Superhydrophobic lab-on-chip measures secretome protonation state and provides a personalized risk assessment of sporadic tumour

Secretome of primary cultures is an accessible source of biological markers compared to more complex and less decipherable mixtures such as serum or plasma. The protonation state (PS) of secretome reflects the metabolism of cells and can be used for cancer early detection. Here, we demonstrate a superhydrophobic organic electrochemical device that measures PS in a drop of secretome derived from liquid biopsies. Using data from the sensor and principal component analysis (PCA), we developed algorithms able to efficiently discriminate tumour patients from non-tumour patients. We then validated the results using mass spectrometry and biochemical analysis of samples. For the 36 patients across three independent cohorts, the method identified tumour patients with high sensitivity and identification as high as 100% (no false positives) with declared subjects at-risk, for sporadic cancer onset, by intermediate values of PS. This assay could impact on cancer risk management, individual’s diagnosis and/or help clarify risk in healthy populations

Microfluidic platforms for cell cultures and investigations

This review covers several aspects of microfluidic devices used for culturing and monitoring of both adherent and non-adherent cells, including a multitude of applications. A comparison of available platforms with high throughput analysis, automation capability, interface to sensors and integration, is reported. Aspects, such as operational versatility of the devices, are scrutinized in terms of their analytical efficacy. It is found that due to multi-functionality capability of modern microfluidics, there is big amount of experimental data obtainable from a single device, allowing complex experimental control and efficient data correlation, particularly important when biomedical studies are considered. Hence several examples on cell culture and monitoring are given in this review, including details on design of microfluidic devices with their distinctive technological peculiarities

Predicting WNV circulation in Italy using earth observation data and extreme gradient boosting model

West Nile Disease (WND) is one of the most spread zoonosis in Italy and Europe caused by a vector-borne virus. Its transmission cycle is well understood, with birds acting as the primary hosts and mosquito vectors transmitting the virus to other birds, while humans and horses are occasional dead-end hosts. Identifying suitable environmental conditions across large areas containing multiple species of potential hosts and vectors can be difficult. The recent and massive availability of Earth Observation data and the continuous development of innovative Machine Learning methods can contribute to automatically identify patterns in big datasets and to make highly accurate identification of areas at risk. In this paper, we investigated the West Nile Virus (WNV) circulation in relation to Land Surface Temperature, Normalized Difference Vegetation Index and Surface Soil Moisture collected during the 160 days before the infection took place, with the aim of evaluating the predictive capacity of lagged remotely sensed variables in the identification of areas at risk for WNV circulation. WNV detection in mosquitoes, birds and horses in 2017, 2018 and 2019, has been collected from the National Information System for Animal Disease Notification. An Extreme Gradient Boosting model was trained with data from 2017 and 2018 and tested for the 2019 epidemic, predicting the spatio-temporal WNV circulation two weeks in advance with an overall accuracy of 0.84. This work lays the basis for a future early warning system that could alert public authorities when climatic and environmental conditions become favourable to the onset and spread of WNV

Anticoagulant therapy for splanchnic vein thrombosis: an individual patient data meta-analysis

Robust evidence on the optimal management of splanchnic vein thrombosis (SVT) is lacking. We conducted an individual-patient meta-analysis to evaluate the effectiveness and safety of anticoagulation for SVT. Medline, Embase, and clincaltrials.gov were searched up to June 2021 for prospective cohorts or randomized clinical trials including patients with SVT. Data from individual datasets were merged, and any discrepancy with published data was resolved by contacting study authors. Three studies of a total of 1635 patients were included. Eighty-five percent of patients received anticoagulation for a median duration of 316 days (range, 1-730 days). Overall, incidence rates for recurrent venous thromboembolism (VTE), major bleeding, and mortality were 5.3 per 100 patient-years (p-y; 95% confidence interval [CI], 5.1-5.5), 4.4 per 100 p-y (95% CI, 4.2-4.6), and 13.0 per 100 p-y (95% CI, 12.4-13.6), respectively. The incidence rates of all outcomes were lower during anticoagulation and higher after treatment discontinuation or when anticoagulation was not administered. In multivariable analysis, anticoagulant treatment appeared to be associated with a lower risk of recurrent VTE (hazard ratio [HR], 0.42; 95% CI, 0.27-0.64), major bleeding (HR, 0.47; 95% CI, 0.30-0.74), and mortality (HR, 0.23; 95% CI, 0.17-0.31). Results were consistent in patients with cirrhosis, solid cancers, myeloproliferative neoplasms, unprovoked SVT, and SVT associated with transient or persistent nonmalignant risk factors. In patients with SVT, the risk of recurrent VTE and major bleeding is substantial. Anticoagulant treatment is associated with reduced risk of both outcomes. © 2022 by The American Society of Hematology

Breaking the diffusion limit with super-hydrophobic delivery of molecules to plasmonic nanofocusing SERS structures

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Use of an Off the Shelf Inner Branch Thoraco-abdominal Endograft for the Treatment of Juxtarenal and Pararenal Aortic Aneurysms

Objective: To investigate outcomes of an off the shelf pre-loaded inner branched endograft (E-nside) for the treatment of juxtarenal and pararenal abdominal aortic aneurysms (JP-AAAs). Methods: Data from a multicentre registry (INBREED), including patients treated with the E-nside endograft, were collected and analysed prospectively. Patients treated for JP-AAA were included. Pre-operative clinical and anatomical characteristics, procedural data, and 30 day and one year outcomes were recorded. Endpoints were technical success, 30 day death, major adverse events (MAEs), and one year freedom from target vessel instability. Results: Of 185 consecutively treated patients, 47 (25.4%) had a JP-AAA (juxtarenal n = 10, 21%; pararenal n = 37, 79%) and were included in the study; 183 target vessels were incorporated through an inner branch. Procedural setting was emergency or urgent in 18 patients (38%) owing to a contained aortic rupture (n = 2, 4%), symptomatic aneurysm (n = 4, 9%), or aneurysm > 70 mm (n = 12, 26%). The mean length of aortic coverage above the coeliac trunk was 116 ± 7 mm. Technical success was 100% and 30 day mortality rate 4% (n = 2 urgent cases). The 30 day cumulative MAE rate was 26% (n = 12): two stroke (4%); and seven spinal cord ischaemia (15%), with six in an elective setting (21%) and one in an urgent setting (6%), and five leading to permanent paraplegia or paraparesis (10%). Freedom from target vessel instability was 99% after 30 days and 97 ± 3% after one year. Conclusion: Use of an off the shelf inner branched device for treating JP-AAA was feasible in urgent and elective settings, with high technical success and satisfactory target vessel stability at one year. In the treatment of JP-AAA, stroke and spinal cord ischaemia may be associated with arm access and the increased aortic coverage that the design brings

Early Outcomes of a Novel Off the Shelf Preloaded Inner Branch Endograft for the Treatment of Complex Aortic Pathologies in the ItaliaN Branched Registry of E-nside EnDograft (INBREED)

Objective: The aim of this study was to investigate the early outcomes of a novel off the shelf pre-loaded inner branched thoraco-abdominal endograft (E-nside) in the treatment of aortic pathologies.Methods: Data from a physician initiated national multicentre registry on patients treated with the E-nside endograft, were prospectively collected and analysed. Pre-operative clinical and anatomical characteristics, procedural data, and early outcomes (90 days) were recorded in a dedicated electronic data capture system. The primary endpoint was technical success. Secondary endpoints were early mortality (90 days), procedural metrics, target vessel patency, endoleak rate, and major adverse events (MAEs) at 90 days.Results: In total, 116 patients from 31 Italian centres were included. Mean + standard deviation (SD) patient age was 73 + 8 years and 76 (65.5%) were male. Aortic pathologies included degenerative aneurysm in 98 (84.5%), post-dissection aneurysm in five (4.3%), pseudoaneurysm in six (5.2%), penetrating aortic ulcer or intramural haematoma in four (3.4%), and subacute dissection in three (2.6%). Mean + SD aneurysm diameter was 66 + 17 mm; aneurysm extent was Crawford I -III in 55 (50.4%), IV in 21 (19.2%), pararenal in 29 (26.7%), and juxtarenal in four (3.7%). The procedure setting was urgent in 25 (21.5%) patients. Median procedural time was 240 minutes (interquartile range [IQR] 195, 303), with a median contrast volume of 175 mL (IQR 120, 235). The endograft's technical success rate was 98.2% and the 90 day mortality rate was 5.2% (n = 6; 2.1% for elective repair and 16% for urgent repair). The 90-days cumulative MAE rate was 24.1% (n = 28). At 90 days, there were 10 (2.3%) target vessel related events (nine occlusions and one type IC endoleak) and one type 1A endoleak requiring re-intervention.Conclusion: In this real life, non-sponsored registry, the E-nside endograft was used for the treatment of a broad spectrum of aortic pathologies, including urgent cases and different anatomies. The results showed excellent technical implantation safety and efficacy, as well as early outcomes. Longer term follow up is needed to better define the clinical role of this novel endograft

Outcomes of off-the-shelf preloaded inner branch device for urgent endovascular thoraco-abdominal aortic repair in the ItaliaN Branched Registry of E-nside EnDograft

Objective: The aim of this study was to report the outcomes of endovascular urgent thoracoabdominal aortic (TAAA) repair, using an off-the-shelf preloaded inner branch device (E-nside; Artivion). Methods: Data from a physician-initiated national multicenter registry, including patients treated with E-nside endograft (INBREED) were prospectively collected (2020-2024); only urgent cases were included in this study. Primary outcomes were technical success and mortality at 30 days. Secondary outcomes were spinal cord ischemia rate, stroke rate, major adverse events (MAE) as also branch instability at 12 months. Results: Of 185 patients enrolled in the INBREED, 64 (34.5%) were treated in a urgent setting and were included in the study. Reason for urgent repair was presence of aneurysm-related symptoms in 31 patients (48.4%), a contained rupture in eight (12.5%), and a large aneurysm >80 mm in 25 (39.1%). Extent of repair was I to III in 32 patients (50%) and IV in 32 (50%); 18 (28%) had a narrow (<25 mm) paravisceral aortic lumen. An adjunctive proximal thoracic endograft was deployed in 29 patients (45.3%); a distal bifurcated abdominal endograft was used in 33 (51.5%). Two hundred forty-nine target vessels (97.2%) were successfully incorporated through an inner branch from an upper arm (81.2%) or femoral (18.8%) access. A balloon expandable stent was used in 184 (75.7%) target vessels, a self-expandable stent in 59 (24.3%). Mean time for target vessel bridging was 39.9 ± 28.4 minutes per target vessel. Thirty-day cumulative major adverse event (MAE) rate was 28%, and mortality occurred in five patients (9.1%). There was one postoperative stroke (1.6%), and the spinal cord ischemia (SCI) rate was 8% (n = 5). For the 249 target vessels successfully incorporated through an inner branch, 1-year freedom from target vessel instability was 93% ± 3% after 1 year. Conclusions: The E-nside represents a valid solution for the urgent treatment of TAAAs, including symptomatic and ruptured TAAAs, as well as large asymptomatic TAAAs that cannot wait for a custom-made device. The preloaded inner branches and available proximal and distal graft diameters might be useful in urgent settings and provided satisfactory early and 1-year results, in terms of both endograft and target vessel stability. Further studies are required to assess the clinical role of E-nside for urgent TAAA repair

ISSN exercise & sport nutrition review: research & recommendations

Sports nutrition is a constantly evolving field with hundreds of research papers published annually. For this reason, keeping up to date with the literature is often difficult. This paper is a five year update of the sports nutrition review article published as the lead paper to launch the JISSN in 2004 and presents a well-referenced overview of the current state of the science related to how to optimize training and athletic performance through nutrition. More specifically, this paper provides an overview of: 1.) The definitional category of ergogenic aids and dietary supplements; 2.) How dietary supplements are legally regulated; 3.) How to evaluate the scientific merit of nutritional supplements; 4.) General nutritional strategies to optimize performance and enhance recovery; and, 5.) An overview of our current understanding of the ergogenic value of nutrition and dietary supplementation in regards to weight gain, weight loss, and performance enhancement. Our hope is that ISSN members and individuals interested in sports nutrition find this review useful in their daily practice and consultation with their clients