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Environment, biodiversity and ecosystem services are essential to ensure food security and nutrition. Managing natural resources and mainstreaming biodiversity across agriculture sectors are keys towards a sustainable agriculture focused on resource efficiency. Vapour Pressure Deficit (VPD) is considered the main driving force of water movements in the plant vascular system, however the tools available to monitor this parameter are usually based on environmental monitoring. The driving motif of this paper is the development of an in-vivo sensor to monitor the effects of VPD changes in the plant. We have used an in vivo sensor, termed “bioristor”, to continuously monitor the changes occurring in the sap ion’s status when plants experience different VPD conditions and we observed a specific R (sensor response) trend in response to VPD. The possibility to directly monitor the physiological changes occurring in the plant in different VPD conditions, can be used to increase efficiency of the water management in controlled conditions thus achieving a more sustainable use of natural resources.

Background Neoadjuvant chemoradiation therapy (nCRT) is the standard treatment modality in locally advanced rectal cancer (LARC). Since response to radiotherapy (RT) is dose dependent in rectal cancer, dose escalation may lead to higher complete response rates. The possibility to predict patients who will achieve complete response (CR) is fundamental. Recently, an early tumour regression index (ERI) was introduced to predict pathological CR (pCR) after nCRT in LARC patients. The primary endpoints will be the increase of CR rate and the evaluation of feasibility of delta radiomics-based predictive MRI guided Radiotherapy (MRgRT) model. Methods Patients affected by LARC cT2-3, N0-2 or cT4 for anal sphincter involvement N0-2a, M0 without high risk features will be enrolled in the trial. Neoadjuvant CRT will be administered using MRgRT. The initial RT treatment will consist in delivering 55 Gy in 25 fractions on Gross Tumor Volume (GTV) plus the corresponding mesorectum and 45 Gy in 25 fractions on the drainage nodes. Chemotherapy with 5-fluoracil (5-FU) or oral capecitabine will be administered continuously. A 0.35 Tesla MRI will be acquired at simulation and every day during MRgRT. At fraction 10, ERI will be calculated: if ERI will be inferior than 13.1, the patient will continue the original treatment; if ERI will be higher than 13.1 the treatment plan will be reoptimized, intensifying the dose to the residual tumor at the 11 th fraction to reach 60.1 Gy. At the end of nCRT instrumental examinations are to be performed in order to restage patients. In case of stable disease or progression, the patient will undergo surgery. In case of major or complete clinical response, conservative approaches may be chosen. Patients will be followed up to evaluate toxicity and quality of life. The number of cases to be enrolled will be 63: all the patients will be treated at Fondazione Policlinico Universitario A. Gemelli IRCCS in Rome. Discussion This clinical trial investigates the impact of RT dose escalation in poor responder LARC patients identified using ERI, with the aim of increasing the probability of CR and consequently an organ preservation benefit in this group of patients. Trial registration ClinicalTrials.gov Identifier: NCT04815694 (25/03/2021).

Objectives To assess the influence of liver and renal function on liver relative enhancement during hepatobiliary phase MRI after Gd-BOPTA administration. Methods In this IRB-approved retrospective cohort study, we included 326 patients who underwent Gd-BOPTA-enhanced 1.5T liver MRI, including hepatobiliary phase (HBP) acquired 90–150 min after injection, in two centres between Jan 2016 and Dec 2019. Liver signal intensity was measured on native and HBP phases and normalized to paraspinal muscles. Liver normalized relative enhancement (NRE) in HBP was calculated and compared with eGFR, total serum bilirubin and HBP acquisition delay by means of Spearman r correlation test and Mann-Whitney U test. Results 221/326 patients received 0.05 mmol/Kg Gd-BOPTA (group A), whereas 105/326 received 0.1 mmol/Kg (group B). Liver NRE in HBP was significantly higher in group B than in group A (0.55vs.0.33, p  < 0.0001). In both groups, liver NRE in HBP had a negative correlation with total serum bilirubin level ( r  = − 0.32, p  < 0.0001, group A; r  = − 0.36, p  = 0.0002, group B). Patients with total bilirubin > 1.2 mg/dl showed significantly lower NRE in HBP compared with those with total bilirubin ≤ 1.2 mg/dl ( p  < 0.0001, group A; p  = 0.04, group B). Patients with impaired liver function in group B showed a NRE during HBP comparable with those with normal liver function in group A. No statistically significant correlation between liver NRE and eGFR or acquisition delay was observed. Conclusions The degree of liver enhancement during HBP is not correlated with eGFR or acquisition delay, but it is significantly reduced in patients with impaired liver function. 0.1 mmol/kg Gd-BOPTA dose might be useful in patients with total serum bilirubin > 1.2 mg/dl. Key Points • The degree of liver enhancement during hepatobiliary phase after Gd-BOPTA administration has a negative correlation with total serum bilirubin level (r = − 0.32, p < 0.0001). • The degree of liver enhancement during HBP after Gd-BOPTA administration is not significantly correlated with renal function and acquisition delay (comprised between 90 and 150 min after contrast injection). • 0.1 mmol/Kg Gd-BOPTA dose might be preferable in patients with increased total serum bilirubin levels.

The fabrication of high-performance organic optoelectronic devices using solution-based techniques, in particular inkjet printing, is both a desirable and challenging goal. Organic light-emitting diodes (OLEDs) are multilayer devices that have demonstrated great potential in display applications, with ongoing efforts aimed at extending their use to the lighting sector. A key objective in this context is the reduction in production costs, for which printing techniques offer a promising pathway. The main obstacle to fully printed OLEDs lies in the difficulty of depositing new layers onto pre-existing ones while maintaining high film quality and avoiding damage to the underlying layers. In a bottom-emitting OLED, the electron transport layer (ETL) is the final organic layer to be deposited, making its printing particularly challenging, a process for which only a few successful examples have been reported. In this work, we report on the optimization of a 2,2′,2″-(1,3,5-Benzinetriyl)-tris(1-phenyl-1-H-benzimidazole) (TPBi)-based ink formulation for ETL printing on an emitting layer composed of 5,10-Bis(4-(3,6-di-tert-butyl-9H-carbazol-9-yl)-2,6-dimethylphenyl)-5,10-dihydroboranthrene (tBuCzDBA). A specific ratio of methanol to diethyl ether was identified as the most suitable for printing the ETL without compromising the integrity of the underlying layer. The printed ETL was successfully integrated into an OLED device, which exhibited a maximum current efficiency of 6.8 cd/A and a peak luminance of about 8700 cd/m2. These results represent a significant step toward the development of a fully printed OLED architecture.

PurposeThis prospective study aimed to evaluate whether 18F-FDG-PET/CT performed before, during and after neoadjuvant chemo-radiotherapy (CRT) could predict histopathological response in patients with locally advanced cervical cancer (LACC) treated with CRT followed by radical surgery.MethodsBetween October 2010 and June 2014, 88 patients with LACC were enrolled. For each patient, three 18F-FDG-PET/CT scans (baseline, early and final) were acquired and evaluated by qualitative and quantitative analysis. Maximum standardized uptake value (SUVmax), SUVmean, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were measured as absolute values and their percentage variation (delta) (early vs. baseline and final vs. baseline). The role of 18F-FDG-PET/CT in predicting lymph node (LN) residual disease was evaluated by qualitative analysis only. Histopathology was the reference standard.ResultsAt histopathology, 40 patients had complete response (CR, pR0), 48 had partial response (PR: 21 microscopic [pR1] and 27 macroscopic [pR2]). At baseline, SUVmax and SUVmean were significantly higher in pR0 than in pR1–pR2 patients. At early evaluation, MTV and TLG were significantly higher in pR1–pR2 than in pR0 patients. At final evaluation, SUVmax, SUVmean and TLG were significantly higher in pR1–pR2 than in pR0 patients. Delta SUV parameters and delta TLG were significantly lower in PR group both during and after CRT. Delta MTV was significantly lower in patients with PR in the early phase only. In receiver operating characteristic (ROC) curve analysis, baseline SUVmean, early delta TLG, and final delta SUVmax better discriminated PR, providing 83.3%, 67.6% and 85% positive predictive value (PPV) and 60.3%, 90% and 70.8% negative predictive value (NPV), respectively. For LN assessment, high NPV was observed at early and final 18F-FDG-PET/CT (93.5% and 92.3%, respectively).ConclusionIn LACC patients treated with CRT followed by surgery, early variations in metabolic parameters effectively discriminate histopathological PR of the primary tumor, suggesting the potential role of 18F-FDG-PET/CT in early personalized treatment. The high NPV of early and final PET/CT could enable “tailored surgery” by avoiding lymphadenectomy in selected patients.

PurposeTo determine whether outpatient transradial emborrhoid technique can be performed safely and effectively in the treatment of symptomatic hemorrhoids.Materials and MethodsThe transradial emborrhoid technique was used to treat 12 patients with symptomatic hemorrhoids in an outpatient setting during a 4-month period. After percutaneous catheterization of the left radial artery, a 5-Fr sheath was introduced to catheterize the inferior mesenteric artery and a microcatheter was advanced into the branches of the superior rectal artery for embolization with 0.018-inch detachable coils (Interlock and IDC—interlocking detachable coils). After embolization, the sheath was withdrawn and puncture site hemostasis was achieved using a wrist band. All patients were evaluated 6 h after the procedure to determine whether they meet the discharge criteria and were discharged the following day. The results of the emborrhoid treatment were assessed at the 4-week follow-up.ResultsThe emborrhoid technique was successful in all patients. There was no major complication associated with the procedure. All patients met the discharge criteria 6 h after the procedure. Reduction of local edema and of hemorrhoidal congestion was observed in all patients.At the follow-up visit, the mean Rorvik score (HDSS + SHS-HD) decreased from 31.50 (7.50) to 13.11 (8.33) (p < .001).ConclusionsTransradial rectal artery embolization is a safe and effective treatment option for patients with chronic symptoms of hemorrhoid disease.

Objectives To prospectively assess reproducibility, safety, and efficacy of microwave ablation (MWA) in the treatment of unresectable primary and secondary pulmonary tumors. Methods Patients with unresectable primary and metastatic lung tumors up to 4 cm were enrolled in a multicenter prospective clinical trial and underwent CT-guided MWA. Treatments were delivered using pre-defined MW power and duration settings, based on target tumor size and histology classifications. Patients were followed for up to 24 months. Treatment safety, efficacy, and reproducibility were assessed. Ablation volumes were measured at CT scan and compared with ablation volumes obtained on ex vivo bovine liver using equal treatment settings. Results From September 2015 to September 2017, 69 MWAs were performed in 54 patients, achieving technical success in all cases and treatment completion without deviations from the standardized protocol in 61 procedures (88.4%). Immediate post-MWA CT scans showed ablation dimensions smaller by about 25% than in the ex vivo model; however, a remarkable volumetric increase (40%) of the treated area was observed at 1 month post-ablation. No treatment-related deaths nor complications were recorded. Treatments of equal power and duration yielded fairly reproducible ablation dimensions at 48-h post-MWA scans. In comparison with the ex vivo liver model, in vivo ablation sizes were systematically smaller, by about 25%. Overall LPR was 24.7%, with an average TLP of 8.1 months. OS rates at 12 and 24 months were 98.0% and 71.3%, respectively. Conclusions Percutaneous CT-guided MWA is a reproducible, safe, and effective treatment for malignant lung tumors up to 4 cm in size. Key Points • Percutaneous MWA treatment of primary and secondary lung tumors is a repeatable, safe, and effective therapeutic option. • It provides a fairly reproducible performance on both the long and short axis of the ablation zone. • When using pre-defined treatment duration and power settings according to tumor histology and size, LPR does not increase with increasing tumor size (up to 4 cm) for both primary and metastatic tumors.

Background: The normal pattern of nipple enhancement on magnetic resonance imaging (MRI) is defined based on healthy individuals, as it correlates with the structural anatomy of the nipple–areola complex (NAC). Understanding the normal range of nipple morphology and enhancement on MRI allows radiologists to better identify abnormalities. Some authors have previously detailed the morphology and characteristics of nipple–areola complex enhancement, both in normal and pathologically infiltrating conditions. Our aim is to present a case series involving a population of women with breast cancer infiltrating the NAC, retrospectively evaluated at our institution. Furthermore, based on previously published literature and our own experience, we intend to propose potential standardized language to describe tumor-infiltrating NAC enhancement on MRI and compare it with CT and PET findings. Methods: Our study included 110 breast cancer patients with NAC infiltration, who were referred to our hospital from August 2023 to July 2024. All patients were candidates for neoadjuvant chemotherapy and therefore underwent MRI and CT; 33 of them also underwent PET/CT. We distinguished the MRI enhancement pattern based on morphology and intensity. There were three types of morphology: SLE (superficial linear enhancement) at the skin level, NEZ (non-enhancing area immediately below the SLE), and INE (nipple enhancement below the NEZ but above the nipple base). In INE, the pattern could be linear or patchy. Depending on the intensity, the enhancement could be minimal, mild, moderate, or marked. The enhancement on CT depended on the distribution of pathological tissue in the infiltrated NAC and could be present or absent; it could involve the nipple base, the nipple body, or both. For quantitative analysis, we used the maximum standardized uptake value (SUV) measured in early-stage PET/CT images, obtained by delineating a three-dimensional volume of interest (VOI) on the NAC. Results: In our population, the most represented enhancement pattern was INE (110), while slightly less than half of the patients showed invasion of the NEZ (49). Approximately one quarter of the patients presented linear ductal INE (36), while the majority presented patchy INE (74). On CT and PET/CT, NAC enhancement was detectable in almost all patients (102), mainly involving the base and the body together. Correlation analysis in the following pairs of variables showed a high association, with a Kendall’s tau value greater than 0.7 (p < 0.001): (1) involvement of the NEZ on ce-MR and pattern of nipple involvement on ce-CT (CT score); (2) morphological pattern of INE on ce-MR (INE score) and intensity of INE enhancement on MR; and (3) pattern of nipple involvement on ce-CT (CT score) and intensity of INE enhancement on MR. The calculated mean SUV of pathological NACs on PET/CT for early-stage images was 3.59, while the mean SUV of contralateral normal NACs was 2.12. The calculated mean NAC-SUV ratio was 1.7. Conclusions: Although pathological involvement of the NAC cannot always be assessed in the final surgical specimen due to the effects of neoadjuvant chemotherapy, so the “gold standard” of histological reference is missing, MRI and CT with morphology and enhancement descriptors, and additionally PET/CT with SUV measurement can, in our opinion, provide valuable information on the infiltrated nipple. Standardized language for describing breast tumors infiltrating the NAC is desirable to ensure consistent interpretation across different radiologists.

Aim To evaluate the magnetic resonance (MR) imaging-MR cholangiopancreatographic (MRCP) findings of focal forms of autoimmune pancreatitis (AIP) to describe ductal involvement at diagnosis. Methods MR examinations of 123 patients affected by AIP were analysed. We included 26 patients who satisfied International Consensus Diagnostic Criteria and were suffering from focal AIP. Image analysis included: site of parenchymal enlargement, main pancreatic duct (MPD) diameter, MPD stenosis, stricture length, presence of upstream dilation within the stricture, signal intensity, and pancreatic enhancement. Results Signal intensity abnormalities were localized in the head in 10/26 (38.5 %) and in the body-tail in 16/26 (61.5 %) patients. MRCP showed a single MPD stenosis in 12/26 (46.1 %) and multiple MPD stenosis in 14/26 (53.8 %) patients, without a dilation of the upstream MPD (mean: 3.83 mm). Lesions showed hypointensity on T1-weighted images in all patients, and hyperintensity on T2-weighted images in 22/26 (84.6 %) patients. The affected parenchyma was hypovascular during the arterial phase in 25/26 (96.2 %) patients with contrast retention. Conclusions MR-MRCP are effective techniques for the diagnosis of AIP showing the loss of the physiological lobulation and the typical contrastographic appearance. The presence of multiple, long stenoses without an upstream MPD dilation at MRCP suggests the diagnosis of AIP, and can be useful in differential diagnosis of pancreatic adenocarcinoma. Key Points • MRI represents the gold standard in the diagnosis of AIP. • MRCP is an increasingly useful technique in the diagnosis of focal AIP. • MRCP could be a problem-solving tool in the differential diagnosis of AIP.

Purpose To evaluate the feasibility, safety and efficacy of a combined single-step therapy in patients with unresectable single large (> 5 cm) hepatocellular carcinoma (HCC), with balloon-occluded microwave ablation (b-MWA) plus transcatheter arterial balloon-occluded chemoembolization (b-TACE).Materials & MethodsFive consecutive Child A patients (mean age: 71.4 ± 3.2 yo; range 68–76 yo) with an unresectable single large HCC (> 5 cm) (mean size: 5.7 ± 0.6 cm; range 5.1–6.5 cm) were enrolled in our pilot study. The schedule consisted of percutaneous microwave ablation of the lesion during balloon occlusion of the hepatic artery supplying the tumor (b-MWA), followed by TACE under the occlusion of feeding arteries by a microballoon catheter (b-TACE). Adverse events and intra- and peri-procedural complications were clinically assessed. Early local efficacy was evaluated on 1- and 6-month follow-up multiphasic computed tomography (CT) on the basis of m-RECIST criteria.ResultsTechnical success was obtained in all procedures. No major complications occurred. A mean necrotic area of 6.8 ± 0.47 cm (range 6.3–7.4 cm) was obtained, with a complete response at 1-month follow-up obtained in 4 out of 5 lesions, with 1 partial response (less than 30% of residual tumor), successfully treated with a single TACE treatment. No residual tumor or local recurrence was registered at 6-month CT follow-up.ConclusionsOur preliminary experience seems to demonstrate that b-MWA plus b-TACE could be a safe and effective combined therapy for unresectable large HCC lesions, allowing a high rate of local response also in lesion exceeding 5 cm in size.