A novel stepwise micro-TESE approach in non obstructive azoospermia

Background: The purpose of the study was to investigate whether micro-TESE can improve sperm retrieval rate (SRR) compared to conventional single TESE biopsy on the same testicle or to contralateral multiple TESE, by employing a novel stepwise micro-TESE approach in a population of poor prognosis patients with non-obstructive azoospermia (NOA). Methods: Sixty-four poor prognosis NOA men undergoing surgical testicular sperm retrieval for ICSI, from March 2007 to April 2013, were included in this study. Patients inclusion criteria were a) previous unsuccessful TESE, b) unfavorable histology (SCOS, MA, sclerahyalinosis), c) Klinefelter syndrome. We employed a stepwise micro-TESE consisting three-steps: 1) single conventional TESE biopsy; 2) micro-TESE on the same testis; 3) contralateral multiple TESE. Results: SRR was 28.1 % (18/64). Sperm was obtained in both the initial single conventional TESE and in the following micro-TESE. The positive or negative sperm retrieval was further confirmed by a contralateral multiple TESE, when performed. No significant pre-operative predictors of sperm retrieval, including patients’ age, previous negative TESE or serological markers (LH, FSH, inhibin B), were observed at univariate or multivariate analysis. Micro-TESE (step 2) did not improve sperm retrieval as compared to single TESE biopsy on the same testicle (step 1) or multiple contralateral TESE (step 3). Conclusions: Stepwise micro-TESE could represent an optimal approach for sperm retrieval in NOA men. In our view, it should be offered to NOA patients in order to gradually increase surgical invasiveness, when necessary. Stepwise micro-TESE might also reduce the costs, time and efforts involved in surgery

A sustainable electrical interface to mitigate emissions due to power supply in ports

The paper presents a proposal of an innovative sustainable power supply solution for seaports with the related design and control. This solution differs from the classical solution for the presence of a smart electrical interface composed by two basic components: the first one, a rotating converter instead of the widely used static converter that ensures higher and therefore much more detectable short-circuit currents; the second, an advanced static var compensator specifically designed for enhancing power quality issues and hence favoring these seaport connection to the main grid for cold ironing applications. The designed control strategy for the tailored power supply solution is proven successful and effective by the numerical applications reported in the last part of the paper

SLC22A3 polymorphisms do not modify pancreatic cancer risk, but may influence overall patient survival

Expression of the solute carrier (SLC) transporter SLC22A3 gene is associated with overall survival of pancreatic cancer patients. This study tested whether genetic variability in SLC22A3 associates with pancreatic cancer risk and prognosis. Twenty four single nucleotide polymorphisms (SNPs) tagging the SLC22A3 gene sequence and regulatory elements were selected for analysis. Of these, 22 were successfully evaluated in the discovery phase while six significant or suggestive variants entered the validation phase, comprising a total study number of 1,518 cases and 3,908 controls. In the discovery phase, rs2504938, rs9364554, and rs2457571 SNPs were significantly associated with pancreatic cancer risk. Moreover, rs7758229 associated with the presence of distant metastases, while rs512077 and rs2504956 correlated with overall survival of patients. Although replicated, the association for rs9364554 did not pass multiple testing corrections in the validation phase. Contrary to the discovery stage, rs2504938 associated with survival in the validation cohort, which was more pronounced in stage IV patients. In conclusion, common variation in the SLC22A3 gene is unlikely to significantly contribute to pancreatic cancer risk. The rs2504938 SNP in SLC22A3 significantly associates with an unfavorable prognosis of pancreatic cancer patients. Further investigation of this SNP effect on the molecular and clinical phenotype is warranted

Strategies implemented by informal caregivers to facilitate self-care in patients with chronic obstructive pulmonary disease (COPD): a scoping review protocol

Background and aim: Chronic obstructive pulmonary disease (COPD) is a disease characterized by persistent respiratory symptoms and airflow limitation. COPD is a significant social and economic burden, and hospital admissions contribute to increased costs. Informal caregivers play a crucial role in supporting COPD patients in their self-care efforts. Therefore, understanding informal caregiver interventions to improve self-care may be helpful in reducing hospitalizations. This is the protocol for a scoping review that aims to map the literature on informal caregiver interventions to facilitate self-care in COPD patients. Research question: What are the strategies implemented by informal caregivers to facilitate self-care for patients with COPD? Methods: The review will adhere to the methodology outlined by the JBI. A comprehensive search strategy will be executed in PubMed, CINAHL, Embase, Web of Science, Scopus, Cochrane, and PsycINFO. Additionally, grey literature and relevant unpublished documents will be searched to minimize publication bias. Studies describing strategies/actions implemented by informal caregivers to promote self-care in COPD patients from all countries will be included. We will exclude abstracts, editorials, articles on paid caregivers and social and healthcare workers. Two independent reviewers will screen titles, abstracts, and full-text articles based on inclusion criteria. Key data from the selected studies will be extracted using a predefined data extraction table. The results will be aggregated into themes and described qualitatively, figures and graphs may also be presented. The results will be presented according to the PRISMA-ScR. Review registration: Open Science Framework https://doi.org/10.17605/OSF.IO/4TWRM

The Impact of the COVID-19 Pandemic on Affect, Fear, and Personality of Primary School Children Measured During the Second Wave of Infections in 2020

In relation to the COVID-19 pandemic outbreak, a large body of research has identified a negative impact on individuals' affectivity, frequently documented by increased prevalence of anxiety and depression symptoms. For children, this research was less extensive, was mainly based on caregivers' reports and neglected personality assessment. In order to measure the impact of the pandemic, and the fears it caused, on primary school children's affect and personality, 323 (180 boys and 143 girls) Italian third, fourth and fifth graders were assessed between October and November 2020, namely during the second wave of COVID-19 infections in Italy, with validated self-reports of affect (Positive and Negative Affect Scale for Children, PANAS-C), fear of COVID-19 (Fear of COVID-19 Scale, FCV-19S) and personality (junior Temperament and Character Inventory, jTCI). In comparison with PANAS-C and jTCI normative scores collected prior to the pandemic, data obtained from children in 2020 showed unchanged affect scores in the overall sample, a decrease of Positive Affect in girls, and a decrease in the Harm Avoidance and an increase in the Self-Transcendence scales of personality. Fear of COVID-19 scores were positively correlated with Negative Affect scores and negatively predicted by children's personality profile of resilience (calculated using scores on the Harm Avoidance and the Self-Directedness scales of personality). These results suggested that Italian primary school children, especially boys, maintained their pre-pandemic levels of affect (or restored them after the first COVID-19 wave) and partially diverged from the typical development of personality in an apparently positive sense, namely toward more courageous/optimistic and spiritual profiles. This sort of children's post-traumatic growth might also be attributed to children's family and education systems, which should continue to be supported to promote and maintain community mental health

Impact of safety-related dose reductions or discontinuations on sustained virologic response in HCV-infected patients: Results from the GUARD-C Cohort

BACKGROUND: Despite the introduction of direct-acting antiviral agents for chronic hepatitis C virus (HCV) infection, peginterferon alfa/ribavirin remains relevant in many resource-constrained settings. The non-randomized GUARD-C cohort investigated baseline predictors of safety-related dose reductions or discontinuations (sr-RD) and their impact on sustained virologic response (SVR) in patients receiving peginterferon alfa/ribavirin in routine practice. METHODS: A total of 3181 HCV-mono-infected treatment-naive patients were assigned to 24 or 48 weeks of peginterferon alfa/ribavirin by their physician. Patients were categorized by time-to-first sr-RD (Week 4/12). Detailed analyses of the impact of sr-RD on SVR24 (HCV RNA <50 IU/mL) were conducted in 951 Caucasian, noncirrhotic genotype (G)1 patients assigned to peginterferon alfa-2a/ribavirin for 48 weeks. The probability of SVR24 was identified by a baseline scoring system (range: 0-9 points) on which scores of 5 to 9 and <5 represent high and low probability of SVR24, respectively. RESULTS: SVR24 rates were 46.1% (754/1634), 77.1% (279/362), 68.0% (514/756), and 51.3% (203/396), respectively, in G1, 2, 3, and 4 patients. Overall, 16.9% and 21.8% patients experienced 651 sr-RD for peginterferon alfa and ribavirin, respectively. Among Caucasian noncirrhotic G1 patients: female sex, lower body mass index, pre-existing cardiovascular/pulmonary disease, and low hematological indices were prognostic factors of sr-RD; SVR24 was lower in patients with 651 vs. no sr-RD by Week 4 (37.9% vs. 54.4%; P = 0.0046) and Week 12 (41.7% vs. 55.3%; P = 0.0016); sr-RD by Week 4/12 significantly reduced SVR24 in patients with scores <5 but not 655. CONCLUSIONS: In conclusion, sr-RD to peginterferon alfa-2a/ribavirin significantly impacts on SVR24 rates in treatment-naive G1 noncirrhotic Caucasian patients. Baseline characteristics can help select patients with a high probability of SVR24 and a low probability of sr-RD with peginterferon alfa-2a/ribavirin

ChatGPT Versus Modest Large Language Models: An Extensive Study on Benefits and Drawbacks for Conversational Search

Large Language Models (LLMs) are effective in modeling text syntactic and semantic content, making them a strong choice to perform conversational query rewriting. While previous approaches proposed NLP-based custom models, requiring significant engineering effort, our approach is straightforward and conceptually simpler. Not only do we improve effectiveness over the current state-of-the-art, but we also curate the cost and efficiency aspects. We explore the use of pre-trained LLMs fine-tuned to generate quality user query rewrites, aiming to reduce computational costs while maintaining or improving retrieval effectiveness. As a first contribution, we study various prompting approaches - including zero, one, and few-shot methods - with ChatGPT (e.g., gpt-3.5-turbo). We observe an increase in the quality of rewrites leading to improved retrieval. We then fine-tuned smaller open LLMs on the query rewriting task. Our results demonstrate that our fine-tuned models, including the smallest with 780 million parameters, achieve better performance during the retrieval phase than gpt-3.5-turbo. To fine-tune the selected models, we used the QReCC dataset, which is specifically designed for query rewriting tasks. For evaluation, we used the TREC CAsT datasets to assess the retrieval effectiveness of the rewrites of both gpt-3.5-turbo and our fine-tuned models. Our findings show that fine-tuning LLMs on conversational query rewriting datasets can be more effective than relying on generic instruction-tuned models or traditional query reformulation techniques

Dioxins and PCBs contamination in mussels from Taranto (Ionian Sea, Southern Italy): a seven years spatio-temporal monitoring study

Introduction. Taranto is of particular Public Health relevance for the presence of industrialsources of dioxins and PCBs. The aim of this study was to monitor these pollutantsin mussels produced from 2012 to 2018.Materials and methods. Mussels were collected on a monthly basis with random sampling.Concentrations were determined through accredited methods.Results. 622 samples were collected. Dioxins and PCBs showed higher median concentrationsin Mar Piccolo 1st Inlet (p s &lt;0.0001; Dioxins: 1.43 pg WHO-TEQ/g ww;Dioxins+DL-PCBs: 5.98 pg WHO-TEQ/g ww; DL-PCBs: 4.57 pg WHO-TEQ/g ww;NDL-PCBs: 61.54 ng/g ww) and in III trimester for all basins (p s &lt;0.02). In Mar Piccolo1 st Inlet, there was a linear increase of dioxins and PCBs moving North (p s &lt;0.05).Conclusions. These findings confirmed higher concentrations in Mar Piccolo 1 st Inletduring the summer period and supported the validity of the Public Health measuresadopted by the Department of Prevention of Taranto

Decentralized Trajectory Tracking Control for Soft Robots Interacting With the Environment

Despite the classic nature of the problem, trajectory tracking for soft robots, i.e., robots with compliant elements deliberately introduced in their design, still presents several challenges. One of these is to design controllers which can obtain sufficiently high performance while preserving the physical characteristics intrinsic to soft robots. Indeed, classic control schemes using high-gain feedback actions fundamentally alter the natural compliance of soft robots effectively stiffening them, thus de facto defeating their main design purpose. As an alternative approach, we consider here using a low-gain feedback, while exploiting feedforward components. In order to cope with the complexity and uncertainty of the dynamics, we adopt a decentralized, iteratively learned feedforward action, combined with a locally optimal feedback control. The relative authority of the feedback and feedforward control actions adapts with the degree of uncertainty of the learned component. The effectiveness of the method is experimentally verified on several robotic structures and working conditions, including unexpected interactions with the environment, where preservation of softness is critical for safety and robustness