A comprehensive guide to digital neurology. An update on current development on digital neurology derived from the Digital Neuro Hub project.

The rapid evolution of digital tools in recent years after COVID-19 pandemic has transformed diagnostic and therapeutic practice in neurology. This shift has highlighted the urgent need to integrate digital competencies into the training of future specialists. Key innovations such as telemedicine, artificial intelligence, and wearable health technologies have become central to improving healthcare delivery and accessibility.

Sustainable and healthy diet index (SHDI) unveils regional differences in Europe and Northern Africa: findings from the SysOrg study.

Purpose: We developed a diet quality index based on the Planetary Health Diet (PHD) to assess healthy and sustainable diets. The index was applied alongside socio-demographic characteristics in five regions across Europe and North Africa.

Methods: The Sustainable Healthy Diet Index (SHDI) was designed using existing and validated healthy diet indexes.

Grid cells accurately track movement during path integration-based navigation despite switching reference frames.

Grid cells, with their periodic firing fields, are fundamental units in neural networks that perform path integration. It is widely assumed that grid cells encode movement in a single, global reference frame. In this study, by recording grid cell activity in mice performing a self-motion-based navigation task, we discovered that grid cells did not have a stable grid pattern during the task.

DNA methylation cooperates with genomic alterations during non-small cell lung cancer evolution.

Aberrant DNA methylation has been described in nearly all human cancers, yet its interplay with genomic alterations during tumor evolution is poorly understood. To explore this, we performed reduced representation bisulfite sequencing on 217 tumor and matched normal regions from 59 patients with non-small cell lung cancer from the TRACERx study to deconvolve tumor methylation. We developed two metrics for integrative evolutionary analysis with DNA and RNA sequencing data.

PML::RARα+ myeloid cells display metabolic alterations that can be targeted to treat resistant/relapse acute promyelocytic leukemias.

At present there is no metabolic characterization of acute promyelocytic leukemia (APL). Pathognomonic of APL, PML::RARα fusion protein rewires metabolic pathways to feed anabolic tumor cell's growth. All-trans retinoic acid (ATRA) and arsenic trioxide (ATO)-based therapies render APL the most curable subtype of AML, yet approximately 1% of cases are resistant and 5% relapse.

Distal Radial Access for Radial Artery Recanalization: Multicenter Outcomes and Stepwise Strategies to Maximize Patency.

Background: Radial artery occlusion complicates transradial access, limiting future access and precluding bypass grafting and dialysis. Distal radial access offers a promising solution by allowing retrograde recanalization of occluded radial arteries.

Objectives: The authors sought to evaluate multicenter outcomes of radial artery recanalization though distal radial access (DRA), focusing on its safety, efficacy, and reproducibility, while identifying procedural strategies to optimize patency.

THE IMPACT OF NOACS VS. VKAS ON ABSOLUTE AND RELATIVE COGNITIVE FUNCTION DECLINE OVER TIME: A MACHINE LEARNING APPROACH.

Background: Atrial fibrillation (AF) is the most common arrhythmia in adults, with incidence increasing with age. Cognitive impairment (CoI) and dementia share risk factors with AF. Meta-analyses indicate that AF increases the risk of CoI by 2.

Defective mitochondrial quality control in the ageing of skeletal muscle.

Age-related skeletal muscle decline is a major contributor to frailty, functional impairment, and loss of independence in advanced age. This process is characterized by selective atrophy of type II fibers, impaired excitation-contraction coupling, and reduced regenerative capacity. Emerging evidence implicates mitochondrial dysfunction as a central mechanism in the disruption of muscle homeostasis with age.

International Multicentre Study on the Treatment of Infrarenal Penetrating Aortic Ulcers.

Objective: This study aimed to evaluate treatment indications, compare therapeutic approaches, and assess outcomes in patients with infrarenal penetrating aortic ulcers (iPAUs).

Methods: This was a retrospective, multicentre, observational study of patients with iPAUs treated between January 2018 and December 2022 across 12 European centres. Treatment strategies included open surgical repair (OSR) and endovascular techniques, including balloon expandable stent grafts (BESGs), covered endovascular reconstruction of the aortic bifurcation (CERAB), and endovascular aortic repair (EVAR) using bifurcated or tube grafts.

Effect of 3-hydroxisobutyrate in vivo administration on cardiometabolic disease in ApoE-/- mouse model.

The valine catabolite 3-hydroxyisobutyrate (3-HIB) is suggested to mediate the uptake of extracellular fatty acids into the cells, thus regulating intracellular lipid metabolism, although the direct mechanism remains unclear. In this study, we assessed the effects of long-term 3-HIB treatment on the development and progression of complex atherosclerotic lesions, lipid metabolism and liver injury in vivo in ApoE-/- mouse model fed Western Diet (WD). Results show that 3-HIB treatment is associated with a significant reduction in weight and serum lipid content, reduced aortic mean plaque area and improvement of liver functions.

Liver disease in people with latent autoimmune diabetes in adults (LADA): A cross-sectional study using magnetic resonance elastography.

Aims: To investigate liver disease and its risk factors in LADA compared to type 1 (T1D) and type 2 (T2D) diabetes.

Methods: Liver magnetic resonance (MR) and MR elastography were used to measure proton density fat fraction (PDFF) and stiffness in 31 people with LADA matched for gender, body mass index (BMI) and disease duration with 31 people with T2D, and for gender, BMI and age with 31 people with T1D. Visceral adipose tissue (VAT) was quantified by DXA.

Effectiveness and Safety of Orodispersible Budesonide for Eosinophilic Esophagitis: A Multicenter Real-World Study.

Background And Aims: Topical corticosteroids represent one of the effective first-line treatment options for EoE, and therapy with budesonide orodispersible tablets (BOTs) has been recently approved for the treatment of EoE and showed great efficacy in randomized-controlled clinical trials, however real-life data is lacking. Thus, we aimed to evaluate the effectiveness of treatment with BOTs in adult EoE patients in a real-life setting.

Methods: In this prospective study, clinical, histologic, endoscopic, and safety measures were assessed.

Real-world use of terlipressin in cirrhosis and acute kidney injury: frequent use beyond hepatorenal syndrome.

Background & Aims: Terlipressin is indicated to treat hepatorenal syndrome (HRS)-acute kidney injury (AKI), but is likely used outside this primary indication in clinical practice. We aimed to investigate real-world practice patterns on the use of terlipressin in AKI in cirrhosis.

Methods: International prospective study including patients hospitalized for decompensated cirrhosis.

Myocardial Work Indexes in elite athletes: An Emerging Echocardiographic Tool to confirm physiologic cardiac remodeling in elite athletes with mildly reduced systolic function.

Background: Athlete's heart, characterized by cardiac chambers adaptations to exercise has some diagnostic overlaps with dilated cardiomyopathy (DCM). In the setting of differential diagnosis, myocardial work indexes (MWI), afterload-independent tool, could be helpful to identify early subclinical alterations. The aim of our study was to assess the utility of MWI in athletes with mildly reduced left ventricular ejection fraction (LVEF).

Risk Factors for Persisting SARS-CoV-2 Infection in Patients with B-Cell Malignancies in the Omicron Era: A Multicenter Cohort Study.

Background: Patients with B-cell malignancies are at high risk of persisting SARS-CoV-2 infection, which may delay oncologic treatments and increase morbidity. We aimed to assess risk factors for persisting infection in this population.

Methods: We conducted a multicenter retrospective study across five tertiary hospitals between January 1, 2022, and January 1, 2023.

A nationwide forensic case-series of femicides in Italy - Part 1: Clues to the motives of the murder.

Understanding the motives behind femicides is crucial to design effective prevention strategies and to support women's self-determination, free from threats to their mental and physical integrity. We conducted a retrospective, multicenter forensic study involving 27 Italian Institutes of Legal Medicine, analyzing 1238 female homicides (1950-2023). Cases were classified as femicide or non-femicide female homicide according to the medico-legal definition of femicide as the murder due to the failure to recognize women's right to self-determination.

Comparative effectiveness and safety of probiotics with psychotropic potential in mental health benefits in irritable bowel syndrome: a systematic review and network meta-analysis.

Background: The use of probiotics as a treatment for irritable bowel syndrome (IBS) is gaining attention, with recent studies indicating that certain probiotics or combinations may have mental health benefits for patients with IBS.

Aims: To systematically review and meta-analyze, using network meta-analysis (NWM), the comparative effectiveness and safety of probiotics with psychotropic potential on quality of life, depression, and anxiety in patients with IBS.

Methods: Relevant randomized controlled trials (RCTs) were analyzed, using a Bayesian NWM, to compare the performance of probiotics with mental health benefits in IBS treatment.

Understanding the epidemiology of gastric cancer: a review and case-only analysis from Italy.

Background: Gastric cancer epidemiology evolved rapidly in the last century, shifting from being one of the main causes of cancer-related death to the sixth in high-income countries.

Methods: We conducted a narrative review on gastric cancer epidemiology. Our review focused on trends of gastric cancer and its relationship with Helicobacter pylori infection; cardia and noncardia gastric cancer risk factors; early onset gastric cancer; second primary cancers in patients with gastric cancer; and implementation of gastric cancer prevention strategies.

Utility of GERAADA score for predicting long-term survival following surgical repair of aortic dissection.

Objectives: We aimed to assess the long-term survival following surgical repair because of type A aortic dissection (ATAAD) and the correlation with the preoperative GERAADA-score value.

Methods: We enrolled patients who underwent emergent aortic surgery because of ATAAD from 2010 to 2022 from 9 hospitals. Follow-up information was obtained by matching the clinical patient data with a national administrative database.

Critical exponents of the spin-glass transition in a field at zero temperature.

We analyze the spin-glass transition in a field in finite dimension [Formula: see text] below the upper critical dimension directly at zero temperature using a recently introduced perturbative loop expansion around the Bethe lattice solution. The expansion is generated by the so-called [Formula: see text]-layer construction, and it has [Formula: see text] as the associated small parameter. Computing analytically and numerically these nonstandard diagrams at first order in the [Formula: see text] expansion, we construct an [Formula: see text]-expansion around the upper critical dimension [Formula: see text], with [Formula: see text].

Biparametric vs Multiparametric MRI for Prostate Cancer Diagnosis: The PRIME Diagnostic Clinical Trial.

Importance: Multiparametric magnetic resonance imaging (MRI), with or without prostate biopsy, has become the standard of care for diagnosing clinically significant prostate cancer. Resource capacity limits widespread adoption. Biparametric MRI, which omits the gadolinium contrast sequence, is a shorter and cheaper alternative offering time-saving capacity gains for health systems globally.

Eustachian tube dysfunction in obstructive sleep apnea patients: implications for a multimodal treatment approach. A systematic review.

Introduction: It is well known that Obstructive Sleep Apnea (OSA) is a complex disease characterized by an Upper Airway (UA) collapse during sleep, with potential consequences on ENT districts. Recent evidence suggests a possible association with Eustachian Tube Dysfunction (ETD). However, the potential effects of both surgical and non-surgical therapeutic strategies on ET function remain poorly explored in the current literature.

Impact of pad wetness on health-related quality of life after radical cystectomy and orthotopic neobladder.

Purpose: We aimed to evaluate the impact of day- and night-time pad wetness on 2yrs-QoL after Radical Cystectomy (RC) with Orthotopic Neobladder (ON) from a Randomized Controlled Trial (RCT) aimed at comparing open RC (ORC) and Robot-Assisted RC (RARC) with intracorporeal (i) ON.

Methods: Between January 2018 and September 2020, 116 patients were enrolled. Data from self-assessed questionnaires (EORTC-QLQ-C30 and QLQ-BLM30) were collected.