Oncological resection and perioperative outcomes of robotic, laparoscopic and open pancreatoduodenectomy for ampullary adenocarcinoma: a propensity score matched international multicenter cohort study.

Background: Ampullary adenocarcinoma (AAC) typically presents at an early stage due to biliary obstruction and therefore might be specifically suitable for minimally invasive pancreatoduodenectomy (MIPD). However, studies assessing MIPD specifically for AAC, including the robotic and laparoscopic approach, are limited. The aim of this study is to compare short- and long-term oncological resection and perioperative outcomes of robotic (RPD), laparoscopic (LPD) and open pancreatoduodenectomy (OPD) performed specifically for AAC.

Evolution and ecology of anti-defence systems in phages and plasmids.

Prokaryotes (Bacteria and Archaea) encode a highly diversified arsenal of defence systems that protect them against mobile genetic elements, such as phages and plasmids. In turn, mobile genetic elements encode anti-defence systems that allow them to escape the activity of these defence systems. This has resulted in an evolutionary arms race in which defence systems and anti-defence systems evolve and adapt continuously, driving intriguing innovation and enormous diversification on both sides.

Source segregation and treatment of urine and faeces from dairy cattle reduces GHG and NH emissions in covered storage.

Managing dairy excreta as slurry can result in significant emissions of ammonia (NH) and greenhouse gases (GHGs) during storage and thereafter. Additionally, slurry often has an imbalanced nitrogen (N) to phosphorus (P) ratio for crop fertilization. While various treatments exist to address emissions and nutrient imbalances, each has trade-offs that can result in pollution swapping.

Nephron-sparing Surgery for Pediatric Renal Tumors After Centralization of Pediatric Oncology Care in the Netherlands: Improved Outcomes With 3D Modeling.

Background And Aim: In this retrospective single center cohort study, we report the surgical outcomes of nephron-sparing surgery (NSS) for Wilms' tumor (WT) patients since centralization of pediatric oncology care in the Netherlands, and implementation of technological advancements. Therewith we describe the influence of experience and innovations for this type of surgery.

Methods: We retrospectively assessed all NSS procedures from January 1st 2015 until January 1st 2024 for patients who underwent surgery for a renal tumor at the Princess Máxima Center for Pediatric Oncology.

Bluetongue virus serotype 12 in sheep and cattle in the Netherlands in 2024 - A BTV serotype reported in Europe for the first time.

Bluetongue (BT) is a viral vector borne disease primarily affecting ruminants such as sheep, cattle, and goats. On 3 September 2023, the Netherlands reported the first case of bluetongue virus serotype 3 (BTV-3/NET2023)), after being BTV free for eleven years. Vaccination with inactivated BT vaccines for serotype 3 has been applied in the Netherlands since May 2024.

Developmental trajectories of visual orienting functions in children born very or extremely preterm.

Background And Aims: Preterm birth increases the risk of neurodevelopmental impairments, such as Cerebral Visual Impairment (CVI), which affects visual processing. Assessing visual functions in young children is challenging with traditional methods that often rely on verbal/motor responses. The aim of the study was to investigate the developmental trajectories of Visual Orienting Functions (VOF) in children born very preterm (<32 weeks gestational age) between 2 and 5 years corrected age (CA) using eye tracking.

Rare delayed hypersensitivity reactions to contrast media: Severe cutaneous adverse reactions.

The risk of developing a severe delayed cutaneous reaction (SCAR) is very low following iodine-based contrast medium (ICM) administration and extremely low following gadolinium-based contrast agent (GBCA) administration. However, SCAR can be very severe and potentially life-threatening. It is crucial for the imaging physician to recognize danger signals: bullous skin eruption, skin erosion and detachment, mucosal involvement, systemic symptoms, and laboratory abnormalities.

Prognostic significance of serum complement activation, neutrophil extracellular traps and extracellular DNA in newly diagnosed epithelial ovarian cancer.

Purpose: We observed that the tumor microenvironment (TME) in metastatic epithelial ovarian cancer (EOC) and in other solid tumors can reprogram normal neutrophils to acquire a complement-dependent suppressor phenotype characterized by inhibition of stimulated T cell activation. This study aims to evaluate whether serum markers of neutrophil activation and complement at diagnosis of EOC would be associated with clinical outcomes.

Experimental Design: We conducted a two-center prospective study of patients with newly diagnosed EOC (N = 188).

Postdural puncture headache: Beyond the evidence.

Despite advances in procedural techniques and equipment, postdural puncture headache (PDPH) remains a serious complication of labour epidural analgesia after accidental dural puncture (ADP). Often considered a temporary inconvenience, PDPH can be debilitating in the short term. It can also be associated with chronic manifestations and serious complications.

Prevalence of child maltreatment in Albania.

Background: Child maltreatment is a global issue that significantly impacts children's lives. In 2018, 32% of 15-year-olds in Albania reported experiencing physical abuse.

Aim: To assess the prevalence and sociodemographic correlates of child abuse and neglect in Albania.

Demonstration of Major Therapeutic Advantage From a Review of EU Conditional Marketing Authorizations in Oncology and Hematology.

In the EU, conditional marketing authorization is a pragmatic tool for early approval of a medicine that fulfills an unmet medical need. In the pharmaceutical legislation, an unmet medical need means that a condition lacks a satisfactory method for diagnosis, prevention, or treatment. If such satisfactory methods exist, the new medicinal product must hold a major therapeutic advantage for those affected, meaning that it must demonstrate an improvement in efficacy or safety over existing methods or, in exceptional cases, a major improvement in patient care.

Genomic Prediction of Individual Inbreeding Levels for the Management of Genetic Diversity in Populations With Small Effective Size.

In populations of small effective size (N), such as those in conservation programmes, companion animals or livestock species, inbreeding control is essential. Homozygosity-by-descent (HBD) segments provide relevant information in that context, as they allow accurate estimation of the inbreeding coefficient, provide locus-specific information and their length is informative about the "age" of inbreeding. Our objective was to evaluate tools for predicting HBD in future offspring based on parental genotypes, a problem equivalent to identifying segments identical-by-descent (IBD) among the four parental chromosomes.

Greater return to sports after anterior cruciate ligament reconstruction combined with anterolateral ligament reconstruction compared with anterior cruciate ligament reconstruction alone: A systematic review and meta-analysis.

Purpose: This study aimed to compare the return to sports, return to competition, Tegner score and anterior cruciate ligament-return to sports injury (ACL-RSI) scores between patients who underwent ACL reconstruction (ACLR) combined with anterolateral ligament reconstruction (ALLR) and those who underwent ACLR alone.

Methods: Two independent reviewers conducted a literature search in PubMed (MEDLINE), EMBASE, Google Scholar and the Cochrane Library in July 2024, followed by data extraction and quality assessment. This study followed the Preferred Reporting Items for Systematic Reviews and meta-analysis guidelines.

Electronic cigarette usage amongst high school students in South Africa: a mixed methods approach.

Background: The WHO has highlighted that: "promotion of e-cigarettes has led to marked increases in e-cigarette use by children and adolescents." The long-term neuropsychiatric and psychological consequences of substance abuse in adolescence is well recognised. Limited data exists on the adolescent burden of vaping-related nicotine addiction and behavioural and/or psychological dependence to guide pharmacological or behavioural interventions to stop electronic cigarette usage.

Medication non-adherence: reflecting on two decades since WHO adherence report and setting goals for the next twenty years.

Background: Non-adherence to medication remains a persistent and significant challenge, with profound implications for patient outcomes and the long-term sustainability of healthcare systems. Two decades ago, the World Health Organization (WHO) dedicated its seminal report to adherence to long-term therapies, catalysing notable changes that advanced both research and practice in medication adherence. The aim of this paper was to identify the most important progress made over the last 2 decades in medication adherence management and to initiate a discussion on future objectives, suggesting priority targets for the next 20 years.

Isolation and characterization of cellulose-mineralizing haloalkaliphilic bacteria from Siberian soda lakes.

Soda lakes are unique double-extreme habitats characterized by high salinity and soluble carbonate alkalinity, yet harboring rich prokaryotic life. Despite intensive microbiology studies, little is known about the identity of the soda lake hydrolytic bacteria responsible for the primary degradation of the biomass organic matter, in particular cellulose. In this study, aerobic and anaerobic enrichment cultures with three forms of native insoluble cellulose inoculated with sediments from five soda lakes in south-western Siberia resulted in the isolation of four cellulotrophic haloalkaliphilic bacteria and their four saccharolytic satellites.

The Uluzzian and Châtelperronian: No Technological Affinity in a Shared Chronological Framework.

Unlabelled: The Châtelperronian and Uluzzian techno-complexes are identified in western Europe in the same stratigraphic position, between the late Middle Palaeolithic and other Upper Palaeolithic assemblages. Both industries include retouched artefacts with abrupt retouch and arched backs, and radiometric dating indicates that these two technocomplexes belong to the same window of time. Here, we provide a detailed, qualitative technological comparison of two Châtelperronian and two Uluzzian lithic assemblages based on a collaborative, first-hand examination of these collections.

Biosecurity measures reducing spp. and hepatitis E virus prevalence in pig farms-a systematic review and meta-analysis.

spp. and hepatitis E virus (HEV) are significant foodborne zoonotic pathogens that impact the health of livestock, farmers, and the general public. This study aimed to identify biosecurity measures (BSMs) against these pathogens on swine farms in Europe, the United States, and Canada.

The additional value of self-reflection and feedback on therapy outcome: a pilot study.

Introduction: Over the past few decades, psychotherapy research was dominated by testing the efficacy of "brand name" therapeutic techniques and models. Another line of research however, suggests that common factors, such as the therapeutic alliance and empathy, might play a greater role in effective therapy than specific therapeutic techniques and models. Routine process monitoring (RPM), focusing on common factors, has emerged as a promising approach to enhance therapy outcomes.

Association between somatic microsatellite instability, hypermutation status, and specific T cell subsets in colorectal cancer tumors.

Background: Microsatellite instability-high (MSI-high) tumors comprise ~15% of sporadic colorectal cancers (CRC) and are associated with elevated T cell infiltration. However, the universality of this response across T cell subtypes with distinct functions is unknown.

Methods: Including 1,236 CRC tumors from three observational studies, we conducted T cell profiling using a customized 9-plex (CD3, CD4, CD8, CD45RA, CD45RO, FOXP3, KRT, MKI67, and DAPI) multispectral immunofluorescence assay.

'We need to be part of the solution': lessons from the 2024 PPRI Conference on ensuring access to affordable medicines through innovative policies.

On 25-26 April 2024, the 5th PPRI (Pharmaceutical Pricing and Reimbursement Information) Conference on ensuring equitable access to affordable medicines took place in Vienna (Austria). Twenty-four accepted contributions were presented either as oral presentations or posters, adding to invited keynote lectures, stakeholder debates and workshops. The global multi-stakeholder audience discussed a range of approaches in pharmaceutical policies, which have the potential to successfully and sustainably address current and future challenges in ensuring patient access to affordable medicines globally.