Publications by authors named "Cesare N"

There is growing attention and evidence that healthcare AI is vulnerable to racial bias. Despite the renewed attention to racism in the United States, racism is often disconnected from the literature on ethical AI. Addressing racism as an ethical issue will facilitate the development of trustworthy and responsible healthcare AI.

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Individual-level assessment of health and well-being permits analysis of community well-being and health risk evaluations across several dimensions of health. It also enables comparison and rankings of reported health and well-being for large geographical areas such as states, metropolitan areas, and counties. However, there is large variation in reported well-being within such large spatial units underscoring the importance of analyzing well-being at more granular levels, such as ZIP codes.

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This work reports the first solvent-free catalytic approach for the cleavage of the fluorenylmethoxycarbonyl (Fmoc) protecting group from amine and alcohol functionalities. Various saccharide, peptide, and glyco-amino acid substrates were efficiently deprotected by simple treatment with 20 mol % neat 4-dimethylaminopyridine (DMAP) (one of the effective base catalysts found), without any solvent or stoichiometric additives. Small model structures were finally assembled through one-pot, base-catalyzed, solvent-free multistep sequences combining the Fmoc cleavage with esterification, amidation, and/or glycosylation steps.

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Article Synopsis
  • The study develops a new index tailored to predict drug overdose deaths specifically relating to opioid misuse, highlighting the influence of social determinants of health (SDoH) like socioeconomic status and food insecurity.
  • It analyzes data from four states (Kentucky, Massachusetts, New York, and Ohio) and uses a random forest model, identifying 28 SDoH measures that account for about 89% of the variance in overdose mortality rates.
  • The findings indicate that current SDoH indices do not effectively capture the complexities surrounding opioid-related deaths, particularly in racially segregated communities, underscoring a need for more targeted approaches.
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Aims: The role of coronary calcification on clinical outcomes among different revascularization strategies in patients presenting with acute coronary syndromes (ACSs) has been rarely investigated. The aim of this investigation is to evaluate the role of coronary calcification, detected by coronary angiography, in the whole spectrum of patients presenting with acute ACS.

Methods And Results: The present study was a post hoc analysis of the MATRIX programme.

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  • Prepulse inhibition (PPI) is a process that helps filter out weak sensory stimuli, and previous research indicates that smoking withdrawal can negatively affect this filtering, especially in individuals with mental health issues.
  • In a study involving trauma-exposed individuals, researchers assessed how changes in PPI during smoking cessation corresponded to smoking abstinence, finding that those who maintained abstinence showed higher PPI levels.
  • The results suggest that improving PPI during the early stages of quitting smoking could support better cessation outcomes for people with a history of trauma, particularly those at greater risk for tobacco addiction.
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This study measures associations between COVID-19 deaths and sociodemographic factors (wealth, insurance coverage, urban residence, age, state population) for states in Nigeria across two waves of the COVID-19 pandemic: February 27th 2020 to October 24th 2020 and October 25th 2020 to July 25th 2021. Data sources include 2018 Nigeria Demographic and Health Survey and Nigeria Centre for Disease Control (NCDC) COVID-19 daily reports. It uses negative binomial models to model deaths, and stratifies results by respondent gender.

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Female genital mutilation/cutting (FGM/C) describes several procedures that involve injury to the vulva or vagina for nontherapeutic reasons. Though at least 200 million women and girls living in 30 countries have undergone FGM/C, there is a paucity of studies focused on public perception of FGM/C. We used machine learning methods to characterize discussion of FGM/C on Twitter in English from 2015 to 2020.

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Background And Objective: In the last few decades, several studies have been performed to investigate traumatic brain injuries (TBIs) and to understand the biomechanical response of brain tissues, by using experimental and computational approaches. As part of computational approaches, human head finite element (FE) models show to be important tools in the analysis of TBIs, making it possible to estimate local mechanical effects on brain tissue for different accident scenarios. The present study aims to contribute to the computational approach by means of the development of three advanced FE head models for accurately describing the head tissue dynamics, the first step to predict TBIs.

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Background: Data on left main (LM) percutaneous coronary interventions (PCI) have mostly been obtained in studies using drug-eluting stent (DES) platforms without dedicated large-vessel devices and with limited expansion capability.

Aims: Our study aimed to investigate the safety and efficacy of LM PCI with the latest-generation Resolute Onyx DES.

Methods: ROLEX (Revascularization Of LEft main with resolute onyX) is a prospective, multicentre study (ClinicalTrials.

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In this study, we measured the association between county characteristics and changes in healthy-food, fast-food, and alcohol tweets during the COVID-19 pandemic in the United States. Our analytic dataset consisted of 1,282,316 geotagged tweets that referenced food consumption posted before (63.2%) and during (36.

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Background: There is a need to evaluate how the choice of time interval contributes to the lack of consistency of SDoH variables that appear as important to COVID-19 disease burden within an analysis for both case counts and death counts.

Methods: This study identified SDoH variables associated with U.S county-level COVID-19 cumulative case and death incidence for six different periods: the first 30, 60, 90, 120, 150, and 180 days since each county had COVID-19 one case per 10,000 residents.

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Objective: Electronic health records (EHR) hold promise for conducting large-scale analyses linking individual characteristics to health outcomes. However, these data often contain a large number of missing values at both the patient and visit level due to variation in data collection across facilities, providers, and clinical need. This study proposes a stepwise framework for imputing missing values within a visit-level EHR dataset that combines informative missingness and conditional imputation in a scalable manner that may be parallelized for efficiency.

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Background/objective: Lack of access to resources such as medical facilities and grocery stores is related to poor health outcomes and inequities, particularly in an environmental justice framework. There can be substantial differences in quantifying "access" to such resources, depending on the geospatial method used to generate distance estimates.

Methods: We compared three methods for calculating distance to the nearest grocery store to illustrate differential access at the census block-group level in the Atlanta metropolitan area, including: Euclidean distance estimation, service areas incorporating roadways and other factors, and cost distance for every point on the map.

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Fascicle and sarcomere lengths are important predictors of muscle mechanical performance. However, their regulation during stretch-shortening cycle (SSC) activities in usual and challenging conditions is poorly understood. In this study, we aimed to investigate muscle fascicle and sarcomere behavior during drop jumps (a common SSC activity) in conditions of variable gravity.

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 The aim of the study is to describe the real-world use of the P2Y inhibitor cangrelor as a bridging strategy in patients at high thrombotic risk after percutaneous coronary intervention (PCI) and referred to surgery requiring perioperative withdrawal of dual antiplatelet therapy (DAPT).  We collected data from nine Italian centers on patients with previous PCI who were still on DAPT and undergoing nondeferrable surgery requiring DAPT discontinuation. A perioperative standardized bridging protocol with cangrelor was used.

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Background: The epidemic of misinformation about COVID-19 transmission, prevention, and treatment has been going on since the start of the pandemic. However, data on the exposure and impact of misinformation is not readily available.

Objective: We aim to characterize and compare the start, peak, and doubling time of COVID-19 misinformation topics across 8 countries using an exponential growth model usually employed to study infectious disease epidemics.

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Article Synopsis
  • The DUBIUS study investigates the timing of administering P2Y12 inhibitors in patients with non-ST elevation acute coronary syndrome, comparing pretreatment with ticagrelor versus a downstream approach with either prasugrel or ticagrelor post-coronary anatomy assessment.
  • The study will enroll 2,520 patients and test two main hypotheses: that the downstream strategy is better than pretreatment and that downstream ticagrelor is comparable to downstream prasugrel, focusing on safety and efficacy outcomes.
  • Results from the DUBIUS study will clarify the benefits and risks of different treatment strategies for managing acute coronary syndrome, potentially influencing clinical practice guidelines.
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Background: Ticagrelor is a widely used P2Y12 inhibitor and represents a fundamental therapeutic agent in acute coronary syndrome treatment and selected post-percutaneous coronary intervention (PCI) cases. Dyspnoea and bradycardia are the most common side effects but the latter has been reported to be of trivial clinical significance.

Case Summary: A 51-year-old gentleman underwent PCI to left anterior descending and obtuse marginal for unstable angina receiving a loading dose of ticagrelor (180 mg).

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Article Synopsis
  • The study aimed to compare two strategies for administering oral P2Y inhibitors in patients with non-ST-segment elevation acute coronary syndrome undergoing invasive treatment: pre-treatment (upstream) versus administering the drugs after angiography (downstream).
  • It involved 1,449 patients and was halted due to a pre-specified rule indicating futility, as there was no significant difference in major health events between the two groups.
  • Both strategies resulted in low rates of ischemic and bleeding complications, with only a minimal numerical difference in event rates, suggesting that the timing of P2Y inhibitor administration may not greatly impact patient outcomes.
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Objective: Vaccination coverage is decreasing worldwide, favoring the potential reemergence of vaccine-preventable diseases. In this study, we performed a longitudinal characterization of vaccination coverage in Brazil and compared the profiles between the distinct regions in the country to test whether there has been a substantial change over the last 5 years.

Methods: De-identified publicly available data were retrieved from the repository of the Brazilian Ministry of Health, comprising detailed information on vaccination coverage in all age groups between 1994 and 2019.

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The editorial materials in top medical and public health journals are opportunities for experts to offer thoughts that might influence the trajectory of the field. To date, while some studies have examined gender bias in the publication of editorial materials in medical journals, none have studied public health journals. In this perspective, we studied the gender ratio of the editorial materials published in the top health and medical sciences journals between 2008 and early 2018 to test whether gender bias exists.

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