Michele Danilo Pierri 
Listening to an invisible organ Long before it was an image, a pressure curve, an electrical trace or a stream of numbers on a monitor, the heart was a sound. For centuries a physician had two options: feel the pulse at the wrist, or put an ear against the patient’s chest, with all the awkwardness … Read more
Last updated: October 2026 Author: Michele D. Pierri Reading time: 25–30 minutes Introduction A 78-year-old woman sits in front of me with an echocardiogram showing severe aortic stenosis. She has already decided on a biological valve. Her question is the one every surgeon hears: “How long will it last?” The honest answer usually comes from … Read more
Article authored by Michele D. Pierri, MDLast updated: October 2026Reading time: 10 minutes Three months ago, the question was whether artificial intelligence was really entering clinical practice. This quarter, that question feels almost outdated. AI is already inside clinical workflows: reading images, screening patients, drafting notes, answering clinical questions, supporting diagnosis, monitoring patients at home … Read more
Randomized trials are not always possible. Observational data can still tell us something about treatment effects, but only if we deal with a basic problem: treated and untreated patients usually differ before treatment even starts. Inverse Probability of Treatment Weighting (IPTW) is one way to handle this. In this tutorial we build an IPTW analysis … Read more
Introduction For a few years now, “artificial intelligence” has mostly meant large language models. The routine is familiar: we type a prompt, the model returns a stream of words, and someone reads it (or some other piece of software parses it). Jev starts somewhere else. TypeSafe AI released it in September 2026 as its first … Read more
Introduction On September 8, 2026, Circulation published the new American Heart Association scientific statement on infective endocarditis (IE) — the first comprehensive AHA document on the subject since 2015 [1]. Ten years is a long time in endocarditis. The patients have changed over that interval. Cardiovascular prostheses and transcatheter devices are now everywhere, molecular microbiology … Read more
Abstract Running a language model locally gives you a kind of control that hosted chatbots often hide. LM Studio, Ollama, llama.cpp, vLLM, and similar tools expose settings such as temperature, top_p, top_k, min_p, repeat_penalty, and context length. The problem is that their names say very little about what an ordinary user will actually notice on … Read more
More Expensive, Slower but Actually Better? Every frontier release arrives with the same implicit promise. Better reasoning, better reliability, better behaviour on the hard cases. Higher cost too, of course, which tends to be presented as the price of that improvement rather than as something anyone is expected to verify. When GPT-6 Astra became available … Read more
Mean heart rate is one of the most familiar numbers in medicine. Useful, immediate, and often enough for a first description. Yet every average carries the same defect: it compresses into a single value everything that happened over time. Two patients can share a mean of 70 beats per minute (bpm) and, across the same … Read more
A reproducible 300-question evaluation across medical exams, biomedical literature, multilingual question answering, and clinical calculation Meta released Muse Glimmer on 10 August 2026: thirty billion parameters, open weights, built for agentic work on consumer hardware.[1,2] I tested a quantized version five days later on a single NVIDIA RTX 3090 — partly because it was the … Read more