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Climate change has been one of the most debated topics in the past few decades, but a number of challenges have hindered the development of robust policies and strategies by nations. At the same time, social media platforms—such as Instagram, Twitter, and Facebook—have given the opportunity for the general public to share opinions and engage with the issue of climate change like never before. This phenomenon is considered to be a new form of soft power which can provide input into the discussion and possibly affect the current international political mechanisms. The present paper aims to (1) define the forms and characteristics of social media as a soft power method, (2) analyze its influence on the awareness of societies, and (3) assess if increased public awareness could influence the official political and policy processes. In order to assess if social media has influence on people’s relative awareness, we have focused on analyzing the links between a few highly visible climate change related events and the trends in people’s searches on the Internet in connection to those events. The study finds that even though it is difficult to assess the effects of social media as a soft power tool with certainty, there are visible links between social media and changing public perceptions, with the possibility of public opinion influencing political decision-making.

Abstract Background Increasing functional residual capacity (FRC) or tidal volume (VT) reduces airway resistance and attenuates the response to bronchoconstrictor stimuli in animals and humans. What is unknown is which one of the above mechanisms is more effective in modulating airway caliber and whether their combination yields additive or synergistic effects. To address this question, we investigated the effects of increased FRC and increased VT in attenuating the bronchoconstriction induced by inhaled methacholine (MCh) in healthy humans. Methods Nineteen healthy volunteers were challenged with a single-dose of MCh and forced oscillation was used to measure inspiratory resistance at 5 and 19 Hz (R5 and R19), their difference (R5-19), and reactance at 5 Hz (X5) during spontaneous breathing and during imposed breathing patterns with increased FRC, or VT, or both. Importantly, in our experimental design we held the product of VT and breathing frequency (BF), i.e, minute ventilation (VE) fixed so as to better isolate the effects of changes in VT alone. Results Tripling VT from baseline FRC significantly attenuated the effects of MCh on R5, R19, R5-19 and X5. Doubling VT while halving BF had insignificant effects. Increasing FRC by either one or two VT significantly attenuated the effects of MCh on R5, R19, R5-19 and X5. Increasing both VT and FRC had additive effects on R5, R19, R5-19 and X5, but the effect of increasing FRC was more consistent than increasing VT thus suggesting larger bronchodilation. When compared at iso-volume, there were no differences among breathing patterns with the exception of when VT was three times larger than during spontaneous breathing. Conclusions These data show that increasing FRC and VT can attenuate induced bronchoconstriction in healthy humans by additive effects that are mainly related to an increase of mean operational lung volume. We suggest that static stretching as with increasing FRC is more effective than tidal stretching at constant VE, possibly through a combination of effects on airway geometry and airway smooth muscle dynamics.

Gynecomastia is a benign glandular proliferation that can affect adolescents causing significant psychological discomfort. Generally, it is idiopathic but underlying endocrinological conditions must be excluded. Different surgical techniques are available, the surgical correction with subareolar incision achieves the goal of satisfactory aesthetic result for patients. We studied all patients treated for gynecomastia in two centers of pediatric surgery. After collection of a detailed family history, we evaluated the presence of early onset of puberty, congenital abnormalities of the external genitalia, use of drugs, eating habits and the presence of genetic disorders. Laboratory tests and ultrasound were made to exclude endocrinological disorders. The surgical treatment was performed by a subareolar incision with gland and adipose tissue excision. A Body - Q chest module to evaluate patient satisfaction has been proposed to everyone before and after surgery. 47 adolescents with median age of 15 years were surgically treated. Three presented endocrinological disorders. Grade of gynecomastia for surgery was: III in 40 patients and IIb in 7 patients. Postoperative complications occurred in 5 patients. The Body - Q chest module was completed by 42 patients and showed good results for all points analyzed, except for social feelings. Gynecomastia in adolescents can be surgically treated with subareolar incision, reporting good aesthetic results and low incidence of complications. Specific tests are useful to assess patient satisfaction.

Objective: Intermittent Preventive Treatment of schoolchildren (IPTsc) is recommended by WHO as a strategy to protect against malaria; to explore whether IPTsc with dihydroartemisinin-piperaquine (DP) or artesunate-amodiaquine (ASAQ) cause a selection of molecular markers in Plasmodium falciparum genes associated with resistance in children in seven schools in Tanga region, Tanzania. Methods: SNPs in P. falciparum genes Pfmdr1, Pfexo, Pfkelch13, and Pfcrt and copy number variations in Pfplasmepsin-2 and Pfmdr1 were assessed in samples collected at 12 months (visit 4, n=74) and 20 months (visit 6, n=364) after initiation of IPTsc and compared with the baseline prevalence (n=379). Results: The prevalence of Pfmdr1 N86 and Pfexo 415G was >99% and 0%, respectively without any temporal differences observed. The prevalence of Pfmdr1 184F changed significantly from baseline (52.2%) to visit 6 (64.6%) (χ2=6.11, P=0.013), but no differences were observed between the treatment arms (χ2=0.05, P=0.98). Finally, only minor differences in the amplification of Pfmdr1 were observed; from 10.2% at baseline to 16.7% at visit 6 (χ2=0.98, P=0.32). Conclusions: The IPTsc strategy does not seem to pose a risk for the selection of markers associated with DP or ASAQ resistance. Continuously and timely surveillance of markers of antimalarial drug resistance is recommended.

Objectives: Partial artemisinin resistance, mediated by Plasmodium falciparum K13 (PfK13) mutations, has been confirmed in certain areas of East Africa that are historically associated with high-level antimalarial resistance. The Democratic Republic of Congo (DRC) borders these areas in the East. This study aimed to determine the prevalence of resistance markers in six National Malaria Control Program surveillance sites; Boende, Kabondo, Kapolowe, Kimpese, Mikalayi, and Rutshuru. Methods: The single nucleotide polymorphisms (SNPs) in P. falciparum genes PfK13, Pfdhfr, Pfdhps, Pfmdr1, and Pfcrt were assessed using targeted next-generation sequencing of isolates collected at enrollment in therapeutic efficacy studies. Results: PfK13 SNPs were detected in two samples: in Kabondo (R561H) and in Rutshuru (P441L), both areas near Uganda and Rwanda. The Pfdhps ISGEGA haplotype, associated with reduced sulfadoxine-pyrimethamine chemoprevention efficacy, ranged from 0.8% in Mikalayi (central DRC) to 42.2% in Rutshuru (East DRC). Conclusions: R561H and P441L observed in eastern DRC are a concern, as they are associated with delayed artemisinin-based combination therapies-clearance and candidate marker of resistance, respectively. This is consistent with previous observations of shared drug resistance profiles in parasites of that region with bordering areas of Rwanda and Uganda. The likely circulation of parasites has important implications for the ongoing surveillance of partial artemisinin-resistant P. falciparum and for future efforts to mitigate its dispersal.

In canine leishmaniosis (CanL), complex interactions between the parasites and the immunological background of the host influence the clinical presentation and evolution of infection and disease. Therefore, the potential use of nutraceuticals as immunomodulatory agents becomes of considerable interest. Some biological principles, mainly derived from plants and referred to as plant-derived nutraceuticals, are considered as supplementation for Leishmania spp. infection. This study provides a systematic review regarding the use of nutraceuticals as a treatment using a text mining (TM) and topic analysis (TA) approach to identify dominant topics of nutritional supplements in leishmaniosis-based research, summarize the temporal trend in topics, interpret the evolution within the last century and highlight any possible research gaps. Scopus® database was screened to select 18 records. Findings revealed an increasing trend in research records since 1994. TM identified terms with the highest weighted frequency and TA highlighted the main research areas, namely “Nutraceutical supports and their anti-inflammatory/antioxidant properties”, “AHCC and nucleotides in CanL”, “Vit. D3 and Leishmaniosis”, “Functional food effects and Leishmaniosis” and “Extract effects and Leishmaniosis”. Despite the existing academic interest, there are only a few studies on this issue so far, which reveals a gap in the literature that should be filled.

Ostriches can be utilized as multipurpose animals suitable for producing meat, eggs, feathers, and leather. This growing interest in ostrich farming leads to an increased demand for comprehensive information on their management. But, little attention is paid to the consequences for their welfare. The study aimed to perform a research literature analysis on ostriches’ welfare using the text mining (TM) and topic analysis (TA) methods. It identifies prevailing topics, summarizes their temporal trend within the last forty years, and highlights potential research gaps. According to PRISMA guidelines, a literature exploration was achieved using the Scopus® database, retaining keywords about ostriches’ welfare. Papers distributed in the English language from 1983 to 2023 were included. Descriptive statistics, TM, and TA were applied to a total of n. 122 documents included. The findings revealed an increasing trend in research records since 1994. TM recognized the terms with the highest weighted frequency and TA identified the main topics of the research area, in the following order: “health and management”, “feeding and nutrition”, “welfare reproduction”, “egg production”, and “welfare during transport”. The study confirms the increased focus on ostriches’ welfare but shows that further studies are required to ensure the welfare of this species.

Cereal wastes such as rice bran and cereal dust are valuable yet underutilised by-products of grain processing. This study aimed to bio-convert these wastes into bacterial cellulose (BC), an emerging sustainable and renewable biomaterial, via an inexpensive solid-state fermentation (SSF) pre-treatment using three mould isolates. Medium substitution by directly using untreated rice bran or cereal dust did not significantly increase the yield of bacterial cellulose produced by Novacetimonas sp. (NCBI accession number PP421219) compared to the standard Hestrin–Schramm (HS) medium. In contrast, rice bran fermented with Rhizopus oligosporus yielded the highest bacterial cellulose (1.55 ± 0.6 g/L dry weight) compared to the untreated control (0.45 ± 0.1 g/L dry weight), demonstrating an up to 22% increase in yield. Using the SSF process, the media production costs were reduced by up to 90% compared to the standard HS medium. Physicochemical characterisation using SEM, EDS, FTIR, XPS, XRD, and TGA was performed to gain insights into the internal structure, morphology, and chemical bonding of differently produced BC, which revealed comparable biopolymer properties between BC produced in standard and waste-based media. Hence, our findings demonstrate the effectiveness of fungal SSF for transforming abundant cereal waste into BC, providing a circular economy solution to reduce waste and convert it into by-products to enhance the sustainability of the cereal industry.

Background: ALK tyrosine kinase inhibitors (TKIs) have revolutionized the treatment and largely improved the survival outcomes of patients with NSCLC harboring ALK rearrangements. Different ALK TKI compounds have demonstrated antitumor activity in these patients and are available in clinical practice. However, clinical expertise across countries varies according to local regulatory approval of different drugs, identifying multiple treatment scenarios to comply with international guidelines and clinical practice. Methods: A virtual webinar was held on July 2023 to discuss the state of the art and future perspectives in the treatment of ALK rearrangement in advanced NSCLC in Italy. The faculty hosting the webinar was composed of eight medical oncologists from different regions of Italy with clinical expertise in treating patients with lung cancer. Live-shared notes were used to produce a report to serve as the basis of a review manuscript on the topic. Results: Alectinib and brigatinib are the preferred front-line treatment options in Italy, pending approval of the front-line medicine lorlatinib, which would be considered among the choices. Due to a local regulatory limitation of second-line lorlatinib, which is not allowed after front-line brigatinib, alectinib is commonly the preferred front-line choice to follow a sequence of alectinib, followed by lorlatinib, followed by platinum plus pemetrexed chemotherapy. Age and performance status were not considered per se as clinical features influencing treatment choice. However, treatment compliance is deemed a relevant factor in decision making with regard to the number of pills to be administered. In general, given the availability of alternative choices, the spectrum of patients’ comorbidities and polypharmacotherapy interactions should be taken into account in treatment selection according to the toxicity profile of each compound. In addition, several issues were debated with regard to improving treatment outcomes, including testing, brain metastases, and management of an oligoprogressive disease. Conclusions: The treatment scenario of ALK-positive disease is dynamically evolving. Furthermore, not all FDA- and EMA-approved compounds are approved in Italy with the same indications. This influences therapeutic opportunities and increases the need for greater clinical expertise to help and guide treatment selection.

Abstract Background Despite significant decline in the past two decades, malaria is still a major public health concern in Tanzania; with over 93% of the population still at risk. Community knowledge, attitudes and practices (KAP), and beliefs are key in enhancing uptake and utilization of malaria control interventions, but there is a lack of information on their contribution to effective control of the disease. This study was undertaken to determine KAP and beliefs of community members and service providers on malaria, and how they might be associated with increased risk and persistence of the disease burden in North-western and Southern regions of Tanzania. Methods This was an exploratory study that used qualitative methods including 16 in-depth interviews (IDI) and 32 focus group discussions (FGDs) to collect data from health service providers and community members, respectively. The study was conducted from September to October 2017 and covered 16 villages within eight districts from four regions of mainland Tanzania (Geita, Kigoma, Mtwara and Ruvuma) with persistently high malaria transmission for more than two decades. Results Most of the participants had good knowledge of malaria and how it is transmitted but some FGD participants did not know the actual cause of malaria, and thought that it is caused by bathing and drinking un-boiled water, or consuming contaminated food that has malaria parasites without warming it. Reported barriers to malaria prevention and control (by FGD and IDI participants) included shortage of qualified health workers, inefficient health financing, low care-seeking behaviour, consulting traditional healers, use of local herbs to treat malaria, poverty, increased breeding sites by socio-economic activities and misconceptions related to the use of bed nets and indoor residual spraying (IRS). Among the misconceptions, some participants believed that bed nets provided for free by the government came with bedbugs while others reported that free bed nets caused impotence among men. Conclusion Despite good knowledge of malaria, several risk factors, such as socio-economic and behavioural issues, and misconceptions related to the use of bed nets and IRS were reported. Other key factors included unavailability or limited access to health services, poor health financing and economic activities that potentially contributed to persistence of malaria burden in these regions. Relevant policies and targeted malaria interventions, focusing on understanding socio-cultural factors, should be implemented to reduce and finally eliminate the disease in the study regions and others with persistent transmission.

Bacterial endocarditis (BE) is a severe infection of the endocardium and cardiac valves caused by bacterial agents in dogs. Diagnosis of endocarditis is challenging due to the variety of clinical presentations and lack of definitive diagnostic tests in its early stages. This study aims to provide a research literature analysis on BE in dogs based on text mining (TM) and topic analysis (TA) identifying dominant topics, summarizing their temporal trend, and highlighting any possible research gaps. A literature search was performed utilizing the Scopus® database, employing keywords pertaining to BE to analyze papers published in English from 1990 to 2023. The investigation followed a systematic approach based on the PRISMA guidelines. A total of 86 records were selected for analysis following screening procedures and underwent descriptive statistics, TM, and TA. The findings revealed that the number of records published per year has increased in 2007 and 2021. TM identified the words with the highest term frequency-inverse document frequency (TF-IDF), and TA highlighted the main research areas, in the following order: causative agents, clinical findings and predisposing factors, case reports on endocarditis, outcomes and biomarkers, and infective endocarditis and bacterial isolation. The study confirms the increasing interest in BE but shows where further studies are needed.

Abstract Background This study aimed to evaluate the gap between guidelines and local clinical practice for diagnosis and treatment of uncomplicated and severe malaria, the patient characteristics, diagnostic approach, treatment, and compliance to standard guideline recommendations. Methods This was a multicentre, observational study conducted between October 2020 and March 2021 in which patients of all ages with symptoms suggestive of malaria and who visited a healthcare facility were prospectively enrolled in six countries in sub-Saharan Africa (The Democratic Republic of the Congo, Mozambique, Nigeria, Rwanda, The United Republic of Tanzania, and Zambia). Results Of 1001 enrolled patients, 735 (73.4%) patients had confirmed malaria (based on overall judgment by investigator) at baseline (uncomplicated malaria: 598 [81.4%] and severe malaria: 137 [18.6%]). Of the confirmed malaria patients, 533 (72.5%) were administered a malaria rapid diagnostic test. The median age of patients was 11 years (range: 2 weeks–91 years) with more patients coming from rural (44.9%) than urban (30.6%) or suburban areas (24.5%). At the community level, 57.8% of patients sought advice or received treatment for malaria and 56.9% of patients took one or more drugs for their illness before coming to the study site. In terms of early access to care, 44.1% of patients came to the study site for initial visit ≥ 48 h after symptom onset. In patients with uncomplicated malaria, the most prescribed treatments were artemisinin-based combination therapy (ACT; n = 564 [94.3%]), primarily using artemether-lumefantrine (82.3%), in line with the World Health Organization (WHO) treatment guidelines. In addition, these patients received antipyretics (85.6%) and antibiotics (42.0%). However, in those with severe malaria, only 66 (48.2%) patients received parenteral treatment followed by oral ACT as per WHO guidelines, whereas 62 (45.3%) received parenteral treatment only. After receiving ambulatory care, 88.6% of patients with uncomplicated malaria were discharged and 83.2% of patients with severe malaria were discharged after hospitalization. One patient with uncomplicated malaria having multiple co-morbidities and three patients with severe malaria died. Conclusions The findings of this study suggest that the prescribed treatment in most patients with uncomplicated malaria, but not of those with severe malaria, was in alignment with the WHO recommended guidelines.

Many governments worldwide are increasingly using developments in information and communication technologies (ICT) to provide online services to their citizens. This process is commonly referred to as e-government. South Africa is one of the leading nations in technology and overall development in the Sub-Saharan-African region. Nevertheless, South Africa has failed to successfully implement a wide range of e-Government services for its population over the past years. This paper focuses on analyzing the success factors for a seamless implementation of eGovernment systems and how countries such as Kenya, which are not a developed as South Africa, were able to adapt and successfully implement functioning systems for their citizens. The theoretical research results have indicated what the main success factors are in e-government implementation. Further analysis has been conducted to find out what the reasons are that South Africa has a non-functioning e-government system. An embedded case study approach has been selected to focus on selected aspects of the case study. The paper provides a comprehensive overview of the current state of e-government services in South Africa and compares it with other Sub-Saharan countries with similar economic conditions. This comparison allows for a better understanding of the challenges and opportunities faced by South Africa in improving its e-government services.

Abstract Background We developed a 13-mer locked nucleic acid (LNA) inhibitor of miR-221 (LNA-i-miR-221) with a full phosphorothioate (PS)-modified backbone. This agent downregulated miR-221, demonstrated anti-tumor activity against human xenografts in mice, and favorable toxicokinetics in rats and monkeys. Allometric interspecies scaling allowed us to define the first-in-class LNA-i-miR-221 safe starting dose for the clinical translation. Methods In this first-in-human, open-label, dose-escalation phase 1 trial, we enrolled progressive cancer patients (aged ≥ 18 years) with ECOG 0–2 into 5 cohorts. The treatment cycle was based on a 30-min IV infusion of LNA-i-miR-221 on 4 consecutive days. Three patients within the first cohort were treated with 2 cycles (8 infusions), while 14 patients were treated with a single course (4 infusions); all patients were evaluated for phase 1 primary endpoint. The study was approved by the Ethics Committee and Regulatory Authorities (EudraCT 2017-002615-33). Results Seventeen patients received the investigational treatment, and 16 were evaluable for response. LNA-i-miR-221 was well tolerated, with no grade 3–4 toxicity, and the MTD was not reached. We recorded stable disease (SD) in 8 (50.0%) patients and partial response (PR) in 1 (6.3%) colorectal cancer case (total SD + PR: 56.3%). Pharmacokinetics indicated non-linear drug concentration increase across the dose range. Pharmacodynamics demonstrated concentration-dependent downregulation of miR-221 and upregulation of its CDKN1B/p27 and PTEN canonical targets. Five mg/kg was defined as the recommended phase II dose. Conclusions The excellent safety profile, the promising bio-modulator, and the anti-tumor activity offer the rationale for further clinical investigation of LNA-i-miR-221 (ClinTrials.Gov: NCT04811898).

Beekeeping provides products with nutraceutical and pharmaceutical characteristics. These products are characterized by abundance of bioactive compounds. For different reasons, honey, royal jelly, propolis, venom, and pollen are beneficial to humans and animals and could be used as therapeutics. The pharmacological action of these products is related to many of their constituents. The main bioactive components of honey include oligosaccharides, methylglyoxal, royal jelly proteins (MRJPs), and phenolics compounds. Royal jelly contains jelleins, royalisin peptides, MRJPs, and derivatives of hydroxy-decenoic acid, particularly 10-hydroxy-2-decenoic acid (10-HDA), which possess antibacterial, anti-inflammatory, immunomodulatory, neuromodulatory, metabolic syndrome-preventing, and anti-aging properties. Propolis has a plethora of activities that are referable to compounds such as caffeic acid phenethyl ester. Peptides found in bee venom include phospholipase A2, apamin, and melittin. In addition to being vitamin-rich, bee pollen also includes unsaturated fatty acids, sterols, and phenolics compounds that express antiatherosclerotic, antidiabetic, and anti-inflammatory properties. Therefore, the constituents of hive products are particular and different. All of these constituents have been investigated for their properties in numerous research studies. This review aims to provide a thorough screening of the bioactive chemicals found in honeybee products and their beneficial biological effects. The manuscript may provide impetus to the branch of unconventional medicine that goes by the name of apitherapy.

This study aimed to investigate changes in the number of, and reasons for, requests for dogs’ euthanasia over the last thirty years. Data (breed, age, gender, neuter status, manner, and cause of death) from dogs’ euthanasia registered between 1990 and 2020 in a small animals’ veterinary hospital were analyzed. The overall period examined has been split into two terms (T1 = 1990–2004 and T2 = 2005–2020) considering the introduction and enforcement of Law 189/2004. During the whole period examined, a significant increasing trend in euthanasia cases has been recorded (p = 0.027). Comparing the two terms, we observed significant differences regarding variables such as age, breed, reproductive status, and ownership. The number of euthanized dogs was significantly higher in T1 than in T2. Dogs euthanized in T2 were older than dogs in T1. A high percentage of the euthanized dogs were crossbred and stray dogs. Additionally, the number of neutered/spayed dogs was significantly higher. Regarding the cause of death, a significantly higher percentage of neoplastic processes was detected in T2. The data here reported suggest a potential influence of Law 189/2004. This law in Italy has proven to be a legal milestone that has influenced the decision-making process between euthanasia and natural death.

This manuscript reports the application of sensors for water use efficiency with a focus on the application of an in vivo OECT biosensor. In two distinct experimental trials, the in vivo sensor bioristor was applied in yellow kiwi plants to monitor, in real-time and continuously, the changes in the composition and concentration of the plant sap in an open field during plant growth and development. The bioristor response and physiological data, together with other fruit sensor monitoring data, were acquired and combined in both trials, giving a complete picture of the biosphere conditions. A high correlation was observed between the bioristor index (ΔIgs), the canopy cover expressed as the fraction of intercepted PAR (fi_PAR), and the soil water content (SWC). In addition, the bioristor was confirmed to be a good proxy for the occurrence of drought in kiwi plants; in fact, a period of drought stress was identified within the month of July. A novelty of the bioristor measurements was their ability to detect in advance the occurrence of defoliation, thereby reducing yield and quality losses. A plant-based irrigation protocol can be achieved and tailored based on real plant needs, increasing water use sustainability and preserving high-quality standards.

In this paper, we present an experimental procedure to enhance the dimensional accuracy of fabrication via stereolithography (SLA) of features at the sub-mm scale. Deviations in sub-mm hemispherical cavity diameters were detected and measured on customized samples by confocal microscopy. The characterization and experimental observations of samples allowed the identification of inaccuracy sources, mainly due to the laser beam scanning strategy and the incomplete removal of uncured liquid resin in post-processing (i.e., IPA washing). As a technology baseline, the measured dimensional errors on cavity diameters were up to −46%. A compensation method was defined and implemented, resulting in relevant improvements in dimensional accuracy. However, measurements on sub-mm cavities having different sizes revealed that a constant compensation parameter (i.e., C = 85, 96, 120 μm) is not fully effective at the sub-mm scale, where average errors remain at −24%, −18.8%, and −16% for compensations equal to 85, 96 and 120 μm, respectively. A further experimental campaign allowed the identification of an effective nonlinear compensation law where the compensation parameter depends on the sub-mm feature size C = f(D). Results show a sharp improvement in dimensional accuracy on sub-mm cavity fabrication, with errors consistently below +8.2%. The proposed method can be extended for the fabrication of any sub-mm features without restrictions on the specific technology implementation.

Stapling devices have emerged as a widespread and effective option for soft tissue surgery, offering promising outcomes for patients by reducing complication rates and surgery time. This review aims to provide an exhaustive analysis of commercially available alternatives in the market, incorporating insights from market analysis, patent landscape, and the existing literature. The main focus lies in identifying and evaluating the most widely adopted and innovative stapling devices, including linear, linear cutting, circular, and powered staplers. In addition, this review delves into the realm of bioabsorbable staples, exploring the materials utilized and the surgical fields where these advanced staples find applications. To facilitate easy comprehension, the gathered information is presented in tables, highlighting the essential parameters for each stapling device. This comprehensive research about stapling devices is intended to aid healthcare practitioners and researchers in making informed decisions when choosing the most appropriate instrument for specific surgical procedures.

The aim of this study was to determine the most appropriate sedation protocol for a standing magnetic resonance imaging (MRI) examination in horses, comparing continuous rate infusions (CRIs) of detomidine and romifidine combined with a single bolus of morphine. Sixteen horses referred for standing low-field open-magnet MRI were randomly assigned to one of two sedation protocols. The horses were premedicated with 0.03 mg/kg of intramuscular acepromazine, and those animals belonging to Group D received an intravenous (IV) loading dose of detomidine (0.01 mg/kg) 30 min later, while those of Group R received romifidine (0.04 mg/kg). If the horses were inadequately sedated, an additional dose of IV detomidine (0.005 mg/kg) or romifidine (0.02 mg/kg) was administered, according to the animal’s group. During the MRI, a single IV bolus of morphine (0.05 mg/kg) was administered, and according to which group it belonged to, the animal started the administration of detomidine (0.01 mg/kg/h) or romifidine (0.02 mg/kg/h). Heart rate (HR), respiratory rate (RR), rectal temperature (RT), depth of sedation, and degree of ataxia were evaluated every 10 min during MRI. Two horses belonging to Group D and four horses from Group R needed additional sedation before entering the MRI unit because they were unsatisfactorily sedated. No side effects were observed following morphine bolus administration. During the MRI procedure, five horses in Group R received an additional IV romifidine bolus (0.01 mg/kg) because the depth of sedation score was 1 and the ataxia score was 0. Any substantial differences were recorded between the two treatments in terms of HR, RR, and RT. In conclusion, at the doses used, a detomidine–morphine combination following a CRI of detomidine appears more suitable than a romifidine–morphine combination following a CRI of romifidine for maintaining an adequate depth of sedation and adequate immobility in horses undergoing standing MRI.

In this paper, I address Max Delbrück’s conceptual and experimental importance for molecular biology (henceforth MB) origins. In particular, his complementarity approach and its anti-reductive implications on the (epistemic) reductionism debate in MB. Regarding Delbrück’s conceptual and experimental importance, I examine his influence on the development of MB by exploring a shift of his interests from physics to biology. Particularly, I outline his central role in “The Phage Group”, the informal group of scientists examining the origin of hereditary life using bacteriophages as their experimental model of choice. Delbrück and “The Phage Group” greatly influenced the development of MB, which culminated with the shared 1969 Nobel Prize for the discoveries regarding replication mechanism and genetic structure of viruses. Moreover, I examine Delbrück’s complementarity approach towards biological explanations. The complementarity in biology assumes that “biological phenomena might require the employment of descriptions that are mutually exclusive yet jointly necessary for understanding life processes” (McKaughan 2011, p. 11). I explore Delbrück’s complementarity approach, in particular the debate between the reductive and anti-reductive interpretations of it. I argue for the latter interpretation by suggesting that Delbrück advanced an anti-reductive view towards biological explanations by advocating for independent status of explanations of various biological disciplines. Furthermore, I address the complementarity approach in the light of the anti-reductive interpretation in the recent developments in MB, particularly, the potentiality of finding the complementarity approach in systems biology, epigenetics, and boundary selection.

Abstract Background It has been more than 20 years since the malaria epidemiologic shift to school-aged children was noted. In the meantime, school-aged children (5–15 years) have become increasingly more vulnerable with asymptomatic malaria prevalence reaching up to 70%, making them reservoirs for subsequent transmission of malaria in the endemic communities. Intermittent Preventive Treatment of malaria in schoolchildren (IPTsc) has proven to be an effective tool to shrink this reservoir. As of 3rd June 2022, the World Health Organization recommends IPTsc in moderate and high endemic areas. Even so, for decision-makers, the adoption of scientific research recommendations has been stifled by real-world implementation challenges. This study presents methodology, challenges faced, and mitigations used in the evaluation of the implementation of IPTsc using dihydroartemisinin-piperaquine (DP) in three councils (Handeni District Council (DC), Handeni Town Council (TC) and Kilindi DC) of Tanga Region, Tanzania so as to understand the operational feasibility and effectiveness of IPTsc on malaria parasitaemia and clinical malaria incidence. Methods The study deployed an effectiveness-implementation hybrid design to assess feasibility and effectiveness of IPTsc using DP, the interventional drug, against standard of care (control). Wards in the three study councils were the randomization unit (clusters). Each ward was randomized to implement IPTsc or not (control). In all wards in the IPTsc arm, DP was given to schoolchildren three times a year in four-month intervals. In each council, 24 randomly selected wards (12 per study arm, one school per ward) were chosen as representatives for intervention impact evaluation. Mixed design methods were used to assess the feasibility and acceptability of implementing IPTsc as part of a more comprehensive health package for schoolchildren. The study reimagined an existing school health programme for Neglected Tropical Diseases (NTD) control include IPTsc implementation. Results The study shows IPTsc can feasibly be implemented by integrating it into existing school health and education systems, paving the way for sustainable programme adoption in a cost-effective manner. Conclusions Through this article other interested countries may realise a feasible plan for IPTsc implementation. Mitigation to any challenge can be customized based on local circumstances without jeopardising the gains expected from an IPTsc programme. Trial registration clinicaltrials.gov, NCT04245033. Registered 28 January 2020, https://clinicaltrials.gov/ct2/show/NCT04245033

Today’s scenarios of constant transformation of society call for a necessary reflection on work from an exquisitely pedagogical point of view, in consideration of the multiple transitions that we are witnessing because of phenomena such as progress, forced digitization, the Covid-19 pandemic, conflicts and economic-financial crises. It’s essential to move, for an education to the transition to the Recommendation of 18 December 2006 of the European Parliament on key competences for lifelong learning, from learning to learn. It is one of the eight competences, but essentially the most characterizing so that “learners take the starting point from what they have previously learned and from their life experiences to use and apply knowledge and skills in a whole range of contexts: at home, at work, in education and training”.

As the complexity of micro-products increases, the micro-manufacturing processes, tool setups, and measurement processes have to be more precise and efficient. Combining them in a multi-stage process chain can effectively improve production accuracy and performance and reduce limitations and production costs. This paper focuses on the process chains for the manufacturing of micro-products and presents the state of the art, highlighting the specific characteristics of the existing models of process chains for micro-manufacturing. Based on the critical review of these characteristics, an evolution of the process chain model for micro-manufacturing is proposed, considering machining, measurement/characterization, referencing processes, and their combination into a suitable sequence. The proposed model accounts for relevant aspects of micro-manufacturing, such as size effects and technological fingerprints at the microscale. This paper also discusses the hierarchical properties of multiple micro-manufacturing process chains and some specific techniques to address the critical issue of referencing processes. Furthermore, some relevant case studies involving micro-electrical discharge machining, micro-injection molding, additive manufacturing, and micro-milling are presented to demonstrate how the micro-manufacturing potentiality can be increased using process chains.

Studies revealed that women are less likely to be entrepreneurs and face more disadvantages starting businesses than men, especially in Sub-Saharan Africa. Thus, the authors investigated the importance of women’s economic empowerment and its impact on the rise of female entrepreneurship and human capital in Botswana. Objectives: The paper aims to get an in-depth insight into the issue and to recognise the most relevant factors and how they influence female entrepreneurship in the selected country. The findings should underline the importance of policies and initiatives for female entrepreneurs and the consequential positive effect on the country’s progress in achieving gender equality and economic growth. Methods/ approach: The research included a case study analysis with four in-depth expert interviews. Data triangulation ensured the study's validity, and the case was examined through pattern matching.

Emerging markets are amongst some of the fastest-growing economies on the globe. However, they must enhance human capital to enable a nation's long-term development. The theory states that the increase in workforce participation highly impacts GDP per capita. Additionally, developing markets can grow even further if they increase women's rate in the labour market. The paper aims to determine the main obstacles for women in the job market and identify the impact of female participation on national development by conducting a case study analysis for Guatemala. The authors decided to apply a data triangulation approach and chose a mixture of three sources of data: documents, archival records, and interviews. Guatemala holds an unfavourable rank in the Global Gender Gap Index. The findings demonstrate that the workforce rate is increasing but still severely lower than the men's rate. In Guatemala, the high number of women in tertiary education does not translate into higher female workforce participation. The main issues are cultural stereotypes, limited access to the job market, and difficulties with combining work and childcare.

Background Approximately one-third of long coronavirus disease 2019 (long COVID) patients report breathlessness and fatigue even during activities of daily living. We hypothesised that abnormalities of combined diffusing capacity of the lung for nitric oxide (DLNO) and carbon monoxide (DLCO) at rest or after mild exercise are associated with breathlessness in patients with long COVID. Methods Single-breath combined DLNO and DLCO were measured at rest and immediately after a short bout of treadmill exercise simulating ordinary walking in 32 Caucasian patients with long COVID and dyspnoea at rest. 20 subjects served as a control group. Results At rest, combined DLNO, DLCO and alveolar volume (VA) were significantly lower in long COVID than in controls, with DLNO and DLCO being below the limits of normal in 69% and 41% of cases, respectively. Mean values of DLNO/VA and DLCO/VA in long COVID patients were less than controls, yet, in only 22% and 12% of long COVID patients were the values of DLNO/VA and DLCO/VA below the limits of normal. After treadmill exercise, DLNO, DLNO/DLCO, VA and heart rate increased significantly without differences between groups. DLNO remained below the limit of normal in 47% of long COVID patients. Conclusion These data suggest localised discrete loss of lung units in approximately half of long COVID patients, not completely explained by loss of VA or of alveolar–capillary recruitment during exercise.

Background In a preliminary study during the first COVID-19 pandemic wave, we reported a high rate of success with continuous positive airway pressure (CPAP) in preventing death and invasive mechanical ventilation (IMV). That study, however, was too small to identify risk factors for mortality, barotrauma and impact on subsequent IMV. Thus, we re-evaluated the efficacy of the same CPAP protocol in a larger series of patients during second and third pandemic waves. Methods 281 COVID-19 patients with moderate-to-severe acute hypoxaemic respiratory failure (158 full-code and 123 do-not-intubate (DNI)), were managed with high-flow CPAP early in their hospitalisation. IMV was considered after 4 days of unsuccessful CPAP. Results The overall recovery rate from respiratory failure was 50% in the DNI and 89% in the full-code group. Among the latter, 71% recovered with CPAP-only, 3% died under CPAP and 26% were intubated after a median CPAP time of 7 days (IQR: 5–12 days). Of the patients who were intubated, 68% recovered and were discharged from the hospital within 28 days. Barotrauma occurred during CPAP in

Three X-ray structures are presented of human aldehyde dehydrogenase family 1 member A3 (ALDH1A3), a potential cancer stem cell biomarker (alone, with NAD+ and with ATP) and structure determination performed using molecular replacement.

In Italy, the consumption of pork meat is increasing, despite consumers’ attitudes being addressed toward a greater sensitivity about animal welfare and its link with safe food. Considering the relatively high animal welfare standards and the divergence in public interest in farm animal welfare and ethical issues, the objective of this study—in continuation of our previous paper relating to consumer behavior and preferences in welfare-friendly pork breeding—was to investigate habits of pork consumers regarding pig welfare, principally evaluating their willingness to pay (WTP) a higher price for pork obtained using raising techniques with an approach based on animal welfare. An ad hoc questionnaire-based survey was submitted to consumers (n = 404) in Messina province, Italy. Results suggest that 47% of consumers were willing to pay an additional price for pork from farms that apply specific animal welfare standards. Positive correlations were between WTP and farming techniques (p = 0.001), organic farming methods (p = 0.001), and farms in which animal welfare is taken care of and guaranteed (p < 0.001). These findings suggest that consumers intend to pay a higher price for pork, like other animal products obtained using animal-friendly raising techniques. The sensitivity to the animal welfare of a single human being may influence consumers’ attitudes toward pork consumption.

Feline leishmaniosis is a worldwide infection caused by the parasite of the genus Leishmania transmitted by sandflies. Based on the complexity of epidemiology and diagnosis of this infection, the role of cats in the epidemiology and clinical impact of disease is still under debate. By using serological and molecular methods, this study aimed to update the epidemiology of the infection in different feline populations from various areas of Italy and to study factors associated with the infection. Of 1490 cats tested, 124 (8.3%, 95% CI 6.9–9.9) were infected, 96 had only specific L. infantum IgG, 18 were only positive for parasite DNA and 10 were both IFAT and qPCR positive. Risk factors for infection were sampling in the winter season (OR = 3.2, 95% CI 2.2–4.8), originating from the Sicily region (OR = 2.0, 95% CI 1.3–3.0), male gender (OR = 1.8, 95% CI 1.1–3.2), outdoor lifestyle (OR = 2.3, 95% CI 0.9–5.6) and seropositivity for FIV antibodies (OR = 2.2, 95% CI 1.2–4.2), while sampling in the spring (OR = 0.5, 95% CI 0.3–0.7) and summer (OR = 0.3, 95% CI 0.1–0.7), and originating from the Lazio region (OR = 0.1, 95% CI 0.05–0.4) were protective factors for infection. In endemic areas, Leishmania infection should be investigated by using both serological and molecular methods and cats should be protected from sandfly bites, particularly if they are FIV infected.

With the recent change to value-based care, institutions have struggled with the appropriate management of patients under observation. Observation status can have a huge impact on hospital and patient expenses. Institutions have implemented specialized observation units to provide better care for these patients. Starting in January 2020, coinciding with the initiation of daily multidisciplinary rounds, our study focused on patients aged 18 and older admitted to our hospital under observation status. Efforts were built upon prior initiatives at Jersey Shore University Medical Center (JSUMC) to optimize patient care and length of stay (LOS) reduction. The central intervention revolved around the establishment of daily “Observation Huddles”—succinct rounds led by hospital leaders to harmonize care for patients under observation. The primary aim was to assess the impact of daily multidisciplinary rounds (MDR) on LOS, while our secondary aim involved identifying specific barriers and interventions that contributed to the observed reduction. Our study revealed a 9-h reduction in observation time, resulting in approximately USD 187.50 saved per patient. When accounting for the period spanning 2020 to 2022, potential savings totaled USD 828,187.50 in 2020, USD 1,046,062.50 in 2021, and USD 1,243,562.50 in 2022. MDR for observation patients led to a reduction in LOS from 29 h to 20 h (p < 0.001).

The emergence of antibiotic resistance is a global health concern. Therefore, understanding the mechanisms of its spread is crucial for implementing evidence-based strategies to tackle resistance in the context of the One Health approach. In developing countries where sanitation systems and access to clean and safe water are still major challenges, contamination may introduce bacteria and bacteriophages harboring antibiotic resistance genes (ARGs) into the environment. This contamination can increase the risk of exposure and community transmission of ARGs and infectious pathogens. However, there is a paucity of information on the mechanisms of bacteriophage-mediated spread of ARGs and patterns through the environment. Here, we deploy Droplet Digital PCR (ddPCR) and metagenomics approaches to analyze the abundance of ARGs and bacterial pathogens disseminated through clean and wastewater systems. We detected a relatively less-studied and rare human zoonotic pathogen, Vibrio metschnikovii, known to spread through fecal-–oral contamination, similarly to V. cholerae. Several antibiotic resistance genes were identified in both bacterial and bacteriophage fractions from water sources. Using metagenomics, we detected several resistance genes related to tetracyclines and beta-lactams in all the samples. Environmental samples from outlet wastewater had a high diversity of ARGs and contained high levels of blaOXA-48. Other identified resistance profiles included tetA, tetM, and blaCTX-M9. Specifically, we demonstrated that blaCTX-M1 is enriched in the bacteriophage fraction from wastewater. In general, however, the bacterial community has a significantly higher abundance of resistance genes compared to the bacteriophage population. In conclusion, the study highlights the need to implement environmental monitoring of clean and wastewater to inform the risk of infectious disease outbreaks and the spread of antibiotic resistance in the context of One Health.

Fourteen quinolizidine derivatives, structurally related to the alkaloids lupinine and cytisine and previously studied for other pharmacological purposes, were presently tested for antiarrhythmic, and other cardiovascular effects on isolated guinea pig heart tissues in comparison to well-established reference drugs. According to their structures, the tested compounds are assembled into three subsets: (a) N-(quinolizidinyl-alkyl)-benzamides; (b) 2-(benzotriazol-2-yl)methyl-1-(quinolizidinyl)alkyl-benzimidazoles; (c) N-substituted cytisines. All compounds but two displayed antiarrhythmic activity that was potent for compounds 4, 1, 6, and 5 (in ascending order). The last compound (N-(3,4,5-trimethoxybenzoyl)aminohomolupinane) was outstanding, exhibiting a nanomolar potency (EC50 = 0.017 µM) for the increase in the threshold of ac-arrhythmia. The tested compounds shared strong negative inotropic activity; however, this does not compromise the value of their antiarrhythmic action. On the other hand, only moderate or modest negative chronotropic and vasorelaxant activities were commonly observed. Compound 5, which has high antiarrhythmic potency, a favorable cardiovascular profile, and is devoid of antihypertensive activity in spontaneously hypertensive rats, represents a lead worthy of further investigation.

The need for cholecystectomy during pediatric age has significantly increased in the last two decades. As biliary pathology increases, the probability of complicated cholecystectomies increases too. The aim of this article is to analyze our experience with difficult laparoscopic pediatric cholecystectomy, focusing on the importance of an accurate pre-operative imaging study. We retrospectively analyzed all patients affected by cholelithiasis who underwent laparoscopic cholecystectomy at the Pediatric Surgery Department of San Camillo Forlanini hospital of Rome and Santa Maria alle Scotte University Hospital of Siena from 2017 to 2022. Demographic data, body mass index (BMI), recovery data, laboratory tests, imaging exams, surgical findings, post operative management and outcome were taken into account. Overall, 34 pediatric patients, with a mean age of 14.1 years (6–18 years) were included, with a mean BMI of 29. All patients underwent abdominal ultrasonography and a liver MRI with cholangiography (cMRI). We identified five cases as “difficult cholecystectomies”. Two subtotal cholecystectomies were performed. Cholecystectomy in pediatric surgery can be difficult. The surgeon must be able to find alternative strategies to total cholecystectomy to avoid the risk of possible bile duct injury (BDI). Pre-operative imaging study trough ultrasound and especially cMRI is crucial to recognize possible difficulties and to plan the surgery.

Several studies conducted on humans demonstrate the increase in cardiac troponins and the onset of arrhythmias in the course of systemic inflammatory response syndrome (SIRS). The aim of the current study was to assess the blood concentration of cardiac troponin I (cTnI) and electrocardiographic findings in SIRS-affected cats. Seventeen shorthair cats hospitalized with SIRS were enrolled (Group 1). SIRS diagnosis was performed based on the detection of at least two of the four criteria such as abnormal body temperature, abnormal heart rate (i.e., tachycardia or bradycardia), abnormal respiratory rate (i.e., tachypnea or bradypnea), and alterations of white blood cell number (i.e., leukocytes or band neutrophils). Ten cats screened for elective surgery such as neutering or dental procedures were evaluated as a control population (Group 2). They were considered healthy based on history, physical examination, hematological and biochemical profile, urinalysis, coprological exam, thyroxine assay, blood pressure measurement, and echocardiography. A physical examination, complete blood cell count, biochemistry test (including an electrolyte panel), electrocardiographic examination, and cTnI assay were carried out in each cat enrolled. Traumatic events, gastrointestinal, neoplastic, respiratory, and neurological disorders were identified as causes of SIRS in Group 1. In Group 1, a significantly higher concentration of cTnI than that in Group 2 was recorded (p = 0.004). In 37.5% of cats with SIRS, ventricular premature complexes occurring in couplets with multiform configuration were detected. Similarly, to humans, data herein reported would indicate possible cardiac damage present in cats with SIRS diagnosis.

Keypoints Sub-Saharan Africa contributes about 95% of global malaria cases and related deaths. Despite safety concerns adoption of SLD primaquine is needed to further reduce malaria transmission, an essential prerequisite for the elimination of the infection in Africa. Large scale administrations of primaquine for control and elimination of malaria have been implemented in other parts of the world where there are severe variants of G6PD deficiency, but only around 1% of the population had mild adverse effects. African G6PD A- is a milder variant of deficiency, and the hemolysis that occurs following a single 0.25 mg/kg primaquine administration in this group is usually mild and self-limiting. With proper planning and preparation for the management of adverse effects, administration of SLD primaquine plus effective schizonticides, in a form of mass drug administration or seasonal malaria chemoprevention can be used in Africa to reduce malaria transmission.

We describe the MalariaGEN Pf7 data resource, the seventh release of Plasmodium falciparum genome variation data from the MalariaGEN network. It comprises over 20,000 samples from 82 partner studies in 33 countries, including several malaria endemic regions that were previously underrepresented. For the first time we include dried blood spot samples that were sequenced after selective whole genome amplification, necessitating new methods to genotype copy number variations. We identify a large number of newly emerging crt mutations in parts of Southeast Asia, and show examples of heterogeneities in patterns of drug resistance within Africa and within the Indian subcontinent. We describe the profile of variations in the C-terminal of the csp gene and relate this to the sequence used in the RTS,S and R21 malaria vaccines. Pf7 provides high-quality data on genotype calls for 6 million SNPs and short indels, analysis of large deletions that cause failure of rapid diagnostic tests, and systematic characterisation of six major drug resistance loci, all of which can be freely downloaded from the MalariaGEN website.

Il lavoro rappresenta oggi uno dei termini più usati e abusati nei contesti dell’umano. In campo pedagogico, declinato attraverso la pratica (pratiche lavorative) e i suoi diversi mutamenti storico-sociali, diviene tema urgente, specie all’indomani della crisi sociale ed economica che ha colpito il mondo con la diffusione del Covid-19. Il presente articolo muove da una riflessione empirica circa la frammentazione dell’educativo nell’era del coronavirus, per giungere a ripensare la persona al centro del dibattito sul lavoro, puntando l’attenzione sui cambiamenti e le evoluzioni di una pedagogia del lavoro che, al pari delle altre scienze umane, a causa della pandemia, deve con urgenza ripensare la propria azione. Una crisi educativa che è crisi economica, sociale e politica, e che non può prescindere dal ripensare la relazione educativa come punto essenziale dal quale far ripartire una nuova idea di lavoro, e di organizzazione, fondata sulla persona.