Quantitative ultrasound (QUS) in the evaluation of liver steatosis: data reliability in different respiratory phases and body positions.

Liver steatosis is the most common chronic liver disease and affects 10-24% of the general population. As the grade of disease can range from fat infiltration to steatohepatitis and cirrhosis, an early diagnosis is needed to set the most appropriate therapy. Innovative noninvasive radiological techniques have been developed through MRI and US. MRI-PDFF is the reference standard, but it is not so widely diffused due to its cost. For this reason, ultrasound tools have been validated to study liver parenchyma. The qualitative assessment of the brightness of liver parenchyma has now been supported by quantitative values of attenuation and scattering to make the analysis objective and reproducible. We aim to demonstrate the reliability of quantitative ultrasound in assessing liver fat and to confirm the inter-operator reliability in different respiratory phases. We enrolled 45 patients examined during normal breathing at rest, peak inspiration, peak expiration, and semi-sitting position. The highest inter-operator agreement in both attenuation and scattering parameters was achieved at peak inspiration and peak expiration, followed by semi-sitting position. In conclusion, this technology also allows to monitor uncompliant patients, as it grants high reliability and reproducibility in different body position and respiratory phases.

Disseminating Science and Education through Social Media: The Experience of a Students' Editorial Team at the University of Padova.

"WeSocial: Online Learning Community" is a project aiming to provide students with the basic skills in science communication via social media as a useful tool in their future careers and to disseminate the University Department of Comparative Biomedicine and Food Science activities to the general public. The project is based on two main actions: professional training on science communication and social media strategies, and the establishment of an editorial team composed of students supervised by the teaching staff. When the training phase was concluded, official department accounts on Instagram (bca_campus_unipd) and Facebook (BCA_campus_unipd) were opened. Currently, the students' editorial team (SET) oversees publishing a maximum of 3 posts per week, whose content deals with the academic, research, and educational areas of the department seen through the students' eyes. The social media accounts are constantly growing and becoming a "place" for the virtual community of the department. Since students are both "information producers" and the "audience" of the project, they propose and focus on issues particularly important to them. As a result, the department's social media has become a meaningful and relevant experience for students, enhancing their sense of belonging to the departmental and university community life. Moreover, the project is fostering the interaction between students and teaching staff and, thanks to peer communication, is increasing the awareness of department activities especially in the student audience.

Medical Electives in Sub-Saharan Africa: A 15-Year Student/NGO-Driven Initiative.

Medical schools are developing global health programmes, and medical students are requesting global health training and creating opportunities when these are not provided by medical schools. This article described the Wolisso Project (WP), a medical experience on clinical electives in Sub-Saharan Africa, driven by a collaboration between a student organisation and a Nongovernmental Organization (NGO). Preclinical medical students spent 4 weeks as part of a multidisciplinary medical team in Africa. Post-elective questionnaires were administered to all subjects who participated in the project. Of all, 141 students responded to the questionnaire. The participants came from 30 Italian universities. The main difficulties reported are due to the lack of resources for the exercise of the medical activity, and difficulties related to language and communication. The African experience had a positive impact on the progress of the studies upon return, with an increase in determination and motivation. The experience had also positive influences on the future professional choices and carriers. The experience seems to contribute not only to the professional growth, but also to the personal development. A key factor in the positive outcomes of this experience is it being implemented by an NGO with long-term working relationships with the African populations. Another is that the project is carried out in health facilities where NGO staff have been working for a long time. These factors reduce the potential risks connected with this type of experience. They ensure a satisfactory level of supervision, the lack of which has been a serious problem in many similar experiences. A well-structured, mentored experience in international health can have a positive impact on preclinical students' attitudes, including their compassion, volunteerism, and interest in serving underserved populations. Only a small number of Italian universities facilitate pre-graduate medical elective experiences in LMICs. The WP seems to be attempting to compensate for the lack of international experience in LMICs offered by universities. Italian medical schools should incorporate changes in their curricula to train socially responsible physicians.

Morpho-functional cardiovascular adaptation in hypertensive patients: two-dimensional speckle tracking echocardiographic study.

BACKGROUND: Twenty-four-hour blood pressure (BP) variability is an important predictor of organ damage and cardiovascular events. Although epidemiological data are widely based on evaluation of office (clinic) BP, 24-hour ambulatory BP monitoring (ABPM) accurately assess the severity of hypertension to predict cardiovascular events in hypertensive patients, because it more accurately reflects BP load on heart and blood vessels. Conventional transthoracic echocardiography (TTE), such as M-mode and two-dimensional (2D), and more advanced techniques, such as tissue Doppler imaging (TDI) and speckle tracking echocardiography (STE), are used to identify pathological changes of the hypertensive heart disease. In addition, the study of systemic arterial compliance (SAC) predicts the impact of the arterial stiffness on the LV remodeling. METHODS: Fifty-eight patients (34 males and 24 females, aged 53±12 years) with hypertension for at least one year were studied using Ambulatory Blood Pressure Monitoring (ABPM), with evaluation of 24-hour, day time, night time and sleep and awake average systolic and diastolic BP, and subsequently with TTE, to evaluate the influence of the 24-hour average BP, integrated with echocardiographic parameters, on cardiovascular adaptations in hypertensive patients. ECHO parameters examined were: left ventricle (LV) mass indexed to body surface area (LVMi), LV ejection fraction (EF), left atrial volume indexed to body surface area (LAVi), mitral inflow velocities (E, A and E/A), mitral annulus velocities (S' and E') and E/E' ratio by TDI, LV global longitudinal strain (GLS) using 2D STE. SAC was derived by the ratio SVi/PP, using echocardiographic stroke volume index to body surface area (SVi) and pulse pressure (PP). RESULTS: LVMi showed a correlation with the 24-hour average BP (SBP r=0.32; DBP r=0.26), SBPd (r=0.32), DBPd (r=0.28) and SBPn (r=0.29). GLS was correlated with the 24-hour average BP (SBP r=0.30; DBP r=0.32), SBPd (r=0.32), DBPd (r=0.32) and with LVMi (r=0.42), LAVi with 24 hour SBP (r=0.28), while SAC with LVMi (r=0.29) and LAVi (r=0.33). CONCLUSIONS: ABPM and TTE evaluation can be particularly useful in hypertensive patients, even with normal office BP, to highlight the influence of 24-hour blood pressure profile on LVM, and to a lesser extent, on LAV. SAC, instead, seems to be correlated both to LVM and LAV, independently of BP levels.