Hematologic malignancies are a group of heterogeneous neoplasms which originate from hematopoietic cells. The most common among them are leukemia, lymphoma, and multiple myeloma. Machine learning (ML) is a subfield of artificial intelligence that enables the analysis of large amounts of data, possibly finding hidden patterns. Methods: We performed a narrative review about recent applications of ML in the most common hematological malignancies. We focused on the most recent scientific literature about this topic. Results: ML tools have proved useful in the most common hematological malignancies, in particular to enhance diagnostic work-up and guide treatment. Conclusions: Although ML has multiple possible applications in this field, there are some issue that have to be fixed before they can be used in daily clinical practice.

Contrast enhancement resolution induced by corticosteroids is a phenomenon primarily associated with primary central nervous system lymphoma, while malignant brain gliomas usually maintain a consistent radiological appearance during systemic steroid treatment.Although rare, a few primary and metastatic intracranial lesions have shown similar radiographic changes following corticosteroid therapy. In the case of glioblastomas, corticosteroid therapy is commonly used to alleviate pressure effects from peritumoral edema, but its impact on contrast enhancement is not well-established.A few reported cases in the literature describe reduced contrast enhancement in glioblastomas after corticosteroid treatment.We present a case of corticosteroid-induced regression on imaging of glioblastoma evaluated at our institutionwith the intention to explore the pathogenesis of this response and discuss the therapeutic and prognostic implications of this discovery.

Introduction: The recent rise of immunotherapy for melanoma brain metastases (MBM) has enhanced the interest in characterizing the composition of local immune microenvironment. Despite the central nervous system (CNS) is well known for harbouring a peculiar immunological milieu, its role in MBM is only partially understood. The aim of our study was to characterize tumour-infiltrating lymphocytes (TILs) and tumour-associated macrophages (TAMs) distribution and density in a cohort of MBM and their potential relevance as prognostic biomarkers. Materials and methods: Ninety-four MBM patients were retrospectively evaluated for morphological, molecular features and follow-up data. Formalin-fixed and paraffin-embedded (FFPE) tissue sections were immunostained with the following antibodies: CD4, CD8, FoxP3 CD68, CD163, PD-L1, HLA-ABC. Semiquantitative assessment of TILs and TAMs density and spatial distribution was performed and statistical analysis for prognostic correlations was carried out. Results: The distribution of CD4+ TILs was higher in the intratumoral region (p=0.012) while CD163+ TAMs in the peritumoral (p=0.016). An association was also found between tumour-associated astrogliosis (TAA) and CD163+ TAMs (p=0.021). Increased CD68+ TAMs correlated with BRAF V600 mutation (p=0.038). CD4+ TILs were significantly higher in PD-L1

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Testicular germ cell tumors (TGCTs), the most common malignancies affecting young men, are characterized by high sensitivity to cisplatin-based chemotherapy, which leads to high cure rates even in metastatic disease. However, approximately 30% of patients with metastatic TGCTs relapse after first-line treatment and those who can be defined as platinum-refractory patients face a very dismal prognosis with only limited chemotherapy-based treatment options and an overall survival of few months. Hence, to understand the mechanisms underlying cisplatin resistance is crucial for developing new treatment strategies. This narrative review explores the potential role of PARP inhibitors (PARPis) in overcoming cisplatin resistance in TGCTs, starting from the rationale of their ability to induce DNA damage in cells with homologous recombination repair (HRR). Thus far, PARPis have failed to show meaningful clinical activity in platinum-refractory TGCT patients, either alone or in combination with chemotherapy. However, few responses to PARPis in TGCTs have been detected in patients with BRCA1/2, ATM or CHEK2 mutations, reinforcing the idea that patients should be optimally selected for tailored treatments in the era of personalized medicine. Future preclinical and clinical research is needed to further investigate the molecular mechanisms of cisplatin resistance and to identify novel therapeutic strategies in resistant/refractory TGCTs patients.

Chronic hepatitis B (HBV), alongside hepatitis D virus (HDV) super-/co-infection and chronic hepatitis C (HCV), are major contributors to cirrhosis, end-stage liver disease, hepatocellular carcinoma (HCC), and liver-related mortality. Despite significant progress in antiviral treatments and HBV vaccination, viral hepatitis remains a global health burden. Vulnerable populations, such as those experiencing homelessness, migrants, and economically disadvantaged groups, are disproportionately impacted by these infections, often facing barriers to care and exclusion from traditional health systems. This leads to undiagnosed cases and ongoing transmission, undermining global efforts to eliminate HBV and HCV by 2030, as outlined by the World Health Organization (WHO). Recent studies highlight the importance of tailored interventions to address health inequalities. For instance, on-site community-based screening initiatives targeting marginalized groups have shown promise, achieving higher linkage to care rates without monetary incentives. These approaches not only enhance diagnosis but also facilitate integration into healthcare systems, addressing both public health and social disparities. This review underscores the need for targeted strategies to promote the early detection and management of HBV and HCV in underserved populations. Such efforts are critical to advancing the WHO’s elimination goals, improving health outcomes, and addressing the broader social determinants of health.