[Mineralocorticoid receptor antagonists in heart failure with preserved/mildly reduced ejection fraction: from TOPCAT to FINEARTS-HF].

Mineralocorticoid receptor antagonists (MRAs) represent one of the cornerstones of treatment for heart failure with reduced ejection fraction. Post-hoc data from the TOPCAT trial, conducted in patients with heart failure mildly reduced or preserved ejection fraction (HFmrEF/HFpEF), suggest the possible clinical benefit of MRAs, particularly for slightly reduced ejection fraction values. The advent of non-steroidal MRAs, including finerenone, seems to represent a turning point in the treatment for HFmrEF/HFpEF.

[Multidisciplinary and multiprofessional care to multimorbid chronic patients with cardiovascular disease: the experience of the Azienda Sanitaria Universitaria Giuliano Isontina].

The world of chronic non-communicable diseases is progressively growing epidemiologically, requiring a significant commitment of resources, continuity of care, and strong integration between healthcare professionals and care settings. The National Recovery and Resilience Plan, in the Ministerial Decree 77 of 23/5/2022, identifies Community Homes as the privileged location for providing integrated, multidisciplinary and multiprofessional interventions, involving specialists and nursing clinics, general practitioners and district structures, utilizing all the necessary technological equipment, including digital platforms for telemedicine. In this context, cardiology is facing a complicated challenge: cardiologists must take care of patients with cardiovascular diseases who have also complex comorbidities and are required to extend their knowledge beyond the specific, sometimes super-specialistic, cardiovascular field, to avoid fragmentation, redundancy, and potential conflicts in the diagnostic-therapeutic care pathways.

Development and Validation of Nomograms to Predict the Overall Survival and Progression-Free Survival in Patients with Advanced Unresectable Intrahepatic Cholangiocarcinoma.

Purpose: This study aimed to develop and validate clinical nomograms for predicting progression-free survival (PFS) and overall survival (OS) in unresectable ICC patients.

Patients And Methods: Patients with ICC between 1 January 2018 and 31 May 2023 were selected and randomized into a training set and an internal validation set as a 7:3 ratio. Data analysis and modeling were conducted through R software.

Protein and DNA Conformational Changes Contribute to Specificity of Cre Recombinase.

Cre, a conservative site-specific tyrosine recombinase, is a powerful gene editing tool in the laboratory. Expanded applications in human health are hindered by lack of understanding of the mechanism by which Cre selectively binds and recombines its cognate sequences. This knowledge is essential for retargeting the enzyme to new sites and for mitigating effects of off-target recombination.

Single-Bundle Posterior Cruciate Ligament Reconstruction With Suture Tape Augmentation and Transtibial Tubercle Fixation.

The posterior cruciate ligament (PCL) is the strongest ligament of the knee and plays an important role in stabilizing the knee joint posteriorly. PCL tears are common injuries in sports injuries and traffic accidents; however, clinical outcomes after PCL reconstruction have not yet met clinicians' expectations, with a high postsurgery failure rate reported. Suture tape augmentation and supplementary fixation have shown ideal biomechanical properties in early studies.

Combined Medial Patellofemoral Ligament and Medial Quadriceps Tendon-Femoral Ligament Reconstruction With Single Knotless Anchor.

Lateral patellar dislocations represent a common orthopaedic condition in young, active individuals who experience patellar instability. Despite increasing interest in re-creating the natural biomechanics and native knee anatomy when performing medial patellar soft-tissue reconstructive procedures, there is no consensus among surgeons regarding the best techniques to use when reconstructing the medial patellofemoral ligament and medial quadriceps tendon-femoral ligament. This article details a method to reconstruct the medial patellofemoral ligament and medial quadriceps tendon-femoral ligament using a single graft and a single all-suture knotless anchor on the patella.

Nomograms Predicting Survival, Recurrence and Beneficiary Identification of Adjuvant Chemotherapy in Treatment-naïve Patients with Rectal Cancer who Underwent Upfront Curative Resection: A multi-institutional study.

Objective: To create and validate nomograms predicting overall survival and recurrence in treatment-naïve rectal cancer (RC) patients who underwent upfront surgery.

Background: Although multidisciplinary treatment is standard for locally advanced RC, understanding surgical efficacy is important for determining indications for perioperative adjuvant therapy.

Methods: RC patients who underwent upfront surgery at the Japanese Society for Cancer of the Colon and Rectum institutions were analyzed.

Methylammonium Lead Iodide across Physical Space: Phase Boundaries and Structural Collapse.

Hybrid perovskites exhibit complex structures and phase behavior under different thermodynamic conditions and chemical environments, the understanding of which continues to be pivotally important for tailoring their properties toward improved operational stability. To this end, we present for the first time a comprehensive neutron and synchrotron diffraction investigation over the pressure-temperature phase diagram of the paradigmatic hybrid organic-inorganic perovskite methylammonium lead iodide (MAPbI). This ambitious experimental campaign down to cryogenic temperatures and tens of kilobars was supported by extensive molecular dynamics simulations validated by the experimental data, to track the structural evolution of MAPbI under external physical stimuli at the atomic and molecular levels.

A Morphospace Exploration Using a General Model of Development Reveals a Basic Set of Morphologies for Early Animal Development and Evolution.

What morphologies are more likely to appear during evolution is a central question in zoology. Here we offer a novel approach to this question based on first developmental principles. We assumed that morphogenesis results from the genetic regulation of cell properties and behaviors (adhesion, contraction, etc.

Beyond predation: Fish-coral interactions can tip the scales of coral disease.

Coral reefs are critical ecosystems, fostering biodiversity and sustaining the livelihoods of millions globally. Nonetheless, they confront escalating threats, with infectious diseases emerging as primary catalysts for extensive damage, surpassing the impacts of other human-induced stressors. Disease transmission via biotic factors, particularly during fish predation, is a crucial yet often overlooked pathway.

Mutability and hypermutation antagonize immunoglobulin codon optimality.

The efficacy of antibody responses is inherently linked to paratope diversity, as generated through V(D)J recombination and somatic hypermutation. Despite this, it is unclear how genetic diversification mechanisms evolved alongside codon optimality and affect antibody expression. Here, we analyze germline immunoglobulin (IG) genes, natural V(D)J repertoires, serum IgG, and monoclonal antibody (mAb) expression through the lens of codon optimality.

Approaches to ensure an equitable and fair admissions process for medical training.

There has been considerable discussion of how best to address racial and ethnic disparities in health outcomes, both globally and specifically in the United States. Increasing diversity among future clinicians and physician-scientists has been identified as a key strategy for addressing and correcting health disparities among underrepresented populations. Increasingly, medical schools, the institutions that train clinicians, have embraced the practice of holistic review for evaluating applicants and virtually all medical schools have reported contributing to a diverse physician workforce as an important aspect of their educational mission.

Major abnormalities of the electrocardiogram and cardiovascular risk in a medium and high-risk Mediterranean population.

Introduction: Major electrocardiogram abnormalities (MECG) are common in middle-aged and older individuals and could be an important factor in predicting cardiovascular events.

Objective: To analyse the association between MECG (Minnesota classification) and CVE independently of classic cardiovascular risk factors (CVRF), and to assess whether they improve the prediction according to the Spanish Coronary Event Risk Function (FRESCO).

Method: 1.

Amino Acid Infusion for Kidney Protection in Cardiac Surgery Patients with Chronic Kidney Disease: A Secondary Analysis of the PROTECTION Trial.

Background: In the PROTECTION trial, intravenous amino acids (AA) decreased the occurrence of acute kidney injury (AKI) in cardiac surgery patients with cardiopulmonary bypass (CPB). Recruitment of renal functional reserve may be responsible for such protection. However, patients with chronic kidney disease (CKD) have diminished renal functional reserve, and AA may be less protective in such patients.

Dual Antiplatelet Treatment up to 72 Hours After Ischemic Stroke Stratified by Risk Profile: A Post Hoc Analysis.

Background: Risk profile of recurrence may influence the effect of antiplatelet therapy. This study aimed to evaluate the efficacy and safety of clopidogrel-aspirin initiated within 72 hours after symptom onset for acute mild stroke or high-risk transient ischemic attack stratified by risk profile.

Methods: This is a secondary post hoc analysis of the INSPIRES (Intensive Statin and Antiplatelet Therapy for Acute High-risk Intracranial or Extracranial Atherosclerosis) randomized clinical trial that enrolled patients 35 to 80 years old with acute mild ischemic stroke or high-risk transient ischemic attack between 2018 and 2022.

Protocol for artificial intelligence-guided neural control using deep reinforcement learning and infrared neural stimulation.

Closed-loop neural control is a powerful tool for both the scientific exploration of neural function and for mitigating deficiencies found in open-loop deep brain stimulation (DBS). Here, we present a protocol for artificial intelligence-guided neural control in rats using deep reinforcement learning (RL) and infrared neural stimulation (INS). We describe steps for integrating RL closed-loop control into neuroscience and neuromodulation studies.

New Diagnoses of Juvenile Idiopathic Arthritis Early in the COVID-19 Pandemic: Analysis of a Large United States Commercial Insurance Database.

Background/objective: Little is known about the rates of rheumatic disease diagnosis among children during the COVID-19 pandemic. We examined the impact of the pandemic on the diagnosis of juvenile idiopathic arthritis (JIA) in the United States.

Methods: We performed a historical cohort study using US commercial insurance data (2016-2021) to identify children aged <18 years without prior JIA diagnosis or treatment in the prior ≥12 months.

Differential effects of liraglutide naltrexone/bupropion, and caloric restriction on metabolic parameters and beta-cell regeneration in type 2 diabetic rat model: role of beta arrestin 1.

Traditional antidiabetic treatments often carry the risk of beta-cell exhaustion, highlighting the need for therapies that promote beta-cell regeneration. This study investigates the comparative effects of Liraglutide, naltrexone/bupropion (NTX + BUP), and caloric restriction on metabolic control and beta-cell regeneration in a rat model of obese type 2 diabetes. Fifty male albino rats were randomized into five groups: normal control, diabetic control, diabetic + caloric restriction (50%), diabetic + NTX + BUP (4 mg/45 mg /kg/day orally), and diabetic + liraglutide (0.

Tropisetron attenuates D-galactose-induced heart aging in male mice: activation of sirtuin1.

This study pursued to evaluate the tropisetron effects in attenuating D-galactose induced heart aging in mice. The study aimed to ascertain whether tropisetron affects apoptotic processes, mitochondrial oxidative stress, or inflammatory variables in cardiac tissue, presumably through the modulation of the SIRT1 signaling pathway or sirtuin 1. Aging was induced via administration of D-galactose (200 mg/kg, s.

THE INFLUENCE OF BIFIDOBACTERIUM ANIMALIS AND LECTIN OF B. SUBTILIS IMV B-7724 ON THE ANTITUMOR IMMUNE RESPONSE OF MICE WITH EHRLICH ADENOCARCINOMA.

Aim: To investigate the effect of bacteria of the genus Bifidobacterium and the extracellular metabolite of B. subtilis IMV B-7724 on the antitumor immune response of mice with a model tumor.

Materials And Methods: The study was conducted on Balb/c mice with transplanted solid Ehrlich adenocarcinoma (ACE).

Talin1 dysfunction is genetically linked to systemic capillary leak syndrome.

Systemic capillary leak syndrome (SCLS) is a rare life-threatening disorder due to profound vascular leak. The trigger and the cause of the disease are currently unknown and there is no specific treatment. Here, we identified a rare heterozygous splice-site variant in the TLN1 gene in a familial SCLS case, suggestive of autosomal dominant inheritance with incomplete penetrance.

Thermoresponsive gel embedding extracellular vesicles from adipose stromal cells improves the healing of colonic anastomoses following irradiation in rats.

Anastomotic leak occurrence is a severe complication after colorectal surgery. Considering the difficulty of treating these leaks and their impact on patient care, there is a strong need for an efficient prevention strategy. We evaluated a combination of extracellular vesicles (EVs) from rat adipose-derived stromal cells with a thermoresponsive gel, Pluronic® F127 (PF-127) to prevent anastomotic leaks.