Respiratory therapist(RT)internet-supervised At-Home Telespirometry(AHT)was validated in pilot 22/95=23% ALS Clinic population. Erect, supine Vital Capacity(eFVC, sFVC)were measured longitudinally using ZephyRx smartphone interface and database recording in-clinic-conventional(Viaire-Vyasis-)and at-home-portable(MIR-Spirobank-Smart-)spirometers. Bland-Altman(BA)analysis supported content validity-precision and 7-day-test-re-test-validity [mean difference=0.15L(conventional–portable;95%CI -0.40L, 0.70L); = 2.7% predicted (conventional-portable;95%CI -12.1%, 17.5%) ]meeting ATS-ERS performance standards. RT Internet-supervised AHT measured sFVC was more frequently obtained[35/52=67.3 %]in-home-vs-in-clinic sFVC[9/21=42.9 %](Chi-Square;P=0.0533). Monthly mean eFVC slope decline for the eFVC > 60 % predicted baseline cohort was – 1.24% predicted per month[95% CI -2.15 ,-0.33% predicted]statistically significantly(P=0.015)less compared with the – 5.86% predicted per month[95% CI -9.44, -2.29 % predicted]decline for the eFVC < 60 % predicted baseline cohort and in this cohort was associated with statistically significant decreased survival(P=0.0219). RT Internet-supervised AHT facilitated initiation of non-invasive ventilation(NIV)in 5/22[23%]patients including 3/4[75%] homebound subjects. RT Internet-supervised AHT can be deployed for ALS patients stratified according to baseline eFVC for earlier detection of eFVC and sFVC decreases between clinic visits. A prospective research study[NCT05106569]is ongoing to further define the capability of online deployment of Respiratory therapist(RT)internet-supervised AHT in the timely initiation of NIV use to improve ALS respiratory care in larger numbers of ALS subjects.

Abstract: Background: Non-invasive acquistion of beat-to-beat pulse transit time (PTT) via piezoelectric/piezocapacitive sensors (PES/PCS) may expand perioperative hemodynamic monitoring. This study evaluated the ability for PTT via PES/PCS to correlate with systolic, diastolic, and mean invasive blood pressure (SBPIBP, DBPIBP, and MAPIBP) and to detect SBPIBP fluctuations. Methods: PES/PCS and IBP measurements were performed in 20 patients undergoing abdominal, urological, and cardiac surgery. A Pearson’s correlation analysis (r) between 1/PTT and IBP was performed. The predictive ability of 1/PTT with changes in SBPIBP was determined by area under the curve (reported as AUC, sensitivity, specificity). Results: Significant correlations between 1/PTT and SBPIBP were found for PES (r=0.64) and PCS (r=0.55) (p<0.01), as well as MAPIBP/DBPIBP for PES (r=0.6/0.55) and PCS (r=0.5/0.45) (p<0.05). A 7% decrease in 1/PTTPES predicted a 30% SBPIBP decrease(0.82, 0.76, 0.76), while a 5.6% increase predicted a 30% SBPIBP increase (0.75, 0.7, 0.68). A 6.6% decrease in 1/PTTPCS detected a 30% SBPIBP decrease (0.81, 0.72, 0.8), while a 4.8% 1/PTTPCS increase detected a 30% SBPIBP increase (0.73, 0.64, 0.68). Conclusions: Non-invasive beat-to-beat PTT via PES/PCS demonstrated significant correlations with IBP and detected significant changes in SBPIBP. Thus PES/PCS as a novel sensor technology may augment intraoperative hemodynamic monitoring during major surgery.

This paper presents a critical review and comparison of the results of recently published studies in the fields of human-machine interface and the use of sonomyography (SMG) for the control of upper limb prothesis. For this review paper, a combination of the keywords "Human Machine Interface", "Sonomyography", "Ultrasound", "Upper Limb Prosthesis", "Artificial Intelligence" and "Non-Invasive Sensors" was used to search for articles on Google Scholar and PubMed. Sixty-one articles were found, of which 59 were used in this review. For a comparison of the different ultrasound modes, feature extraction methods, and machine learning algorithms, 16 articles were used. It was found that various modes of ultrasound devices for prosthetic control, various machine learning algorithms for classifying different hand gestures, as well as various feature extraction methods for increasing the accuracy of artificial intelligence used in their controlling systems are reviewed in this article. The results of the review article show that ultrasound sensing has the potential to be used as a viable human-machine interface in order to control bionic hands with multiple degrees of freedom. Moreover, different hand gestures can be classified by different machine learning algorithms trained with extracted features from collected data with an accuracy of around 95%.

Several extinctions have already been attributed, at least in part, to global warming, as climate change constitutes a serious threat for species living in isolated ecosystems and thus unable to track habitat changes. However, in all these cases extinction was due to human impacts, often directly but generally also through exotic invasive species. For two arboreal land snails in Indian Ocean islands a link has been proposed with decreasing rainfall. The decline (but probably not extinction) of Pachnodus velutinus, a specialist of moist forests on the summits of northwestern Mahé, was most likely caused instead by invasive plants altering its habitat and alien predators decimating the population in the small remaining moist forests. An alternative explanation assuming genetic swamping through hybridization with a species from lower elevations has no basis, as the presumed hybrid constitutes a distinct species able to survive in the altered, dryer habitat. On Aldabra Atoll, the endemic Rhachistia aldabrae was claimed to have been the first extinction due to climate change, but is still extant. No relationship can be detected between number of sightings and annual rainfall, although a weighted measure that takes into account rainfall in previous years suggests a limited impact of weather. Analysis of the sighting record in various ways yields a probability of survival over time that never dropped below 0.3. The decline was caused instead by intense impacts of exotic invasive species. Alternative shortcuts to evaluate extinction rates among poorly known species are shown to be unreliable. Although no contemporary extinction can still be attributed to climate change, indirect and synergistic impacts on biodiversity are expected, especially through promoting biological invasions.

Nonionizing millimeter-waves (MMW) interact with cells in a variety of ways. Here the inhibited cell division effect was investigated using 85-105 GHz MMW irradiation within the ICNIRP (International Commission on Non-Ionizing Radiation Protection) non-thermal 20 mW/cm2 safety standards. Irradiation using a power density of about 1.0 mW/cm2 , SAR over 5-6 hours on 50 cells/μl samples of Saccharomyces cerevisiae model organism resulted in 62% growth rate reduction compared to the control (sham). The effect was specific for 85-105 GHz range, and was energy and cell density dependent. Irradiation of wild type and Δrad52 (DNA damage repair gene) deleted cells presented no differences of colony growth profiles indicating non-thermal MMW treatment does not cause permanent genetic alterations. Dose versus response relations studied using a standard horn antenna (~1.0 mW/cm2) and compared to that of a compact waveguide (17.17 mW/cm2) for increased power delivery resulted in complete termination of cell division via non-thermal processes supported by temperature rise measurements. We have shown that non-thermal MMW radiation has potential for future use in treatment of yeast related diseases and other targeted biomedical outcomes.

Although all isolates of the foodborne pathogen Listeria monocytogenes are considered to be pathogenic, epidemiological evidence indicates that certain serovar 4b lineages are more likely to cause severe invasive (neuromeningeal, maternal-fetal) listeriosis. Recently described as L. monocytogenes “hypervirulent” clones, no distinctive bacterial trait has been identified so far that could account for the differential pathogenicity of these strains. Here we discuss some preliminary observations in experimentally infected mice suggesting that serovar 4b hypervirulent strains may have a hitherto unrecognized capacity for prolonged in vivo survival. We propose the hypothesis that protracted survivability in primary infection foci in liver and spleen –first target organs after intestinal translocation– may cause L. monocytogenes serovar 4b hypervirulent clones to have a higher probability of secondary dissemination to brain and placenta.

Breast cancer develops from cells lining the milk ducts and slowly grows into a lump or a tumour. Breast cancer may be invasive or non-invasive. Invasive cancer spreads from the milk duct or lobule to other tissues in the breast, whereas, non-invasive ones lack the ability to invade other breast tissues. Non-invasive breast cancer is called in situ and may remain inactive for entire lifetime. Due to heterogeneity nature of breast, density as well as masses is variable in size and shape. A dataset of 18056 patients are collected from 20 Government Hospitals and 50 Private Hospitals in West Bengal before COVID-19 and after COVID-19. The classification of patients are made on three classes- Normal, Sign of Abnormality and Abnormality. The reports of MRIs of patients in January 2020 and February 2020 are collected from different hospitals. It is treated as dataset before COVID-19 . MRIS of patients in April 2020 and May 2020 are dataset during COVID-19. The entire datasets are accumulated for testing of any change in patients MRIS after the official announcement of new virus COVID-19 in March 2020. The aim of the paper is to make a comparison of any change in size and shape of masses of MRIs of patients before and after COVId-19. All collected MRIs reports are diagnosed by radiologists of hospitals.

Public access to high quality green environments has become a key issue for city managers and a matter of environmental justice. Remnants of natural ecosystems allow citizens a direct contact with nature, but conversely the presence of people contributes further to the existing disturbances. Urban pressures on ecosystem remnants may act to favour the expansion of some invasive species in cities. Whilst the negative impacts of invasive species on ecosystem function is well documented little is known how invasive species influence the use of green spaces by people. Here, we examined one of the few remnants of urban riparian forests in Europe, the Vistula river valley in Warsaw which has recently become an attractive recreation site. Despite their high ecological value, the poplar and willow forests have been increasingly taken over by the invasive tree species Acer negundo. We examined the status of the invasion process and the relationship between recreational ecosystem services and the characteristics of the tree stands – tree species, tree density and age and NDVI values. We found the willow forest to be more susceptible to invasion by A. negundo than the poplar forest, which was revealed in significantly higher share of the maple individuals and their greater volume per unit area. Presence of A. negundo affected biodiversity resulting in decreased undergrowth density and number of species. The use intensity by the public, assessed on the basis of trampling intensity and the density of existing informal tracks, were negatively correlated to the presence of A. negundo. This study highlights the need to integrate invasive species management into green infrastructure planning and management.

Water hyacinth (Eichhornia crassipes) is an invasive species that has modified ecosystem functioning in the Sacramento-San Joaquin Delta (Delta), California, USA. Studies in lakes and rivers have shown that water hyacinth alters water quality. In tidal systems, such as the Delta, water moves back and forth through the water hyacinth patch so water quality directly outside the patch in either direction is likely to be impacted. In this study, we asked whether the presence or treatment of water hyacinth with herbicides resulted in changes in water quality in this tidal system. We combined existing datasets that were originally collected for permit compliance and long-term regional monitoring into a dataset that we analyzed with a before-after control-impact (BACI) framework. This approach allowed us to describe effects of presence and treatment of water hyacinth, while accounting for seasonal patterns in water quality. We found that although effects of treatment were not detectable when compared with water immediately upstream, dissolved oxygen and turbidity became more similar to regional water quality averages after treatment. Temperature became less similar to the regional average after treatment, but the magnitude of the change was small. Taken together, these results suggest that tidal hydrology exports the effects of water hyacinth upstream, just as river flow is known to transport the effects downstream, creating a buffer of altered water chemistry around patches. It also suggests that although water hyacinth has an effect on dissolved oxygen and turbidity, these parameters recover to regional averages after treatment.

The present essay illustrates the methodological and theoretical premises of an emerging research area carrying out both ethological and (bio)ethical implications: the ethology of the freed animal (EFA). Unlike existing ethological fields, EFA focuses neither on non human (NH) animals in natural conditions of freedom in their own environment, nor on NH animals kept in conditions of “captivity”. Rather, EFA consists of a comparative study of NH animals that are released from a condition of more or less abusive captivity and instead relocated in an environment more appropriate to their species-specific and individual characteristics and inclinations. Ideal places for this study are contexts like “Animal sanctuaries” and parks/reserves provided with a camp or station for researchers, where a previously-captive NH animal can be reintroduced in his/her natural habitat. Even though EFA exists already, as a de facto practice of the specialized and/or volunteer personnel running sanctuaries and parks, the field still lacks a recognizable scholarly paradigm, and it is yet to be acknowledged at institutional/academic level. By consequence, one important aim for creating a field like this lies in the establishment of an active interaction between the two parties involved (researchers and sanctuaries/parks operators).

Flexible surgical robots are emerging as advanced tools for minimally invasive surgeries, offering greater versatility compared to traditional rigid robots. Unlike commercial endoscopes, the overtube should remain fixed to maintain stability, ensure a clear field of view, and allow surgical tools to perform tasks efficiently. While constant curvature bending of the overtube is sufficient for some lesions, certain lesions require the overtube to bend into specific shapes to achieve appropriate positioning. Various methods for creating different bending shapes have been proposed in previous research, typically involving connecting multiple segments. However, this approach complicates control and reduces both space and cost efficiency. This study proposed a conceptual method for adding a shaping tendon to control the bending shape and mathematically analyzed the effect of this shaping tendon, inserted along an arbitrary path in addition to the main driving tendons for constant curvature bending, on the bending shape of the hyper-redundant manipulator with rolling joints. The overall system was modeled and analyzed from an energy perspective, and the validity of the proposed mathematical modeling was verified through comparison with results obtained from physical experiments. In addition, it was identified that the design parameter determining the tendon path is significant element in defining bending shape of the overtube.

The impact of climate change is undeniable: considering the significant carbon footprint of surgical activity, there is an urgent need to pursue sustainability in the operating room as well. At the Breast Surgery Clinic of the IRCCS Ospedale Policlinico San Martino in Genoa, a prospective study was conducted from September 2023 to May 2024 to evaluate the effectiveness of a series of measures aimed at reducing the environmental impact in the operating room. 34 women affected by invasive breast cancer T1-2, cN0 underwent quadrantectomy and sentinel lymph node biopsy (SNLB): 17 according to a standard, high environmental impact approach; 17 according to a green approach based on the "5 R rule" (reduce, reuse, recycle, rethink, research). The implementation of measures such as the use of indocyanine green (ICG) for SNLB, the use of local anesthesia and intravenous sedation, the minimization of waste production, the use of reusable gowns, drapes and surgical instruments and the separate collection of non-infectious plastic waste resulted not only in a reduced environmental impact, but also in benefits for patients, who were spared a hospital admission the day before surgery, the administration of a radiotracer, and, in 58.8% of cases, an overnight stay. Considering the alarming data regarding the threat to our health, it is both possible and necessary to adopt virtuous behaviors in the operating room that reverse the current trend of emitting greenhouse gases.

The EcoFlora Project was launched at the New York Botanical Garden and expanded to other botanical gardens across the United States to enhance our understanding of urban plant biodiversity through community science iNaturalist observations. This study evaluates the strengths and limitations of using iNaturalist observations and herbarium specimen records in biodiversity research, demonstrating their complementary roles. iNaturalist engages community scientists and provides real-time data but may suffer from biases and inconsistent identification accuracy. Conversely, herbarium specimens offer verified, historical records but require significant resources for collection and upkeep. Through case studies in five U.S. metro areas, EcoFloras highlight the effectiveness of combining these data sources for comprehensive biodiversity assessments. The project reveals how leveraging both digital tools and traditional specimen collections can provide a more complete picture of biodiversity, informing conservation strategies and biodiversity management. Integrating community science with established scientific methods fosters greater public involvement in conservation and offers a robust framework for addressing biodiversity challenges. Rigorous data cleaning is essential, and future efforts should focus on linking both data sources to enhance plant conservation strategies. By leveraging the strengths of both iNaturalist and herbarium data, researchers can greatly enhance the effectiveness of conservation strategies.

The backwater lowland habitats of large rivers, like the Mississippi River in North America, present complex often inaccessible environments for traditional capture-based fish biodiversity sampling. Our knowledge of the assemblages of fishes that occupy such habitats are often incomplete, and this can compromise management efforts. We employed environmental DNA (eDNA) metabarcoding methods to sample a Mississippi River bottom wetland system to assess ichthyofaunal diversity, and assemblage structure across habitat types, and we compared our results to capture-based survey records for the same habitats. We collected water samples in spring and fall of 2022 from slough, ditch, shallow lake and bayou habitats that varied in depth, vegetation, seasonal variability, and connectivity to the Mississippi River channel. We detected a diverse array of fish species that included 51 taxa. Nearly all species previously documented in the habitats were detected by eDNA metabarcoding, and we increased the number of documented species by more than a third. Most of the species were ubiquitous across the range of habitats, but there was also substantial assemblage structure, with some species exhibiting clear habitat specificity. Fall sampling was limited to the deeper bayou habitats where seasonal variation between spring and fall was minimal. eDNA metabarcode sampling was demonstrated to be effective at detecting invasive species as well as uncommon species, which included several species of conservation concern.

From the existing millions of fungal species only a few cause disease. In this study, we investigated invasive fungal infections in the head and neck over a 19-year period (2005 to 2024) at a large academic healthcare system. Among 413 cases, 336 were noninvasive, and 77 were invasive. The highest incidence of invasive infections occurred in the sinonasal cavities, with a 15-fold difference compared to other sites. Most infections affected adults over 40 years old. The most common organisms were Mucorales (51%), hyaline molds (29%), and Candida (11%). Risk factors included malignancy, transplant, diabetes, and illicit drug use. Mortality was high in patients with malignancy and/or transplant. Infections affecting the mandible were usually a complication of osteoradionecrosis and were associated with coinfection of Candida and Actinomyces. At other sites, infections were rare and were usually the result of penetrating injuries or immunosuppression. Treatment typically involved a combination of antifungals and surgical procedures.

Objectives: Minimally invasive direct coronary artery bypass (MIDCAB) is an alternative for revascularisation of isolated left anterior descending (LAD) or as multi-vessel (MV) procedure for diagonal branch (RD) or circumflex artery (RCX) region. Methods: From 2021 to 2022 91 patients underwent MIDCAB procedure in our heartcenter. 80% were male. Eighty percent of the patients had two or three vessel coronary artery disease. Mean age was 65±10 years. The left internal mammary artery (LIMA) was anastomosed to the left anterior descending via left minithoracotomy approach in all patients. Fourteen patients received multi-vessel MIDCAB (15%) with two or three anastomoses a saphenous vein graft (as T-graft to LIMA) was anastomosed to RD or RCX. Results: Mean operation time was 2.6±0.8 hours. The 30-day mortality was 0. Mean required packed red blood cells (pRBC) was 0.4±1.2 unit. The intensive care unit stay (ICU) was 1.5±1.6 days mean. We observed two patients (2%) with wound infections postoperatively. Four patients underwent rethoracotomy because of bleeding. Mean follow-up time was 1.5±0.5 years. Seventy-eight patients (86%) were in New York Heart Association (NYHA) class 1, 11 patients (12%) were in NYHA class 2. One patient received percutaneous coronary intervention due to de novo stenosis of the RCA. Late mortality was 2%. The Kaplan-Meier survival rate was 98.8% at 1 and 2 years. Conclusion: MIDCAB is technically demanding. Our postoperative and short-term clinical results demonstrate that this procedure is safe and feasible. Optimal patient selection and an experienced surgical team are mandatory.

Circulating cell-free DNA (cfDNA) refers to small fragments of DNA molecules released after programmed cell death and necrosis in several body fluids such as blood, saliva, urine, and cerebrospinal fluid. The discovery of cfDNA has revolutionized the field of non-invasive diagnostics in the oncologic field, in prenatal testing, and in organ transplantation. Despite the potential of cfDNA and the solid results published in recent literature, several challenges remain, represented by low abundance, need for highly sensitive assays and analytical issues. In this review, the main technical advances in cfDNA analysis are presented and discussed, with a comprehensive examination of the current available methodologies applied in each field. Considering the potential advantages of cfDNA, this biomarker is increasing its consensus among clinicians, as it consents to monitor patients’ conditions in an easy and non-invasive way, offering a more personalized care. Nevertheless, cfDNA analysis is still considered a research marker to be further validated, and very few centers are implementing its analysis in the real-life assistance. As technical improvements are enhancing the performances of cfDNA analysis, its application will transversally improve patients’ quality of life.

The crayfish plague is a devastating disease of European freshwater crayfish and is caused by the oomycete Aphanomyces astaci (Ap. astaci), which was introduced to Europe around 1860. All European species of freshwater crayfish are susceptible to the disease, including the white-clawed crayfish Austropotamobius pallipes. The aquatic mould is primarily spread by North American crayfish species and can also disperse rapidly through contaminated wet gear moved between water bodies. This spread, coupled with competition from non-indigenous crayfish, has drastically reduced and fragmented native crayfish populations across Europe. Remarkably, the island of Ireland remained free from the crayfish plague pathogen for over 100 years, providing a refuge for A. pallipes. However, this changed in 1987 when a mass mortality event was linked to the pathogen marking the pathogen's introduction to the region. Fortunately, the plague did not establish and was not detected again in Ireland until 2015 when a molecular analysis linked a mass mortality event in the Erne catchment to Ap. astaci. Since then, the pathogen has appeared across the island. Between 2015 and 2023, Ap. astaci was detected in 18 Irish water catchments, revealing multiple genotypes. Intriguingly, the pathogen in Ireland exists without its natural host species. The uneven distribution of various genetic lineages strongly suggests human-mediated transport of zoospores via contaminated water equipment as a primary cause of spread. This review details the timeline of these events, Ap. astaci’s introductions into Ireland, its rapid spread, the genotypes documented, the issue of non-indigenous crayfish species in Ireland and management efforts.

Objectives. Invasive fungal spondylodiscitis (IFSD) is rare and could be lethal in certain circumstances. Previous literature revealed limited data concerning the outcomes. This study aimed to establish a risk-scoring system. Methods. A total of 53 patients were included in the study from a multi-centered database in Taiwan. All the clinicopathological and laboratory data were retrospectively analyzed. Variables strongly related to 1-year mortality were identified using a multivariate Cox proportional hazards model. A receiver operating characteristic curve was used to express the performance of our IFSD scoring model. Results. Five strong predictors were included in the IFSD score: predisposing immunocompromised state, the initial presentation of either radiculopathy or myelopathy, initial laboratory findings of WBC > 12.0 or < 0.4 103/uL, hemoglobin < 8 g/dL, and evidence of candidemia. 1-year mortality rates for patients with IFSD Scores of 0, 1, 2, 3, and 4 were 0%, 16.7%, 56.3%, 72.7%, and 100%, respectively. The area under the curve of the receiver operating characteristic curve was 0.823. Conclusions. We developed a practical scoring model with easily obtained demographic, clinical, and laboratory parameters to predict the probability of 1-year mortality in patients with IFSD. However, more large-scale and international validations would be necessary before this scoring model is commonly used.

The status of vegetation and the impacts of mammalian herbivores on rangelands are complex, and such studies in Kenya are scanty. We investigated the dynamics of ground cover vegetation in Hell’s Gate National Park in relation to mammalian herbivory. Removal of palatable vegetation is postulated to enhance the development of invasive plant species. We investigated the influence of mammalian herbivores on vegetation diversity and dynamics in this rangeland. Three sampling blocks approximately 3 Km apart measuring 100 m x 50 m were established, each divided into three belt-transects (100 m x 10 m), and separated by a 10 m buffer zone. 2 m by 2 m quadrats at 20 m intervals were established in each transect. We measured composition the richness of plant and mammal species, and herbivory levels four times for six months (September 2018 to February 2019). Plant cover (P&lt; 0.001) and species diversity (P&lt; 0.001) differed significantly among sampling blocks and between seasons (P&lt; 0.001). Non-metric multidimensional scaling of plant species and herbivores showed co-occurrence of Zebras with Sida tenuicarpa and giraffes with Solanum incunum. We conclude that the removal of preferred plants through herbivory may be giving an edge to invasive species in the park.

Background: We aimed to create a model of radiological and pathological criteria able to predict the upgrade rate of low-grade ductal carcinoma in situ (DCIS) to invasive carcinoma, in patients undergoing vacuum-assisted breast biopsy (VABB) and subsequent surgical excision. Methods: 3100 VABBs were retrospectively reviewed among which we reported 295 low-grade DCIS who subsequently underwent surgery. The association between patients’ features and the upgrade rate to invasive breast cancer (IBC) was evaluated by univariate analysis. Finally, we developed a predictive multivariable model based on the features which were significantly associated with the univariate analysis outcome. Results: the upgrade rate to invasive carcinoma was 10.8 %. At univariate analysis, the risk of upgrade was significantly lower in the absence of post- biopsy residual lesion (p<0.001), age > 50 (p=0.029), and in presence of low-grade DCIS only in specimens with microcalcifications (p=0.002). According to the final multivariable model, the predicted probability of diagnostic underestimation for a patient with all the three favourable features selected at univariate analysis was 1% (95% CI: 0.3%-4%). Conclusions: An easy to use predictive model of radiological and pathological criteria is able to identify patients with low-grade carcinoma in situ with low risk of upstaging to infiltrating carcinomas.

Biological invasions represent a threat to ecosystems, through competition and habitat destruction, which may result in significant changes of the invaded community. Asparagopsis armata is a red macroalgae (Rodophyta) globally recognized as an invasive species. It is found from the intertidal to shallow subtidal areas, on rock or epiphytic, forming natural vegetation belts on exposed coasts. This study evaluated the variations on native intertidal seaweed and macroinvertebrate assemblages inhabiting rock pools with and without the presence of the invasive macroalgae A. armata. To achieve this, manipulation experiments on Atlantic (Portugal) rock pools were done. Three rock pools were maintained without A. armata by manual removal of macroalgae, and three others were not experimentally manipulated during the study period and A. armata was freely present. In this study the variations between different rock pools were assessed. Results showed different patterns in the macroalgae composition of assemblages but not for the macrobenthic communities. Ellisolandia elongata was the main algal species affected by the invasion of A. armata. Invaded pools tended to show less species richness, showing a more constant and conservative structure, with lower variation of its taxonomic composition than the pools not containing A. armata, where the variability between samples was always higher. Despite the importance of the achieved results, further data based on observation of long-term series are needed, in order to further understand more severe effects of the invader A. armata on native macroalgal assemblage.

Over the last two months, as oncology specialists, we have frequently been contacted for estimating prognosis for cancer patients affected by COVID-19 infection. Until now, there have been no clear markers to guide decision making regarding the appropriateness of invasive ventilation in cancer patients affected by COVID-19 infection. Therefore, we developed a practical tool encompassing a prognostic score. We aimed at identifying a subgroup of patients likely to have a better outcome and therefore may be potential candidates for invasive ventilation, "The Milano Policlinico ONCOVID-ICU score". The score is composed by three groups of variables: patient’s characteristics such as sex, age, BMI and comorbidities; oncological variables (treatment intent, life expectancy, on or off-treatment status) and clinical parameters in association with laboratory values (SOFA score and D-dimer). The SOFA score includes six different clinical parameters and during the first few days of ICU admissions has an important prognostic role. The oncological history should never represent, per se, a contraindication to intensive care and must be considered together with other variables, such as laboratory values, clinical parameters and patient characteristics, in order to make the hardest but best possible choice. The Milano Policlinico ONCOVID-ICU score, to our knowledge, is the first prognostic score proposed in this setting of patients and may be a useful tool to assess the prognosis of cancer patients being in this critical condition.

Hymenoscyphus albidus is a native fungus in Europe where it behaves as a harmless decomposer of leaves of common ash. Its close relative Hymenoscyphus fraxineus was introduced into Europe from Asia and currently threatens ash (Fraxinus sp.) stands all across the continent causing ash dieback. H. fraxineus isolates from Europe were previously shown to harbor a mycovirus named Hymenoscyphus fraxineus Mitovirus 1 (HfMV1). In the present study, we describe a conspecific mycovirus that we detected in H. albidus. HfMV1 was consistently identified in H. albidus isolates (mean prevalence: 49.3%) which were collected in the sampling areas before the arrival of ash dieback. HfMV1 strains in both fungal hosts contain a single ORF of identical length (717 AA) for which a mean pairwise identity of 94.5% was revealed. The occurrence of a conspecific mitovirus in H. albidus and H. fraxineus is most likely the result of parallel virus evolution in the two fungal hosts. HfMV1 sequences from H. albidus showed a higher nucleotide diversity and a higher number of mutations compared to those from H. fraxineus, probably due to a bottleneck caused by the introduction of H. fraxineus in Europe. Our data also points to multiple interspecific virus transfers from H. albidus to H. fraxineus, which could have contributed to the intraspecific virus diversity found in H. fraxineus.

Objective: To evaluate three different microincisional ab interno trabeculectomy procedures in a porcine eye perfusion model. Methods: In perfused porcine anterior segments, 90 degrees of trabecular meshwork (TM) were ablated using the Trabectome (T; n = 8), Goniotome (G; n = 8), or Kahook device (K; n = 8). After 24 hours, additional 90 degrees of TM were removed. Intraocular pressure (IOP) and outflow facility were measured at 5 µL/min and 10 µL/min perfusion to simulate an elevated IOP. Structure and function were assessed with canalograms and histology. Results: At 5 µL/min infusion rate, T resulted in a greater IOP reduction than G or K from baseline (76.12% decrease versus 48.19% and 47.96%, P = 0.013). IOP reduction between G and K was similar (P = 0.420). Removing another 90 degrees of TM caused an additional IOP reduction only in T and G but not in K. Similarly, T resulted in the largest increase in outflow facility at 5 µL/min compared with G and K (first ablation: 3.41 times increase versus 1.95 and 1.87; second ablation: 4.60 versus 2.50 and 1.74) with similar results at 10 µL/min (first ablation: 3.28 versus 2.29 and 1.90 (P = 0.001); second ablation: 4.10 versus 3.01 and 2.01 (P = 0.001)). Canalograms indicated circumferential flow beyond the ablation endpoints. Conclusions: T, G and K significantly increased the outflow facility. In this model, T had a larger effect than G and K.

Background: Significant intraoperative and postoperative blood loss are rare but possibly life-threatening complications after lung resection surgery either during open or minimally invasive procedure. Microporous Polysaccharide Hemospheres (ARISTA™AH) have demonstrated time-efficient haemostasis, lower post-operative blood volumes and a lower blood transfusion requirement, without any identified adverse events across other specialities.The primary aim of our study was to evaluate the impact of haemostatic agents on short-term postoperative outcomes in thoracic surgery. Methods: We retrospectively reviewed a prospectively collected database of consecutive early-stage lung cancer patients surgically treated in two European centres(October 2020-December 2022).Exclusion criteria:open surgery,patients with coagulopathy/anticoagulant medication,major intraoperative bleeding,non-anatomical lung resection and age <18 years.The cohort was divided into 5 groups according to the haemostatic agent used.Propensity score matching was used to estimate the effect of ARISTA™AH on various intra- and post-operative parameters(continuous and binary outcome modelling). Results:482 patients(M/F:223/259; VATS 97/RATS 385)with a mean age of 68.9(±10.6)years were analysed.In 253 cases ARISTA™AH was intraoperatively used to control bleeding.This cohort of patients had a significant reduction in total drain volume by 135 mls(standard error 53.9; p=0.012).The use of ARISTA™AH did reduce the average length of hospital stay(-1.47 days)and duration of chest drainage(-0.596 days)albeit not significant.In the ARISTA™AH group,we observed no postoperative bleeding,no blood transfusion required,no 30-day mortality and no requirement for redo-surgery.The use of ARISTA™AH significantly reduced the odds of post-operative complications,need for transfusion and redo surgery. Conclusion: Our data showed that Microporous Polysaccharide Hemospheres are a safe and effective haemostatic device.Its use has a positive effect in short term postoperative outcomes of patients surgically treated for early-stage lung cancer.

Burn patients still represent an important challenge in critical care medicine today. These patients can develop significant neurological conditions up to intracranial hypertension, but as they find themselves hospitalized outside of neurocritical care and are often subjected to sedation for the complex management, they are sometimes underestimated. The aim of this study is to evaluate the feasibility of non-invasive methods for the early diagnosis of intracranial hypertension in these patients. In this prospective observational study, adult burn patients admitted to intensive care within the first 8 hours of the event were enrolled. These patients were studied through ultrasound measurement of optic nerve sheath diameter and intracranial vessel velocimetry with transcranial Doppler. In the 20 patients studied, no frankly pathological values were identified in the 3 different measurement stages (within 8 hours of the burn, then at 48 and 96 hours) and no correlations were identified between the measured values and the extension of the burn with the related risk of mortality. However, this study, one of a kind, demonstrates that these non-invasive methods are applicable to this specific patient population, and can represent an effective method for reducing the incidence of complications that are dangerous for survival.

Background and Objectives: Although adult spinal deformity (ASD) surgery brought about the improvement of quality of life in patients, it accompanied with a high invasiveness of surgery and several complications. Specifically, mechanical complications of rod fracture, instrumentation failures, and pseudarthrosis are still unsolved issues. To better improve these problems, the oblique lateral interbody fusion at L5/S1 (OLIF51) was introduced since 2015 in my institution. The objective of this study was to compare the clinical and radiographic outcomes of anterior-posterior combined surgery for ASD between the use of OLIF51 versus transforaminal interbody fusion (TLIF) at L5/S1. Materials and Methods :A total of 117 ASD patients received anterior-posterior correction surgeries either use of OLIF51 (35 patients) or L5/S1 TLIF (82 patients). In both groups, L1-5 OLIF and minimally invasive posterior procedures of hybrid or circumferential MIS were employed. The sagittal and coronal spinal alignment and spino-pelvic parameters are recorded preoperatively and at follow-up. The quality of life parameters and visual analogue scale were evaluated as well as surgical complications at follow-up. Results: The average follow-up period was thirty months (13-84). The average fused segments were eight (4-12). The operation time and estimated blood loss were significantly smaller in OLIF51 that those in TLIF. The PI-LL mismatch, LLL, L5/S1 segmental lordosis, and L5 coronal tilt were significantly better in OLIF51 than TLIF. The complication rate was statistically equivalent between two groups. Conclusion: The introduction of OLIF51 for adult spine deformity surgery led to the decrease of operation time and estimated blood loss as well as the improvement of sagittal and coronal correction when compared to TLIF.

This overview of extant Siphonaptera lists 19 families with major hosts and general distribution, estimated numbers of genera, species, and subspecies, with a brief taxonomic and phylogenetic review. With around 10 new species described annually, global flea fauna has an estimated extant 249 genera, 2215 species, and 714 subspecies, mostly mammal parasites but 5% of species are on birds. Host specificity varies from euryxenous (i.e. infesting two or more host orders)(e.g. cat fleas, Ctenocephalides felis felis) to monoxenous (e.g. rabbit fleas, Spilopsyllus cuniculi) . The largest family is the paraphyletic Hystrichopsyllidae, making up a third of all flea species. The largest monophyletic family, Ceratophyllidae (rodent and bird fleas), comprise another 20%, and has dispersed to every continent including Antarctica. Fleas descend from scorpionflies (Mecoptera), possibly snow scorpionflies (Boreidae) or Nannochoristidae, and even giant fossils found from the Mesozoic could be Siphonaptera. Flea diversification shows evidence of taxon cycles: "Relict" families such as helmet fleas (Stephanocircidae) have a disjunct distribution reflecting the breakup of Gondwanaland, 70 million years ago. "Niche specialists" include nest fleas (Anomiopsyllus), bat fleas (Ischnopsyllidae), and burrowing fleas, the chigoes (Tungidae). By contrast, Ceratophyllidae fleas could be considered "great speciators". Cat fleas and several other synanthropic flea species are invasive "supertramps". Although those species are intensively studied, many flea species and their hosts require urgent surveys and conservation.

Locust is a pest that attacks human and animal food and endangers national security by threatening food security. Spraying is the easiest and fastest way to deal with them. But the easiest way is not always the best way. With chemical resistance, not only will permanent immunity from locust attacks not arise, but they will also become resistant to poisons. While we have to pay billions of dollars annually for this strategy, we will also cause water and soil pollution. Therefore, the research results of other researchers were used and modeled to measure the possibility of hunting invasive locusts to investigate the possibility and benefits of this action. So, this study was conducted in the field method. The obtained results indicate that it is possible to hunt invasive locusts. If traps are placed on time and in the right place, the possibility of preserving crops after the pest attack increases by 2.3 times more in protected fields than in unprotected fields. By hunting locusts, fields and even pastures are preserved, poisons are prevented from entering the food chain and ecosystem, part of the economic loss of farmers affected by the invasion of locusts will be compensated, and by providing animal feed through hunting locusts, water consumption will be reduced, soil erosion and energy consumption are saved.

Major disturbances fundamentally alter ecosystems through the transformation of both biotic and abiotic factors. The eruption of Mount St. Helens in 1980 resulted in a cataclysmic restructuring of its surrounding landscapes. The Pumice Plain is one of these landscapes, where tree species such as Sitka willow (Salix sitchensis) and their dependent communities have established along newly-formed streams. Thus, the study of these dependent communities provides a unique opportunity to investigate factors influencing metacommunity assembly during true primary succession. We analyzed the influence of landscape connectivity on metacommunity assembly through a novel application of circuit theory, alongside the effects of other factors such as stream locations, willow leaf chemistry, and leaf area. We found that landscape connectivity structures community composition on willows across the Pumice Plain, while our other factors had varied effects. Most importantly, multiple levels of spatial habitat structure linked via landscape connectivity can predict the presence of organisms lacking high rates of dispersal, such as the invasive stem-boring poplar weevil (Cryptorhynchus lapathi). This is critical for management as we show that the maintenance of a heterogeneous mixture of landscape connectivities and resource locations can facilitate meta-community dynamics to promote ecosystem function and mitigate the influences of invasive species.

Invasive candidiasis (IC) is associated with high morbidity and mortality in hospitalized patients if not diagnosed early. Long-term use of central venous catheters is a predisposing factor for IC. Hyphal forms of Candida albicans (the major etiological agent of IC) are related to invasion of host tissues. The secreted proteins of hyphae are involved in virulence, host interaction, immune response, and immune evasion. To identify IC diagnostic biomarker candidates, we characterized the C. albicans hyphal secretome by gel-free proteomic analysis, and further assessed the antibody-reactivity patterns to this subproteome in serum pools from 12 patients with non-catheter-associated IC (ncIC), 11 patients with catheter-associated IC (cIC), and 11 non-IC patients. We identified 301 secreted hyphal proteins stratified to stem from the extracellular region, cell wall, cell surface, or intracellular compartments. ncIC and cIC patients had higher antibody levels to the hyphal secretome than non-IC patients. Seven secreted hyphal proteins were identified to be immunogenic (Bgl2, Eno1, Pgk1, Glx3, Sap5, Pra1 and Tdh3). Antibody-reactivity patterns to Bgl2, Eno1, Pgk1 and Glx3 discriminated IC patients from non-IC patients, while those to Sap5, Pra1 and Tdh3 differentiated between cIC and non-IC patients. These proteins may be useful for development of future IC diagnostic tests.

The horse chestnut leaf miner Cameraria ohridella (Lepidoptera: Gracillariidae) is an invasive pest of horse chestnut and has spread through Europe since 1985. The horse chestnut leaf blotch Guignardia aesculi (Botryosphaeriales: Botryosphaeriaceae) is a fungal disease that also seriously damages horse chestnut trees in Europe. The interaction between the leaf miner and the fungus has not yet been sufficiently described. Therefore, the aim of the present study was to assess leaf damage inflicted to horse chestnut by both C. ohridella and G. aesculi during the vegetation season and to model their interaction. The damage to leaf area was measured monthly from May to September 2013 in České Budějovice, the Czech Republic. A simple phenomenological model describing the expected dynamics of the two species was developed. The study revealed a significant effect of sampling site and sampling period on the damage caused by both the pest and the fungus. The mathematical model indicates that infestation by C. ohridella is more affected by G. aesculi than vice versa. The possible mechanisms affecting the relationship between G. aesculi and C. ohridella are discussed.

Outbreaks of the Nearctic leafhopper Erasmoneura vulnerata represent a recent issue for winegrowers in Southern Europe, in particular in North-eastern Italy. Problems are frequent in organic vineyards because insecticides labeled for organic viticulture show limited effectiveness towards leafhoppers. On the other hand, the response by naturally occurring predators and parasitoids to E. vulnerata populations in vineyards is often unable to keep leafhopper densities under levels that are acceptable for winegrowers. Here we evaluated the potential of two generalist predators, i.e., Chrysoperla carnea and Orius majusculus, in controlling E. vulnerata populations. Laboratory and semi-field experiments were carried out to evaluate both species' predation capacity on E. vulnerata nymphs. Then, predators were released in vineyards colonized by large E. vulnerata populations. Both predator species exhibited a remarkable voracity in the laboratory and significantly reduced leafhopper densities in semi-field experiments. Predator releases in vineyards reduced leafhopper densities by about 30%. Results obtained in laboratory, semi-field, and field experiments are discussed to implement these biocontrol agents' use in pest control tactics.

Agrilus planipennis is a devastating invasive pest of ash trees. This wood-boring insect native to Asia and established in European Russia about 20 years ago poses a serious threat to ash trees all over Europe. In 2019 we first detected Agrilus planipennis in Ukraine. More than 20 larvae have been collected from under the bark of Fraxinus pennsylvanica trees on 5 September 2019 in Markivka District of Luhansk Region. Coordinates of the localities of collection: 49.614991 N, 39.559743 E; 49.614160 N, 39.572402 E and 49.597043 N, 39.561811 E. The photos of damaged trees with larval galleries, exit holes and larvae are presented. There is no doubt that the pest is established in Ukraine. This fact is important for development of quarantine protocols to prevent or at least slow the further spread of this invasive pest in Europe.

The fishery biology of the invasive Atlantic blue crab Callinectes sapidus in the Mediterranean Sea outside the eastern sectors of the basin has been only recently investigated. Here we studied the population of C. sapidus in the Lesina Lagoon (Adriatic Sea, SE Italy). In total, 838 crabs were captured monthly between February 2021 and January 2022 using fyke nets. Abundances varied seasonally with catches per unit effort ranging between 0 and 1.76 crabs fyke nets-1 d-1 in winter and summer. Spatial abundances estimated in summer by a Carle-Strub procedure ranged between 0.06 and 0.64 crabs m-2. Sex ratio (♂/♀) was close to 1:1; males prevailed only in August and September; ovigerous females occurred from April to August. Males’ size at morphological maturity was smaller than females (110.6-112.3 mm vs. 122.1-123.1 mm). Seasonal von Bertalanffy growth parameters indicated that, compared with males, females showed a shorter maximum lifespan (5 vs. 8 years), a higher growth coefficient K (0.6 vs. 0.4 y-1) and growth performance index ' (4.6 vs. 4.3), while maximum sizes CW∞ (237.8 vs. 232.6 mm) and seasonality indices C (0.62 vs. 0.57) were similar. Furthermore, females showed higher natural and fishing mortalities and exploitation rate. We discussed the results of the present study in the context of the available literature to provide a valuable basis for the implementation of standardised Mediterranean-scale management plans, matching exploitation of C. sapidus with sustainable conservation of coastal ecosystems.

Micro-invasive therapeutic approaches in endodontics differentiate between different modified types of access cavities: occlusal via a smaller occlusal opening (15 ° access angle), medial (via the caries defect) for premolars and molars (30 ° access angle) and cervical with wedge-shaped defects or root caries on anterior teeth and single-rooted premolars (45 ° access angle). Therefore, the aim of this work was (i) to create an in-vitro model for the clinical simulation of these three different modified access types, (ii) to assess the biomechanics of the instrumentation and (iii) to measure the volumetric substance loss of four different preparation systems. Material and Method: Simulated S-shaped root canals with a high degree of obliteration (ISO 10) in acrylic polymer bodies with canal entrance angles of 15 °, 30 ° and 45 ° were shaped with NaOCl (3%) irrigation under clinical simulation at body temperature (37 ° C) in randomized blinded sequences (n = 7) according to manufacturer's instructions: 1. Conventional geometry, not heat treated, up to 35 / .04 (F360, Komet) 2. Conventional geometry, heat-treated, spark-eroded up to 40 / .04 (Hyflex EDM, Coltene Hyflex) 3. Spiral geometry, heat treated, up to 36 / .03 (TruNatomy, DentsplySirona) 4. Distinctive spiral geometry, heat-treated (XP-Endo Shaper, FKG) The vectorization (AutoCAD) of the root canals was performed before and after preparation in the apical, middle and coronal third of the root canal. The volumetric loss of substance in cubic millimeters was recorded and statistically evaluated using an independent two-sided t-test. Clinical demonstrations include three cases of micro-invasive access cavities as final proof of principle of fast and safe root canal treatment. Results The total loss of volume at 15 ° entry angles is significantly lowest with TruNatomy and XP Endo. With an access angle of 30 °, the total loss remains low and increases with F360 and Hyflex .. At a 45 ° access angle, the group differences remain: TruNatomy (6.5 mm3) and XP Endo (6.4 mm3) versus F360 (8.3 mm3) and Hyflex (8.4 mm3). This difference in loss of simulated root dentin is highly significant. Conclusions Conventional instruments achieve optimal shape of apical third of root canals at all entrance angles only with higher substance loss in coronal and middle thirds . In contrast, the spiral instrument geometry contributes to dentin protection and supports the concept of minimally invasive endodontics for lifelong tooth preservation as shown in four clinical cases.

Although extracorporeal membrane ventilation offers the possibility for low frequency ventilation, protocols commonly used in patients with acute respiratory distress syndrome (ARDS) and treated with extracorporeal membrane oxygenation (ECMO) vary largely. Whether strict adherence to low frequency ventilation offers benefit on important outcome measures is poorly understood. Background/Objectives: This pilot clinical study investigated the efficacy of low frequency ventilation on ventilator free days (VFDs) in patients suffering from ARDS treated with ECMO therapy. Methods: In this single-center randomized controlled trial, 44 (70% male) successive ARDS patients treated with ECMO (aged 56 ± 12 years, SAPS III 64 (SD ± 14)) were randomly assigned 1:1 to control group (conventional ventilation) or treatment group (low fre-quency ventilation during first 72 hours on ECMO: respiratory rate 4-5/min; PEEP 14-16cm H2O; plateau pressure 23-25 cm H2O, tidal volume: < 4mL/kg). The primary endpoint was VFDs at day 28 of ECMO start. The major secondary endpoint was ICU mortality, 28-day and 90-day mortality. Results Twenty-three (52%) patients could be successfully weaned from ECMO and were discharged from intensive care unit (ICU). Twelve patients in the treatment group and five patients in the control group showed more than one VFD at day 28 after ECMO. VFDs were 3.0 (SD ± 5.5) days in the control group and 5.4 (SD ± 6) days in the treatment group (P = 0.117). Until day 28 after ECMO initiation, patients in the treatment group could be more often successfully weaned from ventilator (OR of 0.164 of 0 VFDs at day 28 after ECMO start; 95% CI 0.036-0.758; P = 0.021). ICU mortality did not differ significantly (36% in treatment group and 59% in control group; P = 0.227). Conclusions: Low frequency ventilation is comparable to conventional protec-tive ventilation in patients with ARDS treated with ECMO. However, low frequency ventilation may support weaning from invasive mechanical ventilation in patients suffering from ARDS treated with ECMO therapy.

Objective. To test the hypothesis that a session of unilateral tSMS over the dominant primary motor cortex (M1) in healthy subjects produces a transient decrease in manual dexterity. Methods. A triple-blinded randomized control trial was conducted in 40 healthy participants who were allocated to real- or sham-tSMS group. Each participant underwent one session of tSMS and were assessed before, immediately after, 15 minutes, and 40 minutes after stimulation. Outcome measures were Finger Tapping Test (FTT), 5-seconds FTT, nine Hole Peg Test, and the hand grip assessment. Results: Significant differences were found between groups 15 minutes after stimulation in favor of the tSMS group in the FTT (2.2 ± 0.99; CI= .18-4.22; d= .84p=.034), and 5-second FTT (4.2 ± 1.98; CI= .199-8.2, d= .68; p=.04). In the intragroup analysis, a significantly lower number of taps 15 minutes after stimulation was observed in sham group (3.3 ± 1.01; CI= .47-6.13; d= .42; p=.015), but not in the real stimulation group. Conclusion: A unilateral session of tSMS in the M1 of the dominant hemisphere of healthy individuals does not reduce manual dexterity or grip strength. This technique could have benefits on the motor performance of the arm contralateral to the stimulated motor cortex

Introduction: Gastric cancer (GC) is one of the most common cancers in the world. It is a very aggressive and heterogeneous tumor. GC does not cause symptoms, so it is often diagnosed in an advanced stage and associated with poor prognosis. Despite new treatment options, it still remains a therapeutic problem. An important element determining the method of treatment of locally advanced gastric cancer (LAGC) is the assessment of lymph node metastases in preoperative and postoperative imaging and/or histopathological examination.Aim: The assessment of lymphovascular invasion (LVI) in histopathological examination in patients with LAGC after gastrectomy. The groups of patients were divided into patients who received preoperative chemotherapy, patients without preoperative chemotherapy, and all patients. Additionally, we assessed the correlation between the presence of LVI and the number of lymph nodes collected during gastrectomy.Material and method: We collected patients with histologically confirmed GC after gastrectomy. The collected samples were divided into three subgroups: patients with neoadjuvant chemotherapy (NAC), patients without NAC, and all patients. Histopathological examination assessed the presence of LVI infiltration. We then assessed the correlation between the presence of LVI and the presence of lymph node metastasis in GC. Additionally, we assessed the correlation between LVI and the number of lymph nodes evaluated in patients in each group. The statistical analyses were performed using Statistica v13.3 and Microsoft Excel 2021. The significance limit was set at p<0.05.Results:The presence of LVI strongly correlated with node involvement, and the result was statistically significant in all patients and the group of patients treated with NAC. The difference was not statistically significant in the group not treated by NAC. Additionally, we did not observe a correlation between the presence of LVI and the number of metastatic lymph nodes in GC.Summary and Conclusions: The presence of LVI in a patient with GC indicates a high probability of lymph node metastasis, which should translate into therapeutic procedures. Assessment of LVI may help identify potential patients with lymph node metastases, particularly in patients undergoing endoscopic resection without planned lymphadenectomy. It is advisable to expand research on a larger scale in order to establish clear standards in this area.

Study design :Technical note. Objectives : To present a new unilateral biportal endoscopic technique for lumbar disc herniation without C-arm . Background : Lumbar disc herniation requires surgical intervention when conservative methods fail. Shifts towards minimally invasive percutaneous endoscopic lumbar discectomy, including uniportal and biportal approaches, have been hindered by challenges such as steep learning curves and reliance on radiation-intensive C-arm guidance. Our study introduces the use of standard intraoperative navigation in unilateral biportal endoscopy (UBE) to reduce radiation exposure and increase surgical acuracy. Materials and Methods : A 24-year-old man with low back and bilateral leg pain with gait disturbance was referred to our hospital. He had have conservative treatment for 12 months in another hospital before admission. However, the conservative treatment did not work for him. He had low back pain (VAS 4/10) and bilateral leg pain (VAS 8/10), muscle waekness of bilateral legs (Manual muscle testing ;MMT of extensor hullusis longs 4 4), and numbness of bilateral lower leg. Preoperative lumbar MRI showed L4/5 large central disc herniation. Results: He underwent C-arm free unilateral biportal endoscopic discectomy under the guidance of O-arm navigation. The patient was successfully treated surgically. Postoperative lumbar MRI showed good decompression of dural sac and bilateral L5 nerve roots. MMT and sensory function of both leg had recovered fully on final follow-up at one year. Conclusions/Level of Evidence: The new unilateral biportal endoscopic technique under navigation guidance is useful technique for lumbar disc herniation. This innovative technique proved to be safe, accurate, and minimized radiation exposure for surgeons for the treatment of lumbar intervertebral disc herniation. Level V.

Biodiversity conservation is a key factor in meeting sustainable development goals. This is even more important in cities, where green spaces are becoming increasingly scarce. This study analyzes the Kinshasa's proliferating ornamental plant nurseries, known as informal horticultural sites (IHS). The analysis focused on characterizing the profile of horticulturists, their production conditions and the ornamental species produced. Fifteen IHSs were sampled using the "snowball" technique, and 178 horticulturists were surveyed. Based on the socio-professional profile of the horticulturists, five groups of IHS are distinguished after a hierarchical classification on principal components. We found that IHSs exclusively employed men, most of whom were new to the trade, from all levels of education, and most of whom ranged from 19 to 45 years old. Production conditions are relatively similar from one site to another. However, all IHS are characterized by permanent land insecurity, the use of phytosanitary products, plant conditioning methods that are not very diversified and calibrated to growers' investment capacities, and diversified seed acquisition methods. A total of 139 ornamental species, most of them exotic, were identified. Of these, 37% are phanerophytes and 24% are considered potentially invasive. We suggest ways of professionalizing the activity and protecting the urban environment.

(1) Background: The stylohyoid syndrome, known as classical Eagle Syndrome (cES), is characterized by calcificatication of the stylohyoid chain with numerous nonspecific symptoms, mainly pain. This study introduces Minimally Invasive Cervical Styloidectomy (MICS). (2) Methods: MICS was performed on sixty-five patients diagnosed with classical Eagle syndrome. Patients underwent meticulous differential diagnosis. Surgical plans were established based on the findings from neck angioCT. (3) Results: The healing process was uneventful without significant complications. The overall success rate was 97.0%, with a follow-up of a minimum of six months. In one case, the surgery did not yield the desired improvement. In one case, a partial relapse of symptoms was observed. (4) Conclusions: MICS is a straightforward and efficient surgical treatment technique for stylohyoid syndrome.

(1) Background: This case report focuses on a 46-year-old female patient diagnosed with a rare and aggressive form of breast cancer known as rapidly growing, ulcerated breast cancer. The patient exhibited rapid progression of the disease, experiencing discomfort and noticeable changes in the size and texture of the affected breast over a short period of time; (2) Methods: An intensive neoadjuvant chemotherapy regimen was employed as the primary treatment approach. The patient's response to this treatment was closely monitored and assessed. Various diagnostic tests and imaging techniques were utilized to evaluate the extent of the disease and track its response to the chemotherapy; (3) Results: The patient's response to the neoadjuvant chemotherapy regimen was remarkable, resulting in a complete pathologic response. This outcome, although unusual in rapidly growing, ulcerated breast cancers, highlights the effectiveness of neoadjuvant chemotherapy in managing large, locally advanced breast cancers; (4) Conclusions: The multidisciplinary approach employed in managing this complex breast cancer case proved to be crucial to the patient's favorable outcome. Despite the aggressive nature of the disease and the challenges posed by the rapid growth and ulceration, the patient achieved a positive result. This case contributes to the limited clinical literature on such unusual and aggressive breast cancer cases, providing valuable insights for future clinical practice.8

BackgroundIndex level disc herniation following lumbar spinal decompression is somewhat overlooked as postoperative complication, resulting in return of symptoms. It is proposed that the combination of local instability and degenerated disc is more likely to result in disc herniation. There is no literature comparing post-decompression disc herniation rates between different techniques. This study compares the postoperative disc herniation rates of the "mini-open" laminectomy versus the tubular system decompression.MethodsIn a retrospective comparative study, 563 patient files who underwent primary lumbar spinal decompression, were reviewed and divided into two groups, distinguished by surgical technique. Demographic, clinical, and postoperative data were collected and compared using independent two-tailed t-test and Fisher's exact test with significance set at p<0.05. Primary outcome: comparison of post-decompression surgery, index level, disc herniation occurrence between two surgical techniques.ResultsPostoperative index level disc herniation was significantly lower in the minimally invasive surgery group with 2 cases (0.8%) versus 19 cases (5.8%) in the "mini-open" group [p=0.002]. Disc herniation following single level and multi-level operations were also significantly lower in the minimally invasive group compared with the "mini-open" group (2 versus 11 and 0 versus 8 respectively; p<0.05).ConclusionPostoperative index level disc herniation following lumbar spinal decompression occurs in 3.7% of surgeries. Minimally invasive surgery is found to result in less herniations then "mini-open".

The purpose of this work was to evaluate a novel methodology developed by Digital Blood Corporation (DBC) to calculate critical blood values using four non-invasive measured values as input. The values obtained using a point-of-care testing (POCT) device were utilized for comparison and reference. Radial arterial blood was collected for the POCT comparator analysis using the Abbott i-STAT^® device. The non-invasive methodology from DBC requires four parameters to be directly measured: temperature, hemoglobin, pO2, and pCO2. Subsequently, sodium, potassium, chloride, ionized calcium, total carbon dioxide, pH, bicarbonate, and oxygen saturation are calculated using an algorithm. The agreement between the POCT and DBC’s methodology was analyzed using Bland-Altman difference plots. For a second data set, pO2 and pCO2 values collected with the POCT were used as input for DBC’s algorithm to test its robustness. Data from 37 healthy ambulatory individuals, mean age: 42.4 + 13 years; range: 18-64 years, were included in the primary analysis. In the case of the non-invasive gained four input values the greatest variation between POCT and DBC’s approach was observed for pO2 and consequently for algorithm values that depend upon pO2 precision. Replacing transcutaneous pO2 and pCO2 with POCT values demonstrates the principal ability of DBC’s algorithm to predict the additional 8 blood values in sufficient agreement with a standard POCT device in healthy patients. The algorithm developed by DBC appears to be robust in the case of healthy patients but does need the four measured input values with preciseness comparable to a POCT device to give reliable and clinically relevant results. The present study thus serves as a proof of concept to facilitate future study and further development of this methodology into a non-invasive device.

To evaluate the 2-year efficacy and safety of ab interno trabeculectomy with the Trabectome in Chinese primary open-angle glaucoma (POAG) patients. This was a multicenter, retrospective study and included POAG patients with or without visually-significant cataracts. The primary outcome was intraocular pressure (IOP) reduction. Secondary outcomes included reduction of glaucoma medications, surgical complications, and success at 2-years. Success was defined as: 1) IOP < 21 mmHg and at least 20% IOP reduction from baseline after 3 months at any two consecutive visits, and 2) no additional glaucoma surgery required. A total of 42 patients were enrolled; thirteen had a history of failed glaucoma surgery. Twelve patients underwent Trabectome surgery combined with phacoemulsification while the remainder underwent Trabectome surgery alone. Overall, the mean preoperative IOP was 21.4±1.23 mmHg. The Trabectome lowered IOP to 18.5± 0.94 mmHg at 2 years (P<0.05). The number of glaucoma medications also decreased from a baseline of 2.0±0.9 to 1.2± 0.21 at 2 years (P=0.04). The overall success was 78%, with patients undergoing combined surgery having a higher success than those with Trabectome surgery alone (100% vs. 76%). No major complications were seen. The Trabectome appears to be an efficient and safe procedure in Chinese POAG patients in the long-term.

Diabetes mellitus is a prevalent disease with a rapidly increasing incidence projected worldwide, affecting both industrialized and developing regions. Effective diabetes management requires precise therapeutic strategies, primarily through self-monitoring of blood glucose levels to achieve tight glycemic control, thereby mitigating the risk of severe complications. In recent years, there have been significant advancements in non-invasive techniques for measuring blood glucose using photoacoustic spectroscopy (PAS) as it shows great promise for the detection of glucose using the Infrared region (e.g. MIR & NIR) of light. A critical aspect of this method is the detection of the photoacoustic signal generated from blood glucose, which needs to be amplified through a photoacoustic resonator (PAR). In this work, an overview of various types of PARs used for noninvasive glucose sensing is reviewed, highlighting their operating principle, design requirements, limitations, and potential improvements needed to enhance the analysis of photoacoustic signals. This analysis will be helpful for the basic understanding and achieving the highly sensitive PAR required for noninvasive glucose monitoring.

Candida spp. is rarely found in the etiology of neonatal early-onset sepsis (EOS). However, candidemia is associated with increased mortality and morbidity, as in late-onset sepsis. Congenital candidiasis may present as mucocutaneous infection or, more rarely, as a systemic infection in term and preterm infants. Material and methods: Case reports of two cases of congenital systemic candidiasis (CSC) produced by Candida albicans and a review of the data in the literature. Results: Both neonates were male, born vaginally, with risk factors for congenital candidiasis. One of the infants was born at term and presented with an almost generalized maculopapular rash at birth; C. albicans grew in the blood culture sampled at 36 hours; parenteral fluconazole was started immediately, and no complications were noted. The other infant was born preterm, at 28 weeks of gestation, and presented signs of respiratory distress on the 4th day of life after initial successful treatment of the respiratory distress syndrome with surfactant and non-invasive respiratory support. C. albicans was present in the neonatal blood and gastric aspirate cultures, and in the maternal vaginal cultures (all sampled at birth); parenteral fluconazole therapy was administered for 30 days as investigations revealed both liver and renal involvement and the infant development bronchopulmonary dysplasia. Conclusion: As data in the literature suggests, despite occurring at any gestational age, CSC may present various clinical pictures, the rash may mimic many other neonatal conditions, and the systemic dissemination cannot be distinguished from bacterial EOS. Careful anamnesis and a high index of suspicion are important for the prompt recognition and treatment of CSC, optimizing the short- and long-term outcomes.

The study aimed to evaluate implant success and bone height variations after transcrestal sinus floor elevation (tSFE) using the osseodensification technique (OD) combined with beta-tricalcium phosphate (β-TCP), as bone graft material and simultaneous implant placement. Thirteen patients requiring the placement of one implant in the upper posterior maxilla, with a residual bone height of

Device-mediated, non-invasive drug delivery across the blood-brain barrier (BBB) represents a significant advancement in treating neurological diseases. The BBB is a tightly packed layer of endothelial cells that shields the brain from harmful substances in the blood, allowing necessary nutrients to pass through. It is a highly selective barrier, which poses a challenge to delivering therapeutic agents into the brain. Several non-invasive techniques and devices have been proposed or investigated to enhance drug delivery across the BBB. This paper presents the current state of the art and case studies that address the pharmacology, technology, delivery systems, regulatory approval, ethical concerns, and future possibilities.

Listerias of the phylogenetic lineage II (PLII) are common in the European environment, and are hypovirulent. Despite this, they caused more than a third of sporadic cases of listeriosis, and multi-country foodborne outbreaks. L. monocytogenes ST37 is one of them. During the COVID-19 pandemic ST37 appeared in the clinical cases and ranked second in occurrence among food isolates in the Moscow region. The aim of this study was to describe the genomic features of ST37 isolates from different sources. All clinical cases of ST37 were in the cohort of male patients (age, 48-81 years) with meningitis-septicemia manifestation, and COVID-19 or Influenza in the anamnesis. The core genomes of the fish isolates were closely related. The clinical and meat isolates revealed a large diversity. Prophages (2-4/genome) were the source of the unique genes. Two clinical isolates displayed the pseudolysogeny, and excided prophages were A006-like. Absence of the plasmids, the assortment of virulence factors and resistance determinants in chromosome corresponded to the hypovirulent characteristics. However, all clinical isolates caused severe disease with deaths in four cases. Thus, these studies allow us to speculate that a previous viral infection increases a human susceptibility to listeriosis.

Detecting the trends of species and populations is fundamental to identify taxa with high conservation priority. Unfortunately, long-term monitoring programs are challenging and often lacking. The Italian agile frog Rana latastei is endemic to Northern Italy and adjacent countries, is considered vulnerable by the IUCN, and is protected at the European level. However, quantitative estimates of its decline are extremely scarce. In this study, we document the trends in abundance and distribution of Rana latastei within the Monza Park, which currently represents the area closer to the type locality of the species. Wetlands within the park were monitored from 2000 to 2023; counts of egg clutches were taken as a measure of reproductive output and of the abundance of breeding females. In 2000, the species occurred over a significant proportion of the park. Total abundance showed strong yearly variation but remained rather constant from 2000 to 2019. However, Rana latastei disappeared from the park around 2021 and was never detected in 2022-23. The decline is probably related to the joint effect of multiple factors, including the conversion of breeding sites for farming, inappropriate water management, invasive alien species, and severe drought. The local extinction of Rana latastei occurred despite legal protection, highlighting the need for more effective and stringent tools for the conservation of European biodiversity.

BACKGROUND. Invasive aspergillosis (IA) is a deadly fungal lung infection. Antifungal resistance and treatment side effects are major concerns. Iron chelators are vital for IA management, but systemic use can cause side effects. We developed nanoparticles (NPs) to selectively deliver the iron chelator deferasirox (DFX) for IA treatment. METHODS DFX was encapsulated in poly(lacticco‐ glycolic acid) (PLGA) NPs using a single emulsion solvent evaporation method. NPs were characterized by light scattering and electron microscopy. DFX loading efficiency and release were assessed spectrophotometrically. Toxicity was evaluated using SRB, luciferase, and XTT assays. Therapeutic efficacy was tested in an IA mouse model, assessing fungal burden by qPCR and biodistribution via imaging.RESULTS DFX‐NPs had a size of ~50nm and a charge of ~‐30mV, with a loading efficiency of ~90%. Release kinetics showed DFX release via diffusion and bioerosion. The EC50 of DFX‐NPs was significantly lower (p<0.001) than the free drug, and they were significantly less toxic (p<0.0001) in mammalian cell cultures. In vivo, NPs treatment significantly reduced Af burden (p<0.05). CONCLUSION The designed DFX‐NPs effectively target and kill Af with minimal toxicity to mammalian cells. The significant in vivo therapeutic efficacy suggests these NPs could be a safe and effective treatment for IA.

The Asian hornet, Vespa velutina, is an invasive species that has not only expanded its range in Asia but also invaded European countries, incurring significant costs on the local honey and bee industry. This phylogeographic study aims to trace the evolutionary trajectory of V. velutina and its close relatives, aiming to identify features that characterize an invasive species. The last successful invasion of Vespa velutina into France occurred in 2002.40, and into South Korea in 2002.77, estimated by fitting a logistic equation to the number of observations over time. The instantaneous rate of increase is 1.3667 for V. velutina in France and 0.2812 in South Korea, consistent with the interpretation of little competition in France and strong competition from local hornet species in South Korea. The invasive potential of two sister lineages can be compared by their distribution area when proper statistical adjustments are made to account for differences in sample size. V. velutina has a greater invasive potential than its sister lineage. The ancestor of V. velutina split into two lineages, one found in Indonesia/Malaysia and the other colonizing the Asian continent. The second lineage split into a sedentary clade inhabiting Pakistan and India, and an invasive lineage colonizing much of Southeast Asia. This latter lineage gave rise to subspecies V. v. nigrithorax that invaded France, South Korea, and Japan. My software PGT, which generates geophylogenies and computes geographic areas for individual taxa, is useful for understanding biogeography in general and invasive species in particular. I discussed the conceptual formulation of an index of invasiveness for comparison between sister lineages.

Minimally invasive surgery for adult spinal deformities (MIS deformity surgery) utilizes MIS lumbar interbody fusion and percutaneous pedicle screw fixation (PPSF) without posterior corrective osteotomy. While MIS reduces issues associated with open deformity surgery, it has limitations in correcting sagittal imbalance. This review discusses the limitations and solutions of lateral lumbar interbody fusion (LLIF) and introduces our experience in addressing marked sagittal deformities. We reviewed the literature and incorporated our clinical experience to evaluate the efficacy of recent MIS techniques, particularly focusing on oblique lumbar interbody fusion (OLIF) at L1-5 and L5-S1. The use of higher profile and greater angle cages and the application of PPSF with curved rods and percutaneous rod compression were discussed. Advances in MIS techniques, such as OLIF, have enabled significant improvements in increasing disc height and angle. Combining these new techniques and concepts, we successfully corrected marked sagittal deformities using MIS deformity surgery. Early onset of proximal junctional kyphosis was identified as a notable complication. Although recent advancements in MIS deformity surgery have shown promise in correcting sagittal deformities, further clinical experience and data are necessary to enhance outcomes and mitigate complications such as proximal junctional kyphosis.

Dopaminergic replacement therapy remains the mainstay of symptomatic treatment for Parkinson’s disease (PD), but many unmet needs and gaps remain. Device based treatments or device-aided non-oral therapies are typically used in the advanced stages of PD, ranging from stereotactic deep brain stimulation to levodopa or apomorphine infusion therapies but there are concerns due to a number of procedural, hardware, or long-term treatment-related side effects of these treatments, and limited nonmotor benefit in PD. Therefore, there is an urgent unmet need for low risk adjuvants or standalone therapies which can address the range of burdensome motor and nonmotor symptoms that occur in PD. Recent studies suggest that non-invasive neurostimulation of the vestibular system may be able to address these gaps with stimulation of the vestibular brainstem sensory network which extensively innervates brain regions regulating both motor and a range of nonmotor functions. Therapeutic non-invasive vestibular stimulation is a relatively modern concept that may potentially improve a broad range of motor and nonmotor symptoms of PD, even at early stages of the disease. Here we review previous studies supporting the therapeutic potential of vestibular stimulation for the treatment of PD and discuss ongoing clinical trials and potential areas for future investigations.

This paper describes the proposal and development of a proof of concept (PoC) for a data logger system designed for operation and fault detection in bench testing of combustion engines. The main objective was to develop a data logger system that collects data on vibration, sound, temperature, and CO2 levels to identify ignition and combustion faults, thereby contributing to reducing greenhouse gas emissions (GHG). The paper presents (i) the proposal and development and (ii) the open-source code: proof of concept for a data logger system focused on detecting faults and monitoring the operational condition of benchtop combustion engines. The results indicate the feasibility of the PoC for data acquisition and dataset creation for Research and Development purposes.

3D-printed models with high anatomic fidelity are an increasingly viable tool in simulation-based medical education. One advantage of 3D models is they provide enhanced tactile and spatial understanding of complex anatomy to develop technical skills used in minimally invasive procedures. We propose that 3D anatomical models can improve the development of Interventional Radiology vascular access skills – first described in the 1950s as the Seldinger Technique – for pre-clerkship medical students. Early adoption of 3D-printed technology in pre-clinical medical education can lead to improved student engagement and satisfaction when learning procedural techniques. This study involved creating a 3D model of the upper extremity vasculature from an anonymized CT angiogram, using it as a medical education tool for 31 pre-clinical medical students practicing the Seldinger Technique on a prefabricated venipuncture arm, and assessing student satisfaction with this form of learning. Overall, attendees responded positively to the incorporation of the 3D model in medical education to improve their anatomic understanding and application to the Seldinger Technique. These results indicate that the use of 3D models in simulation-based medical education can provide benefits to acquiring technical skills and the potential to decrease training costs without harming a patient.

Determining precise boundaries and protective zones for historical and cultural objects enables their effective preservation. This is particularly crucial in the face of increasing tourism, urbanization, and natural disasters. Accurately defining boundaries and protective zones can aid in the planning of scientific research, archaeological excavations, and other studies aimed at exploring the history and cultural significance of these objects. The article presents the framework for establishing protective zones around historical and cultural heritage sites existing in Ukraine, using the example of the Citadel defensive complex located in Lviv (Ukraine). It proposes general and detailed conceptual models for the combined application of remote and non-invasive methods for investigating historical and cultural heritage sites. This conceptual article introduces the theory of integrating radar satellite imaging with ground-based georadar imaging. Additionally, it presents a software module that has been developed to analyze collected data on two-dimensional historical and cultural heritage objects, refine their boundaries, and establish protective zones around them.

Bladder cancer (BC) possesses distinct molecular profiles that influence progression depending on its biological nature and delivered treatment intensity. Muscle-invasive BC (MIBC) and non-MIBC (NMIBC) demonstrate great intrinsic heterogeneity regarding different prognoses, survival, progression, and treatment outcomes. Transurethral resection of bladder tumor (TURBT) is the standard of care in treating NMIBC and serves both diagnostic and therapeutic purposes, despite the prevalent recurrence and progression among many patients. In particular, flat urothelial car-cinoma in situ and urothelial carcinoma with lamina propria invasion are the major precursors of MIBC. A new‐generation photosensitizer, 5‐Aminolevulinic acid (5-ALA), demonstrates high tumor specificity by illuminating the tumor lesion with a specific wavelength of light to produce fluorescence, and has been studied for photodynamic diagnosis to detect precise tumor areas by TURBT. Additionally, it has been applied for treatment by producing its cytotoxic reactive oxygen species, as well as screening for urological carcinomas by excreting porphyrin in the blood and urine. Moreover, 5-ALA may contribute to screening before and after TURBT in NMIBC. Here, we summarize the updated evidence and ongoing research on photodynamic technology for NMIBC, providing insight into the potential for improving patient outcomes.

(1) Background: Sentinel lymph node (SLN) mapping represents an accurate and feasible technique for the surgical staging of endometrial and cervical cancer. This is commonly performed by conventional laparoscopy or robotic-assisted laparoscopy, but in recent years, a new retroperitoneal transvaginal natural orifice transluminal endoscopic surgery (vNOTES) approach has been described. This technique provides easy visualization of lymphatic afferent vessels and pelvic lymph nodes, early SLNs assessment, and a coherent mapping methodology following the lymphatic flow from caudal to cranial. However, only a few publications have reported it. Following the IDEAL (Idea Development Exploration Assessment Long-term follow-up) framework, research concerning this technique is at stage 2a, with only small case series as evidence of its feasibility. Its standardized description appears necessary to provide the surgical homogeneity required to move further. (2) Methods: description of a standardized approach for retroperitoneal pelvic SLN mapping by vNOTES. (3) Results: we described a 10-step approach to successfully perform retroperitoneal vNOTES SLN mapping, including pre-, intra-, and postoperative management. (4) Conclusions: This IDEAL stage 2a study could help other surgeons approach this new technique, and it proposes a common methodology necessary to evolve through future IDEAL stage 2b (multi-center studies) and stage 3 (randomized controlled trials) studies.

Studies of Phytophthora impacts in forests generally focus on individual species without recogni-tion that Phytophthora occur in multispecies communities. We investigated community structure of Phytophthora species in the rhizosphere of Agathis australis (kauri) in Te Wao Nui o Tiriwa / Waitākere Ranges, New Zealand, in the context of kauri dieback disease expression. Soil sampling and tree health monitoring was conducted on 767 randomly selected mature kauri trees. Phy-tophthora species were detected using both soil baiting and DNA metabarcoding of eDNA. Four species were detected with soil baiting (P. agathidicida, P. cinnamomi, P. multivora, and P. pseudo-cryptogea) and an additional three species with metabarcoding (P. kernoviae, P. cactorum/P. aleatoria and an unknown clade 7 species). Phytophthora cinnamomi was the most abundant species and was distributed throughout the forest. Both P. multivora and P. agathidicida were limited to forest edges, suggesting more recent arrivals. P. agathidicida presence was strongly correlated with declining canopy health, confirming its role as the main river of kauri dieback. The limited distribution of P. agathidicida and infrequent detections (11.0% samples) suggests that that this species is spreading as an introduced invasive pathogen and provide hope that with strategic management uninfected areas of the forest can be protected. The frequent detections of P.cinnamomi and P. multivora, from symptomatic trees in the absence of P. agathidicida suggest more research is needed to understand their roles in kauri forest health.

Introduction: The objective of the study is to assess the failure of therapies with HFNO (High-Flow Nasal Oxygen), CPAP, Bilevel or combined therapy in patients with hypoxemic acute respiratory failure due to SARS-CoV-2 during their hospitalization. Methods: Retrospective and observational study of SARS-CoV-2 positive patients who required non-invasive respiratory support (NIRS), at the Reina Sofía General University Hospital of Murcia between March 2020 and May 2021. Results: Of 7355 patients, 197 (11,8%) were included. 95 of them failed this therapy (48,3%). We objectivated that during hospitalization in the ward the combined therapy with HFNO and CPAP had a lower failure rate overall and the highest treatment purely with Bilevel (p = 0,005). In the comparison of failure in therapy without two levels of airway pressure, HFNO, CPAP and combined therapy of HFNO with CPAP, (35,6% of patients) presented a 24,2% failure compared to those who did have two levels of pressure with Bilevel and combined therapy of HFNO with Bilevel (64,4% of patients) with 75,8% associated failure (OR: 0, 374; CI 95%: 0,203-0,688. p=0,001).Conclusions: The use of NIRS in conventional hospitalization is safe and effective in patients with respiratory failure secondary to SARS-CoV-2 infection. The therapeutic strategy with Bilevel increases the probability of failure, with the combined therapy strategy with CPAP and HFNO being the most promising option.

Arrhythmic sudden cardiac death (SCD) has an annual prevalence of 1 per 1000 while 75% of the victims suffer from ischemic and 10% from non-ischemic or hypertrophic cardiomyopathy. Altogether, these three entities account for more than 80% of the total SCD victims. Guidelines for implantable cardiac defibrillators are still dominated by LVEF<30% from the MADIT II study. In terms of arrhythmic risk stratification, the PRESERVE-EF study restored in clinical practice the two-step arrhythmic risk stratification approach based on Electrocardiographic non-invasive risk factors (NIRFs) guiding to electrophysiological study. In our times with the multiple cardiac imaging methods and artificial intelligence applications availability, this two-step approach based on integrated arrhythmia mechanisms detection, emerges as an efficient SCD risk stratification paradigm for these three entities but also for the patients with congenital heart disease.

Emerald ash borer (EAB), Agrilus planipennis, is an invasive beetle of East Asian origin that in North America and Russia killed millions of ash trees (Fraxinus spp.). In September 2020, EAB was de-tected in Saint Petersburg, becoming resonant event for the metropolitan city. The aim of the present study was to investigate occurrence and ecology of EAB in Saint Petersburg. The presence of two distinct enclave populations of EAB was revealed, each of which has (very likely) been established by separate events of “hitchhiking” transport vehicles. Following the invasion, further spread of EAB in Saint Petersburg was slow and locally restricted, main explanation for which is climatic factor. Due to spread by “hitchhiking”, the possibility of EAB further long-distance ge-ographic spread of EAB in the Baltic Sea region (EU) is high, and not only by ground transport (120–130 km distance from EU borders), but also by ferries transporting cars (traditional means of transportation across the Baltic Sea). In certain cases, development of EAB on F. excelsior was more successful (stem portion colonized, larval densities, number of galleries, exit holes, viable larvae, emerged beetles) than in (adjacent) F. pennsylvanica trees. Observed relatively high EAB-sensitivity of F. excelsior therefore questions the efficacy and benefits of the currently ongoing selection and breeding projects against ash dieback (ADB), caused by Hymenoscyphus fraxineus. Inventory, mapping, and monitoring of surviving F. excelsior trees in areas infested by both ADB and EAB are necessary to acquire genetic resource for work on strategic long-term restoration of F. excelsior, tackling (inevitable) invasion of EAB to the EU.

The invasion of the golden mussel has resulted in considerable environmental and socioeconomic alterations, which present a considerable threat to the native biodiversity and sustainability of the region. It is of the utmost importance to gain an understanding of the distribution and biological characteristics of this Asian mussel, as well as its interaction with human activities, in order to develop effective strategies for mitigating and preventing its further spread. This study examines the dispersal route and incidence of golden mussels, tracing their movement from initial populations in Argentina to their arrival in the São Francisco River Basin (SFR). The presence of the mussel was confirmed through an integrative assessment, which included shell taxonomic analyses and mitochondrial DNA signatures. This identified populations located 7.5 km from the river's mouth, in proximity to the Atlantic Ocean, in areas such as shrimp farms, artisanal ports, and marinas. The analysis of mitochondrial DNA revealed the presence of South American-specific and shared ancestral haplotypes in the SFR, Grande River, and Argentina. These findings indicate that intracontinental colonisation towards the northeast of South America originated from Asian populations that entered South America via Argentina. The absence of Asian-specific signatures in the RSF, combined with its geomorphological structure, which is unsuitable for large ports or transoceanic vessels, supports the hypothesis of intercontinental dispersal of Limnoperna fortunei.

Extramammary Paget disease (EMPD) is an uncommon adenocarcinoma of apocrine gland-rich areas, presenting significant diagnostic challenges due to its nonspecific clinical appearance and frequent misidentification as benign, inflammatory skin conditions. Traditional diagnostic methods such as biopsy are invasive and uncomfortable, often required repeatedly due to high recurrence rates. Dermoscopy and non-invasive imaging techniques have been used but provide limited diagnostic accuracy due to their constraints in depth penetration and resolution. Recent advancements in imaging technologies, such as line-field confocal optical coherence tomography (LC-OCT), show promise in enhancing diagnostic precision while minimizing invasive procedures. LC-OCT merges high-resolution imaging with deep penetration capabilities, capturing detailed horizontal and vertical skin images akin to histopathology. This study evaluated the diagnostic performance of LC-OCT in detecting EMPD and its recurrence in 17 clinically suspicious anogenital regions, belonging to 6 patients. Data were collected prospectively at patient bedside by an LC-OCT expert with poor training for EMPD; and, then, reviewed retrospectively by an independent LC-OCT expert with adequate training for EMPD and no concerns about time. The prospective examination yielded 64.7%-accuracy, 71.4%-sensitivity, and 33.3%-specificity. The retrospective analysis achieved 94.1%-accuracy, 100%-sensitivity, and 66.7%-specificity, with the only false positive case being a difficult-to-diagnose concomitant presentation of a lichen sclerosus et atrophicus. Despite the need for specialized training, our results suggest that LC-OCT represents a valuable tool for accurately identifying EMPD and improve its management by reducing unnecessary biopsies. Further studies are needed to standardize its clinical application.

This article provides a detailed analysis of non-invasive techniques for prediction and diagnosis of faults in internal combustion engines, focusing on the application of the Proknow-C and Methodi Ordinatio systematic review methods. Initially, the relevance of these techniques in promoting energy sustainability and mitigating greenhouse gas emissions is discussed, aligning with the Sustainable Development Goals (SDGs) of Agenda 2030 and the Paris Agreement. The systematic review conducted in the subsequent sections offers a comprehensive mapping of the state-of-the-art, highlighting the effectiveness of combining these methods in categorizing and systematizing relevant scientific literature. The results reveal significant advancements in the use of artificial intelligence (AI) and digital signal processors (DSP) to enhance fault diagnosis, as well as underscore the crucial role of non-invasive techniques in minimizing interference in monitored systems. Finally, concluding remarks point towards future research directions, emphasizing the need to develop digital twins for internal combustion engines and identify gaps for further improvements in fault diagnosis and prediction techniques.

Pollution, urbanization and technological advancements have posed stress on the ecosystem and its matrices. Globally, pollutants are observed in all compartments of ecological communities which affect the integrity of the atmosphere, hydrosphere, lithosphere and biosphere. Xenobiotics bioaccumulate and biomagnify across trophic levels or webs. Heavy metals have been implicated in impacts towards biodiversity and environmental declination. In Nigeria, wastes issues are a cause of concern and landfilling or are waste disposal approaches that cause deleterious effects such as depauperation of diversity and species decline, prompting the non-invasive ecotoxicological hazard assessments. Feathers were used to assess concentration levels of 13 metals (Fe, Mn, Zn, Cu, Co, Cr, Cd, Pb, Ni, Al, B, Se and Hg) using fast atomic absorption spectrophotometer (FAAS), one-way ANOVA was used in comparing variations in mean concentrations across trophic levels, diversity indices and point count methods were used to estimate diversity and abundance. Four avian species were assessed Hirundo aethiopica (insectivore), Streptoptelia senegalensis (granivore), Turdus pelios (omnivore), and Anthus leucophrys. (insectivore). Observed concentrations of important metals like iron were high with the insectivores having the highest concentrations of iron (2.6985 ± 0.1975 ppm) and granivores having the lowest (2.0100 ± 0.3172 ppm). The insectivores had the highest concentrations for cadmium, cobalt and chromium (0.0005 ± 0.0005ppm), nickel (at 00.0012 ± 0.0017 ppm) and least was observed in the granivores (0.0003 ± 0.0006 ppm). Selenium concentrations were quite high in insectivores (0.0775 ± 0.0035 ppm) and lowest in granivores (0.0433 ± 0.0015 ppm) likewise mercury for insectivores (0.0280 ± 0.0010 ppm) and granivores (0.0213 ± 0.0015 ppm). From the study, it is apparent that landfills are sources of pollution and poor management of wastes can affect biota (causing effects such as asymmetry and bioaccumulation) and ecosystem balance. The observation of heavy metals in the feathers serve as good sentinels due to their trophic levels and could be signs for what could be yet to occur. The heavy metal concentrations were significantly different at p < 0.05.

Sepsis still remains one of the most difficult conditions to diagnose as it presents unspecific clinical signs and symptoms, which makes early detection crucial. Our study aimed to enhance the accuracy of sepsis diagnosis by integrating multimodal monitoring technologies with traditional diagnostic methods. The research involved 121 newborns, comprising 39 cases of late-onset sepsis, 35 cases of early-onset sepsis, and 47 control subjects. Biosignals including pulse oximetry (PO), near-infrared spectroscopy (NIRS), and skin temperature (ST) were continuously monitored and an algorithm was developed using Python for identifying early signs of sepsis. The model demonstrated the ability to detect sepsis 6 to 48 hours in advance with an accuracy rate of 87.67% ± 7.42%. Sensitivity and specificity were recorded at 76% and 90%, respectively, with NIRS and ST having the most significant impact on predictive accuracy. Despite the promising results, limitations such as sample size, data variability, and potential biases were noted. The findings highlight the critical role of non-invasive biosensing methods in conjunction with traditional biomarkers and cultures, offering a robust framework for early sepsis detection and improved neonatal care. Further studies are recommended to validate these results across diverse clinical settings.

Treatment of bladder cancer remains a critical unmet need and requires advanced approaches, particularly the development of local drug delivery systems. The physiology of the urinary bladder causes the main difficulties in the local treatment of bladder cancer: regular voiding prevents the maintenance of optimal concentration of the instilled drugs, while poor permeability of the urothelium limits the penetration of the drugs into the bladder wall. Therefore, much research effort is spent to overcome these hurdles, thereby improving the efficacy of available therapies. The explosive development of nanotechnology, polymer science and related fields has contributed to the emergence of a number of nanostructured vehicles (nano- and micro scale) applicable for intravesical drug delivery. Moreover, the engineering approach has facilitated the design of several macro-sized depot systems (centimeter scale) capable of remaining in the bladder for weeks and months. In this article, the main rationales and strategies for improved intravesical delivery are reviewed. Here, we focused on analysis of colloidal nano- and micro-sized drug carriers, and indwelling macro-scale devices which were evaluated for applicability in local therapy of bladder cancer in vivo.

Background and Objectives: C-arm free MIS techniques can offer significantly reduced rates of postoperative complications such as blood loss and hospitalization time. Another advantageous long-term aspect is the notably diminished exposure to radiation which is known to cause ma-lignant changes. This study emphasizes that, in some cases of spinal conditions which require a procedural intervention, C-arm free MIS techniques hold stronger indications than open surgeries guided by image intensifier. Materials and Methods: In this research, a retrospective analysis and review of various cervical and thoracic spinal procedures, performed in our hospital, by applying C-arm free techniques. The course of the study explains the basic steps of the procedures and demonstrating postoperative or intra-operative results. For anterior cervical surgery, we performed OPLL resection, while for posterior cervical surgery, we performed posterior fossa decompression for Chiari malformation, minimally invasive cervi-cal pedicle screw fixation (MICEPS) and modified Goel technique with C1 lateral mass screw for atlantoaxial subluxation. Re-garding the thoracic spine, we performed anterior correction for Lenke type 5 scoliosis, and transdiscal screw fixation for DISH fractures. Results: C-arm free techniques are safe procedures that offer precise and high-quality postoperative results by offering sufficient spine alignment and adequate decompression depending on the case. Blood loss, postoperative pain and wound infection are other important aspects of spine surgery that must be always taken into consideration. Conclusions: Navigated C-arm free techniques are safe and precise procedures implemented in the treatment of surgically demanding conditions. They can significantly increase accuracy while decreasing the operative time. They represent the advancement in the field spine surgery and are hailed as the future of the same

Invasive fungal infections, notably candidemia, have been associated with COVID-19. The epidemiology of candidemia has significantly changed during the COVID-19 pandemic. We aim to identify the microbiological profile, resistance rates, and outcomes of COVID-19 associated candidemia (CAC) compared to patients with candidemia not associated with COVID-19. We retrospectively collected data on patients with candidemia admitted to the American University of Beirut Medical Center between 2004 and 2022. We compared the epidemiology of candidemia during and prior to the COVID-19 pandemic. Additionally, we compared the outcomes of critically ill patients with CAC to those with candidemia without COVID-19 from March 2020 till March 2022. Among 245 candidemia episodes, 156 occurred prior to the pandemic and 89 during the pandemic. Of the latter, 39 (43.8%) were CAC, most of which (82%) were reported from intensive care units (ICU). Non-albicans Candida (NAC) spp. were predominant throughout the study period (67.7%). Candida auris infection was the most common cause of NAC spp. in CAC. C. glabrata had decreased susceptibility rates to fluconazole and caspofungin during the pandemic period (46.1% and 38.4% respectively). Mortality rate in the overall ICU population during the pandemic was 76.6%, much higher than the previously reported mortality of candidemia from previous studies at our center. There was no significant difference in 30-day mortality between CAC and non-CAC (75.0% vs 78.1%; P =0.76). Performing ophthalmic examination (P = 0.002), CVC removal during the 48 hours following the candidemia (P = 0.008) and identifying the Candida spp. (P = 0.028) were significantly associated with a lower case-fatality rate. The epidemiology of candidemia has been significantly affected by the COVID-19 pandemic at our center. Rigorous infection control measures and proper antifungal stewardship are essential to combat highly resistant species like C. auris.

Bladder cancer (BC) is the most common neoplasm of the urinary tract, which originates in the epithelium that covers the inner surface of the bladder. The molecular BC profile has led to the development of different classifications of non-muscle invasive bladder cancer (NMIBC) and muscle-invasive (MIBC). However, the genomic BC landscape profile of the Mexican population, including NMIBC and MIBC, is unknown. In this study, we aimed to identify somatic single nucleotide variants (SNVs) and copy number variations (CNVs) in Mexican patients with BC and their associations with clinical and pathological characteristics. We retrospectively evaluated 37 patients treated between 2012 and 2021 at the National Cancer Institute - Mexico (INCan). DNA samples were obtained from paraffin-embedded tumor tissues and ran exome sequencing. Strelka2 and Lancet packages were used to identify SNVs and insertions or deletions. FACETS was used to determine CNVs. We found a high frequency of mutations in TP53 and KMT2D, gains in 11q15.5 and 19p13.11-q12, and losses in 7q11.23. STAG2 mutations and 1q11.23 deletions were also associated with NMIBC and low histologic grade.

Glaucoma is a leading cause of blindness. Surgical and pharmacological treatment of glaucoma aims to lower the intraocular pressure (IOP) and preserve visual function. The severe acute res-piratory syndrome coronavirus 2 pandemic has placed a strain on the healthcare system. We aimed to compare the quantity, type of anti-glaucoma surgeries, and the disease stage before and during the coronavirus disease pandemic. We analyzed 362 eyes of 306 patients and 172 eyes of 149 patients from the pre-pandemic and pandemic groups, respectively. The number of an-ti-glaucoma surgeries was halved during the pandemic compared to a similar pre-pandemic pe-riod, with a significant difference in the procedural structures between the two groups (p<0.001). The most common procedures in the pre-pandemic group were Ex-Press implantation (33.7%) and trabeculectomy (31.5%). Within the pandemic group, half of the eyes underwent tra-beculectomy (50.0%), followed by Preserflo microshunt (11.6%). A significant difference in the average IOPs was revealed among patients who qualified for surgery 22.21 ± 7.83 mmHg in the pre-pandemic group and 25.16 ± 9.48 mmHg in the pandemic group; p<0.001). There was no significant difference in the best corrected visual acuity between the groups (p=0.263). Glaucoma treatment remained relatively accessible during the pandemic.

In Åhlberg (2021, 2022b), I presented evidence for 57 health-promoting substances that all green vascular WEPs contain. I continued searching for health-promoting substances in the plant cells' basic structures and processes. While reading research reports of five invasive species, I found eight more health-promoting substances all green vascular wild edible plants have. This article adds eight new substances to the earlier 57, bringing the total to 65. This is a novel finding for which I provide research evidence. I present the latest research on five invasive wild edible plants (WEPs) species. Each contains at least the same 65 health-promoting substances and a varying number of species-specific health-promoting substances. Each WEP has 1) shared health-promoting substances that all green vascular plants have and 2) species-specific health-promoting substances. I also present how many of these substances prevent Alzheimer’s disease, according to experimental research.

MGMT promotor hypermethylation is the most important biomarker for predicting temozolomide sensitivity in aggressive glioblastoma (GBM), a disease with a poor prognosis. An MGMT status prediction without biopsy is mandatory for tailored therapy because methylated MGMT patients have better prognosis. To this end, this paper proposes the radiogenomic model for predicting the status of MGMT Promoter methylation in glioblastoma patients based on the multi-modal MRI data and the EfficientNet deep learning architecture. Perhaps using sophisticated machine learning-based non-invasive methods of genetic prognosis may decrease risky biopsies. The Magnetic Resonance Imaging (MRI) sequences in the BraTS21 competition dataset include T1-weighted and contrast-enhanced images, T2-weighted images, and Fluid Attenuated Inversion Recovery (FLAIR) images. Image preprocessing consisted of normalization, scaling, and data augmentation Fourier transformations for cross-modal alignment. The EfficientNet-b0 model was initially pre-trained on ImageNet and then fine-tuned to the binary classification of methylation and unmethylated MGMT. The models were evaluated based on AUC-ROC, accuracy, and the F1 score. The model’s capability of accurately identifying MGMT methylation status was moderate, with an AUC-ROC score of 0.62393 at its best. These differences influenced validation findings: overfit and resulted in accuracy variations for the small or unbalanced datasets. Applying multimodal MRI data elevated feature extraction, proving that deep learning models have radiogenic predictive power. Therefore, this study demonstrates that ALC and DL models can noninvasively estimate MGMT promoter methylation status. They also suffer from problems of overfitting or generalization, which will require some optimization. It might be safer than biopsies and can enhance approaches to glioblastoma treatment.

Diabetes mellitus is a widespread chronic metabolic disorder demanding regular blood glucose level surveillance (BGLs). Current invasive techniques, such as finger-prick tests, often result in discomfort for patients, leading to infrequent monitoring and potential health complications. The primary objective of this study was to design a novel, portable, non-invasive system for diabetes detection using breath samples, named as DiabeticSense, an affordable digital health device for early detection, encouraging immediate intervention. The device employed MOSFET-based electrochemical sensors to assess volatile organic compounds in breath samples, whose concentrations differ between diabetic and non-diabetic individuals. The system merged body vital signs with sensor voltages obtained by processing breath sample data to predict diabetic conditions. Our research used readings from 100 patients at a nationally recognised hospital to form the dataset. Data was then processed 10 using a Gradient Boosting Classifier model, and performance was cross-validated. The proposed system attained a promising accuracy of 86.6%, marking an improvement of 20.72% over an existing regression technique. The developed device introduces a non-invasive, cost-effective, and user-friendly solution for preliminary diabetes detection. It has the potential to increase patient adherence to regular monitoring.

FACTS devices provide significance to enhance the functioning of both static and dynamic power systems. The type, size, and location of FACTS devices determine how well they achieve the goals of enhancing voltage stability, loadability, and loss minimization simultaneously. The aim of the function in this study includes voltage stability, line loadings, and loss minimization, which are expected to obtain the most benefits from their installation and other weights allocated to them. It has been determined how installing TCSC, and SVC will improve loadability under situations of continuously increasing load. In this study, a novel optimization technique known as differential evolution invasive weed optimization (DEIWO) is utilized to locate the optimal location for FACTS devices within the IEEE 14 bus system by considering valve point effects. DEIWO was a recently developed, dominant, and simple metaheuristic algorithm for genuine parameter optimization. DEIWO was inspired by the natural process of weed colonization and dissemination, and it is highly effective at addressing broad multi-dimensional, linear and nonlinear optimization problems. The proposed method was implemented in the IEEE 14 bus testing system. Different methods from the research papers have been used to compare and analyze the results. The results demonstrate the DEIWO algorithm's capability and show how it may be used in practice to locate FACTS devices in deregulated electricity networks in the most advantageous place. A comparison of the proposed process to existing algorithms found in the literature and implemented using traditional techniques reveals that it performs better in terms of precision and convergence

Background: Objectives. The objective of this study was to compare the efficacy of direct current stimulation (DCS) applied at the transcranial, suboccipital and spinal level on experimental sensory modalities and pain outcome measures in healthy subjects. The hypothesis of this study was that systematic analysis of the efficacy of DCS on modulating evoked thermal and mechanical pain modalities and mechanisms such as endogenous pain modulation in healthy individuals would reveal sensitive outcome measures help develop this technique for the control of chronic pain. Materials and Methods. Database searches were conducted up to December 2019 for randomized controlled trials that performed sham-controlled DCS of experimental sensory modalities and pain outcomes following transcranial, suboccipital and spinal locations in healthy participants. Standardized mean differences with 95% confidence intervals were calculated for sensory modalities, including random-effect metanalysis. Results: Thirty-one studies were included for analysis (647 participants). A significant decrease in pain intensity for active vs sham transcranial stimulation was identified for pain intensity (n=158; SMD=0.79; 95% CI=0.56 to 1.02), a significant increase in heat pain threshold (n=222; SMD=1.16; 95% CI=0.95 to 1.37), and a significant increase in cold pain threshold (n = 155; SMD = 0.77, 95% CI 0.53 to 1.01). No significant modulation of pressure pain threshold was identified with DCS and only a limited number of studies focused on experimental pain modulation following neuromodulation at the suboccipital or spinal level. Conclusions: These results show significant transcranial DCS neuromodulation of pain intensity and on thermal pain modalities. Future studies should focus on endogenous pain and sensory modality modulation with sham-controlled DCS applied at transcranial, suboccipital and spinal locations.

Due to the rapid developments in aquaculture industry, Artemia franciscana, originally an American species, has been intentionally introduced to the Eurasia, Africa and Australia. In the present study, we used a partial sequence of the mitochondrial DNA Cytochrome Oxidase subunit I (mt-DNA COI) gene and genomic fingerprinting by Inter-Simple Sequence Repeats (ISSRs) to determine the genetic variability and population structure of Artemia populations (indigenous and introduced) from 14 different geographical locations in Western Asia. Based on the haplotype spanning network, Artemia urmiana has exhibited higher genetic variation than native parthenogenetic populations. Although A. urmiana represented a completely private haplotype distribution, no apparent genetic structure was recognized among the native parthenogenetic and invasive A. franciscana populations. Our ISSR findings have documented that despite invasive populations have lower variation than source population in Great Salt Lake (Utah, USA), they have significantly revealed higher genetic variability compare to the native populations in Western Asia. According to the ISSR results, the native populations were not fully differentiated by the PCoA analysis, but the exotic A. franciscana populations were geographically divided in four genetic groups. We believe that during the colonization, invasive populations have experienced substantial genetic divergences, under new ecological conditions in the non-indigenous regions.

This paper discusses a cross-disciplinary, international collaboration aimed at researching a series of 15th century choir books at the abbey of San Giorgio Maggiore on the homonymous island in Venice. Produced for the abbey itself, the books have never left the island during their 500-years history, thereby allowing a unique opportunity to analyse historic artefacts, which have undergone little modification over time. Prompted by ongoing cataloguing work on the manuscripts, a week-long analytical campaign using a combination of non-invasive analytical methods used in portable configuration allowed the comprehensive characterisation of ten volumes. The manuscripts’ palette and painting techniques were analysed using near-infrared imaging, reflectance spectroscopy in the UV-vis-NIR range, Raman spectroscopy, X-ray fluorescence mapping and digital microscopy. The paper will discuss the challenges linked to the fragility and the large dimensions of the volumes as well as the most interesting results of the investigation. These include the detection of unusual painting materials such as bismuth ink, as well as the discovery of a less homogeneous palette than originally expected, which prompted a partial revision of the attribution of the decoration in one of the volumes to a single artist.

Minimally invasive implantology has brought about a paradigm shift in dental and surgical practices by prioritizing techniques that minimize patient discomfort, reduce tissue trauma, and shorten recovery periods. Central to this transformation is the integration of advanced technologies that enhance procedural precision and clinical efficiency. Among these, the surgical microscope stands out as a critical innovation. By providing enhanced magnification and illumination, surgical microscopes allow clinicians to perform intricate implant procedures with greater accuracy, even in anatomically complex or challenging areas. This paper explores the diverse applications of surgical microscopes within the field of minimally invasive implantology. It examines how the use of these devices contributes to precise implant placement, improved soft tissue management, and enhanced bone augmentation outcomes, thereby reducing complications and promoting faster healing. Additionally, the paper reviews clinical case studies and recent advancements in the literature to demonstrate the role of surgical microscopes in elevating patient safety standards. In doing so, this research underscores the importance of incorporating such technologies to meet the growing demand for minimally invasive techniques in modern implantology. The findings emphasize that magnification and illumination provided by surgical microscopes are integral to achieving optimal clinical results and advancing the future of implant surgeries.

Introduction: Treating elbow fracture-dislocation is a challenge, especially in the situation of basal-coronoid trans-ulnar fracture. The study ams to explain whether or not the minimal invasive surgery (MIS) would be feasible in elbow dislocation with coronoid fracture. Materials & Methods: At Taipei Veterans General Hospital, patients who had elbow dislocations with coronoid process fractures underwent single one surgeon’s MIS techniques which included the fluoroscopy-guided ulnar anteromedial (FGUAM) approach in the stage of reducing coronoid process. When there is a proximal ulnar fracture, the posterior incision should be necessary, followed by the incision over the lateral or medial elbow in treating radial fractures or ligament injuries. Results: The Flow Diagram about approach recommendation was established in base of defining MIS as not to do cross-plane dissection. Anteriorly rigid fixation for the coronoid process was also emphasized. Conclusions: MIS can be achieved by multiple limited surgical incisions. However, if there is an unstable ulnar metaphysis or ligament avulsion fracture, the posterior approach has to be extended and the so-called MIS fails to be established.

The increasing prevalence of Metabolic Syndrome (MetS), a serious condition associated with elevated risks of cardiovascular diseases, stroke, and type 2 diabetes, underscores the urgent need for effective diagnostic tools. This research carefully examines the effectiveness of 16 diverse machine learning (ML) models in predicting MetS, a multifaceted health condition linked to increased risks of heart disease and other serious health complications. Utilizing a comprehensive, unpublished dataset of imbalanced blood test results, spanning from 2017 to 2022, from the Laboratory Information System of the General Hospital of Amfissa, Greece, our study embarks on a novel approach to enhance MetS diagnosis. By harnessing the power of advanced ML techniques, we aim to predict MetS with greater accuracy using non-invasive blood test data, thereby reducing the reliance on more invasive diagnostic methods. Central to our methodology is the application of the Borda count method, an innovative technique employed to refine the dataset. This process prioritizes the most relevant variables, as determined by the performance of the leading ML models, ensuring a more focused and effective analysis. Our selection of models, encompassing a wide array of ML techniques, allows for a comprehensive comparison of their individual predictive capabilities in identifying MetS. This study not only illuminates the unique strengths of each ML model in predicting MetS but also reveals the expansive potential of these methods in the broader landscape of health diagnostics. The insights gleaned from our analysis are pivotal in shaping more efficient strategies for the management and prevention of Metabolic Syndrome, thereby addressing a significant concern in public health.

Considering the controversial benefits of video-assisted thoracoscopic surgery (VATS), we intended to evaluate the impact of surgical approach on cardiac function after lung resection using myocardial work analysis. Echocardiographic data of 45 patients (25 thoracotomy vs. 20 VATS) were retrospectively analyzed. All patients underwent transthoracic echocardiography (TTE) 2 weeks before and after surgery, including two-dimensional speckle tracking and tissue doppler imaging. No notable changes in left ventricular (LV) function, assessed mainly using the LV global longitudinal strain (GLS), global myocardial work index (GMWI), and global work efficiency (GWE), were observed. Right ventricular (RV) TTE values, including tricuspid annular plane systolic excursion (TAPSE), tricuspid annular systolic velocity (TASV), and RV free-wall GLS (RVFWGLS), indicated greater RV function impairment in the thoracotomy group than in the VATS group [TAPSE (mm): 17.90 ± 3.80 vs. 20.60 ± 3.50, p &lt; 0.018; TASV (cm/s): 12.40 ± 2.90 vs. 14.60 ± 2.50, p &lt; 0.010; RVFWGLS (%): −11.50 ± 8.50 vs. −17.50 ± 9.70, p &lt; 0.033), respectively]. Unlike RV function, LV function remained preserved after lung resection. The thoracotomy group exhibited greater RV function impairment than did the VATS group. Further studies should evaluate the long-term impact of surgical approach on cardiac function.

(1) Background: Considering highly selected patients with ductal carcinoma in situ (DCIS), active surveillance is a valid alternative to surgery. Our study is aimed at showing the reliability of post-biopsy complete lesion removal, documented by mammogram, as additional criterion to select these patients. (2) Methods: 2173 Vacuum Assisted Breast Biopsies (VABB) documented as DCIS have been reviewed. Surgery has been performed in all cases. We retrospectively collected the reports of post-VABB complete lesion removal and the histological results of the biopsy and surgery. We calculated the rate of upgrade of DCIS identified on VABB upon excision for patients with post-biopsy complete lesion removal and for those showing residual lesion. (3) Results: We observed 2173 cases of DCIS: 408 classified as low grade; 1262 as intermediate grade; 503 as high grade. The overall upgrading rate to invasive carcinoma was 15.2% (330/2173). The upgrade rate was significantly lower (8.2%) when considering patients showing mammographically documented complete removal of the lesion. (4) Conclusion: The absence of mammographically documented residual lesion following VABB is associated to a lower upgrading rate of DCIS to invasive carcinoma on surgical excision and should be considered when deciding the proper management DCIS diagnosis.

Unicellular eukaryotes of the Trypanosomatidae family include human and animal pathogens that belong to the Trypanosoma and Leishmania genera. Diagnosis of the diseases they caused requires the sampling of body fluids (blood, lymph, peritoneal fluid, cerebrospinal fluid, etc.) or organ biopsies (bone marrow, spleen, etc.), which are mostly obtained through invasive methods. Body fluids or appendages can be alternatives to these invasive biopsies but appropriateness remains poorly studied. To further address this question, we perform a systematic review on clues evidencing the presence of parasites, genetic material, antibodies, and antigens in body secretions, appendages, or the organs or proximal tissues that produce these materials. Paper selection was based on searches in PubMed, Web of Science, WorldWideScience, SciELO, Embase, Google. The information of each selected article (n=333) was classified into different sections and data were extracted from 77 papers. The presence of Trypanosomatidae parasites has been tracked in most of organs or proximal tissues that produce body secretions or appendages, in naturally or experimentally infected hosts. The meta-analysis highlights the paucity of studies on Human African Trypanosomiasis and a the absence on animal Trypanosomiasis. Among the collected data high heterogeneity in terms of the I² statistic (100%) is recorded. A high positivity is recorded for antibody and genetic material detection in urine of patients and dogs suffering leishmaniasis, and of antigen for leishmaniasis and Chagas disease. Data on conjunctival swab can be analyzed with molecular methods solely for dogs suffering canine visceral leishmaniasis. Saliva and hair/bristle showed a pretty good positivity that support their potential to be used for leishmaniasis diagnosis. In conclusion, our study pinpoints significant gaps that need to be filled in order to properly address the interest of body secretion and hair or bristle for the diagnosis of infections caused by Leishmania and by other Trypanosomatidae parasites.

Extracellular vesicles (EVs) represent a heterogeneous population of small vesicles, consisting of a phospholipidic bilayer surrounding a soluble interior cargo. Almost all cell types release EVs, thus they are naturally present in all body fluids. Among the several potential applications, EVs could be used as drug delivery vehicles in disease treatment, in immune therapy because of their immunomodulatory properties and in regenerative medicine. In addition to general markers, EVs are characterized by the presence of specific biomarkers (proteins, miRNAs) that allow the identification of their cell- or tissue-origin. For these features, they represent a potential powerful diagnostic tool to monitor state and progression of specific diseases. As regards, a large body of studies supports the idea that endothelial derived (EMPs) together with platelet-derived microparticles (PMPs) are deeply involved in the pathogenesis of diseases characterized by micro- and macrovascular damages, including diabetes. Existing literature suggests that the detection of circulating EMPs and PMPs and their specific miRNA profile may represent a very useful non-invasive signature to achieve informations about the onset of peculiar disease manifestations. In this Review, we discuss the possible utility of EVs in the early diagnosis of diabetes-associated microvascular complications, specifically related to kidney.

Many natural areas are colonised by the invasive species Ailanthus altissima. Its presence in natural ecosystems damages the ecological richness while competing with native flora. A. altissima is one of the most widespread weed species in natural areas of temperate regions such as conservation parks, archaeological sites and communication corridors. Not many active ingredients are available to control this weed, being the most popular, the glyphosate, banned by many municipalities. In order to test the efficacy of alternative active ingredients, naturally occurring populations in Collserola Conservation Park of Barcelona (Catalonia, Spain) were treated with different herbicides using three different techniques. Aclonifen, metribuzin, flazasulfuron, metsulfuron-methyl, fluroxypyr, isoxaflutole + thiencarbazone-methyl and triclopyr mixed with 2.4-D, fluroxypyr, aminopyralid and clopyralid, were applied by stem injection, cut stump injection or basal bark techniques against trees of around 5 cm diameter. Both cut stump and stem injection gave almost total control of the trees while basal bark showed more varied results depending on the herbicide. Best control was achieved when flazasulfuron or triclopyr were present as active ingredients and poorer control was observed when using metsulfuron-methyl or isoxaflutole + thiencarbazone-methyl. Aclonifen showed no damage to the trees. Metribuzin worked better if the cut stump injection technique was used. These results showed that several alternatives are available to the use of glyphosate which is been banned for some uses due to environmental concerns.

Background - Compared to the da Vinci platform, there is limited experience with the Hugo RAS platform for colorectal surgery in Europe. This difference is especially notable when considering a single complex procedure, such as total colectomy. Aim - To demonstrate the feasibility and safety of using the Hugo RAS for assisted total colectomy. Clinical case- Female patient: eighteen-year-old with Familial Adenomatous Polyposis (FAP). Her IBM was 19. She underwent a total colectomy with ileorectal anastomosis using the Hugo RAS platform. The procedure took 230 minutes and had no complications. The postoperative period was uneventful. She was discharged from the hospital on the third postoperative day. Conclusion - The Hugo RAS platform is one of the emergent minimally invasive robotic platforms that can be used even in total colectomy if the proper patient selection is made. The placement choice of arms and trocars was crucial to obtain a similar operative time of the single laparoscopic approach. The certification of Hugo’s new instruments, such as energy devices and staplers, will make this platform even more competitive.

The mixing of terrestrial groundwater and seawater creates dynamic reaction zones in intertidal areas, where land-derived Fe(II) is oxidized to Fe(III) and then precipitates as Fe hydroxides at groundwater-seawater interface. These hydrogeochemical processes contribute to the formation of iron curtains beneath soil surface, which in turn influences the evolution of coastal aquifers. This paper provides a comprehensive review of physical and geochemical processes at field scale in coastal areas, explores the impact of mineral precipitation on pore structure at pore scale, and synthesizes reactive transport modeling (RTM) approaches for illustrating continuum-scale soil physio-chemical parameters during the evolution of porous media. Upon this review, knowledge gaps and research needs are identified. Additionally, challenges and opportunities are presented. Therefore, the incorporation of observational data into a comprehensive physico-mathematical model becomes imperative for capturing the pore-scale processes in porous media and their influence on groundwater flow and solute transport at large scales. Furthermore, a synergistic approach integrating pore-scale modeling and non-invasive imaging can provide detailed insights into intricate fluid-pore-solid interactions for future studies, as well as facilitate the development of regional engineering-scale models and physio-chemical coupled models with diverse applications in submarine science and engineering.

Sacroiliac (SI) joint dysfunction can lead to debilitating pain but can be treated with minimally invasive sacroiliac joint fusion (SIJF). This treatment is commonly performed using 2D fluoroscopic guidance. This makes placing the implants without damaging surrounding neural structures challenging. Virtual surgical planning (VSP) using simulated fluoroscopic images may improve perioperative guidance. This article describes a workflow with VSP in SIJF using simulated fluoroscopic images and evaluates achieved implant placement accuracy. Routinely collected survey data on the added value of VSP were also evaluated. Ten interventions were performed on 10 patients by the same surgeon, comprising 30 implants; the median age was 39 years, and all patients were female. The overall mean implant placement accuracy was 4.9 ± 1.26 mm and 4.0 ± 1.44°. There were no malpositioning complications. The VSP helped the surgeon understand the anatomy and determine the optimal position and length of the implants. The average Likert scale score of the survey was 4.7, suggesting a positive role of VSP for SIJF. Planned positions of the implants could be reproduced in surgery with clinically acceptable accuracy and VSP was a valuable asset for the surgeon.

Osteoporotic spinal fractures represent an increasingly widespread health problem in our aging society. We aimed to investigate the treatment options for low-energy spinal fractures in the el-derly and their impact on mortality, focusing on surgical stabilization using minimally invasive and open techniques. We evaluated 1356 patients over 50 years of age with compression frac-tures sustained due to low energy trauma treated at a single trauma center. We compared the mortality of patients following stable and operated/non-operated unstable compression frac-tures and the eligibility to surgery using the open and minimally invasive approach. The pa-tients received surgical or conservative care according to severity and eligibility to surgery. The mortality hazard ratio of patients who underwent screw fixation was 1.02 (P > .91), of patients who refused surgery was 1.68 (P < .001) and that of patients with anesthesiological contraindica-tion was 1.57 (P = .08), compared to conservatively treated patients with stable fractures. The dif-ference in mortality between open and minimally invasive surgeries was not significant, but the number of patients eligible for surgery with the minimally invasive procedure was significantly higher (OR: 0.25; P < .001). Spinal stability after fractures may be an important predictor of sur-vival in patients with low-impact fractures.

In recent years, the demand for efficient and accurate measurement techniques has surged across various industries, driving the development of non-invasive methods that leverage computer vision technology. This paper explores the principles and applications of non-invasive measurement techniques utilizing computer vision, emphasizing their ability to deliver precise measurements without the need for physical contact or specialized sensors. We delve into the underlying algorithms, including image processing, machine learning, and deep learning methods, that enable the extraction of dimensional data from visual inputs. Case studies across diverse fields such as manufacturing, healthcare, and logistics illustrate the effectiveness of these techniques in enhancing operational efficiency and reducing measurement errors. Furthermore, we discuss the challenges and limitations of implementing computer vision-based measurement systems, including the need for robust algorithms capable of functioning in varied environmental conditions. By highlighting the transformative potential of non-invasive measurement techniques, this paper aims to provide insights into future developments in computer vision and its role in advancing measurement practices across multiple sectors.

Abstract: The Mediterranean diet, a widely studied and highly beneficial diet, underpins my research. Initially, the Mediterranean diet included Wild Edible Plants (WEPs). According to numerous research reports, this diet 1) promotes health and longevity and 2) prevents various modern diseases, including coronary and Alzheimer’s disease. A vital component of this diet is consuming locally available green plants, which are rich in health-promoting substances. In Åhlberg (2021, 2022b), I presented evidence for 56 health-promoting substances that all green vascular WEPs contain. While reading research reports of these five species, I found eight more health-promoting substances that all green vascular wild edible plants have. This article adds eight new substances to the earlier 56, bringing the total to 64. This is a novel and groundbreaking finding for which I provide research evidence. Each WEP has 1) health-promoting substances that all green vascular plants share and 2) species-specific health-promoting substances. I present the latest research on five invasive wild edible plants (WEPs) species. Each contains at least 64 health-promoting substances and varying species-specific health-promoting substances. I also present the experimental research results showing how many of these substances prevent Alzheimer’s disease. Keywords: wild edible plants (WEPs); wild food plants; Mediterranean diet; functional foods; good health, longevity; Alzheimer’s disease; alimurgic plants; invasive species; sustainability

Patients with pT1 high-grade (HG) bladder cancer (BC) and a very high risk of progression might benefit from immediate radical cystectomy (RC), but this option remains controversial. Validation of a standardized method to evaluate the extent of lamina propria (LP) invasion (with recognized prognostic value) in transurethral resections (TURBT) specimens is still needed. The Rete Oncologica Lombarda (ROL) system showed a high predictive value for progression after TURBT in recent retrospective studies. Our aim was to validate ROL system on a large mono-institutional prospective series of primary urothelial carcinomas. From 2016 to 2020, we adopted ROL for all patients with pT1 HG BC on TURBT. We employed a 1.0-mm threshold to stratify tumors in ROL1 and ROL2. A total of 222 pT1HGBC were analyzed. Median age was 74 years, with male predominance (73.8%). ROL was feasible in all cases: 91 cases were ROL1 (41%) and 131 ROL2 (59%). At a median follow up of 26.9 months (IQR 13.8-40.6), we registered 80 recurrences and 40 progressions. ROL was a significant predictor of tumor progression at both univariable (HR 3.53; CI 95% 1.56 – 7.99; p&lt;0.01) and multivariable (HR 2.90; CI 95% 1.25 – 6.75; p=0.01) Cox regression analyses. At Kaplan-Meier estimates, ROL showed correlation with both PFS (p=0.0012) and RFS (p=0.0167). Our results confirmed the strong predictive value of ROL for progression on a large prospective series. We encourage the application of ROL for reporting the extent of LP invasion, substaging T1 HG BC, and improving risk tables for urological decision making.

The reproductive biology of the invasive blue crab Callinectes sapidus was studied in the Thermaikos Gulf (Northwest Aegean Sea, Eastern Mediterranean). In the two-year survey 5,698 (2,897♂/ 2,801♀) crabs were caught with the use of fyke nets. Total sex ratio (♂/♀) reached equality (1.03:1). The female blue crab exhibited a protracted reproductive period. Mature and ovigerous females exhibit short migratory movements from estuarine and inshore waters, where the population mostly congregates (0-3 m), and move to slightly deeper waters (1-3 m) up to 9 m for spawning. A total of 340 ovigerous females were caught. Their number varied both spatially and temporally; they were observed for a 7-month period (April to October) with a clear peak in July - August and at a 3 m depth gradient corresponding to ≈60% of the total number of ovigerous females caught in both years. Size at first sexual maturity (CW50) was estimated at 113.1 mm CW. Average fecundity was ≈790,000 eggs. Experimental trawling showed that inshore waters (<1 m) in the estuaries serve as nursery areas for juveniles. Defining the spatiotemporal and bathymetrical distribution of ovigerous females in any invaded coastal habitat could be considered key information for the implementation of a management policy for the species.

In our study, we investigated the prognostic significance of hematological markers—NLR (Neutrophil-to-Lymphocyte Ratio), PLR (Platelet-to-Lymphocyte Ratio), and RDW-CV (Red Blood Cell Distribution Width - Coefficient of Variation)—in 117 glioblastoma patients. Data collected from January 2016 to December 2018 included demographics, clinical scores, and treatment regimens. Unlike previous research, which often examined these markers solely before surgery, our unique approach analyzed them at multiple stages: preoperative, postoperative, and before adjuvant therapies. We correlated these markers with overall survival (OS) and progression-free survival (PFS) using statistical tools, including ANOVA, Cox regression, and Kaplan-Meier survival analyses, employing SPSS version 29.0. Our findings revealed notable variations in NLR, PLR, and RDW-CV across different treatment stages. NLR and PLR decreased after surgery, with some stabilization post-STUPP phase (NLR: p=0.007, η2p=0.06; PLR: p=0.001, η2p=0.23), while RDW-CV increased post-surgery and during subsequent treatments (RDW-CV: p &lt; 0.001, η2p=0.67). Importantly, we observed significant differences between the preoperative phase and other treatment phases. Additionally, higher NLR and RDW-CV at the second-line treatment and disease progression were associated with an increased risk of death (NLR at 2nd line: HR=1.03, p=0.029; RDW-CV at progression: HR=1.14, p=0.004). We proposed specific marker cutoffs that demonstrated significant associations with survival outcomes when applied to Kaplan-Meier survival curves (NLR at 2nd line &lt; 5: p&lt;0.017; RDW-CV at progression &lt; 15: p=0.007). Elevated NLR and RDW-CV at later treatment stages correlated with poorer OS and PFS. No significant preoperative differences were detected. These biomarkers may serve as non-invasive tools for glioblastoma management.