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Background While extensive research exists on muscle injuries among adult football players, a notable gap persists in studies concerning younger footballers. The aim of the current study is to provide epidemiological data on the characteristics of time-loss muscle injuries in young football players participating in the Italian Under-19 male elite Championship (“Primavera 1”). Results Conducted as a multicentre, prospective, observational cohort study, this research gathered injury data from the 2022-23 season across 14 of the 18 Clubs in the first Italian Under-19 championship. The cohort comprised 391 players with a mean age (± standard deviation) of 18.0 ± 0.4 years. A total of 479 injuries were reported, resulting in 14,231 days of activity lost. Of these, muscle injuries were 209 (44%), accounting for 4,519 (32%) days lost. Overall muscle injuries incidence was 1.82/1000 hours, with a mean injury burden of 39.4 days lost/1000 hours. Almost all muscle injuries (206 out of 209: 98.5%) occurred in hamstrings, quadriceps, adductors, calf and iliopsoas. Hamstrings injuries were the most burdensome (18.8 days lost/1000 hours) accounting for nearly half of all days lost due to muscle injuries. Incidence and burden of adductors injuries (0.25 injuries and 4.1 days lost/1000 hours, respectively) were found to be comparable to calf injuries (0.24 injuries and 4.7 days lost/1000 hours, respectively). Iliopsoas injuries accounted for a noteworthy portion of the total, with an injury incidence of 0.16/1000 hours and a burden of 3.3 days lost/1000 hours. Injuries with myo-tendinous or myo-aponeurotic involvement demonstrated delayed return-to-football compared to those without such involvement (35.6 vs. 18.5 days, p  < 0.0001). Conclusions The study highlighted a peculiar distribution of non-contact muscle injuries among elite young football players. While hamstring injuries were confirmed as the most burdensome, incidence and burden of adductors and calf injuries were found to be similar. A significant incidence and burden of iliopsoas injuries were observed. These findings suggest potential implementations for targeted injury prevention strategies in the Italian male elite Under-19 football Championship. Key points • In the Italian male elite Under-19 football Championship, each Club can expect around 15 non-contact muscle injuries during the season (for a team of 25 players) distributed as follows: 6 hamstrings, 3 quadriceps, 2 adductors, 2 calf and 1 iliopsoas muscle injuries. • Hamstrings injury incidence and burden (both in training sessions and during matches), as well as the proportion of reinjuries, were found to be the highest among muscle sites. • Injuries to adductors and calf muscles exhibited comparable values of incidence and burden. • Iliopsoas emerged as a noteworthy site of injury in the current cohort, particularly during training sessions. • Aponeurosis or tendon damage was associated with longer return to football timing, particularly in hamstrings and adductors injuries.

Carotid Intima Media Thickness (IMT) is currently used to assess the relationship between progression of coronary and systemic atherosclerosis. To date, however, the possible impact of regular physical activity (PA) on this parameter has not been well estimated. Our study aims to examine this aspect especially in the absence of cardiovascular (CV) risk factors. 100 master athletes (MA) and 51 sedentary controls (SC) were enrolled. They were evaluated by echo test with dedicated software (QIMT-Esaote) for IMT, and Bruce protocol and 2D echocardiography for cardiac hemodynamic parameters. All values were within normal range. Left IMT mean values were significantly higher than right IMT values in both MA and SC groups (MA: IMT left 635 ± 104 µ, IMT right 614 ± 104 µ and mean IMT 624 ± 91.9 µ; SC: IMT left 633 ± 78 µ, IMT right 622 ± 90 µ and mean IMT 627 ± 78.1 µ). A positive relationship was found in both groups between IMT mean values and age (P < 0.01) and between IMT mean values and peak systolic blood pressure (MA: 0.28 R, P < 0.01; SC: 0.32 R, P < 0.05). At rest, only in MA was a significant relationship evident, between mean arterial pressure value and IMT (P < 0.01). In the absence of CV risk factors, only age is associated with a slight increase of wall carotid thickening. The data are indicative of a physiological increase in IMT, as a consequence of increased peak effort systolic pressure after regular PA in athletes.

Background Thyroid carcinoma includes several variants characterized by different biological and clinical features: from indolent microcarcinoma to undifferentiated and aggressive anaplastic carcinoma. Inflammation plays a critical role in thyroid tumors. Conditions predisposing to cancer, as well as oncogene activity, contribute to the construction of an inflammatory microenvironment that facilitates thyroid tumor progression. Moreover, oncogene-induced senescence, a mechanism tightly connected with inflammation, and able to restrain or promote cancer progression, is involved in thyroid cancer. The interactions between thyroid tumor cells and the microenvironment are not completely clarified. Methods We characterize in vitro the interplay between macrophages and senescent thyrocytes and tumor-derived cell lines, modeling early and late thyroid tumor stages, respectively. Purified peripheral blood-derived human monocytes were exposed to thyroid cell-derived conditioned medium (CM) and assessed for phenotype by flow cytometry. The factors secreted by thyroid cells and macrophages were identified by gene expression analysis and ELISA. The protumoral effect of macrophages was assessed by wound healing assay on K1 thyroid tumor cells. The expression of PTGS2 and M2 markers in thyroid tumors was investigated in publicly available datasets. Results Human monocytes exposed to CM from senescent thyrocytes and thyroid tumor cell lines undergo M2-like polarization, showing high CD206 and low MHC II markers, and upregulation of CCL17 secretion. The obtained M2-like macrophages displayed tumor-promoting activity. Among genes overexpressed in polarizing cells, we identified the prostaglandin-endoperoxide synthase enzyme (PTGS2/COX-2), which is involved in the production of prostaglandin E2 (PGE2). By using COX-2 inhibitors we demonstrated that the M2-like polarization ability of thyroid cells is related to the production of PGE2. Co-expression of PTGS2 and M2 markers is observed a significant fraction of human thyroid tumors. Conclusions Our results demonstrate that both senescent thyrocytes and thyroid tumor cell lines trigger M2-like macrophage polarization that is related to PGE2 secretion. This suggests that the interaction with the microenvironment occurs at both early and late thyroid tumor stages, and favors tumor progression. The co-expression of PTGS2 gene and M2 markers in human thyroid carcinoma highlights the possibility to counteract tumor growth through COX-2 inhibition.

BackgroundWhile laparoscopic approach for right hemicolectomy (LRH) is considered appropriate for the surgical treatment of both malignant and benign diseases of right colon, there is still debate about how to perform the ileo-colic anastomosis. The ColonDxItalianGroup (CoDIG) was designed as a cohort, observational, prospective, multi-center national study with the aims of evaluating the surgeons’ attitude regarding the intracorporeal (ICA) or extra-corporeal (ECA) anastomotic technique and the related surgical outcomes.MethodsOne hundred and twenty-five Surgical Units experienced in colorectal and advanced laparoscopic surgery were invited and 85 of them joined the study. Each center was asked not to change its surgical habits. Data about demographic characteristics, surgical technique and postoperative outcomes were collected through the official SICE website database. One thousand two hundred and twenty-five patients were enrolled between March 2018 and September 2018.ResultsICA was performed in 70.4% of cases, ECA in 29.6%. Isoperistaltic anastomosis was completed in 85.6%, stapled in 87.9%. Hand-sewn enterotomy closure was adopted in 86%. Postoperative complications were reported in 35.4% for ICA and 50.7% for ECA; no significant difference was found according to patients’ characteristics and technologies used. Median hospital stay was significantly shorter for ICA (7.3 vs. 9 POD). Postoperative pain in patients not prescribed opioids was significantly lower in ICA group.ConclusionsIn our survey, a side-to-side isoperistaltic stapled ICA with hand-sewn enterotomy closure is the most frequently adopted technique to perform ileo-colic anastomosis after any indications for elective LRH. According to literature, our study confirmed better short-term outcomes for ICA, with reduction of hospital stay and postoperative pain.Trial registrationClinical trial (Identifier: NCT03934151).

BackgroundAnastomotic leakage (AL) is one of the dreaded complications following surgery in the digestive tract. Near-infrared fluorescence (NIRF) imaging is a means to intraoperatively visualize anastomotic perfusion, facilitating fluorescence image-guided surgery (FIGS) with the purpose to reduce the incidence of AL. The aim of this study was to analyze the current practices and results of NIRF imaging of the anastomosis in digestive tract surgery through the EURO-FIGS registry.MethodsAnalysis of data prospectively collected by the registry members provided patient and procedural data along with the ICG dose, timing, and consequences of NIRF imaging. Among the included upper-GI, colorectal, and bariatric surgeries, subgroup analysis was performed to identify risk factors associated with complications.ResultsA total of 1240 patients were included in the study. The included patients, 74.8% of whom were operated on for cancer, originated from 8 European countries and 30 hospitals. A total of 54 surgeons performed the procedures. In 83.8% of cases, a pre-anastomotic ICG dose was administered, and in 60.1% of cases, a post-anastomotic ICG dose was administered. A significant difference (p < 0.001) was found in the ICG dose given in the four pathology groups registered (range: 0.013–0.89 mg/kg) and a significant (p < 0.001) negative correlation was found between the ICG dose and BMI. In 27.3% of the procedures, the choice of the anastomotic level was guided by means of NIRF imaging which means that in these cases NIRF imaging changed the level of anastomosis which was first decided based on visual findings in conventional white light imaging. In 98.7% of the procedures, the use of ICG partly or strongly provided a sense of confidence about the anastomosis. A total of 133 complications occurred, without any statistical significance in the incidence of complications in the anastomoses, whether they were ICG-guided or not.ConclusionThe EURO-FIGS registry provides an insight into the current clinical practice across Europe with respect to NIRF imaging of anastomotic perfusion during digestive tract surgery.

BackgroundThree-dimensional view in laparoscopic general, gynaecologic and urologic surgery is an efficient, safe and sustainable innovation. The present paper is an extract taken from a full health technology assessment report on three-dimensional vision technology compared with standard two-dimensional laparoscopic systems.MethodsA health technology assessment approach was implemented in order to investigate all the economic, social, ethical and organisational implications related to the adoption of the innovative three-dimensional view. With the support of a multi-disciplinary team, composed of eight experts working in Italian hospitals and Universities, qualitative and quantitative data were collected, by means of literature evidence, validated questionnaire and self-reported interviews, applying a final MCDA quantitative approach, and considering the dimensions resulting from the EUnetHTA Core Model.ResultsFrom systematic search of literature, we retrieved the following studies: 9 on general surgery, 35 on gynaecology and urology, both concerning clinical setting. Considering simulated setting we included: 8 studies regarding pitfalls and drawbacks, 44 on teaching, 12 on surgeons’ confidence and comfort and 34 on surgeons’ performances. Three-dimensional laparoscopy was shown to have advantages for both the patients and the surgeons, and is confirmed to be a safe, efficacious and sustainable vision technology.ConclusionsThe objective of the present paper, under the patronage of Italian Society of Endoscopic Surgery, was achieved in that there has now been produced a scientific report, based on a HTA approach, that may be placed in the hands of surgeons and used to support the decision-making process of the health providers.

Background Although complete mesocolic excision (CME) is supposed to be associated with a higher lymph node (LN) yield, decreased local recurrence, and survival improvement, its implementation currently is debated because the evidence level of these data is rather low and still not supported by randomized controlled trials. Method This is a multicenter, randomized, superiority trial (NCT04871399). The 3-year disease-free survival (DFS) was the primary end point of the study. The secondary end points were safety (duration of operation, perioperative complications, hospital length of stay), oncologic outcomes (number of LNs retrieved, 3- and 5-year overall survival, 5-year DFS), and surgery quality (specimen length, area and integrity rate of mesentery, length of ileocolic and middle-colic vessels). The trial design required the LN yield to be higher in the CME group at interim analysis. Results Interim data analysis is presented in this report. The study enrolled 258 patients in nine referral centers. The number of LNs retrieved was significantly higher after CME (25 vs. 20; p = 0.012). No differences were observed with respect to intra- or post-operative complications, postoperative mortality, or duration of surgery. The hospital stay was even shorter after CME ( p = 0.039). Quality of surgery indicators were higher in the CME arm of the study. Survival data still were not available. Conclusions Interim data show that CME for right colon cancer in referral centers is safe and feasible and does not increase perioperative complications. The study documented with evidence that quality of surgery and LN yield are higher after CME, and this is essential for continuation of patient recruitment and implementation of an optimal comparison. Trial registration The trial was registered at ClinicalTrials.gov with the code NCT04871399 and with the acronym CoME-In trial.

The Dryopteris affinis species complex has a predominantly European distribution. The taxonomy and distribution of the Mediterranean taxa belonging to this complex are poorly studied and not fully understood. This paper provides new information on the occurrence and distribution of two taxa belonging to the D. affinis complex in Sicily, following the 2021 discovery of a new population in the Peloritani Mts in the Cataolo Valley. The new population is composed of approximately 15 individuals. Plant material (7 individuals) was collected in May 2024 along an altitudinal gradient ranging from 1070 to 1120 m a.s.l. A detailed morphological investigation, genome size analysis and ploidy level estimation were conducted for all of the sampled plants. Two individuals were identified as belonging to the diploid D. affinis subsp. affinis var. affinis, whereas the remaining 5 individuals were identified as triploid D. robusta. The confirmation of the presence of D. affinis in Sicily and the first finding of D. robusta on the island proves the key role played by the Peloritani Mts. as a refuge for species with a mid-European and boreal range.

Ethnoprimatology emphasizes the complex sociocultural dimensions of human-alloprimate interactions, often overlooked in conservation practices and narratives shaped by ecological perspectives alone. In Madagascar, lemurs are deeply embedded in local traditions structured around taboos, legends, and kinship beliefs. Among them, the aye-aye ( Daubentonia madagascariensis ) is frequently subject to a narrative portraying it as an evil animal, an omen, or a harbinger of misfortune. Yet, cultural representations of the aye-aye across Madagascar are far more diverse. While some reports describe ritual killings, others recount respectful mortuary practices bestowed upon these primates. We explored the beliefs, narratives, and practices associated with the aye-aye in three regions of eastern Madagascar. Drawing on a mixed-methods approach, we combined quantitative and qualitative data from 219 semistructured interviews with grounded theory methodology and developed an interpretive framework for understanding the species’ cultural representations. Our results revealed a wide variety of traditions, including magical and therapeutic uses of aye-aye body parts and three legends underpinning these belief systems. We propose that these traditions stem from the belief that the aye-aye is inhabited by a spirit, whether evil or ancestral. Responses to its perceived nefarious powers vary from ritual display of the killed animal to mortuary practices comparable to human funerals. These findings urge a shift away from reductive narratives long popularized in recent decades, recognizing complexity and site-specificity. Similar to other contemporary ethnoprimatologists, we advocate for a cautious, context-sensitive approach to both reporting lemur-related traditions and designing conservation programs, emphasizing the need for carefully considering the religious systems that underlie practices involving threatened species.

Inflammation plays a critical role in thyroid cancer onset and progression. We previously characterized the in vitro interplay between macrophages and senescent human thyrocytes and thyroid tumor-derived cell lines, modeling the early and the late thyroid tumor phases, respectively. We reported that both models are able to induce pro-tumoral M2-like macrophage polarization, through the activation of the COX2-PGE2 axis. Here, we investigated the presence of macrophage infiltrating cells in mouse xenografts derived from the above described cells models. We showed that subcutaneous injection in immunodeficient mice of both senescent human thyrocytes and thyroid tumor-derived cell lines elicits macrophage recruitment. Furthermore, considering the type of macrophage infiltrate, we observed a stronger infiltration of Arginase I positive cells (M2-like). Overall, these results demonstrate the in vivo capability of senescent and tumor thyroid cells to recruit and polarize macrophages, suggesting that the promotion of a pro-tumoral microenvironment through tumor associated macrophages may occurs in late as well as in early thyroid tumor stages, favoring tumor onset and progression.