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Atrial flutter (AFL) is a common atrial arrhythmia typically characterized by electrical activity propagating around specific anatomical regions. It is usually treated with catheter ablation. However, the identification of rotational activities is not straightforward, and requires an intense effort during the first phase of the electrophysiological (EP) study, i.e., the mapping phase, in which an anatomical 3D model is built and electrograms (EGMs) are recorded. In this study, we modeled the electrical propagation pattern of AFL (measured during mapping) using network theory (NT), a well-known field of research from the computer science domain. The main advantage of NT is the large number of available algorithms that can efficiently analyze the network. Using directed network mapping, we employed a cycle-finding algorithm to detect all cycles in the network, resembling the main propagation pattern of AFL. The method was tested on two subjects in sinus rhythm, six in an experimental model of in-silico simulations, and 10 subjects diagnosed with AFL who underwent a catheter ablation. The algorithm correctly detected the electrical propagation of both sinus rhythm cases and in-silico simulations. Regarding the AFL cases, arrhythmia mechanisms were either totally or partially identified in most of the cases (8 out of 10), i.e., cycles around the mitral valve, tricuspid valve and figure-of-eight reentries. The other two cases presented a poor mapping quality or a major complexity related to previous ablations, large areas of fibrotic tissue, etc. Directed network mapping represents an innovative tool that showed promising results in identifying AFL mechanisms in an automatic fashion. Further investigations are needed to assess the reliability of the method in different clinical scenarios.

Ultra-performance liquid chromatography - mass spectrometry (UPLC-MS) is widely used for untargeted metabolomics in biomedical research. To optimize the quality and precision of UPLC-MS metabolomic analysis, evaluation of blank samples for the elimination of background features is required. Although blanks are usually run either at the beginning or at the end of a sequence of samples, a systematic analysis of their effect of the instrument performance has not been properly documented. Using the analysis of two common bio-fluids (plasma and urine), we describe how the injection of blank samples within a sequence of samples may affect both the chromatographic and MS detection performance depending on several factors, including the sample matrix and the physicochemical properties of the metabolites of interest. The analysis of blanks and post-blank conditioning samples using t-tests, PCA and guided-PCA provides useful information for the elimination of background UPLC-MS features, the identification of column carry over and the selection of the number of samples required to achieve a stable performance.

Aim: The aim of this study was to evaluate the implant survival and the implant-crown success of implants with surface treated with organic acids. Materials and methods: A total of 273 implants (Implus®, Leader-Novaxa, Milan, Italy) were inserted in 63 patients, from June 2006 to June 2010, in a single clinical centre. In each annual follow up session, clinical, radiographic and prosthetic parameters were evaluated. The implant-crown success criteria included the absence of pain, suppuration and clinical mobility, a distance between the implant shoulder and the first visible bone contact (DIB)

To evaluate the influence of at least three abutment changes against the placement of a definitive abutment, which was no longer removed, on hard and soft tissue changes, and to compare the clinical outcomes of immediate non-occlusal loading versus conventional loading.Eighty patients requiring one single crown or one fixed partial prosthesis supported by a maximum of three implants were randomised, after implants were placed with more than 35 Ncm, according to a parallel group design to receive definitive abutments which were loaded immediately (definitive abutment or immediate loading group) or transmucosal abutments which experienced delayed loading after 3 months and were removed at least three times: 1) during the making of the impression (3 months after implant placement); 2) when checking the zirconium core of titanium abutments at single crowns or the fitting of the metal structure at prostheses supported by multiple implants; 3) at delivery of the definitive prostheses (repeated disconnection or conventional loading group). Patients were treated in four centres and each patient contributed to the study with only one prosthesis followed for 4 months after initial loading. Outcome measures were: prosthesis/implant failures, any complication, peri-implant marginal bone level changes, and patient satisfaction.Forty patients were randomly allocated to each group according to a parallel group design. No patient dropped-out and no implants failed. However four provisional prostheses and one definitive prosthesis had to be remade because of misfitting (five single crowns) in the repeated disconnection group; and one provisional prosthesis had to be remade because of frequent debondings in the immediate loading group (difference=10%; 95% CI: -1%, 21%; P=0.109). Five complications (all debondings of the provisional prostheses) were reported in two patients of the immediate loading group, in comparison to three biological complications in three patients of the repeated disconnection group (difference=2%; 95% CI: -8%, 13%; P=1). All patients were very satisfied or satisfied with the function and aesthetics of the prostheses, and would undergo the same procedure again. Mean peri-implant marginal bone loss 4 months after loading was -0.08 (0.16) mm for the definitive abutment group and -0.09 (0.20) mm for the repeated abutment changes group (difference=0.01; 95% CI: -0.07, 0.09; P=0.97). There were no statistically significant differences for any of the outcome measures between the two procedures up to 4 months after initial loading.Preliminary short-term data (4-month post-loading) showed that repeated abutment changes do not alter bone levels significantly. Immediate non-occlusal loading of dental implants are a viable alternative to conventional loading. Therefore clinicians can use the procedure they find more convenient for their specific patient.

Conoscenza scientifica dei meccanismi dell'evento sismico e consistenza della morfologia insediativa

Purpose The maxillary sinus lift is recognized and stable, and there have been different innovations to optimize the technique. The aim of this study was to investigate the maxillary sinus lift technique with the use of a blood clot and without the use of a bone graft. Materials and Methods Ten patients were recruited for a unilateral sinus lift; patients without sinus pathology or other contraindication were selected. The maxillary sinus was accessed conventionally under local anesthesia followed by an osteotomy and a 1-cm 2 bony window access. The sinus membrane was detached and the window was repositioned above and stabilized with a 12- or 14-mm osteosynthesis screw introduced through the alveolar ridge. Dental implants were installed in the second surgical stage. Standardized panoramic radiographic checks were performed at every stage. Results Seven completely edentulous patients and 3 partially dentate patients were treated surgically. From the first to the second surgery, a bone gain of 2.37 mm was obtained, although loss of bone height was observed in 1 completely edentulous patient. In 7 patients, it was not possible to install the implants owing to insufficient bone height or inadequate bone quality. Conclusion The protocol used in this investigation failed in the bone increase required for implant installation.

Edizione: Centro Studi Arte Figurative, Università di Tokio

Atti Convegno Lincei: La stabilità del suolo in Italia: zonazione sismica-frane

The seismic ground motion of a test area in the eastern district of Naples is computed with a hybrid technique based on the mode summation and the finite difference methods. This technique allows us the realistic modelling of source and propagation effects, including local soil conditions. In the modelling, we consider the 1980 Irpinia earthquake, a good example of strong shaking for the area of Naples, which is located about 90 km from the epicenter. The detailed geological setting is reconstructed from a large number of drillings. The sub-soil is mainly formed by alluvial (ash, stratified sand and peat) and pyroclastic materials overlying a pyroclastic rock (yellow neapolitan tuff). representing the neapolitan bedrock. The detailed information available on mechanical properties of the sub-soil and its geometry warrants the application of the sophisticated hybrid technique. As expected, the sedimentary cover causes an increase of the signal's amplitudes and duration. If thin peat layers are present, the amplification effects are reduced, and the peak ground accelerations are similar to those observed for the bedrock model. This can be explained by the backscattering of wave energy at such layers, that tend to seismically decouple the upper from the lower part of the structure. For SH-waves, the influence of the variations of the S-wave velocities on the spectral amplification is studied, by considering locally measured velocities and values determined from near-by-down-hole measurements. The comparison between the computed spectral amplifications confirms the key role of an accurate determination of the seismic velocities of the different layers. The comparison performed between a realistic 2-D seismic response and a standard 1-D response, based on the vertical propagation of waves in a plane layered structure, shows considerable difference, from which it is evident that serious caution must be taken in the modelling of expected ground motion at a specific site.

L'Anatomo-patologo si è avvalso da sempre, nell'esercizio della sua profesione, dell'opera di personale tecnico la cui attiva collaborazione è richiesta sia per l'esecuzione dei preparati istologici e citologici. La figura professionae del tecnio è cresciuta di importanza, specie in anni recenti, con l'introduzione di moderne tecniche istologiche.....