With the advancement of the rural revitalization strategy, counties have emerged as vital platforms for supporting rural revitalization, underscoring the increasing importance of sustainable development in their economies. It is imperative to evaluate the sustainable development potential of county economies and implement precise measures accordingly. This paper selects relevant economic development indicators from 2016 to 2020 for 76 counties in Gansu Province, constructs an evaluation system for assessing their sustainable development potential, and employs methods such as the Theil index, spatial autocorrelation, principal component analysis, and cluster grouping classification. The evaluation considers three aspects: the county economic development gap, the development potential score, and cluster analysis. The findings reveal that the economic development of Gansu Province’s counties exhibits spatial characteristics of multi-point flowering and scattered distribution, with relatively weak communication and development between surrounding counties. Over the five-year period, significant disparities in economic development among Gansu Province’s counties are evident. Liangzhou District ranks highest in county economic development, while other counties with robust economic development are primarily concentrated in the Lanzhou–Baiyin metropolitan area, the Tianshui metropolitan area, the west entrance of the Hexi Corridor economic belt, and the Qingyang–Pingliang group area. These counties exhibit a spatial pattern of agglomeration towards the central and eastern regions. Moreover, some counties in the southeastern region of Longdong demonstrate promising economic development potential, forming an initial scale of contiguous development. This indicates favorable prospects for sustainable development in the region’s county economy. Full article

In this paper, a novel input impedance analysis methodology based on Babinet’s principle to broaden bandwidth is proposed, and a broadband multiple-input and multiple-output (MIMO) antenna system is designed, fabricated, and measured for fifth-generation (5G) and Wireless Fidelity (Wi-Fi) 6E/7 mobile applications. By analyzing the input impedance of open-slot antennas and planar monopole antennas using numerical calculations, the characteristics of the input impedance can be obtained. We find that combining the two antenna types in parallel can significantly enhance the bandwidth. Then, the four-dimensional image calculated by MATLAB based on the parallel impedance formula is processed to validate the methodology. Thus, a broad antenna element based on the impedance property analysis methodology is achieved, which operates ranging from 2.6 GHz to 7.46 GHz. Moreover, the equivalent circuit of the antenna element is established to further verify the validity of the methodology. Finally, a broadband MIMO antenna system consisting of eight antenna elements is designed, fabricated, and measured, and the isolation performance is better than 12 dB. Acceptable total efficiency higher than 45% is also obtained with envelope correlation coefficients (ECCs) lower than 0.05. The proposed impedance property analysis methodology innovatively proposes a new way to increase bandwidth, which can be widely applied in various antenna designs. Also, reasonable results show that the proposed MIMO antenna system is a good candidate for 5G and Wi-Fi 6E/7 mobile applications. Full article

Neurodegenerative diseases represent a cluster of conditions characterized by the progressive degeneration of the structure and function of the nervous system. Despite significant advancements in understanding these diseases, therapeutic options remain limited. The medicinal mushroom Ganoderma lucidum has been recognized for its comprehensive array of bioactive compounds with anti-inflammatory and antioxidative effects, which possess potential neuroprotective properties. This literature review collates and examines the existing research on the bioactivity of active compounds and extracts from Ganoderma lucidum in modulating the pathological hallmarks of neurodegenerative diseases. The structural information and preparation processes of specific components, such as individual ganoderic acids and unique fractions of polysaccharides, are presented in detail to facilitate structure–activity relationship research and scale up the investigation of in vivo pharmacology. The mechanisms of these components against neurodegenerative diseases are discussed on multiple levels and elaborately categorized in different patterns. It is clearly presented from the patterns that most polysaccharides of Ganoderma lucidum possess neurotrophic effects, while ganoderic acids preferentially target specific pathogenic proteins as well as regulating autophagy. Further clinical trials are necessary to assess the translational potential of these components in the development of novel multi-target drugs for neurodegenerative diseases. Full article

Accurately identifying individual wildlife is critical to effective species management and conservation efforts. However, it becomes particularly challenging when distinctive features, such as spot shape and size, serve as primary discriminators, as in the case of Sika deer. To address this challenge, we employed four different Convolutional Neural Network (CNN) base models (EfficientNetB7, VGG19, ResNet152, Inception_v3) within a Siamese Network Architecture that used triplet loss functions for the identification and re-identification of Sika deer. Subsequently, we then determined the best-performing model based on its ability to capture discriminative features. From this model, we extracted embeddings representing the learned features. We then applied a Support Vector Machine (SVM) to these embeddings to classify individual Sika deer. We analyzed 5169 image datasets consisting of images of seven individual Sika deers captured with three camera traps deployed on farmland in Hokkaido, Japan, for over 60 days. During our analysis, ResNet152 performed exceptionally well, achieving a training accuracy of 0.97, and a validation accuracy of 0.96, with mAP scores for the training and validation datasets of 0.97 and 0.96, respectively. We extracted 128 dimensional embeddings of ResNet152 and performed Principal Component Analysis (PCA) for dimensionality reduction. PCA1 and PCA2, which together accounted for over 80% of the variance collectively, were selected for subsequent SVM analysis. Utilizing the Radial Basis Function (RBF) kernel, which yielded a cross-validation score of 0.96, proved to be most suitable for our research. Hyperparameter optimization using the GridSearchCV library resulted in a gamma value of 10 and C value of 0.001. The OneVsRest SVM classifier achieved an impressive overall accuracy of 0.97 and 0.96, respectively, for the training and validation datasets. This study presents a precise model for identifying individual Sika deer using images and video frames, which can be replicated for other species with unique patterns, thereby assisting conservationists and researchers in effectively monitoring and protecting the species. Full article

Over time, inclusive education has evolved in the search for more appropriate designations for its target audience, aiming to promote inclusive language and combat prejudiced and discriminatory behavior. More current paradigms, such as the Universal Design for Learning and the Multilevel Approach, propose completely abandoning the use of designations for students (1). This qualitative study uses a documentary analysis to examine how the statutes of 26 Portuguese public higher education institutions (HEIs) designate students who need academic support and to understand the educational concepts associated with these designations (2). The results revealed that Portuguese HEIs still adopt various student designations, often based on a medical model of classification and diagnosis. Furthermore, these designations do not fully encompass academic diversity, nor do they consider the diverse needs that students may present throughout their academic journey, which consequently limits access for all to inclusive practices in higher education (3). Considering these findings, there is an urgent need to abandon student designations in Portuguese HEIs and promote inclusive practices that cater to everyone, ensuring that students remain in and succeed in higher education, regardless of medical validation (4). Full article

Class III peroxidases (CIII PRXs) are plant-specific enzymes with high activity that play key roles in the catalysis of oxidation-reduction reactions. In plants, CIII PRXs can reduce hydrogen peroxide to catalyze oxidation–reduction reactions, thereby affecting plant growth, development, and stress responses. To date, no systematic analysis of the CIII PRX gene family in litchi (Litchi chinensis Sonn.) has been documented, although the genome has been reported. In this study, a total of 77 CIII PRX (designated LcPRX) gene family members were predicted in the litchi genome to provide a reference for candidate genes in the responses to abiotic stresses during litchi growth and development. All of these LcPRX genes had different numbers of highly conserved PRX domains and were unevenly distributed across fifteen chromosomes. They were further clustered into eight clades using a phylogenetic tree, and almost every clade had its own unique gene structure and motif distribution. Collinearity analysis confirmed that there were eleven pairs of duplicate genes among the LcPRX members, and segmental duplication (SD) was the main driving force behind the LcPRX gene expansion. Tissue-specific expression profiles indicated that the expression levels of all the LcPRX family members in different tissues of the litchi tree were significantly divergent. After different abiotic stress treatments, quantitative real-time PCR (qRT-PCR) analysis revealed that the LcPRX genes responded to various stresses and displayed differential expression patterns. Physicochemical properties, transmembrane domains, subcellular localization, secondary structures, and cis-acting elements were also analyzed. These findings provide insights into the characteristics of the LcPRX gene family and give valuable information for further elucidating its molecular function and then enhancing abiotic stress tolerance in litchi through molecular breeding. Full article

Objectives: Minimally invasive direct coronary artery bypass (MIDCAB) is an alternative for revascularisation of the isolated left anterior descending (LAD) artery or as a multi-vessel (MV) procedure for the diagonal branch (RD) or the left circumflex coronary artery (LCX) region. Methods: From 2021 to 2022, 91 patients underwent MIDCAB or multi-vessel MIDCAB procedures in our heart center. The left internal mammary artery (LIMA) was anastomosed to the left anterior descending artery via the left minithoracotomy approach in all patients. Results: Of the patients, a total of 86.8% were male. Eighty percent of the patients had two- or three-vessel coronary artery disease. The mean age was 65.1 ± 10.1 years. The mean operation time was 2.6 ± 0.8 h. The 30-day mortality was 0. The mean required packed red blood cells (pRBC) was 0.4 ± 1.2 unit. The mean intensive care unit stay (ICU) was 1.5 ± 1.6 days. The mean follow-up time was 1.5 ± 0.5 years. One patient received percutaneous coronary intervention due to de novo stenosis of the RCA. Late mortality was 2.2%. The Kaplan–Meier survival rate was 98.8% at 1 and 2 years. Conclusions: The postoperative complication rate of our MIDCAB cohort is low, and the short-term survival is favorable. Our postoperative and short-term clinical results demonstrate that this procedure is safe and feasible. Full article

Show-through phenomena have always been a challenging issue in color-document image processing, which is widely used in various fields such as finance, education, and administration. Existing methods for processing color-document images face challenges, including dealing with double-sided documents with show-through effects, accurately distinguishing between foreground and show-through parts, and addressing the issue of insufficient real image data for supervised training. To overcome these challenges, this paper proposes a self-supervised-learning-based method for removing show-through effects in color-document images. The proposed method utilizes a two-stage-structured show-through-removal network that incorporates a double-cycle consistency loss and a pseudo-similarity loss to effectively constrain the process of show-through removal. Moreover, we constructed two datasets consisting of different show-through mixing ratios and conducted extensive experiments to verify the effectiveness of the proposed method. Experimental results demonstrate that the proposed method achieves competitive performance compared to state-of-the-art methods and can effectively perform show-through removal without the need for paired datasets. Specifically, the proposed method achieves an average PSNR of 33.85 dB on our datasets, outperforming comparable methods by a margin of 0.89 dB. Full article

Nitrogen is one of the significant pollutants emitted from coal combustion, and the study of its distribution and occurrence is very important for the efficient and clean utilization of coal resources. Four kinds of coal with different metamorphic ranks from major coal-producing provinces of China were studied. A gravity float-and-sink experiment was applied to obtain coal samples with different densities from Shanxi Province. The microscope optical method, Kjeldahl method, and X-ray photoelectron spectroscopy (XPS) were used to assess the occurrence, form, and distribution of nitrogen in the coal. The results show that the nitrogen content was about 0.47%–1.85%, and the maximum nitrogen content was positively correlated with the rank of coal, but the difference was not obvious. In the low-rank coal, the nitrogen content was mainly related to vitrinite and inertinite, while in the middle–high-rank coal, the nitrogen content was mainly related to inertinite and minerals. Pyrrolic (N-5) and pyridinic (N-6) were the main forms of nitrogen in the low-rank coal. The contents of N-6 and N-5 decreased with increases in the coal density, but the contents of quaternary N-Q1 and quaternary N-Q2 increased. N-Q2 mainly comes from fixed ammonia nitrogen in minerals, and vitrinite and liptinite contain more N-6 and less N-Q1 than inertinite. This research provides valuable evaluation guidance for the efficient utilization of coal. Full article

Tropical and subtropical crops are being increasingly cultivated in South Korea, leading to an increase in damage by exotic insect pests. Consequently, ethyl formate (EF) is currently being considered for quarantine and pre-shipment fumigation. In this study, we evaluated the effectiveness of EF fumigation for controlling Aphis spiraecola Patch and Aphis gossypii Glover, two representative quarantine pests on passion fruit (“Pink Bourbon”) during greenhouse cultivation and post-harvest storage. The efficacy of EF against both aphids in terms of the lethal concentration causing 50% mortality (LCt_50%) and LCt_99% was 1.36–2.61 g h/m³ and 3.73–7.55 g h/m³ under greenhouse conditions (23 °C), and 1.37–2.02 g h/m³ and 3.80–14.59 g h/m³ post-harvest (5 °C), respectively. EF at 4 g/m³ for 4 h resulted in 100% mortality of A. spiraecola, which was more resistant to EF, without causing phytotoxic damage to the trees in a 340 m³ greenhouse. Post-harvest fruit fumigation at 10 g/m³ for 4 h in a mid-size (0.8 m³) fumigation chamber resulted in complete disinfection. Moreover, the EF level decreased below the EF threshold within 10 min after natural ventilation in the greenhouse. Therefore, our results suggest EF fumigation as an effective method for controlling A. spiraecola and A. gossypii. Full article

Introduction: Although stentrievers (SRs) have been a mainstay of mechanical thrombectomy (MT), and current guidelines recommend the use of SRs in the treatment of large vessel occlusion stroke (LVO), there is a paucity of studies in the literature comparing SRs directly against each other in terms of mechanical and functional properties. Timely access to endovascular therapy and the ability to restore intracranial flow in a safe, efficient, and efficacious manner have been critical to the success of MT. This study aimed to investigate the impact of contemporary SR characteristics, including model, brand, size, and length, on the first-pass effect (FPE) in patients with acute ischemic stroke. Methods: Consecutive patients with M1 occlusion treated with a single SR+BGC were recruited from the ROSSETTI registry. The primary outcome was the FPE that was defined as modified (mFPE) or true (tFPE) for the achievement of modified thrombolysis in cerebral infarction (mTICI) grades 2b-3 or 3 after a single device pass, respectively. We compared patients who achieved mFPE with those who achieved tFPE according to SR characteristics. Results: We included 610 patients (52.3% female and 47.7% male, mean age 75.1 ± 13.62 years). mFPE was achieved in 357 patients (58.5%), whereas tFPE was achieved in 264 (43.3%). There was no significant association between SR characteristics and mFPE or tFPE. Specifically, the SR size did not show a statistically significant relationship with improvement in FPE. Similarly, the length of the SR did not yield significant differences in the mFPE and tFPE, even when the data were grouped. Conclusions: Our data indicate that contemporary SR-mediated thrombectomy characteristics, including model, brand, size, and length, do not significantly affect the FPE. Full article

The testes serve as the primary source of androgens and the site of spermatogenesis, with their development and function governed by hormonal actions via endocrine and paracrine pathways. Male fertility hinges on the availability of testosterone, a cornerstone of spermatogenesis, while follicle-stimulating hormone (FSH) signaling is indispensable for the proliferation, differentiation, and proper functioning of Sertoli and germ cells. This review covers the research on how androgens, FSH, and other hormones support processes crucial for male fertility in the testis and reproductive tract. These hormones are regulated by the hypothalamic–pituitary–gonad (HPG) axis, which is either quiescent or activated at different stages of the life course, and the regulation of the axis is crucial for the development and normal function of the male reproductive system. Hormonal imbalances, whether due to genetic predispositions or environmental influences, leading to hypogonadism or hypergonadism, can precipitate reproductive disorders. Investigating the regulatory network and molecular mechanisms involved in testicular development and spermatogenesis is instrumental in developing new therapeutic methods, drugs, and male hormonal contraceptives. Full article

The compound 6-methoxyseselin, derived from Zanthoxylum tingoassuiba, demonstrates various therapeutic properties, including vasorelaxation, antinociceptive, anti-inflammatory, and immunomodulatory effects, along with recently discovered antiasthmatic properties. This study aimed to evaluate its preclinical pharmacokinetics and pulmonary delivery in Balb/c mice. The method involved administering the compound via inhalation and intravenous routes, followed by blood sample collection for analysis using high-performance liquid chromatography with diode array detection (HPLC-DAD). The results indicated good linearity, precision, accuracy, and stability of the compound in the biological samples. Pharmacokinetic parameters such as the rate of elimination, half-life, clearance, volume of distribution, area under the curve, and mean residence time were determined for both administration routes, showing similar profiles. The lung concentrations were notably higher than the plasma concentrations, indicating significant lung penetration. These findings suggest 6-methoxyseselin as a promising candidate for new anti-asthmatic drugs, supported by its favorable pharmacokinetic profiles and high lung penetration factors. This study represents the first exploration of the pharmacokinetics and pulmonary delivery of 6-methoxyseselin in mice, highlighting its potential for further drug development. Full article

CoCrFeNiZr_0.3 is a two-phase coexisting (Laves + FCC) high-entropy alloy with high strength, excellent corrosion resistance, and thermal stability. However, the inhomogeneous distribution of the eutectic structure among the dendrites has a detrimental effect on the coordinated deformation of the material. The current study shows that the grain size, weave structure, and second phase distribution of high-entropy alloys can be significantly changed by thermal deformation, which affects the mechanical and physical properties, as well as the chemical stability of the alloys. In this study, the thermal deformation behavior of CoCrFeNiZr_0.3 biphasic hypoeutectic high-entropy alloy was investigated using a Gleeble-3500 thermal simulation tester under the conditions of deformation temperature of 950–1100 °C and deformation rate of 0.001–1 s⁻¹. The results show that CoCrFeNiZr_0.3 high-entropy alloy has higher deformation activation energy, which means its deformation resistance is larger. In addition, the microstructure with finer grain size and uniform distribution of Laves phase can be obtained by EBSD analysis after compression at 1000 °C and 0.01 s⁻¹. Full article

Nature-based solutions (NBSs) are becoming more and more recognized as useful instruments to address the challenges that urban areas are currently facing, i.e., climate change adaptation, flood mitigation, etc. In the present study, we aimed to: (1) compare the efficiency of mosses, lichens, herbs and trees in removing pollutants from the urban air using their biomonitoring potential; (2) assess their efficiency as nature-based solutions to mitigate urban air pollution; and (3) propose a framework for implementing such NBSs in urban areas. The first step involved analyses of the concentrations of 20 potentially toxic elements in eight selected biomonitors. After that, an assessment of their removal capacity was made on the basis of elements accumulation. This is the first complex study in an urban area involving the simultaneous application of organisms of eight different species and four different systematic groups (lichenized fungi, mosses, herbaceous plants, woody species) as well as such a large number of potentially hazardous elements. The present study sheds new light on some well-known biomonitors in the context of their application for air pollution mitigation. The great potential of the eight studied plant species for efficient removal of potentially toxic elements is highlighted and their implementation into NBS frameworks is recommended. Full article

Negeviruses are insect-specific enveloped RNA viruses that exhibit a wide geographic distribution. A novel nege-like virus, tentatively named Aphis gossypii nege-like virus (AGNLV, GenBank: OR880429.1), was isolated from aphids (Aphis gossypii) in Lijiang City, Yunnan, China. AGNLV has a genome sequence of 9258 nt (excluding the polyA tail) encoding three open reading frames (ORFs). ORF1 (7149 nt) encodes a viral methyltransferase, a viral RNA helicase, and an RNA-dependent RNA polymerase. ORF2 (1422 nt) encodes a DiSB-ORF2_chro domain and ORF3 encodes an SP24 domain. The genome sequence of AGNLV shares the highest nucleotide identity of 60.0% and 59.5% with Wuhan house centipede virus 1 (WHCV1) and Astegopteryx formosana nege-like virus (AFNLV), respectively. Phylogenetic analysis based on the RNA-dependent RNA polymerase shows that AGNLV is clustered with other negeviruses and nege-like viruses discovered in aphids, forming a distinct “unclassified clade”. Interestingly, AGNLV only encodes three ORFs, whereas AFNLV and WHCV1 have four ORFs. Structure and transmembrane domain predictions show the presence of eight alpha helices and five transmembrane helices in the AGNLV ORF3. Translational enhancement of the AGNLV 5′ UTR was similar to that of the 5′ UTR of plant viruses. Our findings provide evidence of the diversity and structure of nege-like viruses and are the first record of such a virus from a member of the genus Aphis. Full article

Determining the appropriate sample size is crucial in clinical studies due to the potential limitations of small sample sizes in detecting true effects. This work introduces the use of Wasserstein Generative Adversarial Networks (WGANs) to create virtual subjects and reduce the need for recruiting actual human volunteers. The proposed idea suggests that only a small subset (“sample”) of the true population can be used along with WGANs to create a virtual population (“generated” dataset). To demonstrate the suitability of the WGAN-based approach, a new methodological procedure was also required to be established and applied. Monte Carlo simulations of clinical studies were performed to compare the performance of the WGAN-synthesized virtual subjects (i.e., the “generated” dataset) against both the entire population (the so-called “original” dataset) and a subset of it, the “sample”. After training and tuning the WGAN, various scenarios were explored, and the comparative performance of the three datasets was evaluated, as well as the similarity in the results against the population data. Across all scenarios tested, integrating WGANs and their corresponding generated populations consistently exhibited superior performance compared with those from samples alone. The generated datasets also exhibited quite similar performance compared with the “original” (i.e., population) data. By introducing virtual patients, WGANs effectively augment sample size, reducing the risk of type II errors. The proposed WGAN approach has the potential to decrease costs, time, and ethical concerns associated with human participation in clinical trials. Full article

This study aimed to evaluate walking independence in acute-care hospital patients using neural networks based on acceleration and angular velocity from two walking tests. Forty patients underwent the 10-meter walk test and the Timed Up-and-Go test at normal speed, with or without a cane. Physiotherapists divided the patients into two groups: 24 patients who were monitored or independent while walking with a cane or without aids in the ward, and 16 patients who were not. To classify these groups, the Transformer model analyzes the left gait cycle data from eight inertial sensors. The accuracy using all the sensor data was 0.836. When sensor data from the right ankle, right wrist, and left wrist were excluded, the accuracy decreased the most. When analyzing the data from these three sensors alone, the accuracy was 0.795. Further reducing the number of sensors to only the right ankle and wrist resulted in an accuracy of 0.736. This study demonstrates the potential of a neural network-based analysis of inertial sensor data for clinically assessing a patient’s level of walking independence. Full article

The neuroimmune system is a collection of immune cells, cytokines, and the glymphatic system that plays a pivotal role in the pathogenesis and progression of Alzheimer’s disease (AD). Of particular focus are cytokines, a group of immune signaling molecules that facilitate communication among immune cells and contribute to inflammation in AD. Extensive research has shown that the dysregulated secretion of certain cytokines (IL-1β, IL-17, IL-12, IL-23, IL-6, and TNF-α) promotes neuroinflammation and exacerbates neuronal damage in AD. However, anti-inflammatory cytokines (IL-2, IL-3, IL-33, and IL-35) are also secreted during AD onset and progression, thereby preventing neuroinflammation. This review summarizes the involvement of pro- and anti-inflammatory cytokines in AD pathology and discusses their therapeutic potential. Full article

Optimizing pain management in spinal surgery is crucial for preventing adverse events due to delayed mobilization. Magnesium sulfate has potential benefits in spinal surgery because of its analgesic properties and modulation of neurotransmitters and autonomic nervous system. Existing evidence regarding the use of magnesium sulfate is partial and controversial, necessitating a comprehensive meta-analysis to evaluate its efficacy and safety. The aim of this study was to conduct a comprehensive meta-analysis to evaluate the efficacy and safety of magnesium sulfate in spinal surgery compared to other available options. This meta-analysis adhered to the PRISMA guidelines. Patients undergoing spinal surgery were included, with the intervention group receiving intravenous magnesium sulfate (MS) at various doses or combinations, whereas the comparison group received other alternatives or a placebo. The efficacy and safety outcomes were assessed. Data were collected from multiple databases and analyzed using Review Manager version 5.4. Heterogeneity was assessed and fixed- or random-effects models were applied. The meta-analysis included eight studies (n = 541). Magnesium sulfate demonstrated significant reductions in pain at 24 h (MD −0.20, 95% CI: −0.39 to −0.02) and opioid consumption (SMD −0.66, 95% CI: −0.95 to −0.38) compared to placebo. Additionally, a decrease in the use of muscle relaxants (SMD −0.91, 95% CI: −1.65 to −0.17) and remifentanil (SMD −1.52, 95% CI: −1.98 to −1.05) was observed. In contrast, an increase in extubation time (MD 2.42, 95% CI: 1.14 to 3.71) and verbal response (MD 1.85, 95% CI: 1.13 to 2.58) was observed compared to dexmedetomidine. In conclusion, magnesium sulfate administration in spinal surgery reduced pain and opioid consumption, and prolonged orientation and verbal response. No significant differences in blood pressure or heart rate were observed between the groups. Full article

For patients diagnosed with advanced HER2-altered non-small cell lung cancer (NSCLC), the current standard of care is represented by a platinum-pemetrexed-based chemotherapy, eventually in combination with immunotherapy. Different pan-HER tyrosine kinase inhibitors have been evaluated in limited phase II trials, yielding generally unsatisfactory outcomes, although certain genotypes demonstrated some clinical benefit. Conversely, antibody-drug conjugates (ADCs) targeting HER2, particularly trastuzumab-deruxtecan, have shown promising results against HER2-mutant disease, including a great intracranial activity in patients with brain metastasis. Based on the results obtained from DESTINY-Lung01 and DESTINY-Lung02 trials, trastuzumab deruxtecan received regulatory approval as the first targeted therapy for pre-treated, HER2-mutant, advanced NSCLC patients. More recently, the Food and Drug Administration (FDA) granted the accelerated approval of trastuzumab deruxtecan for advanced, pre-treated HER2-positive solid tumours with no other treatment options. In this scenario, emerging evidence is increasingly pointing towards the exploration of combination regimens with synergistic effects in the advanced disease. In this review, we provide a detailed summary of current approaches and emerging strategies in the management of HER2-altered NSCLC, also focusing on unmet needs, including the treatment of patients with brain metastases. Full article

Background: The diagnosis of coeliac disease (CD) in adults is based on clinical, serological and histological criteria. The inappropriate performance of intestinal biopsies, non-specificity of mild histological lesions and initiation of a gluten-free diet (GFD) before biopsy may hamper the diagnosis. In these situations, determining the intraepithelial lymphogram of the duodenum by flow cytometry (IEL-FC) can be helpful. Objectives: To describe the clinical scenarios in which the IEL-FC is used and its impact on the diagnosis of CD. Methods: All adult patients with suspected CD at three tertiary centres for whom the duodenal histology and IEL-FC were available were identified. Catassi and Fasano’s diagnostic criteria and changes to a CD diagnosis after the IEL-FCs were collected. Results: A total of 348 patients were included. The following indications for an IEL-FC formed part of the initial study for CD (38%): negative conventional work-up (32%), already on a GFD before duodenal biopsies (29%) and refractoriness to a GFD (2%). The IEL-FC facilitated a definitive diagnosis in 93% of patients with an uncertain diagnosis who had had a conventional work-up for CD or who were on a GFD before histology. Conclusions: The IEL-FC facilitates the confirmation or rejection of a diagnosis of CD in clinical scenarios in which a conventional work-up may be insufficient. Full article