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Background: Simulation-based training plays a significant role in surgical education, especially in minimally invasive pediatric surgery and urology. This study aimed to evaluate a novel 3D-printed model as training tool for endoscopic injection of bulking agent. Methods: Forty-three attendees and ten teaching faculty members were invited to complete a post hoc questionnaire after completing training sessions using the Fish Tank Simulation Model (FTSM). The survey consisted of a 7-question 5-point Likert scale to assess the model's realism (face validity) and its effectiveness as training tool (content validity). Results: Regarding the training status, 20/53 (37.7%) participants were fellow and/or specialist in pediatric surgery and 33/53 (62.3%) were surgeons in training. Their level of confidence in endoscopic injection procedure was defined as novice (< 10 procedures per year) in 33/53 (62.3%), intermediate (10–20 procedures per year) in 10/53 (18.9%), and expert (> 20 procedures per year) in 10/53 (18.9%). Regarding both face validity and content validity assessments, no statistically significant differences were found between scores given by novice vs intermediate/expert groups. Similarly, no statistically significant differences emerged between scores given by participant vs faculty groups assessing the content validity of the FTSM. The FTSM was considered a good teaching tool for beginners by 44/53 (83%) and for pediatric surgeons/urologists by 38/53 (71.7%). Conclusions: The 3D-printed Fish Tank Simulation Model proved to be a valuable, high-fidelity, easily accessible, cost-effective, hygienic, and domestic-use training tool for pediatric surgeons/urologists conducting the procedure. The model's user-friendly design and realistic environment enhanced learning opportunities for trainees, regardless of their experience level or training status. Nevertheless, further development is necessary, particularly in enhancing the realism of the ureteral hiatus and reproducing more complex anatomy, to make it beneficial for the training of advanced surgeons. [ABSTRACT FROM AUTHOR]

Introduction: No data are available on the diagnostic algorithms recommended by guidelines for the assessment of diastolic dysfunction (DD) in patients with arterial hypertension. Aim: To fill this gap, we evaluated diastolic function in hypertensive patients with and without LVH matched with healthy subjects by applying 2016 American Society of Echocardiography-European Association of Cardiovascular Imaging Guidelines for the evaluation of LV diastolic function. Methods: 717 healthy and hypertensives with normal LV ejection fraction and with and without LV hypertrophy (LVH), matched 1:1:1 from two prospective registries, represented the study population. Results: By applying algorithm A, indeterminate pattern was found in 0.4% of healthy, in 6.3% of hypertensives without LVH, and in 21% with LVH (overall p < 0.05 vs. healthy). DD was absent in healthy, however present in 2 and 8% of hypertensives without and with LVH (p = 0.06 and p = 0.001 vs. healthy, respectively). By applying algorithm B, no cases of indeterminate pattern were found. DD was observed in 2.9% of healthy, 7 and 10.5% of hypertensives without and with LVH (p < 0.05 vs. healthy). Conclusions: The use of algorithm A should be limited only to truly normal subjects, whereas algorithm B should be applied to all patients with hypertension, even without comorbidities and irrespective of LVH. [ABSTRACT FROM AUTHOR]

Purpose: In Italy, the training of sports workers was carried out through national sports federations (NSF), sports promotion bodies (SPB) and associated disciplines (AD) since there were no laws regarding specific professional figures on a par with other labor sectors. New and recent legislation stipulates that specific training is the responsibility of universities, with the 3-year bachelor's degree program in Exercise and Sports Science (L22) for the cultural and scientific profiling of the new professional figure of the basic kinesiologist. The study measures the perceptions and opinions that students have with respect to the training in their studies and also analyze any gaps in terms of knowledge and skills to be applied in the professional field. Methods: A questionnaire was administered to 30 students consisting of 15 questions divided into three sections: Sect. 1 of sample identification, Sect. 2 assessing perceptions on knowledge acquired, and Sect. 3 assessing perceptions on skills learned. A chi-square (χ2) analysis was performed to check for significant differences. Results: The results showed a difference of opinion. Although 84.2% of the sample thought highly of the training offered, discordant data emerged on the knowledge and skills taught within the courses of study. Although this high percentage is convinced and entrusts their training to the university pathway, it is found that 19% have qualifications issued by NSF, 4.8% by other and 1.6% by SPB. In addition there is significance P =.001 demonstrating liking with respect to the training received. Conclusion: The basic kinesiologist is a key figure within sports organizations, and university training is also considered positive by those trained by NSF, SPB, and AD. [ABSTRACT FROM AUTHOR]

Hypertrophic cardiomyopathy (HCM) is mainly caused by sarcomeric mutations which may affect myocardial mechano-energetic efficiency (MEE). We investigated the effects of sarcomeric mutations on MEE. A non-invasive pressure/volume (P/V) analysis was performed. We included 49 genetically screened HCM patients. MEEi was calculated as the ratio between stroke volume and heart rate normalized by LV mass. Fifty-seven percent (57%) HCM patients carried a sarcomeric mutation. Patients with and without sarcomeric mutations had similar LV ejection fraction, heart rate, LV mass, and LV outflow gradient. Younger age at diagnosis, family history of HCM, and lower MEEi were associated with presence of sarcomeric mutation (p = 0.017; p = 0.001 and p = 0.0001, respectively). Lower MEEi in HCM with sarcomeric mutation is not related to significant differences on filling pressure as shown on P/V analysis. Sarcomeric mutations determine a reduction of the LV pump performance as estimated by MEEi in HCM. Lower MEEi may predict a positive genetic analysis. [ABSTRACT FROM AUTHOR]

Background: Anal fistula and perianal abscess are commonly acquired anorectal pathologies in children. Surgical treatment options commonly adopted are fistulotomy, fistulectomy, cutting seton placement, and more recently video-assisted anal fistula treatment (VAAFT). Optimal postoperative wound dressing remains debated. This study aimed to report our series of pediatric patients, who received VAAFT and postoperative wound dressing using ozonide oil. Methods: All patients who underwent VAAFT between August 2018 and May 2023 were included in the study. Demographics, clinical features, pre-operative imaging, surgical details, outcome, and mid-term outcome data were retrospectively reviewed for each patient. All VAAFT procedures were performed under general anesthesia and using a 10-Ch fistuloscope. Results: Thirty-three VAAFT procedures were performed in 30 patients over the study period. The median patient age was 5.7 years (range 1.75–14). Anal fistula was idiopathic in 26/30 (86.6%), iatrogenic in 2/30 (6.7%), and secondary to Crohn's disease in 2/30 (6.7%). The median duration of surgery was 23 min (range 18–40). All patients received ozonide oil dressing twice a day for 5 weeks postoperatively. The median hospital stay was 24 h (range 9–36). The median healing time was 28 days (range 17–39). With a median follow-up of 2 years (range 0.5–5), disease recurrence occurred in 3/30 (10%) patients with idiopathic fistula, who were re-operated using the same technique, with no further recurrence. No fecal incontinence or soiling was observed. Conclusion: Our series confirmed that VAAFT is a safe and effective technique to treat children with perianal fistula. The technique is versatile, allowing to treat fistulae of different etiologies. Postoperative course was painless and fast. Future comparative prospective studies are needed to better establish these conclusions. [ABSTRACT FROM AUTHOR]

Heart failure (HF) with preserved ejection fraction (HFpEF) is a prevalent global condition affecting approximately 50% of the HF population. With the aging of the worldwide population, its incidence and prevalence are expected to rise even further. Unfortunately, until recently, no effective medications were available to reduce the high mortality and hospitalization rates associated with HFpEF, making it a significant unmet need in cardiovascular medicine. Although HFpEF is commonly defined as HF with normal ejection fraction and elevated left ventricular filling pressure, performing invasive hemodynamic assessments on every individual suspected of having HFpEF is neither feasible nor practical. Consequently, several clinical criteria and diagnostic tools have been proposed to aid in diagnosing HFpEF. Overall, these criteria and tools are designed to assist healthcare professionals in identifying and evaluating patients who may have HFpEF based on a combination of signs, symptoms, biomarkers, and non-invasive imaging findings. By employing these non-invasive diagnostic approaches, clinicians can make informed decisions regarding the best pharmacological and rehabilitation strategies for individuals with suspected HFpEF. This literature review aims to provide an overview of all currently available methods for diagnosing and monitoring this disabling condition. [ABSTRACT FROM AUTHOR]

Purpose: The implementation of the 2021 sports reform in Italy introduced new professional figures, including the sports manager, defined by Legislative Decree no. 36/2021. According to this law, a master's degree in Organization and Management of Services for Exercise and Sport Sciences (LM-47) is required to practice as a sports manager. However, some universities offer bachelor's and master's degree courses in sports management under different study classes, such as Sciences of Legal Services (L-14), Administration and Organization Sciences (L-16), Business and Management Sciences (L-18), and Business Economics (LM-77). These degree courses may qualify individuals as pseudo-sports managers, despite substantial differences in the educational content compared to the legally defined sports manager profile. This study aimed to assess the illegitimate overlap of degree courses outside the class LM-47 and the discrepancies in their study plans compared to those of LM-47, which is the only one corresponding to the sports manager profile. Methods: This documentary investigation used the two Ministerial Decrees of 2007 of the bachelor's and master's degree classes to extrapolate the degree courses involved in the overlap. Universitaly portal was used to identify the relevant subjects included in the individual degree courses in sports management other than the LM-47. The textual analysis of the objectives and content of the degree courses was done through the literature review tool Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), highlighting the relevant or consistent elements of the profile of the sports manager as established by law. Results: Degree courses in Law and Sports Management in class L-14 have a juridical professional profile, which is minimally relevant to the sports manager's role. Similarly, degree courses in Economics and Business Management Sciences in the class L-18 and Administration and Organization Sciences in the class L-16 focus on economic–financial administration and management control, lacking alignment with the sports manager profile. Even master's degree courses in the class LM-77 exhibit disparities with the sports manager profile as defined by the law. Furthermore, all these degree courses lack European credit transfer system (ECTS) credits in the exercise and sport sciences area, an essential aspect of the sports manager profession. Conclusion: There are evident contradictions in the degree courses designed for sports managers other than LM-47. According to the law, a master's degree in study class LM-47 is required to pursue this profession, but there are several degree programs from different classes of study (juridical and economic) available in the national educational offering. This situation may lead to the misapplication of Legislative Decree no. 36/2021 and result in problems with professional accreditation and limited employment opportunities for graduates of such courses. To promote the development of this professional figure, it is necessary to improve the educational offerings in the LM-47 with a more integrated approach to various economic and juridical knowledge to meet the educational needs of future sports managers who navigate the real dynamics of the sports industry. [ABSTRACT FROM AUTHOR]

In the last 20 years, endoscopic injection (EI) has affirmed as a valid alternative to open surgery for management of pediatric vesicoureteral reflux (VUR). This study aimed to investigate and discuss some debated aspects such as indications, bulking agents and comparison, techniques of injection and comparison, predictive factors of success, use in specific situations. EI is minimally invasive, well accepted by patients and families, with short learning curve and low-morbidity profile. It provides reflux resolution rates approaching those of open reimplantation, ranging from 69 to 100%. Obviously, the success rate may be influenced by several factors. Recently, it is adopted as first-line therapy also in high grade reflux or complex anatomy such as duplex, bladder diverticula, ectopic ureters. The two most used materials for injection are Deflux and Vantris. The first is absorbable, easier to inject, has lower risk of obstruction, but can lose efficacy over time. The second is non-absorbable, more difficult to inject, has higher risk of obstruction, but it is potentially more durable. The two main techniques are STING and HIT. To date, the ideal material and technique of injection has not yet clearly established, but the choice remains dependent on surgeon’s preference and experience. [ABSTRACT FROM AUTHOR]

Environmental pollution in considered an established determinant of non-communicable illness, including cardiovascular diseases (CVDs). Air pollution is the result of a complex combination of chemical, physical, and biological agents, and represents one of the main causes of mortality and morbidity in the world population. It is responsible for 7.6% of global mortality. In this regard, it has been documented that it increases the risk of CVDs and major adverse cardiovascular and cerebrovascular events. In northern regions of China, long-term exposures to the particulate matter < 2.5 µm (PM2.5) increase in the risk of ischemic heart disease by almost two-folds. Similarly, the additional risk for stroke, increases by almost 10% for long-term exposure to PM2.5. The detrimental effects of air pollution on cardiovascular system are particularly manifest in vulnerable subjects, such as the elderly, patients with heart disease, and obese individuals. Therefore, nowadays, cardiovascular prevention strategies, in addition to controlling traditional risk factors, should also include measures to improve the environment. This goal can be achieved by the implementation of the health surveillance in occupational medicine and by the extensive application of the national and international legislative measures. In fact, the health surveillance represents a crucial preventive measure for workers exposed to health risks (chemical, physical agents, etc.) that may lead to occupational diseases after long-term exposure. On the other hand, since environmental pollution does not recognize well-defined boundaries, only the implementation of regulations among large territorial areas can be useful to improve the quality of environment. [ABSTRACT FROM AUTHOR]

Background: Elderly status is steadily increasing among patients with acute coronary syndrome (ACS). Dual antiplatelet therapy (DAPT) with aspirin and a potent P2Y12 receptor inhibitor is the cornerstone of treatment to prevent recurrent thrombotic complications in patients with ACS. However, DAPT in older patients is challenged by a concurrent heightened risk of ischemia and bleeding. The aim of this study is to evaluate the pharmacodynamic and pharmacokinetic profile of a lower dose of ticagrelor (60 mg twice daily) among elderly patients during the early phase of ACS. Study Design: PLINY THE ELDER (PLatelet INhibition with two different doses of potent P2y12 inhibitors in THE ELDERly population) (NCT04739384) is a prospective, randomized, open-label, crossover trial to evaluate the non-inferiority of a lower dose of ticagrelor (60 mg twice daily) compared with a standard dose (90 mg twice daily) among elderly patients with ACS undergoing percutaneous coronary intervention (PCI). A total of 50 patients, aged 75 years or more, with indication to potent P2Y12 receptor inhibitors will be randomized within 3 days from PCI for the index ACS. Patients with indication to oral anticoagulant therapy, treatment with glycoprotein IIb/IIIa inhibitors, or active bleeding will be excluded. The primary endpoint is platelet reactivity determined by P2Y12 reaction units (PRU) (VerifyNow, Accumetrics, San Diego, CA, USA) after treatment with ticagrelor 60 or 90 mg twice daily for 14 days. Secondary endpoints will include other pharmacodynamic tests of ADP-induced aggregation (light transmittance aggregometry and multiple electrode aggregometry) and determination of pharmacokinetic profile (plasma levels of ticagrelor and its metabolite AR-C124910XX) by high performance liquid chromatography-tandem mass spectrometry. Conclusions: The PLINY THE ELDER trial will determine whether a lower dose of ticagrelor confers non-inferior platelet inhibition compared with the standard dose in the early phase of ACS among elderly patients undergoing PCI, informing future clinical investigation. [ABSTRACT FROM AUTHOR]

Acute decompensation often represents the onset of symptoms associated with severe degenerative aortic stenosis (AS) and usually complicates the clinical course of the disease with a dismal impact on survival and quality of life. Several factors may derange the faint balance between left ventricular preload and afterload and precipitate the occurrence of symptoms and signs of acute heart failure (HF). A standardized approach for the management of this condition is currently lacking. Medical therapy finds very limited application in this setting, as drugs usually indicated for the control of acute HF might worsen hemodynamics in the presence of AS. Urgent aortic valve replacement is usually performed by transcatheter than surgical approach whereas, over the last decades, percutaneous balloon valvuloplasty gained renewed space as bridge to definitive therapy. This review focuses on the pathophysiological aspects of acute advanced AS and summarizes current evidence on its management. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to measure the number of scientific production of Italian professors, as framed on academic disciplines of Physical training and methodology (code M-EDF/01) and Sport sciences and methodology (code M-EDF/02), afferents to academic recruitment field of Exercise and sports sciences (code 06/N2) and Didactics, special education and educational research (code 11/D2). Methods: The sample consisted of the entire population of full professors (n = 30) of M-EDF/01 and M-EDF/02, plus a proportional representation of the two academic recruitment fields with at least one associate professor per university, for a total of 78 professors. The titles of the first ten scientific products in terms of more citations from the Google Scholar database were analysed for each scientist. The title's full coherence at the scientific declaration of the two academic disciplines of M-EDF/01 and M-EDF/02 and biomedicine and pedagogy domains were assessed. One-way ANOVA with Bonferroni post hoc test was used to compare the two academic disciplines of the two academic recruitment fields with the three domains to highlight the separated data's greater, average and lesser significance. Results: The aggregate data showed a prevalence of the biomedicine domain over the sport and physical activity ones in M-EDF/01 and M-EDF/02 in the academic recruitment field of 06/N2. On the other hand, in the academic recruitment of 11/D2, there was a prevalence of sport and physical activity domain over the biomedicine ones. In addition, a modest pedagogy scientific production in 06/N2 and biomedical in 11/D2 were found. Conclusion: The existence of the problem of the different coherence of the scientific profiles of the researchers concerning the relevant academic recruitment field and possibly also to the two academic disciplines was confirmed. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to assess the association between body mass index (BMI) and platelet reactivity in STEMI patients treated with oral 3rd generation P2Y12 inhibitors. Methods: Overall, 429 STEMI patients were enrolled in this study. Patients were divided into two groups according to BMI (BMI < 25 vs ≥ 25 kg/m2). A propensity score matching (1:1) was performed to balance potential confounders in patient baseline characteristics. Platelet reactivity was assessed by VerifyNow at baseline and after 3rd generation P2Y12 inhibitor (ticagrelor or prasugrel) loading dose (LD). Blood samples were obtained at baseline (T0), 1 h (T1), 2 h (T2), 4–6 h (T3), and 8–12 h (T4) after the LD. High on-treatment platelet reactivity (HTPR) was defined as a platelet reactivity unit value ≥ 208 units. Results: After propensity score matching, patients with BMI ≥ 25 had similar values of baseline platelet reactivity, while they had higher level of platelet reactivity at 1 and 2 h after the LD and higher rate of HRPT. Furthermore, multivariate analysis demonstrated that BMI ≥ 25 was an independent predictor of HTPR at 2 h (OR 2.01, p =.009). Conversely, starting from 4 h after the LD, platelet reactivity values and HRPT rates were comparable among the two study groups. Conclusions: A BMI ≥ 25 kg/m2 is associated with delayed pharmacodynamic response to oral 3rd generation P2Y12 inhibitor LD, and it is a strong predictor of HTPR in STEMI patients treated by dual antiplatelet therapy with ticagrelor or prasugrel. [ABSTRACT FROM AUTHOR]

The increasing production of sewage sludge at global level has addressed the search for technical solutions to take advantage from it, reducing the environmental burden originating from its disposal. Anaerobic digestion is a suitable option to handle sewage sludge in accordance with circular economy principles, as it generates a methane-rich biogas and a digestate with potential fertilizing properties. Several techniques have been proposed to enhance anaerobic digestion performances and, among these, the application of static magnetic field (SMF) has recently gained attention. Nonetheless, the effects of high-intensity SMF on the sewage sludge destined to anaerobic digestion and its impact on the anaerobic digestion process have not been evaluated yet. This study aims to determine the effects of a 1.5 T SMF on the chemical composition of sewage sludge as well as on methane generation during anaerobic digestion. The main parameters influencing the SMF (i.e., flow rate, mixing ratio of magnetized to non-magnetized sludge, number of pumping cycles, and total solid content) were varied to evaluate the impact of different exposure conditions on the chemical characteristics and methane potential of sewage sludge. An extensive exposure to the high-intensity SMF applied resulted in a 24% decrease of methane production, reduced the concentration of the monitored ionic species (i.e., NH4+, NO3−, PO43−, SO42− and Mg2+) in the liquid phase of sewage sludge, and promoted the precipitation of compounds with valuable fertilizing properties, e.g., struvite. These outcomes suggest that high-intensity SMF, although negatively influencing methane generation, can promote the precipitation, and possibly the recovery/recycle of valuable compounds from sewage sludge, enhancing its proper management in a circular economy perspective. [ABSTRACT FROM AUTHOR]

The assessment of vascular complexity in the lower limbs provides relevant information about peripheral artery occlusive diseases (PAOD), thus fostering improvements both in therapeutic decisions and prognostic estimation. The current clinical practice consists of visually inspecting and evaluating cine-angiograms of the interested region, which is largely operator-dependent. We present here an automatic method for segmenting the vessel tree and compute a quantitative measure, in terms of fractal dimension (FD), of the vascular complexity. The proposed workflow consists of three main steps: (i) conversion of the cine-angiographies to single static images with a broader field of view, (ii) automatic segmentation of the vascular trees, and (iii) calculation and assessment of FD as complexity index. In particular, this work defines (1) a method to reduce the inter-observer variability in judging vascular complexity in cine-angiography images from patients affected by peripheral artery occlusive disease (PAOD), and (2) the use of Fractal Dimension as a metric of shape complexity of vascular tree. The inter-class correlation coefficient (ICC) is computed as inter-observer agreement metric and to account for possible systematic error, that depends on the experience of the raters. The automatic segmentation of vascular tree achieved an Area Under the Curve mean value of 0.77 ± 0.07 , with a min-max range of 0.57 - 0.87 . Absolute operator agreement was higher over the segmented image ( I C C = 0.96 ) compared to the video ( I C C = 0.76 ) and the a broader field of view image ( I C C = 0.92 ). Fractal Dimension computed on both manual segmented images (ground truths) and automatically showed a good correlation with the clinical score (0.85 and 0.75, respectively). Experimental analyses suggest that extracting the vascular tree from cine-angiography can substantially improve the reliability of visual assessment of vascular complexity in PAOD. Results also reveal the effectiveness of FD in evaluating complex vascular tree structures. [ABSTRACT FROM AUTHOR]

The aim of this study was to develop a mathematical model to assess the effect of soluble microbial products production and external carbon source addition on the performance of a sulfur-driven autotrophic denitrification (SdAD) process. During SdAD, the growth of autotrophic biomass (AUT) was accompanied by the proliferation of heterotrophic biomass mainly consisting of heterotrophic denitrifiers (HD) and sulfate-reducing bacteria (SRB), which are able to grow on both the SMP derived from the microbial activities and on an external carbon source. The process was supposed to occur in a sequencing batch reactor to investigate the effects of the COD injection on both heterotrophic species and to enhance the production and consumption of SMP. The mathematical model was built on mass balance considerations and consists of a system of nonlinear impulsive differential equations, which have been solved numerically. Different simulation scenarios have been investigated by varying the main operational parameters: cycle duration, day of COD injection and quantity of COD injected. For cycle durations of more than 15 days and a COD injection after the half-cycle duration, SdAD represents the prevailing process and the SRB represent the main heterotrophic family. For shorter cycle duration and COD injections earlier than the middle of the cycle, the same performance can be achieved increasing the quantity of COD added, which results in an increased activity of HD. In all the performed simulation even in the case of COD addition, AUT remain the prevailing microbial family in the reactor. [ABSTRACT FROM AUTHOR]

Performing transcatheter aortic valve implantation with high implantation technique, i.e. with an aorto-ventricular ratio > 60/40, reduces the need of permanent pacemaker implantation. Valve calcification and prosthesis oversizing are predictors of permanent pacemaker implantation, but there are no available data on their role when transcatheter aortic valve implantation is performed with an aorto-ventricular ratio > 60/40. The aim of this study was to evaluate the effect of leaflets/annulus calcification and prosthesis oversizing on the incidence of permanent pacemaker implantation after transcatheter aortic valve implantation with a high implantation technique. Transcatheter aortic valve implantation was performed in 48 patients implanting a balloon-expandable transcatheter heart valve with an aorto-ventricular ratio > 60/40. Calcium burden was assessed by preprocedural multidetector computed tomography. An invasive electrophysiological study was performed before and after transcatheter aortic valve implantation. Five patients (10.4%) needed permanent pacemaker implantation. At univariate analysis, baseline right bundle branch block and postprocedural PR, QRS and His-ventricular interval elongation significantly predicted permanent pacemaker implantation (p < 0.05). Receiver-operating characteristic curve analysis showed a correlation between transcatheter heart valve oversizing and permanent pacemaker implantation need, with the best cut-off being 17% (AUC = 0.72, p = 0.033). Linear regression analysis demonstrated that QRS complex elongation was related to total, left and non-coronary leaflet calcification (p < 0.05). This study demonstrates that, when transcatheter aortic valve implantation is performed using a balloon-expandable transcatheter heart valve deployed with an aorto-ventricular ratio > 60/40, the presence of leaflets/annulus calcification or the need to oversize the prosthesis correlate with the occurrence of pathological cardiac conduction delays. [ABSTRACT FROM AUTHOR]

To evaluate longitudinal systolic function in patients with myocarditis, its correlation with cardiac magnetic resonance (CMR) features, and its predictive value in functional recovery and arrhythmias onset during follow-up (FU) on optimized medical therapy (OMT). Patients with acute myocarditis, confirmed through CMR criteria, and age- and sex-matched healthy controls were enrolled. Two-dimensional (2D) transthoracic echocardiography, including speckle tracking analysis, was performed at admission and after 6 months of FU. Patients of myocarditis group also underwent 24 h ECG Holter monitoring during FU. 115 patients with myocarditis (mean age 41 ± 17, 70% males) and 70 healthy subjects were enrolled. Global longitudinal strain (GLS) and sub-epicardial strain were markedly lower in the myocarditis group than in controls (mean GLS%: − 14.1 ± 5.1 vs − 23.1 ± 3.6, p < 0.001). A strong positive correlation between total scar burden (TSB) on CMR and baseline LV GLS was found (r = 0.67, p < 0.0001). GLS improved after 6 months of FU in myocarditis on OMT (mean GLS%: − 14.1 ± 5.1 vs − 16.5 ± 4.8, p < 0.01). By bivariate correlation analysis, baseline LVEF, GLS, and TSB were all associated with LVEF at 6 months of FU. Moreover, by multivariable linear regression analysis, these parameters confirmed to be independent predictors of functional recovery at 6 months (LVEF β 0.38, p < 0.01; GLS β − 0.35, p < 0.01; total scar burden β − 0.52, p < 0.0001). Segmental peak systolic strain was significantly different between segments with and without late gadolinium enhancement on CMR (− 13.2 ± 3.1% vs − 18.1 ± 3.5%, p < 0.001). A segmental strain of − 12% identified scar with a sensitivity of 79% and a specificity of 84% (AUC = 0.91; 95% CI 0.73–0.97; p < 0.001). In addition, baseline LV GLS in myocarditis resulted predictive of non-sustained ventricular tachycardias (cut-off value > − 12%; sensitivity84%; specificity74.4%; AUC = 0.75). Parameters of myocardial longitudinal deformation are importantly associated with the presence of a scar on CMR and are predictors of functional outcome and ventricular arrhythmias in patients with acute myocarditis. Their assessment during ultrasound examination should be considered to get more information about the prognosis and risk stratification of this subset of patients. [ABSTRACT FROM AUTHOR]

Prompt detection of cardiovascular abnormalities in children with anorexia nervosa and physical instability requiring hospitalization is essential to identify patients at higher cardiovascular risk. We studied all anorexia nervosa children requiring admission at Paediatric Institute in the period 2015–2019. Anorexia nervosa cardiopathy at admission was defined by the presence of at least two of the following clinical findings: pericardial effusion, mitral regurgitation, bradycardia, mitral billowing, aortic regurgitation, altered LV morphology and ECG abnormalities. Echocardiographic data were compared with those registered at 3–8-month follow-up and with data from a healthy population. Thirty-eight anorexia nervosa children were examined. Prevalence of anorexia nervosa cardiopathy at admission was 63% (24 patients). Pericardial effusion, bradycardia and mitral regurgitation were present together in 26% of patients. Most cardiovascular changes recovered at follow-up. Anorexia nervosa cardiopathy was associated with significantly lower left ventricle end-diastolic diameters and mass, and higher E wave, E/A and E/e′ ratios and left ventricle sphericity index values vs healthy population and vs anorexia nervosa children without cardiopathy (p<0.05). Left ventricle global longitudinal strain was significantly reduced only in anorexia nervosa cardiopathy patients but recovered, whereas end-diastolic diameters, E/A ratio and sphericity index values remained impaired. Conclusion: Among anorexia nervosa children requiring hospitalization, those presenting several cardiac findings together express an acute anorexia nervosa cardiopathy which is characterized by worse LV filling, geometry and subclinical myocardial deformation impairment. Despite treatment, in those patients, some alterations persist at mid-term follow-up. What is Known: • Cardiac and electrocardiographic changes are present in anorexia nervosa children at diagnosis or during stable disease, and most recover after body-weight treatment. • It is unknown if anorexia nervosa children with more severe cardiac impairment during hospitalization present higher cardiovascular-risk profile despite treatment. What is New: • In anorexia nervosa children needing hospitalization for physical reasons, prevalence of acute anorexia nervosa cardiopathy at admission is high, around 60%. • By advanced echocardiography, children with anorexia nervosa cardiopathy at admission have a worse cardiac filling, impaired cardiac geometry and systolic deformation that only partially recover at mid-term follow-up. [ABSTRACT FROM AUTHOR]

The online version of the original article can be found at https://doi.org/10.1007/s10741-023-10312-7. To rectify this, we wish to clarify that the author's surname is Immobile Molaro and her name is simply Maddalena, with no middle name. B Correction to: Heart Failure Reviews b https://doi.org/10.1007/s10741-023-10312-7 Unfortunately, there was an error in the name of one of the authors. [Extracted from the article]