Transperineal Laser Ablation (TPLA) Treatment of Focal Low-Intermediate Risk Prostate Cancer.

Background: This interventional pilot study aimed to evaluate the short-term (3 years) efficacy of focal laser ablation (FLA) in treating the index lesion of low-intermediate-risk prostate cancer, along with assessing the safety of the procedure (ClinicalTrials.gov ID NCT04045756). Methods: Forty patients aged between 46 and 86 with histologically proven organ-confined prostate cancer and low-to-intermediate progression risk were included. FLA was performed under percutaneous fusion magnetic resonance/ultrasound guidance in a Day Hospital setting under local anesthesia. Patients underwent regular clinical and functional assessments through the international index of erectile function (IIEF-5) and the International Prostatism Symptom Score (IPSS), PSA measurements, post-procedure MRI scans, and biopsies at 36 months or if positive findings were detected earlier. Statistical analyses were conducted to assess trends in PSA levels and cavity dimensions over time. Results: Forty patients were initially included, with fifteen lost to follow-up. At 36 months, a mean PSA reduction of 60% was observed, and 80% of MRI scans showed no signs of in-field clinically significant residual/recurrent cancer. Biopsies at 36 months revealed no malignant findings in 20 patients. No deterioration in sexual function or urinary symptoms was recorded. Conclusions: FLA appears to be safe, feasible, and effective in the index lesion treatment of low-intermediate-risk prostate cancer, with a high rate of tumor eradication and preservation of quality of life.

Vaccine Hesitancy, Knowledge, and COVID-19 Vaccination in a Sample of Italian and Albanian Healthcare Students Attending an University in Albania.

BACKGROUND: Vaccine hesitancy (VH) has increased over the past decade with large geographical variations between countries, posing a threat to global public health. This phenomenon is growing in the general population as well as among healthcare workers (HCWs), who are the most reliable source of vaccine-related information for patients. Special attention must therefore be paid to medical students, who are the future HCWs. METHODS: We conducted a cross-sectional study (November 2022-January 2023) on all the Albanian and Italian students attending medical science courses at the Catholic University "Our Lady of Good Counsel" (Tirane, Albania) to investigate VH and the factors contributing to it (using the Vaccination Attitude Examination Scale-VAX), including COVID-19 vaccination. Vaccine knowledge was assessed using the Zingg and Siegrist Scale. Students were asked to voluntarily answer an anonymous questionnaire. RESULTS: 689 questionnaires were collected (58.8% Albanians, 72.3% female; 70.4% aged 20-25 years; 70.4% attending the Medicine and Surgery course). Generally, students showed low VH, especially Italians (p < 0.001); however, some hesitancy was observed regarding the potential long-term effects of vaccines, especially among Albanians (p < 0.05). The results also showed a significant difference in vaccine knowledge scores between different course years (χ2 = 90.058; df = 40; p = < 0.001) and different degree courses (χ2 = 89.932; df = 40; p = < 0.001). With regard to COVID-19 vaccination, being of Albanian origin significantly increases the risk of not being vaccinated (OR = 7.215; 95%CI 3.816-13.640, p < 0.001), highlighting possible differences in vaccine coverage and policy between the two countries. CONCLUSION: Vaccine hesitancy should be addressed at early stages during medical sciences courses, in order to protect future healthcare workers, to preserve essential health services, and reduce the risk of further pandemics.

Lung clearance index short-term variability in cystic fibrosis: a pre-post pulmonary exacerbation study.

BACKGROUND: Multiple Breath washout (MBW) represents an important tool to detect early a possible pulmonary exacerbation especially in Cystic Fibrosis (CF) disease. Lung clearance index (LCI) is the most commonly reported multiple breath washout (MBW) index and in the last years was used as management measure for evaluation. Our aim was to analyze clinical utility of LCI index variability in pulmonary exacerbation in CF after intravenous (IV) antibiotic therapy. METHODS: A single-center study was conducted at CF Unit of Bambino Gesù Children's Hospital among hospitalized > 3 years patients for pulmonary exacerbations and treated with antibiotic IV treatment for 14 days. MBW and spirometry were evaluated within 72 h of admission to hospital and at the end of hospitalization. Descriptive analysis was conducted and correlations between quantitative variables were investigated. RESULTS: Fifty-seven patients (M22/F35) with an average age 18.56 (± 8.54) years were enrolled. LCI2.5 was significantly reduced at the end of antibiotic treatment in both pediatric and adult populations with an average reduction of -6,99%; 37/57 patients denoted an improvement, 20/57 are stable or worsened in LCI2.5 values and 4/57 (7.02%) had a significant deterioration (> 15%) at end of treatment. On the contrary a significative elevation of FEV1 and FVC were found, respectively of + 7,30% and of + 5,46%. A positive good correlection among LCI 2.5 and Scond (rho = + 0,615, p = 0.000) and LCI 2.5 and Sacin (rho = + 0,649, p = 0.000) and a negative strong correlation between FEV1 and LCI 2.5 were found in post treatment period. A similar modification of LCI 2.5 and FEV1 was noticed in both adult and pediatric population. CONCLUSIONS: LCI may have a role in the routine clinical care of both adult and pediatric CF patients as a good tool to assess response to IV antibiotic end-therapy in the same way as FEV1.

Enhancing Radiation Detection by Drones through Numerical Fluid Dynamics Simulations.

This study addresses the optimization of the location of a radioactive-particle sensor on a drone. Based on the analysis of the physical process and of the boundary conditions introduced in the model, computational fluid dynamics simulations were performed to analyze how the turbulence caused by drone propellers may influence the response of the sensors. Our initial focus was the detection of a small amount of radioactivity, such as that associated with a release of medical waste. Drones equipped with selective low-cost sensors could be quickly sent to dangerous areas that first responders might not have access to and be able to assess the level of danger in a few seconds, providing details about the source terms to Radiological-Nuclear (RN) advisors and decision-makers. Our ultimate application is the simulation of complex scenarios where fluid-dynamic instabilities are combined with elevated levels of radioactivity, as was the case during the Chernobyl and Fukushima nuclear power plant accidents. In similar circumstances, accurate mapping of the radioactive plume would provide invaluable input-data for the mathematical models that can predict the dispersion of radioactivity in time and space. This information could be used as input for predictive models and decision support systems (DSS) to get a full situational awareness. In particular, these models may be used either to guide the safe intervention of first responders or the later need to evacuate affected regions.