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Background: A noninvasive, highly sensitive and specific urine test is needed for bladder cancer (BC) diagnosis and surveillance in addition to the invasive cystoscopy. We previously described the diagnostic effectiveness of urinary tyrosine-phosphorylated proteins (UPY) and a new assay (UPY-A) for their measurement in a pilot study. The aim of this work was to evaluate the performances of the UPY-A using an independent cohort of 262 subjects. Methods: Urinary tyrosine-phosphorylated proteins were measured by UPY-A test. The area under ROC curve, cutoff, sensitivity, specificity and predictive values of UPY-A were determined. The association of UPY levels with tumour staging, grading, recurrence and progression risk was analysed by Kruskal–Wallis and Wilcoxon’s test. To test the probability to be a case if positive at the UPY-A, a logistic test adjusted for possible confounding factor was used. Results: Results showed a significant difference of UPY levels between patients with BC vs healthy controls. For the best cutoff value, 261.26 Standard Units (SU), the sensitivity of the assay was 80.43% and the specificity was 78.82%. A statistically significant difference was found in the levels of UPY at different BC stages and grades between Ta and T1 and with different risk of recurrence and progression. A statistically significant increased risk for BC at UPY-A ⩾261.26 SU was observed. Conclusions: The present study supplies important information on the diagnostic characteristics of UPY-A revealing remarkable performances for early stages and allowing its potential use for different applications encompassing the screening of high-risk subjects, primary diagnosis and posttreatment surveillance.

Purposes GreenLight laser has gained increasing acceptance as a less invasive treatment for lower urinary tract symptoms due to benign prostatic hyperplasia (BPH/LUTS). Three surgical options were developed: standard photovaporization (PVP), anatomical PVP and GreenLight enucleation of prostate (GreenLEP); however, literature lacks a direct comparison among the procedures. Aim of the present study is to compare the three techniques in a multicentre series of patients. Methods Data were collected from consecutive patients with indication to surgical management of BPH/LUTS in five institutions. Patients underwent standard PVP, anatomical PVP or GreenLEP according to surgeon preferences. Standard parameters associated with transurethral prostate surgery were documented prior surgery and during the follow-up. Patients’ perception of improvement was measured using a single-item scale. Early (within first 30 post-operative days) and delayed post-operative complications were recorded. Descriptive statistics, univariate and multivariate analysis were used. Results We evaluate 367 consecutive patients (mean age 69.1 years). Median prostate size and PSA were 68 ml (IQR 50–90) and 2.8 ng/ml (IQR 1.7–4.3), respectively. The median operative time and applied energy were 60 min (IQR 45–75) and 250 kJ (IQR 160–364). Catheterization time and median post-operative stay were 1 and 2 days. No patient was transfused. The overall median Q max values increased for 8–19 ml/s ( p  < 0.05), median International Prostate Symptoms Score decreased from 24 to 7 ( p  < 0.05). A total of 7.4% urinary retention, 33.4% bothersome storage symptoms, 2.5% short-term stress incontinence were recorded. Three heart attacks, one pulmonary embolism and one death occurred. Prostate volume was a predictive factor for post-operative storage symptoms ( p  = 0.049). Nine percentage of patients experienced long-term complications (4, 0.9 and 0.9% of urethral stricture, bladder neck contracture and prostatic fossa sclerosis, respectively) with 2.5% of long-term stress urinary incontinence (conservatively managed). The reintervention rate was 6%. Late complications were associated at univariate analysis with pharmacological therapy (combination therapy vs. alpha blockers alone vs. none: p value = 0.042) and with the surgical approach (standard PVP vs. anatomical PVP vs. GreenLEP p value = 0.011). The patients’ perception of satisfaction was 68% “greatly improved”, 27% “improved”, 4% “not changed” and 1% “worsened” with no differences between techniques. Conclusion The availability of three different GreenLight laser techniques allows surgeons with different skills to safety use this technology that remains effective with high patient satisfaction. Anatomical vaporization seems to guarantee the best balance between functional outcomes, surgical procedures and complications.

PurposeTo compare the efficacy, safety, Patient Global Impression of Improvement (PGI-I), and complications rates after 180-W GreenLight laser (180-W GL laser) standard and anatomical photoselective vaporization (sPVP and aPVP).MethodsWithin a multi-institutional database, we identified patients who underwent sPVP or aPVP to relief BPH symptoms. IPSS, Qmax, and prostate-specific antigen (PSA) were measured at baseline and during the follow-up. PGI-I score as well as early and late complications were recorded at follow-up visits. Log-binomial and multivariable proportional odds regression models were fitted to estimate the effect of aPVP vs. sPVP on PGI-I as well as on early and late complication rates, before and after adjustment for propensity score.Results813 patients were included. Of those, the 50.4% underwent aPVP. Patients who underwent aPVP had larger prostate (64 vs. 55 mL, p < 0.001) and higher baseline PSA levels (3.1 vs. 2.5 ng/mL, p < 0.001). PGI-I score was signaled as very improved, improved, slightly improved, unchanged, or worsened in 55.5, 32.8, 8.3, 2.3, and 1.2% of the cases, respectively, with no differences according the technique used (p = 0.420). Acute urinary retention occurred in 9.2 vs. 8.9% of patients after aPVP vs. sPVP (p = 0.872). All models failed to find differences in: patients’ satisfaction (OR 1.19, p = 0.256), early complications (RR 0.93, p = 0.387), early urge/incontinence symptoms (RR 0.97, p = 0.814), and late complications rates (RR 0.70, p = 0.053), after aPVP vs. sPVP.ConclusionOur results showed similar functional results and complication rates after aPVP and sPVP. However, aPVP was used in larger prostates. Both techniques guarantee high patient’s satisfaction.

We describe the case of a patient affected by multiple endocrine neoplasia type IIA with a new diagnosis of an asymptomatic right pheochromocytoma. The patient underwent laparoscopic adrenalectomy with adrenal sparing. The removal of the tumor was successful with preservation of about one third of the adrenal gland. At the time of the last follow-up, the patient is well with partial hypoadrenalism without replacement therapy. The limitations to cortical-sparing adrenalectomy imposed by traditional open surgery (small tumor with peripheral location) can be reconsidered using the laparoscopic approach. Laparoscopic cortical-sparing adrenalectomy should become the gold standard for treatment of bilateral pheochromocytoma. The advantages of this technique are its efficacy and its reduced invasiveness with a low rate of complications either during the operation or in the postoperative period. Moreover, the preservation of a portion of the adrenal cortex may prevent the need for a life-long steroid replacement therapy.

The complicated structure of the neutron cannot be calculated using first-principles calculations due to the large colour charge of quarks and the self-interaction of gluons. Its simplest structure observables are the electromagnetic form factors1, which probe our understanding of the strong interaction. Until now, a small amount of data has been available for the determination of the neutron structure from the time-like kinematical range. Here we present measurements of the Born cross section of electron–positron annihilation reactions into a neutron and anti-neutron pair, and determine the neutron’s effective form factor. The data were recorded with the BESIII experiment at centre-of-mass energies between 2.00 and 3.08 GeV using an integrated luminosity of 647.9 pb−1. Our results improve the statistics on the neutron form factor by more than a factor of 60 over previous measurements, demonstrating that the neutron form factor data from annihilation in the time-like regime is on par with that from electron scattering experiments. The effective form factor of the neutron shows a periodic behaviour, similar to earlier observations of the proton form factor. Future works—both theoretical and experimental—will help illuminate the origin of this oscillation of the electromagnetic structure observables of the nucleon.Form factors encode the structure of nucleons. Measurements from electron–positron annihilation at BESIII reveal an oscillating behaviour of the neutron electromagnetic form factor, and clarify a long-standing photon–nucleon interaction puzzle.

The rapid evolution of digital pathology has enabled large-scale data acquisition, driving sophisticated clinical research and advancing the development of AI-driven tools. These innovations have also revolutionised histopathological slide review, especially the annotation step (i.e. the process of marking specific areas of interest on glass-mounted tissue samples to add relevant clinical information) by digitising the process, enhancing precision and efficiency, and facilitating collaboration. However, currently available open-source annotation tools typically employ single-label approaches that provide a flat representation of whole-slide images (WSI), limiting their ability to capture the complexity of the diagnosis-significant elements in a detailed and structured way. Furthermore, the difficulty of strictly following precise review protocols and lack of provenance tracking during annotation processes can result in high variability and limit reproducibility and reusability of the collected data. In this work we present the CRS4 Digital Pathology Platform (CDPP), an open-source system for research studies that manages WSI collections and focuses on high-quality, structured annotations, gathered according to well-defined protocols. Its main features include: (1) structured, multi-label morphological and clinical image annotation; (2) support for controlled but customisable annotation protocols; (3) dedicated annotation tools to facilitate enhanced accuracy, efficiency and consistency in the annotation process; and (4) workflow-based computational analysis with integrated provenance tracking. We show how the platform has successfully supported three different studies, demonstrating the CDPP’s ability to assist pathologists in the generation of high-quality annotated datasets, also suitable for reuse, in the context of digital pathology research.

BackgroundPhysical therapies have been recommended as crucial components in Parkinson’s disease (PD) rehabilitation.ObjectiveThe study aims to examine the effectiveness of a new dance-physiotherapy combined intervention, called DArT method, in mild PD patients.MethodsA prospective, randomized, single-blind, controlled pilot trial was conducted on 38 mild PD patients under dopaminergic therapy. The intervention consisted in an add-on protocol: the control group received 1 h of conventional physiotherapy followed by 1 h of conventional physiotherapy each day, 3 times a week, for 5 weeks. The experimental group received 1 h of conventional physiotherapy followed by 1 h of dance class each day, 3 times a week, for 5 weeks. The week before and after the training period, patients were assessed for motor, cognitive, emotional, and sensory components of PD, with MDS-UPDRS-III as primary outcome measure.ResultsDArT method was associated with a 2.72-point reduction in the post-treatment MDS-UPDRS-III total score compared to control group (95% CI − 5.28, − 0.16, p = 0.038, d = 0.71), and with a 2.16-point reduction in the post-treatment MDS-UPDRS-III upper body subscore (95% CI − 3.56, − 0.76, p = 0.003, d = 1.02). Conversely, conventional physiotherapy program was associated with a 2.95-point reduction in the post-treatment trait anxiety compared to the experimental group (95% CI 0.19, 5.71, p = 0.037, d = 0.70). Withdrawal and fall rates were equal to 0% in both groups.ConclusionDArT method showed to be safe, well accepted, and more effective than an intensive program of conventional physiotherapy in improving motor impairment in mild PD.

A bstract We report a search for an axion-like particle a in B → K (*) a decays using data collected with the Belle detector at the KEKB asymmetric-energy electron-positron collider. The search is based on a 711 fb − 1 data sample collected at the Υ(4 S ) resonance energy, corresponding to a sample of 772 × 10 6 Υ(4 S ) events. In this study, we search for the decay of the axion-like particle into a pair of photons, a → γγ . We scan the two-photon invariant mass in the range 0 . 16 GeV–4 . 50 GeV for the K modes and 0 . 16 GeV–4 . 20 GeV for the K * modes. No significant signal is observed in any of the modes, and 90% confidence level upper limits are established on the coupling to the W boson, g aW , as a function of a mass. The limits range from 3 × 10 − 6 GeV − 1 to 3 × 10 − 5 GeV − 1 , improving the current constraints on g aW by a factor of two over the most stringent previous experimental results.

Though immensely successful, the standard model of particle physics does not offer any explanation as to why our Universe contains so much more matter than antimatter. A key to a dynamically generated matter–antimatter asymmetry is the existence of processes that violate the combined charge conjugation and parity (CP) symmetry 1 . As such, precision tests of CP symmetry may be used to search for physics beyond the standard model. However, hadrons decay through an interplay of strong and weak processes, quantified in terms of relative phases between the amplitudes. Although previous experiments constructed CP observables that depend on both strong and weak phases, we present an approach where sequential two-body decays of entangled multi-strange baryon–antibaryon pairs provide a separation between these phases. Our method, exploiting spin entanglement between the double-strange Ξ − baryon and its antiparticle 2 Ξ ¯ + , has enabled a direct determination of the weak-phase difference, ( ξ P  −  ξ S ) = (1.2 ± 3.4 ± 0.8) × 10 −2  rad. Furthermore, three independent CP observables can be constructed from our measured parameters. The precision in the estimated parameters for a given data sample size is several orders of magnitude greater than achieved with previous methods 3 . Finally, we provide an independent measurement of the recently debated Λ decay parameter α Λ (refs.  4 , 5 ). The Λ Λ ¯ asymmetry is in agreement with and compatible in precision to the most precise previous measurement 4 . Using spin-entangled baryon–antibaryon pairs, the BESIII Collaboration reports on high-precision measurements of potential charge conjugation and parity (CP)-symmetry-violating effects in hadrons.

A bstract We present the result of a search for the charged-lepton-flavor violating decays τ − → e ∓ ℓ ± ℓ − , where ℓ is a muon or an electron, using a data sample with an integrated luminosity of 428 fb − 1 recorded by the Belle II experiment at the SuperKEKB e + e − collider. The selection of e + e − → τ + τ − events containing a signal candidate is based on an inclusive-tagging reconstruction and on a boosted decision tree to suppress background. Upper limits on the branching fractions between 1.3 and 2.5 × 10 − 8 are set at the 90% confidence level. These results are the most stringent bounds to date for four of the modes.