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A numerical method based on the equivalence principle and the dyadic Green's function is presented. It can be used to compute the spherical-multipole amplitudes with respect to an origin in a subdomain 2 due to sources in a distinct subdomain 1. As an example, consider that subdomain 1 contains a horn antenna that is solved numerically using a commercial full-wave simulator. The radiated field serves as the incident field for subdomain 2 which contains the scatterer, in our example a lossless dielectric sphere. The proposed method is based on the equivalence currents on a Huygens surface enclosing the antenna and uses the free-space dyadic Green's function to compute the electric and magnetic fields on a sphere enclosing the scatterer. From this electromagnetic field on the spherical surface, the spherical-multipole amplitudes of the incident field with respect to the center of the sphere enclosing the scatterer are obtained numerically and can be further processed. The results obtained with this method are compared to the results solely computed by the numerical full-wave simulator.

Inductive and capacitive end couplings in the design of combline microwave filters are compared. For instance, a combline microwave cavity filter for the E1 Galileo band (1559–1591 MHz, 2 % fractional bandwidth) is considered. The inductive end coupling is composed of an L-shaped pin in galvanic contact with the end resonator, while the capacitive end coupling is realized by a straight pin parallel to the end resonator's axis. Although both end couplings can realize the desired external quality factor, the capacitive end coupling is easier to manufacture, while the inductive end coupling is less sensitive to the design parameter. An excellent agreement between synthesized (5th-order Chebyshev mask with 0.05 dB ripple) and measured responses is observed for the realized prototype of the filter. The insertion losses at the center frequency are 1.72 and 1.53 dB for the inductive and capacitive end couplings, respectively. The spurious-free ranges are up to 8.23 and 8.92 GHz for inductive and capacitive end couplings, respectively.

Background and Aims: EndoZip TM is a fully automated operator independent robotic endoscopic suturing device developed for gastric volume reduction and treatment of obesity. We aim to assess the efficacy and safety of EndoZip TM to treat patients with obesity., Methods: We conducted a prospective multicenter study and recruited 45 patients with a BMI of 30-40 kg/m 2 . Our primary outcome was to assess the percentage total body weight loss (%TBWL) at 12 months. The secondary outcome was to determine the safety and change in quality of life using the IWQOL questionnaire at 1 year., Results: The mean ±SD age was 44.2 ± 8.8 years, and the mean ±SD BMI was 34.5 ± 2.9 Kg/m 2 . A majority (90.7%) were female. The procedure was technically successful in all patients (100%). A median of 4 (range, 3-5) full-thickness sutures were placed, and the mean procedure time was 30.8 ± 15.8 minutes. At 12-months, the mean %TBWL was 13.21 (95% CI: 10.11- 16.31%) and 76.6% of patients achieved >5% TBWL. We observed significant reduction in waist circumference, HbA1C, and ALT levels at 12 months (p<0.001). We found a significant improvement in quality of life at 12 months (51.28 ±16.22 vs. 35.8±11.9, p<0.001). Serious adverse events occurred in 2 patients (4.4%). The average length of stay was 1 day., Conclusion: Our first-in-human study showed that the Endozip TM device is safe and effective in treating obesity. The weight loss led to comorbid changes and improvement in quality of life (Clinicaltrials.gov, NCT04773795)., (Copyright © 2024 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)

Background: Feline Bowenoid in situ carcinoma (BISC) is frequently associated with Felis catus papillomavirus-2 (FcaPV-2). Although surgical excision of BISC is expected to be curative, recurrent lesions are reported and it is not known whether it is a consequence of incomplete surgery or residual viral load., Objectives: To combine colorimetric in situ hybridisation (CISH) and quantitative (q)PCR for the detection of viral DNA, and to correlate the clinical outcome of cats with BISC in which FcaPV-2 DNA is detected at surgical margins., Animals: Twenty-seven cats with a histopathological diagnosis of BISC., Materials and Methods: Sections including core and margins of the lesions were used for histopathological evaluation, qPCR and CISH. After surgical removal of the lesion, clinical follow-up data were recorded for 6 months., Results: Six of 12 cases in which all four histological margins were evaluable were used to correlate the infection status at the margins with the follow-up data. Four showed margin positivity, of which half relapsed as expected and half cured; two cases were negative, of which one cured as expected while the other relapsed. Fifteen cases where only three, two or one of the histological margins were evaluable, were considered to adequately correlate the status of infection with the follow-up data if CISH was positive. Follow-up data were available for three with positive margins: one relapsed while the other two were cured., Conclusions and Clinical Relevance: Wide clinical surgical margins are always recommended for neoplastic conditions, yet there was no evidence that CISH margin examination would be beneficial in predicting recurrence in this viral-induced lesion., (© 2024 The Author(s). Veterinary Dermatology published by John Wiley & Sons Ltd on behalf of ESVD and ACVD.)

Water is known to play an important role in collagen self-assembly, but it is still largely unclear how water-collagen interactions influence the assembly process and determine the fibril network properties. Here, we use the H[Formula: see text]O/D[Formula: see text]O isotope effect on the hydrogen-bond strength in water to investigate the role of hydration in collagen self-assembly. We dissolve collagen in H[Formula: see text]O and D[Formula: see text]O and compare the growth kinetics and the structure of the collagen assemblies formed in these water isotopomers. Surprisingly, collagen assembly occurs ten times faster in D[Formula: see text]O than in H[Formula: see text]O, and collagen in D[Formula: see text]O self-assembles into much thinner fibrils, that form a more inhomogeneous and softer network, with a fourfold reduction in elastic modulus when compared to H[Formula: see text]O. Combining spectroscopic measurements with atomistic simulations, we show that collagen in D[Formula: see text]O is less hydrated than in H[Formula: see text]O. This partial dehydration lowers the enthalpic penalty for water removal and reorganization at the collagen-water interface, increasing the self-assembly rate and the number of nucleation centers, leading to thinner fibrils and a softer network. Coarse-grained simulations show that the acceleration in the initial nucleation rate can be reproduced by the enhancement of electrostatic interactions. These results show that water acts as a mediator between collagen monomers, by modulating their interactions so as to optimize the assembly process and, thus, the final network properties. We believe that isotopically modulating the hydration of proteins can be a valuable method to investigate the role of water in protein structural dynamics and protein self-assembly., Competing Interests: Competing interests statement:The authors declare no competing interest.

Purpose: Obesity and pregnancy are strictly related: on the one hand, obesity-one of the most common comorbidities in women of reproductive age-contributes to infertility and obesity-related pregnancy complications, whereas pregnancy is a condition in which, physiologically, the pregnant woman undergoes weight gain. Endoscopic sleeve gastroplasty (ESG) may be used for the treatment of obesity in women of childbearing age., Materials and Methods: A retrospective analysis was conducted to evaluate weight trajectories, the evolution of obesity-related comorbidities, and lifestyle modification in women who became pregnant after ESG. A comparison was made between childbearing-age women who became pregnant after ESG and non-pregnant women., Results: A total of 150 childbearing-age women underwent ESG at a large tertiary medical center. Of these, 11 patients (33.4 ± 6.2 years) became pregnant after the procedure, following a mean time interval of 5.5 ± 3.9 months. Three women (two affected by polycystic ovary syndrome) reported difficulty getting pregnant before undergoing ESG. The mean preconception BMI was 31.9±4.0 kg/m 2 (-7.24 ± 4.0 kg/m 2 after ESG). Total body weight loss (TBWL, %) was 18.08 ± 8.00, 11.00 ± 11.08, and 12.08 ± 8.49, at the beginning of pregnancy, at the delivery, and at the first follow-up (19.6 ± 7.8 months after ESG). TBWL of at least 5% was achieved before pregnancy in all patients (73% reached a TBWL ≥ 10%). No significant differences in weight loss and QoL were found between the pregnancy and non-pregnancy groups up to 24 months after ESG., Conclusions: Endoscopic sleeve gastroplasty allows for adequate weight loss before and after pregnancy in patients with obesity., (© 2023. The Author(s).)

In recent decades, the request for more efficient performances in the aeronautical sector moved researchers to pay particular attention to all the related mechanisms and systems, especially with respect to the saving of power. In this context, the bearing modeling and design, as well as gear coupling, play a fundamental role. Moreover, the need for low power losses also concerns the study and the implementation of advanced lubrication systems, especially for high peripheral speed. With the previous aims, this paper presents a new validated model for toothed gears, added to a bearing model; with the link of these different submodels, the whole model describes the system's dynamic behavior, taking into account the different kinds of power losses (windage losses, fluid dynamic losses, etc.) generated by the mechanical system parts (especially rolling bearings and gears). As the bearing model, the proposed model is characterized by high numerical efficiency and allows the investigation of different rolling bearings and gears with different lubrication conditions and frictions. A comparison between the experimental and simulated results is also presented in this paper. The analysis of the results is encouraging and shows a good agreement between experiments and model simulations, with particular attention to the power losses in the bearing and gears.

Background: Both weight regain and dumping syndrome (DS) after Roux-en-Y gastric bypass (RYGB) have been related to the dilation of gastro-jejunal anastomosis. The aim of this study is to assess the safety and long-term efficacy of endoscopic transoral outlet reduction (TORe) for DS and/or weight regain after RYBG., Materials and Methods: A retrospective analysis was performed on a prospective database. Sigstad's score, early and late Arts Dumping Score (ADS) questionnaires, absolute weight loss (AWL), percentage of total body weight loss (%TBWL), and percentage of excess weight loss (%EWL) were assessed at baseline and at 6, 12, and 24 months after TORe., Results: Eighty-seven patients (median age 46 years, 79% female) underwent TORe. The median baseline BMI was 36.2 kg/m 2 . Out of 87 patients, 58 were classified as "dumpers" due to Sigstad's score ≥ 7. The resolution rate of DS (Sigstad's score < 7) was 68.9%, 66.7%, and 57.2% at 6, 12, and 24 months after TORe, respectively. A significant decrease in Sigstad's score as well as in early and late ADS questionnaires was observed (p < 0.001). The median Sigstad's score dropped from 15 (11-8.5) pre-operatively to 2 (0-12) at 24 months. The %TBWL was 10.5%, 9.9%, and 8.1% at 6, 12, and 24 months, respectively. Further, "dumpers" with resolution of DS showed better weight loss results compared with those with persistent DS (p < 0.001). The only adverse event observed was a perigastric fluid collection successfully managed conservatively., Conclusion: TORe is a minimally invasive treatment for DS and/or weight regain after RYGB, with evidence of long-term efficacy., (© 2023. The Author(s).)

Purpose: With the aging of the population and the epidemic spread of obesity, the frequency of older individuals with obesity is steadily growing. To date, no data evaluating the use of endoscopic sleeve gastroplasty (ESG) in the elderly have been published. In this case series, we evaluate the short- and medium-term outcomes of ESG in patients with obesity aged 65 years and older., Materials and Methods: A retrospective analysis was done on a prospective database; patients aged 65 years and older were included in our analysis. EWL%, TBWL%, the Bariatric Analysis and Reporting Outcome System (BAROS) questionnaire, and the presence of comorbidities were assessed., Results: Eighteen patients aged 65 years and older underwent ESG between November 2017 and July 2021. The median age was 67 years and the mean baseline BMI was 41.2 kg/m 2 . After ESG, the median TBWL% was 15.1%, 15.5%, and 15.5% at 6, 12, and 24 months, while the median %EWL was 39%, 37%, and 41% at 6, 12, and 24 months, respectively. The median BAROS score was 3.0, 3.4, and 2.5 at 6, 12, and 24 months, respectively. Six out of twelve patients with hypertension and 3/4 diabetic patients reduced or removed their medications within 12 months following ESG. Two out of six patients with OSA stopped therapy with CPAP. No adverse events were recorded., Conclusion: According to our experience, ESG is a promising therapeutic option for elder individuals with obesity who fail non-invasive methods, and who refuse or are deemed not suitable for bariatric surgery because of age and comorbidities., (© 2022. The Author(s).)

Background: Osteoarthritis (OA) is a joint disease involving articular cartilage degeneration causing patients pain, joint stiffness, physical disability, and significantly reducing their quality of life (QoL). Purpose: The aim of this study was to assess whether the daily consumption of a gastroresistant food supplement formulation containing a combination of B oswellia serrata and bromelain could improve the QoL of patients suffering from various forms of OA. Materials and Methods: Forty-nine patients were enrolled in this pilot study conducted from June 2015 to October 2016. Patients took a Boswellia- and bromelain-based supplement for a period between 1 and 6 months. At baseline and at the end of the study, patients completed a self-assessment QoL questionnaire regarding their independence in performing daily activities. QoL scores were compared between baseline and follow-up by means of the Wilcoxon signed-rank test in all patients and in the subgroups of patients with knee, hip, or generalized OA. Results: Forty-nine patients, 6 men and 43 women, aged between 23 and 92 years, (mean age 63.24) participated in the study. At follow-up (3.0 ± 0.7 months), a significant improvement was observed for 7 of 10 QoL questions and, overall, for the total QoL score. The most significant improvements were observed in the joints that were more strongly affected at baseline. A similar trend was observed when separately considering patients with knee, hip, or generalized OA. No patients experienced adverse events and no drug interactions were reported. Conclusions: From this pilot study, it emerges that the use of the gastroresistant formulation containing the combination of Boswellia and bromelain supplements can represent a valuable nonpharmacological tool for improving the QoL of patients suffering from different forms of OA. Further studies should be conducted to confirm this first evidence.

Obstructive sleep apnea (OSA) has a high prevalence in patients with obesity. Only patients with clinical symptoms of OSA are admitted to polysomnography; however, many patients with OSA are asymptomatic. We aimed to create and validate a population-based risk score that predicts the severity of OSA in patients with obesity.We here report the cross-sectional analysis at baseline of an ongoing study investigating the long-term effect of bariatric surgery on OSA. One-hundred sixty-one patients of the Obesity Center of the Catholic University Hospital in Rome, Italy were included in the study. The patients underwent overnight cardiorespiratory monitoring, blood chemistry analyses, hepatic ultrasound, and anthropometric measurements. The patients were divided into 2 groups according OSA severity assessed by the apnea-hypopnea index (AHI): AHI < 15 = no or mild and AHI ≥ 15 moderate to severe OSA. A statistical prediction model was created and validated. C statistics was used to evaluate the discrimination performance of the model.The prevalence of OSA was 96.3% with 74.5% of the subjects having moderate/severe OSA. Sex, body mass index, diabetes, and age were included in the final prediction model that had excellent discrimination ability (C statistics equals to 83%). An OSA risk chart score for clinical use was created.Patients with severe obesity are at a very high risk for moderate or severe OSA in particular if they are men, older, more obese, and/or with type 2 diabetes. The OSA risk chart can be useful for general practitioners and patients as well as for bariatric surgeons to select patients with high risk of moderate to severe OSA for further polysomnography.

Local modulation of temperature has emerged as a new mechanism for regulation of molecular transport through nanopores. Predicting the effect of such modulations on nanopore transport requires simulation protocols capable of reproducing non-uniform temperature gradients observed in experiment. Conventional molecular dynamics (MD) method typically employs a single thermostat for maintaining a uniform distribution of temperature in the entire simulation domain, and, therefore, can not model local temperature variations. In this article, we describe a set of simulation protocols that enable modeling of nanopore systems featuring non-uniform distributions of temperature. First, we describe a method to impose a temperature gradient in all-atom MD simulations based on a boundary-driven non-equilibrium MD protocol. Then, we use this method to study the effect of temperature gradient on the distribution of ions in bulk solution (the thermophoretic effect). We show that DNA nucleotides exhibit differential response to the same temperature gradient. Next, we describe a method to directly compute the effective force of a thermal gradient on a prototypical biomolecule-a fragment of double-stranded DNA. Following that, we demonstrate an all-atom MD protocol for modeling thermophoretic effects in solid-state nanopores. We show that local heating of a nanopore volume can be used to regulate the nanopore ionic current. Finally, we show how continuum calculations can be coupled to a coarse-grained model of DNA to study the effect of local temperature modulation on electrophoretic motion of DNA through plasmonic nanopores. The computational methods described in this article are expected to find applications in rational design of temperature-responsive nanopore systems.

The clinicopathological and immunohistochemical findings of a primary feline mammary tumour with features similar to human and canine primary inflammatory carcinoma are described for the first time. The cat presented to the clinic for the rapid onset of oedema, severe erythema, local pain and warmth of the inguinal region, with a pustular-to-nodular cutaneous lesion in association with an ill-defined underlying mass. An epithelial malignant tumour was diagnosed by cytological investigation. Necropsy revealed a thickening of the skin with oedema of the subcutis in the right inguinal area, and regional and distant metastases. Histology showed an unencapsulated tubulopapillary proliferation of malignant epithelial cells, with a massive embolisation in the dermal lymphatics and a mild inflammatory infiltrate. Through immunohistochemistry, the tumour was found to be oestrogen (ER)-alpha-, androgen (AR)- and progesterone (PR)-negative; neoplastic cells were ER-alpha, AR-negative and focally PR-positive. An irregular, mild and focal HER-2 immunoreactivity was present (score +1, non-HER-2 overexpressing). The neoplastic cells were cyclo-oxygenase-2 and vascular endothelial growth factor positive.

Adherence to vaccination campaigns can be negatively influenced by Web presence of unreliable information. Aim of study is qualitative and quantitative evaluation of Italian WebPages contents about vaccinations to address prevention strategies in countries that, like Italy, wouldn't like vaccination to be mandatory any longer In August 2011 two researchers conducted a Systematic Review in Italian WebPages about vaccination risks. First 100 results of 9 common search engines have been combined; pro and against pages were compared (CHI2, p <0,05). 144 WebPages were analysed: 67% of them, often on top positions, was against vaccinations and 24% of them was written by Medical Doctors. All institutional pages (12%) were pro vaccinations but they resulted in less important positions. Against WebPages were different from pro ones in terms of use of emotional images, personal negative experiences, advertising purposes (books or alternative medicine products). Main criticism was: inefficacy, low safety profile and stakeholder's interests. This study would like to represent a useful tool for parents and Medical Doctors, especially because many of them are progressively more sceptical about vaccination practises. The great number of anti-vaccination movements on Italian Web should improve public health strategies in terms of "Evidence-Based prevention".

The aim of this study was to evaluate the efficacy of a mobile laminar airflow (LAF) unit in reducing bacterial contamination at the surgical area in an operating theatre supplied with turbulent air ventilation. Bacterial sedimentation was evaluated during 76 clean urological laparotomies; in 34 of these, a mobile LAF unit was added. During each operation, settle plates were placed at four points in the operating theatre (one at the patient area and three at the perimeter), a nitrocellulose membrane was placed on the instrument table and an additional membrane near the wound. During four operations, particle counting was performed to detect particles > or =0.5 microm. Mean bacterial sedimentation on the nitrocellulose membrane on the instrument table was 2730 cfu/m(2)/h under standard ventilation conditions, whereas it decreased significantly to a mean of 305 cfu/m(2)/h when the LAF unit was used, i.e. within the suggested limit for ultraclean operating theatres (P=0.0001). The membrane near the wound showed a bacterial sedimentation of 4031 cfu/m(2)/h without the LAF unit and 1608 cfu/m(2)/h with the unit (P=0.0001). Particle counts also showed a reduction when the LAF unit was used. No significant difference was found at the four points in the operating theatre between samplings performed with, and without, the LAF unit. Use of a mobile LAF unit with turbulent air ventilation can reduce bacterial contamination at the surgical area in high-risk operations (e.g. prosthesis implant).

The metabolic syndrome represents a cluster of several risk factors for atherosclerosis that increases the risk of future cardiovascular events. In this study, we evaluated whether oxidative stress is increased in subjects with the metabolic syndrome. We studied 100 subjects (50 men and 50 women) with the metabolic syndrome, as defined by the Adult Treatment Panel III, and 50 (25 men and 25 women) matched subjects without the syndrome. Insulin sensitivity was assessed with the homeostasis model assessment (HOMA) methods; endothelium-dependent flow-mediated vasodilation (FMD) was evaluated in the right brachial artery with a high-resolution ultrasound machine; oxidative stress was assessed by measuring the circulating levels of nitrotyrosine (NT), considered a good marker for the formation of endogenous peroxynitrite. Compared with control subjects, patients with the metabolic syndrome had greater waist circumference, higher HOMA and systolic pressure values, higher triglyceride and lower HDL-cholesterol levels. NT levels were higher (0.44+/-0.12 micromol/l, mean+/-SD) while FMD was lower [7.3 (4.4/9.6), median and interquartile range] in subjects with the metabolic syndrome as compared with control subjects [0.27+/-0.08 and 11.8 (8.6/14.9), respectively, p<0.001]. There was an increase in NT levels and HOMA score as the number of components of the metabolic syndrome increased. NT levels were associated with waist circumference (r=0.38, p=0.01), triglycerides (r=0.32, p<0.02), systolic blood pressure (r=0.21, p<0.05) and fasting glucose (r=0.24, p<0.05). The oxidative stress that accompanies the metabolic syndrome is associated with both insulin resistance and endothelial dysfunction, providing a connection which is highly deleterious for vascular functions.

Context: Cell-derived microparticles are supposed to be involved in atherogenesis., Objective: This study aimed to evaluate circulating microparticles in obese women and their relation with anthropometric measures and endothelial dysfunction., Design, Setting, and Participants: Forty-one obese [body mass index (BMI) > 30 kg/m(2)] women and 40 normal weight (BMI < 25 kg/m(2)) age-matched women were studied. Flow cytometry was used to assess microparticles by quantification of circulating endothelial microparticles (EMP, CD31+/CD42b-) and platelet microparticles (PMP, CD31+/CD42b+) in peripheral blood; endothelium-dependent flow-mediated vasodilation (FMD) was evaluated in the right brachial artery after reactive hyperemia., Results: Compared with lean women, obese women presented significantly higher numbers of EMP and PMP, and reduced FMD. BMI did not correlate with either EMP (r = 0.02, P = 0.9) or PMP (r = -0.07, P = 0.645), whereas waist-to-hip ratio (WHR) showed significant correlation with both microparticles (r = 0.699, P < 0.001; r = 0.373, P = 0.016, respectively). Both EMP and PMP counts positively correlated with impairment of FMD in obese women. Multivariate analysis correcting for age, anthropometric indices, lipid parameters, and PMP identified EMP as the only independent predictor for impaired endothelial-dependent vasodilation (P = 0.003)., Conclusions: EMP are elevated in obese women and independently involved in the pathogenesis of endothelial dysfunction. WHR is the anthropometric measure more closely related to EMP and endothelial dysfunction.