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Galectin-3 is a circulating biomarker of fibrosis whose prognostic role in pulmonary arterial hypertension (PAH) has not been fully explored. We undertook a pilot study to evaluate the relationship between galectin-3 plasma levels and validated risk scores in PAH. The study included 70 PAH patients admitted to a single referral center from June 2016 to June 2018. Patients were stratified according to the REVEAL 2.0 risk score, according to the parameters suggested by the European Society of Cardiology and European Respiratory Society (ESC/ERS) Guidelines, and according to a focused echocardiographic assessment of right heart performance. The association between galectin-3 levels and risk profiles was evaluated by generalized linear regression model with adjustment for etiology. Galectin-3 plasma levels increased linearly in the three risk strata based on the REVEAL 2.0 score (from 16.0 ± 5.7 in low-risk to 22.4 ± 6.3 in intermediate-risk and in 26.9 ± 7.7 ng/mL in high-risk patients (p for trend < 0.001). Galectin-3 levels were significantly lower in low-risk patients defined according to the prognostic parameters of ESC/ERS Guidelines (delta between low-risk and intermediate/high-risk = −9.3, 95% CI −12.8 to −5.8, p < 0.001, p < 0.001). Additionally, galectin-3 levels were lower in the low-risk profile defined on the basis of the echocardiographic evaluation of right heart performance (delta between low-risk and intermediate-/high-risk = −6.3, 95% CI −9.9 to −2.7, p = 0.001). Galectin-3 plasma levels are directly associated with several risk profiles in PAH patients. The prognostic role of this biomarker in PAH is worthwhile to be explored in larger prospective studies.

Many ST-segment elevation acute coronary syndrome (STEACS) patients fail to activate the Emergency Medical System (EMS), with possible dramatic consequences. Prior studies focusing on barriers to EMS activation included patients with any acute coronary syndrome (ACS) without representation of southern European populations. We aimed to investigate the barriers to EMS call for patients diagnosed for STEACS in Italy. A prospective, single-center, survey administered to all patients treated with primary percutaneous coronary intervention for STEACS in a tertiary hospital in northern Italy from 01/06/2018 to 31/05/2020. The questionnaire was filled out by 293 patients. Of these, 191 (65.2%) activated the EMS after symptoms onset. The main reasons for failing to contact EMS were the perception that the symptoms were unrelated to an important health problem (45.5%) and that a private vehicle is faster than EMS to reach the hospital (34.7%). Patients who called a private doctor after symptoms onset did not call EMS more frequently than those who did not and 30% of the patients who did not call the EMS would still act in the same way if a new episode occurred. Previous history of cardiovascular disease was the only predictor of EMS call. Information campaigns are urgently needed to increase EMS activation in case of suspected STEACS and should be primary focused on patients without cardiovascular history, on the misperception that a private vehicle is faster than EMS activation, and on the fact that cardiac arrest occurs early and may be prevented by EMS activation.

Patient education is a key component of diabetes care. Limits in resources often prevent the participation of many patients with type 2 diabetes to structured education programs. The identification of predictors of response to group education could help in selecting those patients in whom the intervention is more cost-effective. A structured interactive group program was proposed to a consecutive series of 150 type 2 diabetes patients, who were then followed prospectively in 24 months, with measurements of HbA1c, BMI, quality of life, eating habits. For comparison, another consecutive series of 113 patients who had received no intervention was also observed for 12 months. A significant reduction in HbA1c was observed in the intervention group at 12 and 24 months (from 7.5 ± 1.4 to 6.9 ± 1.2 and 6.6 ± 1.1% at 12 and 24 months, respectively, both P  < 0.01), with no variation in BMI and quality of life. A sustained reduction in total energy, protein, and fat intake was observed after education. The proportion of success (HbA1c < 7% and/or HbA1c reduction from baseline > 1%) in the intervention group was 60.7% (vs. 38.1% in controls) and 63.3% at 12 and 24 months, respectively. In the intervention group, patients with success at 12 months showed lower baseline HbA1c, BMI, duration of diabetes, protein, and cholesterol intake. Patients with a lower duration of diabetes appear to have a greater response to structured group education, whereas age is not a predictor of response. Therefore, educational intervention should be planned in the earlier phases of the disease.

Background and aims. A series of validation studies was performed on the Moynihan questionire to obtain data on nutrition knowledge, translated and adapted to Italian eating habits. Higher scores mean lower knowledge. Methods. Test-retest reliability was assessed administering the questionire at a 15-day interval in 52 inpatients. Factor structure and correlation with demographic and anthropometric characteristics were studied on a larger sample, which included a number of health professiols. Filly, sensitivity to change induced by an educatiol program was verified in a sample of 11 patients with type 1 diabetes. Results. Test-retest reliability was satisfactory; factor structure suggested one single principal component. Test scores were inversely correlated with age (r=0.24; p=0.02), but not with body mass index or waist circumference. Patients with higher education show a greater degree of nutrition knowledge. Among type 1 diabetic patients, an educatiol program induces a significant improvement of test scores (from 20.6 [18.6-22.8] to 16.6 [15.5-17.7], p=0.003). Conclusions. The Italian version of the questionire appears to be psychometrically adequate for its use in clinical research.

Cosmic noon represents the prime epoch of galaxy assembly, and a sweet spot for observations with the James Webb Telescope (JWST) and ground-based near-IR integral-field unit (IFU) spectrographs. This work analyses JWST NIRSpec Micro Shutter Array (MSA), NIRCam Wide Field Slitless Spectroscopy (WFSS) of K20-ID7, a large spiral, star-forming (SF) galaxy at z=2.2, with evidence for radial gas inflows. By exploiting the synergy with ground-based IFU ERIS observations, we conduct a comprehensive and resolved study of the interstellar medium (ISM) and stellar properties, from rest optical to near-IR, via emission-line diagnostics, resolved spectral energy distribution (SED) fitting of high-resolution imaging, and Pa\\(\\) line detection in NIRCam WFSS data. Our analysis reveals massive (\\(M_\\)(0.67-3.5)\\(\\)10\\(^9\\) \\(M_\\)) SF clumps with star formation rates (SFRs) ~3-24 \\(M_\\)/yr, and quite low dust attenuation (\\(A_V\\)0.4), electron density (\\(n_e\\)<300 cm\\(^-3\\)), and ionisation (log(U)\\( -3.0\\)). The central bulge turns out to be modestly massive (\\(M_\\)=(7\\(\\)3)\\(\\)10\\(^9\\) M\\(_\\)), heavily obscured (\\(A_V\\)=6.43\\(\\)0.55), and likely to have formed most of its stellar mass in the past (SFR=82\\(\\)42 \\(M_\\)/yr over the last 100 Myr), yet still forming stars at a lower rate (SFR=12\\(\\)8 M\\(_\\)/yr over the last 10 Myr). We infer a metallicity 12+log(O/H)~8.54 and an apparent enhancement of the N/O abundance (log(N/O)\\( -1.0\\)) in all distinct galaxy regions, a likely consequence of dilution effects due to radial inflows of metal-poor gas. We measure a sub-solar sulfur abundance (log(S/O)\\(\\)-1.9). Finally, the radial stellar age profile reveals older stellar populations in the inner galaxy regions compared to the outskirts, pointing to an inside-out growth of K20-ID7.