Wetlands are complex ecosystems, considered among the most productive environments of the world. They contain major biodiversity hotspots, providing the resources upon which countless species of plants and animals depend and they perform important environmental and economic functions. Wetlands reduce flooding events, improve water quality and represent a valuable cultural and natural heritage. It is estimated that 2/3 of Europe wetlands have disappeared since the beginning of the 20th Century, mainly lost through development processes which did not take their functions and values adequately into account. The European Directive (2000/60/EC) re-quires to foster an integrated approach for wetland management through collaborative governance processes. The Wetland Contract is a tool that has been developed and implemented to set the ground for voluntary-based commitments for the sustainable governance of water systems. Among the Mediterranean countries, Italy and Croatia count on a rich variety of coastal wetlands that, together with the plants and animals inhabiting and crossing them, constitute an extremely precious natural heritage. The aim of this paper is to present and discuss, whit a critical approach, the output of the Interreg Project CREW that, between 2018-21, contributed to the drafting of seven new Wetland Contracts.

Background. National surveys reported on variable prevalence of chronic kidney disease (CKD) due to differences in characteristics of population, design, equations used to estimate glomerular filtration rate (eGFR) and definitions. The EH-UH 2 survey is the first study evaluating CKD prevalence, characteristics and awareness in Croatia. Methods. This was a cross-sectional nationwide observational study designed to assess the prevalence and cardio-kidney-metabolic risk factors in Croatia which included 1765 randomly selected subjects. We estimated the prevalence of CKD by means of albumin-to-creatinine ratio (ACR) and eGFR (CKD EPI equation). Comorbidities, anthropometric and social factors related to the prevalence of CKD were analyzed, and CV risk profile was evaluated. Results. The weighted prevalence of CKD (any stage), CKD stage ≥ G3A A2, and CKD defined only as eGFR < 60 ml/min/1.73 m2 were estimated at 17.1%, 9.8% and 7.9%, respectively. The prevalence was higher in men than in women (11.8% vs. 7.9%; p 30 mg/g was 15.1%. Older age, male gender, diabetes, ePWV, and uric acid were independently associated with CKD prevalence. The awareness of CKD of 9.5%. Unaware were older with lower income, less educated, having more frequently diabetes, hypertension (less frequently controlled) and milder renal impairment. Conclusion. In Croatia, the estimated prevalence of CKD is high, being more frequently presented in men than in women. CKD patients have unfavorable CV risk profile. The awareness of CKD is very low reflecting poor health literacy in general population but also in health care workers.

In this study, nanostructured cerium-doped TiO2 (Ce-TiO2) films with the addition of different amounts of cerium (0.00, 0.08, 0.40, 0.80, 2.40, and 4.10 wt. %) were deposited on a borosilicate glass substrate, by flow coating sol-gel process. After flow coating, deposited films were dried at the temperature of 100 °C for 1 h, followed by calcination at the temperature of 450 °C for 2 h. For the characterization of sol-gel TiO2 films, the following analytic techniques were used: X-ray diffraction (XRD), thermal gravimetry (TG), differential thermal analysis (DTA), and differential scanning calorimetry (DSC). Sol-gel derived Ce-TiO2 films were used for photocatalytic degrada-tion of the ciprofloxacin (CIP). The influence of the amount of Ce in TiO2 films, the duration of the photocatalytic decomposition, and the irradiation type (UV-A and simulated solar light) on the CIP degradation were monitored. Kinetics parameters (reaction kinetics constants and the half-life) of the CIP degradation, as well as photocatalytic degradation efficiency, were determined. The best photocatalytic activity was achieved by the TiO2 film doped with 0.08 wt.% Ce, under both UV-A, and solar irradiation.

DFT calculations on the photoisomerization reactions of pyridazine N-oxide derivatives are presented. The irradiation of 3,6-diphenylpyridazine N-oxide allowed to obtain the first excited singlet state that underwent to a ring opening reaction induced to the oxygen migration to the adjacent carbon atom, with the formation of a diazo derivative. This intermediate can give a ring closure reaction to give a pyrazole derivative, or, with a higher transition energy, it can lose nitrogen allowing the formation of 2,5-diphenylfuran. The irradiation of 3-phenylpyridazine N-oxide allowed the formation only of 2-phenylfuran. In this case, calculations allowed to explain this behavior. The first excited singlet state gave a photoisomerization reaction with the formation of the corresponding diazo intermediate. This intermediate could not be converted into the corresponding pyrazole derivative because it was converted into a N-formyl pyrazole never reported in literature. The only possible reaction is the loss of nitrogen and the formation of 2-phenylfuran.

Background and Objectives: Infections are the most common and potentially life-threatening complications of the treatment of children with acute lymphoblastic leukemia (ALL). The aim of this study was to determine epidemiological, clinical and microbiological characteristics of infections in pediatric patients with ALL. Materials and Methods:  Twenty-three children (16 male and 7 female, mean age 5.9 years [range 1.3 to 12.2 years]) with ALL, treated at the Division of Hematology, Oncology and Clinical Genetics, Department of Pediatrics, Clinical Hospital Center Rijeka, Croatia, from January 1, 2015 to December 31, 2020, were included in the study Results: One hundred and four infectious episodes (IEs) were reported (average 4.5 IE per patient). IEs were more frequent in the intensive phases of antileukemic treatment. Neutropenia was present in 48 IEs (46.2%) with a duration greater than 7 days in 28 IEs (58.3%). The respiratory tract was the most common infection site (48.1%). We documented 49 bacterial (47.1%), 4 viral (3.9%), 4 fungal (3.9%) and 10 mixed isolates (9.6%), while in 37 IEs (35.6%) pathogen was not isolated. The most common causes of bacteremia were coagulase-positive staphylococci. The most frequent empirical therapy was third- and fourth-generation cephalosporins, followed by piperacillin/tazobactam. Modification of the first-line antimicrobial therapy was performed in 56.9% of IEs. Granulocyte-colony stimulating factor was administered in 53.8% of IEs, and intravenous immunoglobulins in 62.5% of IEs. One patient required admission to the intensive care unit. No infection-related mortality was reported. Conclusions: ALL patients have frequent IEs. Close monitoring, identification of risk factors, rapid empirical use of antibiotics in febrile neutropenia, and timely modification of antimicrobial therapy play a key role in reducing infection-related morbidity and mortality in children with ALL.

World Health Organization recommends adjusting the salt intake as a part of the nine global targets to reduce premature mortality from non-communicable chronic diseases as priority and most cost-effective intervention. In 2006. the main aim of the Croatian Action on Salt and Health was to decrease salt intake for 16% because of its critical intake and consequences on human health. We have organized educative activities for increasing awareness on salt harmfulness, defined food categories of prime interest, collaborate with industries and determine salt intake (24h urine-sodium excretion). It was determined that the proportion of salt in ready-to-eat baked bread should not exceed 1.4%. In the period 2014 –2022, salt in the semi-white bread was reduced 14%, in bakery 22% and in largest meat industry in Croatia 25%. Awareness of the harmfulness of salt on health increased from 65.3% in 2008 to 96.9% in 2023 and salt intake was reduced 15.9%-1.8 grams/day (22.8% men, 11.7% women). In last 18 years a significant decrease in salt intake was achieved in Croatia, awareness of its harmfulness increased, collaboration with food industry established and regulatory documents launched. However, salt intake is still very high underlying the need for continuation of efforts and even stronger activities.

Cardiovascular diseases, which are the leading cause of death in Croatia, are linked to the high prevalence of hypertension. Both are associated with high salt intake which was determined almost two decades ago when Croatian Action on Salt and Health (CRASH) was launched. The main objective of the present study was to evaluate salt, potassium, and iodine intake using 24-hour urine samples in a random sample of adult Croatian population, and to analyse trends in salt consumption after the CRASH has intensively started. Methods: In this national population-based EH-UH 2 study performed in 2018-2021 (participation rate 72 %) in which we analysed a single 24-hour urine sample, 1067 adult participants (mean age 57.12 (SD 13.9), men 35%) were included. Results: Mean salt and potassium intakes were 8.6 g/day (IQR 6.2-11.2) and 2.8 g/day (IQR 2.1-3.5), respectively, with sodium-to-potassium ratio of 2.6 (IQR 1.8-3.3). We detected a decrease of 17.6% (2 g/day less) in salt consumption compared to our previous salt-mapping study. However, only 13.7%, and 8.9 % met the WHO salt and potassium recommended target of 5 g/day, and 3.5 g/day, respectively. Salt intake was higher, and potassium ingestion was lower in rural vs. urban regions, and in continental vs. Mediterranean parts of Croatia. Moderate to severe iodine insufficiency was determined in only 3% adult participants. Conclusion: In the last fifteen years, salt consumption has been significantly reduced in Croatian adult population because of intensive and broad CRASH program led by the Croatian Society of Hypertension and the Croatian Hypertension League. However, salt intake is still too high, and potassium ingestion is too low. With expected more active engagement and help of the government, obtained results could be significantly improved. Salt reduction programs are most cost-effective methods of cardiovascular disease prevention and should be considered more seriously by the government and health policy makers.

The question of the relevance of human and natural capital, as well as the potential adverse effect of natural capital on economic growth, has gained increased attention in development economics. The aim of this paper is to theoretically and empirically assess the relevance of several forms of capital on economic growth in small economies that are dependent upon tourism or natural resources. The empirical framework is based on Impulse Response Functions obtained from Vector Autoregressive models in which we focus on the model where economic growth is the dependent variable for ten small economies that are dependent upon either tourism or natural resources. We find that there is evidence of the ‘’natural resource curse’’, especially in the economies that have a strong dependence on resources that are easily substitutable and whose prices constantly fluctuate. We further find that in the majority of observed cases the type of capital these small economies are most dependent on for their economic growth causes negative impulses in the majority of the observed periods. The main policy recommendation should be to assure that even these small economies should strive towards further diversification and avoid dependence on only one segment of their economy.

Giant unilamellar vesicles (GUVs) are membrane model used to study membrane properties. Electroformation is one of the methods used to produce GUVs. During electroformation protocol dry lipid film is formed. Drying of the lipid film induce Cholesterol (Chol) demixing artifact, in which Chol forms anhydrous crystals, where these crystals does not participate in formation of vesicles. This leads to a lower Chol concentration in the vesicle bilayers compared to the Chol concentration in the initial lipid solution. To address this problem, we propose novel electroformation protocol that includes rapid solvent exchange, plasma cleaning and spin-coating methods to produce GUVs. We tested the protocol focusing on vesicles with high Chol content using different spin-coating durations and vesicle types deposition. Additionally, we compared the novel protocol using completely dry lipid film. The optimal spin-coating duration for vesicles made out of phosphatidylcholine/Chol mixture was 30 s. Mulitlamellar vesicles (MLVs), large unilamellar vesicles (LUVs) obtained by extrusion of MLVs through 100 nm membrane pores and LUVs obtained by extrusion of previously obtained LUVs through 50 nm membrane pores were deposited on electrode for 1.5/1 Chol/phosphatidylcholine lipid mixture and the results were compared. Electroformation using all three deposited vesicle types gave a high GUVs yield, but deposition of LUVs obtained by extrusion of MLVs through 100 nm membrane pores gave the most reproducible results. Using deposition of these LUVs, we produced GUVs with high yield for 6 different Chol concentrations (from 0 % to 71.4%). Using protocol that includes dry lipid film GUVs yield was lower and Chol demixing artifact was induced, proving that the lipid film should never undergo drying when Chol content is high.

Background: Population studies have shown that prehypertension is associated with adverse cardiometabolic risk profile even among apparently healthy populations. Although associations between serum triglyceride (TG) concentrations and the risk of atherosclerotic cardiovascular disease have been reported, there are lack of data on the association of hypertriglyceridemia with cardiovascular risk (CVR) in a low risk prehypertensive population. Aim: Our aim was to analyze the cardiorenometabolic characteristics of prehypertensives (PHT) compared to normotensives (NT) and untreated hypertensives (HT) and its associations with CVR. Materials and methods: In our cross-sectional study we included 323 apparently healthy untreated subjects 18-45 years who underwent basic anthropometric and standardized blood pressure measurement, fasting blood sampling, spot urine collection and transthoracic echocardiogram. Results: Higher BMI, waist circumference, HOMA-IR, LDL-cholesterol, TG, uric acid and LVMI contribute to higher CVR in PHT compared to true NT (p

With around one billion of the world's population affected, the era of Metabolic-associated fatty liver disease (MAFLD) pandemic has entered the global stage. MAFLD is a chronic progressive liver disease with accompanying metabolic disorders such as type 2 diabetes mellitus and obesity which can progress asymptomatically to liver cirrhosis and subsequently to hepatocellular carcinoma (HCC), and for which, to date there is almost no approved pharmacologic options. Because MAFLD has a very complex etiology and it affects also extrahepatic organs, a multidisciplinary approach is required when it comes to finding an effective and safe active substance for MAFLD treatment. The optimal drug for MAFLD should diminish steatosis, fibrosis and inflammation in the liver, and the winner for MAFLD drug authorisation seems to be the one that significantly improves liver histology. Saroglitazar (Lipaglyn®) was approved for Metabolic dysfunction associated steatohepatitis (MASH) in India in 2020; however, the drug is still being investigated in other countries. Despite that a pharmaceutical industry is still lagging behind to develop an ap-proved pharmacologic therapy for MAFLD, research has been recently intensified and many molecules which are underway in the final stages of clinical trials are expected to be approved in the coming few years. Already this year, the first drug (Rezdiffra™) in the United States was ap-proved via accelerated procedure for treatment of MAFLD, i.e. of MASH in adults. This review underscores the most recent information related to the development of drugs for MAFLD treatment, focusing on the molecules that have come furthest towards approval.

The use of omega-3 fatty acids (omega-3 FA) in the treatment of atopic dermatitis (AD) is an area of ongoing research. Some studies suggest that dietary supplementation with omega-3 FA can help manage symptoms of AD by reducing lesion severity, skin inflammation, dryness and itching, while other show no significant beneficial effect. The aim of this study was to evaluate the effect of omega-3 FA form fish oil in combination with GLA form blackcurrant seed oil in children with AD. This is a longitudinal, prospective, randomized, triple blind, placebo-controlled parallel clinical trial. The study was conducted during the 2-year period from autumn, winter, and spring avoiding the summer when AD usually improves. Children were randomized to receive the active study product (Mega Kid®) containing specific blend of omega-3 and omega-6 fatty acids or placebo. Primary outcomes were change in severity of AD measured using SCORing Atopic Dermatitis (SCORAD) patient oriented SCORAD (PO-SCORAD) and the difference in TCS use. Secondary outcomes were change in itch intensity, sleep quality and Family Dermatology Life Quality Index (FDLQI). Data were analyzed for 52 children (26 in the intervention group and 26 in the placebo group). In children receiving active product intention-to-treat analysis showed that after 4 months of treatment, there was a significant decrease in the SCORAD index (from median 42 to 25, p < 0.001) and use of topical corticosteroids (from median 30 to 10 mg/day, p < 0.001) but also significant improvement in itch, sleep quality and overall quality of life. Omega-3 fatty acids in combination with GLA and vitamin D has a great beneficial effect in treatment of atopic dermatitis in children. Therefore, we can conclude that supplementation with this specific combination could be considered a safe and effective intervention that can significantly reduce the severity of AD in pediatric patients.

The conformity assessment of products or a measured value with the given standards is carried out based on the global risk of producers and consumers calculation. A product may conform to specifications but be falsely rejected as non-conforming. This is about the producer's risk. If a product doesn't meet the requirements but is falsely accepted as conforming, that poses a risk to the consumer. The conventional approach to risk assessment, which yields only a single numerical value for the global risk of producers and consumers, is naturally extended, and utilized for assessing risk in measurement models with linear regression. The outcomes of the two-dimensional extension, along a moderate scale, are the parabolas with an opening upwards. Risk surfaces were obtained through three-dimensional extension over the area limited by the moderate scale and guard band axes. Four models with different ranges of tolerance intervals were used to test this innovative method of risk assessment in linear regression. The corresponding standard measurement uncertainties are determined by applying a simplified measurement model with the use of comprehensive data on the measurement performance and by determining measurement uncertainty derived from consideration of the functional relationship obtained by linear regression analysis. Models that utilize information from linear regression analysis to determine measurement uncertainty are biased towards risks at the edges of the moderate scale. Testing the model's performances with metrics related to the confusion matrix, such as the F1 score, further substantiated this assertion. The diagnostic odds ratio has been proven to be extremely effective in identifying the curve along the guard band axis, along which the global risks of producers and consumers are at their lowest.

New furan, thiophene and triazole oximes were synthesized through several-step reaction paths to investigate their potential for development of central nervous systems (CNS)-active and cholinesterase-targeted therapeutics in organophosphorus compound (OP) poisonings. Acute OP poisoning is still a challenge in treating patients despite the development of a large number of oxime compounds that should have the capacity to reactivate acetylcholinesterase (AChE) and butyrylcholinesterase (BChE). The activity of these two enzymes, crucial for neurotransmission, are blocked by the OP, which has the consequence of disturbing normal cholinergic nerve signal transduction in the peripheral and CNS, leading to cholinergic crisis. Oximes in use have one or two pyridinium rings and cross the brain–blood barrier poorly due to the quaternary nitrogen. Following our recent study on 2-thienostilbene oximes, in this paper we described the synthesis of 63 heterostilbene derivatives out of which 26 oximes were tested as inhibitors and reactivators of AChE and BChE inhibited by OP nerve agents – sarin and cyclosarin. While the majority of oximes were potent inhibitors of both enzymes in micromolar range, we identified several oximes as BChE or AChE selective inhibitors with a potential for drug development. Moreover, even oximes were poor reactivators of AChE, four heterocyclic derivatives reactivated the cyclosarin-inhibited BChE up to 70%, and cis,trans-5 [2-((Z)-2-(5-((E)-(hydroxyimino)methyl)thiophen-2-yl)vinyl)benzonitrile] had comparable reactivation efficacy to the standard oxime HI-6. In silico analysis and molecular docking studies connected the kinetic data to the structural features of these oximes, and confirmed their productive interactions with the active site of the cyclosarin-inhibited BChE. Based on inhibition and reactivation and their ADMET properties regarding lipophilicity, CNS activity, and hepatotoxicity, these compounds could be considered for further development of CNS-active reactivators in OP poisoning as well as cholinesterase-targeted therapeutics in neurodegenerative diseases like Alzheimer’s and Parkinson’s.

Introduction: The association of gene variants for interleukin 6(IL-6) (rs1800796), interleukin 10 (IL-10) (rs1800896) and tumor necrosis factorα (TNFα (rs1800629) with the occurrence of spontaneous preterm birth (PTB) was investigated to determine whether these genetic variants are a risk factor. Materials and methods: 199 blood samples from pregnant women who had given birth prematurely and 200 control blood samples were analyzed to determine single nucleotide polymor-phisms (SNPs) of genes for IL-6 (rs1800796), IL-10 (rs1800896) and TNFα (rs1800629). The control samples were samples from pregnant women with term delivery. Isolation of DNA was per-formed on mini-spin columns according to the manufacturer's protocol. The quality and purity of the isolated DNA were tested using a Qubit 3 fluorometer. Genotyping was performed with an ABI PRISM 7500 SDS using TaqMan SNP genotyping assays. The genotypes obtained were an-alyzed using the 7500 Software v2.3 package. Results: Carriers of the A/A genotype for the rs1800629 of the TNFα gene have 4.81 times greater chance of late-onset PTB compared to carriers of the G/G and A/G genotypes in the recessive inheritance model. The presence of the G/G genotype in the recessive inheritance model compared with the G/A and A/A genotypes for the rs1800896 of the IL-10 gene represents a potentially protective factor, with mothers in the term-birth group having an almost 2-fold lower odds of PTB in general and an almost 10-fold lower odds of early PTB. On the other hand, carriers of the A/G genotype of rs1800896 have a 1.54-fold higher chance of preterm birth in general and a 1.6-fold higher chance of late preterm birth in the super dominant inheritance model compared to the A/A and G/G genotypes in the group of mothers with PTB. In this study, no association was found between PTB and rs1800796 of the IL-6 gene. Conclusion: rs1800629 in mothers was associated with PTB. rs1800896 shows a potentially protective effect for the occurrence of PTB in this study. No association was found between PTB and rs1800796.

Background: Helicobacter pylori (H. pylori) is a prevalent bacterial pathogen implicated in various gastroduodenal diseases, including chronic gastritis, peptic ulcer disease, and gastric cancer. The COVID-19 pandemic has significantly influenced antibiotic prescription practices, potentially exacerbating antibiotic resistance in H. pylori. Objective: This study aims to investigate antibiotic prescription during COVID-19 pandemic in Croatia and its possible impact on H. pylori antibiotic resistance, with a focus on Croatia. Methods: A comprehensive literature search was conducted to identify relevant studies from March 2020 to June 2024. The search strategy included terms related to COVID-19, antibiotic prescription, and Croatia. Studies were selected based on predefined eligibility criteria, focusing on observational research addressing antibiotic use during the pandemic. Results: The COVID-19 pandemic leads to significant fluctuations in community antibiotic consumption within the European Union/European Economic Area. In Croatia, antibiotic use in 2022 surpassed 2019 levels, driven by increased consumption of macrolides and other antibiotics. This surge, influenced by early pandemic treatment claims and penicillin shortages, contributed to rising antibiotic resistance in H. pylori. Resistance rates to clarithromycin and levofloxacin were notably high, driven by mutations in the 23S rRNA, gyrA, and gyrB genes. Discussion: The increased antibiotic use during the COVID-19 pandemic has highly likely complicated H. pylori eradication efforts, highlighting the necessity of judicious antibiotic use and robust antimicrobial stewardship. The pandemic underscored the need for new therapeutic strategies, optimized eradication regimens, and advanced diagnostic methods to manage bacterial infections effectively. Conclusions: The COVID-19 pandemic has significantly impacted antibiotic use and resistance patterns, posing new challenges for H. pylori eradication. Addressing these challenges requires a multifaceted approach, including the development of new drugs and advanced diagnostics, coupled with sustained efforts in antimicrobial stewardship to combat emerging resistance threats.

The correct selection of the value of p is a complex and iterative procedure that requires experience in the interpretation of the obtained interpolated maps. Inverse Distance Weighting is a method applied to the porosities of the K and L hydrocarbon reservoirs, discovered in the Neogene (Lower Pontian) subsurface sandstones in the northern Croatia (Pannonian Basin System). They represent small and large data samples. Also a standard statistical analysis of the data was made, followed by the qualitative-quantitative analysis of the maps, based on the selection of different values of the power distance exponent (p-value) for the K and L reservoirs maps. According to the qualitative analysis, for a small data set, p-value could be set on 1 or 2 giving the most optimal result, while for a large data set, a p value of 3 and 4 could be applied. By quantitative analysis, for the case of small data p=2 is recommended, resulting in a root mean square error value of 0.03458, a mean absolute error of 0.02013 and a median absolute deviation of 0.00546. Oppositely, a p-value of 3 and 4 is selected as appropriate for a large data set, with root mean square errors of 0.02435 and 0.02437, mean square errors of 0.01582 and 0.01509 and median absolute deviations 0.00896 and 0.00444. Eventually for a small data set, it is recommended to use a p-value of 2, and for a large data set, a p-value of 3 or 4.

The article presents several innovative systems developed through student laboratory projects, including two autonomous vehicles, a four-legged walking robot, an active ankle-foot orthosis, a ball on beam balancing mechanism, a ball on plate system, and a manipulator arm—all powered by pneumatic artificial muscles (PAMs). Fluidic muscles offer significant potential in various mechatronic systems, robots, and manipulators due to their flexible, lightweight nature and compliance. Their ability to produce smooth and adaptable motions is particularly beneficial in applications requiring natural and human-like movement, such as rehabilitation and assistive devices. Although PAMs powered control systems face challenges with nonlinear phenomena, their biologically inspired design holds promise for future applications across various industries. These may include innovative applicability in industrial, automotive, and aerospace sectors, as well as use in sports, medical aids, entertainment, and animatronics. Incorporating self-made laboratory systems actuated by PAMs into control systems education offers a comprehensive learning opportunity that combines theoretical concepts with hands-on experience. This approach develops the necessary skills of future engineers, expanding their understanding of technical principles and preparing them for future challenges in engineering practice.

The purpose of this study is to evaluate the amounts of apically extruded 3% sodium hypochlorite using two modes of Er:YAG laser-activated irrigation (LAI), super short pulse (SSP) and shock wave enhanced emission photoacoustic streaming (SWEEPS®), combining three types of laser tips (FT) and conventional syringe needle irrigation (SNI). Methods: Twenty extracted human maxillary central incisors prepared using Reciproc® instruments (size 40, taper 0.06). Irrigant volumetric flow (IVF) was accurately standardized using a precision syringe pump with constant irrigant delivery through the 27G needle. The tested irrigation protocols (60 s) were groups 1: 27-G SNI with 0.05 ml/s constant IVF; group 2: SSP (10 mJ, 15 Hz, pulse duration 50 μs) + Radial SWEEPS FT; group 3: SSP + photon-induced photoacoustic streaming (PIPS) FT; group 4: SSP+SWEEPS FT; group 5: AutoSWEEPS (20 mJ, 15 Hz, pulse duration 25 µs) + Radial SWEEPS FT; group 6: AutoSWEEPS+PIPS FT; group 7: AutoSWEEPS+SWEEPS FT. Each protocol was evaluated in 10 repetitions each. Apically extruded irrigant was collected, and the net weighted. Results: There were significantly lower amounts of extruded irrigant with SNI and SSP using radial SWEEPS and PIPS FTs compared to the other tested laser protocols (p&lt;0.05). In the AutoSWEEPS groups, all three FTs had similar amounts of extruded irrigant (p&gt;0.05). Conclusion: In straight root canals, the use of various fiber FTs in the AutoSWEEPS mode exhibited a higher potential for irrigant extrusion.

Background and objective: Chronic subdural hematoma (cSDH) is one of the most common neurosurgical entities affecting mostly elderly patients. In this study, we aimed to provide detailed characteristics of surgically treated patients with cSDH and evaluate outcomes between the two conventional treatment methods. Materials and methods: Patients with cSDH surgically treated with burr hole craniostomy (BHC) and craniotomy (CO) in tertiary centers in Croatia and Serbia during 2017-2019 were included in the study. Characteristics and outcomes of these patients were prospectively collected. Results: In total, 155 patients (mean age 72.3±13.4) were included in the study. BHC group consisted of 124 (80 %) and CO group of 31 (20 %) patients. 32 (20.6 %) patients presented with bilateral cSDH, head trauma was documented in 92 (59.4 %), and anticoagulant therapy in 37 (23.9 %) individuals. The most common symptom was hemiparesis (n=85, 54.8 %). The two groups did not differ by age. CO group had higher Glasgow Coma Scale (GCS) score at the admission, with a significant decrease at discharge compared to admission (12.6±4.8 vs 14.4±1.7, p

Polyphenols are the most common organic compounds in wine. They improve both the sensory aspects of wine and human health by activating antioxidant systems. Therefore, there is a great need for a simple, fast and accessible method to determine the polyphenol content of wine. The aim of this study is to characterize polyphenolic compounds in natural wine samples using an electrochemical method and a modified carbon paste electrode with TiO2 nanoparticles. This work is motivated by the promising improvement of the sensing properties of a TiO2 nanoparticle-modified carbon paste electrode observed in the electrooxidation of different polyphenols. Since the voltammetric response of wine is largely irreversible, another motivation was the possibility of improving the processing of voltammograms to obtain data indicative of wine polyphenols, based on the approach described in the seminal work by Espinoza et al. The modified electrode studied provides an improved and reproducible voltammetric response of gallic acid in wine samples and provides a good basis for further development of an integrated sensor/data system with the possibility of wider application for the quantification of gallic acid as a flavor and visually relevant parameter in winemaking.

A 7.4 m long sediment core has been retrieved from the central part of Lake Vrana on the Island of Cres to reconstruct the paleoenvironmental conditions. Lake Vrana is the deepest freshwater lake in Croatia, located in the karst region of the eastern Adriatic coast. A dated sediment sequence in Lake Vrana of 4.4 m spans the past 16.4 kyr, and features a dynamic sediment deposition until the beginning of the Holocene, including strong sediment input and supply to the lake by runoff sediments of dolomitic origin from the catchment in the period 16.4-14.4 cal kyr BP. High organic carbon content, which originates from mixed terrestrial and aquatic origins in the periods 14.4-13.3 cal kyr BP and 12.7-11.7 cal kyr BP, indicates fluctuating lake levels in shallow water environments during the late glacial to Holocene transition. The Holocene sequence indicates the development of more stable conditions and continuous sediment deposition, characterized by increasing trend of siliciclastic sediments delivered into the lake during the early Holocene (11.7-10 cal kyr BP), and dominantly from 8 to 4.4 cal kyr BP, indicating enhanced input and erosion, which coincides with humid and pluvial period, recorded in the central Mediterranean region. It is followed by sediments with high organic carbon content between 4.4 to 1.6 cal kyr BP, which points to higher lake productivity. Calcite sedimentation prevail between 1.6 to 0.4 cal kyr BP, indicating stable deeper-lake conditions, while dominantly siliciclastic sediments in the period 0.4-0.1 cal kyr BP indicate erosion during Little Ice Age (LIA), with enhanced precipitation and sediment discharge from the catchment. The re-establishment of calcite sedimentation has been observed over the last 100 years.

Thalassemia syndromes are common monogenic disorders that represent a significant global health issue. No systematic epidemiological and molecular investigations on thalassemias in Croatian population have been reported to date. This prospective study included 70 children with a presumptive diagnosis of thalassemia, and their 42 first-degree relatives. Molecular characterization was performed using direct sequencing and gap-PCR methods. We identified 46 (30 children and 16 first-degree relatives) β-thalassemia heterozygous carriers from 24 unrelated families, carrying eight different mutations and one hemoglobin variant. Five variants account for approximately 85% of all affected β-globin alleles: Hb Lepore-Boston-Washington (32,6%), HBB: c.93-21G&gt;A (19,6%), HBB:c.315+1G&gt;A (13,1%), HBB:c.92+1G&gt;A (10,9%), and HBB:c.92+6T&gt;C variant (8,7%). A need for more detailed genetic profiling of β-thalassemia carriers is emphasized since genetic modifiers can significantly impact their phenotype. Our study provides important new insights into the relevance of β-thalassemia heterozygosity in the pediatric clinical practice.

In this paper it is examined how, if at all, logical laws can be normative for human reasoning, wherein the notion of normativity is analysed with respect to approaches to logic given in works of Aristotle, Descartes, Kant, Frege and Wittgenstein. During the ancient and medieval period, logic was being considered in terms of discourse and dialogical practice, but since Descartes and especially Kant it has been treated as a system of laws with which the process of individual human reasoning has been compared. Therefore, normativity can be investigated in private sphere (for thinking and reasoning) and in public sphere (for dialogic practices in a community). Wittgenstein discussed both aspects of normativity: in Tractatus, a focus is on laws of logic that are primarily normative for the state of affairs in the world, while in Philosophical Investigations an emphasis is on a social aspect of normativity (which is closer to Aristotle’s view), which is derived from adopted rules that have been applied in a certain community. Taken that way, logic is certainly normative in the public sphere, but the more difficult issue is whether logic is normative for thinking, regarding to the difference between the logical laws and those of thought.

Bacillus Calmette-Guérin (BCG) therapy for patients with non-muscle invasive bladder cancer (NMIBC) faces limitations in efficacy and significant side effects, aggravated by a recent global shortage. In this prospective clinical study, we report outcomes of sequential intravesical adminis-tration of gemcitabine and docetaxel (Gem/Doce) as the first-line treatment in BCG-naïve patients with high-risk NMIBC (HR NMIBC). From October 2019 until April 2022, we enrolled 52 patients and followed treatment protocol set by the University of Iowa. Follow-up assessments were con-ducted every 3 months. In this cohort, 25 (48.1%) patients were diagnosed with T1HG bladder cancer, 10 (19.2%) patients had carcinoma in situ (CIS), and 17 (32.7%) patients had a combination of CIS+T1HG. Median time to first recurrence in T1HG, CIS and T1HG+CIS groups was 11, 10.5 and 8.8 months, respectively. The recurrence-free survival was 98.1%, 94.2% and 80.8% at 6, 9 and 12 months, respectively. The rate of progression-free survival was 100%, 98.1% and 92.3% at 6, 9 and 12 months, respectively. We demonstrated the safety and efficacy of Gem/Doce therapy in BCG-naïve patients with HR NMIBC during a one-year follow-up. Further research with extended follow-up, as well as direct comparison of Gem/Doce and other anticancer agents, are essential.

Here we report a comparative study of the pyhtochemical profile and a biological activity of the two onion extracts, namely A. cepa L. and A. × cornutum (Clementi ex Visiani 1842). Identification of flavonoids and anthocyanins and their individual quantities were determined by high performance liquid chromatography (HPLC). The potency of both extracts to scavenge free radicals was determined by DPPH (2,2'-diphenyl-1-picrylhydrazyl) radical-scavenging activity and oxygen radical absorbance capacity (ORAC) methods. DNA protective role was further tested by single-cell gel electrophoresis (COMET) assay and by Fenton’s reagent causing double strand brakes on pUC19 plasmid. In the presence of both extracts, a significant decrease in the DNA damage was observed, which indicates a protective role of A. cepa and A. × cornutum on the DNA strand brakes. Additionally, cytotoxicity was tested on glioblastoma and breast cancer cell lines. The results showed that both extracts had antiproliferative effect, but the most prominent decrease in cellular growth was observed with glioblastoma cells

In the era of DevOps, developing new toolsets and frameworks that leverage DevOps principles is crucial. This paper demonstrates how Ansible’s powerful automation capabilities can be harnessed to manage the complexity of Kubernetes environments. This paper evaluates efficiency across various CNI (Container Network Interface) plugins by orchestrating performance analysis tools across multiple power profiles. Our methodology, which involves managing numerous components, dependencies, and configurations, requires high expertise and precision. Our performance evaluations across network interfaces with different theoretical bandwidths gave us a comprehensive understanding of CNI performance and overall efficiency. Our research confirms that certain CNIs are better suited for specific use cases, mainly when tuning our environment for smaller or larger network packages and workload types, but also that there are configuration changes we can make to mitigate that. This paper also provides research into how to use performance tuning to optimize the performance and efficiency of our CNI infrastructure, with practical implications for improving the performance of Kubernetes environments in real-world scenarios, particularly in more demanding scenarios such as High-Performance Computing (HPC) and Artificial Intelligence (AI).

Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality worldwide, including in Croatia. Since most patients have multiple disorders and diseases caused largely by the same risk factors, and as it is essential to approach each patient as a person with all disorders, today we are talking about a new paradigm - cardio-renal-metabolic (CKM) syndrome and cardio-renal-metabolic health, which necessarily includes brain health. Elevated systolic blood pressure, LDL cholesterol, smoking, obesity, diabetes, impaired renal function or chronic kidney disease, which all stem from insufficient physical activity, unhealthy diet with excessive intake of table salt, and air pollution, are the leading causes of overall morbidity and mortality from CKM diseases, especially mortality from CVD. Experts from various fields key to CKM health have written this document with the aim of integrating it as part of the national plan for the prevention of chronic non-communicable diseases with a focus on CVD, which should become mandatory and be based on the existing guidelines of professional societies.

In the past twenty years, the IT industry has moved away from using physical servers for workload management to workloads consolidated via virtualization and, in the next iteration, further consolidated into containers. In the next step, container workloads based on Docker and Podman as underlying container technologies were orchestrated/automated via Kubernetes or OpenShift. On the other hand, high-performance computing (HPC) environments have been lagging in that process, as there’s still much work to figure out how to apply containerization platforms for HPC in real-life scenarios. Kubernetes and OpenShift have many advantages – generally speaking, container technologies use quite a bit less overhead from the computing perspective while providing many benefits in flexibility, modularity, and maintenance. Therefore, they are ideal for tasks requiring a lot of computing power. There are also some tradeoffs regarding the complexity of these two platforms - they’re just not that user-friendly when used by people without years of experience managing them. In this paper, we propose a different architecture based on seamless hardware integration and user-friendly, dynamic workload placement based on real-time performance analysis and prediction coupled with Machine Learning-based scheduling.

In the dynamic realm of HPC (High-performance computing) and cloud-native applications, ensuring optimal network performance for Kubernetes Container Network Interfaces (CNIs) is critical. Traditional manual methods for evaluating network bandwidth and latency are prone to errors, time-consuming, and lack consistency. This paper introduces a novel approach that leverages Ansible to automate and coordinate network performance tests across diverse CNIs, performance profiles, and configurations. By automating these processes, we eliminate the potential for human errors, ensure the ability to replicate the process, and significantly reduce the time required for comprehensive testing. The use of Ansible playbooks facilitates the efficient and scalable deployment, configuration, and execution of performance tests, enabling comprehensive and standardized benchmarking across various environments. The set of Ansible playbooks, which we will make available online, has a significant real-world impact by providing DevOps teams with robust and reliable tools for consistently monitoring and enhancing network performance. This, in turn, enhances the stability and efficiency of cloud-native applications, accelerates the development cycle, and ensures that Kubernetes-based infrastructures can meet the demanding performance requirements of modern applications.

Academic stress affects students' psychological and physiological well-being. Dental undergraduate programs are known for their demanding curriculum, leading to significant stress symptoms. Objective was to determine if salivary cortisol levels were higher in students exposed to academic stress, assess the relationship between stress severity/temperament and cortisol values, and explore relaxation technique effects. Salivary cortisol was measured at two time points for all participants: before exams and during a relaxation period after summer break. A third measurement was conducted for students with high pre-test cortisol levels who received instructions on progressive muscle relaxation(PMR) before subsequent exams. Additionally, participants completed two questionnaires: Perceived Stress Scale(PSS) and Fisher's Temperament Questionnaire. The group analysis based on the PSS indicated that 39 participants reported high stress. Women demonstrated significantly higher stress than men(p=0.042054). A significant difference in stress levels was observed between Director and Builder temperament types(p=0.029276). Cortisol levels showed a significant decrease from the first measurement to the second measurement, and the third measurement after implementing PMR. The grade in the "Dermatovenereology" course correlated with stress level according to the PSS(k=0.578467). Pre-test cortisol levels correlated with the frequency of using PMR guidelines during winter test periods(k=0.416138). Stress negatively affects the immune system and poses health risks. Implementing stress reduction techniques in dental/medical education could benefit students and the healthcare system.

Metabolic syndrome (MetS) refers to the group of several interconnected risk factors that collectively double the risk of cardiovascular disease. Epilepsy is linked to MetS across all age groups, though its prevalence differs across various studies. This can be understood from the perspective of seizure-related metabolic abnormalities, long-term antiepileptic drugs (AEDs) use, and a more sedentary lifestyle due to epilepsy. The factors that are considered in developing MetS for patients with epilepsy (PWE) are age, residence, level of physical activity, food intake status, epilepsy subtype, epilepsy duration, current (AEDs) use, drug responsiveness status, body-mass index (BMI), total cholesterol and LDL-cholesterol levels. A deeper understanding of the epilepsy-AED-MetS connection and the exploration of lifestyle interventions hold the promise of significantly improving the overall health and well-being of PWE. Clinicians managing PWE should closely monitor various risk factors for developing MetS and consider them when selecting AED treatment.

This study investigated the effects of a ten-visit individual coordinative locomotor training (CLT) program, including both a hands-on and a hands-off approach, on static and dynamic trunk stability in healthy adults with sedentary occupations. During the ten-visit program, the performance of eight subjects was monitored using a modified one-leg stance test in the sprinter and skater position, the Y-balance test, and the scapula and ischial tuberosity control test in the four-legged position. The data were analyzed using parametric and nonparametric statistics at an overall level of significance α=0.05. In the one-leg stance test, all subjects achieved a maximum value of 60 s on all ten visits. The improvement over time in the Y-balance test results was statistically significant for all directions (p<0.001). In addition, a statistically significant improvement in the Y-balance test composite score was observed between the first and the last visit (p=0.015-0.041). Subject-specific patterns were observed in the results of the Y-balance test. Significant improvements were observed over time in the four-legged position test score (p=0.008-0.010). Overall, the CLT program led to a significant improvement in trunk stability and leg extension in the anterior and posterolateral directions, as well as a reduction in instability as determined by the composite score of the Y-balance test.

(1) Background: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a lifesaving treatment but carries a high infection risk. Diagnosing infections remains challenging due to the limited accuracy of standard biomarkers. (2) Methods: This single-center study aimed to evaluate presepsin (PSP) and YKL-40 as infection biomarkers in febrile patients during the allo-HSCT pre-engraftment phase. Biomarker levels were prospectively measured in 61 febrile episodes from 54 allo-HSCT patients at admission, representing baseline levels and then at Day 1, 3, 5, and 7 following fever onset. The diagnostic value was compared to that of procalcitonin (PCT). (3) Results: PSP showed fair diagnostic value on Day 1 (AUC 0.656; 95% CI: 0.510 – 0.802) and Day 3 (AUC 0.698; 95% CI: 0.559 – 0.837). YKL-40 did not provide any significant diagnostic value across measured time points. PCT outperformed PSP and YKL-40, particularly on Day 3 (AUC 0.712; 95% CI: 0.572 – 0.852). When combining biomarkers, the best model for predicting infection used PSP > 3.144 ng/mL and PCT > 0.28 g/L on Day 3, resulting in R2 of about 31% (p < 0.001). (4) Conclusion: Neither test showed sufficient discriminative power for early infection to recommend their use as individual diagnostic tools in clinical practice.

The targeted compounds in this research, resveratrol analogs 1–14 were synthesized as mixtures of isomers by the Wittig reaction using heterocyclic triphenylphosphonium salts and various benzaldehydes. The planned compounds were those possessing the trans-configuration as the biologically active trans-resveratrol. The pure isomers were obtained by repeated column chromatography in various isolated yields depending on the heteroaromatic ring. It was found that butyrylcholinesterase (BChE) was more sensitive to the heteroaromatic resveratrol analogs than acetylcholinesterase (AChE), except for 6, the methylated thiophene derivative with chlorine, which showed equal inhibition toward both enzymes. Compounds 5 and 8 achieved the highest BChE inhibition with IC50 values of 22.9 and 24.8 μM, respectively. The same as with AChE and BChE, methylated thiophene subunits of resveratrol analogs showed better enzyme inhibition than unmethylated ones. Two antioxidant spectrophotometric methods, DPPH and CUPRAC, were applied to determine the antioxidant potential of new heteroaromatic resveratrol analogs. Molecular docking of these compounds was conducted to visualize the ligand-active site complexes' structure and identify the non-covalent interactions responsible for the complex's stability, which influence the inhibitory potential. As ADME properties are crucial in developing drug product formulations, they have also been addressed in this work. The potential genotoxicity is evaluated by in silico studies for all compounds synthesized.

Obstructive sleep apnea (OSA) often goes unrecognized despite common symptoms such as excessive daytime sleepiness, fatigue, and impaired quality of life (QoL). CPAP is the gold standard treatment for OSA, but optimal daily usage and time needed for observable effects remain unclear. This study aimed to investigate the short-term effects of CPAP on daytime sleepiness and QoL in patients with severe OSA. Medical records were collected from 87 patients with severe OSA who initiated CPAP therapy. Also, validated questionnaires were used before and after one month of CPAP to analyze QoL - the Calgary Sleep Apnea Quality of Life Index (SAQLI), the Cues to CPAP Use Questionnaire (CCUQ), and daytime sleepiness - the Epworth Sleepiness Scale (ESS). Multiple regression analysis was conducted to identify predictors of CPAP usage. Of the total participants aged 55.6±12.5, 77% were males, and 62% were CPAP adherent. Reductions in daytime sleepiness (ESS) were noted, as well as improvements in both overall QoL (SAQLI) and specifically in the domains of daily functioning, social interactions, emotional well-being, and symptom perception. Important cues for CPAP usage recognized by patients were physicians’ instructions and physicians’ worry regarding patients' condition. Furthermore, multiple regression revealed higher SAQLI scores and lower ESS scores as positive predictors of CPAP usage, along with lower AHI after one month of CPAP being associated with sufficient adherence.

Ischemic stroke is one of the leading causes of death and permanent disability in the world. Rapid diagnosis and intervention are crucial for reducing its consequences on individuals and societies. Identifying reliable biomarkers for early detection, prognostics and therapy is a criti-cal imperative for improving the stroke patient treatment. Metabolomics has been shown as a promising tool for biomarker discovery since many of the post-ischemic metabolites can found in the plasma or serum of the patient. In this research, we have performed comparative targeted metabolomic analysis of stroke thrombi, patient serums and healthy control serums in order to determine the alteration in the patients’ metabolome. The most statistically altered metabolites characterized in patient compared to control serums were glutamate and serotonin, followed by several lipid metabolites (phospholipids and triacylglycerols) and glucose. In stroke thrombi compared to patient’s serums, the most significantly altered metabolites were classified as li-pids, with choline-containing phospholipids and sphingomyelins having the highest discrimi-natory score. The results of this study could help in understanding the roles of different meta-bolic changes occurring during thrombosis and cerebral ischemia and possibly suggest new metabolic biomarkers of the ischemic stroke.

Purpose: Investigation for the co-occurrence of two unrelated genetic disorders of muscular dystrophy and Prader-Willi syndrome (PWS) (OMIM # 176270) using joint whole genome sequencing (WGS). Methods: Trio WGS joint analysis was performed to investigate the genetic etiology in a proband with PWS, prolonged muscular hypotonia associated hyperCKemia, and early-onset obesity. The parents were unaffected. Results: Results showed maternal isodisomy uniparental disomy (UPD) in chromosome 15 expanding from 15q11.2 to 15q22.2, including PWS regions at 15q11.2-15q13. Maternal heterodisomy was detected from 15q22.2 to 15q26.3. A pathogenic variant, NM_000070.3(CAPN3):c.550del (p.Thr184fs), was identified at 15q15.1 in a heterozygous state in the mother that was homozygous in the proband due to maternal isodisomy. Conclusion: This is the first study of the concurrent molecular etiology of PWS and calpainopathy (OMIM # 253600) in the same patient. This report highlights the utility of joint analysis and need for the assessment of autosomal recessive disease in regions of isodisomy in patients with complex and unexplained phenotype.

This paper examines the impact of stringent regulations on personal data protection on customer perception of data security and online shopping behavior. In the context of the rapidly expanding e-commerce landscape, ensuring the security of personal data is a complex and crucial task. The study of several legal frameworks, including Malaysia's compliance with EU regulations and Indonesia's Personal Data Protection Law, provides valuable insights into consumer data protection. The challenges of balancing data safeguarding and unrestricted movement and tackling misuse by external entities are significant and require careful consideration. This research elucidates the pivotal role of trust in e-commerce environments and the deployment of innovative e-commerce models designed to minimize personal data sharing. By integrating advanced privacy-enhancing technologies and adhering to stringent regulatory standards such as the GDPR, this study demonstrates effective strategies for robust data protection. The paper contributes to the academic discourse by providing a comprehensive framework that synergizes legal, technological, and procedural elements to fortify data security and enhance consumer trust in digital marketplaces. This approach aligns with international data protection standards and offers a pragmatic blueprint for achieving sustainable data security in e-commerce.

Introduction: Migraine is one of the most prominent headache disorders with a global burden of over one billion patients and presented as a disabling and painful disorder. Pathophysiological mechanism of migraine is not fully understood, but the most accepted theory suggests that migraine is caused primarily by neural dysfunction leading to secondary changes in cerebral perfusion. Methods: Authors conducted a case-control study in 175 patients; 88 of them were migraineurs and 87 health controls. Optical coherence tomography (OCT) was performed in all patients using spectral-domain OCT device in the same environmental conditions. All participants met both inclusion and exclusion criteria in order to achieve more homogeneous groups. OCT was performed to scan all retinal layers with an emphasis on the inner plexiform layer (IPL). Results: Among 175 examined subjects, 84% of them were women and in the group of migraineurs we found 56% without aura and 44 % with aura. After collecting tomography data authors did not find subjects in which changes of IPL were found. Nevertheless, only moderate differences in the IPL thickness in all quadrants except the central area were found in the group of migraineurs with aura using Pearson’s test. Conclusion: According to presented results, no significant changes of the IPL thickness in migraine patients were found. Authors have to emphasize the need for further investigation of the relationship between average migraine headache days per month and the thickness of the IPL.

The spectrum, intensity and overlap of symptoms between FGIDs and other gastrointestinal disorders characterize patients with FIGDs, who are incredibly different in their backgrounds. An additional challenge with regard to the diagnosis and treatment's applicability is the ongoing expansion of the risk factors believed to be connected to these disorders. Many cytokines and inflammatory cells have been found causing the continuous existence of low-inflammation, which is thought to be a basic pathophysiological process. The idea of the gut-brain axis has been created to offer a basic framework for the complex interactions that occur between the nervous system and intestinal functions, including the involvement of the gut bacteria. In this review paper, we intend to promote a hypothesis that FGIDs, should be seen through the perspective of the network of the neuroendocrine, immunological, metabolic and microbiome pathways. Hypothesis arises from an increased understanding of chronic inflammation as a systemic disorder, being omnipresent in chronic health conditions. Better understanding of inflammation role in the pathogenesis of FGIDs can be achieved by clustering markers of inflammation with data indicating symptoms, comorbidities, and psycho-social factors. Finding subclasses among related entities of FGIDs, may reduce patient heterogeneity and help clarify pathophysiology for better treatment.

This paper introduces an innovative approach that enables automated and precise prediction of the steel's chemical composition based on the desired Jominy curve. The microstructure, and in fact the presence of martensite, is decisive for the hardness of the steel, so the study considered the occurrence of this phase at particular distances from the quenched-end of the Jominy sample. Steels for quenching and tempering and case hardening were investigated. With representative collected dataset of hardness values from quenched-end of Jominy specimen, microstructure and chemical composition of steels, the complex regression model was made using supervised artificial neural networks. The balance between cost and required hardenability can be achieved through optimizing the chemical composition of steel. This model of designing steel with required hardenability can be of great benefit in the mechanical engineering and manufacturing industry. The model is verified experimentally.

The Zero Trust Architecture (ZTA) security system follows the "never trust, always verify" principle. The process constantly verifies users and devices trying to access resources. This paper describes how Microsoft Azure uses ZTA to enforce strict identity verification and access rules across the cloud environment to improve security. Implementation is time-consuming and difficult. Azure's extensive services and customizations require careful design and implementation. Azure administrators struggle to navigate and change configurations due to its complex user interface (UI). Each Azure ecosystem component must meet ZTA criteria. ZTA's comprehensive policy definitions, multi-factor and pass-wordless authentication, and other advanced features are tested in a mid-size business scenario. These configuration changes require a solid grasp of Azure's architecture and Zero Trust. Implementing an Azure ZTA reduces vulnerabilities and restricts authorized users' access to critical resources. Implementation is time-consuming and expensive, requires a significant commitment to changing IT procedures, and can be confusing because the same features are available in multiple places. Azure ZTA has shown great potential for both hybrid and cloud-native companies.

Type II diabetes (T2D) is a multifaceted metabolic disease influenced by various factors (genetic, epigenetic, environmental, and other). An alarming surge in T2D prevalence is estimated, reaching 700 million cases by 2045 worldwide. This review explores the complex interactions of multiple risk factors throughout life and offers a new perspective on T2D. Genetic and epigenetic influences are described in detail. Prenatal factors, such as exposure to undernutrition and maternal overfeeding, induce lasting epigenetic changes, affecting T2D susceptibility. Furthermore, birthweight is a crude proxy for perinatal programming, with low and high birthweights associated with increased T2D risk. Often overlooked, the early postnatal period also significantly contributes to perinatal programming. Neonatal over-nutrition and feeding choices exert lasting effects on DNA methylation and metabolic outcomes later in life. Stress during this period further exacerbates T2D susceptibility. In continuation, childhood behaviors which are influenced by prior periods contribute substantially to T2D risk. Adverse childhood experiences amplify the risk of many diseases, including T2D. Sleep hygiene throughout life plays a role in metabolic health, influencing insulin resistance and appetite regulation. In adulthood, obesity remains a prominent predictor of T2D, with chronic stress contributing to weight gain and unhealthy lifestyle. This review proposes a novel perspective, considering T2D pathophysiology as a nonlinear process governed by numerous factors and their interactions throughout life. The inherent unpredictability suggests a need for personalized interventions tailored to specific risk profiles, emphasizing the importance of understanding gene-environment interactions and embracing a holistic view of T2D pathogenesis.

Recent advances in signal processing and AI-based inference enable the exploitation of communication signals to collect information on devices, people, actions and the environment in general, i.e., to perform Integrated Sensing And Communication (ISAC). This possibility opens new and exciting opportunities for IoT systems, but at the same time poses unprecedented threats to security and privacy of data, devices, and systems. In fact, ISAC operates at the PHY and Medium Access Control (MAC) layers, where it is impossible to protect the information with standard encryption techniques, or with any other purely digital methodologies. The work we present analyzes, within the framework of IoT and distributed, pervasive communication systems, the threats to security and privacy posed by ISAC and how they do intertwine at the PHY layer. Next, possible countermeasures are presented and discussed, with proper architectural choices and tradeoffs to implement them, as well as solutions and protocols to preserve the potential benefits of ISAC while ensuring data protection and users’ privacy.

Acrylates and methacrylates are widely used, especially in the dental industry, but can cause adverse skin reactions. These compounds, including 2-hydroxyethyl methacrylate, triethylene glycol dimethacrylate, and bisphenol A-glycidyl methacrylate, are strong contact irritants or allergens. Found in dental prostheses, composite resins, dentin bonding materials, and glass ionomers, they pose a higher risk of exposure for dental personnel. Clinically, acrylate allergies manifest as facial rashes, eczema with cracked skin on fingers (pulpitis), nail dystrophy, and periungual dermatitis. Recently, the highest frequency of allergic reactions to acrylates has shifted from dentistry to the beauty industry due to increased use in artificial nails, eyelashes, and hair extensions. This has led to greater sensitization. Acrylates are also used in medical applications, such as bone cement for orthopedic endoprostheses, soft contact lenses, hearing aids, histological preparations, and wound dressings, which can also cause allergic reactions. Severe dermatitis from surgical glue containing acrylates has been documented, and diabetic medical devices are potential sources of allergic contact dermatitis. Given the extensive use and prolonged skin contact of products containing acrylates and methacrylates, this review aims to present current knowledge and literature on reactions to these compounds across different industries.

In 2020, the Covid-19 outbreak led many countries across the globe to introduce lockdowns (LDs) that effectively caused most anthropic activities to either stop completely or be significantly reduced. In Europe, Italy played a pioneeristic role via the early introduction of a strict nationwide LD on March 9^th. This study is aimed at evaluating, using both chemical and meteorological data, the environmental response to that occurrence as observed by the Lamezia Terme (LMT) GAW/WMO station in Calabria, Southern Italy. The first 2020 lockdown has therefore been used as a “proving ground” to assess CO, CO₂, CH₄, BC, and NO_x concentrations in a rather unique context by exploiting the location of LMT in the context of the Mediterranean Basin. In fact, its location on the Tyrrhenian coast of Calabria and local wind circulation both lead to daily cycles where western-seaside winds depleted in anthropogenic pollutants can be easily differentiated from northeastern-continental winds, enriched in anthropogenic outputs. In addition to that, the first Italian LD occurred during the seasonal transition from Winter to Spring and, consequently, Summer, thus providing new insights on emission outputs correlated with seasons. Findings have clearly indicated BC and, in particular, CO as strongly correlated with average daily temperatures, and possibly domestic heating. CO₂’s reduction during the lockdown and consequent increase in the post-lockdown period, combined with wind data, has allowed to constrain local source of emissions located northeast from LMT. NO_x reductions during specific circumstances are consistent with hypotheses from previous research which linked them to rush hour traffic and other forms of transportation emissions. CH₄’s stable patterns are consistent with livestock, landfills, and other sources assumed to be nearly constant during LD periods.

This paper explores innovative approaches to determining eigenvalues and eigenvectors through the combination of neural networks and traditional numerical methods. Traditional methods like the Newton-Raphson and Durand-Kerner algorithms are proven effective but often require good initial approximations and can be sensitive to the choice of starting points. In this study, we propose a hybrid approach that uses neural networks to generate better initial approximations, which are then iteratively refined using traditional methods. By combining the pattern recognition power of neural networks with the adaptability of traditional numerical methods, we demonstrate faster convergence and higher accuracy in determining eigenvalues and eigenvectors. Experimental results on various polynomials of different degrees and characteristics show that our hybrid approach outperforms individual methods, providing a more robust and efficient solution.

Due to its high short-term global warming potential (GWP) compared to carbon dioxide, methane (CH₄) is a considerable agent of climate change. This research is aimed at analyzing data on methane gathered at the GAW (Global Atmosphere Watch) station of Lamezia Terme (Calabria, Southern Italy) spanning seven years of continuous measurements (2016-2022) and integrating the results with key meteorological data. Compared to previous studies on detected methane mole fractions at the same station, daily-to-yearly patterns have become more prominent thanks to the analysis of a much larger data set. Overall, the yearly increase of methane at the Lamezia Terme station is in general agreement with global measurements by NOAA, though local peaks are present, and an increase linked to Covid-19 is identified. Seasonal changes and trends have proved to be fully cyclic, with the daily cycles being largely driven by local wind circulation patterns and synoptic features. Outbreak events have been statistically evaluated depending on their weekday of occurrence to test possible correlations with anthropic activities. A cross analysis between methane peaks and specific wind directions has also proved that local sources may be deemed responsible for the highest mole fractions.

D-dimer testing in combination with clinical assessment is commonly used to diagnose suspected DVT and pulmonary embolism. However, as D-dimer levels are physiologically higher in elderly patients, this test loses clinical specificity in the setting of geriatric patients. The aim of our study was to investigate the changes in D-dimer levels with age and the specificity of the D-dimer test in the diagnosis of pulmonary embolism. 1617 elderly patients consecutively admitted to the Geriatric Emergency Care Department of the INRCA-IRCCS hospital between January 2013 and February 2014 and for whom D-dimer results were available were included. The D-dimer immunoturbidimetric assay was performed on a cs-2100i Sysmex Siemens using a conventional cut-off level of 500 µg/L. The median D-dimer level was 1200 [550-2990] µg/L FEU, and the percentage of patients with D-dimer levels below the conventional cut-off was only 22.1%. As expected, there was a significant age-related increase in D-dimer, even when sex was considered, and a significant decrease in the specificity of D-dimer assay with age. The most established use of D-dimer testing is in the diagnosis of deep vein thrombosis or pulmonary embolism. Our study confirms the need for an age-adjusted cut-off for D-dimer testing in geriatric patients.

This paper presents a comprehensive comparative analysis of four different computational vision algorithms for implementing an unpalleting system in a factory environment, under typical edge computing constraints. The primary objective is to automate the process of detecting and locating specific variable-shaped objects on a pallet, enabling a robotic system to accurately unstack them. The four algorithms evaluated are Pattern Matching, Scale-Invariant Feature Transform, Oriented FAST and Rotated BRIEF, and Haar cascade classifiers. Each technique is described in detail in this paper, and their implementations are outlined. Experimental results are thoroughly analyzed, assessing the algorithms’ performance based on accuracy, robustness to variability, computational speed, detection sensitivity, and resource consumption. The findings reveal the strengths and limitations of each algorithm, providing valuable insights for selecting the most appropriate technique based on the specific requirements of the unpalleting system. This research contributes to the advancement of automated object detection and localization in industrial environments, paving the way for more efficient and reliable unpalleting systems.

Ovarian cancer is among the most common causes of female mortality. Despite improvements in diagnostic methods, non-specific symptoms and delayed gynecological exams can lead to late-stage ovarian tumor discovery. In this study, the effect of an anti-cancer compound, 3-amino-N-(3-chloro-2-methylphenyl)-5-oxo-5,6,7,8-tetrahydrothieno[2,3-b]quinoline-2-carboxamide (Compound 1) was examined. Cytotoxicity, apoptosis, and metabolomic changes in ovarian cancer cell lines SK-OV-3 and OVCAR-3, as well as glycosphingolipid (GSL) expression, both on cancer stem cells (CSCs), marked as CD49f+ and non-CSCs (CD49f-) were explored. Treatment with Compound 1 reduced the percentage of CSCs compared to non-treated cells (P &lt; 0.001). The expression of eight GSLs on CSCs and non-CSCs was examined using flow cytometry. Both cell lines showed a change in the glycophenotype of the cells, either up or down of its expression, after the treatment. These findings raise the possibility of specifically targeting CSCs in ovarian cancer therapy. Additionally, treatment of Compound 1 resulted in a statistically significant increase in both early and late apoptosis (P&lt;0.001) suggesting a pivotal role in initiating programmed cell death by the apoptotic pathway. The metabolic analysis revealed that the treated cancer cells showed reduced metabolic activity compared to the control group (P &lt; 0.001)

Collaboration across the agriculture supply chain is essential to address the high-yield demand and sustainable practices amid global overpopulation. Limited resources, such as soil, are compromised by excessive chemical agents and nutrient use. The Internet of Things (IoT) and smart farming offer solutions by optimizing agent application, data analysis, and farm monitoring. Evidence from numerous studies indicates that collaboration in the supply chain, including farmers, can improve efficiency and productivity, reduce costs, and enhance crop quality. This research focuses on implementing IoT technology to enhance decision-making for crop yield optimization and sustainable practices on a real farm. By collaborating with a farm in the southern region of Zagreb, Croatia, farmers were trained on sensor usage and yield monitoring. Small farms in that region face challenges in improving yields due to limited capacity and lack of entrepreneurial skills. The DMAIC methodology was applied to define the problem and measure relevant parameters. The analysis demonstrated consistent patterns between electrical conductivity (EC) measurements and potassium levels in soil. It suggests the potential for estimating potassium concentrations based on EC readings, or vice versa. Leveraging EC as a proxy for potassium levels could offer a cost-effective means of assessing soil fertility and nutrient dynamics. Additionally, the PCA biplot analysis highlighted that pH value behaved independently. Understanding these dynamics enhances knowledge of soil variability and informs sustainable soil management practices.

Mediterranean Diet (MD), rich in minimally processed plant foods and in monounsaturated fats, but low in saturated fats, meat and dairy products, represents one of the most studied diets for cardiovascular health. It has been shown, from both observational and randomized controlled trials, that MD reduces body weight, improves cardiovascular disease surrogates such as waist-to-hip ratio, lipids, and inflammation markers, and even prevents the development of fatal and non-fatal cardiovascular disease, diabetes, obesity, and other diseases. However, it is unclear whether it offers cardiovascular benefits from its individual components or as a whole. Furthermore, limitations in the methodology of studies and meta-analyses have raised some concerns on its potential cardiovascular benefits. MD is also associated with characteristic changes in the intestinal microbiota, mediated through its constituents. These include increased growth of species producing short-chain fatty acids, such as Clostridium leptum and Eubacterium rectale, increased growth of Bifidobacteria, Bacteroides and Faecalibacterium prausnitzii species, and reduced growth of Firmicutes and Blautia species. Such changes are known to be favorably associated with inflammation, oxidative status, and overall metabolic health. This review will focus on the effects of MD on cardiovascular health through its action on gut microbioma.

Hereditary cardiomyopathies (CMPs), including Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC), Dilated Cardiomyopathy (DCM), and Hypertrophic Cardiomyopathy (HCM), represent a group of heart disorders that significantly contribute to cardiovascular morbidity and mortality and are often driven by genetic factors. Recent advances in Next-Generation Sequencing (NGS) technology have enabled the identification of rare variants in both well-established and minor genes associated to CMPs. Nowadays, a set of core genes is included in diagnostic panels for ARVC, DCM, HCM. On the other hand, despite their lesser-known status, variants in the minor genes may contribute to disease mechanisms and influence prognosis. This review evaluates the current evidence supporting the involvement of the minor genes in CMPs, considering their potential pathogenicity and clinical significance. A comprehensive analysis of databases such as ClinGen, ClinVar, and GeneReviews, along with recent literature and diagnostic guidelines, provides a thorough overview of the genetic landscape of minor genes in CMPs and offers insights for future research and translation to clinical practice. Given the increasing knowledge on these less-understood genetic factors, future studies are essential to clearly assess their roles, ultimately leading to improved diagnostic precision and therapeutic strategies in hereditary CMPs.

Surgical site infections (SSIs) are a major concern in public healthcare, leading to increased morbidity, pro-longed hospital stays length, and significant economic costs. Understanding the epidemiology and risk fac-tors of SSIs is crucial for developing effective prevention and management strategies. In the last century, CDC ‘s HICPAC improved a bundle for prevention of HAIs based on the use of aseptic procedures, disin-fection of the skin and correct use of antibiotics for SSIs. In our country, Gelli-Bianco law introduced the national health guidelines system that include the prophylaxis antibiotic therapy pre- and post-surgery. The aim of our study is to evaluate adherence and appropriateness of the use of antibiotic-preoperative prophylaxis in a province of southern Italy and to identify risk factors that may influence the development of an SSI. The study found many statistically significant associations among the factors examined, i.e. the timing of administration adherent to guidelines, with 47% of the analyzed files administering antibiotics within 60 min before the intervention and 62.7% using intravenous administration.

The key towards a sustainable future is the reduction of mankind’s impact on natural systems via the development of new technologies and the improvement of source apportionment. Though days, years and seasons are arbitrarily set, their mechanisms are based on natural cycles driven by Earth’s orbital periods. This is not the case for weeks, which are a pure anthropic category and are known from literature to influence emission cycles. For the first time since it started data gathering operations, CO (carbon monoxide), CO₂ (carbon dioxide), CH₄ (methane) and eBC (equivalent black carbon) values detected by the Lamezia Terme WMO/GAW station in Calabria, Southern Italy have been evaluated via a two-pronged approach accounting for weekly variations in absolute concentrations, as well as the number of hourly averages exceeding select thresholds. The analyses were performed on seven continuous years of measurements, from 2016 to 2022. Moreso, the two results have been combined into a new parameter: the hereby defined WDWO (Weighed Distribution of Weekly Outbreaks) normalizes weekly trends of CO, CO₂, CH₄ and eBC on an absolute scale as percentages, with the scope of providing regulators and researchers alike with a new tool meant to better evaluate anthropogenic pollution and mitigate its effects.

This study investigates the mean annual water temperature trends at the confluence of the Sava and Danube Rivers, along with air temperature trends at the Belgrade meteorological station, spanning from 1956 to 2020. Results reveal a consistent increase in temperature across all three measuring stations, with the Danube experiencing a rise of 0.34°C/10 years, the Sava at 0.44°C/10 years, and Belgrade's air temperature increasing by 0.39°C/10 years. Employing the RAPS method, sharp rises in water temperature were pinpointed in 1989 for the Sava and 1990 for the Danube, while Belgrade's air temperature surge began in 1998. The highest intensity of air temperature increase within the recent period (1998-2020) was observed at the Belgrade observatory, reaching 0.76°C/10 years. Notably, the Sava exhibited a faster increase in water temperature over the last thirty years compared to the Danube. August marked the peak average water temperature for both rivers, while July recorded the highest average air temperature in Belgrade. Despite differing flow rates, both rivers exhibit similar hydrological regimes, with maximum flows occurring in April and minimum flows in August for the Sava, and October for the Danube. Seasonal temperature increases were most pronounced in summer, notably in August, with the smallest rises occurring during cold periods. Additionally, an inverse proportional relationship between mean annual water temperatures and discharges was observed at both river stations.

Introduction Emergency laparotomy is a surgical procedure associated with significantly higher mortality rates compared to elective surgeries. Awake laparotomy under neuraxial anaesthesia has recently emerged as a promising approach in abdominal surgery to improve patient outcomes. This study aims to evaluate the feasibility and potential benefits of using lumbar spinal anaesthesia as the primary anaesthetic technique in emergency laparotomies. Methods We conducted a case series involving 16 patients who underwent emergency laparotomy for bowel ischemia, perforation, or occlusion. Lumbar spinal anaesthesia was employed as the main anaes-thetic technique. We analysed patient demographics, clinical characteristics, intraoperative details, and postoperative outcomes. The primary outcome measures included the adequacy of postoper-ative pain control, the incidence of postoperative complications, and mortality rates. Results Among the 16 patients, adequate postoperative pain control was achieved, with only 2 patients requiring additional analgesia. Postoperative complications, including sepsis, wound dehiscence, and pneumonia, were observed in 7 patients (44%). The observed mortality rate was relatively low at 6% (1 patient). Notably, conversion to general anaesthesia was not necessary in any of the cases, and no early readmissions were reported. Discussion Our findings highlight the feasibility and potential benefits of using neuraxial anaesthesia in emergency laparotomies. The observed low mortality rate and the avoidance of conversion to general anaesthesia suggest that lumbar spinal anaesthesia may be a useful alternative in emer-gency settings. However, the occurrence of postoperative complications in 44% of patients indi-cates the need for cautious patient selection and close monitoring. Further research with larger sample sizes is warranted to fully elucidate the efficacy, safety, and potential impact of this tech-nique on patient outcomes in emergency laparotomies.

Phased injection of natural gas into internal combustion marine engines is a promising solution for optimizing performance and reducing harmful emissions, particularly unburned methane, a potent greenhouse gas. This innovative practice distinguishes itself from continuous injection because it allows for more precise control of the combustion process with only a slight increase in system complexity. By synchronizing the injection of natural gas with the intake and exhaust valve opening and closing times while also considering the gas path in the manifolds, methane release into the atmosphere is significantly reduced, making a substantial contribution to efforts to address climate change. Moreover, phased injection improves the efficiency of marine engines, resulting in reduced overall fuel consumption, lower fuel costs, and increased ship autonomy. This technology has been tested on a single-cylinder, large-bore, four-stroke research engine designed for marine applications, operating in dual-fuel mode with diesel and natural gas. Performance was compared with that of the conventional continuous feeding method. Evaluation of the effect on equivalent CO2 emissions indicates a potential reduction of up to approximately 20%. This reduction effectively brings greenhouse gas emissions below those of the diesel baseline case, especially when injection control is combined with supercharging control to optimize the air-fuel ratio.

The COVID-19 pandemic has underscored the intricate interplay between viral infections and opportunistic bacterial pathogens such as Klebsiella pneumoniae. K. pneumoniae harbors various antibiotic resistance determinants like extended-spectrum and plasmid-mediated AmpC β-lactamases and carbapenemases. In the two years following the pandemic, carbapenemase producing K. pneumoniae isolates obtained routinely in outpatient and inpatient setting demonstrated similar resistance patterns which prompted research. The aim was to compare and subsequently analyze carbapenem-resistant hospital and outpatient’s K. pneumoniae isolates’ resistance mechanisms, traits and molecular epidemiology, following the COVID-19 pandemic. Disk diffusion and broth dilution method were the methods of choice to determine antibiotic susceptibility. β-lactamases were screened by phenotypic methods and confirmed with PCR. In total 113 isolates were analysed. Resistance to amoxicillin-clavulanate and ertapenem was confirmed in all strains. High resistance rates (over 90%) were observed for extended-spectrum cephalosporins, and ciprofloxacin. OKNV testing and PCR detected OXA-48 in 106, NDM in 7 and KPC in only one isolate. ESBLs accompanied carbapenemases in 103 isolates. Carbapenem resistance in K. pneumoniae is becoming a global problem, hence careful monitoring of its resistance traits is of utmost importance in order to combat the arising threat. OXA-48 seems to continue predominating in the turbulent period after pandemic.

Radial nerve palsies present a challenging clinical scenario, often leading to substantial functional impairment. This study focuses on evaluating the outcomes of tendon transfer surgeries in patients with post-traumatic radial nerve injuries. The radial nerve, vital for upper limb movements, faces various etiologies such as trauma, compression, or idiopathy. Patients with radial nerve palsy encounter difficulties in daily activities, emphasizing the need for effective management strategies. The research introduces a novel evaluation protocol, aiming to comprehensively assess tendon transfer outcomes. This protocol incorporates functional movements of wrist and finger joints, encompassing both objective and subjective parameters. The retrospective study includes eleven patients treated between 2010 and 2022, with a minimum follow-up of one year post-surgery. Tendon transfers demonstrated positive results. The evaluation protocol covers a wide range of parameters, including wrist and finger mobility, thumb function, grip strength, and patient satisfaction. The results indicate successful restoration of motor function, with an average grip strength of 70% compared to the healthy arm. The proposed evaluation protocol facilitates standardized and reproducible assessment, minimizing subjective errors in clinical evaluations. Despite the study's limitations, such as a relatively small sample size, the findings underscore the effectiveness of tendon transfers in treating radial nerve palsies. The introduced evaluation scheme provides a comprehensive and reproducible approach to assess outcomes, contributing to the global standardization of tendon transfer assessments in radial nerve injuries.

Background: Ankle fractures, comprising about 10% of musculoskeletal injuries, pose a significant healthcare burden with an increasing incidence, particularly among an aging population. This study focuses on isolated Danis-Weber type B fractures. Recent trends lean towards surgical intervention for anatomical restoration, quicker recovery, albeit with associated complications. This report aims to assess the safety and efficacy of NewClip narrow locking plate system with early weight bearing in treating isolated fibular fractures. Methods: The study includes patients with Danis-Weber type B fractures surgically treated with NewClip narrow locking plate system. Exclusions involved nondisplaced fractures, open fractures, or those requiring additional fixation.Results: Fifteen patients were enrolled in this study. Minor complications, including wound swelling, were observed in two cases. The Visual Analogue Scale (VAS) for pain exhibited a steady decline postoperatively, with almost complete resolution by the third month. At three months, the FAOS demonstrated excellent results, and final follow-up at twelve months revealed complete osseous healing without complications.Conclusions: The use of this type of plates in treating isolated fibular fractures with early weight bearing shows promising results in terms of fracture healing, pain resolution, and functional outcomes warranting further investigation with larger cohorts.

Both grape pomace and whey are waste products from the food industry that are rich in valuable ingredients. The utilisation of these two by-products is becoming increasingly possible as consumer awareness of upcycling increases. The biological activities of grape pomace extract (GPE) are diverse and depend on its bioavailability, which is influenced by processes in the digestive system. In this work, goat whey protein (GW) was used as the primary coating to protect the phenolic compounds of GPE during the spray drying process. In addition, trehalose (T), sucrose (S), xylose (X) and maltodextrin (MD) were added to the goat whey proteins as co-coatings and protein stabilisers. All spray drying experiments resulted in microcapsules (MC) with high encapsulation efficiency (77.6—95.5%) and yield (91.5—99.0%) and almost 100% recovery of phenolic compounds during the release test. For o-coumaric acid, the GW-coated microcapsules (MC) showed a bioavailability index of up to 731.23%. A semi-crystalline structure and hydrophilicity are characteristics of the MC coated with 10% T, S, X or 5% MD. GW alone or in combination with T, S, MD or X has proven to be a promising carrier for polyphenols from grape pomace extract and ensures good bioavailability of these natural antioxidants.

Introduction: The emergency of the SARS-CoV-2 virus spread and its subsequent global pan-demic have raised significant concerns regarding its impact on pregnancy outcomes. This review aims to summarize the emerging data on the risk of preterm delivery in pregnant women infected with SARS-CoV-2. Materials and Methods: A systematic search was conducted from March 2020 to December 2023 using PubMed, following PRISMA guidelines. Studies correlating maternal COVID-19 infection with preterm birth were included. Results: Thirteen studies were analyzed, indicating a higher incidence of preterm birth in SARS-CoV-2 positive pregnant women compared to controls. The average incidence rate of pre-term birth in infected patients was 18.5%, with a median of 12.75%, while non infected women showed an average incidence of preterm birth of 10% with a median of 8.2%. Discussion: Studies suggest an association between SARS-CoV-2 infection during pregnancy and increased risk of preterm birth and cesarean section. Severity of symptoms and underlying comorbidities further elevate this risk. Notably, infections during the third trimester pose the highest risk of preterm birth. Conclusion: Preventing SARS-CoV-2 infection during pregnancy is crucial to mitigate adverse obstetric outcomes. Close monitoring and tailored interventions for infected pregnant women, particularly those in later trimesters and with comorbidities, are imperative to reduce the risk of preterm birth and improve maternal-fetal outcomes.

This article provides a literature review on tubal carcinoma to offer an updated insight into its preventative strategies, diagnosis, treatment, and oncological surveillance. In addition to the search string utilized, the authors' focus extended to key scientific studies, consensus statements, guidelines, and relevant case reports essential for the proper clinical management of the disease, providing a methodologically well-structured literature review combined with the practical expertise in the oncological field. The article also includes two emblematic clinical cases that emphasize the importance of understanding the physiopathology and the current state of the art in the anatomopathological advancements of tubal/ovarian/peritoneal carcinoma, often assimilated into a single clinical entity.

JAK2 V617F is a somatic mutation associated with myeloproliferative neoplasm (MPN): polycythemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis (PMF). In MPNs this mutation is associated with the germline GGCC (46/1) haplotype. Most studies consider the association of the JAK2 haplotypeGGCC_46/1 with some MPNs clinical parameters but no one analyzed the association between JAK2 haplotypeGGCC_46/1 and the onset of onco-drug resistance. Thus, we assessed for JAK2 46/1 haplotype correlation with therapy response in JAK2 V617F positive patients. Patients with MPN, selected by the Hematology Laboratory of “V. Fazzi” Hospital (LE), were analyzed with RLFP-PCR assay with rs10974944 SNP. Most of them had PV (63%) or PMF (61%). Among patients that developed onco-drug resistance, 58% had C/G genotype and only 11% had the G/G allele. No correlation between onco-drug resistance and JAK2 haplotype 46/1 variants emerged. Nevertheless, we observed that G/G allele seems to be related to MPNs evolution to myelofibrosis and to the development of onco-drug resistance clinical parameters (p-value= 0.002449; odd ratio of 3.701209). Thus, although other analyses are required, due to the narrow cardinality of sample, our findings suggest how the G/G allele could be useful for MPNs diagnosis and for the prediction of the disease outcome.

Heart failure (HF) is a growing issue in developed countries and most patients present with a reduced ejection fraction. This condition significantly impairs quality of life and represents a threat not only for patients, but also for the entire healthcare system due to its high management cost. In the last decade, new medical treatments and devices have been developed to reduce HF hospitalizations and improve prognosis, while reducing the overall mortality rate. Medical therapy does not achieve the same results in all patients and, whenever it fails, technology comes in handy: novel devices for the management of HF have reduced symptoms. They have also improved the treatment of fluid retention and life threatening arrhythmias. The present review article gives to the readers a comprehensive overview of the most recent and important findings that need to be considered in HF with reduced ejection fraction patients. Both novel medical treatments and devices have been presented and discussed.

Green investments help to create less harmful alternatives and adequate funds that contribute to economic growth, sustainable development, and social well-being. The applied methods are empirical and analytical based on the study of literature, multi-criteria modelling, determination of weights, and ranking of criteria in deciding green investments mapping of indicators, and monitoring of progress towards green growth through official OECD data. The analysis uses official sources on indicators related to the green economy and the environment. Multi-criteria decision-models (MCDM) were used to select adequate green investments, where instead of indicators from the official OECD-database, investors use the areas in which the indicators are distributed. According to the findings of AHP, half of the investments in the green economy come from public sources (0.51), and the other half are private (0.25), and institutional investors (0.24). While, BWM reveals that the best criterion for the decision to invest in the green economy is the environmental and resource productivity of the economy, and the worst is the base of natural assets. This paper aims to enable decision-makers to use these results as weights for the overall assessment of green investments in ESG and to simplify the decision-making approach in future analyses.

Abstract Background The advent of monoclonal antibodies (mAbs) targeting calcitonin gene-related peptide (CGRP) pathway has transformed the management of migraine, offering newfound optimism for clinicians and individuals with episodic migraine (EM) and chronic migraine (CM). While randomized controlled trials (RCTs) have provided crucial insights into the effectiveness and safety profiles of these treatments, their translation into real-world clinical practice remains a e challenge. Objective This review aims to conduct a comprehensive assessment of real-world studies, offering valuable insights tailored for practical application in clinical settings. Methods We conducted a comprehensive literature search in PubMed, SCOPUS, and MEDLINE for real-life studies on erenumab, fremanezumab, and galcanezumab. Abstracts underwent rigorous screening by two reviewers for relevance. Data extraction from selected articles was performed using a standardized form, with verification by a second reviewer. Data synthesis was narrative, following PRISMA guidelines. Results Our search included 55 pertinent studies conducted between 2019 and 2023. Real-world study designs demonstrated notable variability in the selection and inclusion of migraine patients, influenced by factors such as attack frequency, data collection criteria, and primary/secondary objectives. Key findings commonly reported considerable improvements in efficacy outcomes (migraine frequency, analgesic use, pain severity, disability), high responder rates, and optimal safety and tolerability profiles. Conclusion Real-world evidence underscores the role of anti-CGRP mAbs as targeted therapies for both CM and EM patients. The overall results indicate that the effectiveness and tolerability of anti-CGRP mAbs in real-world applications may exceed those observed in RCTs, an unprecedented finding in clinical neurology.

The ECM is composed of a considerable number of biochemically and structurally diverse constituents. ECM is a highly dynamic system that constantly receives and sends biological, chemical and mechanical signals. Several studies suggest that mechanical signals derived from the extracellular microenvironment regulate skin regeneration and wound healing. We evaluated effects of a mixture of biomolecules extracted and purified from bovine colostrum on restoring the mechanical properties of ECM. Test measuring collagen contraction showed a significant difference in contraction activation in samples treated with the 2% colostrum derivative mixture compared to the control. The analysis of the supernatant showed an inhibition of metalloproteinase-2 expression and an increase in collagen secretion by fibroblasts in treatment samples. Our hypothesis is that the molecules extracted and purified from bovine colostrum restore the ECM environment qualitative and quantitative characteristics, thus guaranteeing through a mechanical action the restoration of the wound due to the transduction of the signal activated by the integrins.

Industrial robots are slowly but surely entering manufacturing companies. This paper explores the effects that robots have on productivity, exports, quality, sustainability and labor in European manufacturing companies. There is lack of research on industrial robot usage and its effects in developed countries. Most research is done on Chinese companies and often the data is outdated. The data in this paper is from the European Manufacturing Survey project conducted in 2022 and includes 476 manufacturing companies. Results of the effects of Industrial robots on Quality, Labor Productivity, Exports and Environmental saving technologies are done by use of T-test between industrial robots’ adopters and non-adopters. However, the effect of higher investment into environmental technology by industrial robots’ adopters was researched by 2-step OLS regression analysis with control variables representing the contextual characteristics of companies. The results show positive effects on all variables. Results show that larger usage of robots are in low to medium-technology-intensity industries, that robots contribute to labor productivity, exports and that companies employing robots usually also employ environmentally saving technologies.

Background/Objectives: Monoclonal antibodies (mAbs) have revolutionized multiple myeloma (MM) treatment. However, post-marketing data on their neuropsychiatric safety is limited. This study aimed to evaluate neuropsychiatric adverse events (AEs) related to mAbs used for MM through a retrospective pharmacovigilance analysis using the Food and Drug Administration (FDA) Adverse Events Reporting System (FAERS) database. Methods: Individual case safety reports (ICSRs) from 2015 to 2023 with at least one neuropsy-chiatric AE and one of the MM-approved mAbs as the suspect drug (i.e., daratumumab, elo-tuzumab, isatuximab, belantamab mafodotin, teclistamab, elranatamab, and talquentamab) were analyzed using descriptive and disproportionality approaches. Results: Unknown signals of disproportionate reporting (SDR) included cerebral infarction for daratumumab (n = 45; reporting odds ratio (ROR) = 2.39, 95% confidence interval (CI) = 1.79-3.21; information component (IC) = 1.54, IC025-IC075 = 1.05-1.9), elotuzumab (25; 7.61, 5.13-11.28; 3.03, 2.37-3.51), and isatuximab (10; 2.56, 1.38-4.76; 1.67, 0.59-2.4); mental status changes for daratumumab (40; 2.66, 1.95-3.63; 1.67, 1.14-2.04) and belantamab mafodotin (10; 4.23, 2.28-7.88; 2.3, 1.22-3.03); altered state of consciousness for daratumumab (32; 1.97, 1.39-2.78; 1.32, 0.73-1.74) and belantamab mafodotin (6; 2.35, 1.05-5.23; 1.6, 0.19-2.52); Guil-lain-Barre syndrome (GBS) for daratumumab (23; 6.42, 4.26-9.69; 2.81, 2.11-3.3), isatuximab (8; 10.72, 5.35-21.48; 3.57, 2.35-4.37), and elotuzumab (3; 4.74, 1.53-14.7; 2.59, 0.52-3.8); and orthos-tatic intolerance for daratumumab (10; 12.54, 6.71-23.43; 3.75, 2.67-4.48) and elontuzumab (4; 28.31, 10.58-75.73; 5 , 3.24-6.08). Conclusions: Our analysis highlighted several previously unacknowledged SDRs for MM-approved mAbs. Given the complex and not entirely understood etiology of some neuropsy-chiatric AEs, including GBS, further investigations are necessary.

HPV51 belongs to group I high-risk HPV (hrHPV) genotypes with a high prevalence of infection in numerous epidemiological studies, although its occurrence varies across geographical regions. To better understand the presence of variants and genetic variation of HPV51, this study aimed to perform a phylogenetic analysis of the E6, E7 and L1 regions to detect the hrHPV variants circulating in women referred to colposcopy in two different Italian regions (Lombardy and Sardinia). Cervical samples were tested using Anyplex™ II HPV HR Detection. HPV51 positive samples were further analysed using previously described PCR protocols to obtain sequences of E6, E7 and L1. A positivity rate for HPV51 of 7.4% (26/351) and 13.6% (11/81) was found in Lombardy and Sardinia, respectively. The majority (34 out of 35) of the analyzed sequences clustered into the A lineage and only one sequence was grouped into B lineage. L1 capsid gene showed the presence of different mutations but none under positive selective pressure. Three nucleotide polymorphisms T6311G, A6312T and G6313A related to the two aminoacidic mutations V264G and G265S were found among all analysed sequences. This study contributes to implement data regarding the molecular epidemiology of HPV but additional analysis on a larger number of sequences is necessary to better understand the role of HPV variants in cervical lesions development.

This study investigates the diversity and evolution of research topics within the dental sciences from 1994 to 2023 using topic modeling and Shannon's entropy as a measure of research diversity. We analyzed a dataset of 412036 scientific articles across six dental disciplines: Orthodontics, Pros-thodontics, Periodontics, Implant Dentistry, Oral Surgery, and Restorative Dentistry. This research relies on BERTopic to identify distinct topics within each field. The study revealed significant shifts in research focus over time, with some disciplines exhibiting robust growth in article numbers such as Periodontics and Prosthodontics. The application of Shannon's entropy revealed an increasing diversification of research efforts in disciplines such as Restorative Dentistry, while others, like Prosthodontics, in spite of their size and their high number of research topics, maintain a more specialized research focus. Taken together, our findings describe the dynamic nature of dental re-search and highlight the balance shifts in research focus across several key areas of Dentistry.

Background: Pediatric obesity treatment is based on high-intensity lifestyle counseling. However, high dropout rates and low effectiveness have been reported even in specialized centers. Mobile health technologies have been used in research settings to overcome these limits with contrasting results. This study aims to evaluate the effectiveness of a six-month intervention with a mobile app for the treatment of pediatric obesity at 6 and 12 months of follow-up. Methods: Patients were randomly assigned to standard care or standard care plus mobile app (2:1). The mobile app delivered high-intensity lifestyle counseling for diet and physical activity. Results: Seventy-five subjects were prospectively enrolled. At six months of follow-up, the m-app group showed significantly lower dropout rates compared to standard care(p=0.01). The risk of dropout was significantly higher in controls compared to the intervention group (OR 3.86,95%C.I. 1.39-10.42,p=0.01). After one year of follow-up, we observed lower albeit non statistically significant dropout rates in the m-app compared to the standard care group(p=0.24). No differences were observed in terms of z-score BMI and percentage of BMI reduction between the two groups. Conclusion: our findings suggest that mobile app might help in the clinical management of children and adolescents with obesity in terms of dropout reduction.

Background: Reliable HPV testing and genotyping are essential for quality assurance in HPV-based primary screening, disease management and for monitoring the impact of HPV vaccination. The clinical validation of HPV molecular diagnostic assays has significantly contributed to these objectives, however little emphasis has been placed in assuring sample quality. This study aims to assess the accuracy of sample cellularity assessment using C-C Motif Chemokine Receptor 5 (CCR5) gene target as a marker of sample adequacy in molecular diagnostics. Methods: Jurkat cell line samples were counted both using Thoma cell-counting chamber and Fluorescent-Activated Cell Sorting (FACS). Jurkat cell line samples at three different concentrations were subsequently evaluated using the OncoPredict HPV Quality Control (QC) real-time PCR assay, employing CCR5 for molecular cellularity quantification. Results: Cellularity values obtained were comparable across the 3 different methods for all dilutions of the cell line tested. Conclusions: The results obtained from this study show that CCR5 represents a promising molecular marker for the accurate quantification of sample cellularity, confirming its use as a reliable sample adequacy control, thus reducing the risk of “false negative” results.

Lung cancer (LC) continues to be an important public health problem being the most common form of cancer and a major cause of cancer deaths worldwide. Despite the great bulk of research to identify genetic susceptibility genes by genome-wide association studies, only few loci associated to nicotine dependence have been consistently replicated. Our previously published study in few phenotypically discordant sib-pairs identified a combination of germline truncating mutations in known cancer susceptibility genes in never smoker early-onset LC patient does not present in their healthy sib. These results firstly demonstrated the presence of an oligogenic combination of disrupted cancer predisposing genes in non-smokers patients, giving experimental support to a model of a “private genetic epidemiology”. Here, we used a combination of whole-exome and RNA sequencing coupled with a discordant sib’s model in a novel cohort of pairs of never-smokers early-onset LC patients and in their healthy sibs used as controls. We selected rare germline variants predicted as deleterious by CADD and SVM bio-informatics tools and absent in the healthy sib. Overall, we identified an average of 200 variants per patient, about 10 of which in cancer predisposing genes. In most of them, RNA sequencing data reinforced the pathogenic role of the identified variants showing: i) downregulation in LC tissue (indicating “second hit” in tumor suppressor genes); ii) upregulation in cancer tissue (likely oncogene); iii) downregulation in both normal and cancer tissue (indicating transcript instability). The combination of the two techniques demonstrates that each patient has an average of six (with a range from four to eight) private mutations with functional effect in tumor predisposing genes. The presence of a unique combination of disrupting events in the affected subjects may explain the absence of familial clustering of non-small cell lung cancer. In conclusion, these findings indicate that each patient has his/her own “predisposing signature” to cancer development and suggest the use of personalized therapeutic strategies in lung cancer.

Probiotics are living microbes that provide benefits to the host. The increasing data on health promotion following probiotics administration triggered growing interest among researchers and pharmaceutical companies looking for novel therapeutic or preventive tools. Infections of the lower genital tract in females are caused by a wide range of pathogens, they are widespread, and represent one of the main areas for the use of probiotics and postbiotics. Vulvovaginal candidiasis (VVC) affects 75% of women in their reproductive age at least once during their lifetime. Of these women 5-8% develop the recurrent form (RVVC). The disease onset is triggered by the overgrowth of Candida species on the vaginal mucosa. Here, we evaluated the beneficial properties of the Bacillus coagulans spore-producing LMG S-24828 against C. albicans and C. parapsilosis. Our results show that both alive B. coagulans and its Cell-Free-Supernatant (CFS) exerted antifungal activity against both fungi. Moreover, alive B. coagulans reduced hyphal formation, inhibited C. albicans adhesion to vaginal epithelial cells and showed co-aggregation capacity. Overall, B. coagulans LMG S-24828 exerted a protective effect on vaginal epithelial cells infected with C. albicans. These data suggest that B. coagulans LMG S-24828 may provide benefits in the context of Candida vaginal infections.

Background: The two-stage technique combining the Endoscopic Retrograde CholangioPancreatography (ERCP) with common bile duct (CBD) clearance carried out before the laparoscopic cholecystectomy represents the most common approach for CBD stones. Over time, different techniques have been proposed to manage cholecysto- choledocholithiasis (CCL) advantageously in one stage. Among these, the laparoendoscopic rendez-vous (LERV) addresses the CCL issue with a laparoscopic cholecystectomy with insertion of a guide wire performed at initial stage of the procedure, followed by the clearance of the bile duct carried out by the endoscopists. The goal of this study was to evaluate the efficacy and safeness of LERV procedure recording results and complications, also making a comparison between our results and current literature. Methods: We reviewed our experience of all consecutive patients with cholecysto-choledocholithiasis managed with LERV between January 2018 and December 2023. LERV success rate, operative time, length of hospital stay, stone recurrence, incidence of endoscopic and surgical complications were analysed. Results: A total of 120 patients underwent LERV in our facilities. We reported a 97% LERV success rate, 1.6% conversion-to-open rate, a median intraoperative time of 122 (range 95-220) min. The median hospital stay was 4 (range 2-38) days. An overall morbidity of 15% was reported (18/120): 15 Clavien-Dindo type 1/2, 2 type 3a and one type 3b. In two cases a re-operation during the hospital stay was necessary. At a median follow-up of 14 months (3-59) five patients experienced stone recurrence requiring redo-ERCP in two cases. Conclusion: LERV offers the significant advantage of a single stage procedure and hospitalisation along with a lower risk of post-ERCP pancreatitis, failed CBD cannulation and complications. Our experience confirms safety and effectiveness of the technique for CCL management.

Recently Candida auris has emerged as a multi-resistant fungal pathogen, with a significant clinical impact, and has become a critical issue in WHO fungal priority list, due to its unique ability to persist for long time on human skin and hospital environments. It is therefore fundamental to reinforce hospital surveillance protocols to limit nosocomial outbreaks. The study purpose was the Fourier-Transform Infrared Spectroscopy (FT-IR) application to investigate the phylogenetic relationships between isolated strains within the C. auris outbreak at the university Intensive Care Unit of a Tertiary University hospital in Turin (Italy). In order to calculate a clustering cut-off, intra- and inter-isolates distance values were analysed. Data showed the presence of a major cluster Alfa and a minor cluster Beta with a defined C. auris clustering cut-off. The results were validated by an external C. auris strain and Principal Component and Linear Discriminant Analysis. The application of FT-IR technology had allowed to obtain important information about the phylogenetic relationships between the analysed strains, defining for the first time a “not WGS-based” clustering cut-off with a statistical-mathematical approach. FT-IR could represent a valid alternative to molecular methods for rapid and cost saving typing of C. auris strains with important clinical implications.

Introduction: Obstructive sleep apnea syndrome (OSAS) is characterized by recurrent episodes of upper airway obstruction and involves intermittent hypoxia and sleep fragmentation, with potentially serious consequences for affected patients. (1–3). Although nocturnal polysomnography is the gold standard, it is an exam that is not readily available and is very expensive. (4). Hence, the need to find new diagnostic methods. Considering that the causes of OSAS can be divided into anatomical-structural ones, related to craniofacial anomalies, it has been hypothesized that anthropometric measurements taken by new 3D stereophotogrammetric systems could be useful as a diagnostic tool in pediatric patients with OSAS (5) (6). The primary objective of the study is, therefore, to evaluate the correlation between mandibular length measured between menton and gonion, obtained through 3D stereophotogrammetry using the "Face Scanner maxi 6", and the severity of OSAS (AHI classification), defined by the score of the Sleep Clinical Record (SCR) questionnaire in a group of pediatric patients with suspected obstructive sleep disorders. The secondary objective concerns the identification of possible correlations between other mandibular parameters estimated by 3D stereophotogrammetry and the severity of OSAS, defined by the McGill Oximetry Score (MOS), and the association between MOS and SCR to determine the AHI level. Materials and methods: The study considered patients who were prescribed a pulseoximetry exam due to suspected obstructive sleep disorders. All participating patients underwent a specialized orthodontic examination, which included completing the SCR questionnaire and taking facial photographs using a 3D stereophotogrammetric system. The SCR questionnaire considers 11 dental, nasal, oropharyngeal, and facial phenotype parameters to determine a final score from 0 to 18, indicating the risk of obstructive sleep apnea syndrome. The acquired stereophotogrammetric images were processed using dedicated software to obtain a three-dimensional model representing the patient's facial phenotype. Subsequently, anatomical landmarks and relevant anthropometric measurements were identified on the model, and it was assessed whether one or more of these showed concordance criteria with the parameters derived from SCR and MOS. The anthropometric evaluation was performed by expert operators, taking into account mandibular variables. Results: Fifteen patients were analyzed, with 2 excluded due to alterations in the stereophotogrammetric images caused by poor patient cooperation during the acquisition of the photographs. Spearman's correlation analysis was performed to investigate the relationship between anthropometric measurements, obtained by 3D stereophotogrammetry, and OSAS severity, by means of SCR, MOS, and SCR+MOS. A significant and negative correlation was observed between right mandibular length (gonion-menton) and MOS (ρ=−0.586, p=0.036). Conclusions: The result obtained has important implications for the field of study and suggests that future attention should focus more on the mandibular length variable as a determining factor for OSAS. However, the sample examined was relatively small, which might obscure the correlation with contralateral mandibular length and potential correlations with other mandibular/facial parameters. Additionally, the small sample size prevented stratification by sex and age. The study thus provides an important contribution to understanding the relationships between 3D stereophotogrammetry and pediatric OSAS but also highlights the need for further research that could potentially influence future developments in diagnosing OSAS in children.

The implementation of sentinel lymph node (SLN) biopsy is changing the scenario in the surgical treatment of early-stage cervical cancer and the oncologic safety of replacing bilateral pelvic lymphadenectomy with SLN biopsy is currently under investigation. One of the undisputed values of SLN biopsy is its diagnostic accuracy in detecting low-volume metastases (LVM) via pathologic ultrastaging. In early-stage cervical cancer, the reported incidence of LVM ranges from 4 to 20%. The prognostic impact and the role of adjuvant treatment in patients with LVM is still unclear. Some non-prespecified analyses in prospective studies showed no impact on the oncologic outcomes compared to node-negative disease. However, the heterogeneity of the studies, the differences in the disease stage and the use of adjuvant treatment, and the concomitant pelvic lymphadenectomy (PLND) make any conclusion on this topic hard. Current guidelines suggest considering micrometastasis (MIC) as a node-positive disease, while isolated tumor cells (ITC) as a node-negative disease, with a low level of evidence. This review aims to highlight the unanswered questions about the definition, identification, prognostic and therapeutic role of LVM and underline the present and future challenges we are facing. We hope this review will guide further research, giving robust evidence on LVM and their impact on clinical practice.

Background: Alfalfa, the most economically important forage legume worldwide, features modest genetic progress due to long selection cycles and large extent of non-additive genetic variance associated with its autotetraploid genome. Methods: To improve the efficiency of genomic selection in alfalfa, we explored the effects of genome parametrization (as autotetraploid and diploid dosage, plus allele ratios) and SNP marker subsetting (all available SNPs; only genic regions; only non-genic regions) on genomic regressions, together with various levels of filtering on reading depth and missing rates. We used Genotyping by Sequencing-generated data and focused on traits of different genetic complexity, i.e., dry biomass yield in moisture-favorable (FE) and drought stress (SE) environments, leaf size, and onset of flowering, assessed on 143 genotyped plants from a genetically-broad European reference population and their phenotyped half-sib progenies. Results: On average, allele ratio improved the predictive ability compared with other genome parametrizations (+7.9% vs. tetraploid dosage, +12.6% vs. diploid dosage), SNP subsetting offered an advantage compared with any tested subsettings (+3.7% vs. genic regions, +7.6% vs. non-genic regions). However, when focusing on specific traits, different combinations of genome parametrization and subsetting reached better performances. We also released Legpipe2, a SNP calling pipeline tailored for reduced representation (GBS, RAD) medium-sized genotyping experiments.

Merkel cell carcinoma (MCC) is a rare, highly aggressive skin cancer characterized by two etiologies: the first one, observed in most cases, is attributed to Merkel cell polyomavirus (MCPyV), a DNA tumor virus, while the second one is due to ultraviolet (UV) radiation exposure. Currently, there are limited diagnostic, prognostic, and therapeutic biomarkers available for MCC. MicroRNAs (miRNAs) are small RNA molecules that do not code for proteins but regulate various cellular processes, including cell cycle progression, proliferation, differentiation, and apoptosis. The dysregulation of miRNAs has been associated with a wide range of cancers since they can act as either tumor suppressors or oncogenes. This paper aims to collect, summarize and re-organize the recent discoveries concerning miRNAs, whose dysregulation in the pathogenesis and progression of MCC is slowly emerging. Furthermore, the potential clinical applications of miRNAs as diagnostic biomarkers, possible differentiation between MCPyV-related and unrelated MCC, predictors of response to therapy and prognostics are also discussed. From this review, it emerges that miRNAs may have, in the near future, the potential to become clinically significant in improving the diagnostic accuracy, prognostic evaluation, and therapeutic options of MCCs. Finally, the new perspectives on the poorly explored field of artificial intelligence in MCC are provided.

Chemical pollution poses a significant threat to human health, with detrimental effects on various physiological systems, including the respiratory, cardiovascular, mental, and perinatal domains. While the impact of pollution on these systems has been extensively studied, the intricate relationship between chemical pollution and immunity remains a critical area of investigation. The focus of this study is to elucidate the relationship between chemical pollution and human immunity. To accomplish this task, this study presents a comprehensive review that encompasses in vitro, ex vivo, and in vivo studies, shedding light on the ways in which chemical pollution can modulate human immunity. Our aim is to unveil the complex mechanisms by which environmental contaminants compromise the delicate balance of the body's defence systems going beyond the well-established associations with defence system delving into the less-explored link between chemical exposure and various immune disorders, adding urgency to our understanding of the underlying mechanisms and their implications for public health.

Critically ill patients treated in the intensive care unit (ICU) can present many abdominal conditions that need a prompt diagnosis and timely treatment because of their general frailty. Clinical evaluation and diagnostic tools like ultrasound or CT scan are not reliable or feasible in these patients. Bedside laparoscopy (BSL) is a minimally invasive procedure that allows surgeons to assess the abdominal cavity directly in the ICU, thus avoiding unnecessary exploratory laparotomy or incidence related to intra-hospital transfer. We conducted a review of the literature to summarize the state-of-the-art of BSL. Medline, The Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus databases were utilized to identify all relevant publications. Indications, contraindications, technical aspects, and outcomes are discussed. The procedure is safe, feasible, and effective. When other diagnostic tools fail to diagnose or exclude an intra-abdominal condition in ICU patients, BSL should be preferred over exploratory laparotomy.

This research presents the creation of a Virtual Reality experience for the Balzi Rossi museum, commemorating the centenary of Prince Albert I Grimaldi's archaeological work at the site. The project, a collaboration between the University of Genoa's 3D Lab Factory, Eurodrone, and the Balzi Rossi archaeological museum, aims to preserve and convey the site's heritage through advanced VR technology. Initially employing Unreal Engine 4, the team used photogrammetry for 3D reconstruction of the "Caviglione" and "Florestano" caves, notable for their ancient rock engravings. This first VR model, despite hardware limitations, provided an interactive exploration of the site. The subsequent development phase utilized Unreal Engine 5, incorporating Nanite technology for enhanced visual fidelity. This advancement resulted in a more detailed and immersive VR experience, presenting the Balzi Rossi cliff across different historical periods, including the Würm glaciation. Key to this phase was optimizing the VR experience for performance, focusing on stable frame rates and minimizing motion sickness, and integrating a multi-lingual interface for broader accessibility. Since November 2023, the VR setup at the Balzi Rossi Museum has been an educational and interactive feature, enabling visitors to explore the site's history virtually. This research demonstrates the potential of VR in cultural heritage preservation and education, providing a foundation for future technological improvements in the field.

QSO B0218+357 is a blazar located at a cosmological redshift of 0.944. The source is gravitationally lensed by a spiral galaxy located at the redshift of 0.68. Strong gravitational lensing splits the signals emitted by the source into two components separated by 10-12 days, as observed in radio and gamma-ray bands. In July 2014 a GeV flare was observed by Fermi-LAT, triggering follow-up observations with the MAGIC telescopes at energies above 100 GeV. The expected time delay between the components allowed us to plan broad band MWL observations before, during and after the trailing component of the emission. The MAGIC observations at the expected time of arrival of the trailing component resulted in the first detection of QSO B0218+357 in Very-High-Energy (VHE, >100 GeV) gamma rays. It is both the farthest known VHE object and one of only a few Flat Spectrum Radio Quasars detected in this energy range. We report here the observed multiwavelength spectral and temporal properties of the emission during the 2014 flare.

The treatment of acute myeloid leukemia (AML) with adverse genetics remains unsatisfactory, with very low response rates to standard chemotherapy and shorter durations of remission commonly observed in these patients. The complex biology of AML with adverse genetics is continuously evolving. Herein, we discuss recent advances which have investigated the contribution of cell intrinsic mechanisms as well as of the immune system to myeloid leukemogenesis in this specific subset of AML. We focus on the biological rationales for combining targeted therapy and immunotherapy, which are currently being investigated in ongoing trials, and could hopefully ameliorate the poor outcomes for these patients

Furthermore, the nasal congestion typical of rhinitis can contribute to upper airway obstruction and sleep-disordered breathing. A vicious circle is created between asthma and sleep-disordered breathing: uncontrolled asthma and sleep-disordered breathing can worsen each other. In children with genetic obesity, despite alterations in the immune system, fewer allergies are found compared to the general population. The causes of this reduced allergenicity are unclear but probably involve genetic, immunological, and environmental factors. Further studies are needed to understand the mechanisms. The study emphasizes the importance of jointly evaluating and managing allergies, obesity, and sleep-disordered breathing in children, considering their close interconnection.

In the last three decades the presence of phospholipids in the nucleus has been shown and thoroughly investigated. A great interest raised about nuclear inositol lipids mainly because of their role in signalling acting. Here we review the main issues of nuclear phospholipid localization and the role of nuclear inositol lipids and their related enzymes in cellular signaling both in physiological and pathological conditions.

Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a genetic disorder characterized by the development and progression of multiple renal cysts, leading to progressive renal function decline. To date, the only approved treatment for this condition is able to slow down the loss of annual renal function, without stopping the disease progression. Furthermore, this therapy is approved only for patients with rapid disease progression and its compliance is problematic because of the impact of this drug on quality of life. The recent literature suggests that cystic cells are subject to metabolic dysregulation in the glucose pathway (Warburg Effect). This finding paved the way for new lines of research targeting potential therapeutic interventions for ADPKD. In particular, this review highlights the latest studies on the use of ketosis, through ketogenic dietary interventions (daily calorie restriction, intermittent fasting, time-restricted feeding, and ketogenic diets), as a potential strategy for patients with ADPKD, and the possible involvement of microbiota in the ketogenic interventions’ effect.

Antimicrobial peptides represent a promising alternative to traditional drugs in relation to cost, toxicity and, primarily, the growing problem of drug resistance. Here we report on the activity against HSV-1 and HSV-2 of a previously described wide-spectrum synthetic decapeptide, Killer Peptide (KP). As determined by plaque reduction assays, treatment with KP at 100 μg/mL resulted in a reduction in the viral yield titer of 3.5 Logs for HSV-1 and 4.1 Logs for HSV-2. Further evaluation of KP antiviral activity focused on the early stages of virus replicative cycle, including the determination of the residual infectivity of viral suspensions treated with KP. A direct effect of the peptide on viral particles, impairing virus absorption and penetration, was shown. The toxicity profile proved to be extremely good with a selectivity index of 29.6 for HSV-1 and 156 for HSV-2. KP was also active against an acyclovir (ACV)-resistant HSV-1 strain, while HSV-1 subcultures in the presence of sub-inhibitory doses of KP did not lead to the emergence of resistant strains. Finally, the antiviral action of KP proved to be synergistic with that of ACV. Overall, these results demonstrate that KP could represent an interesting addition/alternative to acyclovir for antiviral treatment.

Ultrasound (US) scans of the inferior vena cava (IVC) provide useful information on the volume status of a patient. However, their investigation is user-dependent and prone to measurement errors. An important technical problem is the objective difficulty in studying a very compliant blood vessel like IVC, which makes large respirophasic movements and shows a complicated three dimensional geometry. Using bi-dimensional (2D) B-mode views either in long or short axis has improved the characterization of IVC dynamics compared to a measurement along a single direction (M-mode). However, specific movements of the IVC can challenge also the information provided by these 2D sections. Thus, these two orthogonal views, provided by an US system in X-plane, are here integrated by an innovative method. It is tested on simulated videos of the IVC performing complicated movements, that are compensated by the new method, overcoming the biased measurements provided by 2D scans. The method is then applied on example experimental data.

Refractoriness to antiseizure medications is still a major concern in the pharmacotherapy of epilepsy. For this reason, we decided to evaluate the combination of levetiracetam and cannabidiol, administered at a subthreshold dose, to limit the possible adverse effects of this phytocannabinoid. We administered levetiracetam (300 mg/kg/day, via osmotic minipumps), cannabidiol (120 mg/kg/day, injected once a day subcutaneously), or their combination for one week in epileptic rats. Saline-treated epileptic rats were the control group. Animals were monitored with video electroencephalography the week before and after the treatment. No changes were found in the controls. Levetiracetam did not significantly reduce the total seizure number or the overall seizure duration. Still, the overall number of seizures (p&lt;0.001, Duncan’s new multiple range test) and their total duration (p&lt;0.01) increased in the week following treatment withdrawal. Cannabidiol did not change seizures when administered as a single drug. Instead, levetiracetam combined with cannabidiol resulted in a significant reduction in the overall number and duration of seizures (p&lt;0.05), when comparing values measured during treatment with both pre- and post-treatment values. These findings depended on changes in convulsive seizures, while non-convulsive seizures were stable. These results suggest cannabidiol determined a remarkable potentiation of levetiracetam antiseizure effects at a subthreshold dose.

Background: Colorectal adenoma undergoes neoplastic progression via the normal epithelium-adenoma-adenocarcinoma sequence as reported in the Vogelgram. The risk of developing cancer is strongly associated with the number and size of adenoma and with the subtype. Currently, adenomatous polyps can be distinguished on the basis of histology: the prevalence are tubular, 5-15% are villous and tubular/villous. Considering the increased risk for malignant transformation described for tubular/villous adenomas, patients diagnosed with adenomatous polyposis are at increased risk of developing CRC. The Wnt/β-catenin pathway plays a key role in the onset of colorectal adenoma, in particular intestinal cells first acquire loss-of-function mutations in APC gene that induce the formation of adenomas. Methods: Wnt/β-catenin pathway APC, Wnt3a, Wnt5a, LEF1, BCL9 genes and protein expression analyses were conducted by qRT-PCR and western blot in 68 colonic samples (polyps and adjacent mucosa) from 41 patients, of which 17 affected by FAP. Ten normal colonic mucosal samples were collected from 10 healthy donors. Results: In this study both APC gene and protein resulted less expressed in colon tumor compared to the adjacent colonic mucosa. Conversely, activated β-catenin was more expressed in polyps than in the adjacent mucosa. All results confirmed literature data on carcinomas. A statistically significant correlation between Wnt3a and BCL9 both in polyps and in the adjacent mucosa underlies that the canonical Wnt pathway is activated in early colon carcinogenesis and that the adjacent mucosa is already altered. Conclusion: This is the first study analyzing the difference in expression of Wnt/β-catenin pathway in human colorectal adenomas. Understanding the progression from adenomas to colorectal carcinomas is essential for the development of new therapeutic strategies and improving clinical outcomes.

The reconstruction of standard at-grade intersection into roundabout is very often motivated by the need to improve the safety of a part of the road network. To assure the effect of the reconstruction before-after analyses based on traffic accidents or some other indirect traffic safety parameter is needed. This paper presents a detailed analysis of four roundabouts reconstructed from the at-grade intersection according to the Croatian Guidelines for Roundabout Design. The analysis included a comparison of speeds at the location - a standard intersection- before and a roundabout – after reconstruction, time distribution of operational speed and applied design elements as well as their correlations. Experimentally gathered data on operational speed showed that the expected effect of speed reduction was not achieved in most of the analyzed cases. The conclusion is that given that the Croatian Guidelines set a very wide range for roundabout elements, the designer has a great influence on the selection and, consequently, on the effects of the roundabout implementation. The revision of the Guidelines is suggested.

Background: We evaluate the genetic and phenotypic features of a cohort of 12 Italian patients affected by Retinitis Pigmentosa (RP) associated with RP1 sequence variants.; Methods: Retrospective, single center study (Careggi Hospital, Florence), including a cohort of twelve Italian patients (Five male and seven female) affected by RP carrying pathogenic variants of the RP1 gene. A complete ophthalmic assessment and pedigree analysis was conducted with focus on the onset of disease symptoms, the patient’s age at the first diagnosis, the follow up duration and the possible presence of comorbidities; Results: The mean age at onset of symptoms was 31,0 ± 24,1 years old, with a mean follow-up period of 9,1± 2,4 years. The main symptoms at presentation were hemeralopia and visual field constriction. Fundus evaluation revealed a classic type of RP. Fundus autofluorescence (FAF), Optical Coherence Tomography (OCT), Electroretinogram (ERG), and visual field confirmed in most of the cases the typical features of classic retinitis pigmentosa.; (4) Conclusions: This single-center cohort of Italian patients provided information on the clinical and genetic features of RP1-associated RP. By comprehensively clarifying the genetic variations and their associated clinical manifestations, we can better tailor therapeutic interventions aimed at targeting specific genetic abnormalities. This ultimately promises to improve the prognosis and quality of life for individuals with RP-associated RP1.

In this paper, different concepts of reconfigurable RF-MEMS attenuators for beamforming applications are proposed and critically assessed. Capitalizing on the previous part of this work, the 1-bit attenuation modules featuring series and shunt resistors and low-voltage membranes (7-9 V) are employed to develop a 3-bit attenuator for fine-tuning attenuations (&lt; -10 dB) in the 24.25-27.5 GHz range. More substantial attenuation levels are investigated by means of fabricated samples of coplanar waveguide (CPW) sections equipped with Pi-shaped resistors aiming at attenuations of -15, -30, and -45 dB. The remarkable electrical features of such configurations, showing flat attenuation curves and limited return losses, and the investigation of a switched-line attenuator design based on them led to the final proposed concept of a low-voltage 24-state attenuator. Such simulated device combines the Pi-shaped resistors for substantial attenuations with the 3-bit design for fine-tuning operations, showing a maximum attenuation level of nearly -50 dB while maintaining steadily flat attenuation levels and limited return losses (< -11 dB) along the frequency band of interest.