Role of the tricuspid regurgitation after mitraclip and transcatheter aortic valve implantation: a systematic review and meta-analysis

Treatment of tricuspid regurgitation (TR) is common after surgery for mitral and/or aortic valves. The prognostic role of moderate to severe TR in patients undergoing mitraclip or transcatheter aortic valve implantation (TAVI) is not well-defined. Thus, the aim of this article is to perform a systematic review and meta-analysis of articles valuing the prognostic role of TR for patients undergoing mitraclip and TAVI

e-Learning e formazione universitaria nelle scienze mediche: indagine qualitativa su opinioni e aspettative di Docenti e Studenti

L’evoluzione degli strumenti dell’Information and Communication Technology rappresenta una sfida per la formazione universitaria nelle Scienze Mediche. Lo sviluppo di metodologie e-Learning in affiancamento alla didattica tradizionale risponde a bisogni formativi in evoluzione e alle nuove esigenze organizzative del contesto universitario.Introduction. The development of Information and Communication Technology is a challenge for university education in medical sciences. This study, sponsored and coordinated by the “Giovanni D’Addona” Remote Teaching Unit of the Sapienza – University of Rome, aims to provide useful indications for the implementation of e-Learning methodologies in medical sciences. Materials and methods. This qualitative study examined the opinions, attitudes and experiences of a sample of teachers, researchers and students of the Faculties of Medicine and Health Professions of the Sapienza - University of Rome. Focus groups, interviews and open-ended questions were used for data collection. A content analysis was performed with the aim of data reduction, naming data, obtaining analytical code and determining categories and themes. Results. The analysis revealed four main themes regarding the implementation of e-Learning methodologies in the study context. These were: advantages and potential of e-Learning, limitations, organizational constraints and prospects of e-Learning. Conclusions. In undergraduate medical education, traditional on-site learning is fundamental for clinical practice. The development of e-Learning methodologies allow to respond to changing educational needs of students and organizational requirements of the specific university context. The introduction of a blended learning approach requires organizational changes as well as modifications to the current teaching paradigms, with the involvement of professionals specialized in e-Learning methodologies

The Importance of Participation in Regeneration of Peripheral Urban Spaces: the Experience of “Serpentone Reload”

Suburbs are often very contradictory places. Despite great part of urban population live there, these parts of cities are mostly considered as degradation places. The topic of suburbs regeneration is relevant today. Nevertheless, often expensive interventions implemented by local authorities fail to regenerate their public spaces, increasing the degradation condition. This paper presents the experience of “Serpentone reload”, a workshop based on participatory reactivation of abandoned or underused spaces and buildings in "Cocuzzo/Serpentone" neighbourhood in Potenza (Basilicata, Italy). The workshop particularly focused on the reuse of the "Ship", an underground building with a park coverage completed in 2010 and designed by the firm Archea. The "Ship" has been forgotten and not used for long time, not only by the neighbourhood, but by the whole citizenship, because it has been perceived as an extraneous element and the result of an imposition from the top, definitely not the outcome of shared choices. During the workshop, the "Ship" (“Nave” in Italian language) has become an art centre called N.Av.E. (New Expressive Adventures – Nuove Avventure Espressive in Italian), a place capable to host temporary events (expositions, lectures, theatre and dance performance, movies projection, etc.). Such a choice has allowed the neighbourhood and the city to take back that “object” so hated as ignored. The experience is particularly significant, because it shows how low cost interventions, realized with citizens involvement and participation, could contribute to the regeneration of peripheral urban areas more than expensive and complex imposed interventions, which often do not take into account dwellers real needs and expectations

Mirna Expression Profiles Identify Drivers in Colorectal and Pancreatic Cancers

Altered expression of microRNAs (miRNAs) hallmarks many cancer types. The study of the associations of miRNA expression profile and cancer phenotype could help identify the links between deregulation of miRNA expression and oncogenic pathways.Expression profiling of 866 human miRNAs in 19 colorectal and 17 pancreatic cancers and in matched adjacent normal tissues was investigated. Classical paired t-test and random forest analyses were applied to identify miRNAs associated with tissue-specific tumors. Network analysis based on a computational approach to mine associations between cancer types and miRNAs was performed. in pancreatic cancers.MiRNA expression profiles may identify cancer-specific signatures and potentially useful biomarkers for the diagnosis of tissue specific cancers. miRNA-network analysis help identify altered miRNA regulatory networks that could play a role in tumor pathogenesis

Rationale and Design of the PARTHENOPE Trial: A Two-by-Two Factorial Comparison of Polymer-Free vs. Biodegradable-Polymer Drug-Eluting Stents and Personalized vs. Standard Duration of Dual Antiplatelet Therapy in All-Comers Undergoing PCI.

BACKGROUND Over the past few decades, percutaneous coronary intervention (PCI) has undergone significant advancements as a result of the combination of device-based and drug-based therapies. These iterations have led to the development of polymer-free drug-eluting stents. However, there is a scarcity of data regarding their clinical performance. Furthermore, while various risk scores have been proposed to determine the optimal duration of dual antiplatelet therapy (DAPT), none of them have undergone prospective validation within the context of randomized trials. DESIGN The PARTHENOPE trial is a phase IV, prospective, randomized, multicenter, investigator-initiated, assessor-blind study being conducted at 13 centers in Italy (NCT04135989). It includes 2,107 all-comers patients with minimal exclusion criteria, randomly assigned in a 2-by-2 design to receive either the Cre8 amphilimus-eluting stent or the SYNERGY everolimus-eluting stent, along with either a personalized or standard duration of DAPT. Personalized DAPT duration is determined by the DAPT score, which accounts for both bleeding and ischemic risks. Patients with a DAPT score <2 (indicating higher bleeding than ischemic risk) receive DAPT for 3 or 6 months for chronic or acute coronary syndrome, respectively, while patients with a DAPT score ≥2 (indicating higher ischemic than bleeding risk) receive DAPT for 24 months. Patients in the standard DAPT group receive DAPT for 12 months. The trial aims to establish the non-inferiority between stents with respect to a device-oriented composite endpoint of cardiovascular death, target-vessel myocardial infarction, or clinically-driven target-lesion revascularization at 12 months after PCI. Additionally, the trial aims to demonstrate the superiority of personalized DAPT compared to a standard approach with respect to a net clinical composite of all-cause death, any myocardial infarction, stroke, urgent target-vessel revascularization, or type 2 to 5 bleeding according to the Bleeding Academic Research Consortium criteria at 24-months after PCI. SUMMARY The PARTHENOPE trial is the largest randomized trial investigating the efficacy and safety of a polymer-free DES with a reservoir technology for drug-release and the first trial evaluating a personalized duration of DAPT based on the DAPT score. The study results will provide novel insights into the optimizing the use of drug-eluting stents and DAPT in patients undergoing PCI

Investigation of Multiple Susceptibility Loci for Inflammatory Bowel Disease in an Italian Cohort of Patients

BACKGROUND: Recent GWAs and meta-analyses have outlined about 100 susceptibility genes/loci for inflammatory bowel diseases (IBD). In this study we aimed to investigate the influence of SNPs tagging the genes/loci PTGER4, TNFSF15, NKX2-3, ZNF365, IFNG, PTPN2, PSMG1, and HLA in a large pediatric- and adult-onset IBD Italian cohort. METHODS: Eight SNPs were assessed in 1,070 Crohn's disease (CD), 1,213 ulcerative colitis (UC), 557 of whom being diagnosed at the age of ≤16 years, and 789 healthy controls. Correlations with sub-phenotypes and major variants of NOD2 gene were investigated. RESULTS: The SNPs tagging the TNFSF15, NKX2-3, ZNF365, and PTPN2 genes were associated with CD (P values ranging from 0.037 to 7×10(-6)). The SNPs tagging the PTGER4, NKX2-3, ZNF365, IFNG, PSMG1, and HLA area were associated with UC (P values 0.047 to 4×10(-5)). In the pediatric cohort the associations of TNFSF15, NKX2-3 with CD, and PTGER4, NKX2-3, ZNF365, IFNG, PSMG1 with UC, were confirmed. Association with TNFSF15 and pediatric UC was also reported. A correlation with NKX2-3 and need for surgery (P  =  0.038), and with HLA and steroid-responsiveness (P  =  0.024) in UC patients was observed. Moreover, significant association in our CD cohort with TNFSF15 SNP and colonic involvement (P  =  0.021), and with ZNF365 and ileal location (P  =  0.024) was demonstrated. CONCLUSIONS: We confirmed in a large Italian cohort the associations with CD and UC of newly identified genes, both in adult and pediatric cohort of patients, with some influence on sub-phenotypes

Functional Implications of MicroRNAs in Crohn’s Disease Revealed by Integrating MicroRNA and Messenger RNA Expression Profiling

Crohn’s disease (CD) is a debilitating inflammatory bowel disease (IBD) that emerges due to the influence of genetic and environmental factors. microRNAs (miRNAs) have been identified in the tissue and sera of IBD patients and may play an important role in the induction of IBD. Our study aimed to identify differentially expressed miRNAs and miRNAs with the ability to alter transcriptome activity by comparing inflamed tissue samples with their non-inflamed counterparts. We studied changes in miRNA–mRNA interactions associated with CD by examining their differential co-expression relative to normal mucosa from the same patients. Correlation changes between the two conditions were incorporated into scores of predefined gene sets to identify biological processes with altered miRNA-mediated control. Our study identified 28 miRNAs differentially expressed (p-values &lt; 0.01), of which 14 are up-regulated. Notably, our differential co-expression analysis highlights microRNAs (i.e., miR-4284, miR-3194 and miR-21) that have known functional interactions with key mechanisms implicated in IBD. Most of these miRNAs cannot be detected by differential expression analysis that do not take into account miRNA–mRNA interactions. The identification of differential miRNA–mRNA co-expression patterns will facilitate the investigation of the miRNA-mediated molecular mechanisms underlying CD pathogenesis and could suggest novel drug targets for validation