Differentiating the Acceleration Mechanisms in the Slow and Alfvénic Slow Solar Wind

In the corona, plasma is accelerated to hundreds of kilometers per second and heated to temperatures hundreds of times hotter than the Sun's surface before it escapes to form the solar wind. Decades of space-based experiments have shown that the energization process does not stop after it escapes. Instead, the solar wind continues to accelerate, and it cools far more slowly than a freely expanding adiabatic gas. Recent work suggests that fast solar wind requires additional momentum beyond what can be provided by the observed thermal pressure gradients alone, whereas it is sufficient for the slowest wind. The additional acceleration for fast wind can be provided through an Alfvén wave pressure gradient. Beyond this fast/slow categorization, however, a subset of slow solar wind exhibits high Alfvénicity that suggests that Alfvén waves could play a larger role in its acceleration compared to conventional slow wind outflows. Through a well-timed conjunction between Solar Orbiter and Parker Solar Probe (PSP), we trace the energetics of slow wind to compare with a neighboring Alfvénic slow solar wind stream. An analysis that integrates remote and heliospheric properties and modeling of the two distinct solar wind streams finds that Alfvénic slow solar wind behaves like fast wind, where a wave pressure gradient is required to reconcile its full acceleration, while non-Alfvénic slow wind can be driven by its nonadiabatic electron and proton thermal pressure gradients. Derived coronal conditions of the source region indicate good model compatibility, but extended coronal observations are required to effectively trace solar wind energetics below PSP's orbit

Deep learning neural network prediction of postoperative complications in patients undergoing laparoscopic right hemicolectomy with or without CME and CVL for colon cancer: insights from SICE (Società Italiana di Chirurgia Endoscopica) CoDIG data

BackgroundPostoperative complications in colorectal surgery can significantly impact patient outcomes and healthcare costs. Accurate prediction of these complications enables targeted perioperative management, improving patient safety and optimizing resource allocation. This study evaluates the application of machine learning (ML) models, particularly deep learning neural networks (DLNN), in predicting postoperative complications following laparoscopic right hemicolectomy for colon cancer.MethodsData were drawn from the CoDIG (ColonDx Italian Group) multicenter database, which includes information on patients undergoing laparoscopic right hemicolectomy with complete mesocolic excision (CME) and central vascular ligation (CVL). The dataset included demographic, clinical, and surgical factors as predictors. Models such as decision trees (DT), random forest (RF), and DLNN were trained, with DLNN evaluated using cross-validation metrics. To address class imbalance, the synthetic minority over-sampling technique (SMOTE) was employed. The primary outcome was the prediction of postoperative complications within 1 month of surgery.ResultsThe DLNN model outperformed other models, achieving an accuracy of 0.86, precision of 0.84, recall of 0.90, and an F1 score of 0.87. Relevant predictors identified included intraoperative minimal bleeding, blood transfusion, and adherence to the fast-track recovery protocol. The absence of intraoperative bleeding, intracorporeal anastomosis, and fast-track protocol adherence were associated with a reduced risk of complications.ConclusionThe DLNN model demonstrated superior predictive performance for postoperative complications compared to other ML models. The findings highlight the potential of integrating ML models into clinical practice to identify high-risk patients and enable tailored perioperative care. Future research should focus on external validation and implementation of these models in diverse clinical settings to further optimize surgical outcomes

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Le vivant et le recyclage des matériaux de chantier, facteurs de résilience environnementale et de lien social

L’impact sur le plan social, écologique et économique de la construction d’habitats, de bâtiments administratifs et industriels, d’infrastructures de transport et de loisir et leurs aménagements, n’est plus à démontrer. Épuisement des ressources naturelles, transformation des matériaux, transports, gestion des déchets de chantier et d’excavations, autant de sources d’émissions de GES et d’effets négatifs sur le sol et le paysage qui influent sur la qualité de vie et les perspectives d’avenir de la population, à l’échelle du territoire, de la ville, du quartier. Cette présentation aborde la question de la prise en compte du vivant dans une démarche d’optimisation de la qualité de notre environnement, dimension encore trop souvent sous-estimée dans le processus de la construction et véritable enjeu de ce début de 21e siècle. 1. L’impact écologique : tenir compte du sol, non comme un matériau inerte, socle physique aux seules qualités de support, mais comme un complexe vivant de grande valeur et grande fragilité, rare et indispensable à la végétation et à la gestion des eaux. Le sol fertile se raréfie en milieu bâti, dans la ville en particulier où l’anthroposol et les revêtements imperméables deviennent la règle. 2. L’impact social : Mettre en relation les acteurs du site, une responsabilité sociale. La prise en compte des personnes, habitants actuels et futurs, voisins, la population dans son ensemble et les visiteurs, tous impactés de près ou de loin par les nuisances des travaux, la transformation des lieux, la perte d’éléments repères et à la recherche affirmée et croissante d’une qualité de vie en espace construit

Towards a "comprehensive" and smart platform for coordinated waste management in construction in Geneva? ::a case study

In order to reduce environmental and financial costs caused by construction material flow, web platforms have been created. Their objective is to increase the visibility of materials available on construction sites and promote their reuse. A benchmark of existing national and international platforms - considering functional aspects, effectiveness and how the platform interacts with local construction community - has been established by the research team. Strengths and weaknesses of each analyzed platform have been identified, giving an up-todate picture. The benchmark points out, that no “comprehensive“ platform, providing material exchange services as well as support for a large and strong user community, exists. Such a platform could be enhanced by several features – like linking it to geographical information systems and technical assistance, creating a coordinated waste management among construction sites thereby. The Great Geneva Area has been identified as an ideal location to implement the concept and an action plan has been proposed

Inhibitors of ADAM10 reduce Hodgkin lymphoma cell growth in 3D microenvironments and enhance brentuximab-vedotin effect

Shedding of ADAM10 substrates, like TNFa or CD30, can affect both anti-tumor immune response and antibody-drug-conjugate (ADC)-based immunotherapy. We have published two new ADAM10 inhibitors, LT4 and MN8 able to prevent such shedding in Hodgkin lymphoma (HL). Since tumor tissue architecture deeply influences the outcome of anti-cancer treatments, we set up a new threedimensional (3D) culture systems to verify whether ADAM10 inhibitors can contribute to, or enhance, the anti-lymphoma effects of the ADC brentuximab-vedotin (BtxVed). In order to recapitulate some aspects of lymphoma structure and architecture, we assembled two 3D culture models: mixed spheroids made of HL lymph node (LN) mesenchymal stromal cells (MSC) and Reed Sternberg/Hodgkin lymphoma cells (HL cells) or collagen scaffolds repopulated with LN-MSC and HL cells. In these 3D systems we found that: i) the ADAM10 inhibitors LT4 and MN8 reduce ATP content or glucose consumption, related to cell proliferation, increasing lactate dehydrogenase release as a cell damage hallmark; ii) these events are paralleled by mixed spheroids size reduction and inhibition of CD30 and TNFa shedding; iii) the effects observed can be reproduced in repopulated HL LN-derived matrix or collagen scaffolds; iv) ADAM10 inhibitors enhance the anti-lymphoma effect of the anti-CD30 ADC BtxVed both in conventional cultures and in repopulated scaffolds. Thus, we provide evidence for a direct and combined antilymphoma effect of ADAM10 inhibitors with BtxVed, leading to the improvement of ADC effects; this is documented in 3D models recapitulating features of the LN microenvironment, that can be proposed as a reliable tool for anti-lymphoma drug testing.</jats:p

Inhibitors of A Disintegrin And Metalloproteinases-10 reduce Hodgkin lymphoma cell growth in 3D microenvironments and enhance brentuximab-vedotin effect

none16Shedding of A Disintegrin And Metalloproteinases (ADAM10) substrates, like TNFα or CD30, can affect both anti-tumor immune response and antibody-drug-conjugate (ADC)-based immunotherapy. We have published two new ADAM10 inhibitors, LT4 and MN8 able to prevent such shedding in Hodgkin lymphoma (HL). Since tumor tissue architecture deeply influence the outcome of anti-cancer treatments, we set up new three-dimensional (3D) culture systemsto verify whether ADAM10 inhibitors can contribute to, or enhance, the anti-lymphoma effects of the ADC brentuximab-vedotin (BtxVed).To recapitulate some aspects of lymphoma structure and architecture, we assembled two 3D culture models: mixed spheroids made of HL lymph node (LN) mesenchymal stromal cells (MSC) and Reed Sternberg/Hodgkin lymphoma cells (HL cells) or collagen scaffolds repopulated with LN-MSC and HL cells. In these 3D systems we found that: 1) the ADAM10 inhibitors LT4 and MN8 reduce ATP content or glucose consumption, related to cell proliferation, increasing lactate dehydrogenase (LDH) release as a cell damage hallmark; 2) these events are paralleled by mixed spheroids size reduction and inhibition of CD30 and TNFα shedding; 3) the effects observed can be reproduced in repopulated HL LN-derived matrix or collagen scaffolds; 4) ADAM10 inhibitors enhance the antilymphoma effect of the anti-CD30 ADC BtxVed both in conventional cultures and in repopulated scaffolds. Thus, we provide evidence for direct and combined anti-lymphoma effect of ADAM10 inhibitors with BtxVed, leading to improvement of ADC effects; this is documented in 3D models recapitulating features of LN microenvironment, that can be proposed as reliable tool for antilymphoma drug testing.openPece, Roberta; Tavella, Sara; Costa, Delfina; Varesano, Serena; Camodeca, Caterina; Cuffaro, Doretta; Nuti, Elisa; Rossello, Armando; Alfano, Massimo; D'Arrigo, Cristina; Galante, Denise; Ravetti, Jean-Louis; Gobbi, Marco; Tosetti, Francesca; Poggi, Alessandro; Zocchi, Maria RaffaellaPece, Roberta; Tavella, Sara; Costa, Delfina; Varesano, Serena; Camodeca, Caterina; Cuffaro, Doretta; Nuti, Elisa; Rossello, Armando; Alfano, Massimo; D'Arrigo, Cristina; Galante, Denise; Ravetti, Jean-Louis; Gobbi, Marco; Tosetti, Francesca; Poggi, Alessandro; Zocchi, Maria Raffaell

Differentiating the Acceleration Mechanisms in the Slow and Alfvénic Slow Solar Wind

In the corona, plasma is accelerated to hundreds of kilometers per second and heated to temperatures hundreds of times hotter than the Sun's surface before it escapes to form the solar wind. Decades of space-based experiments have shown that the energization process does not stop after it escapes. Instead, the solar wind continues to accelerate, and it cools far more slowly than a freely expanding adiabatic gas. Recent work suggests that fast solar wind requires additional momentum beyond what can be provided by the observed thermal pressure gradients alone, whereas it is sufficient for the slowest wind. The additional acceleration for fast wind can be provided through an Alfvén wave pressure gradient. Beyond this fast/slow categorization, however, a subset of slow solar wind exhibits high Alfvénicity that suggests that Alfvén waves could play a larger role in its acceleration compared to conventional slow wind outflows. Through a well-timed conjunction between Solar Orbiter and Parker Solar Probe (PSP), we trace the energetics of slow wind to compare with a neighboring Alfvénic slow solar wind stream. An analysis that integrates remote and heliospheric properties and modeling of the two distinct solar wind streams finds that Alfvénic slow solar wind behaves like fast wind, where a wave pressure gradient is required to reconcile its full acceleration, while non-Alfvénic slow wind can be driven by its nonadiabatic electron and proton thermal pressure gradients. Derived coronal conditions of the source region indicate good model compatibility, but extended coronal observations are required to effectively trace solar wind energetics below PSP's orbit

Correction to: Practice of proctology among general surgery residents and young specialists in Italy: a snapshot survey

The originally published article the collaborators of ProctoSurvey Group has not been included. The original article has been updated