Contemporary epidemiology of hospitalised heart failure with reduced versus preserved ejection fraction in England: a retrospective, cohort study of whole-population electronic health records.

Background: Heart failure is common, complex, and often associated with coexisting chronic medical conditions and a high mortality. We aimed to assess the epidemiology of people admitted to hospital with heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF), including the period covering the COVID-19 pandemic, which was previously not well characterised.

Methods: In this retrospective, cohort study, we used whole-population electronic health records with 57 million individuals in England to identify patients hospitalised with heart failure as the primary diagnosis in any consultant episode of an in-patient admission to a National Health Service (NHS) hospital.

Impact of positive surgical margins (PSMs) after robotic prostatectomy on biochemical recurrence (BCR): Multicenter analysis.

Objective: To study and analyze any correlations between positive surgical margins after RARP and biochemical recurrence.

Methods: We enrolled 105 patients who underwent robot-assisted radical prostatectomy (RARP) from 2016-2020 with PSMs on final pathology, all performed or supervised by a senior surgeon in two tertiary referral center. Pathology has been described indicating also the area (apical, base, mediolateral, anterior, or multiple) and the extent of PSMs: focal (≤3 mm) or extensive (>3 mm).

Ultrasonographic appearance and measurement of abdominal structures in healthy Capuchin monkeys (Sapajus spp.).

Background: Previous ultrasonographic studies of Sapajus apella to determine the normal anatomy and physiology are incomplete. The aim of this study was to determine normal ultrasonographic appearance and measurements of all abdominal organs and structures of interest.

Methods: Twelve adult monkeys were recruited considered healthy on the basis of history, physical examination, and general blood work.

Time-domain delay-and-sum beamforming for time-reversal detection of intermittent acoustic sources in flows.

This study focuses on the identification of intermittent aeroacoustic sources in flows by using the time-domain beamforming technique. It is first shown that this technique can be seen as a time-reversal (TR) technique, working with approximate Green functions in the case of a shear flow. Some numerical experiments investigate the case of an array measurement of a generic acoustic pulse emitted in a wind-tunnel flow, with a realistic multi-arm spiral array.

On the nature of the intrinsic connectivity of the cat motor cortex: evidence for a recurrent neural network topology.

The details and functional significance of the intrinsic horizontal connections between neurons in the motor cortex (MCx) remain to be clarified. To further elucidate the nature of this intracortical connectivity pattern, experiments were done on the MCx of three cats. The anterograde tracer biocytin was ejected iontophoretically in layers II, III, and V.

Corticospinal control of antagonistic muscles in the cat.

We recently suggested that movement-related inter-joint muscle synergies are recruited by selected excitation and selected release from inhibition of cortical points. Here we asked whether a similar cortical mechanism operates in the functional linking of antagonistic muscles. To this end experiments were done on ketamine-anesthetized cats.

Linear summation of cat motor cortex outputs.

Recruitment of movement-related muscle synergies involves the functional linking of motor cortical points. We asked how the outputs of two simultaneously stimulated motor cortical points would interact. To this end, experiments were done in ketamine-anesthetized cats.

The comparable size and overlapping nature of upper limb distal and proximal muscle representations in the human motor cortex.

The purpose of this study was to determine the relative size and location of proximal and distal upper limb muscle representations in the human motor cortex. Motor-evoked potentials (MEPs) evoked by transcranial magnetic stimulation were recorded in the proximal muscle anterior deltoid (AD) and in the distal muscles extensor carpi radialis (ECR) and first dorsal interosseus (1DI). The coil was moved in steps of 1 cm along a grid drawn on a tight-fitting polyester cap placed on the subject's head.

On the potential role of the corticospinal tract in the control and progressive adaptation of the soleus h-reflex during backward walking.

When untrained subjects walk backward on a treadmill, an unexpectedly large amplitude soleus H-reflex occurs in the midswing phase of backward walking. We hypothesized that activity in the corticospinal tract (CST) during midswing depolarizes the soleus alpha-motoneurons subliminally and thus brings them closer to threshold. To test this hypothesis, transcranial magnetic stimulation (TMS) was applied to the leg area of the motor cortex (MCx) during backward walking.

[Survey of physical activity and doping in a sample of 6,915 students aged 14-18 years].

Aim: Promoting physical activity is one of the main goals of health-promotion policies. The period of adolescence is characterised by a high rate of abandonment of any physical activity. In this age range, moreover, the risk of assuming substances in order to improve muscular-mass or athletic results is concrete.

How shunting inhibition affects the discharge of lumbar motoneurones: a dynamic clamp study in anaesthetized cats.

In the present work, dynamic clamp was used to inject a current that mimicked tonic synaptic activity in the soma of cat lumbar motoneurones with a microelectrode. The reversal potential of this current could be set at the resting potential so as to prevent membrane depolarization or hyperpolarization. The only effect of the dynamic clamp was then to elicit a constant and calibrated increase of the motoneurone input conductance.

[Evaluation of the efficacy of the "Spazi Giovani" of family clinics. Results of 3 ASL services of the City of Milan].

"Spazio Giovani" is a service offered once a week by many Family Counselling Services and aimed at addressing the needs of tenagers and young people who can access it free of charge and without booking an appointment. This kind of services started in the Eighties to address the needs of young people who were sexually active and often not accessing conventional services. The objective of this study has been to assess how attitudes for unprotected sex and at risk sex behaviours decrease in a population attending the Youth Corner on a regular basis in comparison with the same attitudes and behaviours in a group of first-time users of the service over a six month period.

Positive proprioceptive feedback elicited by isometric contractions of ankle flexors on pretibial motoneurons in cats.

Pretibial flexor motoneurons were recorded intracellularly in anesthetized cats during unfused isometric contractions of a subpopulation of motor units from either tibialis anterior (TA) or extensor digitorum longus (EDL) muscles. The contractions elicited excitatory postsynaptic potentials in 23 of 28 pretibial flexor motoneurons. No effect was observed in the remaining motoneurons.

[Tobacco habits in a cohort of 4,135 adolescents attending high school in northern Italy. Results of a multicenter study].

Assuming that adolescence--a high risk age as far as this behavior is concerned--is the crucial stage for prevention procedures, we don't know much about Italian adolescents' tobacco related behaviors, regardless of the fact that tobacco smoking is one of the most relevant problems of Public Health. The goal of this research has been assessing, through a multicentric study using an anonymous questionnaire, how spread is this behavior among 4135 students attending high school in five different areas of Northern Italy. The research points out a remarkable spreading of the phenomenon and suggests to anticipate prevention procedures during compulsory education, taking in account gender features.

[Assessment of eating disorders-related risk in a cohort of adolescents living in Northern Italy. Results from a multicenter study].

Background: Clinical evidence and epidemiological research show an increasing number of subjects trying to become lean and reaching consequently harmful weight conditions. Aim of this paper is to assess the risk for eating disorders during adolescence.

Methods: In a multicentric study high school students of 5 different districts of Northern Italy have been asked to fill up anonymously the Italian version of the American YRBSS (Youth Risk Behaviour Surveillance System) questionnaire.

Maternal serum screening for trisomy 18 in the first trimester of pregnancy.

The aim of this study was to evaluate the feasibility of first-trimester biochemical screening for trisomy 18, by using pregnancy-associated plasma protein A (PAPP-A) and free beta human chorionic gonadotropin (hCG) in combination with maternal age. Maternal serum levels of PAPP-A and free beta-hCG were assayed retrospectively in stored sera from 323 singleton pregnancies at 8-13 weeks' gestation. These samples included 23 trisomy 18 pregnancies and 300 unaffected controls, diagnosed either at chorionic villus sampling or at mid-trimester amniocentesis.

First trimester screening for Down's syndrome using maternal serum PAPP-A and free beta-hCG in combination with fetal nuchal translucency thickness.

The aim of this study was to evaluate the potential effectiveness of maternal serum pregnancy-associated plasma protein A (PAPP-A) and free beta-hCG in combination with nuchal translucency thickness in first trimester screening for Down's syndrome. Maternal serum levels of PAPP-A and free beta-hCG were assayed in stored sera from 32 Down's syndrome and 200 unaffected pregnancies. Fetal nuchal translucency was measured by ultrasound at the time of blood sampling.

Comparison between two methods of standardization for gestational age differences in fetal nuchal translucency measurement in first-trimester screening for trisomy 21.

Our purpose was to compare two different methods of expressing nuchal translucency (NT) measurements in first-trimester screening for trisomy 21: the difference in millimeters from the median of nuchal translucency (delta value: delta NT) and the multiple of the expected median (MoM). Fetal nuchal translucency was measured in 32 fetuses with trisomy 21 and in 3180 normal fetuses at 9-13 weeks' gestation. For each fetus, the measured nuchal translucency was expressed both as a delta value and MoM.

A rare case of cytogenetic discrepancy between extraembryonic and fetal tissue.

We present a case of false-negative discrepancy between extraembryonic and fetal tissue sampled at 14 weeks of amenorrhoea when ultrasound examination showed morphological anomalies of the fetus. The same cytogenetic characteristic was confirmed on tissue samples after abortion.

[The use of Rossavik's mathematical model in determining individual intrauterine growth curves. Our experience].

Objective: To evaluate the performance of Rossavik growth models, derived from II trimester ultrasound measurements, to predict growth in normally growing fetuses.

Design: Comparison between observed measurements after 25 weeks and those predicted by Rossavik growth models determined from the data collected in 2 ultrasound examinations at approximately 16 weeks and 24 weeks.

Setting: Teaching hospital obstetric unit, in Florence.

[Infibulation practice: clinical aspects in an adolescent outside the community].

Because of the increase arrival of extra-community people, now it is easy to meet with new pathologies or with old ones that we believed disappeared. We describe a case of infibulation practice observed in a thirteen year old coloured adolescent. She was admitted for an unknown-provenance fever.

Identification of hematopoietic progenitor cells in human amniotic fluid before the 12th week of gestation.

Due to technical difficulties in performing amniocentesis before the 12th week of pregnancy, very little is known about the components of human amniotic fluid before that time. Amniocentesis was performed between the 7th-11th week of gestation in 25 informed and consenting patients, who had to undergo therapeutic interruption of pregnancy. The cells from the amniotic fluid were stained, counted on a hemocytometer, and checked for vitality.

Evaluation of maternal serum alpha-fetoprotein and ultrasound examination to screen fetal chromosomal abnormalities.

Maternal serum alpha-fetoprotein (MSAFP), anatomic anomalies and precocious defects of foetal growth were shown as possible "indicators" of foetal chromosomal pathology, in particular Down's syndrome, and thus suggested for prenatal screening of risk patients for this chromosomal abnormalities. The Authors carried out a retrospective study on 1472 patients who underwent amniocentesis for prenatal diagnosis. Between the 15th and the 20th week, a dosage of MSAFP was effected, in order to evaluate if the serum concentration of this substance could predict Down's syndrome.

High maternal serum alpha-fetoprotein levels during the 2nd trimester of pregnancy: diagnostic approach.

The limit of the classic diagnostic protocols following the evidence of high maternal serum alpha-fetoprotein levels is represented by the high number of amniocenteses performed and that, in the most part of cases, give false negative results. Now days the introduction of high resolution ecographic equipments allows to us, in many cases, to clarify the diagnostic without further examinations. The Authors propose a diagnostic protocol that include the execution of high resolution ultrasound at the second withdrawal of serum alpha-fetoprotein, limiting the use of amniocentesis only when is necessary to determine the fetal karyotype.