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The ability to effectively grasp and hold objects with different shapes is enabled by the hand’s capacity to preshape its fingers and adapt them to the object’s shape (i.e. preshaping and shape-adaptive behaviour). This work analyzes the 3D-printed prosthetic hand models developed so far and aims to advance the design for additive manufacturing of linkage-driven prosthetic fingers provided with both preshaping and shape-adaptivity. After reviewing the main possibilities enabled by additive manufacturing, the work proposes a method based on multi-material printing to develop mechanically compliant elements that can be effectively exploited in linkage-driven prosthetic hands with preshaping and shape-adaptive behaviour. The proposed method is tested on a specific link and validated using an Instron Universal Testing machine to experimentally identify the best manufacturing parameters. The results achieved, although specific to a particular link, support the feasibility of the proposed approach. This paved the way for the development of reliable and affordable 3D-printed linkage-driven prosthetic hands provided with preshaping and shape-adaptive behaviour.

Our study investigated how different levels of antioxidants and contrasting proportions of native legumes in the diet affect lamb meat quality. Twenty-four male Texel lambs were randomly assigned to three groups: two groups on a natural pasture in southern Brazil (Pampa Biome), each at a different proportion of legumes: Low-legume (LL, 4.37%) and High-legume (HL, 14.01%); the other group was stall-fed (Control) to achieve the same growth rates as the grazing groups. Cold carcass yield from the Control lambs was higher than HL. The meat from pasture-fed animals had a higher deposition of muscle α-tocopherol and lower lipid oxidation (TBARS values) after 9 days of storage. LL lambs had higher subcutaneous fat thickness, which promoted better sensory quality of the meat, as assessed by a trained panel. Pasture-based diets enhanced odd- and branched-chain fatty acids (OBCFAs), trans vaccenic acid, and total conjugated linoleic acids (CLAs), while decreasing elaidic acid. Despite the lower ∆9-desaturase activity, the higher proportion of Desmodium incanum (condensed tannin-rich native legume) in the HL diet did not impact meat nutritional quality. Finishing lambs on the Pampa Biome grasslands is an option for improving the oxidative stability and beneficial fatty acid content of lamb meat, which improves product quality and human consumer health.

RESUMO Os indivíduos tomam decisões a todo momento, de caráter simples ou complexo, de forma rápida ou demorada, da pequena ou grande disponibilidade de informações, de natureza única ou constante, entre outros aspectos. Buscando compreender a lógica de desenvolvimento do processo de decisão das pessoas, diversos modelos foram propostos por estudiosos. O presente estudo objetiva realizar a tradução, adaptação transcultural e validação para o contexto brasileiro do Inventário Geral de Estilos de Tomada de Decisão - GDMS. Para tanto, o instrumento passou por seis etapas de tradução e adaptação e, em seguida, após a realização do pré-teste, a versão final do instrumento foi aplicada em um estudo piloto com uma amostra de 250 indivíduos. A partir dos dados encontrados, procedeu-se à análise fatorial exploratória, visando validar a versão final do questionário. Por fim, concluiu-se que o modelo proposto neste estudo se demonstrou adequado à investigação do construto estilos de tomada de decisão individual, apresentando validade e índices de confiabilidade apropriados. A referida escala pode ser ainda utilizada em novas pesquisas na área de Administração e afins, ampliando o conhecimento sobre o tema.

Abstract This study tested the hypothesis that bowel preparation with mannitol should not affect the colonic concentration of H2 and CH4. Therefore, the SATISFACTION study, an international, multicenter, randomized, parallel‐group phase II–III study investigated this issue. The phase II dose‐finding part of the study evaluated H2, CH4, and O2 concentrations in 179 patients randomized to treatment with 50 g, 100 g, or 150 g mannitol. Phase III of the study compared the presence of intestinal gases in 680 patients randomized (1:1) to receive mannitol 100 g in single dose or a standard split‐dose 2 L polyethylene glycol (PEG)‐Asc preparation (2 L PEG‐Asc). Phase II results showed that mannitol did not influence the concentration of intestinal gases. During phase III, no patient in either group had H2 or CH4 concentrations above the critical thresholds. In patients with H2 and/or CH4 levels above detectable concentrations, the mean values were below the risk thresholds by at least one order of magnitude. The results also highlighted the effectiveness of standard washing and insufflation maneuvers in removing residual intestinal gases. In conclusion, bowel cleansing with mannitol was safe as the concentrations of H2 and CH4 were the same as those found in patients prepared with 2 L PEG‐Asc. In both groups, the concentrations of gases were influenced more by the degree of cleansing achieved and the insufflation and washing maneuvers performed than by the preparation used for bowel cleansing. The trial protocol was registered with ClinicalTrials.gov (https://clinicaltrials.gov/ct2/show/NCT04759885) and with EudraCT (eudract_number: 2019‐002856‐18).

ObjectivesURB937, a peripheral fatty acid amide hydrolase (FAAH) inhibitor, exerts profound analgesic effects in animal models. We examined, in rats, (1) the pharmacokinetic profile of oral URB937; (2) the compound's ability to elevate levels of the representative FAAH substrate, oleoylethanolamide (OEA); and (3) the compound's tolerability after oral administration.MethodsWe developed a liquid chromatography/tandem mass spectrometry (LC/MS-MS) method to measure URB937 and used a pre-existing LC/MS-MS assay to quantify OEA. FAAH activity was measured using a radioactive substrate. The tolerability of single or repeated (once daily for 2 weeks) oral administration of supramaximal doses of URB937 (100, 300, 1000 mg/kg) was assessed by monitoring food intake, water intake and body weight, followed by post-mortem evaluation of organ structure.Key findingsURB937 was orally available in male rats (F = 36%), but remained undetectable in brain when administered at doses that maximally inhibit FAAH activity and elevate OEA in plasma and liver. Acute and subchronic treatment with high doses of URB937 was well-tolerated and resulted in FAAH inhibition in brain.ConclusionsPain remains a major unmet medical need. The favourable pharmacokinetic and pharmacodynamic properties of URB937, along with its tolerability, encourage further development studies on this compound.

Abstract This study aimed to define the pharmacokinetics (PKs) of oral mannitol used as an osmotic laxative for bowel preparation for colonoscopy. The PKs of oral mannitol was evaluated in a substudy as part of a phase II dose‐finding, international, multicenter, randomized, parallel‐group, endoscopist‐blinded study. Patients were randomly assigned to take 50, 100, or 150 g mannitol. Venous blood samples were drawn at baseline (T0), 1 h (T1), 2 h (T2), 4 h (T4), and 8 h (T8) after completion of mannitol self‐administration. The mean mannitol plasma concentrations (mg/ml) were dose‐dependent with a consistent difference among doses. The mean maximum concentration (Cmax) ± SD was 0.63 ± 0.15, 1.02 ± 0.28, and 1.36 ± 0.39 mg/ml, in the three dosage groups, respectively. The mean area under the curve from zero to infinity (AUC0−∞) was 2.667 ± 0.668, 4.992 ± 1.706, and 7.403 ± 3.472 mg/ml*h in the 50, 100, and 150 g mannitol dose groups, respectively. Bioavailability was similar in the three dose groups and was just over 20% (0.243 ± 0.073, 0.209 ± 0.081, and 0.228 ± 0.093 in the 50, 100, and 150 g mannitol dose groups, respectively). The present study showed that the bioavailability of oral mannitol is just over 20% and is similar for the three tested doses (50, 100, and 150 g). The linear increase in Cmax, AUC0−t8, and AUC0−∞ must be considered when choosing the oral mannitol dose for bowel preparation to avoid its systemic osmotic effects.

Background: Videocapsule endoscopy (VCE) and double-balloon enteroscopy (DBE) are part of the diagnostic and therapeutic work-up of indications other than suspected small bowel bleeding (OSBB). The literature is currently lacking studies describing these procedures in this particular setting. Objectives: We assessed the clinical impact of VCE and DBE in a large monocentric cohort of OSBB patients, as compared to a control group of suspected small bowel bleeding (SSBB) patients who underwent enteroscopy over the same period. Design: Monocentric, retrospective, cohort study. Methods: We collected the data of consecutive patients with OSBB undergoing VCE and/or DBE from March 2001 to July 2020. The demographic and clinical parameters of the patients, technical characteristics, and adverse events for each procedure were collected. The impact of VCE and DBE was defined in terms of diagnostic yield (DY). The patients were subdivided according to the main indication into four groups: celiac disease, Crohn’s disease (CD), neoplasia, and persistent gastrointestinal symptoms. Results: A total of 611 VCEs and 387 DBEs were performed for OSBB. The main indications were complicated celiac disease and CD. The DYs of VCE and DBE overall were 53 and 61.7%, respectively, with some variance among the four groups. We report no statistical differences in the DY of VCE and DBE in SSBB vs OSBB (57.7% vs 53%, p = 0.0859 and 68.8% vs 61.7%, p = 0.0582, respectively). OSBB patients were significantly younger than those with SSBB. However, similarly to SSBB ( k = 0.059), poor agreement between the enteroscopic techniques was found in the OSBB population ( k = 0.109). The safety of both procedures in OSBB was comparable to that in SSBB patients. Conclusion: VCE and DBE are effective and safe in suspected OSBB, where their role is similar to that in SSBB, their main indication.

Purpose: In this study, we investigated the progression of high-grade dysplasia (HGD)/CRC in patients with hereditary colorectal cancer syndromes (HCSS) and concomitant inflammatory bowel diseases (IBDs). Methods: We described the natural history of a series of patients with confirmed diagnosis of hereditary colorectal cancer syndromes (HCCSs) and concomitant IBDs who were referred to the Hereditary Digestive Tumors Registry at the Fondazione IRCCS Istituto Nazionale dei Tumori of Milan. Results: Between January 1989 and April 2024, among 450 patients with APC-associated polyposis and 1050 patients with Lynch syndrome (LS), we identified six patients with IBDs (five with UC, one with ileal penetrating CD) and concomitant HCCSs (five with LS, one with APC-associated polyposis). Three patients developed CRC (two patients with stage IIA, and one with stage IIIA); in one patient, CRC occurred over a median follow-up of 12 months after IBD diagnosis, while in two, both conditions were diagnosed simultaneously. The median age at initial diagnosis of CRC was 33 years (range 27–41). Five patients (83.3%) underwent surgical procedures (three colonic resections for carcinoma and two for other reasons). Most of them progressed to precancerous or cancerous colonic lesions at a young age. Notably, all patients with CRC had a diagnosis of UC. Conclusion: IBD patients with coexistent HCCSs can develop early CRC onset at an advanced stage. These patients should be always referred to tertiary referral centers for strict surveillance programs and early surgical management of advanced colorectal neoplastic lesions. Noninvasive biomarkers of neoplastic changes are advocated to further improve the management of IBD patients with HCCSs. [ABSTRACT FROM AUTHOR]

Large areas of tropical grass pastures are not grazed by lambs because of the difficulties in managing high growth rate swards with high selective animals. The objective of this study was to evaluate the physical and biochemical characteristics of tropical pastures offered to lambs in continuous grazing. An upright grass and a shrub legume were set out in three pasture types and grazed by lambs: (1) aruana grass monoculture (AG—Panicum maximum Jacq. cv. IZ‐5), (2) pigeon pea monoculture (PP—Cajanus cajan [L.] Millsp. cv. Anão) and (3) contiguous swards (CS), half of the paddock with AG (CSAG) and half with PP (CSPP). The pastures were evaluated for structural characteristics, production, nutritional composition and antioxidant concentrations in four periods over 92 days of continuous grazing by lambs. Hand plucking samples, similar to animal diet, were collected for chemical analysis. Regarding height, the PP legume monoculture after 42 days of grazing had uncontrollable growth by the lambs, reaching 1.2 m in height. This same legume but as a CS beside AG (CSPP) was maintained at a lower and similar height throughout the experimental periods. In general, the leaf:stem ratio of the different pastures decreased over the experimental periods from 0.7 to 0.2. In most periods, the CS showed intermediary nutritional quality compared to AG and PP. The alpha‐tocopherol content was similar among swards, with an average of 137.2 ± 13.67 mg/kg of green matter (p >.05). Pigeon pea showed the highest levels of total tannin and condensed tannin at 63 and 92 days (p <.05). The use of tropical grass together with a legume provides a better physical structure of the pigeon pea for grazing lambs than when monoculture of this species. [ABSTRACT FROM AUTHOR]

This article explores the experiences of graduates with invisible disabilities on how they define and assess their disability and how it influences their persistence and the completion of their studies. The study involved 29 graduates with self-identified invisible disabilities from Italian and Spanish universities. Individual semi-structured interviews were conducted, and the data were analysed following an inductive category and coding system. According to the obtained results, the graduates considered that invisible disability was overlooked, as it goes unnoticed and is more difficult to detect or accept than a visible disability. They also thought of their own disability as being invisible. During their university studies, they faced difficulties such as a poor understanding of their disability and a general lack of social awareness, highlighting how stigma and stereotypes surrounded these disabilities. It was also evident that disability had a negative impact on their university studies, slowing down their trajectories and causing additional challenges, such as studying longer or accepting lower grades. The article concludes that social awareness-raising actions are necessary to promote positive perceptions of disabilities and to combat stereotypes and prejudices. It is crucial to stop viewing disability as a problem and to learn to recognise and celebrate diversity in society and within universities. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD), which includes Crohn’s disease (CD) and ulcerative colitis (UC), is a complex, immune-mediated, disorder which leads to several gastrointestinal and systemic manifestations determining a poor quality of life, disability, and other negative health outcomes. Our knowledge of this condition has greatly improved over the last few decades, and a comprehensive management should take into account both biological (i.e., disease-related, patient-related) and non-biological (i.e., socioeconomic, cultural, environmental, behavioral) factors which contribute to the disease phenotype. From this point of view, the so called 4P medicine framework, including personalization, prediction, prevention, and participation could be useful for tailoring ad hoc interventions in IBD patients. In this review, we discuss the cutting-edge issues regarding personalization in special settings (i.e., pregnancy, oncology, infectious diseases), patient participation (i.e., how to communicate, disability, tackling stigma and resilience, quality of care), disease prediction (i.e., faecal markers, response to treatments), and prevention (i.e., dysplasia through endoscopy, infections through vaccinations, and post-surgical recurrence). Finally, we provide an outlook discussing the unmet needs for implementing this conceptual framework in clinical practice.

Abstract Data regarding double switching from originator infliximab (IFX) to IFX biosimilars in inflammatory bowel diseases (IBDs) are lacking. The purpose of this study was to evaluate the safety and efficacy of switching from originator IFX to CT‐P13 and subsequently to SB2 (double switch) in patients with IBD. Patients undergoing IFX‐double switch in eight Centers in Lombardy (Italy) from November 2018 to May 2019 were retrospectively analyzed. The IFX discontinuation rate, incidence and type of adverse events (AEs), and clinical remission rate were recorded. A comparison with a control group of patients with IBD single‐switched from originator IFX to CT‐P13 was performed, before and after an inverse probability of treatment weighting (IPTW)‐based propensity score analysis. Fifty‐two double‐switched patients with IBD were enrolled. The 24‐ and 52‐week proportions of patients continuing on IFX therapy following the second switch (CTP13 → SB2) were 98% (95% confidence interval [CI] 94%–100%) and 90% (95% CI 81%–99%), respectively. Four patients experienced a total of five AEs, all graded 1–3 according to Common Terminology Criteria for Adverse Events (CTCAE). No infusion reactions were observed. The 24‐week and follow‐up end clinical remission rates following the second switch were 94% and 88%, respectively. No differences were observed in the safety and efficacy outcomes by comparing the double‐switch group with a single‐switch group of 66 patients with IBD; all these results were confirmed by IPTW‐adjusted analysis. The study suggests both the safety and efficacy of the double switch from originator IFX to CT‐P13 and SB2 in patients with IBD is maintained. This strategy may be associated with potential cost implications.