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Purpose The aim of our prospective randomised trial was to demonstrate the efficacy and improvement in surgical skills of inexperienced surgeons in the balloon kyphoplasty procedures trained with virtual reality (VR) compared to untrained inexperienced surgeons. Methods Six orthopaedic residents were randomized to group VR1 (trained) and group VR0 (untrained, control group). At the beginning, all participants, after a theoretical lesson, performed a virtual kyphoplasty. Each resident of the Group VR1 did four training sessions in 1 month (2 h per week) and at the end of training was re-evaluated performing a virtual kyphoplasty. Residents were evaluated with global task completion time and rates subtask ability according to Global Rating Scale of Operative Performance adaptation (both in VR simulation and during the surgery). A percutaneous vertebral augmentation with balloon kyphoplasty was performed by all residents. Intraoperative parameters, complications and cumulative transfer effectiveness ratio (CTER) were analysed. Results Intraoperative scores revealed an improvement in the group VR1 between the first VR trial and the intraoperative phase (2.85 ± 0.65 vs. 4.09 ± 0.62, P  < 0.05), which was not seen in the group VR0 (2.71 ± 0.71 vs. 2.85 ± 0.75). Statistical analyses indicated significant differences in intraoperative scores between the two groups. The CTER was 0.85 and suggests that 10 training sessions could reduce the procedure time by approximately 8 min in a 15 min of surgery. Conclusion Our study about the balloon kyphoplasy reaffirms the potential of VR as an effective and cost-efficient training tool, bridging the gap between theoretical knowledge and practical execution.

PurposeTo evaluate obstetric outcome in women with endometriosis who conceive naturally and receive standard obstetric care in Italy.MethodsCases were consecutive women with endometriosis managed in eleven Italian referral centers. Controls were women in whom endometriosis was excluded. All women filled in a questionnaire addressing previous natural pregnancies. Marginal logistic regression models were fitted to evaluate the impact of endometriosis on obstetric outcome. A post hoc analysis was performed within the endometriosis group comparing women with severe adenomyosis versus women with absent or mild adenomyosis.ResultsThree hundred and fifty-five pregnancies in endometriosis group and 741 pregnancies in control group were included. Women with endometriosis had a higher risk of preterm delivery < 34 weeks (6.4% vs 2.8%, OR 2.42, 95% CI 1.22–4.82), preterm delivery < 37 weeks (17.8% vs 9.7%, OR 1.98, 95% CI 1.23–3.19), and neonatal admission to Intensive Care Unit (14.1% vs 7.0%, OR 2.04, 95% CI 1.23–3.36). At post hoc analysis, women with endometriosis and severe adenomyosis had an increased risk of placenta previa (23.1% vs 1.8%, OR 16.68, 95% CI 3.49–79.71), cesarean delivery (84.6% vs 38.9%, OR 8.03, 95% CI 1.69–38.25) and preterm delivery < 34 weeks (23.1% vs 5.7%, OR 5.52, 95% CI 1.38–22.09).ConclusionWomen with endometriosis who conceive naturally have increased risk of preterm delivery and neonatal admission to intensive care unit. When severe adenomyosis is coexistent with endometriosis, women may be at increased risk of placenta previa and cesarean delivery.Trial registrationClinical trial registration number: NCT03354793.

Wide Field Slitless Spectroscopy (WFSS) provides a powerful tool for detecting strong line emission in star-forming galaxies (SFGs) without the need for target preselection. As part of the GLASS-JWST Early Release Science (ERS) program, we leverage the near-infrared wavelength capabilities of NIRISS (1–2.2 μm) to observe rest-optical emission lines out to z ∼ 3.4, to a depth and with a spatial resolution higher than ever before (Hα to z < 2.4; [O iii]+Hβ to z < 3.4). In this Letter we constrain the rest-frame [O III]λ5007 equivalent width (EW) distribution for a sample of 76 1 < z < 3.4 SFGs in the A2744 Hubble Frontier Field and determine an abundance fraction of extreme emission line galaxies with EW > 750Å in our sample to be 12%. We determine a strong correlation between the measured Hβ and [O III]λ5007 EWs, supporting that the high [O III]λ5007 EW objects require massive stars in young stellar populations to generate the high-energy photons needed to doubly ionize oxygen. We extracted spectra for objects up to 2 mag fainter in the near-infrared than previous WFSS studies with the Hubble Space Telescope. Thus, this work clearly highlights the potential of JWST/NIRISS to provide high-quality WFSS data sets in crowded cluster environments.

Purpose Fatigue is a distressing symptom in head & neck cancer patients before during and at the end of curative therapy. Pharmacologic and not pharmacologic treatments have been proposed with scarce or no evidence of efficacy. The aim of the study is to evaluate the efficacy of American ginseng in respect to placebo in reducing fatigue in patients treated for head and neck cancer with curative intent.Methods Thirty-two patients who had completed oncological treatment for a primary Head & neck tumor for at least 1 year and had a global fatigue score > 4 by means of Brief Fatigue Inventory (BFI) were randomized to receive 1000 mg of American ginseng or placebo per day for 8 weeks with the aim to assess their efficacy. Changes in fatigue scores in the 2 subgroups of patients before and after the treatment with American ginseng or placebo, were assessed by the BFI at baseline and at the end of week 8.Results The mean of the mean values of the BFI measured at 8 weeks (end of treatment) was 4.6 in the Ginseng arm and 3.4 in the Placebo arm (p = ns). Mean comparison showed a tendency to statistical significance only for the single item on interference with general activity (p = 0.06), with better performance for placebo. The mean of the differences between baseline values and 8 weeks values was not significantly different between treatment arms considering the entire questionnaire.ConclusionThe present data shows that American ginseng has insufficient evidence to be recommended for Cancer Related Fatigue (CRF) in post treatment HNC survivors.

The GLASS-JWST Early Release Science (hereafter GLASS-JWST-ERS) Program will obtain and make publicly available the deepest extragalactic data of the ERS campaign. It is primarily designed to address two key science questions, namely, “what sources ionized the universe and when?” and “how do baryons cycle through galaxies?”, while also enabling a broad variety of first look scientific investigations. In primary mode, it will obtain NIRISS and NIRSpec spectroscopy of galaxies lensed by the foreground Hubble Frontier Field cluster, Abell 2744. In parallel, it will use NIRCam to observe two fields that are offset from the cluster center, where lensing magnification is negligible, and which can thus be effectively considered blank fields. In order to prepare the community for access to this unprecedented data, we describe the scientific rationale, the survey design (including target selection and observational setups), and present pre-commissioning estimates of the expected sensitivity. In addition, we describe the planned public releases of high-level data products, for use by the wider astronomical community.

Lubricant oils are largely responsible for environmental contamination and surfactants can hopefully improve the bioremediation process in soils contaminated with this kind of waste. However, to date only a few studies have elucidated how different surfactants affect the bioremediation process in oil-contaminated soils using the bioaugmentation technique. Thus, this study aimed to compare the effects of surfactants on the bioremediation process of waste lubricant oil in soil in association or not with bioaugmentation. Three biostimulating agents were tested: a chemical detergent, a synthetic surfactant, and a biosurfactant (rhamnolipid). The bioaugmentation process with Pseudomonas aeruginosa showed a faster biodegradation activity with total biodegradation on 181 day after application. The biosurfactant increased the number of microbial and fungal colonies leading to high biodegradation levels and a quicker treatment with or without the bioaugmentation. Bioaugmentation associated with biosurfactant reached 30.43 mg of CO 2 of production on 181 day (90% of total biodegradation of waste lubricant oil) and reduced soil toxicity to 30%. Therefore, results showed that the association of biosurfactant and bioaugmentation with P. aeruginosa represents an ecologically viable strategy for bioremediation of soils contaminated with waste lubricant oil.

Esophageal adenocarcinoma (EAC) is a highly aggressive malignancy with rising incidence and poor prognosis. TP53, previously identified as the most frequently mutated gene in EAC in our studies, plays a central role in tumor suppression and regulation. However, the metabolic consequences of TP53 mutations in EAC remain largely uncharacterized. We metabolically profiled three TP53-mutant EAC cell models (OE33, OE19, and FLO1) representing progressive stages of tumor differentiation and harboring distinct TP53 alterations. Our analyses revealed different metabolic phenotypes associated with TP53 status. OE33 cells predominantly use glycolytic metabolism but display limited adaptability to environmental changes, possibly due to a higher differentiation state. FLO1 cells exhibit a strong glycolytic dependence, elevated lactate production, and robust proliferation under acidic conditions, consistent with an aggressive and metastatic phenotype. OE19 cells preferentially utilize oxidative phosphorylation, demonstrated by resilience to glucose and glutamine deprivation, and ROS accumulation. These findings highlight the metabolic plasticity of EAC and suggest that TP53 mutation type might influence bioenergetic dependencies. Targeting these metabolic vulnerabilities may offer novel therapeutic avenues for personalized treatment in EAC.

Enantiostyly is a floral polymorphism consisting in the presence of two floral morphs that differ in the deflection of the style to the right or left in the populations. Monomorphic enantiostyly consists in plants showing both morphs within an individual and is thought to promote pollen transference between morphs, reduce levels of self-pollination and geitonogamy and avoid damage to floral parts during pollinator’s visit. In this study, we examined the function of this floral polymorphism in a group of plants with non-typical enantiostylous characteristics, the family Vochysiaceae. In particular, we evaluated how floral morphology (both sexual organ separation and the match between complementary sexual organs in the morphs) is related to pollen deposition on the pollinators’ body and to patterns of pollen flow among individuals. For this, we used floral morphometrics, insect captures and fluorescent powder dyes. We confirmed that monomorphic enantiostyly increased pollen transference between morphs compared to non-enantiostyly. Moreover, pollen flow occurred only between flowers of opposite morph. We also observed that pollen deposition on the insect’s body depended on their body shape rather than floral morphology. In fact, an intertegular distance slightly larger than the anther–stigma distance in the flowers increased pollen transference because anthers filaments and stigmas are flexible, which facilitated pollen brushing on insects’ body when approaching the flowers. Since the species are self-incompatible, we further discuss the role of mirror flowers in the reduction of geitonogamy and inbreeding depression.

Background It is not clear whether changes in body composition induced by androgen deprivation therapy (ADT) in prostate cancer (PC) patients are uniform or vary in the different body districts and whether regional lean body mass (LBM) and fat body mass (FBM) could have an impact on bone health. Objective To prospectively evaluate the regional changes in LBM and FBM in PC patients submitted to degarelix; to explore the relationship of regional body composition and bone mineral density (BMD) and bone turnover markers. Design, setting, and participants 29 consecutive non metastatic PC patients enrolled from 2017 to 2019. FBM, LBM and bone mineral density (BMD) evaluated by dual-energy x-ray absorptiometry (DXA) at baseline and after 12-month of ADT. Alkaline phosphate (ALP) and C-terminal telopeptide of type I collagen (CTX) assessed at baseline, 6 and 12 months. Intervention All patients underwent degarelix administration. Outcome measurements and statistical analysis T -test or sign test and Pearson or Spearman test for continuous variables were used when indicated. Results and limitations Median percent increase in FBM ranged from + 14.5% in trunk to + 25.4% in the left leg after degarelix. LBM changes varied from + 2% in the trunk to − 4.9% in the right arm. LBM in both arms and legs and their variations after degarelix directly correlated with ALP and inversely correlated with CTX. Lean mass of limbs, trunk and legs significantly correlated with BMD of the hip, lean mass of the trunk significantly correlated with spine BMD. These are post-hoc analysis of a prospective study and this is the main limitation. Conclusions an heterogeneous change in body composition among body district is observed after ADT and bone turnover is influenced by lean mass and its variation. A supervised physical activity is crucial to maintain general physical performance and preserving bone health.

The use of a high-affinity VHL ligand allows the development of chimeric molecules that promote the association of ERRα or RIPK2 with the VHL E3 ubiquitin ligase complex, resulting in protein degradation. The current predominant therapeutic paradigm is based on maximizing drug-receptor occupancy to achieve clinical benefit. This strategy, however, generally requires excessive drug concentrations to ensure sufficient occupancy, often leading to adverse side effects. Here, we describe major improvements to the proteolysis targeting chimeras (PROTACs) method, a chemical knockdown strategy in which a heterobifunctional molecule recruits a specific protein target to an E3 ubiquitin ligase, resulting in the target's ubiquitination and degradation. These compounds behave catalytically in their ability to induce the ubiquitination of super-stoichiometric quantities of proteins, providing efficacy that is not limited by equilibrium occupancy. We present two PROTACs that are capable of specifically reducing protein levels by >90% at nanomolar concentrations. In addition, mouse studies indicate that they provide broad tissue distribution and knockdown of the targeted protein in tumor xenografts. Together, these data demonstrate a protein knockdown system combining many of the favorable properties of small-molecule agents with the potent protein knockdown of RNAi and CRISPR.