27 research outputs found
Culture Takeaway
No full textThis keynote is mainly based on Wallace's research for Volume X of La Cultura Italiana published by UTET in 2010. The volume is in Italian and, by translating it, it can now be shared with colleagues, students and friends. The relationship that each citizen has with his/her own country and culture is mediated by personal experiences and matured during a lifetime. It is a delicate task to identify what motivates the consciousness of “insiders” of a culture whilst, at the same time, stimulating the interest of outsiders. To be able to observe the prodigious artistic production of one’s own country from the point of view of another culture and another genetic material offers fresh cues. Curiosity, prodded by geographical and physical distance, helps to identify in a schematic way those characteristics that define a country’s visual culture in a decisively distinctive way
The role of tax assessment in the fight against criminal phenomena
No full textLo scritto si occupa del possibile ruolo che l’attività di accertamento effettuata dall’Amministrazione finanziaria può assumere nella lotta ai fenomeni criminali. Ricostruendo i principali strumenti di accertamento sia in ambito nazionale che internazionale, l’Autore si interroga sui possibili punti di contatto e sulle sinergie interistituzionali che possono instaurarsi fra l’Amministrazione finanziaria e l’Autorità penale.The paper addresses the potential role that the assessment activity carried out by the Tax Administration can play in the fight against criminal phenomena. By reconstructing the main assessment tools at both national and international levels, the Author examines the possible contacts and the inter-institutional synergies that may be established between the Tax Administration and the Criminal Justice Authority
New Imaging Technologies To Characterize Arrhythmic Substrate
No full textThe cornerstone of the new imaging technologies to treat complex arrhythmias is the electroanatomic (EAM) mapping. It is based on tissue characterization and in particular on determination of low potential region and dense scar definition. Recently, the identification of fractionated isolated late potentials increased the specificity of the information derived from EAM. In addition, non-invasive tools and their integration with EAM, such as cardiac magnetic resonance imaging and computed tomography scanning, have been shown to be helpful to characterize the arrhythmic substrate and to guide the mapping and the ablation. Finally, intracardiac echocardiography, known to be useful for several practical uses in the setting of electrophysiological procedures, it has been also demonstrated to provide important informations about the anatomical substrate and may have potential to identify areas of scarred myocardium
Biomarkers Of Myocardial Injury With Different Energy Sources For Atrial Fibrillation Catheter Ablation
No full textPediatric surgery and International Cooperation: case study at Malindi Subcounty Hospital, Kenya
No full text“Bimbo semplice che fui / dal cuore in mano e dalla fronte alta”: sui modi di dire nella poesia di Guido Gozzano
No full textIn this paper, we will focus on a few poems by Guido Gozzano, which are taken from the only poetic collections published by the author during his lifetime: La via del rifugio (1907) and I colloqui (1911). Several collocations will be examined, i.e. some sequences of words linked together by more or less solid, more or less fixed connections. Of these, moreover, we will attempt to outline very briefly the history, the evolution in the field of Italian literature from its origins up to contemporary times, because it is precisely from the diachronic study of such material that it will be possible to derive information on the function it plays in Gozzani's poetry. On the other hand, as Uberto Motta stated: «studying the “sources” of a text, reconstructing its references and the comparisons generated from the words and images of which it is composed, [...] allows us to relocate it within the system [...] into which it was conceived». As we will try to demonstrate, idiomatic expressions, because of their fixedness, participate in that operation which allows the poet of I Colloqui to «satisfy the radical need [...] to possess something that is now past, immobile». Therefore, the presence of this phenomena of crystallisation of language (literary and daily), of a word which can no longer mutate, which becomes a certain and secure anchorage, takes on absolute importance. A word which, thanks to its own immobility, is perceived by Gozzano as a stable landing place, and ends up constituting the one and only reassuring «way of refuge»
Electrostatic Map of Proteasome α-Rings Encodes the Design of Allosteric Porphyrin-Based Inhibitors Able to Affect 20S Conformation by Cooperative Binding
No full textThe importance of allosteric proteasome inhibition in the treatment of cancer is becoming increasingly evident. Motivated by this urgent therapeutic need, we have recently identified cationic porphyrins as a highly versatile class of molecules able to regulate proteasome activity by interfering with gating mechanisms. In the present study, the mapping of electrostatic contacts bridging the regulatory particles with the α-rings of the human 20S proteasome led us to the identification of (meso-tetrakis(4-N-methylphenyl pyridyl)-porphyrin (pTMPyPP4) as a novel non-competitive inhibitor of human 20S proteasome. pTMPyPP4 inhibition mechanism implies a positive cooperative binding to proteasome, which disappears when a permanently open proteasome mutant (α-3ΔN) is used, supporting the hypothesis that the events associated with allosteric proteasome inhibition by pTMPyPP4 interfere with 20S gating and affect its "open-closed" equilibrium. Therefore, we propose that the spatial distribution of the negatively charged residues responsible for the interaction with regulatory particles at the α-ring surface of human 20S may be exploited as a blueprint for the design of allosteric proteasome regulators. © 2017 The Author(s)
High-density substrate-guided ventricular tachycardia ablation: Role of activation mapping in an attempt to improve procedural effectiveness
No full textBackground Advanced techniques of electroanatomical mapping efficiently guide ventricular tachycardia (VT) ablation strategies; in this context, the adjunctive value of combining activation mapping (AMap) to improve accuracy has not been elucidated. Objective To investigate whether conventional AMap further contributes to the identification of critical sites of VT reentry and whether this translates into a more effective ablation outcome in a cohort of patients undergoing VT ablation. Methods We prospectively enrolled 126 patients (mean age 65.3 ± 10.5 years; left ventricular ejection fraction 33.3% ± 7.2%) with ischemic (n = 89) or idiopathic (n = 37) dilated cardiomyopathy undergoing endocardial (n = 105) or endo-epicardial (n = 21) electroanatomical mapping and ablation. A substrate-guided strategy targeting surrogate markers of reentry was accomplished in all patients, but the feasibility and efficacy of AMap was preliminarily assessed for all induced VTs focusing on early VT suppression obtained during radiofrequency delivery. VT-free survival was assessed by ICD interrogation. Results AMap successfully guided ablation in 62 of 104 (59.6%) patients with inducible VT(s). At 1 year, 6 of 126 (4.8%) patients died; VT recurred in 28 of 126 (22.2%) patients. No significant difference in VT recurrence rate was observed between patients in whom AMap proved effective versus those in whom substrate-guided ablation was not corroborated by AMap (16 of 62 [25.8%] vs 12 of 64 [18.8%]; log-rank test, P =.3). Conclusions Our findings support the efficacy of a substrate-guided strategy targeting specific markers of arrhythmogenicity identified during sinus rhythm. AMap proves highly efficient acutely but does not improve overall VT-free survival, suggesting that in patients with advanced cardiac disease, life-threatening arrhythmias can be successfully treated by ablation in sinus rhythm, thus limiting procedural risks
Concomitant cryoballoon ablation and percutaneous closure of left atrial appendage in patients with atrial fibrillation
No full textAims Pulmonary veins (PVs) isolation is the cornerstone of atrial fibrillation (AF) ablation and can be achieved either by conventional radiofrequency ablation or by cryoenergy. Left atrial appendage (LAA) closure has been proposed as alternative treatment to vitamin K antagonists (VKA). We aimed to evaluate the feasibility of combining cryoballoon (CB) ablation and LAA occlusion in patients with AF and a high thromboembolic risk or contraindication to antithrombotic therapy. Methods and results Thirty-five patients (28 males, 74 ± 2 years) underwent CB ablation. Left atrial appendage occlusion was carried out by using two occluder devices (Amplatz Cardiac Plug, ACP, St. Jude Medical, MN, USA, in 25 patients; Watchman, Boston Scientific, MA, USA, in 10 patients). Thirty patients (86%) had previous stroke/TIA episodes, 6 patients (17%) had major bleeding while on VKA therapy, and 7 patients (20%) had inherited bleeding disorders. Over the follow-up (24 ± 12 months), atrial arrhythmias recurred in 10 (28%) patients. Thirty patients (86%) had complete sealing; 5 patients (14%) showed a residual flow (<5 mm) at first transoesophageal echocardiography (TEE) check, while at 1-year TEE residual flow was detected in 3 patients. In 13 patients (37%), VKA therapy was immediately discontinued. Six patients (17%) received novel oral anticoagulants treatment and then discontinued 3 months thereafter. No device-related complications or clinical thromboembolic events occurred. Conclusion Combined CB ablation and LAA closure using different devices appears to be feasible in patients with non-valvular AF associated with high risk of stroke or contraindication to antithrombotic treatment
The growing culture of a minimally fluoroscopic approach in electrophysiology lab
No full textAbstract
Most of interventional procedures in cardiology are carried out under fluoroscopic imaging guidance. Besides other peri-interventional risks, radiation exposure should be considered for its stochastic (inducing malignancy) and deterministic effects on health (tissue reactions like erythema, hair loss and cataracts). In this article we analized the radiation risk from cardiovascular imaging to both patients and medical staff and discusses how customize the X-ray system and how to implement shielding measures in the cath lab. Finally, we reviewed the most recent developments and the latest findings in catheter navigation and 3D electronatomical mapping systems that may help to reduce patient and operator exposure
