Left Atrial Appendage Occlusion in Patients With Atrial Fibrillation and Hemodialysis: An International, Multicentric Registry.

Background: The net benefit of oral anticoagulation in patients with end-stage renal disease on hemodialysis (HD) is uncertain. In recent years, left atrial appendage closure (LAAC) has emerged as an alternative to oral anticoagulation; however, there is scant evidence of LAAC in patients on HD.

Objectives: This study aimed to assess the feasibility and safety of LAAC in patients on HD.

Prediction of long-term drug-free outcomes in ACPA-positive and ACPA-negative rheumatoid arthritis by combined clinical and ultrasound assessment of residual disease: a 5-year prospective study.

Objective: To delineate, within the framework of current clinical practice and criteria, the sustainability of first-line immuno-suppressive treatment discontinuation in rheumatoid arthritis (RA) and the impact of residual disease in remission on long-term drug-free (DF) outcomes.

Methods: RA patients, referring to the Pavia early arthritis clinic (EAC) between 2009 and 2021 and achieving remission after Disease Activity Score-driven methotrexate (MTX) monotherapy, were recruited. Eligible patients underwent DF follow-up at 3-month intervals over 5 years after MTX discontinuation.

Antidepressants versus placebo for generalised anxiety disorder (GAD).

Background: Generalised anxiety disorder (GAD) is a mental health condition characterised by excessive anxiety and worry about everyday events. GAD is a common disorder and generally affects women twice as often as men. Treatments include various psychological and pharmacological therapies.

Systematic review on Endocrine Disrupting Chemicals in breastmilk and neuro-behavioral development: insight into the early ages of life.

Breast milk (BM) is the main nutrition source for infants that plays a key role on growth and development. Human milk composition includes endogenous and exogenous substances, including endocrine disrupting chemicals (EDCs). EDCs are man-made environmental chemicals present in everyday environment and food that can disrupt the programming of endocrine signalling pathways during development, resulting in adverse effects that may not be apparent until much later in life.

The inflammatory profiling in a cohort of older patients suffering from cognitive decline and dementia.

Background: During aging, there is a progressive impairment of immune cell function that triggers the production of pro-inflammatory cytokines causing the so-called "inflammaging". Frailty represents a condition of increased vulnerability to stresses and reduced homeostatic reserve reflecting not only health status but also biological age. In older subjects without dementia, we showed that markers of inflammaging were differently associated with chronological age than with frailty.

Anaphylaxis definition, overview, and clinical support tool: 2024 consensus report.

Background: The 2006 National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network (NIAID/FAAN) anaphylaxis criteria are widely used in clinical care and research. In 2020, the World Allergy Organization (WAO) published modified criteria that have not been uniformly adopted. Different criteria contribute to inconsistent care and research outcomes.

Genomic insights into the biogeography and evolution of Galápagos iguanas.

Galápagos iguanas are a monophyletic group endemic to the Galápagos archipelago, comprising the marine iguana Amblyrhynchus cristatus and three species of land iguanas: Conolophus subcristatus, C. pallidus and C. marthae.

Cerclage in singleton pregnancies with no prior spontaneous PTB and short cervix: a randomized controlled trial.

Background: PTB (PTB) remains a leading cause of neonatal morbidity and mortality. Cerclage for short cervical length (CL) ≤25mm in singletons with a history of spontaneous PTB is associated with decreased neonatal morbidity/mortality. Both vaginal progesterone and cerclage individually have level 1 evidence supporting benefit in prevention of PTB in pregnancies complicated by short CL, however there is a paucity of level 1 evidence regarding the potential benefit of cerclage with progesterone compared to progesterone alone for short CL ≤25mm in singletons without a history of spontaneous PTB.

How the COAPT trial affected the selection of patients with secondary mitral regurgitation undergoing transcatheter edge-to-edge repair: insights from the GIOTTO Registry.

Background: The impact of the COAPT results on clinical practice has not yet been investigated in large real-world cohort study. The aim of the study is to evaluate the potential impact of the COAPT trial by analyzing the temporal trends of baseline characteristics and outcome of secondary mitral regurgitation (SMR) patients undergoing MitraClip (MC) included in the GIOTTO registry.

Methods: The study population was divided into two groups, considering the enrolment before or after the COAPT publication.

Latest clinical frontiers related to autism diagnostic strategies.

The diagnosis of autism is currently based on the developmental history, direct observation of behavior, and reported symptoms, supplemented by rating scales/interviews/structured observational evaluations-which is influenced by the clinician's knowledge and experience-with no established diagnostic biomarkers. A growing body of research has been conducted over the past decades to improve diagnostic accuracy. Here, we provide an overview of the current diagnostic assessment process as well as of recent and ongoing developments to support diagnosis in terms of genetic evaluation, telemedicine, digital technologies, use of machine learning/artificial intelligence, and research on candidate diagnostic biomarkers.

Synthesis of expert opinions on fluid management in severe sepsis: A contextual review of human albumin and crystalloids.

Background: Sepsis is a critical condition associated with high mortality rates that necessitates effective fluid resuscitation. Crystalloids are widely utilized; however, human albumin solutions have been attributed potential oncotic and anti-inflammatory benefits. Given the ongoing debate and the absence of definitive empirical evidence, expert opinions provide valuable insights into the contextual and practical aspects of fluid management.

Cost-effectiveness of robotic compared with laparoscopic rectal resection. Results from the Spanish prospective national trial ROBOCOSTES.

Objective: The costs related to robotic surgery are known to be greater than those associated with laparoscopy. However, the potential for better outcomes of the former could lead to a cost-effectiveness advantage. The aim of this study is therefore to highlight the difference in cost-effectiveness between robotic and laparoscopic rectal resection.

Otolaryngological manifestations of cystic fibrosis in children: A systematic review.

Purpose: Cystic fibrosis (CF) is the most common autosomal recessive disorder in the Caucasian population. Otolaryngological manifestations pose a significant impact on the quality of life of children with CF. The primary aim of this review is to provide a state of the art update of current literature on the otolaryngological manifestations of CF in children.

ShadowGAN-Former: Reweighting self-attention based on mask for shadow removal.

Shadow removal remains a challenging visual task aimed at restoring the original brightness of shadow regions in images. Many existing methods overlook the implicit clues within non-shadow regions, leading to inconsistencies in the color, texture, and illumination of the reconstructed shadow-free images. To address these issues, we propose an efficient hybrid model of Transformer and Generative Adversarial Network (GAN), named ShadowGAN-Former, which utilizes information from non-shadow regions to assist in shadow removal.

Characterization of children with early onset pediatric multiple sclerosis.

Background: Early onset pediatric multiple sclerosis (EOPMS) provides an early window of opportunity to understand the mechanisms leading to MS.

Objective: To investigate clinical, laboratory and imaging differences between children with early onset pediatric MS (<11 years, EOPMS) and late onset pediatric MS (≥11 years, LOPMS).

Methods: Mostly prospectively collected data of children with MS including clinical presentation, MRI at onset, time to second relapse, relapse rate, treatment history, and CSF markers were eligible.

Assessing the potential acoustic impact of floating offshore wind farms in the Central Mediterranean Sea.

The Strait of Sicily, a vital marine passage with diverse fauna, is seeing a steep rise in the planning of offshore wind farm projects. This study assesses the acoustic impact of these wind farms on local marine species. Underwater propagation was modeled for three proposed floating wind farms using JASCO's Marine Operations Noise Model (MONM), which integrates a parabolic equation method for frequencies from 10 to 800 Hz and a beam-tracing model for 1 to 25 kHz.

Management of presymptomatic juvenile patients with late-onset Pompe disease (LOPD).

Late-onset Pompe disease (LOPD) includes patients from 1 year of age to adulthood. The vast heterogeneity in clinical manifestations and disease progression is not fully explained; however, a short disease duration and a young age seem to be good predictors of a better response to treatment. For this purpose, we investigated and followed up a cohort of 13 juvenile patients with LOPD from the clinical and therapeutic point of view, mainly pointing out the transition from presymptomatic to symptomatic status.

Technical aspects of neuraxial analgesia during labor and maternity care: an updated overview.

Labor analgesia is increasingly widespread throughout the world with a rate ranging from 10 to 60%. The benefits regarding clinical and non-clinical maternal-fetal outcomes are currently discussed in international scientific literature. Even stage of labor needs a different and appropriate approach to control the pain; however, different techniques are reported in literature.

How does BMI correlate with menarche onset? Evidence from the Italian HBSC cross-sectional study.

Menarche is an important period in a female's life; its time of onset may depend on various factors and could correlate with the development of diseases in adulthood. Our study aims to investigate the relationship between body mass index and age at onset of menarche; METHODS: We used a unique standardized national dataset on adolescent girls participating in the Italian Health Behaviour in School-aged Children Study. Two independent nationally representative survey datasets: one on 15-year-olds (n = 6505, year 2017/2018) and one on 11-year-olds (n = 6548, year 2013/2014) were analysed.

Resistance-breaking strains of tomato spotted wilt virus hamper photosynthesis and protein synthesis pathways in a virus accumulation-dependent manner in Sw5-carrying tomatoes.

Tomato spotted wilt virus (TSWV; Orthotospovirus tomatomaculae) is one of the major horticultural threats due to its worldwide distribution and broad host range. In Italy, TSWV is widely spread in tomato (Solanum lycopersicum) crops and causes severe yield losses. In the last decades, several tomato varieties carrying the Sw-5b gene for resistance to TSWV have been released.

A SNARC-like effect for visual speed.

Numerical and nonnumerical magnitudes can be represented along a hypothetical left-to-right continuum, where smaller quantities are associated with the left side and larger quantities with the right side. However, these representations are flexible, as their intensity and direction can be modulated by various contextual cues and task demands. In four experiments, we investigated the spatial representation of visual speed.

Is the treatment of ankle osteoarthritis changing over time in Italy? Analysis of temporal trends for fusion and arthroplasty in a population-based study from 2001 to 2022 on the National Hospital Discharge Record database.

Background: Treatment of ankle osteoarthritis by total ankle replacement (TAR) is increasing worldwide. The aim of the study was to present the overall temporal trends of TAR throughout 22 years (2001-2022) in Italy, analyzing the distributions of hospitals by volume of activity and patients by age and sex, drawing on the National Hospital Discharge Record database. Furthermore, as a secondary aim, we compared these trends with those of ankle fusions.

Deep learning reconstruction of zero-echo time sequences to improve visualization of osseous structures and associated pathologies in MRI of cervical spine.

Objectives: To determine whether deep learning-based reconstructions of zero-echo-time (ZTE-DL) sequences enhance image quality and bone visualization in cervical spine MRI compared to traditional zero-echo-time (ZTE) techniques, and to assess the added value of ZTE-DL sequences alongside standard cervical spine MRI for comprehensive pathology evaluation.

Methods: In this retrospective study, 52 patients underwent cervical spine MRI using ZTE, ZTE-DL, and T2-weighted 3D sequences on a 1.5-Tesla scanner.

CompositIA: an open-source automated quantification tool for body composition scores from thoraco-abdominal CT scans.

Background: Body composition scores allow for quantifying the volume and physical properties of specific tissues. However, their manual calculation is time-consuming and prone to human error. This study aims to develop and validate CompositIA, an automated, open-source pipeline for quantifying body composition scores from thoraco-abdominal computed tomography (CT) scans.