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Patent foramen ovale (PFO) is a remnant of normal fetal anatomy which may persist into adulthood, mostly asymptomatic. In some adults, PFO may result in a potential for shunting venous thromboembolism to the arterial circulation; less frequently it can cause interatrial, right-to-left shunting of deoxygenated blood. The pathogenesis of several medical conditions is related to the presence of PFO. Some randomized clinical trials have shown evidence of benefit for device closure as compared with medical therapy in patients with cryptogenic stroke. The literature reported several cases of carbon dioxide embolism during general laparoscopic surgery and sometimes stroke after laparoscopic or neurosurgery but there are neither prospective studies addressing these issues, nor randomized clinical trials assessing the effectiveness of pharmacotherapy or interventional procedures at decreasing risk. The European position paper suggests routine monitoring in non-cardiac surgery of patients with a PFO and no actual indications for closure. This article aims to further stratify the risk of periprocedural stroke and paradoxical embolism in this category of patients.

Obesity is a chronic and relapsing disease due to the coexistence of a patient with predisposing individual characteristics and an obesogenic environment. The recent acquisition of detailed knowledge on the mechanisms underlying the energetic homeostasis paved the way to more effective therapeutic hypotheses as compared to traditional treatments. Since obesity is a complex issue, it requires a multidisciplinary approach which is difficult to implement. However, new drugs appear promising. Currently, therapeutic success is discrete in the short term, but unsatisfying in the long term due to the high probability of body weight gain. Cardiologists play a key role in managing patients with obesity, but they are not used to manage them. The aim of this document is to summarize knowledge that clinicians need to have to appropriately manage these patients. The paper emphasizes the pivotal role of an appropriate relationship with the patient to embark on a successful treatment journey. We analyze the criteria commonly used to diagnose obesity and point out strengths and limitations of different criteria. Furthermore, we discuss the figure of the obesitologist and the role of the cardiologist. In addition, we report the main components of an effective therapeutic strategy, from educational questions to pharmacological options.

The issue of suboptimal drug regimen adherence in secondary cardiovascular prevention presents a significant barrier to improving patient outcomes. To address this, the utilization of drug combinations, specifically single pill combinations (SPCs) and polypills, was proposed as a strategy to simplify treatment regimens. This approach aims to enhance treatment accessibility, affordability, and adherence, thereby reducing healthcare costs and improving patient health. The document is an ANMCO scientific statement on simplifying drug regimens for secondary cardiovascular prevention. It discusses the underuse of treatments despite available, effective, and accessible options, highlighting a significant gap in secondary prevention across different socioeconomic statuses and countries. The statement explores barriers to implementing evidence-based treatments, including patient, healthcare provider, and system-related challenges. The paper also reviews international guidelines, the role of SPCs and polypills in clinical practice, and their economic impact, advocating for their use in secondary prevention to improve patient outcomes and adherence.

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(Series Information) European Papers - A Journal on Law and Integration, 2024 9(1), 53-68 | European Forum Insight of 2 May 2024 | (Table of Contents) I. Le contexte des interventions devant la CIJ. – II. Les modalités d’intervention devant la CIJ. – II.2. L’intervention en interprétation de l’art. 62 du Statut de la CIJ. – II.2. L’intervention en interprétation de l’art. 63 du Statut de la CIJ. – III. Les principaux arguments des interventions. – III.1. La question centrale de la compétence de la Cour: art. IX de la Convention. – III.2. L’interprétation des arts I et VIII de la Convention. – III.3. L’interprétation des arts II et III de la Convention. – IV. Impact procédural des interventions multiples devant la CIJ. – IV.1. Le double objectif des déclarations d’intervention des États membres de l’Union européenne. – IV.2. Une crainte de retard rapidement rassurée. – IV.3. L’ordonnance du 5 juin 2023. – V. Conclusion. | (Abstract) In the context of the litigation relating to the Allegations of Genocide under the Convention on the Prevention and Punishment of the Crime of Genocide (Ukraine v Russian Federation) before the International Court of Justice (ICJ), the Member States of the European Union (EU) have in turn filed a declaration of intervention on the basis of art. 63 of the Statute of the ICJ. Scarcely deployed in practice, this procedure allows third parties’ States to the proceedings to declare the interpretation they adopt on the convention in dispute to which they are parties. In the present case, the States, on the one hand, interpret the convention in such a way as to ensure the jurisdiction of the Court and, on the other hand, that the use of armed force without the authorization of the Security Council is not a means of prevention or repression, even in the case of a potential genocide. In doing so, the intervening States openly show their support for Ukraine. Furthermore, the massive use of the declaration of intervention also tends to look like a instrumentalization of the law, directed towards Russia.

(Series Information) European Papers - A Journal on Law and Integration, 2024 9(1), 69-86 | European Forum Insight of 02 May 2024 | (Table of Contents) I. Introduction. - II. Frontex under scrutiny: allegations, investigations, and the rule of law dilemma. - III. From Aleppo to the CJEU: WS et al. challenge Frontex in Court. - IV. The findings of the Court: no direct causal link. - V. Legal remedies and litigation avenues before the CJEU. - VI. In light of precedent: evolving perspectives on causation and joint liability. - VII. Consequences of WS for Frontex Accountability. - vii.1. Rapid reactions and resounding criticism. - vii.2. Unaddressed aspects: what the Court didn't say. - vii.3. Frontex Liability under the Competence Model. - VIII. Broader Consequences of WS for EU Law. - viii.1. The ecosystem of integrated administration. - viii.2. Is there space in EU law for joint liability?. - IX. Conclusion: shaping the EU joint liability landscape? | (Abstract) The Insight delves into the CJEU judgment of WS et al. v Frontex, the first action for damages against the European Border and Coast Guard Agency, Frontex, for human rights violations at the EU's external borders. Despite the prevalence of systemic violations and heightened attention to the agency's accountability, the Court, applying a stringent causality threshold, dismissed the claim, sidestepping crucial questions of positive obligations and responsibility attribution. The analysis critiques the judgment's shortcomings in causality assessment, emphasising its broader repercussions for EU law, particularly concerning liability frameworks and accountability dynamics within the new multi-actor reality of EU integrated administration. The Insight underscores the pressing need to reevaluate the existing competence model of determining liability in EU law to address its limitations and introduces the classification of these limitations as the binary of causality and the binary of jurisdiction. The CJEU’s reluctance to establish an effective framework for joint liability not only perpetuates contested accountability gaps but also risks establishing precarious areas devoid of accountability, thereby compromising the foundational principles of the Rule of Law in the European Union. The Insight concludes with a call to address these shortcomings, emphasising that rectification is not merely a matter of procedural refinement but a crucial step towards ensuring robust accountability mechanisms in EU law.

Background: This study aimed to obtain insights from epilepsy specialists on the use of Patient-Reported Outcome (PRO) measures and how they can affect the management of people with epilepsy and healthcare resource utilization. Methods: The heads of two referral units for people with epilepsy at one tertiary care hospital were invited to respond to a structured survey. Results: Paper-based questionnaires and face-to-face interviews were the main modalities used to measure the quality of life of people with epilepsy. The Quality of Life in Epilepsy Inventory-31 (QOLIE-31), the Adverse Event Profile (adult centre), the Generalized Anxiety Disorder-7, Short-Form Health Survey 36, PSY-Flex, SAFA and Child Behavior Checklist (paediatric centre) were the most used scales. There was consensus about the favourable impact of PRO upon patient management, disease management and measurement of the success of a treatment. Both respondents considered the PRO as important as other main indicators like efficacy and tolerability of the treatment. Lack of time, personnel and economic resources was identified as a barrier on the use of PRO. The PRO could reduce the number of visits, exams and treatments, and increase the time spent on each patient and the number of neuropsychological, psychological and rehabilitation services. The standardized use of PRO was considered useful and the increase in human resources was considered a priority to achieve this goal. Conclusions: Despite the heterogeneity in the actual collection of PRO, there was a uniform perception about their role to optimize the care of people with epilepsy.

This article addresses the pervasive silence around menstrual health management (MHM) in Nepal, emphasizing its impact on women's rights. Despite being a natural process, menstruation remains taboo, perpetuating gender discrimination and restricting women's empowerment. This study examines the lack of sufficient menstruation-related targets in international development agendas and focuses on Nepal's cultural norms concerning this issue that affect women's behaviour, health, and social participation. The paper advocates for a comprehensive understanding of women's experiences and preferences to design effective MHM interventions. It explores various strategies, including campaigns against practices like Chhaupadi, presents findings from a field survey and introduces the Sparśa project - a women-led social enterprise offering biodegradable pads to counteract menstrual discrimination across Nepal. The article emphasises the historical neglect of menstrual-related needs, resulting in adverse effects like school absenteeism and social marginalization. It highlights the crucial role of coordinated efforts and fostering knowledge-sharing to implement more impactful and comprehensive interventions in the field of MHM. The research highlights the Sparśa project's potential to transform societal perceptions of menstruation, break the silence, and contribute to women's rights. It offers insights into the challenges faced by Nepali women and provides valuable considerations for global menstrual health initiatives.

How did the exhibition in the Chinese pavilion at the 57th Venice Biennale entitled Continuum – Generation by Generation (buxi 不息) mobilize the concept of buxi, which translates literally as “endlessness” or “never ceasing”? What does it mean to conceive of art, the world, and oneself through the lens of buxi, as endlessly intrarelated? This paper delves into this question from a multi-pronged perspective. First, it explains the meaning of buxi and analyzes how the show engages with aesthetic, epistemological, social and political implications of art and the world conceived through a contemporary perspective on the concept of “endlessness”. Second, the paper explores how a reading of the show and the artworks – their adopted aesthetic strategies, media, techniques, and materialities – through the lens of buxi complicates the critical and aesthetic framework for contemporary art in the global context. Finally, the paper evaluates the engagement with buxi – and the respective alternative processual ontology and temporality of art and world – as a useful mode of decolonizing the discipline of art history, even as it emphasizes the importance of adopting a dynamic pluriversal approach that attends to the transcultural relations that shape and reshape the multiplicity of meanings of art in a global framework, its multiple and entangled critical and aesthetic discourses, and the complexity of power structures, and avoids obscuring significant contexts and experiences.