Durability and effectiveness of dual vs. triple therapy and tablet simplification in ART: findings from the Italian MOSAICO study.

Introduction: Treatment optimization in people with HIV (PWH) has increasingly focused on reducing drug burden and improving regimen simplicity. However, comparative real-world evidence on dual therapy (DT) vs. triple therapy (TT), and single-tablet regimens (STR) vs.

Thresholds for Transfusion Practice During ECMO Support. A Systematic Review and Network Meta-Analysis.

Purpose: The benefits of adopting restrictive transfusion strategies, as opposed to a liberal approach, during extracorporeal membrane oxygenation (ECMO) remain unclear. This network meta-analysis aims to determine whether a restrictive transfusion strategy is more effective than liberal thresholds in minimizing red blood cell (RBC) transfusions and improving secondary outcomes.

Methods: A comprehensive literature search (PROSPERO-CRD42025637794) across Medline, Embase, and Scopus was conducted.

Assessing the Accuracy and Readability of Large Language Model Guidance for Patients on Breast Cancer Surgery Preparation and Recovery.

Accurate and accessible perioperative health information empowers patients and enhances recovery outcomes. Artificial intelligence tools, such as ChatGPT, have garnered attention for their potential in health communication. This study evaluates the accuracy and readability of responses generated by ChatGPT to questions commonly asked about breast cancer.

Retrospective Evaluation of Pediatric Emergency Department Visits of Children With Medical Complexity in a Tertiary Care Center in Italy.

Objective: Children with medical complexity are a growing population with multiple conditions, medical device dependency and frequent need for emergency department (ED) visits; their care and management in an emergency setting may be challenging. The pediatric palliative care (PPC) network aims to address the needs of these children and their families to improve their quality of life.The purpose of this retrospective single-center study was to determine the prevalence and reasons for visiting the ED, the management, outcome, and quality of care received in a Tertiary Care Pediatric Hospital, where the PPC facility is strongly integrated and cooperating with the ED.

The main protease (M) from SARS-CoV-2 triggers plasma clotting in vitro by activating coagulation factors VII and FXII.

Although the connection between COVID-19 and coagulopathy has been clear since the beginning of SARS-CoV-2 pandemic, the underlying molecular mechanisms remain elusive. Available data support that the hyper-coagulant state is sustained by systemic inflammation. Here we show that the SARS-CoV-2 main protease (M) can play a direct role in the activation of coagulation.

The Impact of THV Platforms on Transfemoral TAVR in Complex Vascular Access: Insights From the Hostile Registry.

Background: The choice of transcatheter heart valve (THV) platform, including self-expanding valves (SEVs) and balloon-expandable valves (BEVs), may influence outcomes in patients with peripheral artery disease (PAD) undergoing transfemoral transcatheter aortic valve replacement (TAVR). This relationship remains underexplored in high-risk populations with challenging vascular access.

Aims: This study assessed the impact of SEVs and BEVs on clinical outcomes in PAD patients, considering hostile score severity.

One-Year Results of the Magmaris BRS in Coronary Artery Disease Patients: The IT-MASTERS Registry.

Recent studies have highlighted the potential of the Magmaris Resorbable Magnesium Scaffold (RMS; Biotronik AG, Bülach, Switzerland) in routine clinical practice. However, limited data are available on its clinical and procedural performance in challenging coronary lesions. The IT-MASTERS registry is a prospective, investigator-initiated study conducted at 21 Italian centers, aiming to evaluate the safety and efficacy of Magmaris in a real-world cohort.

Large language models in public health: opportunity or threat? The case of button battery injuries.

Background: Button battery (BB) injuries in children represent a severe and growing public health burden. The literature on the topic is extensive; however, there is a notable lack of structured public health initiatives addressing the problem. The present study aimed to test the feasibility of using large language models (LLMs) to draft recommendations for preventing and managing BB ingestion in children.

Analyzing the Caloric Variability of Bites in a Semi-Naturalistic Dietary Setting.

Obesity is a major public health issue in developed countries, primarily managed through dietary interventions and physical activity. Food portion sizes influence the estimation of energy intake, particularly through bites, of which characteristics remain insufficiently defined. This study investigates the variability in bite energy content.

Fourteen-year analysis of rugby injuries in a pediatric emergency department.

Background: Rugby is the third most played contact team sport worldwide. Its growing popularity is raising concerns about injuries rates, given its collision-based nature and minimal use of protective gear. However, research on rugby injuries in Italy, especially in the pediatric age group, remains limited.

An Antibiotic Stewardship Program in Pancreatic Surgery.

Importance: Antimicrobial stewardship (AMS) programs optimize antibiotic use and mitigate antimicrobial resistance. The literature on the efficacy of AMS programs in pancreatic surgery is limited.

Objective: To investigate the association of a multifaceted AMS intervention targeting surgical antibiotic prophylaxis (SAP) with the rate of surgical site infections (SSIs) following pancreatic surgery.

Prognostic significance of severe mitral annular calcification in aortic stenosis: implications for aortic valve replacement outcome.

Background: Mitral annulus calcification (MAC) is no longer seen as merely age-related. Recent evidence links MAC to calcific aortic stenosis (AS), but its prognostic value in AS patients undergoing aortic valve replacement (AVR) remains unclear. This study aims to assess the impact of cardiac CT-derived MAC on cardiovascular outcomes in this population.

The Coronary Access After TAVI (CAvEAT) Study: A Prospective Registry of CA After TAVR.

Background: As transcatheter aortic valve replacement (TAVR) is now performed in patients with longer life expectancy, the need for coronary access (CA) after TAVR is expected to rise.

Objectives: The aim of this study was to evaluate the feasibility of CA after TAVR with 4 different types of transcatheter heart valves (THVs).

Methods: In the multicenter, prospective CAvEAT (Coronary Access After TAVI; NCT04647864) registry, coronary angiography was performed immediately following transfemoral TAVR using short-frame SAPIEN 3 or SAPIEN 3 Ultra (SAPIEN 3/Ultra) and tall-frame ACURATE neo or ACURATE neo2 (ACURATE neo/neo2), Portico or Navitor, and Evolut Pro or Evolut Pro+ (Evolut Pro/Pro+) THVs.

Transcriptomic profiling of cytomegalovirus infection in cardiac transplantation: proof-of-concept for a new strategy in tissue markers application.

Background: Cytomegalovirus (CMV) infection is a relevant threat to heart-transplanted patients during the first year after surgery, leading to increased morbidity and, in some cases, mortality. This study aims to assess the transcriptomic profile of CMV infection in cardiac transplanted patients as a new diagnostic approach to discriminate infection and Acute Cellular Rejection (ACR) on EMB specimens.

Methods: We performed a microarray-based messenger RNA (mRNA) and micro-RNA (miRNA) profiling.

Predicted vs. Observed Prosthesis-Patient Mismatch After Surgical Aortic Valve Replacement.

: Prosthesis-patient mismatch (PPM) after surgical aortic valve replacement (SAVR) is associated with worse clinical outcomes and worse valve durability. The aim of this retrospective single-center study was to evaluate the consistency between predicted PPM (PPMp) and measured PPM (PPMm) after SAVR with three different bioprostheses. : We analyzed data of all consecutive patients who underwent surgical aortic valve replacement with Magna Ease, Intuity, and Inspiris Resilia bioprostheses (Edwards Lifesciences, Irvine, CA, USA) at our institution.

Mathematical Contact Tracing Models for the COVID-19 Pandemic: A Systematic Review of the Literature.

: Contact tracing (CT) is a primary means of controlling infectious diseases, such as coronavirus disease 2019 (COVID-19), especially in the early months of the pandemic. : This work is a systematic review of mathematical models used during the COVID-19 pandemic that explicitly parameterise CT as a potential mitigator of the effects of the pandemic. : This review is registered in PROSPERO.

Large Language Models in Action: Supporting Clinical Evaluation in an Infectious Disease Unit.

Healthcare-associated infections (HAIs), including sepsis, represent a major challenge in clinical practice owing to their impact on patient outcomes and healthcare systems. Large language models (LLMs) offer a potential solution by analyzing clinical documentation and providing guideline-based recommendations for infection management. This study aimed to evaluate the performance of LLMs in extracting and assessing clinical data for appropriateness in infection prevention and management practices of patients admitted to an infectious disease ward.

Robotic Thymectomy for Myasthenia Gravis: Analysis of the Surgical and Neurological Outcomes After a 20 Years' Experience.

Background: Evidence supporting robotic thymectomy for myasthenia gravis is generally based on small sample-size studies, heterogeneous in patient selection and in reporting outcomes. Therefore, this study was conducted to assess the surgical and neurological outcomes of robotic thymectomy in myasthenic patients and to identify prognostic factors associated with symptoms' remission through a large cohort of patients operated in a 20 years' period.

Methods: A retrospective analysis of a prospectively maintained database was conducted for all patients undergoing robotic thymectomy for myasthenia gravis between 2002 and 2022.

Navigating challenges in pediatric trial conduct: integrating bayesian sequential design with semiparametric elicitation for handling primary and secondary endpoints.

Background: This study presents a Bayesian Adaptive Semiparametric approach designed to address the challenges of pediatric randomized controlled trials (RCTs). The study focuses on efficiently handling primary and secondary endpoints, a critical aspect often overlooked in pediatric trials. This methodology is particularly pertinent in scenarios where sparse or conflicting prior data are present, a common occurrence in pediatric research, particularly for rare diseases or conditions.

Comparing local excision with watch and wait for the management of rectal cancer patients responding to neoadjuvant chemoradiotherapy: Composite endpoint analysis using the win ratio.

Aim: The aim of this work was to apply the 'win ratio' to compare the outcomes of rectal-sparing approaches [watch and wait (WW) and local excision (LE)] in the management of locally advanced rectal cancer responding to neoadjuvant chemoradiotherapy.

Method: Patients enrolled in the ReSARCh study (NCT02710812) between 2016 and 2021 were divided into two cohorts (WW vs. LE).

Bayesian dynamic borrowing in group-sequential design for medical device studies.

Background: The integration of historical data into ongoing clinical trials through Bayesian Dynamic Borrowing offers significant advantages, including reduced sample size, trial duration, and associated costs. However, challenges such as ensuring exchangeability between historical and current data and mitigating Type I error inflation remain critical. This study proposes a Bayesian group-sequential design incorporating a Self-Adaptive Mixture (SAM) prior framework to address these challenges in medical device trials.

A Large Language Model-Based Approach for Coding Information from Free-Text Reported in Fall Risk Surveillance Systems: New Opportunities for In-Hospital Risk Management.

Falls are the most common adverse in-hospital event, resulting in a considerable social and economic burden on individuals, their families, and the healthcare system. This study aims to develop and implement an automatic coding system using large language models (LLMs) to extract and categorize free-text information (including the location of the fall and any resulting injury) from in-hospital fall records. : The study used the narrative description of the falls reported through the Incident Reporting system to the Risk Management Service of an Italian Local Health Authority in Italy (name not disclosed as per research agreement).