49 research outputs found

    Indexed left atrial volume is superior to left atrial diameter in predicting nonvalvular atrial fibrillation recurrence after successful cardioversion: a prospective study.

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    BACKGROUND: Although indexed left atrial volume (iLAV) is the most accurate measure of left atrial size, it has not been evaluated prospectively as predictor of recurrence of atrial fibrillation (AFib) after successful cardioversion (CV). METHODS: We prospectively selected 76 patients (mean age 66.1 ± 13.6 years, 65.8% men) with AFib who underwent successful CV. Baseline clinical and echocardiographic characteristics were obtained before CV. LAV was measured using Simpson's method and indexed to body surface area. All patients were scheduled for follow-up visit at 1, 6, 12 months, and then annually. A 24-hour Holter ECG was performed within 6 months and each time the patients reported symptoms suggestive of arrhythmia. RESULTS: The 52 patients (68.4%) with AFib recurrence had larger iLAV (35.5 ± 8.9 mL/m(2) vs 27.0 ± 6.7 mL/m(2) , P < 0.001). Anteroposterior LA diameter was not associated with AFib relapse (OR 1.08, 95% CI: 0.96-1.21, P = 0.09). Each unit increase in iLAV was associated with a 1.15-fold increased risk of recurrence (OR 1.15, 95% CI: 1.06-1.25, P < 0.001). In a multivariable model, iLAV remained the only independent predictor of relapse (adjusted OR 1.14, 95% CI: 1.02-1.28, P = 0.02). The area under ROC curves, generated to compare LA diameter, and iLAV as predictors of AFib recurrence were 0.56 (SE 0.07) versus 0.78 (SE 0.05), respectively (P = 0.003). CONCLUSION: This is the first prospective study to show that larger iLAV, as a more accurate measure of LA remodeling than anteroposterior diameter, is strongly and independently associated with a higher risk of AFib recurrence after CV

    Interleukin-34 sustains pro-tumorigenic signals in colon cancer tissue

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    Interleukin-34 (IL-34), a cytokine produced by a wide range of cells, binds to the macrophage colony-stimulating factor receptor (M-CSFR-1) and receptor-type protein-tyrosine phosphatase zeta (PTP-z) and controls myeloid cell differentiation, proliferation and survival. various types of cancers over-express IL-34 but the role of the cytokine in colorectal cancer (CRC) remains unknown. We here investigated the expression and functional role of IL-34 in CRC. A more pronounced expression of IL-34 was seen in CRC samples as compared to matched normal/benign colonic samples and this occurred at both RNA and protein level. Immunohistochemical analysis of CRC tissue samples showed that both cancer cells and lamina propria mononuclear cells over-expressed IL-34. Additionally, CRC cells expressed both M-CSFR-1 and PTP-z, thus suggesting that CRC cells can be responsive to IL-34. Indeed, stimulation of DLD-1 cancer cells with IL-34, but not with MSCF1, enhanced the cell proliferation and cell invasion without affecting cell survival. Analysis of intracellular signals underlying the mitogenic effect of IL-34 revealed that the cytokine enhanced activation of ERK1/2 and pharmacologic inhibition of ERK1/2 abrogated IL-34-driven cell proliferation. Consistently, IL-34 knockdown in HT-29 cells with a specific IL-34 antisense oligonucleotide reduced ERK1/2 activation, cell proliferation and enhanced the susceptibility of cells to Oxaliplatin-induced death. This is the first study showing up-regulation of IL-34 in CRC and suggesting a role for this cytokine in colon tumorigenesis

    Patrimonio ambientale e creazione del valore. Il turismo come fattore di cambiamento sociale ed economico-aziendale in Provincia di Siena.

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    Il percorso cognitivo seguito nell’indagine muove dalla definizione del quadro concettuale di riferimento in ambito turistico, per poi soffermarsi sugli aspetti definitori e normativi dell’attività agrituristica. Su tali impostazioni presenteremo i risultati di un’indagine empirica svolta nell’intento di apprezzare, in termini evolutivi, la dimensione qualitativa e quantitativa del fenomeno turistico considerato nell’ambito dell’economica nazionale. Da tale livello di studio discenderemo per individuare le caratteristiche che rendono peculiare l’esercizio dell’attività agrituristica nella Regione Toscana per poi giungere alla descrizione dello scenario della Provincia di Siena

    Carbon leakage: an overview. CEPS Special Report No. 79, 6 December 2013

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    Carbon leakage is central to the discussion on climate policy, given the confluence of issues that are currently being debated, including the 2030 Energy and Climate Framework and the review of the EU carbon leakage list by 2014. Carbon leakage is the result of asymmetrical carbon policies, especially carbon pricing, and the resulting carbon cost, which affects the international competitive position of some EU industry and could displace production and/or investment, and the emissions of the activities displaced. This paper identifies the difference between carbon price and carbon cost to leakage exposed industry as one of two fundamental issues to be understood and addressed; lack of visibility on future climate policies and anti-leakage provisions is the other key issue. While this is a global issue, most of the experience has been accumulated in the EU. Carbon leakage is only one of the factors that could affect the competitive position of sectors, but it is difficult to attribute the impact of carbon costs versus other variables such as energy costs, labour, etc. Studies have predicted the risk of a significant amount of production leakage in a number of energy-intensive industries. To address the danger, they were included in the EU ETS carbon leakage list, which gave them access to free allowances. However, a limited number of studies undertaken after the end of the second trading period (2012) show little evidence of production leakage and asks the question whether the issue has not been blown out of proportion. The paper argues that the past may not be a good representation of the future, as it was heavily influenced by a high level of free allocation, the exceptional economic downturn, CO2 prices significantly below what was anticipated, as well as the potential for changes in some fundamental variables such as the shrinking pool of allowances available for free allocation. It emphasises the need for a well-informed debate in the EU on measures to address carbon leakage post-2020, underpinned by a number of options, and objective criteria to evaluate those options. It emphasises that the debate should cover both investment and production leakage, caused by both direct and indirect carbon costs

    El debilitamiento de las oclusivas coronales en francés y en español: pruebas electopalatográficas

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    Lenition of voiced and, to a lesser extent, voiceless stops is widely attested in Western Romance languages. In Spanish, utterance-initial voiced stops as well as those following nasals alternate with approximants in intervocalic position. Acoustic and articulatory studies have revealed factors that condition phonetic weakening. In contrast, very little is known about stop weakening in French. In this paper, using electropalatography, we provide articulatory evidence for the lenition of /t d/ in both Spanish and French. Data obtained from seven Spanish-speaking and four French-speaking participants reveal that, in both languages, /d/ is produced with less linguopalatal contact than /t/, and these differences are strongly conditioned by the position within the utterance or word. The languages differ, however, in the degree of /d/ lenition as well as in some of the contextual conditioning factors. Overall, our results, which should be interpreted with some caution given the number of speakers and the balance of the stimuli set, show that French resembles other Romance languages in its phonetic patterns of lenition, differing mainly in the degree of weakening.El debilitamiento de las oclusivas sonoras, y, en menor medida, el de las sordas, es un proceso frecuente en las lenguas románicas. En español, las oclusivas sonoras en posición inicial absoluta y después de nasal alternan con aproximantes en posición intervocálica. Aunque se han realizado estudios articulatorios y acústicos acerca del debilitamiento en español, poco se sabe acerca de los patrones de debilitamiento en francés. En este trabajo, se presenta evidencia sobre el debilitamiento de /t d/ en ambas lenguas, por medio de datos obtenidos de cuatro hablantes de francés y siete de español usando electropalatografía (EPG). Los resultados muestran que en ambas lenguas /d/ se articula con menos contacto linguo-palatal que /t/ y que las diferencias en los patrones de contacto están condicionadas por la posición en la palabra y en la frase. Ambas lenguas difieren en el grado de debilitamiento de /d/ y en algunos de los factores contextuales que lo afectan. En resumen, los resultados provenientes de esta pequeña muestra de hablantes revelan que el francés se asemeja a otras lenguas románicas en los patrones fonéticos de debilitamiento, aunque difiere en el grado de debilitamiento
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