Search Results (1,547)

Background/Objectives: Neuromodulation is under investigation as a possibly effective add-on therapy in Alzheimer’s disease (AD). While transcranial pulse stimulation (TPS) has shown positive short-term effects, long-term effects have not yet been fully explored. This study aims to evaluate the long-term feasibility, safety, and potential cognitive benefits of TPS over one year in patients with Alzheimer’s disease, focusing on domains such as memory, speech, orientation, visuo-construction, and depressive symptoms. Methods: We analyzed preliminary data from the first ten out of thirty-five patients enrolled in a prospective TPS study who completed one year of follow-up and were included in a dedicated long-term database. The protocol consisted of six initial TPS sessions over two weeks, followed by monthly booster sessions delivering 6000 pulses each for twelve months. Patients underwent regular neuropsychological assessments using the Alzheimer Disease Assessment Scale (ADAS), Mini-Mental Status Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Beck Depression Inventory (BDI-II). All adverse events (AEs) were documented and monitored throughout the study. Results: Adverse events occurred in less than 1% of stimulation sessions and mainly included mild focal pain or transient unpleasant sensations, as well as some systemic behavioral or vigilance changes, particularly in patients with underlying medical conditions, with some potentially related to the device’s stimulation as adverse device reactions (ADRs). Cognitive test results showed significant improvement after the initial stimulation cycle (ADAS total improved significantly after the first stimulation cycle (M_pre = 28.44, M_post = 18.56; p = 0.001, d = 0.80, 95% CI (0.36, 1.25)), with stable scores across all domains over one year. Improvements were most notable in memory, speech, and mood. Conclusions: TPS appears to be a generally safe and feasible add-on treatment for AD, although careful patient selection and monitoring are advised. While a considerable number of participants were lost to follow-up for various reasons, adverse events and lack of treatment effect were unlikely primary causes. A multifocal stimulation approach (F-TOP2) is proposed to enhance effects across more cognitive domains. Full article

Background: Lung cancer remains the leading cause of cancer-related mortality worldwide. Advances in screening, diagnosis, and management have transformed clinical practice, particularly with the integration of immunotherapy and target therapies. Methods: A systematic literature search was carried out for the period between October 2016 to September 2024. Phase II and III randomized trials evaluating ICI monotherapy, ICI–chemotherapy combinations, and dual ICI regimens in patients with advanced NSCLC were included. Outcomes of interest included overall survival (OS), progression-free survival (PFS), and treatment-related adverse events (AEs). Results: PD-1-targeted therapies demonstrated superior OS compared to PD-L1-based regimens, with cemiplimab monotherapyranking highest for OS benefit (posterior probability: 90%), followed by sintilimab plus platinum-based chemotherapy (PBC) and pemetrexed—PBC. PFS atezolizumab plus bevacizumab and PBC, and camrelizumab plus PBC were the most effective regimens. ICI–chemotherapy combinations achieved higher ORRs but were associated with greater toxicity. The most favorable safety profiles were observed with cemiplimab, nivolumab, and avelumab monotherapy, while atezolizumab plus PBC and sugemalimab plus PBC carried the highest toxicity burdens. Conclusions: In PD-L1-unselected advanced NSCLC, PD-1 blockade—particularly cemiplimab monotherapy—and rationally designed ICI–chemotherapy combinations represent the most efficacious treatment strategies. Balancing efficacy with safety remains critical, especially in the absence of predictive biomarkers. These findings support a patient-tailored approach to immunotherapy and highlight the need for further biomarker-driven and real-world investigations to optimize treatment selection. Full article

This study is the first to systematically integrate supervised machine learning (decision tree) and association rule mining techniques to analyze accident data from the Taipei Metro system, conducting a large-scale data-driven investigation into both passenger injury and train malfunction events. The research demonstrates strong novelty and practical contributions. In the passenger injury analysis, a dataset of 3331 cases was examined, from which two highly explanatory rules were extracted: (i) elderly passengers (aged > 61) involved in station incidents are more likely to suffer moderate to severe injuries; and (ii) younger passengers (aged ≤ 61) involved in escalator incidents during off-peak hours are also at higher risk of severe injury. This is the first study to quantitatively reveal the interactive effect of age and time of use on injury severity. In the train malfunction analysis, 1157 incidents with delays exceeding five minutes were analyzed. The study identified high-risk condition combinations—such as those involving rolling stock, power supply, communication, and signaling systems—associated with specific seasons and time periods (e.g., a lift value of 4.0 for power system failures during clear mornings from 06:00–12:00, and 3.27 for communication failures during summer evenings from 18:00–24:00). These findings were further cross-validated with maintenance records to uncover underlying causes, including brake system failures, cable aging, and automatic train operation (ATO) module malfunctions. Targeted preventive maintenance recommendations were proposed. Additionally, the study highlighted existing gaps in the completeness and consistency of maintenance records, recommending improvements in documentation standards and data auditing mechanisms. Overall, this research presents a new paradigm for intelligent metro system maintenance and safety prediction, offering substantial potential for broader adoption and practical application. Full article

Background: Doppler-guided haemorrhoidal artery ligation with rectoanal repair (HAL-RAR) is a minimally invasive alternative to conventional haemorrhoidectomy. While associated with reduced postoperative pain and quicker recovery, data on its safety, recurrence rates, and applicability across haemorrhoid grades remain limited, particularly in Australian settings. Methods: A retrospective review was conducted on 128 consecutive patients who underwent elective HAL-RAR at a single institution between February 2022 and December 2024. Data on demographics, operative details, postoperative outcomes, and recurrence were collected. Outcomes were stratified by haemorrhoid grade. Multivariate logistic regression was used to identify predictors of recurrence, day-case completion, and conversion to excisional surgery. Results: The median age was 49 years, and 77.3% had Grade II or III haemorrhoids. HAL-RAR was completed as a day case in 76.6% of patients. Postoperative urinary retention occurred in 3.9%, return to theatre in 0.8%, and 30-day readmission in 7.0%. The symptomatic recurrence rate was 17.6%. Grade IV haemorrhoids were independently associated with increased recurrence (aOR 3.64, 95% CI 1.03–12.84), reduced likelihood of day-case management (aOR 0.14, 95% CI 0.03–0.93), and higher conversion to excisional haemorrhoidectomy (aOR 7.23, 95% CI 1.13–46.40). Conclusions: HAL-RAR is a safe, effective, and low-morbidity option for the management of Grade II and III haemorrhoids, suitable for day-case surgery. In selected Grade IV cases, it may offer benefit, although with higher recurrence and conversion risk. Careful patient selection is essential, and longer-term prospective studies are needed to assess durability. Full article

The mold clamping mechanism is crucial in injection molding machines and significantly influences molding. This research optimizes the Stephenson-chain mechanism with double-toggle effects, particularly focusing on acceleration and driving force. A design incorporating double-toggle effects in the closed position enhances clamping force and ensures safety. For a 6-bar linkage, the Watt-chain mechanism and Stephenson-chain mechanism are available. In this paper, Stephenson-chain mechanisms were selected and subjected to a comprehensive analysis of their kinematic characteristics using vector loop and finite difference methods. The optimal design process included defining the objective function and evaluating the maximum acceleration and force ratio. The results show that the optimal Stephenson-I mechanism achieves a 1.92% increase in the maximum acceleration, and the maximum driving force decreases by 12.34% compared to the optimal Watt-chain mechanism. The Stephenson-II mechanism performs even better, with a 33.94% reduction in maximum acceleration and a 6.81% decrease in maximum driving force compared to the optimal Watt-chain mechanism. The results indicate that the Stephenson-II mechanism outperforms the Stephenson-I mechanism and other existing designs in terms of the maximum acceleration and driving force. Full article

Adipose stem cells (ASCs) are a subset of mesenchymal stem cells with validated immunomodulatory and regenerative capabilities that make them attractive tools for treating neurodegenerative disorders, such as multiple sclerosis (MS). Several studies conducted on experimental autoimmune encephalomyelitis (EAE), the animal model of MS, have clearly shown a therapeutic effect of ASCs. However, controversial data on their efficacy were obtained from I- and II-phase clinical trials in MS patients, highlighting standardization issues and limited data on long-term safety. In this context, ASC-derived extracellular vesicles from (ASC-EVs) represent a safer, more reproducible alternative for EAE and MS treatment. Moreover, their physical characteristics lend themselves to a non-invasive, efficient, and easy handling of intranasal delivery. Using an in vitro setting, we first verified ASC-EVs’ ability to cross the human nasal epithelium under an inflammatory milieu. Magnetic resonance corroborated these data in vivo in intranasally treated MOG35-55-induced EAE mice, showing a preferential accumulation of ASC-EVs in brain-inflamed lesions compared to a stochastic distribution in healthy control mice. Moreover, intranasal treatment of ASC-EVs at the EAE onset led to a long-term therapeutic effect using two different experimental protocols. A marked reduction in T cell infiltration, demyelination, axonal damage, and cytokine production were correlated to EAE amelioration in ASC-EV-treated mice compared to control mice, highlighting the immunomodulatory and neuroprotective roles exerted by ASC-EVs during EAE progression. Overall, our study paves the way for promising clinical applications of self-administered ASC-EV intranasal treatment in CNS disorders, including MS. Full article

Artificial intelligence (AI) agents are increasingly shaping vital sectors of society, including healthcare, education, supply chains, and finance. As their influence grows, AI alignment research plays a pivotal role in ensuring these systems are trustworthy, transparent, and aligned with human values. Leveraging blockchain technology, proven over the past decade in enabling transparent, tamper-resistant distributed systems, offers significant potential to strengthen AI alignment. However, despite its potential, the current AI alignment literature has yet to systematically explore the effectiveness of blockchain in facilitating secure and ethical behavior in AI agents. While existing systematic literature reviews (SLRs) in AI alignment address various aspects of AI safety and AI alignment, this SLR specifically examines the gap at the intersection of AI alignment, blockchain, and ethics. To address this gap, this SLR explores how blockchain technology can overcome the limitations of existing AI alignment approaches. We searched for studies containing keywords from AI, blockchain, and ethics domains in the Scopus database, identifying 7110 initial records on 28 May 2024. We excluded studies which did not answer our research questions and did not discuss the thematic intersection between AI, blockchain, and ethics to a sufficient extent. The quality of the selected studies was assessed on the basis of their methodology, clarity, completeness, and transparency, resulting in a final number of 46 included studies, the majority of which were journal articles. Results were synthesized through quantitative topic analysis and qualitative analysis to identify key themes and patterns. The contributions of this paper include the following: (i) presentation of the results of an SLR conducted to identify, extract, evaluate, and synthesize studies on the symbiosis of AI alignment, blockchain, and ethics; (ii) summary and categorization of the existing benefits and challenges in incorporating blockchain for AI alignment within the context of ethics; (iii) development of a framework that will facilitate new research activities; and (iv) establishment of the state of evidence with in-depth assessment. The proposed blockchain-based AI alignment framework in this study demonstrates that integrating blockchain with AI alignment can substantially enhance robustness, promote public trust, and facilitate ethical compliance in AI systems. Full article

Drug repurposing or drug repositioning is the process of identifying new therapeutic uses for approved or investigational drugs beyond the original treatment indication. The discovery of new drugs for cancer therapy needs this cost-effective and time-saving alternative strategy to traditional drug development for a rapid clinical translation in Phase II/III studies, especially for unmet medical needs and rare diseases. Neuroendocrine tumors (NETs) are a heterogeneous group of rare neoplasms arising from cells of the neuroendocrine system that, though often indolent, can be aggressive and metastatic. In this context, drug repurposing has emerged as a promising strategy to improve treatment options due to the limited number of effective treatments and the heterogeneity of the disease. Indeed, a large number of non-oncology drugs have the potential to address more than one target that could be therapeutic for cancer patients. Although many repurposed drugs are used off-label, efficacy for the new use must be demonstrated in clinical trials. Within regulatory frameworks, both the Food and Drug Administration (FDA) and the European Medicines Agency (EMA) have procedures to reduce the need for extensive new studies and to expedite the review of drugs for serious conditions when preliminary evidence indicates substantial clinical improvement over available therapy. In spite of several advantages, including reduced development time, lower costs, known safety profiles, and faster regulatory approval, difficulty in obtaining new patents for old drugs with limited protection for intellectual property may reduce commercial returns and disincentivize investments. This review aims to provide comprehensive information on some marketed drugs currently under investigation to be repurposed or used in clinical practice for NETs and to discuss the major clinical challenges. Although drug repurposing is a useful strategy for early access to medicines, the monitoring of the clinical benefit of oncologic drugs during the post-marketing authorization is crucial to support the safety and effectiveness of treatments. Full article

New approach methodologies (NAMs), including microphysiological systems (MPSs), can recapitulate structural and functional complexities of organs. Vanoxerine was reported to induce cardiac adverse events, including torsade de points (TdP), in a Phase III clinical trial. Despite earlier nonclinical animal models and Phase I–II clinical trials, events of QT prolongation or proarrhythmia were not observed. Here, we utilized cardiac NAMs to evaluate the functional consequences of vanoxerine treatment on human cardiac excitation–contraction coupling. The cardiac MPS used in this study was a microfabricated fluidic culture platform with human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) capable of evaluating voltage, intracellular calcium handling, and contractility. Likewise, the hiPSC-CM comprehensive in vitro proarrhythmia assay (CiPA) was employed based on multielectrode array (MEA). Vanoxerine treatment delayed repolarization in a concentration-dependent manner and induced proarrhythmic events in both NAM platforms. The complex cardiac MPS displayed a frequency-dependent vanoxerine response such that EADs were eliminated at a faster pacing rate (1.5 Hz). Moreover, exposure analysis revealed a 99% vanoxerine loss in the cardiac MPS. TdP risk analysis demonstrated high to intermediate TdP risk at clinically relevant concentrations of vanoxerine and frequency-independent EAD events in the hiPSC-CM CiPA model. These findings demonstrate that nonclinical cardiac NAMs can recapitulate clinical outcomes, including detection of vanoxerine-induced delayed repolarization and proarrhythmic effects. Moreover, this work provides a foundation to evaluate the safety and efficacy of novel compounds to reduce the dependence on animal studies. Full article

Terahertz (THz) communications and simultaneous wireless information and power transfer (SWIPT) hold the potential to energize battery-less Internet-of-Things (IoT) devices while enabling multi-gigabit data transmission. However, severe path loss, blockages, and rectifier nonlinearity significantly hinder both throughput and harvested energy. Additionally, high-power THz beams pose safety concerns by potentially exceeding specific absorption rate (SAR) limits. We propose a sensing-adaptive power-focusing (APF) framework in which a reconfigurable intelligent surface (RIS) embeds low-rate THz sensors. Real-time backscatter measurements construct a spatial map used for the joint optimisation of (i) RIS phase configurations, (ii) multi-tone SWIPT waveforms, and (iii) nonlinear power-splitting ratios. A weighted MMSE inner loop maximizes the data rate, while an outer alternating optimisation applies semidefinite relaxation to enforce passive-element constraints and SAR compliance. Full-stack simulations at 0.3 THz with 20 GHz bandwidth and up to 256 RIS elements show that APF (i) improves the rate–energy Pareto frontier by 30–75% over recent adaptive baselines; (ii) achieves a 150% gain in harvested energy and a 440 Mbps peak per-user rate; (iii) reduces energy-efficiency variance by half while maintaining a Jain fairness index of 0.999;; and (iv) caps SAR at 1.6 W/kg, which is 20% below the IEEE C95.1 safety threshold. The algorithm converges in seven iterations and executes within <3 ms on a Cortex-A78 processor, ensuring compliance with real-time 6G control budgets. The proposed architecture supports sustainable THz-powered networks for smart factories, digital-twin logistics, wire-free extended reality (XR), and low-maintenance structural health monitors, combining high-capacity communication, safe wireless power transfer, and carbon-aware operation for future 6G cyber–physical systems. Full article

The use of chloride-based deicing salts, particularly sodium chloride (NaCl) and calcium chloride (CaCl₂), is a common practice in cold regions for maintaining road safety during winter. However, the accumulation of salt residues in adjacent soils poses serious environmental threats, including reduced pH, increased electrical conductivity (EC), disrupted soil structure, and plant growth inhibition. This study aimed to evaluate the combined effect of activated carbon (AC) and Pennisetum alopecuroides, a salt-tolerant perennial grass, in alleviating salinity stress under deicer-treated soils. A factorial greenhouse experiment was conducted using three fixed factors: (i) presence or absence of Pennisetum alopecuroides, (ii) deicer type (NaCl or CaCl₂), and (iii) activated carbon mixing ratio (0, 1, 2, 5, and 10%). Soil pH, EC, and ion concentrations (Na⁺, Cl⁻, Ca²⁺) were measured, along with six plant growth indicators. The results showed that increasing AC concentrations significantly increased pH and reduced EC and ion accumulation, with the 5% AC treatment being optimal in both deicer systems. Plant physiological responses were improved in AC-amended soils, especially under CaCl₂ treatment, indicating less ion toxicity and better root zone conditions. The interaction effects between AC, deicer type, and plant presence were statistically significant (p < 0.05), supporting a synergistic remediation mechanism involving both adsorption and biological uptake. Despite the limitations of short-term controlled conditions, this study offers a promising phytomanagement strategy using natural adsorbents and salt-tolerant plants for sustainable remediation of salt-affected soils in road-adjacent and urban environments. Full article

To prevent the occurrence of excavation face instability incidents during shield tunneling, this study takes the Bailuyuan tunnel of the ‘Hanjiang-to-Weihe River Water Diversion Project’ as the engineering background. A three-dimensional discrete element method simulation was employed to analyze the tunneling process, revealing the displacement response of the excavation face to various tunneling parameters. This led to the development of a risk assessment method that considers both tunneling parameters and geological conditions for deep-buried shield tunnels. The above method effectively overcomes the limitations of finite element method (FEM) studies on shield tunneling parameters and, combined with the Analytic Hierarchy Process (AHP), enables rapid tunnel analysis and assessment. The results demonstrate that the displacement of the excavation face in shield tunnel engineering is significantly influenced by factors such as the chamber earth pressure ratio, cutterhead opening rate, cutterhead rotation speed, and tunneling speed. Specifically, variations in the chamber earth pressure ratio have the greatest impact on horizontal displacement, occurring predominantly near the upper center of the tunnel. As the chamber earth pressure ratio decreases, horizontal displacement increases sharply from 12.9 mm to 267.3 mm. Conversely, an increase in the cutterhead opening rate leads to displacement that first rises gradually and then rapidly, from 32.1 mm to 121.1 mm. A weighted index assessment model based on AHP yields a risk level of Grade II, whereas methods from other scholars result in Grade III. By implementing measures such as adjusting the grouting range, cutterhead rotation speed, and tunneling speed, field applications confirm that the risk level remains within acceptable limits, thereby verifying the feasibility of the constructed assessment method. Construction site strategies are proposed, including maintaining a chamber earth pressure ratio greater than 1, tunneling speed not exceeding 30 mm/min, cutterhead rotation speed not exceeding 1.5 rpm, and a synchronous grouting range of 0.15 m. Following implementation, the tunnel construction successfully passed the high-risk section without any incidents. This research offers a decision-making framework for shield TBM operation safety in complex geological environments. Full article

This research investigated the temporal dynamics of the anthropogenic impact of fishing pressure on the resilience of the fish species Sarotherodon melanotheron (Rüppel, 1858) in the African Lake Toho, located in southwest Benin. The sampling and analysis of monthly length frequency data were conducted from April 2002 to March 2003 and from April 2022 to March 2023 using the FAO-ICLARM Stock Assessment Tool (FiSAT II software program (version 1.2.2.). The analysis of the S. melanotheron population in Lake Toho revealed a significantly diminishing resilience potential, reflected mainly in general reductions in both the average size and weight of individuals. There was a notable reduction in the size of Sarotherodon melanotheron individuals caught between 2002–2003 and 2022–2023, reflecting the increased pressure on juvenile size classes. Catches are now concentrated mainly on immature fish, revealing increasing exploitation before sexual maturity is reached. An analysis of maturity stages showed a decrease in the percentage of mature individuals in the catches (69.27% in 2002–2003 compared to 55.07% in 2022–2023) and a reduction in the number of mega-spawners (4.53% in 2002–2003 compared to 1.56% in 2022–2023). Growth parameters revealed a decrease in asymptotic length (from 32.2 cm to 23.8 cm) and longevity (from 9.37 years to 7.89 years), while the growth coefficient slightly increased. The mean size at first capture and optimal size significantly declined, indicating increased juvenile exploitation. The total and natural mortalities increased, whereas the fishing mortality remained stable. The exploitation rate remained high, despite a slight decrease from 0.69 to 0.65. Finally, the declines in the yield per recruit, maximum sustainable yield, and biomass confirm the increasing fishing pressure, leading to growth overfishing, recruitment overfishing, reproductive overfishing, and, last but not least, a decreasing resilience potential. These findings highlight the growing overexploitation of S. melanotheron in Lake Toho, compromising stock renewal, fish population resilience, sustainability, and production while jeopardizing local food safety. Full article

Background: Intravenous thrombolysis (IVT) is the standard treatment for ischemic stroke within 4.5 h of symptom onset. However, a significant proportion of patients present beyond this window. This study aims to evaluate the efficacy and safety of IVT beyond the 4.5 h window in selected patients. Methods: A systematic literature search was conducted across PubMed, Cochrane Library, and Google Scholar from inception to April 2025. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Results: A total of 12 RCTs were included, with 3236 patients. Compared to controls, IVT significantly improved excellent functional outcomes [OR: 1.40; 95% CI: 1.21–1.62] and good functional outcomes [OR: 1.26; 95% CI: 1.06–1.50] at 90 days. IVT also improved recanalization [OR: 2.47; 95% CI: 1.96–3.12], reperfusion [OR: 2.20; 95% CI: 1.26–3.84], and early neurological improvement [OR: 1.91; 95% CI: 1.12–3.26]. However, it was associated with a significantly higher risk of symptomatic intracranial hemorrhage (sICH) [OR: 2.17; 95% CI: 1.25–3.79], any ICH [OR: 1.49; 95% CI: 1.09–2.04], and type-II parenchymal hemorrhage (PH) [OR: 2.14; 95% CI: 1.19–3.83]. No significant difference was observed in systemic hemorrhage, 90-day all-cause mortality, 7-day mortality, or 90-day intervention-related mortality (p > 0.05). Conclusions: IVT beyond 4.5 h improves neurological outcomes in patients with ischemic stroke without increasing overall mortality or systemic bleeding, though it raises the risk of sICH, any ICH, and type-II PH. Further large RCTs are needed to confirm these findings and guide clinical practice. Full article

Background: The transapical off-pump NeoChord procedure is a recognized minimally invasive surgical approach for the treatment of severe degenerative mitral regurgitation. This study aims to report the initial Greek experience with the NeoChord procedure, presenting mid-term clinical and echocardiographic outcomes from a single cardiothoracic surgical center, with a median follow-up duration of 20 months. Methods: In this study, 42 symptomatic patients with moderate to severe and severe primary mitral regurgitation underwent mitral valve repair with the Neochord procedure between March 2018 and December 2024. All patients were evaluated clinically and echocardiographically by the Heart team preoperatively, after 1 month, and at the last follow-up (end of 2024). The primary endpoint was established as the presence of a major clinical event (all-cause mortality, reintervention due to deterioration of MR, and cardiac-related rehospitalization). Results: The median age of patients was 69 [61.75–79.25] years, and 69% of patients were men. The median EuroScore II was 1.79 [1.32–2.48], and the STS-PROM MV repair score was 3.18 [2.28–4.66]. Regarding the preprocedural mitral valve anatomical evaluation, 35 patients had type A (83.3%),4 had type B(9.5%), whereas only two patients had type C and 1 with type D anatomy. The median of LAI was 1.2 [1.15–1.25], whereas the CI was 4 [2.15–5]. More than two neochordae were implanted in 34 patients (81%). MR severity improved at 1-month (<moderate:92.85%) and at the last follow-up (<moderate:92.1%). NYHA class decreased within 1 month (I + II: 95.23%) after the procedure and was maintained at the last follow-up (I + II: 94.73%). The median left ventricular ejection fraction (LVEF) before the procedure was 63 [58–67]%, which significantly decreased to 57 [53–61]% at the 1-month follow-up (2-sided p < 0.001). At the final follow-up, LVEF increased to 65 [60–68]%, however, this change was not statistically significant compared to the preprocedural value. During the follow-up period, four deaths were documented—three due to non-cardiac and one attributable to a cardiac cause. Two cases proceeded to reoperation for surgical valve implantation due to recurrent mitral valve regurgitation 6 months and 8 months after the NeoChord procedure. Conclusions: Transapical off-pump NeoChord implantation offers a minimally invasive alternative to conventional surgery for symptomatic patients with moderate-to-severe or severe primary mitral regurgitation. Among patients with suitable mitral valve anatomy, the procedure has demonstrated a favorable safety profile and promising mid-term outcomes, in terms of cardiac mortality, as well as freedom from reoperation and rehospitalization. Full article