The Role of Multimodality Imaging in Multiple Valvular Heart Diseases. A Clinical Consensus Statement of the European Association of Cardiovascular Imaging (EACVI) of the ESC.

With this document, the European Association of Cardiovascular Imaging (EACVI) provides an Expert Consensus on the role of multi-modality imaging (MMI) in the management of patients with multiple valvular heart disease (MVD). Emphasis is given to the use of MMI to unravel the diagnostic challenges that characterize these patients and to improve risk stratification. Complementing the last European Society of Cardiology and European Association of Cardio-Thoracic Surgery guidelines on valvular heart disease, this Expert Consensus document also outlines how MMI assessment should form an integral part of the multi-disciplinary heart team discussion for patients with MVD to help with complex decision-making regarding the choice and timing of treatment.

Aspirin Plus Rivaroxaban Versus Rivaroxaban Alone for the Prevention of Venous Stent Thrombosis Among Patients With Post-Thrombotic Syndrome: The Multicenter, Multinational, Randomized, Open-label ARIVA Trial.

Background: In patients with post-thrombotic syndrome (PTS), stent recanalization of iliofemoral veins or the inferior vena cava can restore venous patency and improve functional outcomes. The risk of stent thrombosis is particularly increased during the first 6 months after intervention. The ARIVA trial tested whether daily aspirin 100 mg plus rivaroxaban 20 mg is superior to rivaroxaban 20 mg alone to prevent stent thrombosis within 6 months after stent placement for PTS.

Evaluating robustly standardized explainable anomaly detection of implausible variables in cancer data.

Objectives: Explanations help to understand why anomaly detection algorithms identify data as anomalous. This study evaluates whether robustly standardized explanation scores correctly identify the implausible variables that make cancer data anomalous.

Materials And Methods: The dataset analyzed consists of 18 587 truncated real-world cancer registry records containing 8 categorical variables describing patients diagnosed with bladder and lung tumors.

Informed Consent and Shared Decision-Making in Modern Medicine. Case-based Approach, Current Gaps and Practical Proposal.

Advances in personalized medicine and Systems Biology have introduced probabilistic models and error discovery to cardiovascular care, aiding disease prevention and procedural planning. However, clinical application faces cultural, technical, and methodological hurdles. Patient autonomy remains essential, with shared decision-making (SDM) gaining importance in managing complex cardiovascular treatment options.

The Diagnostic Assessment of Inherited Platelet Function Defects.

In this article, our goal is to offer an introduction and overview of the diagnostic approach to inherited platelet function defects (iPFDs) for clinicians and laboratory personnel who are beginning to engage in the field. We describe the most commonly used laboratory methods and propose a diagnostic four-step approach, wherein each stage requires a higher level of expertise and more specialized methods. It should be noted that our proposed approach differs from the ISTH Guidance on this topic in some points.

The Diagnostic Assessment of Platelet Function Defects.

Congenital platelet disorders are rare and targeted treatment is usually not possible. Inherited platelet function disorders (iPFDs) can affect surface receptors and multiple platelet responses such as defects of platelet granules, signal transduction, and procoagulant activity. If iPFDs are also associated with a reduced platelet count (thrombocytopenia), it is not uncommon to be misdiagnosed as immune thrombocytopenia.

Multicomponent Electrosynthesis of Enaminyl Sulfonates Starting from Alkylamines, SO, and Alcohols.

An electrochemical one-pot synthesis of enaminyl sulfonate esters was established, featuring a quasidivided cell under constant current conditions. The multicomponent reaction utilizes simple and readily available alkylamines and an easy-to-use stock solution of SO and alcohols. Omission of additional supporting electrolyte through in-situ-generated monoalkylsulfite facilitates the downstream processing.

Long-Term Outcomes in Radioiodine-Resistant Follicular Cell-Derived Thyroid Cancers Treated with [Lu]Lu-DOTAGA.FAPi Dimer Therapy.

The study aimed to analyze the long-term outcomes of [Lu]Lu-DOTAGA.FAPi dimer therapy in individuals diagnosed with radioiodine-resistant (RAI-R) follicular cell-derived thyroid cancer. In this retrospective study, 73 patients with RAI-R follicular thyroid carcinoma who had undergone multiple lines of previous treatments were included.

Early-life adversity as a predictor of fibromyalgia syndrome: the central role of perceived stress over endocrine stress indicators.

This study investigates the associations between early childhood adversities, stress perception, and fibromyalgia syndrome (FMS). Although the interconnection between dysregulated stress systems and FMS is well documented, the interconnection between early adversities and FMS remains less understood. This study explores the relationship of early-life stress and FMS by examining its mediation through perceived stress, and acute and chronic endocrine stress indicators.

Diagnosis and management of de novo non-specific spinal infections: European Association of Neurosurgical Societies (EANS) Spine Section Delphi consensus recommendations.

Introduction: The management of de novo non-specific spinal infections (spondylodiscitis - SD) remains inconsistent due to varying clinical practices and a lack of high-level evidence, particularly regarding the indications for surgery.

Research Question: This study aims to develop consensus recommendations for the diagnosis and management of SD, addressing diagnostic modalities, surgical indications, and treatment strategies.

Material And Methods: A Delphi process was conducted with 26 experts from the European Association of Neurosurgical Societies (EANS).

Copper-Induced Transgenerational Plasticity in Plant Defence Boosts Aphid Fitness.

Transgenerational plasticity in plants is an increasingly recognized phenomenon, yet it is mostly unclear whether transgenerational plasticity is relevant to both the fitness of the plant and its interacting species. Using monoclonal strains of the giant duckweed (Spirodela polyrhiza) and its native herbivore, the waterlily aphid (Rhopalosiphum nymphaeae), we assessed whether pre-treating plants with copper excess, both indoors and outdoors, induces transgenerational plasticity in plant defences that alter plant and herbivore fitness. Outdoors, copper pre-treatment tended to increase plant growth rates under recurring copper excess.

Precision in Liver Diagnosis: Varied Accuracy Across Subgroups and the Need for Variable Thresholds in Diagnosis of MASLD.

Background And Aims: The performance of non-invasive liver tests (NITs) is known to vary across settings and subgroups. We systematically evaluated whether the performance of three NITs in detecting advanced fibrosis in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) varies with age, sex, body mass index (BMI), type 2 diabetes mellitus (T2DM) status or liver enzymes.

Methods: Data from 586 adult LITMUS Metacohort participants with histologically characterised MASLD were included.

Jacob Fidelis Ackermann (1765-1815): pioneer in the anatomical description of basilar invagination.

Jacob Fidelis Ackermann was a German Medical Doctor born in 1765 in the city of Rüdesheim. Between 1789 and 1815 years he was professor of medicine at the universities of Mainz and Heidelberg, teaching the disciplines of anatomy, physiology, botany, and natural history. In his famous work on basilar invagination, Ackermann described and illustrated the cranial base flattening in two skulls from Italy.

Exogenous dsRNA triggers sequence-specific RNAi and fungal stress responses to control Magnaporthe oryzae in Brachypodium distachyon.

In vertebrates and plants, dsRNA plays crucial roles as PAMP and as a mediator of RNAi. How higher fungi respond to dsRNA is not known. We demonstrate that Magnaporthe oryzae (Mo), a globally significant crop pathogen, internalizes dsRNA across a broad size range of 21 to about 3000 bp.

Biocompatibility of variable thicknesses of a novel directly printed aligner in orthodontics.

Direct printed aligners (DPAs) offer benefits like the ability to vary layer thickness within a single DPA and to 3D print custom-made removable orthodontic appliances. The biocompatibility of appliances made from Tera Harz TA-28 (Graphy Inc., Seoul, South Korea) depends on strict adherence to a standardized production and post-production protocol, including UV curing.

Apixaban versus aspirin for stroke prevention in people with subclinical atrial fibrillation and a history of stroke or transient ischaemic attack: subgroup analysis of the ARTESiA randomised controlled trial.

Background: People with subclinical atrial fibrillation are at increased risk of stroke, albeit to a lesser extent than those with clinical atrial fibrillation, leading to an ongoing debate regarding the benefit of anticoagulation in these individuals. In the ARTESiA trial, the direct-acting oral anticoagulant apixaban reduced stroke or systemic embolism compared with aspirin in people with subclinical atrial fibrillation, but the risk of major bleeding was increased with apixaban. In a prespecified subgroup analysis of ARTESiA, we tested the hypothesis that people with subclinical atrial fibrillation and a history of stroke or transient ischaemic attack, who are known to have an increased risk of recurrent stroke, would show a greater benefit from oral anticoagulation for secondary stroke prevention compared with those without a history of stroke or transient ischaemic attack.

Isolated subsegmental pulmonary embolism identification based on international classification of diseases (ICD)-10 codes and imaging reports.

Background: Isolated subsegmental pulmonary embolism (issPE) is a commonly encountered diagnosis. Although the International Classification of Diseases (ICD)-10 codes are used for research, their validity for identifying issPE is unknown. Moreover, issPE diagnosis is challenging, and the findings from radiology reports may conflict with those from expert radiologists.

The vestibular and oculomotor dysfunction in Fabry disease: a cohort study in China.

Objective: Whereas a few studies have evaluated vestibular involvement in Fabry disease (FD), the relationship between vestibular/oculomotor abnormalities and disease-specific biomarkers remain unclear. Therefore, we seek to evaluate these quantitatively and analyze their relationship with disease phenotype and biomarkers in FD.

Methods: This cohort study enrolled 37 Chinese FD patients registered in our center.

Pharmaceutical Humanities and Narrative Pharmacy: An Emerging New Concept in Pharmacy.

The complexity of our life experiences and the rapid progress in science and technology clearly necessitate reflections from the humanities. The ever-growing intersection between science and society fosters the emergence of novel interdisciplinary fields of research. During the past decade, Medical Humanities arose to meet the need to unravel hidden information beyond technology-driven and fact-based medicine.

Clinical Outcomes Following a Switch of Therapy to Faricimab in Patients Affected by Neovascular Age-Related Macular Degeneration.

In this study, we evaluated clinical outcomes following a therapy switch to Faricimab, in a patient cohort affected by neovascular age-related macular degeneration (nAMD), having received prior intravitreal anti-VEGF therapy. A retrospective investigation, including 28 eyes of 23 patients, treated for nAMD at the University Medical Center Mainz, Germany was performed. A switch in therapy to Faricimab was conducted, due to an inadequate response to the previous anti-VEGF treatment.

Exploring the Link Between Renal Function Fluctuations Within the Physiological Range and Serum/CSF Levels of NfL, GFAP, tTAU, and UCHL1.

Impaired renal function can influence biomarker levels through mechanisms involving blood-brain barrier integrity and clearance pathways; however, the impact of variations within normal renal function remains unclear. The main aim of this study was to determine whether adjustment for the specific level of renal function is necessary when renal function remains within physiological levels. We studied n = 183 patients (NID n = 122; other neurological diseases n = 39; somatoform controls n = 22) who underwent lumbar puncture at University Hospital Frankfurt.

Proteostasis Decline and Redox Imbalance in Age-Related Diseases: The Therapeutic Potential of NRF2.

Nuclear factor erythroid 2-related factor 2 (NRF2) is a master regulator of cellular homeostasis, overseeing the expression of a wide array of genes involved in cytoprotective processes such as antioxidant and proteostasis control, mitochondrial function, inflammation, and the metabolism of lipids and glucose. The accumulation of misfolded proteins triggers the release, stabilization, and nuclear translocation of NRF2, which in turn enhances the expression of critical components of both the proteasomal and lysosomal degradation pathways. This process facilitates the clearance of toxic protein aggregates, thereby actively maintaining cellular proteostasis.