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During the Covid-19 outbreak in northern Italy, the daily rate of admissions for acute coronary syndrome at 15 hospitals was significantly lower than the rate during two control intervals (13.3 admissions vs. 18.0 and 18.9 admissions for the two control periods).

The MGuard (MG) is a stainless-steel closed cell stent covered with an ultra-thin polymer mesh sleeve, which has the purpose of ensuring reduced distal embolization of thrombotic material, thus lowering the risk of no-reflow/slow-flow phenomena. Only few data are available that evaluated the usefulness of the MG stent in patients with ST-elevation myocardial infarction (STEMI) with a high thrombotic burden. We prospectively collected data of patients presenting with STEMI and high thrombotic burden (thrombus burden grade 4 or 5 according to the TIMI score) who underwent primary percutaneous coronary intervention (PCI) with MG stent implantation in our center. Lesions involving a bifurcation or very calcified and tortuous vessels were not included. Final TIMI 3 flow, normal myocardial blush grade (MBG), and complete ST-segment resolution were defined as short-term endpoints, whereas major adverse cardiovascular events were evaluated during follow-up. From August 2008 to June 2013, the MG stent was implanted in 104 (9.3%) of 1108 patients who underwent primary PCI. Cardiogenic shock on admission was present in 4 patients (3.8%). Final TIMI 3 flow was achieved in 97.1% of patients, MBG 3 in 56.7%, and regression of ST-segment elevation ≥70% within 90 min was recorded in 64.4% of patients. In-hospital mortality was 2.9% (n=3), and at a mean follow-up of 455±430 days overall major adverse cardiovascular events were 11 (10.6%). Cardiac death occurred in 5 patients (4.9%) and stent thrombosis in 2 (1.9%). In selected patients with STEMI undergoing primary PCI, the use of the mesh-covered MG stent in vessels with high thrombotic burden despite thrombus aspiration was effective and safe both immediately and at mid-term follow-up.

Place recognition is essential for long-term autonomous navigation, enabling loop closure and consistent mapping. Although deep learning has improved performance, deploying such models on resource-constrained platforms remains challenging. This work explores efficient LiDAR-based place recognition for EdgeAI by leveraging Bird's Eye View representations to enable lightweight image-based networks. We benchmark representative architectures without aggregation heads using a unified descriptor scheme based on global pooling and linear projection, and evaluate performance under FP32, FP16, and INT8 quantization. Experiments reveal trade-offs between accuracy, robustness, and efficiency: FP16 matches FP32 with lower cost, while INT8 introduces architecture-dependent degradation. Overall, the presented results are a strong basis for future research on 'use-case'-aware quantisation of Neural Networks for Edge deployment.

In some institutions a percutaneous approach to unprotected left main (ULM) disease has become a valid alternative to coronary artery bypass graft. Despite the feasibility of the technique and favorable results in terms of low mortality and myocardial infarction rates, restenosis still remains a major issue for interventionalists. In the last few years the use of drug-eluting stents and the availability of new strategies to treat atherosclerosis have only partially succeeded in reducing the phenomenon that still represents an intriguing challenge. A relapse of disease in such a delicate localization, even if causing an acute coronary syndrome in only a third of subjects, may cause severe myocardial ischemia and influence patient prognosis. To date there are many randomized and retrospective studies focusing on the treatment of 'naive' ULM but little data regarding the outcome and the optimal management of restenosis in such patients. Our aim is to review the literature in order to summarize the incidence of the phenomenon and to describe the three main possibilities for its treatment: optimal medical therapy, percutaneous reintervention and cardiac surgery.

This work presents a systematic investigation into how alternative LiDAR-to-image projections affect metric place recognition when coupled with a state-of-the-art vision foundation model. We introduce a modular retrieval pipeline that controls for backbone, aggregation, and evaluation protocol, thereby isolating the influence of the 2-D projection itself. Using consistent geometric and structural channels across multiple datasets and deployment scenarios, we identify the projection characteristics that most strongly determine discriminative power, robustness to environmental variation, and suitability for real-time autonomy. Experiments with different datasets, including integration into an operational place recognition policy, validate the practical relevance of these findings and demonstrate that carefully designed projections can serve as an effective surrogate for end-to-end 3-D learning in LiDAR place recognition.

Razionale. Lo stent MGuard (MG) è un dispositivo dotato di una rete esterna in Dacron (mesh-covered), disegnato al fine di limitare la frammentazione e migrazione distale del materiale trombotico durante l’impianto di stent e il fenomeno del “slow-flow” o “no-reflow”. Dati inerenti all’utilizzo di MG nel contesto di infarto miocardico con sopraslivellamento del tratto ST (STEMI) e persistenza di elevato carico trombotico nonostante tromboaspirazione manuale sono tuttavia scarsi. Materiali e metodi. Sono stati arruolati prospetticamente tutti i pazienti con STEMI ed elevato carico trombotico (grado 4-5 secondo TIMI score) sottoposti nel nostro centro a procedura coronarica percutanea (PCI) primaria con impianto di stent MG. Sono state escluse stenosi in biforcazione, in vasi molto calcifici e tortuosi. A fine procedura sono stati valutati come endpoint di interesse il flusso TIMI 3, il grado 3 di blush miocardico (MBG) e la risoluzione del tratto ST ≥70% entro 90 min mentre gli eventi cardiovascolari maggiori (morte, reinfarto e rivascolarizzazione della stessa lesione) sono stati valutati durante il follow-up. Risultati. Tra agosto 2008 e giugno 2013 lo stent MG è stato impiantato in 104 (9.3%) su 1108 pazienti sottoposti a PCI primaria. Quattro (3.8%) pazienti erano in shock cardiogeno al momento dell’ospedalizzazione. Il flusso TIMI 3 finale è stato raggiunto nel 97.1% dei pazienti, un MBG 3 nel 56.7% e una regressione del tratto ST ≥70% entro 90 min nel 64.4% dei pazienti. La mortalità intraospedaliera è stata del 2.9% (n=3) mentre ad un follow-up medio di 455 ± 430 giorni gli eventi cardiovascolari maggiori sono stati 11 (10.6%), 5 le morti per causa cardiaca e 2 (1.9%) le trombosi di stent. Conclusioni. L’utilizzo di uno stent mesh-covered come l’MG in pazienti con elevato carico trombotico sottoposti a PCI primaria rappresenta una valida strategia per ottenere un’adeguata riperfusione, con un buon profilo di sicurezza a lungo termine in pazienti selezionati.

Background. The MGuard (MG) is a stainless-steel closed cell stent covered with an ultra-thin polymer mesh sleeve, which has the purpose of ensuring reduced distal embolization of thrombotic material, thus lowering the risk of no-reflow/slow-flow phenomena. Only few data are available that evaluated the usefulness of the MG stent in patients with ST-elevation myocardial infarction (STEMI) with a high thrombotic burden.Methods. We prospectively collected data of patients presenting with STEMI and high thrombotic burden (thrombus burden grade 4 or 5 according to the TIMI score) who underwent primary percutaneous coronary intervention (PCI) with MG stent implantation in our center. Lesions involving a bifurcation or very calcified and tortuous vessels were not included. Final TIMI 3 flow, normal myocardial blush grade (MBG), and complete ST-segment resolution were defined as short-term endpoints, whereas major adverse cardiovascular events were evaluated during follow-up.Results. From August 2008 to June 2013, the MG stent was implanted in 104 (9.3%) of 1108 patients who underwent primary PCI. Cardiogenic shock on admission was present in 4 patients (3.8%). Final TIMI 3 flow was achieved in 97.1% of patients, MBG 3 in 56.7%, and regression of ST-segment elevation ≥70% within 90 min was recorded in 64.4% of patients. In-hospital mortality was 2.9% (n=3), and at a mean follow-up of 455 ± 430 days overall major adverse cardiovascular events were 11 (10.6%). Cardiac death occurred in 5 patients (4.9%) and stent thrombosis in 2 (1.9%).Conclusions. In selected patients with STEMI undergoing primary PCI, the use of the mesh-covered MG stent in vessels with high thrombotic burden despite thrombus aspiration was effective and safe both immediately and at mid-term follow-up.

In some institutions a percutaneous approach to unprotected left main (ULM) disease has become a valid alternative to coronary artery bypass graft. Despite the feasibility of the technique and favorable results in terms of low mortality and myocardial infarction rates, restenosis still remains a major issue for interventionalists. In the last few years the use of drug-eluting stents and the availability of new strategies to treat atherosclerosis have only partially succeeded in reducing the phenomenon that still represents an intriguing challenge. A relapse of disease in such a delicate localization, even if causing an acute coronary syndrome in only a third of subjects, may cause severe myocardial ischemia and influence patient prognosis. To date there are many randomized and retrospective studies focusing on the treatment of 'naive ULM but little data regarding the outcome and the optimal management of restenosis in such patients. Our aim is to review the literature in order to summarize the incidence of the phenomenon and to describe the three main possibilities for its treatment: optimal medical therapy, percutaneous reintervention and cardiac surgery.

Purpose To assess the performance and the reproducibility of ultrasound-guided attenuation parameter (UGAP) and two-dimensional shear wave elastography (2D-SWE) in patients with biopsy-proven metabolic dysfunction-associated steatotic liver disease (MASLD). Methods This study included consecutive adult patients with MASLD who underwent ultrasound with UGAP, 2D-SWE and percutaneous liver biopsy. The median values of 12 consecutive UGAP measurements were acquired by two independent radiologists (R1 and R2). Hepatic steatosis was graded by liver biopsy as: (0) < 5%; (1) 5–33%; (2) > 33–66%; (3) > 66%. Areas under the curve (AUCs) were calculated to determine the diagnostic performance. Inter- and intra-observer reliability was assessed with intraclass correlation coefficient (ICC). Results A hundred patients (median age 55.0 years old) with MASLD were prospectively enrolled. At histopathology, 70 and 42 patients had grade ≥ 2 and 3 steatosis, respectively. Median UGAP was 0.78 dB/cm/MHz (IQR/Med: 5.55%). For the diagnosis of grade ≥ 2 steatosis, the AUCs of UGAP were 0.828 (95% CI: 0.739, 0.896) for R1 and 0.779 (95% CI: 0.685, 0.856) for R2. The inter- and intra-operator reliability of UGAP were excellent, with an ICC of 0.92 (95% CI: 0.87–0.95) and 0.95 (95% CI: 0.92–0.96), respectively. The median liver stiffness was 6.76 kPa (IQR/Med: 16.30%). For the diagnosis of advanced fibrosis, 2D-SWE had an AUC of 0.862 (95% CI: 0.757, 0.934), and the optimal cutoff value was > 6.75 kPa with a sensitivity of 80.6% and a specificity of 75.7%. Conclusion UGAP and 2D-SWE provide a good performance for the staging of steatosis and fibrosis in patients with MASLD with an excellent intra-operator reliability of UGAP. Key Points Question How well do ultrasound-guided attenuation parameter (UGAP) and two-dimensional shear wave elastography (2D-SWE) perform for quantifying hepatic steatosis and fibrosis? Findings UGAP had a maximum AUC of 0.828 for the diagnosis of grade ≥ 2 steatosis, and 2D-SWE had an AUC of 0.862 for diagnosing advanced fibrosis. Clinical relevance UGAP and 2D-SWE allow rapid, reproducible, and accurate quantification of hepatic steatosis and fibrosis that can be used for the noninvasive assessment of patients with metabolic dysfunction-associated steatotic liver disease.

Toll-like receptors (TLRs) are key receptors through which infectious and non-infectious challenges act with consequent activation of the inflammatory cascade that plays a critical function in various acute and chronic diseases, behaving as amplification and chronicization factors of the inflammatory response. Previous studies have shown that synthetic analogues of lipid A based on glucosamine with few chains of unsaturated and saturated fatty acids, bind MD-2 and inhibit TLR4 receptors. These synthetic compounds showed antagonistic activity against TLR4 activation in vitro by LPS, but little or no activity in vivo. This study aimed to show the potential use of N-palmitoyl-D-glucosamine (PGA), a bacterial molecule with structural similarity to the lipid A component of LPS, which could be useful for preventing LPS-induced tissue damage or even peripheral neuropathies. Molecular docking and molecular dynamics simulations showed that PGA stably binds MD-2 with a MD-2/(PGA)3 stoichiometry. Treatment with PGA resulted in the following effects: (i) it prevented the NF-kB activation in LPS stimulated RAW264.7 cells; (ii) it decreased LPS-induced keratitis and corneal pro-inflammatory cytokines, whilst increasing anti-inflammatory cytokines; (iii) it normalized LPS-induced miR-20a-5p and miR-106a-5p upregulation and increased miR-27a-3p levels in the inflamed corneas; (iv) it decreased allodynia in peripheral neuropathy induced by oxaliplatin or formalin, but not following spared nerve injury of the sciatic nerve (SNI); (v) it prevented the formalin- or oxaliplatin-induced myelino-axonal degeneration of sciatic nerve. SIGNIFICANCE STATEMENT We report that PGA acts as a TLR4 antagonist and this may be the basis of its potent anti-inflammatory activity. Being unique because of its potency and stability, as compared to other similar congeners, PGA can represent a tool for the optimization of new TLR4 modulating drugs directed against the cytokine storm and the chronization of inflammation.