The consumption of fisheries and aquaculture products has been increasing in recent decades, and it is necessary to strike a balance between production and sustainability in aquaculture; this is essential homework to support the demand for human food. This study aimed to investigate the sensory and nutritional characteristics of a sausage made from the fillet of the native fish Old Blue (Andinoacara rivulatus) to stimulate the local economy. A multifactorial A*B*C design was used, with Factor A being rearing systems (wild and farmed), Factor B being types of protein (quinoa meal and soybean meal), and Factor C being lipids of animal (pork fat) and vegetable (sunflower oil) origin. Highly significant differences were observed in all formulas, according to Tukey (p < 0.05). The highest protein percentage was with soybean flour at 11.24%, while quinoa flour had 10.80% of the product. In sensory characteristics, the best attributes were for texture in the mouth with a hedonic scale from 0 to 5, with 4.2 firmness being mostly acceptable, odor at 4.5, the aromatic attribute with the highest and best value, and color was the clearest at 4.3 acceptability. The flavor was 4.3, mostly more pleasant according to the tasters. The yield of farmed fillets was 23.16% compared to wild 13.89%, and the balance of sausage yield was 393 g with a yield of 76.33% of the total weight. Microbiological analysis of the sausage with the native species showed the absence of pathogenic microorganisms. A commercial shelf life of 30 days was also established for the sausage, demonstrating an added value through this processing, allowing its exploitation in areas further away from the fishing sites and, thus, a greater possibility of social development in the area. Full article

The stepwise synthesis and characterization of three new mixed-ligand organometallic tetranuclear platinum squares were achieved. All of the complexes were constituted by the conjunction of two (2,2′-bpy)Pt-terph-Pt(2,2′-bpy) (terph = p-terphenyl) fragments linked by a variety of N^N ligands (4,4′-bipyridine (4,4′-bpy), 1,4-di(pyridin-4-yl)benzene (dpbz), and 4,4′-di(pyridin-4-yl)-1,1′-biphenyl (dpbph)), which occupied the fourth coordination site of each metal center, giving rise to square-shaped molecules of the general formula [Pt₂(2,2′-bpy)₂(terph)(N^N)]₂. Consequently, the tetranuclear complexes, {[Pt(2,2′-bpy)]₄(μ-terph)₂(μ-4,4′-bpy)₂}{PF₆}₄ (7), {[Pt(2,2′-bpy)]₄(μ-terph)₂(μ-dpbz)₂}{PF₆}₄ (8), and {[Pt(2,2′-bpy)]₄(μ-terph)₂(μ-dpbph)₂}{PF₆}₄ (9) were constructed. The photophysical properties of these complexes were studied both in the solid state and in various solvents, revealing fluorosolvatochromism. Full article

Three new heteroleptic Ag(I) complexes, labeled as [AgL(POP)]BF₄ (1–3), were successfully synthesized and comprehensively characterized. Here, L represents 2,9-bis((E)-4-methoxystyryl)-1,10-phenanthroline (L1), 2,9-bis((E)-4-methylthiostyryl) -1,10-phenanthroline (L2), and 2,9-bis((E)-4-diethylaminostyryl)-1,10-phenanthroline (L3), while POP stands for Bis[(2-diphenylphosphino)phenyl] ether. The stability of these compounds in solution was confirmed through multinuclear 1D (¹H, ¹³C, ³¹P) and 2D NMR (COSY, NOESY, HMBC, HSQC) spectroscopies. Additionally, their molecular structure was elucidated via X-ray crystallography. The photophysical properties of the complexes were assessed both in the solid state and in solution (dichloromethane). Compounds 1–3 demonstrated moderate emissions in solution, with quantum yields ranging from 11–23%. Interestingly, their solid-state luminescent behavior differed. Large bathochromic shifts (42–75 nm) of the emission maxima and a decrease in quantum yields (2.5–9.5%) were evident, possibly due to the presence of excimers. Compound 3 stands out as a rare example of an Ag(I) red-color emitter. Full article

The main objective of this research is to establish a new formulation and mathematical model based on graph theory to create dynamic equations and provide clarity on the fundamental formulation. We have employed graph theory as a new approach to develop a new representation and formulate the vertical dynamics of a motorcycle with four degrees of freedom, including a suspension and tire model. We have outlined the principal procedural steps required to generate the mathematical and dynamic equations. This systematic approach ensures clarity and precision in our formulation process and representation. Subsequently, we implemented the dynamics equations to examine the dynamic behavior of both the sprung and unsprung masses’ vertical displacements, while considering the varying conditions of the road profile. Full article

The incorporation of distributed generation with photovoltaic systems entails a drawback associated with intermittency in the generation capacity due to variations in the solar resource. In general, this aspect limits the level of penetration that this resource can have without producing an appreciable impact on the quality of the electrical supply. With the intention of reducing its intermittency, this paper presents the characterization of a methodology for maximizing grid-connected PV system operation under low-solar-radiation conditions. A new concept of a hybrid system based on a constant current source and capable of integrating different sources into a conventional grid-connected PV system is presented. Results of an experimental characterization of a low-voltage grid–PV system connection with a DC/DC converter for constant-current source application are shown in zero and non-zero radiation conditions. The results obtained demonstrate that the proposed integration method works efficiently without causing appreciable effects on the parameters that define the quality of the electrical supply. In this way, it is possible to efficiently incorporate another source of energy, taking advantage of the characteristics of the GCPVS without further interventions in the system. It is expected that this topology could help to integrate other generation and/or storage technologies into already existing PV systems, opening a wide field of research in the PV systems area. Full article

This present study investigated the anti-skin-aging properties of Rosa rugosa. Initially, phenolic compounds were isolated from a hot water extract of Rosa rugosa’s flower buds. Through repeated chromatography (column chromatography, MPLC, and prep HPLC), we identified nine phenolic compounds (1–9), including a previously undescribed depside, rosarugoside D (1). The chemical structure of 1 was elucidated via NMR, HR-MS, UV, and hydrolysis. Next, in order to identify bioactive compounds that are effective against TNF-α-induced NHDF cells, we measured intracellular ROS production in samples treated with each of the isolated compounds (1–9). All isolates reduced the level of ROS at a concentration of 10 μM. Particularly, two depsides—rosarugosides A and D (2 and 1)—significantly inhibited ROS expression in TNF-α-induced NHDFs compared to the other phenolic compounds. Subsequently, the production of MMP-1 and procollagen type Ι α1 by these two depsides was examined. Remarkably, rosarugoside A (2) significantly decreased MMP-1 secretion at all concentrations. In contrast, rosarugoside D (1) regulated the expression of procollagen type Ι α1. These findings collectively suggest that Rosa rugosa extracts and their isolated compounds, rosarugosides A (2) and D (1), hold significant potential for protecting against aging and skin damage. Overall, these findings suggest that Rosa rugosa extracts and their isolated compounds, rosarugosides A (2) and D (1), have the potential to prevent and protect against aging and skin damage, although more specific quantitative analysis is needed. Full article

Cardiovascular diseases (CVDs) represent the leading cause of death globally. Romania recorded the highest mortality rate due to CVDs in the EU in 2022, with 162,984 deaths, while the number of registered patients with CVDs surpassed 4 million. This study aims to measure the population’s potential spatial accessibility to cardiovascular hospitals in Romania, as timely access to such healthcare facilities is crucial to minimise avoidable mortality due to CVDs. Although distance is an essential parameter of spatial accessibility, time-based analysis is more reflective of real-world scenarios due to the unpredictability of travel. The potential spatial accessibility was measured using the Application Program Interface (API) offered through the Google Maps platform and a personal car as the transportation mode. The country’s cardiovascular hospital network comprises 161 units, of which 84 can provide complex care. Because all of them are located in urban areas, three different time slots were considered to distinguish between high and low traffic congestion situations. We created hierarchies of ten-minute and five km intervals for travel time and distance, respectively, to emphasize the population percentages with better or low potential spatial accessibility. Results showed that only 15% of the population can reach the nearest cardiovascular hospital in less than 20 min, and 23% must travel for over 60 min, while 45.7% live farther than 20 km from a cardiovascular hospital. Inhabitants living in remote areas, especially rural ones, are the most vulnerable, having to travel for the longest time and distance. Actions like improving the existing transport infrastructure and upgrading healthcare facilities and equipment are needed to ensure better medical care and an adequate response to population needs. This study can support local authorities in optimising spatial accessibility to cardiovascular care by identifying the most burdened hospitals in the context of low medical specialised staff and large catchment areas. Full article

The B4 topology is an interesting alternative to the conventional B6 inverter due to its reduced number of parts and lower cost. Although it has been widely used in the past, especially in low-power motor drive applications, its application as a grid-connected inverter is an open area of research. In this regard, this paper analyses the feasibility of the B4 inverter topology for grid-connected applications. A versatile 7 kW inverter prototype, which may be configured as B4 and B6, was built, allowing for a comprehensive evaluation of the performance of both topologies. Through an analytical study and experimental tests, the performance of the B4 and B6 topologies was comparatively evaluated in terms of efficiency, total harmonic distortion of line currents, current unbalance, cost, and mean time between failures. The study was carried out in the context of microgrid systems, highlighting their role in the integration of renewable energy and distributed generation. Full article

This paper presents a low-power, energy-efficient, 12-bit incremental zoom analog-to-digital converter (ADC) for multi-channel bio-signal acquisitions. The ADC consists of a 7-stage ring voltage-controlled oscillator (VCO)-based incremental ΔΣ modulator (I-ΔΣM) and an 8-bit successive approximation register (SAR) ADC. The proposed VCO-based I-ΔΣM can provide fast phase-alignment of the ring-VCO to reduce the interval settling time; thereby, the I-ΔΣM can accommodate time-division-multiplexed input signals without phase leakage between consecutive measurements. The SAR ADC also adopts splitting unit capacitors that can support V_CM-free tri-level switching and prevent invalid states from the phase frequency detector with minimal logic gates and switches. The proposed ADC has been fabricated in a standard 180 nm standard 1P6M CMOS process, exhibiting a 67-dB peak signal-to-noise ratio, a 74-dB dynamic range, and a Walden figure of merit of 19.12 fJ/c-s, while consuming a power of 3.51 μW with a sampling rate of 100 kS/s. Full article

Sentiment Analysis in text, especially text containing scientific citations, is an emerging research field with important applications in the research community. This review explores the field of sentiment analysis by focusing on the interpretation of citations, presenting a detailed description of techniques and methods ranging from lexicon-based approaches to Machine and Deep Learning models. The importance of understanding both the emotion and the intention behind citations is emphasized, reflecting their critical role in scientific communication. In addition, this study presents the challenges faced by researchers (such as complex scientific terminology, multilingualism, and the abstract nature of scientific discourse), highlighting the need for specialized language processing techniques. Finally, future research directions include improving the quality of datasets as well as exploring architectures and models to improve the accuracy of sentiment detection. Full article

Ternary organic solar cells contain a single three-component photoactive layer with a wide absorption window, achieved without the need for multiple stacking. However, adding a third component into a well-known binary blend can influence the energetics, optical window, charge carrier transport, crystalline order and conversion efficiency. In the form of binary blends, the low-bandgap regioregular polymer donor poly(3-hexylthiophene-2,5-diyl), known as P3HT, is combined with the acceptor PC₆₁BM, an inexpensive fullerene derivative. Two different non-fullerene acceptors (ITIC and eh-IDTBR) are added to this binary blend to form ternary blends. A systematic comparison between binary and ternary systems was carried out as a function of the thermal annealing temperature of organic layers (100 °C and 140 °C). The power conversion efficiency (PCE) is improved due to increased fill factor (FF) and open-circuit voltage (V_oc) for thermal-annealed ternary blends at 140 °C. The transport properties of electrons and holes were investigated in binary and ternary blends following a Space-Charge-Limited Current (SCLC) protocol. A favorable balanced hole–electron mobility is obtained through the incorporation of either ITIC or eh-IDTBR. The charge transport behavior is correlated with the bulk heterojunction (BHJ) morphology deduced from atomic force microscopy (AFM), contact water angle (CWA) measurement and 2D grazing-incidence X-ray diffractometry (2D-GIXRD). Full article

Bronchial asthma is characterized by airway inflammation, airway hyperresponsiveness, and reversible airway obstruction. Eosinophils contribute to the pathogenesis of airway disease mainly by releasing eosinophil-specific granules, lipid mediators, superoxide anions, and their DNA. Type-2 cytokines such as interleukin (IL)-4 and IL-13 also play roles in the development of bronchial asthma. Among these cytokines, IL-4 is involved in T-cell differentiation, B-cell activation, B-cell differentiation into plasma cells, and the production of immunoglobulin E. Although IL-13 has similar effects to IL-4, IL-13 mainly affects structural cells, such as epithelial cells, smooth muscle cells, and fibroblasts. IL-13 induces the differentiation of goblet cells that produce mucus and induces the airway remodeling, including smooth muscle hypertrophy. IL-4 and IL-13 do not directly activate the effector functions of eosinophils; however, they can induce eosinophilic airway inflammation by upregulating the expression of vascular cell adhesion molecule-1 (for adhesion) and CC chemokine receptor 3 ligands (for migration). Dupilumab, a human anti-IL-4 receptor α monoclonal antibody that inhibits IL-4 and IL-13 signaling, decreases asthma exacerbations and mucus plugs and increases lung function in moderate to severe asthma. In addition, dupilumab is effective for chronic rhinosinusitis with nasal polyps and for atopic dermatitis, and IL-4/IL-13 blocking is expected to suppress allergen sensitization, including transcutaneous sensitization and atopic march. Full article

In order to improve the pseudocapacitance performance of metal sulfide electrode materials and obtain supercapacitor energy storage devices with excellent electrochemical reversibility and long-term cycle stability, the synthesis of flower-shaped crystal nickel–cobalt sulfide and its supercapacitor performance were studied. NiCo₂S₄ flower-shaped crystal nickel–cobalt sulfide was prepared by the hydrothermal method with nickel foam as the raw material, and electrode materials were added to prepare supercapacitor electrodes for testing of the supercapacitor performance. The physical properties of flower-shaped crystal nickel–cobalt sulfide were tested by a scanning electron microscope and transmission electron microscope, and the voltammetric cycle and constant current charge and discharge of supercapacitor electrodes prepared from this sulfide were analyzed through experiments. The experimental results showed that the flower crystal microstructure had a positive effect on the electrochemical properties. The capacitance value was always high at different current densities, and the capacity was as high as 3867.8 A/g at pH 12. After 2000 voltage–charge–discharge cycle tests, the petal-like sulfide capacity still had a retention rate of 90.57, the flower crystal nickel–cobalt sulfide still showed an excellent supercapacitor performance and the specific capacity was still high, which demonstrates that this sulfide has excellent cyclic stability and durability in electrochemical applications. Full article

Background: Pericapsular nerve group (PENG) block, although effective for pain management following total hip arthroplasty (THA), does not cover skin analgesia. In this randomized controlled trial, we compared the effectiveness of PENG block combined with lateral femoral cutaneous nerve (LFCN) block or wound infiltration (WI) on postoperative analgesia and functional outcomes. Methods: Fifty patients undergoing posterior-approached THA under spinal anesthesia were randomly allocated to receive LFCN block with 10 mL of 0.5% ropivacaine or WI with 20 mL of 0.5% ropivacaine. In both groups, PENG block was performed by injecting 20 mL of 0.5% ropivacaine. Primary outcomes were static and dynamic pain scores (0–10 numeric rating scale) measured in the first 24 h after surgery. Secondary outcomes included postoperative opioid consumption, functional assessment and length of hospital stay. Results: Postoperative static NRS of patients receiving LFCN was higher than that of patients receiving WI at 6 h but lower at 24 h, with a median (IQR) of 3 (2–4) vs. 2 (1–2) (p < 0.001) and 2 (2–3) vs. 3 (3–4) (p = 0.02), respectively. Static pain scores at 12 h did not show significant differences, with an NRS of 3 (2–4) for WI vs. 3 (3–4) for LFCN (p = 0.94). Dynamic pain and range of movement followed a similar trend. No significant differences were detected in other outcomes. Conclusions: LFCN block was not inferior to WI for postoperative analgesia and functional recovery in association with PENG block during the first postoperative day, although it had worse short-term pain scores. Based on these results, it is reasonable to consider LFCN block as a valid alternative to WI or even a complementary technique added to WI to enhance skin analgesia during the first 24 h after THA. Future studies are expected to confirm this hypothesis and find the best combination between PENG block and other techniques to enhance analgesia after THA. Full article

Objectives: Twin pregnancy implies a higher risk of preterm birth and, consequently, higher neonatal morbidity and mortality. In singleton pregnancies, infections of the lower genital tract (LGTIs) and bacterial vaginosis are associated with preterm labor, and their early detection has been proven effective in reducing complications like the preterm premature rupture of membranes (pPROM) and preterm delivery. The same evidence, however, is lacking for twin pregnancies. This study aimed to evaluate whether the early identification and treatment of LGTIs or bacterial vaginosis in asymptomatic women with twin pregnancy could reduce the rate of miscarriages, pPROM, and preterm birth. Methods: This study performed a retrospective comparison of 285 women with a multiple pregnancy submitted for a cervico-vaginal swab only at 20–22 weeks (Single Test Group, STG), and 199 women who underwent the swab at 12–14 and again at 20–22 weeks (Double Test Group, DTG). All women included in the study had a twin pregnancy and were followed up at Sant’Anna Hospital, Turin (Italy), between September 2012 and February 2021. Results: In STG, 21.7% of patients had a positive swab; in DTG, 19.9% had an early positive swab that was immediately treated by targeted antibiotics; and 16.7% had a mid-pregnancy positive swab. The DTG showed a significantly lower incidence of pPROM in univariate analysis (14.4% vs. 23.1%, p = 0.021), which was confirmed by multivariate analysis (OR 0.55, CI 0.33–0.93, p = 0.025). Conclusions: Our study suggests that, in asymptomatic women with twin pregnancy, the early screening of LGTIs and bacterial vaginosis by a cervico-vaginal swab at 12–14 weeks of gestational age is effective in reducing the risk of pPROM. Full article

Background: Common bile duct (CBD) stones may pass spontaneously without any intervention. Assessment of the predictors of spontaneous passage can contribute to avoiding unnecessary endoscopic retrograde cholangiopancreatography (ERCP) implementation. This study aimed to investigate the factors related to spontaneous passage of CBD stones. Methods: From January 2021 to August 2023, patients with naïve papilla who had undergone biliary ERCP and with CBD stones detected by MRCP before the procedure were analyzed retrospectively. Subjects were divided into two groups on the basis of the presence of stones during the ERCP procedure: the spontaneous passage group and the non-passage group. Groups were compared in terms of demographic, laboratory, and radiological data. Results: A total of 236 patients, including 26 in the spontaneous passage group and 210 in the non-passage group, were involved. Multivariate logistic regression analyses revealed that only stone size was significantly associated with spontaneous passage. From ROC curve analysis, stone size with a cut-off value of 4.3 mm predicted spontaneous passage with 58% sensitivity and 85% specificity. Conclusions: Stones with a size of less than 4.3 mm are more likely to pass spontaneously without endoscopic intervention. Paying attention to the stone diameter before ERCP procedures can contribute to avoiding unnecessary ERCP implementation. Full article

To address the various challenges in aluminum surface defect detection, such as multiscale intricacies, sensitivity to lighting variations, occlusion, and noise, this study proposes the AluDef-ClassNet model. Firstly, a Gaussian difference pyramid is utilized to capture multiscale image features. Secondly, a self-attention mechanism is introduced to enhance feature representation. Additionally, an improved residual network structure incorporating dilated convolutions is adopted to increase the receptive field, thereby enhancing the network’s ability to learn from extensive information. A small-scale dataset of high-quality aluminum surface defect images is acquired using a CCD camera. To better tackle the challenges in surface defect detection, advanced deep learning techniques and data augmentation strategies are employed. To address the difficulty of data labeling, a transfer learning approach based on fine-tuning is utilized, leveraging prior knowledge to enhance the efficiency and accuracy of model training. In dataset testing, our model achieved a classification accuracy of 98.01%, demonstrating significant advantages over other classification models. Full article

Background: Hormonal changes during pregnancy have a substantial effect on the swelling of the mucous membrane in the nasal cavity, resulting in rhinitis and Eustachian tube dysfunction. The aim of the study was to assess subjective and objective changes in nasal cavity and Eustachian tube patency in the third trimester of pregnancy. Materials and Methods: The study group included fifty 18–41 year-old women in the third trimester of pregnancy. The control group consisted of 25 females aged 25 to 31 who were not pregnant. The Eustachian tube and nasal cavity patency examination was carried out using a rhinomanometer, a tympanometer and a SNOT-22 Questionnaire. Results: The SNOT-22 showed that subjective nasal obstruction was assessed as strong or worse by 42% of the study group, which was significantly higher than in the control group and confirmed with rhinomanometry. A total of 68% of the study group reported a subjective ear fullness which correlated with the week of pregnancy. The tympanometry showed that all pregnant women exhibited a type A tympanogram, but tympanometry values decreased at higher weeks of pregnancy, and statistical analysis confirmed a significant difference between the study group and the control group in tympanometry for both ears. Conclusions: The results highlight the substantial impact on both subjective and objective measurements of nasal and Eustachian tube patency. Almost every woman in the third trimester of pregnancy experiences nasal obstruction, and nearly 70% struggle with ear fullness. Recognizing and addressing these challenges are pivotal for ensuring the well-being of pregnant individuals and enhancing the quality of antenatal care. Full article

Background: Diabetes mellitus (DM) and osteoporosis are two of the most widespread metabolic diseases in the world. The aim of this study is to investigate the prevalence of DM among patients affected by osteoporosis and fragility fractures, and to search for differences in clinical characteristics. Methods: This is a single-center retrospective, case–controlled study. A total of 589 patients attending CTO Bone Unit between 2 January 2010 and 31 May 2023, due to osteoporosis and fragility fractures, were divided into two groups, according to the diagnosis of DM. The clinical and bone characteristics of patients were compared. Results: Prevalence of DM was 12.7%. Compared to patients without DM, the median age at the time of first fracture was similar: 72 years ± 13.5 interquartile range (IQR) vs. 71 years ± 12 IQR; prevalence of combination of vertebral and hip fractures was higher (p = 0.008), as well as prevalence of males (p = 0.016). Bone mineral density (BMD) at all sites was higher in DM group; trabecular bone score (TBS), instead, was significantly lower (p < 0.001). Conclusions: Patients with fragility fractures and DM more frequently show combination of major fractures with higher BMD levels. In these patients, TBS could be a better indicator of bone health than BMD and, therefore, might be used as a diagnostic tool in clinical practice. Full article

Background: Mitral valve prolapse (MVP) and mitral annular disjunction (MAD) are common valvular abnormalities that have been associated with ventricular arrhythmias (VA). Cardiac magnetic resonance imaging (CMR) has a key role in risk stratification of VA, including assessment of late gadolinium enhancement (LGE). Methods: Single-center retrospective analysis of patients with MVP or MAD who had >1 CMR and >1 24 h Holter registration available. Data are presented in detail, including evolution of VA and presence of LGE over time. Results: A total of twelve patients had repeated CMR and Holter registrations available, of which in four (33%) patients, it was conducted before and after minimal invasive mitral valve repair (MVR). After a median of 4.7 years, four out of eight (50%) patients without surgical intervention had new areas of LGE. New LGE was observed in the papillary muscles and the mid to basal inferolateral wall. In four patients, presenting with syncope or high-risk non-sustained ventricular tachycardia (VT), programmed ventricular stimulation was performed and in two (50%), sustained monomorphic VT was easily inducible. In two patients who underwent MVR, new LGE was observed in the basal inferolateral wall of which one presented with an increased burden of VA. Conclusions: In patients with MVP and MAD, repeat CMR may show new LGE in a small subset of patients, even shortly after MVR. A subgroup of patients who presented with an increase in VA burden showed new LGE upon repeat CMR. VA in patients with MVP and MAD are part of a heterogeneous spectrum that requires further investigation to establish risk stratification strategies. Full article

Preeclampsia (PE) is a hypertensive disorder in pregnancy associated with significant fetal and maternal complications. Antiphospholipid syndrome (APS) is an acquired form of thrombophilia characterized by recurrent venous or arterial thrombosis and obstetric complications that significantly increases morbidity and mortality rates. While preeclampsia may not be the most prevalent obstetric complication in APS, it significantly impacts the long-term health of both mother and child. The treatment of preeclampsia in antiphospholipid syndrome is different from the treatment of preeclampsia as an independent disease. Despite current treatments involving anticoagulants, antiplatelet agents, and antihypertensive drugs, obstetric complications may persist, underscoring the need for cohesive management and effective treatments. The objective of our review is to briefly present knowledge about the physiopathology of preeclampsia and the role of antiphospholipid antibodies in this process. Based on the existing literature, our review aims to identify future directions in molecular pathology toward the discovery of biomarkers and targeted treatments. The application of multidisciplinary approaches and prognostic models, including new biomarkers, could be beneficial in the prediction of PE. Full article

Re-expansion pulmonary edema is a rare and potentially life-threatening complication that can occur after the rapid re-expansion of a collapsed lung due to pneumothorax or pleural effusion. It has a multifactorial pathogenesis, and risk factors for re-expansion pulmonary edema, such as chronic lung collapse, rapid re-expansion, and changes in pulmonary vascular permeability, have been identified. Clinical manifestations vary, ranging from almost asymptomatic to a rapidly fatal condition, and its incidence may be more common and less fatal than previously believed. The literature emphasizes the importance of early recognition and management to ensure favorable outcomes. However, there is ongoing debate regarding the indications for ventilatory support and the timing of non-invasive or invasive ventilation. Herein, we report a case series of three paradigmatic examples of massive re-expansion pulmonary edema occurring over a period of 10 years in our institution among a population of 815 patients with spontaneous pneumothorax. We also conducted a literature review on re-expansion pulmonary edema, with a particular focus on diagnosis and management. In each case, despite initially normal clinical parameters, severe respiratory distress developed following the insertion of a thoracic drainage tube for a massive spontaneous pneumothorax. Two patients required High-Flow Nasal Oxygen, and one was addressed to intensive management, including CPAP. In all cases, the patient’s outcome was optimal. Full article