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AIMS To evaluate outcomes of transfemoral transcatheter aortic valve implantation (TF-TAVI) using three different new-generation devices. BACKGROUND Although new generation transcatheter aortic valves (TAVs) have demonstrated to improve procedural outcomes, to date few head-to-head comparisons are available among these devices. METHODS This is a single center, retrospective study. From September 2014 to February 2018, 389 patients underwent elective TF-TAVI for native, severe aortic stenosis using a new-generation transcatheter aortic valve (TAV) with a preprocedural multi-detector computed tomography assessment. Among these, 346 patients received an Edwards SAPIEN 3 (n = 134), Medtronic Evolut R (n = 111), or Boston ACURATE neo (n = 101) prosthesis. Differences in baseline clinical characteristics between groups were accounted using the propensity score weighting method. RESULTS The mean age for the entire study cohort was 81.4 ± 5.2 years while the Society of Thoracic Surgery predicted risk of mortality was 4.0 ± 2.5%. After propensity score weighting adjustment, TAVs did not differently impact on 30-day all-cause and cardiovascular mortality. Evolut R device showed an increased risk of permanent pacemaker implantation (PPI) after the procedure (8.3% for SAPIEN 3 vs. 16.7% for Evolut R vs. 2.1% for ACURATE neo, p

In the light of sustainability, satisfactory living conditions is an important factor for people&rsquo, s positive feedback in their own living environment. Acoustic comfort and noise exposure should then be carefully monitored in all human settlements. Furthermore, it is already well-known that high or prolonged noise levels may lead to unwanted health effects. Unfortunately, while in the last decades scientists and public authorities have investigated the noise produced by roads, trains, and airports, not enough efforts have been spent in studying what happens around the coastal and port areas. Following the attention brought to the subject by recent European projects on noise in port areas, the present paper characterizes the sound power level and 1/3 octave band sound power spectrum of seagoing ships while moving at low speeds. Five different categories have been distinguished: Roll-on/roll-off (RORO), container ship, oil tanker, chemical tanker, and ferry. The analysis is based on a continuous noise measurement lasting more than three months, performed in the industrial canal of the port of Livorno (Italy). The resulting noise emissions are new and useful data that could be inserted in acoustic propagation models to properly assess the noise in the areas affected by port activities. Thus, the present work can act as a supporting tool in planning ship traffic in ports towards better sustainability.

Introduction: We describe a patient without a history of cardiovascular diseases as an example of Wellens’ syndrome (WS). Case Report: A 65-year-old man presented to emergency department due to intermittent chest pain. Physical examination and chest x-ray were unremarkable. Electrocardiogram (ECG) showed biphasic T-wave in precordial leads V1-V4. Primary cardiac serum biomarkers including high-sensitive cardiac troponin T (hs-cTnT) and CK-MB were slightly elevated, that further assessment did not show any increases; while ECG recorded during a pain period revealed T-wave pseudo-normalization. The patient underwent coronary angiography that revealed a proximal left anterior descending artery lesion. Conclusion: WS is a diagnostic and management challenge and serial ECG evaluation is still essential for a possible acute coronary syndrome. Having knowledge of all subtle features of this syndrome, could avoid improper discharge of high-risk patients. Definitely, accurate risk stratification, and prompting these patients to an early coronary angiogram and treatment are mandatory to avoid development of a massive anterior myocardial infarction.

After the European Environmental Noise Directive prescribed noise maps and action plans, wide scientific literature and a consistent number of mitigation strategies emerged for road, railway, airport, and industrial noise. Unfortunately, very little attention has been paid to the noise produced by ports in their surroundings, even though there could be many areas affected by it. At present, more attention seems to be paid to noise produced underwater, mostly for military and security reasons and for its interference with wildlife, rather than airborne noise and its influence on human health. In the framework of a project aiming to shed more light on a topic so far under-investigated, this paper presents an acoustical characterization of different small vessels at various speeds that move around on a daily basis in every type of port, produced by means of short- and long-term measurements. The new information acquired was used to produce a map of noise generated by vessels moving in Livorno&rsquo, s canals, which branch off in a densely inhabited area. The simulations were validated using long-term measurement. The number of citizens exposed was also estimated and used to calculate the number of highly annoyed people according to the recent curve for road traffic noise proposed by Guski et al. In order to prevent citizen exposure to noise and possible complaints about small boats, different scenarios and possible future situations such as various vessel speeds, limited flow, restricted areas for some categories, or new residential areas were studied.

Only recently has noise been considered in the assessment of the sustainability of port infrastructures, after decades of unawareness. INTERREG Maritime projects unveiled problems that have been neglected so far, such as the lack of proper regulation and noise exposure assessments for citizens. While it is true that a port area includes a huge variety of possible noise sources, very few of them have been characterized from an acoustical point of view. INTERREG projects have boosted research in the field, and previous studies have dealt with noise produced by moving ships in ports. The present work starts from a previous measurement campaign used to obtain broadband and 1/3-octave-band noise emissions of moving ships, and it aims to explain their uncertainties. More than a month&rsquo, s worth of continuous acoustic measurements and video recordings were deeply analyzed in order to obtain an input database that is as precise as possible. A multiple regression analysis was performed in order to understand the influence that parameters such as minimum distance, speed, and draught have on ships&rsquo, noise emissions, which were calculated using pass-by measurements, with a special focus on ferries. The minimum distance of each ship&rsquo, s passage from the microphone was measured using a video recording with an innovative methodology, providing results with 3 m of uncertainty. Knowing which parameter is more influential would help in planning proper measurements for monitoring or for drafting correct guidelines. Draught was determined to be uninfluential in ferries&rsquo, noise emissions, while the minimum distance and speed relations were estimated and accounted for in the calculation of a refined sound power level. From a spectrum point of view, the frequencies from 500 Hz to 2.5 kHz were determined to be those that contributed the most to the noise produced by the transit of a ship, and they vary with speed. With the studied corrections, different ferry models resulted in similar noise emissions. The standard deviation of noise emitted was reduced by 0.5 dB (A), and the average was also improved by positioning the ships&rsquo, flow at the correct average minimum distance. Furthermore, the right placement of a source is also important in the acoustic mapping phase for a correct evaluation of the propagation of noise at a distance. The use of more precise input data is important for improving the output of acoustic propagation models during the assessment of port noise in the surrounding areas.