Textbook Outcome (TO) combines optimal surgical outcomes into a single measure. This study evaluates achievement of TO using a multicenter database, assessing hospital variation, its correlation with early and late results, and refining a tailored definition of Textbook Outcome in Gastric Surgery (TOGS). Data from patients undergoing curative gastrectomy (2011–2020) in Italian centers affiliated to the Italian Gastric Cancer Research Group (GIRCG) were analyzed. TOGS was introduced at the 2024 GIRCG Annual Meeting in Siena (Italy). Among 1988 patients (median age 72 years, BMI 24.9 kg/m2), 1523 underwent surgery in higher-volume centers (≥ 30 cases per year) and 465 in lower-volume centers (15–30 cases per year). TO was achieved in 54.6
The catastrophic events are characterized by “low frequency and high severity”. Nevertheless, during the last decades, both the frequency and the magnitude of these events have been significantly rising worldwide. In 2021, the European Commission adopted a new Strategy on Adaptation to Climate Change aiming to reinforce the adaptive capacity and minimize vulnerability to the effects of climate change and natural catastrophes. In a continuous time framework over an infinite horizon, we solve in closed form the problem of a representative consumer who holds a production technology (firm) and who optimises with respect to both the intertemporal consumption and the mix between an insurance (adaptation) against the magnitude of the catastrophic losses, and an effort strategy (mitigation) aimed at reducing the frequency of such losses. The catastrophic events are modelled as a Poisson jump process. We then propose some numerical simulations calibrated to the country-specific data of the five main European economies (Germany, France, Italy, Spain, and Netherlands). Our model demonstrates that an optimal mix of mitigation/effort strategies allows to reduce the volatility of the economic growth rate, even if its level may be lowered due to the effort costs. Simulations allow us to also conclude that different countries must optimally react differently to catastrophes, which means that a one-for-all policy does not seem to be optimal.
Microorganisms produce siderophores, which are low-molecular-weight iron chelators when iron availability is limited. The present analyzed the role of LNPF1 as multifarious PGPR for improving growth parameters and nutrient content in peanut and soil nutrients. Such multifarious PGPR strains can be used as effective bioinoculants for peanut farming. In this work, rhizosphere bacteria from Zea mays and Arachis hypogaea plants in the Salem area of Tamil Nadu, India, were isolated and tested for biochemical attributes and characteristics that stimulate plant growth, such as the production of hydrogen cyanide, ammonia (6 µg/mL), indole acetic acid (76.35 µg/mL), and solubilizing phosphate (520 µg/mL). The 16S rRNA gene sequences identified the isolate LNPF1 as Pseudomonas fluorescens with a similarity percentage of 99
Cardiovascular diseases (CVD) remain the leading cause of morbidity and mortality worldwide, accounting for significant public health and economic burdens. Cardiac rehabilitation (CR) is a comprehensive, multidisciplinary program designed to aid patients in recovering from cardiac events and to prevent further complications. The aim of CR is to improve their quality of life and prognosis. It involves continued prognostic stratification, clinical stabilization, optimization of pharmacological and non-pharmacological therapy, management of comorbidities, treatment of disabilities, reinforcement of secondary prevention interventions, and maintenance of adherence to therapy. The most recent European Society of Cardiology guidelines for the diagnosis and management of atrial fibrillation (AF) emphasize the importance of cardiorespiratory fitness, recommending that patients engage in moderate-intensity exercise and remain physically active to prevent AF incidence or recurrence. Through this symbiotic relationship, CR addresses all aspect of cardiac fitness in AF management. The program's structured exercise regimens are specifically tailored to address the challenges associated with AF, promoting overall cardiovascular health and reducing the risk for cardiac death. CR is also crucial for emotional well-being, offering support and coping mechanisms for the psychological impact of AF, beyond the physical training program. CR programs involve a multidisciplinary approach that is carried out collaboratively by a team of healthcare professionals, including nurses, physiotherapists, psychologists, and dietitians. Moreover, CR in AF patients aims to carry out comprehensive patient support through clinical stabilization and therapy optimization interventions, prescription and implementation of physical activity, educational support on lifestyle risk factors and social-emotional distress, and periodic assessment of outcomes. This narrative review aims to elucidate the role of CR in AF patients, shedding light on the potential benefits and challenges associated with integrating rehabilitation programs into the care of individuals with AF.
Blood biomarkers have emerged as accurate tools for detecting Alzheimer's disease (AD) pathology, offering a minimally invasive alternative to traditional diagnostic methods such as imaging and cerebrospinal fluid (CSF) analysis. Yet, the logistics surrounding venipuncture for blood collection, although considerably simpler than the acquisition of imaging and CSF, require precise processing and storage specific to AD biomarkers that are still guided by medical personnel. Consequently, limitations in their widescale use in research and broader clinical implementation exist. The DROP-AD project investigates the potential of dried plasma spot (DPS) and dried blood spot (DBS) analysis, derived from capillary blood, for detecting AD biomarkers, including phosphorylated tau at amino acid 217 (p-tau217), glial fibrillary acidic protein and neurofilament light. Here, 337 participants from 7 centers were included, with 304 participants providing paired capillary DPS or DBS and venous plasma samples. We observed strong correlations between DPS p-tau217 and venous plasma p-tau217 (r(S) = 0.74, P < 0.001). DPS p-tau217 progressively increased with increasing disease severity, and showed good accuracy in predicting CSF biomarker positivity (area under the curve = 0.864). Similarly, we demonstrated the successful detection of glial fibrillary acidic protein and neurofilament light with strong correlations between DBS and DPS, respectively, using paired venous plasma samples. Notably, the method was also effective in individuals with Down syndrome, a population at high genetic risk for AD but in whom standard blood sampling by venipuncture may be more complicated, revealing elevated biomarkers in those with dementia compared with asymptomatic individuals. The study also explored unsupervised blood collection, finding high concordance between supervised and self-collected samples. These findings underscore the potential of dried blood collection and capillary blood as a minimally invasive, scalable approach for AD biomarker testing in research settings. Yet, further refinement of collection and analytical protocols is needed to fully translate this approach to be viable and useful as a clinical tool.
