Endoscopic Contrast-Enhanced Ultrasound and Fine-Needle Aspiration or Biopsy for the Diagnosis of Pancreatic Solid Lesions: A Systematic Review and Meta-Analysis.

INTRODUCTION: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) are currently recommended for the pathologic diagnosis of pancreatic solid lesions (PSLs). The application of contrast-enhanced endoscopic ultrasound (ECEUS) could aid the endoscopist during an FNA and/or FNB procedure. CEUS is indeed able to better differentiate the pathologic tissue from the surrounding healthy pancreatic parenchyma and to detect necrotic areas and vessels. OBJECTIVES: Our objective was to evaluate if ECEUS could reduce the number of needle passes and side effects and increase the diagnostic efficacy of FNA and/or FNB. METHODS: A comprehensive literature search of clinical studies was performed to explore if ECEUS-FNA or FNB could increase diagnostic accuracy and reduce the number of needle passes and adverse effects compared to standard EUS-FNA or FNB. In accordance with the study protocol, a qualitative and quantitative analysis of the evidence was planned. RESULTS: The proportion of established diagnoses of ECEUS was 90.9% compared to 88.3% of EUS, with no statistically significant difference (p = 0.14). The diagnosis was made through a single step in 70.9% of ECEUS patients and in 65.3% of EUS patients, without statistical significance (p = 0.24). The incidence of adverse reactions was substantially comparable across both groups (p = 0.89). CONCLUSION: ECEUS-FNA and FNB do not appear superior to standard EUS-FNA and FNB for the diagnosis of pancreatic lesions.

Shear-wave elastography to predict hepatocellular carcinoma after hepatitis C virus eradication: A systematic review and meta-analysis.

BACKGROUND: Direct-acting antiviral agents (DAAs) are highly effective treatment for chronic hepatitis C (CHC) with a significant rate of sustained virologic response (SVR). The achievement of SVR is crucial to prevent additional liver damage and slow down fibrosis progression. The assessment of fibrosis degree can be performed with transient elastography, magnetic resonance elastography or shear-wave elastography (SWE). Liver elastography could function as a predictor for hepatocellular carcinoma (HCC) in CHC patients treated with DAAs. AIM: To explore the predictive value of SWE for HCC development after complete clearance of hepatitis C virus (HCV). METHODS: A comprehensive literature search of clinical studies was performed to identify the ability of SWE to predict HCC occurrence after HCV clearance. In accordance with the study protocol, a qualitative and quantitative analysis of the evidence was planned. RESULTS: At baseline and after 12 wk of follow-up, a trend was shown towards greater liver stiffness (LS) in those who go on to develop HCC compared to those who do not [baseline LS standardized mean difference (SMD): 1.15, 95% confidence interval (95%CI): 020-2.50; LS SMD after 12 wk: 0.83, 95%CI: 0.33-1.98]. The absence of a statistically significant difference between the mean LS in those who developed HCC or not may be related to the inability to correct for confounding factors and the absence of raw source data. There was a statistically significant LS SMD at 24 wk of follow-up between patients who developed HCC vs not (0.64; 95%CI: 0.04-1.24). CONCLUSION: SWE could be a promising tool for prediction of HCC occurrence in patients treated with DAAs. Further studies with larger cohorts and standardized timing of elastographic evaluation are needed to confirm these data.

Proof-of-Concept Quantum Simulator Based on Molecular Spin Qudits.

The use of d-level qudits instead of two-level qubits can largely increase the power of quantum logic for many applications, ranging from quantum simulations to quantum error correction. Magnetic molecules are ideal spin systems to realize these large-dimensional qudits. Indeed, their Hamiltonian can be engineered to an unparalleled extent and can yield a spectrum with many low-energy states. In particular, in the past decade, intense theoretical, experimental, and synthesis efforts have been devoted to develop quantum simulators based on molecular qubits and qudits. However, this remarkable potential is practically unexpressed, because no quantum simulation has ever been experimentally demonstrated with these systems. Here, we show the first prototype quantum simulator based on an ensemble of molecular qudits and a radiofrequency broadband spectrometer. To demonstrate the operativity of the device, we have simulated quantum tunneling of the magnetization and the transverse-field Ising model, representative of two different classes of problems. These results represent an important step toward the actual use of molecular spin qudits in quantum technologies.

Gut dysbiosis-related thrombosis in inflammatory bowel disease: Potential disease mechanisms and emerging therapeutic strategies.

Patients with inflammatory bowel disease (IBD) have an increased risk of developing venous thromboembolic events, which have a considerable impact on morbidity and mortality. Chronic inflammation plays a crucial role in the pathogenesis of thrombotic events in patients with IBD. However, many unresolved questions remain, particularly regarding the mechanisms that determine the persistent inflammatory state independent of disease activity. This review explored the role of gut microbiota dysbiosis and intestinal barrier dysfunction, which are considered distinctive features of IBD, in determining pro-thrombotic tendencies. Gut-derived endotoxemia due to the translocation of bacterial lipopolysaccharides (LPS) from the intestine to the bloodstream and the bacterial metabolite trimethylamine-N-oxide (TMAO) are the most important molecules involved in gut dysbiosis-related thrombosis. The pathogenic prothrombotic pathways linked to LPS and TMAO have been discussed. Finally, we present emerging therapeutic approaches that can help reduce LPS-mediated endotoxemia and TMAO, such as restoring intestinal eubiosis, normalizing intestinal barrier function, and counterbalancing the effects of LPS and TMAO.

Low-Dose Rivaroxaban to Prevent Recurrences of Venous Thromboembolism in Cancer: A Real-Life Experience with a Focus on Female Patients.

BACKGROUND: The way in which to prevent recurrent venous thromboembolism (VTE) is an unmet clinical need in cancer patients. International guidelines only provide conditional recommendations and do not specify which anticoagulant and dose should be used. In the last 2 years, we have been using low-dose rivaroxaban to prevent VTE recurrences in cancer patients. The results of this real-life experience are presented in this study. METHODS: All patients had cancer and had previously completed a cycle of at least six months of full-dose anticoagulation for the treatment of a VTE index event, before receiving a prescription of low-dose rivaroxaban (10 mg once daily) for secondary prevention of VTE. Effectiveness and safety of this therapeutic regimen were evaluated in terms of VTE recurrences, major bleedings (MB), and clinically relevant non-major bleedings (CRNMB). RESULTS: The analysis included 106 cancer patients. Their median age was 60 years (IQR 50-69). Metastatic cancer was present in 87 patients (82.1%). Six patients (5.7%) had brain metastases. Over a median follow-up time of 333 days (IQR 156-484), the incidence of VTE recurrences was 3.8% (95%CI 1.0-9.4), with a recurrence rate of 4.0 per 100 person-years (95%CI 1.1-10.2). We observed no MB (0.0%) and three CRNMB (2.8%) (95%CI 0.6-8.1). CONCLUSIONS: Low-dose rivaroxaban is potentially effective and safe in cancer patients that require prevention of recurrent VTE. Large-scale studies are needed to confirm these findings.

Chiral-induced spin selectivity in photo-induced electron transfer: Investigating charge and spin dynamics in a master equation framework.

Investigating the role of chiral-induced spin selectivity in the generation of spin correlated radical pairs in a photoexcited donor-chiral bridge-acceptor system is fundamental to exploit it in quantum technologies. This requires a minimal master equation description of both charge separation and recombination through a chiral bridge. To achieve this without adding complexity and entering in the microscopic origin of the phenomenon, we investigate the implications of spin-polarizing reaction operators to the master equation. The explicit inclusion of coherent evolution yields non-trivial behaviors in the charge and spin dynamics of the system. Finally, we apply this master equation to a setup comprising a molecular qubit attached to the donor-bridge-acceptor molecule, enabling qubit initialization, control, and read-out. Promising results are found by simulating this sequence of operations assuming realistic parameters and achievable experimental conditions.

Ultrasound Elastography to Assess Age of Deep Vein Thrombosis: A Systematic Review.

BACKGROUND AND AIMS: Deep-vein thrombosis (DVT) is a widely diffused condition, and its accurate staging has major clinical and therapeutic implications. Ultrasound elastography (UE) is a rapidly evolving imaging technique that allows quantification of elastic tissue properties and could play a crucial role in determining thrombus age. The aim of this review is to find clinical evidence regarding the application of UE in the evaluation of DVT and its usefulness in differentiating thrombosis age. METHODS: A literature search of clinical studies was performed to identify the ability of UE of discriminate acute, subacute, and chronic DVT. Heterogeneity and publication bias were calculated. In accordance with the study protocol, a qualitative analysis of the evidence was planned. The results were summarized with a comprehensive summary table of study characteristics and baseline characteristics of participant patients. RESULTS: Nine studies matched the predetermined eligibility requirements for this systematic review regarding the risk of bias; the greatest criticalities were found within the domains of patient selection and index test. Based on the quality assessment, two publications were excluded from the qualitative synthesis because of the presence of significant applicability concerns. Among the seven studies that were considered eligible for qualitative synthesis, four evaluated strain elastography and three evaluated shear-wave elastography. Despite significant differences concerning study design, thrombus age definitions, and patient characteristics, nearly all studies demonstrated an increase in thrombus stiffness according to DVT age. CONCLUSIONS: UE could play a key role in routine ultrasound examination of DVT. The measurement of thrombus stiffness has a high biological plausibility and its use is supported by the finding of a correlation between the stiffness and the progression of the DVT age.

Correction: Quantum error correction with molecular spin qudits.

Correction for 'Quantum error correction with molecular spin qudits' by Mario Chizzini et al., Phys. Chem. Chem. Phys., 2022, https://doi.org/10.1039/D2CP01228F.

Quantum error correction with molecular spin qudits.

Thanks to the large number of levels which can be coherently manipulated, molecular spin systems constitute a very promising platform for quantum computing. Indeed, they can embed quantum error correction within single molecular objects, thus greatly simplifying its actual realization in the short term. We consider a recent proposal, which exploits a spin qudit to encode the protected unit, and is tailored to fight pure dephasing. Here we compare the implementation of this code on different molecules, in which the qudit is provided by either an electronic or a nuclear spin (S, I > 1), coupled to a spin-1/2 electronic ancilla for error detection. By thorough numerical simulations we show that a significant gain in the effective phase memory time can be achieved. This is further enhanced by exploiting pulse-shaping techniques to reduce the leakage and/or the impact of decoherence during correction. Moreover, we simulate the implementation of single-qubit operations on the encoded states.

A Cost-Effective Semi-Ab Initio Approach to Model Relaxation in Rare-Earth Single-Molecule Magnets.

We discuss a cost-effective approach to understand magnetic relaxation in the new generation of rare-earth single-molecule magnets. It combines ab initio calculations of the crystal field parameters, of the magneto-elastic coupling with local modes, and of the phonon density of states with fitting of only three microscopic parameters. Although much less demanding than a fully ab initio approach, the method gives important physical insights into the origin of the observed relaxation. By applying it to high-anisotropy compounds with very different relaxation, we demonstrate the power of the approach and pinpoint ingredients for improving the performance of single-molecule magnets.

Imaging of Carotid Plaque Neovascularization by Contrast-Enhanced Ultrasound and Dynamic Contrast-Enhanced Magnetic Resonance Imaging.

BACKGROUND: Carotid plaque neovascularization (vasa vasorum [VV]) may be useful for detecting high-risk atherosclerotic plaques. Contrast-enhanced ultrasound (CEUS) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) are 2 commonly used techniques for imaging VV of the carotid plaque, yet the relationship between their measurements remains unknown. OBJECTIVES: We aimed to blindly evaluate the correlation between CEUS and DCE-MRI in measuring carotid plaque VV. METHODS: We recruited subjects with asymptomatic carotid stenosis (≥50%). VV was graded by CEUS, based on richness of contrast signal, according to 3 different methods named CEUS_A, CEUS_B and CEUS_C on different point scales (the higher the values, the higher the estimated VV). A 3.0 T MRI scanner was used for VV quantification by DCE-MRI using gadolinium contrast kinetic modelling for computing the fractional plasma volume (vp) and transfer constant (Ktrans). RESULTS: The analysis included 30 patients. A significant correlation between CEUS and DCE-MRI findings was observed when CEUS_C was used for neovessel grading and DCE-MRI was used to determine adventitial (r = 0.460, p = 0.010) and plaque (r = 0.374, p = 0.042) Ktrans values. CEUS_B (r = 0.416, p = 0.022) and CEUS_C (r = 0.443, p = 0.014) grading showed a significant correlation with regard to the maximal Ktrans. CONCLUSIONS: We found a positive but weak correlation and a moderate diagnostic agreement between neovessels as visually graded by CEUS and adventitial neovessels assessed by DCE-MRI Ktrans in carotid atherosclerosis. These findings may help in understanding how VV density, flow, and permeability influence in vivo measurements by CEUS and DCE-MRI as well as in selecting the most appropriate variables and imaging method in future research and potentially in clinical settings. Further confirmative studies are necessary to confirm our results.

Correction: Anisotropy of CoII transferred to the Cr7Co polymetallic cluster via strong exchange interactions.

[This corrects the article DOI: 10.1039/C8SC00163D.].

Anisotropy of CoII transferred to the Cr7Co polymetallic cluster via strong exchange interactions.

The Cr7Co ring represents a model system to understand how the anisotropy of a CoII ion is transferred to the effective anisotropy of a polymetallic cluster by strong exchange interactions. Combining sizeable anisotropy with exchange interactions is an important point in the understanding and design of new anisotropic molecular nanomagnets addressing fundamental and applicative issues. By combining electron paramagnetic resonance and inelastic neutron scattering measurements with spin Hamiltonian and ab initio calculations, we have investigated in detail the anisotropy of the CoII ion embedded in the antiferromagnetic ring. Our results demonstrate a strong and anisotropic exchange interaction between the Co and the neighbouring Cr ions, which effectively transmits the anisotropy to the whole molecule.

Data on consistency among different methods to assess atherosclerotic plaque echogenicity on standard ultrasound and intraplaque neovascularization on contrast-enhanced ultrasound imaging in human carotid artery.

Here we provide the correlation among different carotid ultrasound (US) variables to assess echogenicity n standard carotid US and to assess intraplaque neovascularization on contrast enhanced US. We recruited 45 consecutive subjects with an asymptomatic≥50% carotid artery stenosis. Carotid plaque echogenicity at standard US was visually graded according to Gray-Weale classification (GW) and measured by the greyscale median (GSM), a semi-automated computerized measurement performed by Adobe Photoshop®. On CEUS imaging IPNV was graded according to the visual appearance of contrast within the plaque according to three different methods: CEUS_A (1=absent; 2=present); CEUS_B a three-point scale (increasing IPNV from 1 to 3); CEUS_C a four-point scale (increasing IPNV from 0 to 3). We have also implemented a new simple quantification method derived from region of interest (ROI) signal intensity ratio as assessed by QLAB software. Further information is available in "Contrast-enhanced ultrasound imaging of intraplaque neovascularization and its correlation to plaque echogenicity in human carotid arteries atherosclerosis (M. Cattaneo, D. Staub, A.P. Porretta, J.M. Gallino, P. Santini, C. Limoni et al., 2016) [1].

Contrast-enhanced ultrasound imaging of intraplaque neovascularization and its correlation to plaque echogenicity in human carotid arteries atherosclerosis.

BACKGROUND: Currently the most widely accepted predictor of stroke risk in patients with carotid atherosclerosis is the degree of stenoses. Plaque echogenicity on ultrasound imaging (US) and intraplaque neovascularization (IPNV) are becoming recognized as factors of plaque vulnerability. Aim of the study was to investigate the correlation between the echogenicity of the carotid atherosclerosis by standard US and the degree of IPNV by contrast enhanced US (CEUS). METHODS: We recruited 45 consecutive subjects with an asymptomatic ≥50% carotid artery stenoses. Carotid plaque echogenicity at standard US was visually graded according to Gray-Weale classification (GW) and measured by the grayscale median (GSM), a semi-automated measurement performed by Adobe Photoshop©. On CEUS imaging IPNV was graded by different point scales according to the visual appearance of contrast within the plaque as follows: CEUS_A (1=absent; 2=present); CEUS_B (increasing IPNV from 1 to 3); and CEUS_C (increasing IPNV from 0 to 3). RESULTS: The correlation between echogenicity by GW and IPNV grading was as follows: CEUS_B (-0.130 p .423), CEUS_C (-0.108, p .509), CEUS_A (0.021, p .897). The correlation between echogenicity by GSM measurement and IPNV was as follows: using a CEUS_A (-0.125, p .444), CEUS_C (-0.021, p .897) (0.005, p .977). No correlation was found statistically significant. CONCLUSION: Our results display that there is no significant correlation between plaque echogenicity and IPNV. The small sample number and the multifaceted pathophysiology of the atherosclerotic plaque may explain the absence of statistically significantly correlation. Curtailing vulnerability explanation to either IPNV or echolucency may be misleading.

A combined "in vivo" noninvasive evaluation of carotid plaques using ultrasonography and high-resolution magnetic resonance - new insight into plaque burden and vulnerability.

BACKGROUND: Qualitative change in carotid plaques was prospectively evaluated by Gray Scale Median (GSM) analysis at repeated examinations "in vivo", in relation to quantitative change in carotid arterial geometry, as assessed by high-resolution magnetic resonance imaging (HR-MRI). PATIENTS AND METHODS: Duplex ultrasound with GSM analysis and HR-MRI at the carotid level were performed at baseline and 1- and 2-year follow up in 30 patients with < 70% carotid stenosis. Changes in GSM values (ΔGSM) were evaluated as the intra-individual difference between 2-year and baseline values. HR-MRI studies were evaluated for lumen area (LA), total vessel area (TVA), vessel wall area (VWA = TVA-LA) and normalized wall index (NWI = VWA/TVA). RESULTS: ΔGSM value distribution was divided into quartiles. Predominantly echolucent plaques with ΔGSM value in the lowest quartile (ΔGSM ≤- 8) showed a significantly greater mean 2-year LA (28.62 ± 10.9 mm2 vs. 17.88 ± 4.8 mm2, p = 0.04) and a greater mean 2-year TVA (83.64 ± 19.4 mm2 vs. 63.26 ± 9.2 mm2, p = 0.02) than predominantly echogenic plaques with ΔGSM value in the highest quartile (ΔGSM ≥8). CONCLUSIONS: Increasing echolucency during the 2-year follow up was associated with a 2-year lower degree of stenosis and higher tendency toward lumen preservation. By corroborating that plaque vulnerability is highly independent of stenosis severity, our study provided a possible new combined "in vivo" noninvasive approach for the assessment of carotid plaque vulnerability.

[CrF(O2 C(t) Bu)2 ]9 : Synthesis and Characterization of a Regular Homometallic Ring with an Odd Number of Metal Centers and Electrons.

The first regular homometallic ring containing an odd number of metal centers is reported. The ring was synthesized by means of amine-templated self-assembly. Extensive physical characterization studies, including magnetic measurements, powder inelastic neutron scattering (INS), and DFT calculations, show that the molecule has a near perfect match to the expected behavior for a frustrated system with the lowest energy pair of S=1/2 spin states separated by only 0.1 meV (0.8 cm(-1) ).

A modular design of molecular qubits to implement universal quantum gates.

The physical implementation of quantum information processing relies on individual modules-qubits-and operations that modify such modules either individually or in groups-quantum gates. Two examples of gates that entangle pairs of qubits are the controlled NOT-gate (CNOT) gate, which flips the state of one qubit depending on the state of another, and the gate that brings a two-qubit product state into a superposition involving partially swapping the qubit states. Here we show that through supramolecular chemistry a single simple module, molecular {Cr7Ni} rings, which act as the qubits, can be assembled into structures suitable for either the CNOT or gate by choice of linker, and we characterize these structures by electron spin resonance spectroscopy. We introduce two schemes for implementing such gates with these supramolecular assemblies and perform detailed simulations, based on the measured parameters including decoherence, to demonstrate how the gates would operate.

Evidence for Detrimental Cross Interactions between Reactive Oxygen and Nitrogen Species in Leber's Hereditary Optic Neuropathy Cells.

Here we have collected evidence suggesting that chronic changes in the NO homeostasis and the rise of reactive oxygen species bioavailability can contribute to cell dysfunction in Leber's hereditary optic neuropathy (LHON) patients. We report that peripheral blood mononuclear cells (PBMCs), derived from a female LHON patient with bilateral reduced vision and carrying the pathogenic mutation 11778/ND4, display increased levels of reactive oxygen species (ROS) and reactive nitrogen species (RNS), as revealed by flow cytometry, fluorometric measurements of nitrite/nitrate, and 3-nitrotyrosine immunodetection. Moreover, viability assays with the tetrazolium dye MTT showed that lymphoblasts from the same patient are more sensitive to prolonged NO exposure, leading to cell death. Taken together these findings suggest that oxidative and nitrosative stress cooperatively play an important role in driving LHON pathology when excess NO remains available over time in the cell environment.