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Background: The concept of damages for loss of chance originated in France in 1877 and was adapted to healthcare in 1962. In Italy, it was first introduced in healthcare liability in 2004, with Civil Court of Cassation decision No. 4400. Italian jurisprudence recognizes the loss of chance as an independent, legally and economically assessable damage, distinct from the actual outcome lost. The landmark St. Martin Judgments of 2019 further established that such damages can be claimed if they involve appreciable, serious, and consistent values. This requires proving a causal link between the conduct and the lost chance, based on established civil law criteria. Case report: 1) a 71-year-old man whose lung carcinoma was not diagnosed in time, leading to a significant reduction in survival chances. 2) a woman whose breast cancer diagnosis was delayed, resulting in a more advanced stage and decreased survival prospects. Discussion: In medical professional liability, the Supreme Court requires a high probability or certainty of causation for recognizing the causal link between wrongful conduct and damage. The assessment involves proving both the causal link and the reasonable probability of a lost opportunity's realization. Hypothetical damage is insufficient for compensation. Conclusions: The compensability of loss of chance relies on proving the causal link between the negligent act and the uncertain event, where the impact on the patient's non-pecuniary sphere is significant. Medicolegal practice faces challenges in distinguishing between causality and damage, which can lead to confusion between biological damage and damage from loss of opportunity.

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There is an increasing demand to develop predictive medicine through the creation of predictive models and digital twins of the different body organs. To obtain accurate predictions, real local microstructure, morphology changes and their accompanying physiological degenerative effects must be taken into account. In this article, we present a numerical model to estimate the long-term aging effect on the human intervertebral disc response by means of a microstructure-based mechanistic approach. It allows to monitor in-silico the variations in disc geometry and local mechanical fields induced by age-dependent long-term microstructure changes. Both lamellar and interlamellar zones of the disc annulus fibrosus are constitutively represented by considering the main underlying microstructure features in terms of proteoglycans network viscoelasticity, collagen network elasticity (along with content and orientation) and chemical-induced fluid transfer. With age, a noticeable increase in shear strain is especially observed in the posterior and lateral posterior regions of the annulus which is in correlation with the high vulnerability of elderly people to back problems and posterior disc hernia. Important insights about the relation between age-dependent microstructure features, disc mechanics and disc damage are revealed using the present approach. These numerical observations are hardly obtainable using current experimental technologies which makes our numerical tool useful for patient-specific long-term predictions.

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BACKGROUND: Inhalation of particulate matter (PM) from cigarette smoke is hazardous to smokers and non-smokers. This contribution simulates the deposition of cigarette PM on the lung surface by trapping tobacco smoke particulates on Croton megalocarpus biochar. This study investigated one commercial cigarette (MM) and one local cigarette (RR). METHODOLOGY: Biochar was incorporated into the filters of MM and RR cigarettes in order to adsorb PM from mainstream cigarette smoke. A weighed 5 mg of biochar with adsorbed cigarette PM was analyzed using a scanning electron microscope and a Fourier transform infrared spectrometer. The size distribution of cigarette smoke particulates was processed using ImageJ software. RESULTS: At 15 s puff time, the mean particulate diameters for the commercial and the local cigarettes, respectively, can be classified as coarse ≈ PM10 . Conversely, the mean particulate diameter at 2 s puff time for the commercial cigarette falls under the ultrafine classification of ≤PM2.5 , whereas at the same puff time, the mean particulate diameter for the local cigarette was approximately PM2.5 . Data from Fourier transform infrared spectroscopy indicate the PM in the two model cigarettes contains aromatic structures that feature the C=C bond characterized by an intense absorption band at δs (1600 cm-1 ). CONCLUSIONS: This study found that PM in mainstream cigarette smoke depends on puff time. Although cigarette smoking was conducted for two model cigarettes, this study can be extended to any other form of cigarette. Moreover, this study emphasizes the need for comprehensive studies on real-world cigarette smoking conditions, taking into account cigarette smokers who use larger puff volumes.

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Thorium (232Th), long lived (14.05 billion years) most stable thorium isotope, is thrice naturally abundant than uranium. 232Th occurs as rocky deposits and black monazite sands on the earth's crust geographically distributed in coastal South India and other places globally. Monazite sand comprises of cerium and large quantities of radioactive thorium. The environmental hazard lies in monazite rich area being termed as High Background Radiation Area (HBRA). In this study, we mimicked the HBRA under controlled chamber conditions using thorium oxalate as a thorium source for BALB/c mice exposure. Furthermore, sequential radio-disintegration of 232 Th leads to thoron (220Rn), the noble gas and other daughter products/progeny predominantly via alpha decay/emissions. Such progeny tend to attach to aerosol and dust particles having potential inhalation hazard followed by alpha emissions and damages that we evaluated in mouse lung tissues post thoron inhalation. Secondly, along with the radio disintegration and alpha emission, high energy gamma is also generated that can travel to various distant organs through the systemic circulation, as significant findings of our study as damages to the liver and kidney. The mechanistic findings include the damages to the hematological, immunological and cellular antioxidant systems along with activation of canonical NF-κß pathway via double stranded DNA damage.

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Lecanicillium gracile is a recently described micromycete species isolated from mineral-based building materials (plaster and limestone) in interiors of cultural heritage sites in Russia. In this work, the composition of L. gracile metabolites, as well as of the culture liquid, have been characterized. The results suggest that L. gracile is a promising candidate for the search for novel biologically active compounds. During the exponential growth phase, the diversity of metabolites in the mycelium was low; the metabolome profile demonstrated predominant accumulation of monosaccharides and polyols. In the stationary phase, the metabolite diversity in the L. gracile mycelium was high; apparently, at this stage biosynthesis dominated over energy-producing processes. L. gracile synthesized extracellular polymer compounds and shifted medium рН to the alkaline range. When fungi are developing on rock substrates, their extracellular polymer matrix not only serves to facilitate the formation of biofilms with other microorganisms of lithobiont communities, but also, at alkaline pH values, it promotes the formation of secondary calcite on calcium-containing substrates, such as limestone and marble. That is, L. gracile possesses certain biochemical traits that facilitate its long-term growth on rock substrates and reflect the specific character of interactions between the fungus and the substrate materials.

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Andean blackberry is a fruit recognized by its health benefits associated with its high content of bioactive compounds. However, it is also one of the most perishable fruits because it does not have a protective cuticle, and it shows high respiration and ethylene production rates. Furthermore, it is susceptible to microbiological attacks. During harvest and commercialization, the highest percentage of losses is caused by factors such as the maturity stage, harvest practices and containers, and marketing packages. The current work aims at studying the effect of the package on fruit quality, for which the harvested fruits were placed in clamshells, traditional wooden and plastic crates with a capacity of 7 kg. The quality of the fruit was evaluated by counting in situ, damage by bruising, cuts, deformations, microbiological attacks, missing of the peduncle, and non-uniform pollination. Damage analysis included the evaluation of different regression models considering information criteria and significant parameters (P ≤ 0.05). The use of traditional packages led to higher damage from cuts and bruises. Although in clamshells there was a higher probability of finding healthy fruits, a proposal for its redesign is proposed to guarantee a better quality and shelf life of the Andean blackberry fruits.

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PURPOSE: To compare the effect of dual-source dual-energy CT versus single-energy CT on DNA double-strand breaks (DSBs) in blood lymphocytes at CT pulmonary angiography (CTPA). METHODS AND MATERIALS: Sixty-two patients underwent either dual-energy CTPA (Group 1: n = 21, 80/Sn140 kVp, 89/38 mAs; Group 2: n = 20, 100/Sn140 kVp, 89/76 mAs) or single-energy CTPA (Group 3: n = 21, 120 kVp, 110 mAs). Blood samples were obtained before and 5 min after CTPA. DSBs were assessed with fluorescence microscopy and Kruskal-Walls tests were used to compare DSBs levels among groups. Volume CT dose index (CTDIvol), dose length product (DLP) and organ radiation dose were compared using ANOVA. RESULTS: There were increased excess DSB foci per lymphocyte 5 min after CTPA examinations in three groups (Group 1: P = .001; Group 2: P = .001; Group 3: P = .006). There were no differences among groups regarding excess DSB foci/cell and percentage of excess DSBs (Group 1, 23%; Group 2, 24%; Group 3, 20%; P = .932). CTDIvol, DLP and organ radiation dose in Group 1 were the lowest among the groups (all P < .001). CONCLUSION: DSB is increased following dual-source and single-source CTPA, while dual-source dual-energy CT protocols do not increase the estimated radiation dose and also do not result in a higher incidence of DNA DSBs in patients undergoing CTPA.

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In recent years, plasma-activated solutions (PASs) have made good progress in the disinfection of medical devices, tooth whitening, and fruit preservation. In this study, we investigated the inactivation efficacy of Newcastle disease virus by PASs. Water, 0.9% NaCl, and 0.3% H2O2 were excited by plasma to obtain the corresponding solutions PAS(H2O), PAS(NaCl), and PAS(H2O2). The complete inactivation of virus after PAS treatment for 30 min was confirmed by the embryo lethality assay (ELA) and hemagglutination (HA) test. Scanning electron microscopy (SEM) results showed that the morphology of the viral particle changed under PAS treatments. The total protein concentration of virus decreased as measured by a Bradford protein assay due to PAS treatment. The nucleic acid integrity assay demonstrated that viral RNA degraded into smaller fragments. Moreover, the physicochemical properties of PASs, including the oxidation-reduction potential (ORP), electrical conductivity, and H2O2 concentration, and electron spin resonance spectra analysis indicated that reactive oxygen and nitrogen species play a major role in the virus inactivation. Therefore, the application of PASs, as an environmentally friendly method, would be a promising alternative strategy in poultry industries.IMPORTANCE Newcastle disease (ND), as an infectious viral disease of avian species, caused significant economic losses to domestic animal and poultry industries. The traditional chemical sanitizers, such as chlorine-based products, are associated with risks of by-product formation with carcinogenic effects and environmental pollution. On the basis of this, plasma-activated water as a green disinfection product is a promising alternative for applications in stock farming and sterilization in hospitals and public places. In this study, we explored the inactivation efficacy of different plasma-activated solutions (PASs) against ND virus (NDV) and the possible underlying mechanisms. Our results demonstrated that reactive oxygen and nitrogen species detected in PASs, including short-lived OH˙ and NO˙ and long-lived H2O2, changed the morphology, destroyed the RNA structure, and degraded the protein of the virus, consequently resulting in virus inactivation. These lay a foundation for the application of PASs to resolve the issues of public health and environmental sanitation.

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The relationships between changes in habitat quality (disturbed and undisturbed sites) and the population parameters (density, size distribution, reproductive activity and diet) of a goby Microgobius meeki were investigated in a tropical estuary to assess its value as an indicator of anthropogenic changes, predominantly the effects of sedimentation and mangrove removal in shallow estuarine areas. Fish sampling surveys were conducted bimonthly between June 2009 and May 2010 over the entire estuarine gradient of the Paraguaçu River estuary, located on the central Brazilian coast. A predictive model was developed to assess the population changes of this species in 10 other tropical estuaries with different dimensions, basin features and distinct levels of anthropogenic disturbance. General linear models were used to relate the population structure of M. meeki to sediment type, habitat type resulting from mangrove conservation status, anthropogenic pressure and environmental characteristics such as salinity, dissolved oxygen concentrations and temperature. Sediment type and the presence of mangrove forests were the most effective predictors of local variability in the population structure of M. meeki. Individuals with mature gonads and high rates of feeding activity were associated predominantly with undisturbed habitats. Estuaries and estuarine sectors with high levels of sedimentation in shallow marginal areas, anthropogenic pressure from domestic and industrial effluents, and evidence of mangrove deforestation yielded the lowest capture rates of both juvenile and adult M. meeki. Based on these findings, M. meeki is identified as a potential indicator of the consequences of anthropogenic disturbance in transitional waters. A simple, but efficient collection protocol, in which overt signs of distress can be promptly observed is proposed. Testing the generality of this approach across different systems might prove useful in a broader conservation biology context.

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Over the last four decades, bioarchaeology has experienced significant technical growth and theoretical maturation. Early 21st century bioarchaeology may also be enhanced from a renewed engagement with the concept of biological stress. New insights on biological stress and disease can be gained from cross-disciplinary perspectives regarding human skeletal variation and disease. First, pathophysiologic and molecular signaling mechanisms can provide more precise understandings regarding formation of pathological phenotypes in bone. Using periosteal new bone formation as an example, various mechanisms and pathways are explored in which new bone can be formed under conditions of biological stress, particularly in bone microenvironments that involve inflammatory changes. Second, insights from human biology are examined regarding some epigenetic factors and disease etiology. While epigenetic effects on stress and disease outcomes appear profoundly influential, they are mostly invisible in skeletal tissue. However, some indirect and downstream effects, such as the developmental origins of adult health outcomes, may be partially observable in bioarchaeological data. Emerging perspectives from the human microbiome are also considered. Microbiomics involves a remarkable potential to understand ancient biology, disease, and stress. Third, tools from epidemiology are examined that may aid bioarchaeologists to better cope with some of the inherent limitations of skeletal samples to better measure and quantify the expressions of skeletal stress markers. Such cross-disciplinary synergisms hopefully will promote more complete understandings of health and stress in bioarchaeological science.

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