Calcium is widely used to improve apple postharvest performance and reduce bitter pit development, but the mechanisms linking calcium accumulation with cold storage tolerance remain unclear. This study investigated calcium-mediated responses in peel and flesh tissues of two apple cultivars, ‘King Roat’ and ‘Golden Chief’, during harvest and cold storage. Repeated preharvest calcium applications increased calcium accumulation in both tissues, maintained fruit firmness, and markedly reduced bitter pit symptoms after cold storage. Integrated cell wall, metabolomic, and transcriptomic analysis showed that calcium protection extended beyond its classical structural role. Calcium reshaped pectin-, xyloglucan-, and arabinogalactan protein-associated cell wall domains in a cultivar- and tissue-dependent manner, supporting improved wall cohesion and reduced tissue destabilization. Metabolomic profiling revealed coordinated changes in carbohydrate, organic acid, lipid, phenolic, and glutathione-related pathways, consistent with metabolic adjustment during storage. Transcriptomic analysis in ‘King Roat’ further indicated that calcium repressed genes associated with cell wall loosening, flavonoid biosynthesis, and programmed cell death, while activating redox-related components. Among the validated genes, MdGRXC11L was consistently induced by calcium across cultivars, tissues, and storage stages, indicating a potential role for glutaredoxin-mediated redox recovery in calcium-associated protection. Overall, these findings support a model in which calcium reduces bitter pit expression by reinforcing cell wall cohesion, maintaining metabolic homeostasis, and promoting glutathione-linked redox regulation during cold storage, providing potential molecular targets for predicting and managing postharvest physiological disorders in apple.
Cutaneous disease is a central component of psoriatic arthritis (PsA), contributing substantially to patient disease burden and influencing therapeutic choices. Beyond plaque psoriasis, specific phenotypes, including nail, scalp, palmoplantar, and inverse involvement, are relatively common in PsA and are frequently associated with greater functional limitation, impaired quality of life, and discordant responses to systemic therapy. Accurate identification of these manifestations is critical for diagnosis, risk stratification, and treatment optimization. This review provides a clinically oriented overview of the dermatologic spectrum of PsA, outlining epidemiology, pathogenic mechanisms linking the skin–joint axis, and the impact of skin disease on outcomes. We summarize evidence for topical therapies, conventional systemic agents, biologics targeting tumour necrosis factor alpha (TNFα), interleukin-17 (IL-17), and interleukin-23 (IL-23), targeted synthetic disease-modifying anti-rheumatic drugs (DMARDs), and emerging treatments, with attention to phenotype-specific considerations and multidisciplinary management. The implications of persistent skin activity in complex-to-manage PsA are also discussed. A domain-based, integrated approach to skin and joint care is required to achieve effective control both of musculoskeletal and cutaneous symptoms. Systematic evaluation and treatment of skin involvement should be considered a core component of PsA management rather than an ancillary concern.
Esophagogastric junction adenocarcinoma (EGJAC) is a distinct and increasingly prevalent malignancy associated with a poor survival. Among EGJACs, Siewert type II tumors pose particular challenges because of their heterogeneous origins, molecular diversity, and the absence of consensus regarding classification and management. Although anatomical classifications remain clinically useful, they inadequately reflect the biological complexity of these tumors. Recent molecular and omics advances have clarified esophagogastric junction tumorigenesis by revealing the interactions between reflux-related conditions and intrinsic and environmental risk factors. Accumulating evidence suggests that Siewert II tumors may originate from multiple cellular populations within the junctional zone, including Barrett’s metaplasia, cardiac-type epithelium, and gastric mucosa, each associated with distinct pathogenetic pathways. Genomic and transcriptomic studies have identified key oncogenic drivers and pathways, supporting biologically driven subclassification and potentially explaining variability in the therapeutic response. Currently, surgical and systemic treatment strategies for Siewert II tumors are largely extrapolated from esophageal and gastric cancer paradigms. Integrating molecular profiling with anatomical classification may improve clinical trial stratification and enable more personalized therapeutic approaches. This review summarizes the current evidence on the epidemiology, risk factors, histopathology, and molecular landscape of Siewert II adenocarcinomas, emphasizing the need for integrative classification frameworks to advance precision oncology and improve the patient outcomes.
The drivers of economic complexity in the countries of the European Union (EU) are a question of significant importance, especially in the context of the emergence of a trade war. Studying the relationship between economic complexity and macroeconomic, educational and technological variables, we offer valuable conclusions for the design and formulation of new policies. The Economic Complexity Index (ECI) is analysed in the context of education expenditure, gross fixed capital formation, fiscal balance, R D expenditure, and patent applications, using relevant econometric techniques such as the 3SLS and the SURE analysis. Education expenditures are found to affect significantly the Economic Complexity of a country. Moreover, after the outburst of the sovereign-debt crisis the fiscal balance has become a prerequisite for all European countries, showing a positive relationship with economic complexity. This result poses the question of how weaker economies can finance the necessary policies to increase their economic complexity, such as raising spending on education, R D, and fixed capital investment, while maintaining fiscal stability.
Robotic surgery has increasingly been adopted for the treatment of rectal cancer. However, most previous meta-analyses included heterogeneous rectal procedures, limiting conclusions specific to low anterior resection. The present study aimed to provide an updated systematic review and meta-analysis comparing robotic versus laparoscopic low anterior resection for rectal cancer. This systematic review and meta-analysis was conducted according to PRISMA guidelines and recommendations from the Cochrane Handbook. PubMed, Scopus, and the Cochrane Library were systematically searched from inception to the most recent date. Comparative studies evaluating robotic low anterior resection (R-LAR) versus laparoscopic low anterior resection (L-LAR) for rectal cancer were included. Risk of bias was assessed using RoB 2 for randomized trials and ROBINS-I for non-randomized studies. Certainty of evidence was evaluated using the GRADE approach. Thirty-three studies including 82,149 patients were analyzed (R-LAR: 56,290; L-LAR: 25,859). R-LAR was associated with a significantly lower conversion rate (OR 0.45, 95
