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A 3-months baby comes to our emergency department for an abdominal mass of elastic consistency that suddenly appeared for a week and grown exponentially in the last few days. Blood examinations identify a septic state of the child, and the emergency CT recognizes the abdominal mass’s cystic structure. The surgical removal and the histological analysis will confirm the diagnosis of Infected Common Macrocystic Lymphatic Malformation. This case allows us to remember to pediatricians the main features of Cystic Lymphatic Malformations that should always be considered during the differential diagnosis of abdominal masses of sudden onset in an infant.

Abstract Using a unique sample of European manufacturing firms, we empirically investigate how bank lending technologies nd soft information adoption affected firms’ credit availability during the 2007–2009 financial crisis. Estimation results indicate that transactional lending technologies increased firms’ credit rationing, whereas soft information mitigated asymmetric information problems and improved firms’ access to credit. By looking at the combined effect of bank lending technologies and soft information, we also provide evidence about the complementarity between transactional lending techniques and soft information adoption. When soft information was incorporated in transactional lending technologies firms’ credit rationing significantly reduced. This result is especially strong for small borrowing firms and for companies matching with large financial institutions.

Background: Contemporary guidelines advocate for early invasive strategy with coronary angiography in patients with non-ST-elevation acute coronary syndromes (NSTE-ACS). Still, the impact of an invasive strategy in older patients remains controversial and may be challenging in spoke hospitals with no catheterization laboratory (cath-lab) facility. Purpose: The purpose of this study was to analyse the characteristics and outcomes of patients ≥80 years old with NSTE-ACS admitted to spoke hospitals. Methods: Observational–retrospective study of all consecutive NSTE-ACS patients admitted to two spoke hospitals of our cardiology network, where a service strategy (same-day transfer between a spoke hospital and a hub centre with a cath-lab facility in order to perform coronary angiography) was available. Patients were followed up for 1 year after the admission date. Results: From 2013 to 2017, 639 patients were admitted for NSTE-ACS; of these, 181 (28%) were ≥80 years old (median 84, IQR 82–89) and represented the study cohort. When the invasive strategy was chosen (in 105 patients, or 58%), 98 patients (93%) were initially managed with a service strategy, whereas the remainder of the patients were transferred from the spoke hospital to the hub centre where they completed their hospital stay. Of the patients managed with the service strategy, a shift of strategy after the invasive procedure was necessary for 10 (10%). These patients remained in the hub centre, while the rest of the patients were sent back to the spoke hospitals, with no adverse events observed during the back transfer. The median time to access the cath-lab was 50 h (IQR 25–87), with 73 patients (70%) reaching the invasive procedure <72 h from hospital admission. A conservative strategy was associated with: older age, known CAD, clinical presentation with symptoms of LV dysfunction, lower EF, renal failure, higher GRACE score, presence of PAD and atrial fibrillation (all p < 0.03). At the 1-year follow-up, the overall survival was significantly higher in patients treated with an invasive strategy compared to patients managed conservatively (94% ± 2 vs. 54% ± 6, p < 0.001; HR: 10.4 [4.7–27.5] p < 0.001), even after adjustment for age, serum creatinine, known previous CAD and EF (adjusted HR: 2.0 [1.0–4.0]; p < 0.001). Conclusions: An invasive strategy may confer a survival benefit in the elderly with NSTE-ACS. The same-day transfer between a spoke hospital and a hub centre with a cath-lab facility (service strategy) is safe and may grant access to the cath-lab in a timely fashion, even for the elderly.

Abstract One of the challenges in the field of perovskite solar cells (PSC) is the development of inorganic hole-transporting-materials (HTM) suitable for solution-processed deposition, in order to have cheaper, more stable and scalable devices. Herein, we report the synthesis and characterization of p-type copper sulfide nanoparticles for their application for the first time as a low-cost, fully-inorganic HTM in mesoscopic n-i-p PSC. By employing CuS combined with two different perovskites, CH3NH3PbI3 (MAPbI3) and (FAPbI3)0.78(MAPbBr3)0.14(CsPbI3)0.08 (CsFAMAPbIBr), very high current densities and fill-factors are observed, suggesting an effective hole-extraction happening at the CuS interface. Noticeable, our cells exhibit one of the highest power conversion efficiencies (PCE) in n-i-p configuration employing a sole solution-processed inorganic HTM via non-toxic solvents, leading to 13.47% and 11.85% for MAPbI3 and CsFAMAPbIBr, respectively. As a remark, such PCE values are only limited by a reduced open-circuit voltage around 0.8 V, due to different phenomena occurring at perovkite/CuS interface such as an increased non-radiative recombination, caused by considerable difference in valence band value, and the effect of CuS metallic character. Overall, these findings highlight CuS as an extremely cheap alternative to common organic HTMs and pave the way to new improvements employing this material in full-inorganic blocking layers PSC.

Recent sttudies have shown that short-latency somatosensory (SSEP) amplitude as a predictor of outcome in post-anoxi coma is a continuous – rather than a dichotomous – variable. In addition, these studies showed that low-voltage SSEP is as reliable as a bilaterally absent SSEP for predicting severe hypoxic-ischaemic brain injury. Inevitably, when continuous variables are used to predict a dichotomous outcome (good vs. poor), there is a trade-off between sensitivity and specificity along the values of these variables, and we need to establish a threshold value to maximise the measure of accuracy that is more clinically relevant (in this case, specificity). The major problem with this approach is that these thresholds are often inconsistent across studies.

Abstract This paper investigates macroeconomic uncertainty spillover effects across countries and their impact on real economic activity in different economic periods, i.e. pre-crisis and during the recent financial crisis. The analysis is initially carried out using Monte Carlo simulations and, subsequently, real data for four euro zone economies, namely Italy, France, Germany, and Spain. The Monte Carlo findings clearly indicate a need to account for spillover effects across countries when investigating the impact of aggregate uncertainty on economic variables. The empirical results provide clear-cut evidence of the existence of macroeconomic spillovers between the four euro countries, with some feedback from periphery economies, notably Italy, to the core economies during the financial crisis period. Further, the impact of uncertainty on real economic activity is dampened for the four euro countries when spillover effects are accounted for. Spillover effects among the four countries are also observed when US uncertainty is taken into account. Further, US macroeconomic uncertainty impacts negatively on the real economic activity of the four euro countries.

Trimethylamine N-oxide (TMAO) is an organic compound derived from dietary choline and L-carnitine. It behaves as an osmolyte, a protein stabilizer, and an electron acceptor, showing different biological functions in different animals. Recent works point out that, in humans, high circulating levels of TMAO are related to the progression of atherosclerosis and other cardiovascular diseases. However, studies on a direct role of TMAO in cardiomyocyte parameters are still limited. The purpose of this work is to study the effects of TMAO on isolated adult rat cardiomyocytes. TMAO in both 100 µM and 10 mM concentrations, from 1 to 24 h of treatment, does not affect cell viability, sarcomere length, intracellular ROS, and mitochondrial membrane potential. Furthermore, the simultaneous treatment with TMAO and known cardiac insults, such as H2O2 or doxorubicin, does not affect the treatment’s effect. In conclusion, TMAO cannot be considered a direct cause or an exacerbating risk factor of cardiac damage at the cellular level in acute conditions.