Explore the vast range of titles available.

Empathy has been linked to enhanced processing of social information, yet the neurophysiological correlates of such individual differences remain underexplored. Objectives: The aim of this study was to investigate how individual differences in trait empathy are reflected in oscillatory brain activity during the perception of non-verbal social cues. Methods: In this EEG study involving 30 participants, we examined spectral and time–frequency dynamics associated with trait empathy during a visual task requiring the interpretation of others’ body gestures. Results: FFT Power spectral analyses (applied to alpha/mu, beta, high beta, and gamma bands) revealed that individuals with high empathy quotients (High-EQ) exhibited a tendency for increased beta-band activity over frontal regions and markedly decreased alpha-band activity over occipito-parietal areas compared to their low-empathy counterparts (Low-EQ), suggesting heightened attentional engagement and reduced cortical inhibition during social information processing. Similarly, time–frequency analysis using Morlet wavelets showed higher alpha power in Low-EQ than High-EQ people over occipital sites, with no group differences in mu suppression or desynchronization (ERD) over central sites, challenging prior claims linking mu ERD to mirror neuron activity in empathic processing. These findings align with recent literature associating frontal beta oscillations with top-down attentional control and emotional regulation, and posterior alpha with vigilance and sensory disengagement. Conclusions: Our results indicate that empathic traits are differentially reflected in anterior and posterior oscillatory dynamics, supporting the notion that individuals high in empathy deploy greater cognitive and attentional resources when decoding non-verbal social cues. These neural patterns may underlie their superior ability to interpret body language and mental states from visual input.

The ‘Annurca’ apple, a traditional Italian cultivar protected by the “Melannurca Campana” EU PGI designation, undergoes a mandatory, traditional postharvest reddening process in a melaio. While essential for developing its characteristic flavor and color, this process can also lead to significant textural degradation, resulting in a mealy and soft fruit that conflicts with modern consumer expectations. This study investigated an integrated postharvest strategy to resolve this quality trade-off. We evaluated the sensory profile and consumer acceptance of ‘Annurca’ apples subjected to three treatments: traditional melaio reddening (Melaio), a 1-methylcyclopropene treatment alone (MCP), and a combined treatment of MCP followed by melaio reddening (MCP+Melaio). A panel of 534 consumers evaluated the apples for overall liking and the intensity of seven key sensory attributes. The results showed that the integrated ‘MCP+Melaio’ treatment was significantly preferred (Mean liking = 6.61) over both the traditional ‘Melaio’ (M = 5.91) and ‘MCP’ alone (M = 5.91) treatments. This preference was driven by a superior sensory profile that combined the high crunchiness and low mealiness of the MCP treatment with the high perceived aroma intensity and sweetness developed during the melaio phase. Furthermore, consumer segmentation analysis identified four distinct preference clusters, revealing that the integrated treatment’s success derived from its ability to satisfy the divergent priorities of the two largest segments: “Melaio Fans” (37%) and “Texture & Flavor Seekers” (35%). Our findings demonstrate that combining 1-MCP with traditional practices creates a synergistic effect, producing a high-quality apple that is texturally superior, aromatically intense, and has an extended sensory shelf-life. This integrated approach offers a scientifically validated and practical solution to enhance the quality and consistency of ‘Annurca’ apple production.

The ‘Annurca’ apple, an EU Protected Geographical Indication product, undergoes a mandatory post-harvest reddening in the ‘melaio’. This traditional practice enhances color and aroma but initiates detrimental textural degradation, creating a paradox where key quality attributes develop in conflict. This study aimed to characterize the sensory evolution of ‘Annurca’ apples during extended cold storage and its impact on consumer preference. A cohort of 551 untrained consumers evaluated the sensory profile at seven time points over a 221-day cold storage period. Multivariate data analyses were employed to identify preference drivers and define consumer segments. Consumer overall liking and market acceptability followed a significant non-linear, U-shaped trajectory, declining from an initial high (89.4% acceptability) to a minimum at day 159 (46.6% acceptability), before partially recovering. This trend inversely correlated with a peak in perceived mealiness, while hardness and crunchiness remained stable. Juiciness and aroma intensity were consistently identified as powerful positive liking drivers, whereas mealiness was the most significant and consistent negative driver. Sweetness’s importance as a preference driver significantly increased over storage time. Cluster analysis on highly rated samples revealed three distinct consumer preference profiles, challenging the traditional notion of a single ideal ‘Annurca’ apple. This study deconstructs the ‘melaio’ paradox, demonstrating that sensory evolution is a dynamic process defined by a trade-off between flavor development and textural decay. The findings provide a data-driven framework for optimizing the commercial strategy for this unique PGI cultivar, suggesting the need to mitigate mealiness and develop targeted marketing strategies for distinct consumer segments.

Anastomotic leakage (AL) after lower gastrointestinal surgery remains a serious complication with an incidence of 3–30%. Influencing factors include perfusion deficits, tension, inflammation, malnutrition, medications, and previous therapies. Surgical technique and type of anastomosis are also crucial. While various strategies for early detection and management exist, endoscopic negative pressure therapy (ENPT) has shown promising therapeutic benefits. This study evaluates the technique and outcomes of ENPT for treating AL. In this retrospective analysis, 59 patients with grade B AL following rectal resection between June 2016 and February 2022 were included. Patients had endoscopically or radiologically confirmed AL with pelvic abscess and were treated with ENPT. Exclusion criteria included relaparotomy, CT-guided drainage, sealant use, and irrigation without ENPT. Outcomes included leakage closure, abscess recurrence, sepsis, ostomy closure rate, and complications. Of the 59 patients, 16 received ENPT without an ostomy; 10 of these achieved complete healing. Median ENPT duration was 4 weeks. Higher anastomosis levels correlated with better healing. Factors such as leak type, abscess size, and chronicity influenced outcomes. Reported complications included rectovaginal fistula and anastomotic stenosis. ENPT is a safe and effective approach for AL, often avoiding permanent ostomies. A structured, endoscopy-led treatment strategy is essential.

The ‘Annurca’ apple (Malus domestica), a PGI-protected Italian cultivar, undergoes a mandatory postharvest reddening process (melaio). While crucial for skin color development, this process is associated with flesh softening, creating a conflict with consumer demand for crispness. To resolve this quality trade-off, this study compared different postharvest strategies over a five-month commercial cold storage. Specifically, we performed a time-series analysis of the evolution of ripening and skin color dynamics under three strategies: traditional reddening (Melaio), 1-methylcyclopropene application (MCP), and a 1-MCP treatment followed by reddening (MCP+Melaio). While 1-MCP effectively arrested firmness loss, maintaining firmness above 47 N compared to the Melaio-only treatment which dropped to 35.9 N by the end of storage, the pathways of skin color development differed profoundly. The MCP-only strategy led to a highly non-uniform and visually inconsistent appearance (average Total Color Difference, ΔE* > 12) that persisted throughout storage. In contrast, the traditional melaio process proved indispensable for guiding the fruit towards a significantly more homogeneous final coloration (∆E* ≈ 5.5). The integrated MCP+Melaio strategy successfully reconciled these divergent effects, preserving high flesh firmness (47.9 N) while achieving the superior skin color uniformity characteristic of the traditional process (final ΔE* ≈ 5.6). This study demonstrates that pre-treating ‘Annurca’ apples with 1-MCP before the melaio period offers a viable, scientifically validated approach to resolving the critical trade-off between texture and skin color, enabling the ‘Annurca’ industry to meet modern textural expectations while preserving its unique cultural and quality traditions.

After gastrointestinal resections, leakages can occur, persist despite conventional therapy and result in enterocutaneous fistulae. We developed a combination method using flexible endoscopic techniques to seal the enteric orifice with an absorbable plug in addition to a percutaneously and fistuloscopically guided open-pore film drainage (Vac-Plug method). We retrospectively searched our endoscopy database to identify patients treated with the outlined technique. The clinical and pathological data were assessed, the method analyzed and characterized and the technical and clinical success determined. We identified 14 patients that were treated with the Vac-Plug method (4 females, 10 males with a mean age of 56 years, range 50–74). The patients were treated over a time period of 23 days (range 4–119) in between one to thirteen interventions (mean n = 5). One patient had to be excluded due to short follow-up after successful closure. Seventy-seven percent (10/13) were successfully treated with a median follow-up of 453 days (range 35–1246) thereafter. No treatment related complications occurred during the therapy. The data of the analysis showed that the Vac-Plug therapy is safe and successful in a relevant proportion of the patients. It is easy to learn and to apply and is well tolerated. In our opinion, it is a promising addition to the armamentarium of interventional methods of these difficult to treat patients. Of course, its usefulness must be further validated in larger prospective studies.

Background Oncological esophageal surgery has evolved significantly in the last decades. From open esophagectomy over (hybrid) minimally invasive surgery, nowadays, robot-assisted minimally invasive esophagectomy (RAMIE) approaches are applied. Current techniques require an analysis of possible advantages and disadvantages indicating the direction towards a novel gold standard. Methods Robot-assisted Ivor Lewis esophagectomies, performed in the period from April 2017 to June 2019 in five German centers (Berlin, Cologne, Hamburg, Kiel, Mainz), were included in this study. Pre-, intra-, and postoperative parameters were assessed. Cases were grouped for hybrid (H-RAMIE) versus totally robot-assisted (T-RAMIE) approaches. Postoperative parameters and complications were compared using risk ratios. Results A total of 175 operations were performed as T-RAMIE and 67 as H-RAMIE. Patient age (median age 62 years) and sex (83.1% male) were similarly distributed in both groups. Median duration of esophagectomy was significantly lower in the T-RAMIE group (385 versus 427 min, p < 0.001). The risks of “overall morbidity” (32.0 versus 47.8%; risk ratio [RR], 95% confidence interval (CI): 1.5, 1.1–2.1; p = 0.026), “anastomotic leak” (10.3 versus 22.4%; RR, CI: 2.2, 1.2–4.1; p = 0.020), and “respiratory failure” (1.1 versus 7.5%; RR, CI: 6.5, 1.3–32.9; p = 0.019) were significantly higher in case of H-RAMIE. Conclusions In the five participating German centers, T-RAMIE was the preferred procedure (72.3% of operations). In comparison to H-RAMIE, T-RAMIE was associated with a significantly reduced risk of postoperative morbidity, anastomotic leak, and respiratory failure as well as a significantly reduced time necessary for esophagectomy.

Despite a significant decrease of surgery-related mortality and morbidity, anastomotic leakage still occurs in a significant number of patients after esophagectomy. The two main endoscopic treatments in case of anastomotic leakage are self-expanding metal stents (SEMS) and the endoscopic vacuum therapy (EVT). It is still under debate, if one method is superior to the other. Therefore, we performed a systematic review and meta-analysis of the existing literature to compare the effectiveness and the related morbidity of SEMS and EVT in the treatment of esophageal leakage. We systematically searched for studies comparing SEMS and EVT to treat anastomotic leak after esophageal surgery. Predefined endpoints including outcome, treatment success, endoscopy, treatment duration, re-operation rate, intensive care and hospitalization time, stricture rate, morbidity and mortality were assessed and included in the meta-analysis. Seven retrospective studies including 338 patients matched the inclusion criteria. Compared to stenting, EVT was significantly associated with higher healing (OR 2.47, 95% CI [1.30 to 4.73]), higher number of endoscopic changes (pooled median difference of 3.57 (95% CI [2.24 to 4.90]), shorter duration of treatment (pooled median difference − 11.57 days; 95% CI [− 17.45 to − 5.69]), and stricture rate (OR 0.22, 95% CI [0.08 to 0.62]). Hospitalization and intensive care unit duration, in-hospital mortality rate, rate of major and treatment related complications, of surgical revisions and of esophago-tracheal fistula failed to show significant differences between the two groups. Our analysis indicates a high potential for EVT, but because of the retrospective design of the included studies with potential biases, these results must be interpreted with caution. More robust prospective randomized trials should further investigate the potential of the two procedures.

The size and number of the berries and the rachis length are the main elements that define bunch compactness in grapevine (Vitis vinifera L.). This trait is of scientific and commercial interest because it strongly influences phytosanitary status and quality of the fruits. In this work, we investigated the effect of different canopy management strategies based on apical shoot and/or leaf removal applied at the early stage (pre-bloom) in altering the key determinants of bunch compactness. Specifically, we compared apical defoliation (removal of the first half of the shoot leaves from the top), basal defoliation (removal of the second half), and shoot trimming (removal of the apical half of the shoot) to untreated controls. The work was carried out in two red varieties (‘Aglianico’ and ‘Casavecchia’) that have contrasting bunch compactness (compact and loose, respectively). We measured relevant morphological traits, photosynthetic rates, fertility, fruit set, bunch architecture, and fruit main compositional parameters. This study demonstrates that the position of the removed shoot leaves along with the shoot trimming differentially modified fruit set, the number of berries per bunch, and berry fresh weight and composition at harvest. Nonetheless, the influence on bunch compactness was limited mainly because of photosynthetic and morphological factors strongly associated with the cultivar.

Background: Defensive medicine is characterized by medical decisions made primarily as a precaution against potential malpractice claims. For psychiatrists, professional responsibility encompasses not only the appropriateness of diagnosis and treatment but also the effects of their interventions on patients and their behaviors. Objective: To investigate the socio-demographic, educational, and occupational characteristics and work-related attitudes that may serve as predictors of defensive medicine among Italian psychiatrists. This research extends the results of a previous analysis based on a national survey. Methods: A secondary analysis of the database of a national survey on attitudes and behaviors of Italian psychiatrists regarding defensive medicine and professional liability was performed for this study. Results: Among 254 surveyed psychiatrists, 153 admitted to practicing defensive medicine, while 101 had this attitude with less than half of their patients. The first group was predominantly comprised of women (p = 0.014), who were younger in age (43.34 y 9.89 vs. 48.81 y 11.66, p < 0.001) and had fewer years of professional experience (12.09 y ± 9.8 vs. 17.46 y ± 11.2, p < 0.001). There were no significant differences in prior involvement in complaints (p = 0.876) or the usual place of work (p = 0.818). The most prominent predictors for practicing defensive medicine were (1) considering guidelines and good clinical practices not only for their clinical efficacy but also or exclusively for reducing the risk of legal complaints for professional liability (OR = 3.62; 95%CI, 1.75–7.49), and (2) hospitalizing patients with violent intentions even if not warranted according to their mental state (OR = 2.28; 95%CI, 1.50–3.46, p < 0.001). Prioritizing protection from professional liability over patients’ actual needs in prescribing or adjusting drug dosages and in involuntary hospitalization, as well as prescribing lower dosages than recommended for pregnant patients, were identified as additional predictors. Finally, years of professional experience exhibited a protective function against defensive practices. Conclusions: Psychiatrists advocate the need to implement a ‘risk management culture’ and the provision of more balanced duties in order to ensure ethical and evidence-based care to their patients. A particular source of concern stems from their professional responsibility towards not only the health of patients but also their behavior. However, these aspects conflict with a limited potential for assessment and intervention based on effective clinical tools. A reform of professional liability that considers the specificities of patients cared for by mental health services could contribute to reducing the risk of defensive medicine.