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Background Atrial fibrillation is the most common sustained cardiac arrhythmia in adults and it is associated with a high burden of mortality and morbidity worldwide. Atrial fibrillation could be managed with rate-control or rhythm-control strategies. The latter is increasingly used to improve symptoms and prognosis in selected patients, especially after the development of catheter ablation. Although this technique is generally considered safe, it is not free from rare but life-threatening procedure-related adverse events. Among these, coronary artery spasm is an uncommon but potentially fatal complication that requires immediate diagnosis and treatment. Case summary We report a case of severe multivessel coronary artery spasm triggered by ganglionated plexi stimulation during pulmonary vein isolation with radiofrequency catheter ablation in a patient with persistent atrial fibrillation, promptly resolved after intracoronary nitrate administration. Discussion Although rare, coronary artery spasm is a serious complication of atrial fibrillation catheter ablation. Immediate invasive coronary angiography is key for both diagnosis confirmation and treatment of such dangerous condition. As the number of invasive procedures increases, it is important that both interventional and general cardiologists are aware of possible procedure-related adverse events.

Dal desiderio di valorizzare le risorse della montagna pistoiese nasce il progetto THEO (utilizzo del timo come fonte di oli essenziali da impiegare nella lotta a microorganismi e agenti infestanti) finanziato dalla Fondazione Cassa di Risparmio di Pistoia e Pescia con il bando 'Ricerca e innovazione aziendale 2022', con la partecipazione di Cnr, Ecomuseo della Montagna Pistoiese, Azienda Agricola Le Roncacce, e la collaborazione del Museo Naturalistico Archeologico dell'Appennino Pistoiese (MUNAP). Il progetto è incentrato sull’utilizzo del timo (Thymus spp.) come fonte di composti bioattivi ad alto potere antimicrobico per la realizzazione di formulati solidi da impiegare nella conservazione di opere e manufatti museali. “Una montagna di molecole” è un racconto che partendo dall’ascolto storico-documentario prosegue nell’interpretazione di segni ecologici che hanno una relazione con la biodiversità e le risorse del territorio, per trasformarsi in un progetto di ricerca concreto incentrato sull’uso dei derivati delle piante officinali locali. Questo è stato possibile non solo grazie a un prodotto - il timo - e ai suoi derivati, ma anche grazie ad una comunità che lo ha preservato come memoria territoriale., Fondazione Cassa di Risparmio di Pistoia e Pescia

The CO2 desorption process from a CO2-saturated nonaqueous sorbent, 2-(2-aminoethoxy)ethanol (DGA) in diethylene glycol monomethyl ether (DEGMME), was investigated in the absence and presence of four different metal oxides, namely, V2O5, TiO2, WO3, and ZnO, aiming at identifying acid catalysts with the potential to reduce the energy demand for sorbent regeneration. The desorption performances of the DGA-DEGMME solutions with and without catalysts were evaluated in terms of CO2 desorption rate, overall CO2 desorbed, and thermal energy consumption. The desorption mechanism was understood by the 13C NMR speciation study of the solutions during the regeneration experiments. As a result, metal oxide catalysts, depending on the number and types of acidic sites on their surface, can accelerate the carbamate breakdown and the subsequent CO2 release. In particular, WO3 and TiO2 can be considered good candidates for implementation in CO2 capture processes with nonaqueous sorbents, as they greatly improved the desorption performance, and their structures remain unchanged before and after use. The combination of nonaqueous sorbents with catalysts, here reported for the first time, provides an effective strategy that could inspire the design of advanced sorbents for energy-efficient CO2 capture.

In Sub-Saharan Africa, smallholder farms play a key role in agriculture, occupying most of the agricultural land. Design policies for increasing smallholder productivity remains a safe way to establish sustainable food systems and boost local economies. However, efforts are still needed in order to achieve accurate and timely monitoring in smallholder farming systems. With the advent of modern Earth Observation programmes such as the Sentinel satellites, which provide quasi-synchronous and high-resolution multi-source information over any area of the continental surfaces, new opportunities are opened up to accurately map crop yields in smallholder farming systems. This study intends to estimate and forecast millet yields in central Senegal, making the use of multi-source (synthetic-aperture radar (SAR) and optical) image time series and state-of-the-art machine learning models. A Random Forest (RF) model explained up to 50% of the millet yield variability, while deep learning models such as Convolutional Neural Network (CNN) showed promise results but performed lower. We also found that the concatenation of SAR polarizations and vegetation indices improved our crop yield modelling, but such improvement was tightly related to the modelling approach, namely RF and CNN. Using RF to forecast millet yields, we achieved stable and satisfactory accuracy 2 weeks before the harvest period.

Background Dobutamine Stress Echo (DSE) is a test widely used in the diagnosis of ischemic heart disease. The purpose of the following work is to describe a clinical case with uncommon behaviour. Case Description: 63–year–old female with dyspnoea on mild exertion, and history of NSTEMI–ACS 5 years prior with Coronary Angiography (CA) finding of 3–vessel coronary artery disease, treated with PCI + stent (DES) of right coronary artery (CDX), untreated disease sub–occlusion of the first marginal obtuse (OM1), and chronic occlusion of the anterior interventricular artery (IVA). We decide for DSE. During 20 mcg/kg/min infusion, the patient reported dyspnoea and paradoxical bradycardia (BP) was documented on the ECG, in the absence of ST changes, with the appearance of akinesia of the basal and mid posterolateral segments and worsening of the inferior hypokinesia, present in basal conditions on Echocardiograms (EC). The BP and the alterations of the ventricular motion (VCA) did not respond to the administration of Atropine (1+1 mg) while the administration of 240 mg of Aminophylline (AM) restored the HR and the VCA to baseline values. The CA demonstrated patency of the CDX with the presence of collateral circulation for IVA and occluded OM1. Discussion This case is characterized by the presence of a double paradox: the BP and the Atropine–Resistance (AR). BP during DEB, as demonstrated in previous studies, occurred in 8% of cases, with signs of significant coronary artery disease in 57% of cases. The BP is an expression of ischemia only in just over half of the patients, in the rest of the cases it appeared referable to the Bezold–Jarish reflex, a vagal reflex determined by the stimulation of the intracardiac mechanoreceptors. In our case, the presence of AR seems to exclude the possibility that bradycardia is due to this reflex. The appearance of paradoxical bradycardia during DSE is a rare complication and can lead to premature termination of the test with inconclusive results. In our case, the BP and the AR confirm the positivity of the test also in consideration of the response to the AM antagonist of Adenosine, which accumulates during ischemia. Conclusions This uncommon response to DSE, where AR and AM response in addition to BP could identify patients with severe coronary artery disease in whom the ischemic response is driven by adenosine accumulation, rather than a vagal reflex responding to atropine administration.

Background On December 2017 the Italian Parliament approved law n. 219/2017 “Provisions for informed consent and advance directives” regarding challenging legal and bioethical issues related to healthcare decisions and end-of-life choices. The law does not contain an explicit reference to Ethics Committees (ECs), but they could still play a role in implementing the law. Methods A questionnaire-based survey was performed among the ECs of the Italian Institute for Research and Care belonging to the Network of neuroscience and neurorehabilitation, with the aim of (1) knowing whether the ECs participated and, if so, how in the process of implementation of law n. 219/2017 in the referring institutes; (2) investigating the point of view of the ECs regarding their possible involvement in the process; (3) exploring the contribution ECs can provide to give effective implementation to the law principles and provisions. Results Seventeen ECs out of thirty took part in the survey; the characteristics of the responding and non-responding committees are similar, so the responding ECs can be regarded as representative of all ECs in the Network. Nine ECs did not discuss the law in anyway: the main reason for this is that the referring institutions (6) and the health care professionals (3) did not ask for an EC intervention. Nevertheless, the large majority of the ECs believe that their involvement in the implementation of the law as a whole is appropriate (8) or absolutely appropriate (6), while 3 of them are neutral. No EC believes that the involvement is inappropriate. The aspect of the law on which the 14 ECs converge in considering the EC involvement appropriate/absolutely appropriate is the one related to the health facilities obligation to guarantee the full and proper implementation of the principles of the law. Conclusions Our survey confirms that ECs believe they can play a role in the implementation of law n. 219/2017, although this does not entirely correspond to what the committees have actually done in reality. This role could be better exercised by ECs specifically established for clinical practice, which would have a composition, functioning and a mandate better suited to the purpose. This supports the call for a national regulation of ECs for clinical practice.

Gold chemistry has experienced in the last decades exponential attention for a wide spectrum of chemical applications, but the +3 oxidation state, traditionally assigned to gold, remains somewhat questionable. Herein, we present a detailed analysis of the electronic structure of the pentanuclear bow tie Au/Fe carbonyl cluster [Au{η2-Fe2(CO)8}2]- together with its two one-electron reversible reductions. A new interpretation of the bonding pattern is provided with the help of inverted ligand field theory. The classical view of a central gold(III) interacting with two [Fe2(CO)8]2- units is replaced by Au(I), with a d10 gold configuration, with two interacting [Fe2(CO)8]- fragments. A d10 configuration for the gold center in the compound [Au{η2-Fe2(CO)8}2]- is confirmed by the LUMO orbital composition, which is mainly localized on the iron carbonyl fragments rather than on a d gold orbital, as expected for a d8 configuration. Upon one-electron stepwise reduction, the spectroelectrochemical measurements show a progressive red shift in the carbonyl stretching, in agreement with the increased population of the LUMO centered on the iron units. Such a trend is also confirmed by the X-ray structure of the direduced compound [Au{η1-Fe2(CO)8}{η2-Fe2(CO)6(μ-CO)2}]3-, featuring the cleavage of one Au-Fe bond.