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Aims: Electrical storm (ES) is a life-threatening condition requiring a rapid management. Percutaneous stellate ganglion block (PSGB) is proved to be safe and effective on top of standard therapy, but no data are available about its early use., Methods and Results: We considered all patients enrolled from 1 July 2017 to 30 April 2024 in the STAR registry (STellate ganglion block for Arrhythmic stoRm), a multicentre, international, observational, prospective registry. We aimed to assess the effectiveness of the first PSGB only. Patients were divided into two groups depending on whether they received PSGB before [early PSGB, often due to antiarrhythmic drug (AAD) contraindication] or after (delayed PSGB) intravenous AADs (AADs other than beta-blockers). We considered 180 PSGB (26 early PSGB and 154 AAD first). In the early PSGB group, we observed a statistically significant reduction of treated arrhythmic events in the hour after PSGB compared with the hour before: 0 (0-0) vs. 4.5 (1-10), P < 0.001, and the extent of the reduction was similar in the early PSGB and delayed PSGB groups [-4.5 (-7 to -2) vs. -2.5 (-3.5 to -1.5), P = ns]. The percentage of patients free from arrhythmias was similar in the two groups up to 12 h after PSGB (81 vs. 84%, P = 0.6, after 1 h; 77 vs. 79%, P = 0.8, at 3 h; and 65 vs. 69%, P = 0.7, after 12 h)., Conclusion: Percutaneous stellate ganglion block is proved to be effective also when used early in the treatment of ES. Due to its rapidity of action, our results may suggest its early use to reduce the number of defibrillations and possibly to reduce the likelihood of a refractory ES., Competing Interests: Conflict of interest: none declared., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: Data on the predictors of percutaneous stellate ganglion block (PSGB) efficacy in electrical storm are scanty., Objective: We aimed to assess whether PSGB efficacy is influenced by the arrhythmia type and cycle length before the procedure., Methods: This is a subanalysis of the multicenter STAR study. The population was stratified into 3 groups according to the median cycle length of the latest ventricular arrhythmia before PSGB: ventricular fibrillation (VF), fast ventricular tachycardia (VT), and slow VT. The primary outcome was the number of treated arrhythmic episodes (with antitachycardia pacing or direct current shocks) in the hour immediately after PSGB compared with the hour before., Results: We considered 139 PSGBs from 112 patients divided into VF (51 procedures), fast VT (44 procedures, VT cycle <375 ms), and slow VT (44 procedures, VT cycle ≥375 ms). The number of treated arrhythmic episodes in the hour after every PSGB was significantly lower compared with the hour before in all groups (VF: 0 [0-1] vs 5 [2-8], P < .001; fast VT: 0 [0-0] vs 1 [0-6.5], P < .001; slow VT: 0 [0-0] vs 1 [0-4.5], P = .001). In analyzing the reduction of the number of antitachycardia pacing sequences or direct current shocks from the hour before to the hour after PSGB, a significant trend was observed across the groups (Jonckheere-Terpstra trend P < .001), and a significant difference was observed in comparing slow VT vs VF and fast VT vs VF but not in comparing slow VT vs fast VT. VF was independently associated with the probability of reduction of treated events after PSGB., Conclusion: PSGB is an effective treatment of electrical storm in patients with all types of ventricular arrhythmias. However, its effectiveness was more pronounced in patients with VF., Competing Interests: Disclosures The authors have no conflicts of interest to disclose., (Copyright © 2024 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)

Purpose: This study examined the language and nonverbal inhibitory control skills of Italian monolingual and bilingual typically developing (TD) preschoolers with Italian as their second language and of age-matched monolingual and bilingual peers with developmental language disorder (DLD)., Method: Four groups of preschoolers were enrolled: 30 TD Italian monolinguals, 24 TD bilinguals, 19 Italian monolinguals with DLD, and 19 bilinguals with DLD. All children were assessed in Italian on vocabulary, receptive morphosyntax, and morphological markers for DLD in the Italian language (i.e., third-person verb inflections, definite articles, third-person direct-object clitic pronouns, simple prepositions) and nonverbal inhibitory control skills. Group performance was compared using a series of one-way analyses of variance., Results: Monolingual and bilingual children with DLD achieved significantly lower performance in all language measures compared to both TD monolingual and bilingual children. However, TD bilinguals, although comprehensively showing better language skills than monolinguals with DLD, achieved a performance closer to that of monolinguals with DLD but significantly higher than that of bilinguals with DLD. Both TD monolinguals and bilinguals showed better results than both DLD groups in inhibitory control tasks, particularly in the interference suppression task., Conclusions: This study provides a picture of language and inhibitory control characteristics of children with various language profiles and adds to the literature on potential markers of DLD among bilingual children. These results suggest that the assessment of nonlinguistic markers, which are associated with language impairment, could be a useful approach to better specify the diagnosis of DLD and reduce cases of misdiagnosis in the context of bilingualism.

Background : As adipose tissue-derived mesenchymal stem cells are becoming the tool of choice for many clinical applications; standardized cryopreservation protocols are necessary to deliver high-quality samples. For this purpose, the cryopreservation and thawing of native adipose tissue under GMP conditions could represent an extremely useful and powerful tool for the direct reinfusion of the tissue, and consequently, of its stromal vascular fraction. Methods : In this study, 19 samples of adipose tissue were cryopreserved and characterized before and after storage in liquid nitrogen vapors. Of these 19 samples, 14 were processed in research and 5 in a GMP-compliant environment. Storage with and without cryopreservation medium was also evaluated. After one week to three months of storage, samples were thawed, washed, enzymatically digested, and characterized with flow cytometry. Results : The results show that there is a loss of nearly 50% of total nucleated cells during the cryopreservation/thawing process. Non-GMP and GMP samples are comparable for all parameters analyzed. This study also allowed us to exclude the cryopreservation of adipose tissue without any cryopreservation medium. Conclusions : The data shown in this work are consistent with the idea that native adipose tissue, if properly processed and controlled, could be a useful source of cells for regenerative medicine, keeping in mind that there is a clear difference in the quality between fresh and thawed samples.

Background and Aims: An electrical storm (ES) is a clinical emergency with a paucity of established treatment options. Despite initial encouraging reports about the safety and effectiveness of percutaneous stellate ganglion block (PSGB), many questions remained unsettled and evidence from a prospective multicentre study was still lacking. For these purposes, the STAR study was designed., Methods: This is a multicentre observational study enrolling patients suffering from an ES refractory to standard treatment from 1 July 2017 to 30 June 2023. The primary outcome was the reduction of treated arrhythmic events by at least 50% comparing the 12 h following PSGB with the 12 h before the procedure. STAR operators were specifically trained to both the anterior anatomical and the lateral ultrasound-guided approach., Results: A total of 131 patients from 19 centres were enrolled and underwent 184 PSGBs. Patients were mainly male (83.2%) with a median age of 68 (63.8-69.2) years and a depressed left ventricular ejection fraction (25.0 ± 12.3%). The primary outcome was reached in 92% of patients, and the median reduction of arrhythmic episodes between 12 h before and after PSGB was 100% (interquartile range -100% to -92.3%). Arrhythmic episodes requiring treatment were significantly reduced comparing 12 h before the first PSGB with 12 h after the last procedure [six (3-15.8) vs. 0 (0-1), P < .0001] and comparing 1 h before with 1 h after each procedure [2 (0-6) vs. 0 (0-0), P < .001]. One major complication occurred (0.5%)., Conclusions: The findings of this large, prospective, multicentre study provide evidence in favour of the effectiveness and safety of PSGB for the treatment of refractory ES., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

The study investigates whether Italian verbal inflectional morphology is associated with inhibitory control skills after controlling for receptive vocabulary and verbal working memory. A sample of Italian preschoolers aged 4;0 to 6;0 was assessed using a standardized inhibitory control task tapping two different inhibitory skills (response inhibition and interference suppression), and a morphological task requiring simple and complex inflections of verbs. The hierarchical multiple regression analyses showed that working memory and the interference suppression scores were significantly associated with complex inflections but not with simple inflections of the verbs.

A growing body of research has supported the implementation of innovative and immersive video for teaching and learning across the lifespan. Immersive video, delivered through eXtended Reality (XR) tools like 360 video, provides users with new ways to see real or created environments. Unfortunately, most of the existing research has highlighted immersive video without accompanying immersive audio. This use of monophonic audio can create a disconnect for viewers as they experience close to real world video with sounds that do not match a real-world environment. The purpose of this study was to respond to this gap in the literature by exploring the use of ambisonic audio and its impact on preservice teacher noticing and variability of viewing focus when watching 360 video. Data were collected from undergraduate teacher education students who participated in a self-paced online activity that included watching 360 videos and responding to a questionnaire. A convergent mixed methods design was employed to compare participants' professional noticing and observed viewing behavior in the context of ambisonic and monophonic audio. Results showed that users in ambisonic audio conditions in 360 video environments were more likely to have higher focus. Moreover, for users who had specific professional knowledge, monophonic audio with immersive video had a negative impact on their variance in focus. The paper concludes with recommendations for future research on the use of audio in virtual and augmented reality environments., (© Association for Educational Communications and Technology 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Aims: The coronavirus disease-19 (COVID-19) outbreak has been recently associated with lower hospitalization rates for acute coronary syndromes. Aim of the study was to investigate whether a similar behaviour is observed in admissions for urgent pacemaker implant., Methods: This retrospective study included 1315 patients from 18 hospitals in Northern Italy with a high number of COVID-19 cases. Hospitalization rates for urgent pacemaker implant were compared between the following periods: 20 February to 20 April 2020 (case period); from 1 January to 19 February 2020 (intra-year control period); from 20 February to 20 April 2019 (inter-year control period)., Results: The incidence rate of urgent implants was 5.0/day in the case period, 6.0/day in the intra-year control period and 5.8/day in the inter-year control period. Incidence rate in the case period was significantly lower than both the intra-year [incidence rate ratio (IRR): 0.81, 95% CI 0.67-0.99, P = 0.040] and inter-year control periods (IRR: 0.79, 95% CI 0.66-0.95, P = 0.012); this reduction was highest after the national lockdown (IRR 0.68, 95% CI 0.52-0.91, P = 0.009). The prevalence of residents in rural areas undergoing urgent pacemaker implant was lower in the case period (36%) than in both the intra-year (47%, P = 0.03) and inter-year control periods (51%, P = 0.002). Elective pacemaker implants also decreased in the case period, with the incidence rate here being 3.5/day vs. 6.4/day in the intra-year (-45%) and 6.9/day in the inter-year period (-49%)., Conclusion: Despite severe clinical patterns, the COVID-19 outbreak has negatively affected the population presentation to Emergency Departments for bradyarrhythmias requiring urgent pacemaker implant in Northern Italy. This mainly occurred after the national lockdown and concerned patients living in rural areas., (Copyright © 2021 Italian Federation of Cardiology - I.F.C. All rights reserved.)