Search

AbstractThe overall value of treatments for chronic lymphocytic leukemia (CLL) depends on several factors, including preferences of the general population, who contributes to the financing of health systems. This study investigated societal preferences for attributes of CLL treatments in Italy. An online large-scale survey was designed using a discrete choice experiment (DCE) methodology and delivered to the Italian adult general population. Ten treatment attributes were identified, covering efficacy, safety, operational aspects and (hypothetical) out-of-pocket cost. DCE data were analyzed using a mixed logit regression model, estimating the willingness-to-pay for attribute levels’ change. The general population significantly preferred more effective treatments, with shorter duration, administered orally rather than orally + intravenously. Changes in therapy duration, frequency of checkups and organ damage risk had the greatest impact on preferences. The integration of societal preferences in the value judgments of CLL therapies may help health authorities in establishing priority setting and taking pricing-reimbursement decisions. [ABSTRACT FROM AUTHOR]

Acute coronary syndromes (ACS), encompassing conditions like ST-elevation myocardial infarction (STEMI) and non-ST-elevation acute coronary syndromes (NSTE-ACS), represent a significant challenge in cardiovascular care due to their complex pathophysiology and substantial impact on morbidity and mortality. The 2023 European Society of Cardiology (ESC) guidelines for ACS management introduce several updates in key areas such as invasive treatment timing in NSTE-ACS, pre-treatment strategies, approaches to multivessel disease, and the use of imaging modalities including computed tomography (CT) coronary angiography, magnetic resonance imaging (MRI), and intracoronary imaging techniques, such as optical coherence tomography (OCT) and intravascular ultrasound (IVUS). They also address a modulation of antiplatelet therapy, taking into consideration different patient risk profiles, and introduce new recommendations for low-dose colchicine. These guidelines provide important evidence-based updates in practice, reflecting an evolution in the understanding and management of ACS, yet some potentially missed opportunities for more personalized care and technology adoption are discussed. [ABSTRACT FROM AUTHOR]

This short, five-paragraph article introduces the reader to the distinguished preacher Friar Giuseppe Ragusa from Modica (Syracuse). The article begins by talking about preaching in the Franciscan Order. Next, it recounts events in Friar Giuseppe's life. Friar Giuseppe was born in 1806. He professed vows in 1826, and was ordained to the priesthood in 1828. He completed his studies in Catania [Sicily] and in 1836, having earned a Bachelor's degree, he was co-opted by the Order's other college students. After graduating in theology in 1839, he alternated between teaching and preaching. However, he achieved ever-increasing success as a preacher. The grave misfortune that struck his family, the memory of which aroused great horror in Friar Giuseppe, induced him to accept membership in the Province of Bologna, where he was assigned to the friary in Faenza. He became its guardian several times. He was well liked by the clergy and the people. He was also elected the Minister Provincial of Bologna for a three-year term (1849-1852). Longing for quiet, he retired to Longiano, in the Italian Province of Forlì, to the Shrine of the Most Holy Crucifix. He died of cancer on May 19, 1869. [ABSTRACT FROM AUTHOR]

Dual antiplatelet therapy (DAPT), comprising aspirin and a P2Y12 receptor inhibitor, is the cornerstone of post-percutaneous coronary intervention treatment to prevent stent thrombosis and reduce the risk of adverse cardiovascular events. The selection of an optimal DAPT regimen, considering the interplay of various antiplatelet agents, patient profiles, and procedural characteristics, remains an evolving challenge. Traditionally, a standard duration of 12 months has been recommended for DAPT in most patients. While contemporary guidelines provide general frameworks, DAPT modulation with longer or shorter treatment courses followed by aspirin or P2Y12 inhibitor monotherapy are evolving towards an individualized strategy to optimize the balance between efficacy and safety. This review comprehensively examines the current landscape of DAPT strategies after coronary stenting, with a focus on emerging evidence for treatment individualization. [ABSTRACT FROM AUTHOR]

In this work, we study the neutrino mixing sum rules arising from discrete symmetries and the class of Littlest Seesaw (LS) neutrino models. These symmetry-based approaches all offer predictions for the cosine of the leptonic CP phase  cos δ  in terms of the mixing angles,  θ 13 ,  θ 12 ,  θ 23 , while the LS models also predict the sine of the leptonic CP phase  sin δ , as well as making other predictions. In particular, we study the solar neutrino mixing sum rules, arising from charged lepton corrections to tri-bimaximal (TB), bimaximal (BM), golden ratio (GR) and hexagonal (HEX) neutrino mixing, and the atmospheric neutrino mixing sum rules, arising from preserving one of the columns of these types of mixing—for example, the first or second column of the TB mixing matrix (TM1 or TM2)—and we confront them with an up-to-date global fit of the neutrino oscillation data. We show that some mixing sum rules, such as an atmospheric neutrino mixing sum rule arising from a version of neutrino golden ratio mixing (GRa1), are already excluded at 3 σ , and we determine the remaining models allowed by the data. We also consider the more predictive LS models (which obey the TM1 sum rules and offer further predictions) based on constrained sequential dominance CSD(n) with  n ≈ 3 . We compare for the first time the three cases  n = 2.5 ,  n = 3  and  n = 1 + 6 ≈ 3.45 , which are favored by theoretical models, using a new type of analysis to accurately predict the observables  θ 12 ,  θ 23  and  δ. We study all the above approaches, solar and atmospheric mixing sum rules and LS models, together so that they may be compared and to give an up-to-date analysis of the predictions of all of these possibilities, when confronted with the most recent global fits. [ABSTRACT FROM AUTHOR]

The effectiveness of ritual is a major anthropological question. In this paper, I challenge some of the explanations anthropologists have provided to such a question and I attempt to formulate an original theorization of ritual as metaphor. The proposed hypothesis is grounded in two inspiring concepts: Ernesto De Martino's idea of "dehistorification" as the main technique of the ritual and Bruce Kapferer's "virtuality" as its proper dynamic dimension. Drawing on these theoretical foundations and a direct ethnographic experience and conceiving of ritual as a practice rather than as a symbol, I propose to regard it as a particular practice of metaphorization that is not representative of reality but effective on it. [ABSTRACT FROM AUTHOR]

The initial part of the text is dedicated to the figure of Fr. Michele Mantiglia, a Sicilian transplanted in Bohemia, who distinguished himself above all in Prague, in the Order's new College founded on 4th December 1621 by the Minister General Giacomo Montanari, approved by the popes, of which Mantiglia was the first regent (1622-1625). Later Fr. Michele became the first Provincial of Bohemia, elected in 1627. The part of the article devoted to the history of Prague College also suggests that the original design of the work was to narrate its complete history. It reconstructs, based on partial documents, the names of the regents and bachelor graduates, from the Bohemian foundation to its transfer to Italy, to Fermo, around 1716. [ABSTRACT FROM AUTHOR]

We consider an extension of the Standard Model that explains the neutrino masses and has a rich dark matter phenomenology. The model has two dark matter candidates, a vector WIMP and a fermion FIMP, and the sum of their relic densities matches the total dark matter abundance. We extensively study the dark matter production mechanisms and its connection with the neutrino sector, together with various bounds from present and future experiments. The extra scalar field in the model may induce a first-order phase transition in the early Universe. We study the production of stochastic gravitational waves associated with the first-order phase transition. We show that the phase transition can be strong, and thus the model may satisfy one of the necessary conditions for a successful electroweak baryogenesis. Detectability of the phase transition-associated gravitational waves is also discussed. [ABSTRACT FROM AUTHOR]

Background: Although there is no consensus regarding the best skin disinfection technique, whatever antiseptic solution is used, the "prep and drape" portion of most upper extremity procedures requires the presence of at least one operative room assistant or scrub nurse to elevate and hold the hand and forearm. Nonetheless, especially in a busy hand surgery practice and during fast procedures, an operative room assistant or scrub nurse are frequently not available leading to a reduced time efficiency between procedures. Purpose: This article describes an innovative easy-to-use and hands-free device that helps the surgeon during disinfection of the skin and the setup of the surgical field by keeping elevated the upper limb with respect for tissues. Methods: The development of the surgical arm holder starts from three easily available and washable thermoplastic splint sheets 40 × 60 cm with 2.5 cm thickness. The final device measures 40 × 25 × 15 cm and is placed underneath the proximal third of the humerus in order to keep the upper limb suspended at about 10–15 cm from the operating table. A retrospective analysis of the "surgical malpractice claims" and institutional non-conformities registered in the period 2011–2020 was conducted in our Hospital looking for bone or soft tissue complications related to the use of the device. Results: Three thousand one hundred eighty-seven surgical procedures were performed between 2011 and 2020 using this device. The retrospective analysis of all "surgical malpractice claims" showed no skin lesions, no neurological complications (such as neuroapraxia), no need for secondary bone procedures or interference with the draping process. Conclusion: Our device proved to be a low-cost, easy to use and alternative solution helping surgeons during the disinfection phase, improving hospital pre-operative flow and reducing the need for other staff members to be engaged in holding the upper limb in the operating room. [ABSTRACT FROM AUTHOR]

The article briefly recalls the figures of the Apostolic Prefects of the Conventual Franciscan missions in China and Zambia. In the climate of great missionary fervour ad gentes (to the nations), inspired by the pope of Missions Pius XI (1922-1939), the Order of Friars Minor Conventual also received from the Holy See the urgent invitation to open a mission in the Far East. The Franciscan Order was born as missionary (chapter XII of the Regula Bullata is dedicated to the missions of unbelievers), but at the time the provinces were recovering from suppression by States. There was therefore resistance, but it was overcome by the generosity of the Sardinian Province which was able to provide six of the eight missionaries in the group of pioneers. The mission in China was opened in 1925, and it developed wonderfully. The Zambian mission desired by the Minister General, Fr. Alfonso Orlini, was opened in 1930 (the document of erection is dated 13 January 1931). Thanks to the Prefect, Mazzieri, it had an exceptional growth. From this territory, the prefecture of Solwezi was born. The first Prefect, Ruppert Hillerich was not very efficient, but his successor Abdon Potani proved to be more active. In addition to the protagonists, other noteworthy characters are mentioned. The mission in China, after the expulsion of the foreign missionaries, is currently tentatively recovering. [ABSTRACT FROM AUTHOR]

We consider an extension of the Standard Model that accounts for the muon g − 2 tension and neutrino masses and study in detail dark matter phenomenology. The model under consideration includes a WIMP and a FIMP scalar dark matter candidates and thus gives rise to two-component dark matter scenarios. We discuss different regimes and mechanisms of production, including the novel freeze-in semi-production, and show that the WIMP and FIMP together compose the observed relic density today. The presence of the extra scalar fields allows phase transitions of the first order. We examine the evolution of the vacuum state and discuss stochastic gravitational wave signals associated with the first-order phase transition. We show that the gravitational wave signals may be probed by future gravitational wave experiments which may serve as a complementary detection signal. [ABSTRACT FROM AUTHOR]

The article presents the figure of Fr. Carlo Belleo, a prominent person of the Friars Minor Conventual and an illustrious philosopher. He was born around 1525 in Ragusa (Syracuse) and died on May 21st 1580 in Padua. He held the chair of Scotist metaphysics at the University. He was the Minister Provincial of St. Agatha and St. Lucy for ten months, regent in various Studies of the Order and a distinguished speaker. [ABSTRACT FROM AUTHOR]

To obtain a list of recommendations about clinical and radiological factors affecting outcome in thoraco-lumbar fractures with the aim of helping spine surgeons in daily practice. A systematic literature search in PubMed and Google Scholar database was done from 2010 to 2020 on the topic "thoracolumbar fracture AND radiology AND surgical outcomes" and "thoracolumbar fracture AND radiology AND surgical outcomes." A total of 58 papers were analyzed and WFNS (World Federation of Neurosurgical Societies) Spine Committee organized 2 consensus meetings to formulate the specific recommendations the first in Peshawar in December 2019 and in a subsequent virtual meeting in June 2020 to reach an agreement. Both meetings utilized the Delphi method to analyze preliminary literature review statements based on the current evidence levels to generate recommendations through a comprehensive voting session. Eight statements were presented and reached the consensus about this topic. A variety of clinical factors is known to influence outcome of patients with thoracolumbar fractures. Some of these are well-known established factors such as blood pressure augmentation and patient age, while some are not well studied. Overall, the quality of evidence is low and we need more randomized controlled studies to validate our results. Similarly, radiological factors that can predict outcome are well stated and there is a high accordance worldwide. In reverse, still under debate is the application to choose which surgical treatment is advisable based on them. [ABSTRACT FROM AUTHOR]

The author notes in the opening caption of the article, which intends to continue the work on the bishops of the Order begun by two OFM Conventual historians: Fr. Domenico Sparacio (1877-1929) and Fr. Giuseppe Abate (18991969). The aforementioned authors wrote in Latin, but very succinctly, especially Sparacio, while the author who uses the Italian language, intends to treat the new profiles in a less concise way, reporting the documentation in the footnotes, which are absent in the writings of Sparacio and Abate. The continuation starts from where the Abate left off (1930). However, the profiles of Francesco Maria Berti, Giovanni Maria Sanna, Pio Leonardo Navarra, Girolamo Mileta and Luigi Bondini are integrated. In this work the profiles of the bishops, with their respective coats of arms (9 and 16 have not been located) a total of 19 between 1907 and 2020. All bishops are deceased. [ABSTRACT FROM AUTHOR]

After a brief introduction based on the title, the author distinguishes the work in three points: 1) The friary of the Friars Minor Conventual in Gela. 2) The Conventual Friar Minor. 3) The Franciscan Cardinal. The first point illustrates the town of Gela, formerly Terranova di Sicilia, which at the time of Panebianco was a village of about 9,000 inhabitants, but thanks to its commercial port and tourism, today it has over 70,000 inhabitants. The friary of St. Francis, founded in the countryside around 1265, was given to the Capuchins in 1574, when the Conventuals moved to the coast. There are many prominent Gelesi Conventuals. The second point is dedicated to the life of Antonio Panebianco. Born in Gela in 1808, he trained in Catania before being counted among the students of the College of St. Bonaventure in Rome (1834). All documentation of the sacred ordinations of the Panebianco were found in the Archbishop's Archives in Catania. Unfortunately, the date of his priestly ordination is missing. From other documents, however, it is certain that he was ordained a priest in 1832. He held many positions in his Province of Sicily, which he also governed as Minister Provincial. He was Assistant General and he missed out by a few votes on being elected Minister General. The third point, the Franciscan Cardinal, begins with the appointment of Panebianco as Consultor of the Holy Office, a prelude to elevation to Cardinal of the Congregation for Indulgences and Sacred Relics [S.R.C.] (1861), to the return of the Delegation to Transylvania led by the Nuncio in Vienna Antonio De Luca on mixed marriages, concluded to the satisfaction of the Holy See and the Emperor of Austria. As Cardinal his title church in Rome was St. Girolamo degli Schiavoni, instantly changed to that of The Basilica of the Twelve Holy Apostles. As Prefect of the Sacred Congregation of Indulgences and Relics, he was a member of almost all the Roman congregations. He participated in the First Vatican Council (1870). He was very close to the Holy Father Pius IX and shared his ambition for the fall of the Papal State (1870). He was among the papabile in the conclave of 1878 in which Leo XIII was elected. He died on November 21, 1885 at SS. Apostoli, where he remained in community as a cardinal. He is buried at Campo Verano. [ABSTRACT FROM AUTHOR]

This article focuses on the ethnographic case study of a festival revival observed in Celano, a hill town in Abruzzo (Italy). On 17 January, in accordance with the Catholic calendar, the community celebrates the feast of Saint Anthony the Abbot. In the folkloric iconography, the Saint is strongly connected with animals, specifically the pig, which is even represented with him in the sacred effigy. While in the past a more complex ritual was performed, what is central nowadays in the 're-invented' tradition is the food sharing involving the whole community. On the feast night, a huge fire is set on the central square, and people flock around it, eat roasted pork sausages and drink wine. In the article, I discuss how the current ritual pork-sharing is emically maintained as a tradition to preserve the community's identity, and how this enacts and reshapes the global–local dynamic. [ABSTRACT FROM AUTHOR]

Aims: To describe through emblematic images rare but clinically relevant carotid artery stenting complications that occurred at two high-volume centres for carotid artery stenting (CAS). Background: CAS is an alternative to carotid endarterectomy (CEA) for the treatment of carotid artery stenosis in patients judged to be at high risk for CEA. CAS complications range between 1 and 9% and are higher in older patients complaining of neurological symptoms at the time of presentation. Besides periprocedural or early-after-procedure stroke, which remains the true Achilles' heel of CAS, other dramatic complications might compromise the clinical outcomes of this procedure. Methods: Five infrequent complications, out of more than 1000 CAS performed in the years 2016–2021, have been described. Results: Among CAS complications, acute carotid stent thrombosis, rescue retrieval of a disconnected distal cerebral embolic protection device, plaque prolapse after carotid stenting, cerebral hyperperfusion syndrome (CHS), and radial artery long sheath entrapment requiring surgical intervention were found to account for 0.3% of the total number of procedures performed by operators with high CAS volume. Conclusions: Unusual CAS complications may infrequently occur, even in hands of expert operators. To know how to deal with such complications might help interventionalists to improve CAS performance. [ABSTRACT FROM AUTHOR]

Double or triple antithrombotic therapy (DAT/TAT) including or excluding aspirin in association with oral anticoagulant and P2Y12 inhibitor are currently two available options in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI). We evaluated efficacy and safety outcomes for DAT vs. TAT. Four non-vitamin K oral anticoagulants (NOAC)-based randomized controlled trials comparing DAT vs. TAT with a total of 10,938 patients were pooled. Bleeding events occurred more frequently than ischemic events. DAT as compared to TAT was associated to an increased risk of stent thrombosis (RR 1.54, 95% CI 1.10–2.14; p = 0.03), myocardial infarction (RR 1.23, 95% CI 1.04–1.46; p = 0.03) and cardiovascular mortality (RR 1.09, 95% CI 1.01–1.19; p = 0.04) and to a reduced risk of ISTH major or clinically relevant non-major bleeding (RR 0.59, 95% CI 0.62–0.93; p = 0.03). A consistent effect was observed in all safety endpoints. Intracranial haemorrhage was numerically reduced by DAT. No difference for all-cause death was observed. Antithrombotic treatment in patients with AF undergoing PCI represents a trade-off between ischemia and bleeding. A careful patient selection based on baseline ischemic and bleeding risk may optimize the net clinical balance in this population. • In AF patients undergoing PCI or with ACS, withdrawal of aspirin, transitioning from a TAT to a DAT, reduces bleeding events. • A concomitant, yet less frequent, increased risk of ST and MI with DAT is observed. • DAT after an initial brief treatment with corresponding TAT appears the best strategy for the majority of patients. • Selected patients deemed at elevated ischemic risk might still benefit from a longer course of TAT. • A personalized treatment strategy based on individual ischemic and bleeding risk is essential to optimize patients' net outcome. [ABSTRACT FROM AUTHOR]

Purpose: Previous studies have shown an association between obstructive sleep apnoea syndrome (OSAS) and cardiovascular events. Whether this association is mediated by an impairment of endothelial function, which is itself a driver of elevated cardiovascular risk, has yet to be clarified, as it is the eventual protective role of several OSAS treatments. The aim of our meta-analysis is to evaluate the effect of various OSAS treatments on endothelial function calculated by means of flow-mediated dilatation (FMD). Methods: We conducted a meta-analysis of prospective studies including patients affected by mild to severe OSAS treated with continuous positive airway pressure (CPAP), surgery, oral appliance and medical treatments. FMD was measured before and after treatment Results: After pooling results from different treatment strategies, OSAS treatment showed a positive impact on endothelial function (Mean Difference [MD] = 2.58; 95% CI 1.95–3.20; p < 0.00001). Conclusions: Our study supports the hypothesis that several modalities of treatment for OSAS positively impact endothelial function. Whether this effect also associates with an improvement of clinical outcomes remains to be ascertained. [ABSTRACT FROM AUTHOR]

Cardiogenic shock is a dreadful complication of myocardial infarction. Despite widespread use and availability, intra‐aortic balloon pump (IABP) does not reduce mortality nor improves outcomes. Advanced mechanical circulatory support with IMPELLA system can substantially support hemodynamics and improve short‐term prognosis in patients with myocardial infarction and cardiogenic shock. [ABSTRACT FROM AUTHOR]

Until 1986, St. Francis Anthony Fasani was known only as a great orator, with a following of many devotees both in Lucera and in the regions of Daunia (both places are in the province of Foggia). However, his stature as a Franciscan writer was unknown. Thanks to the commendable and hard work of Fr. Bonaventura Danza OFMConv from Puglia, the manuscripts of the Maestro, Fasani, almost all in Latin, documented by typewriter, are now more accessible to scholars, who immediately had the pleasant surprise of being confronted by a writer worthy of the name. The appreciative discovery dates back to 1986, the year of the canonization of the Saint Francis Anthony Fasani. At that time Fr. Eugenio Galignano, then Minister Provincial of Puglia, invited a team of professors of Saint Bonaventure’s College (Seraphicum), to collaborate and these responded enthusiastically to the appeal. In 1986, professors from the Theological Faculty of the Order edited the first Rosary of Fasani for the numerous editions of Messenger of St. Anthony of Padua, and Fasani’s seven Marian novenas were published with various examinations by the same professors. Again, through the Faculty and the editions of the Messenger of St. Anthony, a large volume appeared on Fasani in 1989 between apostolic history and doctrine. In 1997, the Committee for the Cultural Promotion of Fasani was established. This committee, in the years 1997 - 2000, edited the following new works by Fasani: A short commentary on the Our Father, a second Rosary, a Second Commentary on the Our Father. A new work by Fasani entitled “God probes the heart” was published in 2018 in Lucera, with a corresponding Italian translation by Fr. Eugenio Galignano, a great promotor of the cultural movement of Fasani. [ABSTRACT FROM AUTHOR]

Background: Complex percutaneous coronary intervention (PCI) is associated with higher ischemic risk, which can be mitigated by long-term dual antiplatelet therapy (DAPT). However, concomitant high bleeding risk (HBR) may be present, making it unclear whether short- or long-term DAPT should be prioritized.Objectives: This study investigated the effects of ischemic (by PCI complexity) and bleeding (by PRECISE-DAPT [PREdicting bleeding Complications in patients undergoing stent Implantation and SubsequEnt Dual AntiPlatelet Therapy] score) risks on clinical outcomes and on the impact of DAPT duration after coronary stenting.Methods: Complex PCI was defined as ≥3 stents implanted and/or ≥3 lesions treated, bifurcation stenting and/or stent length >60 mm, and/or chronic total occlusion revascularization. Ischemic and bleeding outcomes in high (≥25) or non-high (<25) PRECISE-DAPT strata were evaluated based on randomly allocated duration of DAPT.Results: Among 14,963 patients from 8 randomized trials, 3,118 underwent complex PCI and experienced a higher rate of ischemic, but not bleeding, events. Long-term DAPT in non-HBR patients reduced ischemic events in both complex (absolute risk difference: -3.86%; 95% confidence interval: -7.71 to +0.06) and noncomplex PCI strata (absolute risk difference: -1.14%; 95% confidence interval: -2.26 to -0.02), but not among HBR patients, regardless of complex PCI features. The bleeding risk according to the Thrombolysis In Myocardial Infarction scale was increased by long-term DAPT only in HBR patients, regardless of PCI complexity.Conclusions: Patients who underwent complex PCI had a higher risk of ischemic events, but benefitted from long-term DAPT only if HBR features were not present. These data suggested that when concordant, bleeding, more than ischemic risk, should inform decision-making on the duration of DAPT. [ABSTRACT FROM AUTHOR]

Objective : To mitigate the risk of iatrogenic instability, new posterior decompression techniques able to preserve musculoskeletal structures have been introduced but never extensively investigated from a biomechanical point of view. This study was aimed to investigate the impact on spinal flexibility caused by a unilateral laminotomy for bilateral decompression, in comparison to the intact condition and a laminectomy with preservation of a bony bridge at the vertebral arch. Secondary aims were to investigate the biomechanical effects of two-level decompression and the quantification of the restoration of stability after posterior fixation. Methods : A universal spine tester was used to measure the flexibility of six L2-L5 human spine specimens in intact conditions and after decompression and fixation surgeries. An incremental damage protocol was applied : 1) unilateral laminotomy for bilateral decompression at L3-L4; 2) on three specimens, the unilateral laminotomy was extended to L4-L5; 3) laminectomy with preservation of a bony bridge at the vertebral arch (at L3-L4 in the first three specimens and at L4-L5 in the rest); and 4) pedicle screw fixation at the involved levels. Results : Unilateral laminotomy for bilateral decompression had a minor influence on the lumbar flexibility. In flexion-extension, the median range of motion increased by 8%. The bone-preserving laminectomy did not cause major changes in spinal flexibility. Two-level decompression approximately induced a twofold destabilization compared to the single-level treatment, with greater effect on the lower level. Posterior fixation reduced the flexibility to values lower than in the intact conditions in all cases. Conclusion : In vitro testing of human lumbar specimens revealed that unilateral laminotomy for bilateral decompression and bone-preserving laminectomy induced a minor destabilization at the operated level. In absence of other pathological factors (e.g., clinical instability, spondylolisthesis), both techniques appear to be safe from a biomechanical point of view. [ABSTRACT FROM AUTHOR]

The Author analyses the painful story of friar Giovanni Pesce of the Friars Minor Conventual (ca. 1355-1448), bishop of Catania (1431-1447), who was removed from his Diocese by Pope Eugene IV (1431-1447). Giovanni Pesce was of a noble family from Catania; he was a professor of theology, orator, Minister Provincial of Sicily, and a councillor at the court of Alfonso the Magnanimous. Elected bishop of the diocese of Etna, he, together with the archbishop of Palermo, Nicola Tudisco was sent by King Alfonso to the Council of Basel where both took part in the conciliar decisions that weakened the authority of the pope, as well as adhering to the antipope Felix V. He returned to orthodoxy when the king was reconciled with Eugene IV in 1443 and withdrew his subjects from the council. Established in Catania in 1444, the General Studio defended the heritage of the Episcopal See on which the Municipality wanted to make the financing of the study heavy, attracting, still, due to the ambiguity of the king, the hatred of the jurors and citizens who asked for it to be replaced. In fact Eugene IV, in the consistory of 3 February 1447 expelled Bishop Pesce from his diocese. There is not however the motivation in the document of condemnation that, according to A., should be sought out in the case of the Studio. A friend of St. John of Capestrano, of the Observant Minors, Pope Eugene favoured this reform, opposed the Conventuals, who were accused of having betrayed the Franciscan Rule in matters of poverty and of living in a depraved manner. It was therefore necessary to expel them from their friaries. Beginning in Rome, Pope Eugene took from them the friaries of St. Francis a Ripa and Santa Maria in Aracoeli. Giovanni Pesce belonged to the Conventuals, the Order loathed by Eugene IV because of their dishonesty, and therefore could not be the head of a diocese. Following this expulsion, a titular bishop of Plovdiv in Syria survived for a year, dying before December 2, 1448. [ABSTRACT FROM AUTHOR]

Dual antiplatelet therapy (DAPT) prevents recurrent ischemic events after an acute coronary syndrome (ACS) as well as stent thrombosis (ST) in patients with prior stent implantation. Nevertheless, these benefits are counterbalanced by a significant bleeding hazard, which is directly related to the treatment duration. Although DAPT has been extensively studied in numerous clinical trials, optimal treatment duration is still debated, mostly because of apparent inconsistencies among studies. Shortened treatment duration of 6 or 3 months was shown to mitigate bleeding risk compared with consensus-grounded 12-month standard duration, without any apparent excess of ischemic events. However, recent trials showed that a >12-month course of treatment reduces ischemic events but increases bleeding compared with 12 months. The inconsistent benefit of a longer DAPT course compared with shorter treatment durations is puzzling, and requires a careful appraisal of between-studies differences. We sought to summarize the existing evidence aiming at reconciling apparent inconsistencies among these studies, as well as thoroughly discuss the possible increased risk of fatal events associated with long-term DAPT. Benefits and risks of prolonging or shortening DAPT duration will be discussed, with a focus on treatment individualization. Finally, we will provide an outlook for possible future directions in the field. [ABSTRACT FROM AUTHOR]

Poor adherence to antihypertensive treatment is the single most important factor of unsatisfactory blood pressure (BP) control. This review focuses on therapy-related factors affecting adherence and suggests how to improve it with a wise choice of treatment schedule. Complex drug treatment schemes, poor tolerability and drug substitutions are frequent causes of poor adherence which, in turn, causes insufficient BP control, greater incidence of cardiovascular events and, finally, higher global health costs. The effects of prescribing generic drugs and of drug substitutions on adherence is also discussed. In terms of adherence, generic drugs do not seem to be better than branded drugs, unless patients have to bear very high 'out of pocket' expenses to buy original drugs, suggesting no advantages in switching drug with the mere goal of reducing the cost of therapy. An important role in improving adherence (and thus cardiovascular events and health expenditure) is also played by the availability of fixed-dose combinations; among antihypertensive drugs, angiotensin receptor blockers (ARBs) are those associated with higher levels of adherence and persistence. Among ARBs, olmesartan stands out for a wide choice of effective fixed-dose combinations. [ABSTRACT FROM AUTHOR]

Intramembrane proteases, such as γ secretase, typically recruit multiple substrates from an excess of single-span membrane proteins. It is currently unclear to which extent substrate recognition depends on specific interactions of their transmembrane domains (TMDs) with TMDs of a protease. Here, we investigated a large number of potential pairwise interactions between TMDs of γ secretase and a diverse set of its substrates using two different configurations of BLaTM, a genetic reporter system. Our results reveal significant interactions between TMD2 of presenilin, the enzymatic subunit of γ secretase, and the TMD of the amyloid precursor protein, as well as of several other substrates. Presenilin TMD2 is a prime candidate for substrate recruitment, as has been shown from previous studies. In addition, the amyloid precursor protein TMD enters interactions with presenilin TMD 4 as well as with the TMD of nicastrin. Interestingly, the Gly-rich interfaces between the amyloid precursor protein TMD and presenilin TMDs 2 and 4 are highly similar to its homodimerization interface. In terms of methodology, the economics of the newly developed library-based method could prove to be a useful feature in related future work for identifying heterotypic TMD−TMD interactions within other biological contexts. [ABSTRACT FROM AUTHOR]