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The urgent need to increase the sustainability of crop production has pushed the agricultural sector towards the use of biostimulants based on natural products. The current work aimed to determine whether the preharvest application of two commercial formulations, based on a Fabaceae enzymatic hydrolysate or a blend of nitrogen sources including fulvic acids, and two lab-made aqueous extracts from

Objective: To assess the effectiveness, safety, and tolerability of erenumab in a real-life migraine population, while trying to identify responsiveness predictors. Background: Erenumab is a fully human Ig-2 monoclonal antibody blocking the calcitonin gene-related peptide receptor, indicated for migraine prophylaxis. Phase II and III trials demonstrated that erenumab is effective, safe, and well tolerated in the prevention of episodic and chronic migraine (CM), showing an early onset of action. Methods: This is a multicenter, prospective, cohort, and real-life study. We considered for enrolment all consecutive patients aged 18–65 affected by high-frequency episodic migraine (HFEM) or CM, with or without medication overuse, visited at nine Italian Headache Centers from December 20, 2018 to September 30, 2019. Each patient was treated with erenumab 70mg, administered subcutaneously every 4weeks. Treatment duration was planned to last from 6 to 12months, depending on the patient's response. The primary endpoint was the change in monthly migraine days (MMDs) at weeks 9–12 compared to baseline. Secondary endpoints included changes in monthly analgesics intake, ≥50%, ≥75%, and 100% responder rates and any variation in the Visual Analog Scale (VAS) and Headache Impact Test scores (HIT). Results: In total, 372 migraine patients were treated with at least one dose of erenumab 70mg. At weeks 9–12, erenumab decreased MMDs by 4.5±4.1days (mean±SD) in patients with HFEM and by 9.3±9.1 (mean±SD) days in those with CM compared to baseline. At weeks 9–12 VAS score was reduced by 1.9±1.9 (mean±SD), HIT score by 10.7±8.8 (mean±SD), and median monthly analgesics intake passed from 12.0 (interquartile range [IQR] 10.0–14.0) to 5.0 (IQR 3.0–7.0) in HFEM. In CM patients, VAS was reduced by 1.7±2.0 (mean±SD), HIT by 9.7±10.4 (mean±SD), and median monthly analgesics intake passed from 20.0 (IQR 15.0–30.0) to 8.0 (IQR 5.0–15.0). At week 12, ≥50% responders were 60/101 (59.4%) for HFEM and 146/263 (55.5%) for CM, ≥75% responders were 17/101 (16.8%) and 59/263 (22.4%) and 100% responders 1/101 (1.0%) and 3/263 (1.1%), respectively. Erenumab responsiveness in HFEM was positively associated with unilateral pain localization (OR: 3.03, 95% CI: 1.24–7.40; p=0.015), whereas in CM responsiveness was positively associated with and baseline migraine frequency (OR: 1.06, 95% CI:1.02–1.11; p=0.031), dopaminergic symptoms (OR: 2.01, 95% CI: 1.14–3.52; p=0.015), and negatively associated with psychiatric comorbidities (OR: 0.43, 95% CI: 0.20–0.93; p=0.003). Conclusions: Erenumab 70mg is effective, safe, and well tolerated in real life. Easily obtainable clinical features might be of help in predicting patient's responsiveness.

Cold Spray is an innovative technology to create coatings through the impact of metallic particles on substrates. Its application to composites’ surfaces is recently attracting the attention of the scientific community thanks to the possibility to functionalize and improve their thermal and wear properties. Within this context, the generation of the first metal-to-composite layer is fundamental. This work presented an experimental investigation of a composite panel, reinforced with glass fibers and coated with aluminum particles. The coating investigation was carried out through active pulsed thermography, analyzing the thermal response of single and double hatches. The thermal outputs were compared with a standard microscopic analysis, with a critical discussion supporting the identification of factors that influence the thermal response to the pulse: (1) layer’s thickness, (2) cold spray coverage, (3) layer compactness, (4) particle-substrate adhesion, (5) particle’s oxidation, and (6) surface roughness.

Background— D-dimer has been reported to be elevated in acute aortic dissection. Potential use as a “rule-out” marker has been suggested, but concerns remain given that it is elevated in other acute chest diseases, including pulmonary embolism and ischemic heart disease. We evaluated the diagnostic performance of D-dimer testing in a study population of patients with suspected aortic dissection. Methods and Results— In this prospective multicenter study, 220 patients with initial suspicion of having acute aortic dissection were enrolled, of whom 87 were diagnosed with acute aortic dissection and 133 with other final diagnoses, including myocardial infarction, angina, pulmonary embolism, and other uncertain diagnoses. D-dimer was markedly elevated in patients with acute aortic dissection. Analysis according to control disease, type of dissection, and time course showed that the widely used cutoff level of 500 ng/mL for ruling out pulmonary embolism also can reliably rule out aortic dissection, with a negative likelihood ratio of 0.07 throughout the first 24 hours. Conclusion— D-dimer levels may be useful in risk stratifying patients with suspected aortic dissection to rule out aortic dissection if used within the first 24 hours after symptom onset.

Aims This multicentre prospective randomised trial was undertaken to evaluate the usefulness of an electrophysiological study (EPS)eguided/implantable cardioverter defibrillator (ICD) strategy in patients at high risk of sudden death (SD)

Endothelial dysfunction versus early atherosclerosis: A study with high resolution imaging☆☆☆ Olivia Manfrini , Edina Cenko , Edoardo Verna , Jorge A. Salerno Uriarte , Raffaele Bugiardini a,⁎ a University of Bologna, Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Bologna, Italy b University of Insubria, Hospital of Circolo and Foundation Macchi, Department of Cardiology, Varese, Italy c University of Insubria, Department of Clinical Medicine, Varese, Italy

Aims Radiofrequency catheter ablation is effective at terminating ventricular tachycardia, but the overall clinical role of the technique in patients with a prior myocardial infarction is still debated, due to the uncertainties of the long-term reliability of the procedure. The purpose of this study was to prospectively investigate the relationship between acute results obtained by catheter ablation and long-term outcome in a homogeneous population of patients with post-myocardial infarction ventricular tachycardia. Methods and Results One hundred and twenty-four consecutive patients with recurrent, drug-refractory, haemodynamically tolerated ventricular tachycardia were included in the study. This population accounted for 30% of the patients with post-myocardial infarction ventricular tachycardia admitted between April 1992 and September 1997 to the investigating centres. The ablation was successful in eliminating sustained ventricular tachycardia in 91 of them (73%); a partial result was obtained in 21 (17%) and failure in 12 (10%). Low dose amiodarone and/or beta-blockers were maintained in 86% of the patients. Over a median follow-up of 41·5 months (interquartile range 30·5–59·5 months), there were 15 deaths (12%), three of which were sudden (2·4%); the 12 remaining patients died of heart failure. Event-free survival analysis showed a significally lower ventricular tachycardia recurrence rate in patients with a successful procedure as compared to those with failure or a partial result (19% vs 53% at one year and 27% vs 60% at 3 years, P =0·003). A repeat procedure was performed in 15 patients with early recurrences and was followed in all by long-term success. Of those who submitted to a second procedure, 93/124 patients (75%) are free of ventricular tachycardia recurrences. An implantable cardioverter-defibrillator (ICD), following procedure failure, was implanted in 13 patients (11%) of the study population. Conclusions Radiofrequency catheter ablation is effective in a wide population of patients with recurrent tolerated ventricular tachycardia, with very low sudden death and cardiac mortality rates over the long-term. Persistent ventricular tachycardia inducibility after catheter ablation requires an ICD implant and/or repeat ablation.

this disease. Our earlier study showed a prevalence of 25%,1 and the described study was 40%.2 Because our conditions were limited to tertiary centers that see and treat aortic dissection routinely and thus likely have increased awareness to this disease, we noted that these figures are most likely higher than those that will be seen in the community setting. Thus, we described likelihood ratios rather than predictive values because the latter is affected by prevalence. Dr Hugli’s second issue concerns clinical spectrum. Our study and its findings were based on patients with suspected acute aortic dissection and not chest pain in general; thus, caution is needed in the generalization of our findings beyond the tested parameters of patients with acute aortic dissection presenting to mainly tertiary centers. Furthermore, on the topic of selection and verification bias, results of D-dimer measurements were not made available to the treating physician; therefore, this bias was not applicable to the present study. We disagree with the reasoning that examination of consecutive cases may have caused selection bias but rather assert that this allowed a more unbiased selection process. Although our present findings are limited to the described conditions, we believe that D-dimer is useful at present and that our findings, as an initial step, will help make possible the actual clinical use of D-dimer for acute aortic dissection and provide a diagnostic algorithm to optimize the use of imaging tests in these settings. We expect our findings to serve as a “working hypothesis” to be tested in more general settings such as in patients presenting with chest pain in general and in extension to the community setting (eg, nontertiary centers, healthcare systems) and further in studies that address usefulness of diagnostic strategies that incorporate both biochemical and imaging tests. We envision that a clinical algorithm will be developed that assigns patients to clinical risk groups that will help distinguish between high-risk patients who go directly to imaging and moderate-risk groups and identify lower-risk groups in which D-dimer may emerge as a rule-out screening measure.

Aims: The early diagnosis of acute aortic dissection (AD) remains challenging. We sought to determine the utility of the troponin-like protein of smooth muscle, calponin, as a diagnostic biomarker of acute AD. Methods and results: Immunoassays against calponin (acidic, basic, and neutral isoforms) were developed and the levels were compared in a convenience sample of 59 patients with radiographically proven AD [34 males, age 59 ± 15 (SD) years] vs. 158 patients suspected of having AD at presentation (116 males, age 63 ± 15 years) but whose final diagnosis was not AD. Basic calponin, which is the most specific and abundant in smooth muscle, and acidic calponin, respectively, showed greater than two-fold and three-fold elevations in patients with acute AD. Diagnostic performance as determined by receiver-operating characteristics curve analysis showed that both acidic and basic calponin have the potential to detect AD in the first 24 h [respective areas under the curve (AUCs) 0.63 and 0.58], with superior performance of basic calponin (when compared with acidic) in the initial 6 h (respective AUCs 0.63 and 0.67). Conclusion: Circulating calponin levels were elevated in acute AD compared with controls. These biomarkers have the potential for use as an early diagnostic biomarker for acute AD.

Infrared thermography is a powerful, fast and non contact method for non destructive testing of materials, based on heat conduction. While techniques like pulse or lockin thermography are based on external heat sources, other thermographic techniques, like vibro-lockin thermography, use internal sources of heat, where loss angle effect is involved. One advantage of these latter techniques is that some material features are selectively heated, so that the interpretation of the image can be straightforward. Another advantage is that the heat is generated directly on the defect, allowing to reach greater depths. Some interesting examples of thermographic inspection using ultrasonic heating source are here illustrated.