Patient‐Specific Strategy for Coronary Alignment in TAVI With Evolut FX+

ABSTRACT Coronary access after transcatheter aortic valve implantation (TAVI) is an increasingly relevant issue, particularly in patients who may require future coronary interventions or redo‐TAVI procedures. Although commissural alignment is routinely achieved in surgical valve replacement, it remains challenging during TAVI because of anatomical variability and reliance on two‐dimensional fluoroscopic guidance. Moreover, optimal commissural alignment does not necessarily ensure adequate coronary alignment, as the spatial relationship between native commissures and coronary ostia varies substantially among individuals. This work describes a patient‐specific, CT‐ and fluoroscopy‐guided strategy to optimize coronary alignment during TAVI using the Evolut FX+ platform. The proposed approach integrates systematic pre‐procedural CT analysis of coronary ostial position, intercoronary angle, and valve geometry with the identification of a customized fluoroscopic implantation view, termed the Coronary Customized Projection. This projection is applied during valve deployment to guide valve orientation and enable mono‐coronary or bi‐coronary alignment according to individual anatomy. The strategy enhances procedural control and aims to preserve coronary access without increasing procedural complexity. Prospective studies are warranted to evaluate its impact on coronary reaccess and long‐term clinical outcomes.

Impact of P2Y₁₂ Inhibitor Pretreatment on Clinical Outcomes in ST‐Segment Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention: A Retrospective Cohort Study

ABSTRACT Background The benefit of P2Y₁₂ inhibitor pretreatment before primary percutaneous coronary intervention (PCI) in ST‐segment elevation myocardial infarction (STEMI) remains uncertain. Aims This study examined the association between pretreatment and short‐ and long‐term cardiovascular outcomes. Methods In this retrospective cohort study, adults (≥ 18 years) hospitalized for STEMI and undergoing PCI were identified from the TriNetX US Collaborative Network (January 2010 to December 2024). Patients receiving P2Y₁₂ inhibitors before PCI ( n  = 72,913) were matched 1:1 by propensity score to those without pretreatment ( n  = 66,450), yielding 21,689 patients per group. Primary endpoints at 1 month and 1 year included all‐cause mortality, major adverse cardiovascular events (MACE), stent thrombosis, and stent restenosis. Multivariable Cox regression provided adjusted hazard ratios (HRs) with 95% confidence intervals (CIs). Results After matching, baseline characteristics were balanced (all standardized mean differences < 0.10). At 1 month, pretreatment was associated with higher all‐cause mortality (4.5% vs. 4.0%; RR 1.13; p  = 0.007), MACE (8.7% vs. 7.5%; RR 1.16; p  < 0.001), stent thrombosis (1.9% vs. 0.8%; RR 2.39; p  < 0.001), and stent restenosis (5.3% vs. 4.0%; RR 1.32; p  < 0.001). These differences persisted at 1 year (mortality 10.2% vs. 9.0%; RR 1.14; p  < 0.001; MACE 18.9% vs. 18.2%; RR 1.04; p  < 0.001; thrombosis 2.4% vs. 1.1%; RR 2.26; p  < 0.001; restenosis 11.0% vs. 9.6%; RR 1.14; p  < 0.001). Secondary endpoints showed no differences in major bleeding or cardiac arrest, while ischemic stroke was lower at 1 month and MI recurrence was reduced at 6 months and 1 year. In Cox models, pretreatment predicted higher 1‐year hazards for mortality, MACE, and restenosis, and a threefold increase in 1‐month stent thrombosis. Conclusion In this retrospective, non‐randomized analysis of administrative data from the TriNetX database, P2Y₁₂ inhibitor pretreatment before PCI in STEMI was linked to modestly increased 1‐year risks of mortality, MACE, and restenosis, and markedly higher 1‐month stent thrombosis, highlighting the need for prospective trials to optimize antiplatelet strategies.

Tezepelumab Improves Small Airways Dysfunction in Severe Asthma: A 52‐Week Real‐World Study

The Rising Misuse of Pharmacovigilance Reporting Systems: A Threat to Evidence‐Based Medicine

In recent years, different national and international regulatory authorities, notably the FDA, have made their adverse event repositories publicly available, offering user‐friendly dashboards. This has led to a large increase in low‐quality, poorly reported research using adverse event reporting databases (e.g., FDA’s Adverse Event Reporting System [FAERS]). Such publications producing thousands of statistical associations erroneously presented as “safety signals” can create unscientifically grounded alarm with considerable impact on healthcare provider practices and patient behaviors.

Impact of Erythritol Air‐Polishing on Titanium Implant Surface Properties and Bacterial Colonization: An In Vitro Study

ABSTRACT Objectives This study aimed to investigate the effect of erythritol air‐polishing on implant surface topography and bacterial colonization, and to determine the antimicrobial activity of erythritol powder. Materials and Methods Titanium implants, with machined/acid‐etched hybrid design, were divided into three groups: erythritol air‐polishing for 1 min (E1), 5 min (E5), and untreated control. Surface analysis was performed using a stylus profilometer and scanning electron microscope (SEM). To test the ability to prevent biofilm formation, four bacteria strains ( Staphylococcus aureus , Klebsiella pneumoniae , Streptococcus mutans , Streptococcus sanguinis ) were separately cultured on five implants per group and colony counting was performed. The intrinsic erythritol antibacterial activity was investigated by means of minimum inhibitory concentration against the same strains. Results At SEM analysis implant surfaces appeared unaltered by air‐polishing and presented increasing amount of residues depending on the treatment duration. Machined surfaces exhibited no significant differences in roughness parameters between the groups. On acid‐etched surfaces, E5 presented significantly lower Ra (vs. E1 and control) and Rz (vs. control). The count of colonies was significantly lower for all bacterial strains on treated implants as compared to control, with E1 and E5 being equally capable to reduce by 1.5 log bacteria growth. Erythritol antimicrobial activity against all tested bacterial strains was confirmed. Conclusions The proposed erythritol air‐polishing protocols did not alter implant surfaces and the antimicrobial properties of erythritol are conserved by the titanium implant surfaces. Clinical Relevance Erythritol air‐polishing could be repeatedly used in supportive peri‐implant care programmes.

Physical Climate Risk in Asset Management

ABSTRACT Climate‐related phenomena are increasingly affecting regions worldwide, manifesting as floods, water scarcity, and heat waves, significantly impairing companies' assets and productivity. It is essential for asset managers to quantify the exposure of their portfolios to such risk. To this aim, we develop a framework, based on the Vasicek model for credit risk, that introduces downward jumps due to climate phenomena in a company asset's dynamics. These negative shocks are designed to mirror the negative effect of extreme climate events. The model calibration relies on companies' asset intensity and geographical exposure. We apply the new multivariate firm value model with jumps to assess the impact of climate‐related extreme events on expected and unexpected portfolio losses. Our findings indicate that expected losses increase over time, with pronounced differences in exposure observed across sectoral indices. From an environmental policy perspective, these results suggest the need for additional capital buffers to offset losses arising from physical climate risks, particularly in sectors with high asset intensity.

Cyt‐Geist: Current and Future Challenges in Cytometry: Reports of the CYTO 2025 Conference Workshops

A Robust Multistep Digestion Method for Microplastics Detection in Human Tissue by MicroRaman Analysis

ABSTRACT The presence of microplastics (MPs) in human tissues has raised growing concerns, necessitating robust protocols for their reliable extraction and analysis. This study systematically evaluated and optimized digestion protocols to efficiently process a variety of human tissues—placenta, lung, kidney, adipose tissue, muscle, spleen, liver, thyroid, and brain—while preserving the integrity of MP particles. Initial assessments employing single‐reagent protocols such as nitric acid (HNO 3 ), proteinase K enzymatic digestion, and Fenton oxidative digestion demonstrated limited effectiveness, due to incomplete tissue breakdown or formation of turbid digestates that hindered filtration. Building upon these results, combined digestion approaches were investigated to improve organic matter removal and facilitate filtration through fine pore‐size filters (0.2 μm). The optimized 3‐day protocol included an initial oxidative Fenton digestion followed by enzymatic digestion (proteinase K). The final step involved lipid removal through ethanol addition and sonication, resulting in clear digestates amenable to filtration. This protocol efficiently digested complex tissue matrices, reducing filter clogging at 1‐μm size pore and preserving various common MP polymers, including low‐density polyethylene (LDPE), polyethylene terephthalate (PET), polytetrafluoroethylene (PTFE), and polyamides (PA6 and PA12). Application of the optimized digestion allowed successful isolation and characterization of MPs using optical microscopy and Raman spectroscopy. The method showed improved reproducibility and reliability over single‐reagent protocols, making it suitable for comprehensive MP analysis in human tissues. The application of an efficient and robust protocol for tissue digestion may contribute to advance human exposure assessment and toxicological studies related to MP contamination.

Differential Eating Disorder Symptom Trajectories Across the Perinatal Period and Associated Psychosocial Factors

ABSTRACT Background The perinatal period is a critical risk period for changes in eating disorder (ED) symptoms. However, extant research is mixed regarding the direction of these changes, with some studies identifying relief from ED symptoms and others finding evidence of worsening symptoms during this time. To account for heterogeneity in ED symptom change among pregnant and postpartum individuals, the current study aimed to explore ED symptom trajectories and their psychosocial correlates during pregnancy and the first postpartum year using person‐centered statistical approaches. Method A community sample of pregnant people recruited online ( N  = 315) completed assessments of ED symptoms and psychosocial factors during pregnancy, 8‐weeks postpartum, and 1‐year postpartum between October 2020 and January 2023. ED symptom trajectories were identified using group‐based multivariate trajectory modeling. Multinomial logistic regression tested if psychosocial factors (anxiety, depression, stress, emotion regulation difficulties, self‐compassion, social support, and body mass index) during pregnancy and across postpartum were associated with trajectory groups. Results Four distinct groups were identified: decreasing ED cognitions group (34% of the sample), increasing ED symptoms group (29%), early postpartum ED risk group (22%), and early postpartum alleviation group (15%). Postpartum weight retention and increasing depression from pregnancy to 1‐year postpartum were associated with higher odds of membership in the increasing ED symptoms group, relative to other groups. Discussion Although perinatal ED symptoms were commonly endorsed, symptom changes were heterogeneous. It is important to continue to investigate prospective correlates of perinatal ED symptoms and utilize idiographic modeling to inform prevention and early intervention approaches.

Weathering the Storm: Legacies of Extreme Meteorological Events and Daily Weather Variability Shape the Skin Microbiota of the Endangered Golden Alpine Salamander Salamandra atra aurorae (Trevisan, 1982)

ABSTRACT Ecosystems worldwide are undergoing unprecedented changes, and as a result amphibians are experiencing devastating population declines driven by subsequent habitat loss and emerging pathogens. The skin microbiota is an important first line of defence for amphibians against pathogens. Here, for the first time, we characterised the bacteria and fungi comprising the skin microbiota of 56 individual golden Alpine salamanders ( Salamandra atra aurorae , Trevisan, 1982), a highly endemic and endangered amphibian subspecies. In addition, we investigated the impact of the 2018 Vaia windstorm on skin microbiota of salamanders in plots classified as impacted or non‐impacted based on windthrows. Salamander sex, weather during sampling, and dominant tree species in plots were also investigated as influencers of microbiota. Beta diversity estimates revealed greater variation in bacterial microbiota composition among individuals from non‐impacted plots compared to plots impacted by Vaia. Notably, we found differential abundances of five genera of bacteria and eight genera of fungi in the skin microbiota of salamanders from impacted compared with non‐impacted plots. Further analyses revealed that median relative abundances of Aeromonas hydrophila , the causative agent of the potentially fatal red‐leg syndrome, were significantly higher in microbiota of salamanders from impacted plots. Weather conditions during sampling significantly influenced both alpha and beta diversity of the skin microbiota, and explained up to 9% of bacterial and 6% of fungal variation. Bacterial richness and phylogenetic diversity were lower during rainfall, whereas fungal beta diversity increased, suggesting contrasting moisture preferences. These findings suggest that extreme weather events, as well as moderate daily weather fluctuations, may be associated with the microbial communities of amphibian skin, potentially affecting their resilience to pathogens. This study underscores the importance of considering both natural and human‐mediated disturbances in conservation strategies for vulnerable species like the golden Alpine salamander.