Modeling Climate-Driven Vegetation Changes Under Contrasting Temperate and Arid Conditions in the Mediterranean Basin.

This study investigates climate change impacts on spontaneous vegetation, focusing on the Mediterranean basin, a hotspot for climatic changes. Two case study areas, Monti Sibillini (central Italy, temperate) and Sidi Makhlouf (Southern Tunisia, arid), were selected for their contrasting climates and vegetation. Using WorldClim's CMCC-ESM2 climate model, future vegetation distribution was predicted for 2050 and 2080 under SSP 245 (optimistic) and 585 (pessimistic) scenarios.

End-procedural adherence to recommended hemodynamic targets does not improve the outcome of elective tips in cirrhotic patients.

Background Aims: In clinical practice, the reduction of porto-caval pressure gradient (PCPG) following trans-jugular intra-hepatic porto-systemic shunt (TIPS) does not always meet the recommendation of current guidance. We evaluated the impact of different degrees of PCPG reduction, measured at the end of an elective TIPS, on ascites control, recurrence of portal hypertension-related bleeding (PHRB) and survival.

Approach And Results: Cirrhotic patients receiving TIPS for refractory ascites (RA) or for the secondary prophylaxis of PHRB were consecutively enrolled.

Treatment Outcomes and Toxicities of Multiple Tyrosin Kinase Inhibitors for Metastatic Medullary Thyroid Cancer: A Case Series.

: The current possible treatments of advanced medullary carcinoma (MTC) include different drugs belonging to the class of tyrosine kinase inhibitors (TKIs): vandetanib, cabozantinb, and selpercatinib. Although the effects of these TKIs have been well described in clinical trials, the real-practice evidence of the effectiveness and safety of these treatment is scant. This real-world case series aims to describe a niche of patients with advanced MTC treated with more than one TKI by focusing on treatment responses and any reported adverse events (AEs) and to provide additional insight on the individualized approach to the management of metastatic MTC.

Trends in Demographic Characteristics and Risk Factors among Individuals with Syphilis in Colorado from 2011-2020.

Background: Identify opportunities to improve syphilis screening by describing changes in patient characteristics and risk factors among individuals with syphilis and by comparing cases with and without an indication for syphilis screening.

Methods: This retrospective cohort study used Colorado public health surveillance data to identify 8,326 syphilis diagnoses from 2011-2020. Demographics, clinical characteristics, and risk factors were compared across 2-year groups and between individuals with and without an indication for screening.