Contemporary care of patients with ST-elevation myocardial infarction (STEMI) with primary percutaneous coronary intervention (PCI) is still dominated by “24/7 PCI-capable” hospital model, whereas a novel approach encompassing true “PCI now” capabilities could provide meaningful clinical benefits. Indeed, prehospital electrocardiogram (ECG) acquisition, early emergency medical service activation of the interventional team, direct transfer to the catheterization laboratory when appropriate, and continuous in-house staff coverage may reduce treatment delays, especially during off-hours, and may improve clinical outcomes. In this perspective, first-medical-contact-to-PCI and total ischemic time appear more meaningful quality indicators than door-to-balloon time alone, as also testified by regional data from Lazio and the experience from Santa Maria Goretti Hospital in Latina which show how delays frequently arise when patients first present to non-PCI hospitals, whereas organized direct-transfer pathways may streamline care. Development of centralized, sectorized STEMI networks, together with transparent auditing of performance and safeguards against false-positive activation, including ECG transmission, teleconsultation, standardized criteria, and validated artificial intelligence tools, may allow a safer and more effective management of STEMI. We hereby thus formally propose the universal adoption of such PCI now approach for STEMI care.

A theoretical investigation of the photochemical isomerization of carvone was conducted using Density Functional Theory (DFT) and multiconfigurational methods. Geometry optimizations, excited-state calculations, and reaction pathway analyses were performed at the B3LYP/6-311G+(d,p) level, supported by TD-DFT and CASSCF(6,6) calculations. The results provide strong computational evidence for the mechanism proposed by Büchi in 1957, in which the reaction proceeds through the first excited triplet state rather than a concerted singlet-state cycloaddition. After photoexcitation, intersystem crossing leads to a triplet state with pronounced radical character at the carbon atom β to the carbonyl group. Intramolecular coupling with the terminal olefinic carbon of the isopropenyl side chain generates a triplet biradical intermediate through a very low activation barrier (0.22 eV), which subsequently cyclizes to form the observed tricyclic terpene. Although the final product is thermodynamically less stable than the reactant, the process is kinetically feasible under photochemical conditions. CASSCF calculations did not reveal a conical intersection in the first excited singlet state, excluding a concerted [2+2] pathway. Solvent effects were also rationalized, with polar, hydrogen-bonding solvents significantly stabilizing the biradical intermediate, in agreement with experimentally observed variations in quantum yield.

The present Editorial deals with the paramount relevance of the scientific methodology employed for pursuing the objectives of any human and veterinary biomedical study. Within a sound "evidence-based medicine" perspective, the quality of obtained results should be evaluated on the basis of the methods used, either inspired by reliable bibliographic sources (e.g. PubMed) or, alternatively, by the web. In the latter case, a concrete risk refers to the possibility that results of doubtful, or even of no scientific value, may be magnified by the general public over those generated following a rigorous and standardized scientific methodology.

Background: Medtronic Onyx zotarolimus-eluting stents (ZES) are widely used in complex percutaneous coronary interventions (PCI), yet real-world safety signals remain underexplored outside of clinical trials. We conducted a focused case study leveraging the Food and Drug Administration (FDA) Manufacturer and User Facility Device Experience (MAUDE) database to characterize complications and technical failure modes specifically associated with Onyx platforms. Methods: We applied a ChatGPT 5-assisted extraction and curation workflow to the 500 most recent MAUDE reports retrieved using the query Manufacturer = “Medtronic” AND Product = “Onyx” (as of September 30, 2025). The model accurately parsed free-text narratives to identify device problems, clinical outcomes, and event severity, guided by a standardized taxonomy, which were then summarized providing row counts and prevalence rates, with exact 95% confidence intervals. Notably, out of 30 randomly selected reports manually verified by two independent reviewers, no inaccuracies were evident for death (0 [0-11.6%]) and two for non-fatal events (6.7% [0.8%-22.1%]). Results: We identified 499 reports (one was excluded because focusing on a non-coronary device), with death occurring in 21 cases (4.2% [2.8%-6.3%]). Devices were predominantly Onyx Frontier (n=419, 84.0% [80.5%-86.9%]), with Trucor (n=68, 13.6% [10.9%-16.9%]) and Trustar (n=12, 2.4% [1.4%-4.2%]). Leading issues included stent dislodgement/displacement (n=400, 80.2% [76.4%-83.4%]) and positioning failure (n=183, 36.7% [32.6%-41.0%]); balloon breakage/burst and balloon malfunction occurred in 58 (11.6% [9.1%-14.7%]) and 42 (8.4% [6.3%-11.2%]), respectively. Other reported outcomes included myocardial infarction in 19 (3.8% [2.5%-5.9%]), bleeding in 10 (2.0% [1.1%-3.6%]), and stroke in 3 (0.6% [0.2%-1.8%]). Conclusions: This case study demonstrates the feasibility and accuracy of ChatGPT 5 in extracting structured safety signals from unstructured MAUDE narratives. Complications linked to Medtronic Onyx stents were predominantly procedural, centering on delivery and positioning challenges, with case fatality of 4.2%. These findings are promising and insightful, albeit hypothesis-generating. They underscore the need for procedural optimization and enriched linkage with clinical registries to contextualize risk.

This is a short editorial summarizing a highly relevant clinical problem from an epidemiological perspective i.e. the possible pathophysiological links between testosterone deficiency (hypogonadism) in males, a condition known as hypogonadism, and renal function in patients with chronic kidney disease. While these two conditions may share important pathophysiological links, in clinical practice they are mostly considered unrelated. Testosterone hormone replacement therapy (HT) may likely help reduce the progression of chronic kidney disease, although patient phenotyping and the recognition of potential diagnostic biases must be considered to avoid risks.

The United Nations General Assembly proclaimed the years 2024–2033 as the International Decade of Sciences for Sustainable Development, designating UNESCO as the lead agency for its implementation. This global initiative underscores the pivotal role of science—basic, applied, social, and human—in advancing the 2030 Agenda for Sustainable Development while ensuring that the benefits of scientific progress are equitably shared across societies. The Decade emphasizes the expansion of scientific literacy, the widespread adoption of open science practices, the strengthening of global research collaborations, and the transformation of national innovation systems. At the same time, it confronts crucial barriers, including the proliferation of misinformation, insufficient investment in basic sciences, and widening inequalities in access to scientific education and infrastructure. This paper discusses the vision, challenges, and expected outcomes of the Decade, while presenting an example of a UNESCO-endorsed initiative that successfully evolved from basic research to applied science and ultimately democratized access to scientific knowledge. STOPTIGRE is a pioneering project that combines eco-sustainable vector control methods, science-art transdisciplinary approaches, Citizen science and community engagement to contrast the spread of insect vectors, such as mosquitoes. Citizen science involves citizens in research activities promoting social inclusion, sustainable development, and active citizenship, but its application still faces significant challenges to ensure effective public engagement and fully value its contribution. The project specifically aimed at addressing this challenge by developing an innovative and transdisciplinary approach, based on integrated actions of participatory science and art, for citizen engagement in eco-friendly mosquito monitoring and control. The test in the field of this approach, on the Mediterranean island of Procida, Italy, produced a significant impact both in reducing the infestation of tiger mosquitoes and in enhancing community awareness and cohesion.

The editorial proposes an original algorithm for hormonal treatment of patients with normogonadotropic azoospermia (NOAN). This condition is very common in clinical practice, and the approach of endocrinologists varies. Different therapeutic strategies are recommended based on clinical (testicular volume and body mass index) and hormonal parameters (inhibin B and 17-alpha hydroxyprogesterone levels). The algorithm suggests the role of follicle-stimulating hormone or chorionic gonadotropin, or incretin therapy, which are fully included in the potential therapeutic proposal due to the significant repercussions of metabolic syndrome and obesity on sperm quality.

Primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) typically relies on well-established access and device strategies. However, complex anatomical constraints may necessitate unconventional approaches. We report a case of acute anterior STEMI in a dialysis-dependent patient with no usable radial or femoral access. Ulnar artery cannulation enabled emergency angiography, revealing a long, calcified proximal left anterior descending artery occlusion. A microcatheter-specialty guidewire combination achieved lesion crossing, followed by guide extension catheter support to facilitate delivery. Intravascular lithotripsy (IVL) was employed to modify extensive calcification, allowing for stent implantation with restoration of TIMI 3 flow. The patient had an uneventful recovery. This case underscores the procedural relevance of niche interventional techniques—including alternative access, advanced lesion crossing strategies, guide support augmentation, and IVL—in select, high-risk STEMI patients. The discussion contextualizes each tool within the evidence base, suggesting that such a sequential, integrative strategy may be valuable when standard PCI is inadequate. As the prevalence of severe coronary calcification rises, especially among patients with chronic kidney disease or peripheral artery disease, awareness and appropriate deployment of these adjuncts may expand the boundaries of effective emergent PCI.

The United Nations General Assembly has officially designated 2025 as the International Year of Quantum Science and Technology (IYQ). This global initiative, supported by UNESCO and co-sponsored by several countries, marks the centenary of quantum sciences, which encompass quantum mechanics, quantum chemistry, and related fields. These disciplines serve as the foundation for fundamental research across the natural sciences. Quantum mechanics provides the theoretical framework for understanding matter and energy at the microscopic scale. While public celebrations of the International Year of Quantum Science and Technology often showcase quantum technologies to engage a broader audience, it is crucial to remember that the emergence of quantum theory primarily represented a ground-breaking shift in the basic sciences. This article explores the complex relationship between quantum mechanics and concepts of traditional chemistry, particularly concerning the microscopic world of atoms and molecules. It highlights how quantum mechanics, a holistic and nonlocal theory, features concepts such as entanglement and the indistinguishability of components that challenge classical chemical notions of distinct interatomic interactions and well-defined molecular structures. While quantum mechanics excels at determining the overall stability and dynamics of the system, the article explains that quantum chemistry relies on the classical Born-Oppenheimer approximation to maintain the view of local interactions and identifiable atoms within a molecule. Then, the article discusses the historical development and limitations of transition state theory in explaining chemical reactions, highlighting chemistry’s specific focus on bond breaking and bond making as a fundamental explanatory principle.

Coronary artery aneurysms (CAAs) are uncommon but potentially serious findings increasingly detected through advanced coronary imaging. Their etiology is diverse, including atherosclerosis and iatrogenic injury, and their clinical implications range from benign to life-threatening. Treatment strategies vary based on aneurysm size, location, and associated symptoms, and while surgical options have been traditional, percutaneous techniques are gaining ground. We hereby report the case of a patient with an incidentally discovered aneurysm arising from a secondary branch of the proximal right coronary artery. Following heart team evaluation, coil embolization was successfully performed via femoral access using selective wiring and deployment of neurovascular coils, achieving complete exclusion of the aneurysm. We also review the current evidence supporting percutaneous options for CAA management, including covered stents, coils, vascular plugs, liquid embolics, and custom devices. While percutaneous techniques offer promising outcomes with lower procedural morbidity, high-quality comparative data are lacking. Our case highlights the feasibility and safety of coil embolization in anatomically favorable scenarios and supports the need for individualized procedural planning. Broader adoption of these strategies will require systematic data collection and consensus-driven guidelines to optimize long-term outcomes in CAA management.