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BACKGROUND: Rib fractures are one of the most common traumatic injuries and may result in significant morbidity and mortality. Despite growing evidence, technological advances and increasing acceptance, surgical stabilization of rib fractures (SSRF) remains not uniformly considered in trauma centers. Indications, contraindications, appropriate timing, surgical approaches and utilized implants are part of an ongoing debate. The present position paper, which is endorsed by the World Society of Emergency Surgery (WSES), and supported by the Chest Wall Injury Society, aims to provide a review of the literature investigating the use of SSRF in rib fracture management to develop graded position statements, providing an updated guide and reference for SSRF. METHODS: This position paper was developed according to the WSES methodology. A steering committee performed the literature review and drafted the position paper. An international panel of experts then critically revised the manuscript and discussed it in detail, to develop a consensus on the position statements. RESULTS: A total of 287 studies (systematic reviews, randomized clinical trial, prospective and retrospective comparative studies, case series, original articles) have been selected from an initial pool of 9928 studies. Thirty-nine graded position statements were put forward to address eight crucial aspects of SSRF: surgical indications, contraindications, optimal timing of surgery, preoperative imaging evaluation, rib fracture sites for surgical fixation, management of concurrent thoracic injuries, surgical approach, stabilization methods and material selection. CONCLUSION: This consensus document addresses the key focus questions on surgical treatment of rib fractures. The expert recommendations clarify current evidences on SSRF indications, timing, operative planning, approaches and techniques, with the aim to guide clinicians in optimizing the management of rib fractures, to improve patient outcomes and direct future research.

This work presents a detailed case study on using Generative AI (GenAI) to develop AI surrogates for simulation models in fusion energy research. The scope includes the methodology, implementation, and results of using GenAI to assist in model development and optimization, comparing these results with previous manually developed models.

A real-time capable core Ion Cyclotron Range of Frequencies (ICRF) heating model on NSTX and WEST is developed. The model is based on two nonlinear regression algorithms, the random forest ensemble of decision trees and the multilayer perceptron neural network. The algorithms are trained on TORIC ICRF spectrum solver simulations of the expected flat-top operation scenarios in NSTX and WEST assuming Maxwellian plasmas. The surrogate models are shown to successfully capture the multi-species core ICRF power absorption predicted by the original model for the high harmonic fast wave and the ion cyclotron minority heating schemes while reducing the computational time by six orders of magnitude. Although these models can be expanded, the achieved regression scoring, computational efficiency and increased model robustness suggest these strategies can be implemented into integrated modeling frameworks for real-time control applications.

OBJECTIVES: The Salivary Gland Committee of the American Academy of Otolaryngology-Head and Neck Surgery seeks to standardize terminology and technique for ultrasonograpy used in the evaluation and treatment of salivary gland disorders. METHODS: Development of expert opinion obtained through interaction with international practitioners representing multiple specialties. This committee work includes a comprehensive literature review with presentation of case examples to propose a standardized protocol for the language used in ultrasound salivary gland assessment. RESULTS: A multiple segment proposal is initiated with this focus on the submandibular gland. We provide a concise rationale for recommended descriptive language highlighted by a more extensive supplement that includes an extensive literature review with additional case examples. CONCLUSION: Recommendations are provided to improve consistency both in performing and reporting submandibular gland ultrasound.

Abstract This study examined the presence of autistic traits in a sample of adult women diagnosed with different Eating Disorders (ED), and explored the concurrent role of autistic traits and sensory sensitivity in influencing both their eating disorder symptomatology and their autism-related eating behaviours. Seventy-five women with different ED (Anorexia Nervosa, Bulimia Nervosa, Binge-Eating Disorder, Other Specified Feeding or Eating Disorder) completed the Eating Attitude Test (EAT-26), the Autism Quotient (AQ), the Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R), the Sensory Perception Quotient - Short Form 35 item (SPQ-SF35) and the Swedish Eating Assessment for Autism Spectrum Disorders (SWEAA). Twelve percent of participants scored above the cut-off on both the AQ and the RAADS-R, while 68% scored above the cut-off on the RAADS-R only. A mediation analysis revealed that the association between sensory sensitivity (SPQ-SFR35) and scores on both the EAT-26 and the SWEAA was significantly mediated by the presence of autistic traits (RAADS-R). These findings, first, confirm the presence of autistic traits in individuals with ED; second, they show that a lower sensory threshold (i.e., a higher sensory sensitivity) is associated with a higher presence of autistic traits which were, in turn, positively associated with dysfunctional eating behaviours typical of ED and ASD. This study ultimately highlights the importance of further research on autistic traits across all diagnostic categories of ED.

Abstract Background Rib fractures are one of the most common traumatic injuries and may result in significant morbidity and mortality. Despite growing evidence, technological advances and increasing acceptance, surgical stabilization of rib fractures (SSRF) remains not uniformly considered in trauma centers. Indications, contraindications, appropriate timing, surgical approaches and utilized implants are part of an ongoing debate. The present position paper, which is endorsed by the World Society of Emergency Surgery (WSES), and supported by the Chest Wall Injury Society, aims to provide a review of the literature investigating the use of SSRF in rib fracture management to develop graded position statements, providing an updated guide and reference for SSRF. Methods This position paper was developed according to the WSES methodology. A steering committee performed the literature review and drafted the position paper. An international panel of experts then critically revised the manuscript and discussed it in detail, to develop a consensus on the position statements. Results A total of 287 studies (systematic reviews, randomized clinical trial, prospective and retrospective comparative studies, case series, original articles) have been selected from an initial pool of 9928 studies. Thirty-nine graded position statements were put forward to address eight crucial aspects of SSRF: surgical indications, contraindications, optimal timing of surgery, preoperative imaging evaluation, rib fracture sites for surgical fixation, management of concurrent thoracic injuries, surgical approach, stabilization methods and material selection. Conclusion This consensus document addresses the key focus questions on surgical treatment of rib fractures. The expert recommendations clarify current evidences on SSRF indications, timing, operative planning, approaches and techniques, with the aim to guide clinicians in optimizing the management of rib fractures, to improve patient outcomes and direct future research.

Abstract Studies for the preservation of seagrass beds biotopes have met difficulties in establishing appropriate methods assessing their health. We tested the efficiency of space occupation by seagrasses scattered worldwide (dgrass index), which proved to be dependent on clonal growth form and morphometric plasticity. dgrass correlated with the above-ground to below-ground biomass ratio. However, the latter was misleading when high ratios resulted from low below-ground biomass. Nutrient Posphate-limitations were revealed in situations of theoretical Nitrogen-limitation. Enhanced nutrient supply benefitted seagrasses only up to a threshold after which it became detrimental. Better nurtured, healthier meadows with denser canopies increased the organic matter in the sediment and had associated greater abundances of benthic macrofauna. Hence, seagrass biotopes could benefit from moderate anthropogenic nutrient additions. However, organic matter above ≈6% and/or reduced riverine discharges (dams upstream and climate-change-related droughts) were detrimental to healthy meadows, jeopardizing ecosystem services such as macrofauna abundances and carbon sinks.

Abstract Background Over the past three decades, our understanding of sleep apnea in women has advanced, revealing disparities in pathophysiology, diagnosis, and treatment compared to men. However, no real-life study to date has explored the relationship between mask-related side effects (MRSEs) and gender in the context of long-term CPAP. Methods The InterfaceVent-CPAP study is a prospective real-life cross-sectional study conducted in an apneic adult cohort undergoing at least 3 months of CPAP with unrestricted mask-access (34 different masks, no gender specific mask series). MRSE were assessed by the patient using visual analog scales (VAS). CPAP-non-adherence was defined as a mean CPAP-usage of less than 4 h per day. The primary objective of this ancillary study was to investigate the impact of gender on the prevalence of MRSEs reported by the patient. Secondary analyses assessed the impact of MRSEs on CPAP-usage and CPAP-non-adherence depending on the gender. Results A total of 1484 patients treated for a median duration of 4.4 years (IQ25–75: 2.0–9.7) were included in the cohort, with women accounting for 27.8%. The prevalence of patient-reported mask injury, defined as a VAS score ≥ 5 (p = 0.021), was higher in women than in men (9.6% versus 5.3%). For nasal pillow masks, the median MRSE VAS score for dry mouth was higher in women (p = 0.039). For oronasal masks, the median MRSE VAS score for runny nose was higher in men (p = 0.039). Multivariable regression analyses revealed that, for both women and men, dry mouth was independently and negatively associated with CPAP-usage, and positively associated with CPAP-non-adherence. Conclusion In real-life patients treated with long-term CPAP, there are gender differences in patient reported MRSEs. In the context of personalized medicine, these results suggest that the design of future masks should consider these gender differences if masks specifically for women are developed. However, only dry mouth, a side effect not related to mask design, impacts CPAP-usage and non-adherence. Trial Registration: InterfaceVent is registered with ClinicalTrials.gov (NCT03013283).First registration date is 2016–12-23.

Abstract Fusobacterium necrophorum is a Gram-negative anaerobic bacterium responsible for localized infections of the oropharynx that can evolve into bacteremia and/or septic thrombophlebitis of the jugular vein or peritonsillar vein, called Lemierre’s syndrome. To identify microbial genetic determinants associated with the severity of this life-threatening disease, 70 F. necrophorum strains were collected and grouped into two categories according to the clinical presentation: (i) localized infection, (ii) bacteremia with/without Lemierre’s syndrome. Comparative genomic analyses revealed two clades with distinct genetic content, one clade being significantly enriched with isolates from subjects with bacteremia. To identify genetic determinants contributing to F. necrophorum pathogenicity, genomic islands and virulence factor orthogroups (OVFs) were predicted. The presence/absence profiles of OVFs did not group isolates according to their clinical category, but rather according to their phylogeny. However, a variant of lktA, a key virulence factor, with a frameshift deletion that results in two open reading frames, was associated with bacteremia. Moreover, a genome-wide association study identified three orthogroups associated with bacteremic strains: (i) cas8a1, (ii) a sodium/solute symporter, and (iii) a POP1 domain-containing protein. Further studies must be performed to assess the functional impact of lktA mutation and of these orthogroups on the physiopathological mechanisms of F. necrophorum infections.

Abstract This paper presents a detailed characterization of the positron beam delivered by the Beam Test Facility at Laboratori Nazionali of Frascati to the PADME experiment during Run III, which took place from October to December 2022. It showcases the methodology used to measure the main beam parameters such as the position in space, the absolute momentum scale, the beam energy spread, and its intensity through a combination of data analysis and Monte Carlo simulations. The results achieved include an absolute precision in the momentum of the beam to within ~1–2 MeV/c, a relative beam energy spread below 0.25%, and an absolute precision in the intensity of the beam at the level of 2%.

Scientific collaboration yields many advantages, especially in fields that require interdisciplinary approaches, as it fosters the sharing of knowledge and resources and is essential for the implementation of complex projects. The concept of scientific internationalism emerged around the 1900s, emphasizing that science surpasses national boundaries and promotes global peace and collaboration. International scientific cooperation is halted by geopolitical tensions and conflicts, such as World War II and the Cold War. Nevertheless, many examples show that scientific collaboration can surpass conflicts and bring scientific and society development, such as in the cases of the Tick-borne Encephalitis vaccine, the Apollo-Soyuz test project and more recently the international endeavour for COVID-19 vaccine development. In this contest, UN and WHO have an imporant role to promote peace and scientific cooperation, examplified by the 16th Sustainable Development Goal, to “Promote just, peaceful and inclusive societies”.

Abstract Matching of various chalcogenide films shows the advantage of delivering multilayer heterostructures whose physical properties can be tuned with respect to the ones of the constituent single films. In this work, (Ge–Sb–Te)-based heterostructures were deposited by radio frequency sputtering on Si(100) substrates and annealed up to 400 °C. The as-deposited and annealed samples were studied by means of X-ray fluorescence, X-ray diffraction, scanning transmission electron microscopy, electron energy loss spectroscopy and Raman spectroscopy. The heterostructures, combining thermally stable thin layers (i. e. Ge-rich Ge5.5Sb2Te5, Ge) and films exhibiting fast switching dynamics (i. e. Sb2Te3), show, on the one side, higher crystallization-onset temperatures than the standard Ge2Sb2Te5 alloy and, on the other side, none to minimal Ge-segregation.

Abstract Ion channels are critical in enabling ion movement into and within cells and are important targets for pharmacological interventions in different human diseases. In addition to their ion transport abilities, ion channels interact with signalling and scaffolding proteins, which affects their function, cellular positioning, and links to intracellular signalling pathways. The study of “channelosomes” within cells has the potential to uncover their involvement in human diseases, although this field of research is still emerging. LRRC8A is the gene that encodes a crucial protein involved in the formation of volume-regulated anion channels (VRACs). Some studies suggest that LRRC8A could be a valuable prognostic tool in different types of cancer, serving as a biomarker for predicting patients’ outcomes. LRRC8A expression levels might be linked to tumour progression, metastasis, and treatment response, although its implications in different cancer types can be varied. Here, publicly accessible databases of cancer patients were systematically analysed to determine if a correlation between VRAC channel expression and survival rate exists across distinct cancer types. Moreover, we re-evaluated the impact of LRRC8A on cellular proliferation and migration in colon cancer via HCT116 LRRC8A-KO cells, which is a current topic of debate in the literature. In addition, to investigate the role of LRRC8A in cellular signalling, we conducted biotin proximity-dependent identification (BioID) analysis, revealing a correlation between VRAC channels and cell-cell junctions, mechanisms that govern cellular calcium homeostasis, kinases, and GTPase signalling. Overall, this dataset improves our understanding of LRRC8A/VRAC and explores new research avenues while identifying promising therapeutic targets and promoting inventive methods for disease treatment.

Three machine learning techniques (multilayer perceptron, random forest, and Gaussian process) provide fast surrogate models for lower hybrid current drive (LHCD) simulations. A single GENRAY/CQL3D simulation without radial diffusion of fast electrons requires several minutes of wall-clock time to complete, which is acceptable for many purposes, but too slow for integrated modeling and real-time control applications. More accurate simulations with fast electron diffusion are even slower, requiring multiple hours of run time with parallel processing. The machine learning models use a database of 16,000+ GEN-RAY/CQL3D simulations for training, validation, and testing. Latin hypercube sampling methods implemented in πScope ensure that the database covers the range of 9 input parameters (ne0, Te0, Ip, Bt, R0, n∥︀, Ze f f, Vloop, PLHCD) with sufficient density in all regions of parameter space. The surrogate models reduce the computation time from minutes-hours to ms with high accuracy across the input parameter space. Data-driven surrogate models also allow for solving inverse and "lateral"problems. A surrogate model for the inverse problem maps from a desired current drive or power deposition profile to a set of input parameters that would result in such a profile, while a surrogate model for the lateral problem maps from a measured experimental quantity such as hard x-ray emission to a current drive or power deposition profile. The πScope database creation workflow is flexible and applicable to other RF simulation codes such as TORIC.

Objetivos: Os objetivos deste trabalho foram estabelecer um estoque de segurança de concentrado de hemácias, ajustado com base no histórico de demanda para três agências transfusionais atendidas pelo Hemonúcleo de Apucarana: Honpar, Hospital da Providência e Labora e também obter a redução de descarte por vencimento de hemácias nestas agências. Material e métodos: Para estabelecer o estoque de segurança, foram coletados dados de 36 meses de cada agência, abrangendo: distribuição, descarte e estoque de hemácias. Os registros de distribuição foram obtidos do sistema informatizado SBSWeb, sendo os dados categorizados por tipo sangupineo e fator Rh. As informações sobre descarte foram consultadas por no sistema novo SHTweb. Já os dados de estoque no primeiro dia do mês, foram fornecidos pela agência ao hemonúcleo. Os dados foram organizados em uma planilha elaborada na suíte de escritórios de código aberto LibreOffice, versão 24.2.1, para análise estatística. Dessa forma, foram obtidos os quantitativos de distribuição, o percentual de descarte e o percentual de atendimento. A partir da planilha, foram calculadas as médias de distribuição por ABO/RH, além da média percentual de descarte por vencimento e do percentual de não atendimento à demanda solicitada. Esses cálculos foram realizados separadamente para cada agência. Resultados: Conseguiu-se chegar em um estoque de segurança de concentrado de hemácias para cada agência, considerando ABO/RH, facilitando a programação semanal de distribuição de hemácias para estas agências, bem como para facilitar o quantitativo a ser pedido pelas agências ao hemonúcleo. O descarte geral por vencimento das hemácias, sem considerar ABO/RH, apresentou uma considerável redução, principalmente na agência Honpar, responsável por cerca de 66 % da distribuição de hemácias do Hemonúcleo de Apucarana. Antes da implantação destes indicadores, o índice mensal de descarte chegava até 6%, ou seja, até 33 bolsas de hemácias, correspondendo a média de um dia de coleta do Hemonúcleo de Apucarana. Atualmente esta mesma agência, já houve meses com 0 % de descarte por vencimento, com a média anual atual de 1%. A agência do Hospital da Providência, responsável por cerca de 29 % da distribuição de hemácias, no início apresentava média anual de descarte por vencimento de 0,8% e atualmente sua média é 0,41%. Já a agência do Labora, responsável por cerca de 5% da distribuição de hemácias no início apresentava média anual de descarte por vencimento de 2% e atualmente sua média é 1,24 %. Discussão: Considerando que 33% das hemácias distribuídas pelo hemonúcleo citado são de origem da hemorrede, não sendo portanto a unidade autossuficiente e considerando que duas destas agências transfusionais não ficam localizadas no mesmo município do hemonúcleo, o estoque de segurança propicia uma melhor logística tanto para o hemonúcleo quanto para as agências. Também pode-se observar a considerável diminuição do descarte de hemácias, em todas as agências transfusionais atendidas. Estes resultados satisfatórios, com real possibilidade de implantação em outras unidades, por ser um método simples, foram possíveis pois houve parceria, colaboração, treinamento e comprometimento dos responsáveis pelas agências transfusionais, que se empenharam e entenderam a importância da gestão eficaz de estoque. Conclusão: Com a implantação do estoque de segurança e a redução de descarte de hemácias, conclui-se que os objetivos do trabalho foram atingidos, aprimorando assim o gerenciamento de estoque tanto do hemonúcleo de Apucarana quanto das agências transfusionais. Este bom gerenciamento de ambas as partes, reflete em economias no ciclo do sangue, promovendo a cada dia o uso racional de hemocomponentes.

A new fossil bird is described from the Upper Lumbrera Formation of Northwestern Argentina. Lumbrerornis rougieri gen. et sp. nov. is represented by three-dimensionally preserved elements of the hindlimb of a single individual. Morphological comparative studies and particular characters of the tibiotarsus suggest that the new species might be related to the extinct clades Palaeotididae and Geranoididae of the Northern Hemisphere, which were recently hypothesized to be Paleogene palaeognathous birds. However, the fragmentary preservation of the new fossil prevents a confident systematic position. The Upper Lumbrera Formation is a widely recognized fossiliferous unit with a very rich fauna of mammals and other vertebrates (e.g., fishes, crocodilians, turtles, snakes). This is the first record of a three-dimensionally preserved fossil bird from the Eocene of northwestern Argentina and thus provides fresh evidence of the Eocene faunas from the area and improves our understanding of the poorly known early Paleogene avifaunas from South America.

ABSTRACT In humans, sterile alpha motif (SAM) domain- and histidine–aspartic acid (HD) domain-containing protein 1 (SAMHD1) is a dNTPase enzyme that prevents HIV-1 infection in non-cycling cells, such as differentiated THP-1 cells and human primary macrophages. Although phosphorylation of threonine 592 (T592) in SAMHD1 is recognized as the primary regulator of the ability to prevent HIV-1 infection, the contributions of SAMHD1 acetylation to this ability remain unknown. Mass spectrometry analysis of SAMHD1 proteins derived from cycling and non-cycling THP-1 cells, primary cycling B cells, and primary macrophages revealed that SAMHD1 is preferentially acetylated at lysine residues 354, 494, and 580 (K354, K494, and K580). In non-cycling cells, SAMHD1 is preferentially acetylated at K580, suggesting that this post-translational modification may contribute to the ability of SAMHD1 to block HIV-1 infection. Consistent with this finding, we found that mutations in K580 disrupted the ability of SAMHD1 to block HIV-1 infection without affecting the ability of SAMHD1 to deplete cellular dNTP levels. Gene editing of SAMHD1 in macrophage-like cells revealed that an intact K580 is required for HIV-1 restriction. This finding suggests that K580 acetylation in SAMHD1 is essential for blocking HIV-1 infection. More importantly, we found that a larger proportion of SAMHD1 featuring K580 acetylation could be detected in human primary macrophages when compared to human primary monocytes. In agreement, we found that SAMHD1 is acetylated during the monocyte-to-macrophage differentiation process. This finding agrees with the idea that the blockade of HIV-1 infection in macrophages requires SAMHD1 acetylation.IMPORTANCEThe natural inhibitor of HIV-1, sterile alpha motif (SAM) domain- and histidine–aspartic acid (HD) domain-containing protein 1 (SAMHD1), plays a pivotal role in preventing HIV-1 infection of macrophages and dendritic cells, which are vital components of the immune system. This study unveils that SAMHD1 undergoes post-translational modifications, specifically acetylation at lysines 354, 494, and 580. Our research underscores the significance of these modifications, demonstrating that acetylation at residue K580 is indispensable for SAMHD1's efficacy in blocking HIV-1 infection. Notably, K580 is found in a critical regulatory domain of SAMHD1, highlighting acetylation as a novel layer of SAMHD1 regulation for HIV-1 restriction in humans. A comprehensive understanding of the regulation mechanisms governing this anti-HIV-1 protein is crucial for leveraging nature's defense mechanisms against HIV-1 and could pave the way for innovative therapeutic strategies.

Esta pesquisa é de natureza qualitativa, especificamente um protocolo de revisão de escopo. Objetivo: mapear as intervenções mais eficazes para o tratamento do Transtorno do Luto Prolongado (TLP) em adultos enlutados por suicídio. O estudo busca identificar e avaliar as diversas abordagens terapêuticas, destacando aquelas com maior eficácia comprovada, bem como as lacunas existentes na literatura atual sobre a temática. Método: trata-se de um protocolo de revisão de escopo. Foi utilizada uma base de informação, com o emprego dos descritores em saúde. O processo de busca, identificação e avaliação de artigos foi norteado pelo protocolo PRISMA-ScR, buscando responder a seguinte questão norteadora: Quais são as intervenções baseadas em evidências mais eficazes para tratar o Transtorno do Luto Prolongado em adultos enlutados por suicídio? Foram incluídos artigos publicados em português e inglês, de domínio público e envolvendo o Transtorno do Luto Prolongado e luto por suicídio. Foram encontrados 17 estudos no total e após todas as etapas da pesquisa, restou apenas uma pesquisa como amostra final. Tal pesquisa é um ensaio clínico randomizado para verificar a eficácia da internet-based cognitive-behavioural grief therapy (ICBGT) em enlutados por suicídio. Os resultados foram analisados e discutidos a partir da análise de conteúdo de Bardin (2015). Por fim, em síntese, a ICBGT se mostrou adequada e eficaz para o tratamento do TLP, assim como para sintomas gerais do processo de luto e sintomas depressivos.