Which explanations do clinicians prefer? A comparative evaluation of XAI understandability and actionability in predicting the need for hospitalization.

Background: This study aims to address the gap in understanding clinicians' attitudes toward explainable AI (XAI) methods applied to machine learning models using tabular data, commonly found in clinical settings. It specifically explores clinicians' perceptions of different XAI methods from the ALFABETO project, which predicts COVID-19 patient hospitalization based on clinical, laboratory, and chest X-ray at time of presentation to the Emergency Department. The focus is on two cognitive dimensions: understandability and actionability of the explanations provided by explainable-by-design and post-hoc methods.

Incidence and risk factors for delayed intracranial hemorrhage after mild brain injury in anticoagulated patients: a multicenter retrospective study.

Background: Anticoagulated patients with mild traumatic brain injury (mTBI) and a negative cerebral CT on admission, commonly undergo a repeated CT scan after observation in the emergency department (ED) to detect delayed intracranial hemorrhage (ICH). However, the utility of this practice is controversial, with recent evidence suggesting that the risk of delayed ICH in these patients is low. This study aims to evaluate incidence, outcomes, and risk factors of delayed ICH in patients receiving direct oral anticoagulants (DOACs) or vitamin K antagonists (VKAs) presenting to the ED with mTBI.

Simulation-based training in ultrasound-guided regional anaesthesia for emergency physicians: insights from an Italian pre/post intervention study.

Background: Despite the importance of Ultrasound-guided Regional Anaesthesia (UGRA) in Emergency Medicine (EM), there is significant variability in UGRA training among emergency physicians. We recently developed a one-day (8 h), simulation-based UGRA course, specifically tailored to help emergency physicians to integrate these skills into their clinical practice.

Methods: In this pre/post intervention study, emergency physicians attended a course consisting of a 4-hour teaching on background knowledge and a practical part structured as follows: a scanning session on a healthy individual; a needling station with an ex-vivo model (turkey thighs); a simulation-based learning experience on local anaesthetic toxicity (LAST); a session on the UGRA simulator BlockSim™.

Deep learning and lung ultrasound for Covid-19 pneumonia detection and severity classification.

The Covid-19 European outbreak in February 2020 has challenged the world's health systems, eliciting an urgent need for effective and highly reliable diagnostic instruments to help medical personnel. Deep learning (DL) has been demonstrated to be useful for diagnosis using both computed tomography (CT) scans and chest X-rays (CXR), whereby the former typically yields more accurate results. However, the pivoting function of a CT scan during the pandemic presents several drawbacks, including high cost and cross-contamination problems.

Lopinavir/Ritonavir and Darunavir/Cobicistat in Hospitalized COVID-19 Patients: Findings From the Multicenter Italian CORIST Study.

Protease inhibitors have been considered as possible therapeutic agents for COVID-19 patients. To describe the association between lopinavir/ritonavir (LPV/r) or darunavir/cobicistat (DRV/c) use and in-hospital mortality in COVID-19 patients. Multicenter observational study of COVID-19 patients admitted in 33 Italian hospitals.

Can Alveolar-Arterial Difference and Lung Ultrasound Help the Clinical Decision Making in Patients with COVID-19?

Background: COVID-19 is an emerging infectious disease, that is heavily challenging health systems worldwide. Admission Arterial Blood Gas (ABG) and Lung Ultrasound (LUS) can be of great help in clinical decision making, especially during the current pandemic and the consequent overcrowding of the Emergency Department (ED). The aim of the study was to demonstrate the capability of alveolar-to-arterial oxygen difference (AaDO) in predicting the need for subsequent oxygen support and survival in patients with COVID-19 infection, especially in the presence of baseline normal PaO/FiO ratio (P/F) values.

Lung ultrasound for the early diagnosis of COVID-19 pneumonia: an international multicenter study.

Purpose: To analyze the application of a lung ultrasound (LUS)-based diagnostic approach to patients suspected of COVID-19, combining the LUS likelihood of COVID-19 pneumonia with patient's symptoms and clinical history.

Methods: This is an international multicenter observational study in 20 US and European hospitals. Patients suspected of COVID-19 were tested with reverse transcription-polymerase chain reaction (RT-PCR) swab test and had an LUS examination.

Lung ultrasound presentation of COVID-19 patients: phenotypes and correlations.

Bedside lung ultrasound (LUS) can play a role in the setting of the SarsCoV2 pneumonia pandemic. To evaluate the clinical and LUS features of COVID-19 in the ED and their potential prognostic role, a cohort of laboratory-confirmed COVID-19 patients underwent LUS upon admission in the ED. LUS score was derived from 12 fields.

Emergency Department and Out-of-Hospital Emergency System (112-AREU 118) integrated response to Coronavirus Disease 2019 in a Northern Italy centre.

Since December 2019, the world has been facing the life-threatening disease, named Coronavirus disease-19 (COVID-19), recognized as a pandemic by the World Health Organization. The response of the Emergency Medicine network, integrating "out-of-hospital" and "hospital" activation, is crucial whenever the health system has to face a medical emergency, being caused by natural or human-derived disasters as well as by a rapidly spreading epidemic outbreak. We here report the Pavia Emergency Medicine network response to the COVID-19 outbreak.

Lung ultrasound in internal medicine: A bedside help to increase accuracy in the diagnosis of dyspnea.

Background: Dyspnea is one of the most frequent causes of admission in Internal Medicine wards, leading to a sizeable utilization of medical resources.

Study Design And Methods: The role of bedside lung ultrasound (LUS) was evaluated in 130 consecutive patients (age: 81±9years), in whom blindly collected LUS results were compared with data obtained by clinical examination, medical history, blood analysis, and chest X-ray. Dyspnea etiology was classified as "cardiac" (n=80), "respiratory" (n=36) or "mixed" (n=14), according to the discharge diagnosis (congestive heart failure either alone [n=80] or associated with pneumonia [n=14], pneumonia [n=24], and obstructive disventilatory syndrome [n=12]).

Longitudinal systolic strain, cardiac function improvement, and survival following treatment of light-chain (AL) cardiac amyloidosis.

Aims: To determine whether echocardiographic longitudinal systolic strain (LS) parameters identify short-term improvement following chemotherapy for light-chain (AL) cardiac amyloidosis (CA). Among patients with CA, standard echocardiographic measures are commonly unchanged at 1 year following successful chemotherapy, despite observed reductions in cardiac biomarkers.

Methods And Results: We retrospectively identified 61 patients with AL-CA treated with high-dose melphalan or bortezomib-based regimens.

New and Evolving Concepts Regarding the Prognosis and Treatment of Cardiac Amyloidosis.

Systemic amyloidoses are rare and proteiform diseases, caused by extracellular accumulation of insoluble misfolded fibrillar proteins. Prognosis is dictated by cardiac involvement, which is especially frequent in light chain (AL) and in transthyretin variants (ATTR, both mutated, (ATTRm), and wild-type, (ATTRwt)). Recently, ATTRwt has emerged as a potentially relevant cause of a heart failure with preserved ejection fraction (HFpEF).

Heart Failure Resulting From Age-Related Cardiac Amyloid Disease Associated With Wild-Type Transthyretin: A Prospective, Observational Cohort Study.

Background: Heart failure caused by wild-type transthyretin amyloidosis (ATTRwt) is an underappreciated cause of morbidity and mortality in the aging population. The aims of this study were to examine features of disease and to characterize outcomes in a large ATTRwt cohort.

Methods And Results: Over 20 years, 121 patients with ATTRwt were enrolled in a prospective, observational study.

Echocardiographic and biohumoral characteristics in patients with AL and TTR amyloidosis at diagnosis.

Background: Few studies have analyzed the clinical and echocardiographic differences between light-chain (AL) and transthyretin (TTR) amyloidosis.

Hypothesis: The aim of the present research was to compare, in a real-world setting, the clinical and echocardiographic profiles of these kinds of amyloidosis, at the time of diagnosis, using new-generation echocardiography.

Methods: Seventy-nine patients with AL and 48 patients with TTR amyloidosis were studied.

Prognostic value of depressed midwall systolic function in cardiac light-chain amyloidosis.

Background: Cardiac amyloidosis represents an archetypal form of restrictive heart disease, characterized by profound diastolic dysfunction. As ejection fraction is preserved until the late stage of the disease, the majority of patients do fulfill the definition of diastolic heart failure, that is, heart failure with preserved ejection fraction (HFpEF). In another clinical model of HFpEF, that is, pressure-overload hypertrophy, depressed midwall fractional shortening (mFS) has been shown to be a powerful prognostic factor.

Prevalence and prognostic value of conduction disturbances at the time of diagnosis of cardiac AL amyloidosis.

Background And Purpose: To evaluate the prevalence and the prognostic implications of conduction delays in a large cohort of cardiac AL patients.

Methods: Echo Doppler and 12-lead ECG were collected in 344 consecutive patients in whom diagnosis of AL amyloidosis was concluded between 2008 and 2010. Patients were subdivided according to the presence (n = 240) or absence (n = 104) of cardiac involvement.

Diagnostic and prognostic value of low QRS voltages in cardiac AL amyloidosis.

Background: In cardiac AL amyloidosis, myocardial infiltration is typically associated with "low QRS voltages" at the 12-lead electrocardiogram (ECG). Although considered as one of the hallmarks of the disease, its reported prevalence varies from 45% to 70%, mainly because of nonhomogeneous definitions.

Methods: To identify the "low QRS voltage" parameter having the best diagnostic value in identifying cardiac amyloidosis, and to assess its possible prognostic role, ECG and echocardiographic data were collected at diagnosis in 337 consecutive never-treated AL patients (233 with, 104 without cardiac involvement).