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Paravalvular leak can complicate transcatheter aortic valve replacement with important prognostic implications. Correction of defects requires complex planning and execution. Multiple or irregular lesions, calcified annulus, and high sealing skirts on self-expandable devices are especially challenging. Such defects may be approximated using malleable vascular closure devices. (Level of Difficulty: Intermediate.)

Crystalline micrometer size stripes in 2.2 μm thick Ge2Sb2Te5 phase-change material films were produced by irradiation with a Continuous Wave Laser of 405 nm wavelength. The shape and the dimensions of the crystallized regions were investigated by Transmission Electron Microscopy and then compared with simulations based on temperature-crystal growth velocity literature data. The temperature-time profile was determined taking into account the laser power, the optical and thermal properties of both the amorphous and crystalline phase. The mechanical properties of the amorphous and of the crystallized regions were characterized by an ultra nano-indentation technique. This procedure allows a direct and local measurement of hardness and Young's modulus in the amorphous and in the contiguous crystalline regions on the micrometer scale. The following values for Young's modulus and for hardness were obtained: 33±4 GPa and 2.00±0.3 GPa for the amorphous phase, and 51±8 GPa and 2.90±0.45 GPa for the crystalline phase. The stresses induced by the density increase in the crystallized region cause, on the irradiated surface, a series of fracture whose characteristic behavior depends on the laser power and on the spacing between two contiguous scans. These results are of relevance for the mechanical failure mechanisms in potential phase-change devices.

The COVID-19 disease spread at different rates in the different countries and in different regions of the same country, as happened in Italy. Transmission by contact or at close range due to large respiratory droplets is widely accepted, however, the role of airborne transmission due to small respiratory droplets emitted by infected individuals (also asymptomatic) is controversial. It was suggested that outdoor airborne transmission could play a role in determining the differences observed in the spread rate. Concentrations of virus-laden aerosol are still poorly known and contrasting results are reported, especially for outdoor environments. Here we investigated outdoor concentrations and size distributions of virus-laden aerosol simultaneously collected during the pandemic, in May 2020, in northern (Veneto) and southern (Apulia) regions of Italy. The two regions exhibited significantly different prevalence of COVID-19. Genetic material of SARS-CoV-2 (RNA) was determined, using both real time RT-PCR and ddPCR, in air samples collected using PM10 samplers and cascade impactors able to separate 12 size ranges from nanoparticles (diameter D 18 µm). Air samples tested negative for the presence of SARS-CoV-2 at both sites, viral particles concentrations were

Polycrystalline tungsten is a promising candidate for future fusion applications as plasma facing material due to its good thermophysical properties at high temperatures. Fracture mechanical properties of sintered and rolled, commercially available polycrystalline tungsten are characterized taking into account the strong anisotropy due to different grain shape and orientation with respect to the rolling direction. The fracture mechanics investigations are accompanied by fractographic analyses of two tungsten plate grades with varying cold working ratios of two different manufacturers (PLANSEE SE, Austria and A.L.M.T Corp., Japan). In this respect three point bending tests (3-PB) with sub sized fracture mechanical specimens in different orientations of the anisotropic microstructure are performed at three temperatures, ranging from 25 °C to 400 °C at a deflection rate of 2 µm s − 1. In addition, crack initiation and crack growth mechanisms depending on texture and cold working ratio are investigated by means of scanning electron microscopy (SEM). Key words: Fracture toughness, Polycrystalline tungsten, Orientations dependency, Crack path analysis

Deficits in attention are a common and devastating consequence of traumatic brain injury (TBI), leading to functional impairments, rehabilitation barriers, and long-term disability. While such deficits are well documented, little is known about their underlying pathophysiology hindering development of effective and targeted interventions. Here we evaluate the integrity of brain systems specific to attentional functions using quantitative assessments of electroencephalography recorded during performance of the Attention Network Test (ANT), a behavioral paradigm that separates alerting, orienting, and executive components of attention. We studied 13 patients, at least 6 months post-TBI with cognitive impairments, and 24 control subjects. Based on performance on the ANT, TBI subjects showed selective impairment in executive attention. In TBI subjects, principal component analysis combined with spectral analysis of the EEG after target appearance extracted a pattern of increased frontal midline theta power (2.5–7.5 Hz) and suppression of frontal beta power (12.5–22.5 Hz). Individual expression of this pattern correlated (r = −0.67, p

Background: Risk assessment at diagnosis is crucial for neuroblastoma (NB) in order to address patients at high-risk to the most timely and appropriate treatments. 3-O-methyldopa (3-OMD), a direct metabolite of L-Dopa, is a promising biomarker of NB at diagnosis able to stratify high-risk patients., Methods: We show the development and validation of a method for measuring 3-OMD from dried plasma samples (DPS) and plasma using liquid chromatography coupled with high resolution mass spectrometry (LC-HRMS) on a Thermo Fisher Scientific Orbitrap Exploris 120., Results: The method was accurate and reproducible in the range 7.8-4000 ng/mL, from small amounts (50 mL) of plasma and DPS (obtained starting from 30 mL plasma). 3-OMD concentrations measured in plasma and DPS were highly correlated (R = 0.99 95 %CI 0.993-0.996). Differences of 3-OMD levels across stages L1 and M and L1 and L2 (p-value < 0.05) were statistically significant. Receiving Operator Curve (ROC) analysis showed that 3-OMD was able to discriminate patients at high-risk with high sensitivity and specificity both from plasma or DPS (AUC = 0.8295 %CI 0.71-0.94, P < 0.0001)., Conclusions: 3-OMD is confirmed as an interesting biomarker of high-risk NB. The described method is an added value for further prospective studies involving multiple sites. The stability of 3-OMD in DPS allows for easy shipment and storage at room temperature., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Lipotoxicity refers to the harmful effects of excess fatty acids on metabolic health, and it can vary depending on the type of fatty acids involved. Saturated and unsaturated fatty acids exhibit distinct effects, though the precise mechanisms behind these differences remain unclear. Here, we investigated the lipotoxicity of palmitic acid (PA), a saturated fatty acid, compared with oleic acid (OA), a monounsaturated fatty acid, in the hepatic cell line HuH7. Our results demonstrated that PA, unlike OA, induces lipotoxicity, endoplasmic reticulum (ER) stress, and autophagy inhibition. Compared with OA, PA treatment leads to less lipid droplet (LD) accumulation and a significant reduction in the mRNA and protein level of diacylglycerol acyltransferase 1 (DGAT1), a key enzyme of triacylglycerol synthesis. Using modulators of ER stress and autophagy, we established that DGAT1 downregulation by PA is closely linked to these cellular pathways. Notably, the ER stress inhibitor 4-phenylbutyrate can suppress PA-induced DGAT1 downregulation. Furthermore, knockdown of DGAT1 by siRNA or with A922500, a specific DGAT1 inhibitor, resulted in cell death, even with OA. Both PA and OA increased the oxygen consumption rate; however, the increase associated with PA was only partially coupled to ATP synthesis. Importantly, treatment with GW7647 a specific PPARα agonist mitigated the lipotoxic effects of PA, restoring PA-induced ER stress, autophagy block, and DGAT1 suppression. In conclusion, our study highlights the crucial role of DGAT1 in PA-induced lipotoxicity, broadening the knowledge of the mechanisms underlying hepatic lipotoxicity and providing the basis for potential therapeutic interventions., Competing Interests: Conflict of interests The authors declare that they have no conflicts of interest with the contents of this article., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: This study aimed to evaluate the impact of pH on the dentin piezoelectric response in root canal treated teeth., Materials and Methods: Thirty extracted mandibular canines were selected by simple random sampling and based on specific inclusion criteria. The middle third of each root was cut into cubic specimens of approximately 2 mm × 2 mm x 4 mm. The prepared samples were soaked in 17% EDTA and 1% sodium hypochlorite for 1 minute. The sections were rinsed in distilled water, dried immediately, and then randomly allocated into 3 groups of 10 each. Samples in each group were soaked in one of 3 solutions with pH 4.4, 7.4, or 10.4 for 5 min. A compression load was applied by a universal mechanical testing machine. The 8000-8-SM scanner detected the potential generated., Results: No significant differences were observed among the groups when the force was applied vertical to the dentinal tubules (P > .05). However, all subgroups indicated significant differences when the force was applied along the dentinal tubules (P < .05). When the force was applied along to the tubules, the mean dentin piezoelectricity was higher in the alkaline, neutral, and acidic groups, respectively., Conclusion: This study demonstrated that the piezoelectric properties of dentin in root canal treated teeth can be influenced by variations in pH, depending on the direction of force applied to the dentinal tubules., (Copyright © 2024. Published by Elsevier Inc.)

In recent years, epigenetics has been revealed as a mechanism able to modulate the expression of virulence traits in diverse pathogens, including Candida albicans. Indeed, epigenetic regulation can sense environmental changes, leading to the rapid and reversible modulation of gene expression with consequent adaptation to novel environments. How epigenetic changes can impact expression and signalling output, including events associated with mechanisms of morphological transition and virulence, is still poorly studied. Here, using nicotinamide as a sirtuin inhibitor, we explored how the accumulation of the H3K56 acetylation, the most prominent histone acetylation in C. albicans, might affect its interaction with the host. Our experiments demonstrate that H3K56 acetylation profoundly affects the production and/or secretion of soluble factors compromising actin remodelling and cytokine production. ChIP- and RNA-seq analyses highlighted a direct impact of H3K56 acetylation on genes related to phenotypic switching, biofilm formation and cell aggregation. Direct and indirect regulation also involves genes related to cell wall protein biosynthesis, β-glucan and mannan exposure, and hydrolytic secreted enzymes, supporting the hypothesis that the fluctuations of H3K56 acetylation in C. albicans might impair the macrophage response to the yeast and thus promote the host-immune escaping., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have influenced the work described in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Recent years have seen a rise in wildfire and extreme weather activity across the globe, which is projected to keep increasing with climate-induced conditions. Air pollution, especially fine particulate matter (PM 2.5 ) concentration, is heavily affected by PM 2.5 emissions from wildfire activity. Paraguay has been historically suffering from fires, with an average of 2.3 million hectares burnt per year during the 2003-2021 period. Annual PM 2.5 concentration in Paraguay is 13.2 μg/m 3 , more than double the recommended by the WHO. We estimate that, historically, almost 40 % of fine air particulates can be attributed to fires. Using a random forest algorithm, we estimate future fire activity and fire related PM 2.5 under different climate change scenarios. With global warming, we calculate that fire activity could increase by up to 120 % by 2100. Annual fire smoke PM 2.5 from fires is expected to increase by 7.7 μg/m 3 by 2100. Under these conditions, Paraguay is expected to suffer an increase in 3500 deaths per year attributable to fire smoke PM 2.5 by 2100. We estimate the economic cost of fire smoke-related mortality by 2100 at US $ 5600 million, equivalent to 2.6 % of Paraguay's GDP, excluding other health- and productivity-related impacts on society., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Nicolas Borchers-Arriagada reports financial support was provided by World Bank Group. Paulina Schulz-Antipa reports financial support was provided by World Bank Group. Mariana Conte-Grand reports was provided by World Bank Group., (Copyright © 2024 © 2024 The World Bank. Published by ELSEVIER B.V. Published by Elsevier B.V. All rights reserved.)

Psoriasis is one of the most common immune-mediated inflammatory diseases (IMIDs). Living in a rural environment during childhood is associated with a decreased risk of certain IMIDs, like asthma, in adulthood. However, its role in other IMIDs, such as psoriasis is still unclear. To evaluate the relationships between different factors related to the environment during childhood and the risk of psoriasis in adulthood we conducted a study in E3N, a French prospective cohort composed of 98 995 women. During the 1990-2018 follow-up of 72 154 study participants, we identified 1 967 incident cases of psoriasis from self-reports in self-administered structured questionnaires. During the 2004-2018 follow-up of 67 917 study participants, 188 moderate-to-severe cases of psoriasis were identified through self-reports and from data from a drug reimbursement database. We fitted Cox proportional hazards regression models with age as the time scale from which we estimated hazard ratios adjusted for putative confounders (aHRs). We found inverse associations with risk of psoriasis for rural birthplace [aHR: 0.89 (95%CI: 0.79-0.96)] and for having farming parents [aHR: 0.84 (95%CI: 0.72-0.97)]. For moderate-to-severe psoriasis we found a nominally similar inverse association with rural birthplace but not with having farming parents. Our results suggest that an exposure to a rural environment during childhood may be associated with a reduced risk of psoriasis. These findings may help to improve our understanding of the pathogenesis of psoriasis., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: This study evaluated the effects of diabetes mellitus (DM) on the nanostructure of root canal dentin using high-resolution transmission electron microscopy (HRTEM) and inductively coupled plasma mass spectrometry (ICP-MS)., Methods: Twenty extracted human premolars from diabetic and nondiabetic patients (n = 10 in each group) were decoronated and sectioned horizontally into 40 2-mm-thick dentin discs, with each disc designated for a specific test. ICP-MS was used to determine the different elemental levels of copper, lithium, zinc, selenium, strontium, manganese, and magnesium in diabetic and nondiabetic specimens. HRTEM was used to analyze the shape and quantity of the apatite crystals in diabetic and nondiabetic dentin at the nanostructural level. Statistical analysis was performed using Kolmogorov-Smirnov and Student t test (P < .05)., Results: ICP-MS revealed significant differences in trace element concentrations between the diabetic and nondiabetic specimens (P < .05), with lower levels of magnesium, zinc, strontium, lithium, manganese, and selenium (P < .05), and higher levels of copper in diabetic specimens (P < .05). HRTEM revealed that diabetic dentin exhibited a less compact structure with smaller crystallites and significantly more crystals in the 2500 nm 2 area (P < .05)., Conclusion: Diabetic dentin exhibited smaller crystallites and altered elemental levels more than nondiabetic dentin, which could explain the higher root canal treatment failure rate in diabetic patients., (Copyright © 2023 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Atmospheric particulate matter (PM) is one of the major risks for global health. The exact mechanisms of toxicity are still not completely understood leading to contrasting results when different toxicity metrics are compared. In this work, PM 10 was collected at three sites for the determination of acellular oxidative potential (OP), intracellular oxidative stress (OSGC), cytotoxicity (MTT assay), and genotoxicity (Comet assay). The in vitro tests were done on the A549 cell line. The objective was to investigate the correlations among acellular and intracellular toxicity indicators, the variability among the sites, and how these correlations were influenced by the main sources by using PMF receptor model coupled with MLR. The OP DTT V , OSGC V , and cytotoxicity were strongly influenced by combustion sources. Advection of African dust led to lower-than-average intrinsic toxicity indicators. OP DTT V and OSGC V showed site-dependent correlations suggesting that acellular OP may not be fully representative of the intracellular oxidative stress at all sites and conditions. Cytotoxicity correlated with both OP DTT V and OSGC V at two sites out of three and the strength of the correlation was larger with OSGC V . Genotoxicity was correlated with cytotoxicity at all sites and correlated with both, OP DTT V and OSGC V , at two sites out of three. Results suggest that several toxicity indicators are useful to gain a global picture of the potential health effects of PM., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Objectives: There are few contemporary data regarding health-related quality of life (HRQOL) measures in patients with chronic limb-threatening ischemia (CLI)., Methods: The Best Endovascular versus Best Surgical Therapy in Patients with CLI (BEST-CLI) trial is an ongoing, National Institutes of Health-sponsored, multicenter, randomized, controlled trial comparing revascularization strategies in patients with CLI. BEST-CLI baseline HRQOL measures were evaluated for patient-specific variables that were associated with poor HRQOL and then compared with published outcomes. The HRQOL measures Vascular Quality of Life Questionnaire (VascQOL), European Quality of Life 5D (EQ-5D), and the Short Form 12 (SF-12) Index score, physical component score (PCS) and mental component score (MCS) were aggregated from preoperative questionnaires completed by trial patients at baseline visits. Multivariable linear regression models were fit to determine which baseline characteristics were associated with poor HRQOL., Results: We randomized 1830 patients into BEST-CLI. The majority (94.9%, 95.8%, and 95.8%) completed the VascQOL, EQ-5D, and SF-12 instruments at baseline, respectively. In the VascQOL, female sex, smoking history, opioid use, and nonindependent ambulation predicted lower HRQOL scores. Overall, VascuQOL scores were similar to those of participants in the Bypass versus Angioplasty in Severe Ischemia of the Leg (mean, 3.07 ± 1.2 vs mean, 2.9 ± 1.1; P = .07). In EQ-5D, nonindependent ambulation predicted lower HRQOL scores. In the SF-12, female sex, opioid use, nonindependent ambulation, and a history of smoking predicted lower HRQOL scores. The mean SF-12 PCS for all patients in the study was 33.0 ± 8.5 and for the MCS was 46.4 ± 12.0), significantly lower than the national SF-12 scores for US population ages more than 60 years, which is a PCS of 46.5 ± 11.4 and an MCS of 52.9 ± 8.7., Conclusions: Patients with CLI entering the BEST-CLI trial have very low HRQOL scores, comparable with patients suffering from other chronic conditions characterized by physical limitations and chronic pain. A history of smoking, impaired ambulation, opioid use, and female sex predicted lower HRQOL in patients with CLI, using multiple HRQOL measurement tools., (Copyright © 2022 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)

Background and Aims: Diagnosis of fish may represent an important challenge for the allergists. This study aimed to evaluate the diagnostic sensitivity of an in vitro multiplex assay using a comprehensive panel of fish allergens and the cross-reactivity patterns between different molecular components., Methods: 56 subjects with fish allergy were enrolled. All patients underwent specific IgE measurement using the Allergy Explorer-Alex 2™ multiplex assay (Macroarray Diagnostics, Vienna, Austria) RESULTS: The single ß-parvalbumins Clu h 1, Cyp c 1, Gad m 1, Sal s 1, Sco s 1, Thu a 1 and Xyp g 1 scored positive in 75.0%, 67.8%, 62.5%, 80.3%,80.3%, 78.8% and 73,2% patients, respectively. 14.3% scored positive for the α-parvalbumin (Raj c-parvalbumin), and 16.1% for the aldolase + enolase (Gad m 2 + 3) components. 92.8% reacted to at least one ß-parvalbumin and 96.4% to at least one of the allergens tested. Overall sensitivity was higher than that obtained using commercial extracts of cod, salmon and tuna for skin prick test (75.8%) and IgE detection (92.3%)., Conclusions: The Alex 2 showed high diagnostic sensitivity and it might be used as an additional assay to investigate the cross-reactivity patterns between different molecular components, looking for potentially safe fish species., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Airborne transmission of SARS-CoV-2 has been object of debate in the scientific community since the beginning of COVID-19 pandemic. This mechanism of transmission could arise from virus-laden aerosol released by infected individuals and it is influenced by several factors. Among these, the concentration and size distribution of virus-laden particles play an important role. The knowledge regarding aerosol transmission increases as new evidence is collected in different studies, even if it is not yet available a standard protocol regarding air sampling and analysis, which can create difficulties in the interpretation and application of results. This work reports a systematic review of current knowledge gained by 73 published papers on experimental determination of SARS-CoV-2 RNA in air comparing different environments: outdoors, indoor hospitals and healthcare settings, and public community indoors. Selected papers furnished 77 datasets: outdoor studies (9/77, 11.7%) and indoor studies (68/77. 88.3%). The indoor datasets in hospitals were the vast majority (58/68, 85.3%), and the remaining (10/68, 14.7%) were classified as community indoors. The fraction of studies having positive samples, as well as positivity rates (i.e. ratios between positive and total samples) are significantly larger in hospitals compared to the other typologies of sites. Contamination of surfaces was more frequent (in indoor datasets) compared to contamination of air samples; however, the average positivity rate was lower compared to that of air. Concentrations of SARS-CoV-2 RNA in air were highly variables and, on average, lower in outdoors compared to indoors. Among indoors, concentrations in community indoors appear to be lower than those in hospitals and healthcare settings., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Objectives: A novel approach in the evaluation of peripheral arterial disease is the photo-optical oxygen tension measurement (pTCpO2). This modality is suggested to be more practical in use in comparison to standard electro-chemical oxygen tension measurement. Hence, pTCpO2 might be of added value to evaluate revascularization of the lower extremities peri-procedural. We conducted a preliminary feasibility study to analyze the potential of pTCpO2 during revascularization., Methods: Ten patients scheduled for revascularization of the lower extremities were enrolled. pTCpO2 values of the affected lower extremity were measured pre-operatively, during revascularization and after revascularization. Results were compared to the pre- and postoperative ankle-brachial index (ABI) and to perioperative angiography. Primary endpoint was the feasibility of perioperative pTCpO2 measurement. Secondary endpoints were concordance between pTCpO2, ABI, angiography and clinical outcome., Results: Two out of twelve measurements were unsuccessful. Eight out of ten patients experienced significant clinical improvement and pTCpO2 increase. Two patients that did not experience clinical improvement corresponded with no changes in intraoperative angiography and without increase in ABI or pTCpO2. A significant and strong correlation was found between prior and after revascularization ABI and pTCpO2 measurements (r = 0.82 P = 0.04)., Conclusions: Photo-optical transcutaneous oxygen tension measurement may serve as an intraoperative tool to evaluate the success of revascularization. pTCpO2 could be an alternative for the ABI to determine the success of lower extremity revascularization., (Copyright © 2021. Published by Elsevier Inc.)

The aim of this work was characterization of airborne particulates in the port city of Rijeka in order to evaluate impact of ship emissions on air quality. Samples of airborne particulates were collected with a ten stages cascade impactor during two campaigns: autumn and spring. A total of 16 weekly samples were analyzed on mass concentration, ions, metals and carbonaceous species (EC, OC, WSOC). Distribution of airborne fractions showed a bimodal distribution, with two maxima: one in coarse, and other in fine fraction. Source apportionment using PMF receptor model identified six sources of airborne particulates in Rijeka: crustal, biomass burning, sea salt, traffic/metal industry, combustion/SIA and HFO burning, i.e., ship emission (contribution 3%). The contribution of ship traffic to primary emission of particulate matter, using vanadium as tracer, indicated a twofold increase for PM 10 and PM 2.5 relative to 2012-14. An unusual desert dust event was registered in autumn campaign., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Objective: Because the treatment of intermittent claudication (IC) is elective, good short- and long-term outcomes are imperative. The objective of the present study was to examine the outcomes of endovascular management of IC reported in the Vascular Quality Initiative and compare them with the Society for Vascular Surgery guidelines for IC treatment to determine whether real-world results are within the guidelines., Methods: Patients undergoing peripheral vascular intervention for IC from 2004 to 2017 with complete data and >9 month follow-up were included. The primary outcome measures were IC recurrence and repeat procedures performed ≤2 years after the initial treatment., Results: A total of 16,152 patients met the inclusion criteria, with a mean age of 66 years. Of the 16,152 patients, 61% were men, 45% were current smokers, and 28% had been discharged without antiplatelet or statin medication. Adjusted analyses revealed that treatment of more than two arteries was associated with a shorter time to IC recurrence (hazard ratio [HR], 1.19; 95% confidence interval [CI], 1.09-1.31) and a shorter time to repeat procedures (HR, 1.25; 95% CI, 1.09-1.45). The use of atherectomy was also associated with a shorter time to IC recurrence (HR, 1.29; 95% CI, 1.08-1.33) and a shorter time to repeat procedures (HR, 1.31; 95% CI, 1.13-1.52). Discharge with antiplatelet and statin medications was associated with a longer time to IC recurrence (HR, 0.84; 95% CI, 0.78-0.91) and a longer time to repeat procedures (HR, 0.77; 95% CI, 0.69-0.87). Life-table analysis at 2 years revealed that only 32% of patients were free from IC recurrence, although 76% had not undergone repeat procedures. Stratified by anatomic treatment level, 37% of isolated aortoiliac interventions, 22% of aortoiliac and femoropopliteal interventions, 30% of isolated femoropopliteal interventions, and 20% of femoropopliteal and tibial interventions had remained free from IC recurrence at 2 years., Conclusions: Most patients treated with an endovascular approach to IC did not meet the Society for Vascular Surgery guidelines for long-term freedom from recurrent symptoms of >50% at 2 years. Many lacked preprocedure optimization of medical management. The use of atherectomy and treatment of more than two arteries were associated with poor outcomes after peripheral vascular intervention for IC, because only 32% of these patients were free from recurrent symptoms at 2 years. Even when risk factor modification is optimized before the procedure, vascular specialists should be aware of the association between atherectomy and multivessel interventions with poorer long-term outcomes and counsel patients appropriately before intervention., (Copyright © 2020 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)

The spread of SARS-CoV-2 by contact (direct or indirect) is widely accepted, but the relative importance of airborne transmission is still controversial. Probability of outdoor airborne transmission depends on several parameters, still rather uncertain: virus-laden aerosol concentrations, viability and lifetime, minimum dose necessary to transmit the disease. In this work, an estimate of outdoor concentrations in northern Italy (region Lombardia) was performed using a simple box model approach, based on an estimate of respiratory emissions, with a specific focus for the cities of Milan and Bergamo (Italy). In addition, the probability of interaction of virus-laden aerosol with pre-existing particles of different sizes was investigated. Results indicate very low (<1 RNA copy/m 3 ) average outdoor concentrations in public area, excluding crowded zones, even in the worst case scenario and assuming a number of infects up to 25% of population. On average, assuming a number of infects equal to 10% of the population, the time necessary to inspire a quantum (i.e. the dose of airborne droplet nuclei required to cause infection in 63% of susceptible persons) would be 31.5 days in Milan (range 2.7-91 days) and 51.2 days in Bergamo (range 4.4-149 days). Therefore, the probability of airborne transmission due to respiratory aerosol is very low in outdoor conditions, even if it could be more relevant for community indoor environments, in which further studies are necessary to investigate the potential risks. We theoretically examined if atmospheric particles can scavenge virus aerosol, through inertial impact, interception, and Brownian diffusion. The probability was very low. In addition, the probability of coagulation of virus-laden aerosol with pre-existing atmospheric particles resulted negligible for accumulation and coarse mode particles, but virus-laden aerosol could act as sink of ultrafine particles (around 0.01 μm in diameter). However, this will not change significantly the dynamics behaviour of the virus particle or its permanence time in atmosphere., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objectives: To assess population-based prevalence, risk factors, hospitalization, and infection fatality rates (IFR) associated with COVID-19., Methods: We conducted two household surveys among the non-institutionalized adult population from May 30 to June 17, 2020, in Lajeado, an 84,000-inhabitant industrial city in southern Brazil. Primary outcome was prevalence of SARS-CoV-2 infection. Secondary outcomes were COVID-19-related hospitalizations and deaths occurring up to June 20, 2020. We summarized prevalence rates across surveys with meta-analysis. We assessed age-range IFR and hospitalization rate and regressed these rates over age strata using nonlinear (exponential) coefficients of determination (R 2 )., Results: Summarized overall prevalence was 3.40% (95% CI, 2.74-4.18), 34% lower in older adults ≥60 years. Prevalence was 14.3 and 5.4 times higher among household contacts and meat-precessing plant (MPP) workers, respectively. IFR ranged from 0.08% (0.06-0.11) to 4.63% (2.93-7.84) in individuals 20-39 years and ≥60 years, respectively. R 2 for hospitalization rate and IFR over age were 0.98 and 0.93 (both p-values <0.0001), respectively., Conclusions: This is the first population-based study in Brazil to estimate COVID-19 prevalence, hospitalization, and fatality rates per age stratum. Rates were largely age-dependent. Household contacts and MPP workers are at higher risk of infection. Our findings are valuable for health-policy making and resource allocation to mitigate the pandemic., (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Functionally significant coronary lesions identification is necessary for appropriate revascularization. This review aims to provide an overview of the available options for coronary stenosis physiologic evaluation with a focus on the latest developments in the field., Competing Interests: Conflicts of interest None., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Introduction: This study compared the tubular density and push-out bond strength of mineral trioxide aggregate (MTA) to dentin in diabetic and nondiabetic patients., Methods: Ten extracted single-rooted human teeth from diabetic and nondiabetic patients (n = 5 in each group) were decoronated, prepared up to a #5 Gates-Glidden drill, and sectioned horizontally at the midroot area to prepare 3 dentin slices, each measuring 2 mm in thickness (1 slice for the push-out test and 2 slices for the tubular density test). MTA was prepared and packed into the root canal space followed by incubation for 3 days. The push-out bond strength values were determined using a universal testing machine. Specimens were viewed under a stereomicroscope and a scanning electron microscope to determine the failure types at the cement-dentin interface. Ten slice specimens in each group were evaluated under SEM at 3 different sites to determine the tubular density. Comparisons were performed using the Mann-Whitney U test (P < .05)., Results: Diabetic patients exhibited significantly lower push-out bond strength of MTA to root canal dentin (P < .05). The pattern of failure at the MTA-dentin interface was different between the 2 groups. The tubular density was significantly higher in diabetic patients (P < .05)., Conclusions: The dentin in diabetic patients exhibited different physicochemical properties. The failure patterns and modes in diabetic patients might be explained by the changes in the push-out bond strength, the calcification mechanism of the dentin-pulp complex, a higher dentinal tubule density, and less peritubular dentin. These differences could explain the higher failure rate of root canal treatment in these patients., (Published by Elsevier Inc.)

The commercial tests currently available as second-level tests to detect ANA sub-specificities are generally used independently from the ANA immunofluorescence (IIF) pattern. The aim of this study was to evaluate the efficacy of the use of a customizable pattern-oriented antigenic panel by immunoblot (IB) using the International Consensus on ANA Patterns (ICAP) classification scheme, in order to introduce a novel and updated autoimmune diagnostic flowchart. 710 sera referred for routine ANA testing were selected on the basis of the ANA pattern according to the ICAP nomenclature (nuclear speckled AC-2,4,5; nucleolar AC-8,9,10,29; cytoplasmic speckled AC-18,19,20) and on an IIF titer ≥1:320. They were then assayed by three experimental IB assays using a panel of selected antigens. ICAP-oriented IB detected 515 antibody reactivities vs. 457 of traditional anti-ENA in the nuclear speckled pattern group, 108 vs. 28 in the nucleolar pattern group, and 43 vs. 34 in the cytoplasmic speckled pattern. This pilot study may lead the way for a new approach introducing an ICAP pattern-oriented follow up testing as a valid alternative to the existing standard panels, thus enabling more patients with autoimmune rheumatic disease to be accurately diagnosed., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Microscopy and sequencing-based technologies are providing increasing insights into chromatin architecture. Nevertheless, a full comprehension of chromosome folding and its link with vital cell functions is far from accomplished at the molecular level. Recent theoretical and computational approaches are providing important support to experiments to dissect the three-dimensional structure of chromosomes and its organizational mechanisms. Here, we review, in particular, the String&Binders polymer model of chromatin that describes the textbook scenario where contacts between distal DNA sites are established by cognate binders. It has been shown to recapitulate key features of chromosome folding and to be able at predicting how phenotypes causing structural variants rewire the interactions between genes and regulators., Competing Interests: Conflict of interest statement Nothing declared., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

A multiscale mathematical model for glioma cell migration and proliferation is proposed, taking into account a possible therapeutic approach. Starting with the description of processes occurring at the subcellular level, the equation for the mesoscopic level is formulated and a macroscopic model is derived, via parabolic limit and Hilbert expansions in the moment equations. After the model set up and the study of the well-posedness of this macroscopic setting, we investigate the role of the fibers in the tumor dynamics. In particular, we focus on the fiber density function, with the aim of comparing some common choices present in the literature and understanding which differences arise in the description of the actual fiber density and orientation. Finally, some numerical simulations, based on real data, highlight the role of each modelled process in the evolution of the solution of the macroscopic equation., (Copyright © 2019. Published by Elsevier Ltd.)

Experimental advances in Molecular Biology demonstrated that chromatin architecture and gene regulation are deeply related. Hi-C data, for instance, returned a scenario where chromosomes form a complex pattern of interactions, including TADs, metaTADs, and compartments, correlated with genomic and epigenomic features. Here, we discuss the emerging hierarchical organization of chromatin and show how it remains partially conserved during mouse neuronal differentiation with changes highly related to modifications in gene expression. In this scenario, models of polymer physics, such as the Strings & Binders (SBS) model, can be a crucial instrument to understand the molecular mechanisms underlying the formation of such a higher order 3D structure. In particular, we focus on the case study of the murine Pitx1 genomic region. At this locus, two alternative spatial conformations take place in the hindlimb and forelimb tissues, corresponding to two different transcriptional states of Pitx1. We finally show how the structural variants can affect the locus 3D organization leading to ectopic gene expression and limb malformations., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background and Aim: Echocardiography is a promising technique for the assessment of epicardial adipose tissue (EAT). Increased EAT thickness is associated with different cardiac diseases, including; coronary artery disease (CAD). Since several different echocardiographic approaches have been proposed to measure EAT, the identification of a standardized method is needed. We propose the assessment of EAT maximal thickness at the Rindfleisch fold, the reproducibility of this measurement and its correlation with EAT thickness and volume assessed at cardiac magnetic resonance (CMR). Finally, we will test the predictive role of this measurement on the presence of significant CAD., Methods and Results: In 1061 patients undergoing echocardiography, EAT thickness was measured at the level of the Rindfleisch fold. In 70 patients, we tested the relationship between echo-EAT thickness and EAT thickness and volume assessed at CMR. In 499 patients with suspected CAD, undergoing coronary artery angiography, we tested the predictive value of EAT on the presence of significant CAD. Echo-EAT thickness measurements had an excellent reliability as indicated by the inter-observer (ICC:0.97; 95% C.I. 0.96 to 0.98) and intra-observer (ICC:0.99; 95% C.I. 0.98 to 0.99) reliability rates. Echo-EAT thickness significantly correlated with CMR-EAT thickness and volume (p < 0.001). An EAT thickness value >10 mm discriminated patients with significant CAD at coronary angiography (p < 0.001). At multivariable analysis, including demographic data and cardiovascular risk factors, EAT thickness was an independent predictor of significant CAD and showed an additive predictive value over common atherosclerotic risk factors., Conclusions: Echocardiographic assessment of EAT thickness at the level of the Rindfleisch fold represents a simple and trustworthy method. An increased EAT thickness shows an additive predictive value on CAD over common atherosclerotic risk factors, thus suggesting its potential clinical use for CAD risk stratification., (Copyright © 2019 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Background: Molecular allergy has significantly improved the quality of allergy diagnosis; however, the positioning of singleplex and multiplex assays in the diagnostic algorithm is still a matter of debate., Methods: Aim of the study was to test the analytical performance of the recently commercialized Allergy Explorer-ALEX® in a selected population (105 allergic patients and 15 negative controls), comparing it with the reference ImmunoCAP® method and with skin prick test (SPT)., Results: Inter-assay qualitative comparison showed a substantial agreement between ALEX® and SPT (k = 0.64). A substantial agreement between ALEX® and ImmunoCAP® was shown on the detection of IgE to extracts (k = 0.64 for inhalants and k = 0.51 for food allergens), whereas a higher agreement was shown on detection of molecular components (k = 0.92 for inhalants and k = 0.72 for food allergens). Quantitative comparison showed a poor correlation between ALEX® and ImmunoCAP®., Conclusion: The simultaneous detection of both extracts and molecular components with ALEX® assay can potentially overcome some of the major limitations of the multiplex assay currently in use. However, before using ALEX® as routine method, the analytical performance (in particular for extracts) needs to be further investigated on a larger scale., (Copyright © 2019. Published by Elsevier B.V.)

Background: The most important determinant of long-term survival in patients with idiopathic pulmonary fibrosis is the right ventricular (RV) adaptation to the increased pulmonary vascular resistance. Our aim was to explore RV contractile reserve during stress echocardiography in early-stage IPF., Methods: Fifty early-stage patients with IPF and 50 healthy control patients underwent rest and stress echocardiography, including RV two-dimensional speckle tracking echocardiography. At peak exertion, blood gas analysis and spirometry were also assessed., Results: At rest, RV diameters were mildly increased in IPF; however, although RV conventional systolic function indexes were similar between the IPF and control groups, RV global longitudinal strain and RV lateral wall longitudinal strain (LWLS) were significantly reduced in the IPF cohort. During physical exercise, patients with IPF showed a reduced exercise tolerance with lower maximal workload (P < .01), level of oxygen saturation (P < .001), and peak heart rate (P < .01). Systolic and diastolic BP values were similar in both groups. Systolic pulmonary artery pressure (PAPs) increase (ΔPAPs) during exertion was higher in IPF vs healthy subjects (P < .0001); RV LWLS increase (ΔRV LWLS) during exercise was lower in patients with IPF vs control patients (P < .00001). By multivariable analysis, RV LWLS at rest and ΔRV LWLS were directly related to peak exertion capacity, PAPs, and blood oxygen saturation level (Spo 2 ; P < .0001). Δ RV LWLS was directly related to diffusion lung carbon monoxide (P < .0001)., Conclusions: RV myocardial dysfunction is already present at rest in early-stage IPF and worsens during exertion as detected by two-dimensional speckle-tracking echocardiography. The RV altered contractile reserve appears to be related to reduced exercise tolerability and impaired pulmonary hemodynamic., (Copyright © 2018 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)

Objectives: We report the results of an Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP) study on the treatment of testicular germ cell tumors (TGCT) with a pediatric PEB (pPEB) regimen (cisplatin 25 mg/m 2 daily on days 1-4; etoposide 100 mg/m 2 daily on days 1-4; bleomycin 15 mg/m 2 on day 2, once per cycle)., Methods and Materials: Male patients under 18 years old with malignant TGCT were enrolled for a second national prospective protocol. All patients underwent orchiectomy at diagnosis. Those with Stage I received no chemotherapy; those with Stage II-III disease received three cycles of pPEB; and those with Stage IV received four cycles. After chemotherapy, resection of radiologically-evident residual disease was recommended. The main study end-points were overall survival and relapse-free survival., Results: Ninety-nine boys from 0.5 to 17.8 years old (median 15.4 years) were evaluable, and staged as follows: 58 Stage I (59%), 7 Stage II (7%), 14 Stage III (14%), and 20 Stage IV (20%). With a median follow-up of 59 months (range 4-165 months), 5-year relapse-free survival (95% CI) was 73% (65%-83%) for the whole sample, 65% (53%-79%) for Stage I patients, and 86% (75%-98%) for Stage II-IV patients. Five-year overall survival (95% CI) was 99% (97%-100%)., Conclusions: We confirmed a good prognosis for malignant TGCT in children and adolescents. Reducing the number of chemotherapy cycles for Stage II-III disease does not seem to negatively affect survival outcomes., (Copyright © 2018. Published by Elsevier Inc.)

Background: Transradial percutaneous coronary intervention (PCI) offers important advantages over transfemoral PCI, including better outcomes. However, when there is indication to ad hoc PCI, a 6 French workflow is a common default strategy, hence potentially influencing vascular access selection in patients with anticipated small size radial artery., Methods: A multidimensional evaluation was performed to compare two ad hoc interventional strategies in women <160cm: a full 6 French workflow (namely 6 French introducer sheath, diagnostic catheters and guiding catheter) with a modified workflow consisting in the use of 5 French diagnostic catheters preceded by the placement of a 6 French sheath introducer and followed by a 6 French guiding catheter use for PCI., Results: Overall 120 women (68±11years) were enrolled in the study. Coronary angiography has been performed using 5 French or 6 French diagnostic catheters in 57 (47.5%) and 63 (52.5%) cases, respectively. Radial spasm and switch to another access occurred more frequently among women who underwent coronary angiography with 6 French rather than 5 French diagnostic catheters (43% vs. 25%, p=0.03 and 2% vs. 11%, p=0.04, respectively). Total time to guidewire lesion crossing was also significantly higher when PCI has been preceded by 6 French rather than 5 French coronary angiography (23±11min vs 16±7min, p=0.013)., Conclusions: In patients with anticipated unfavorable radial access, a workflow consisting in 6 French introducer sheath placement, 5 French coronary angiography, and 6 French coronary intervention is on multiple parameters the most straightforward and effective strategy., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Number and mass particle concentrations and fluxes were measured, simultaneously with CO 2 concentration and flux, in the urban area of Lecce (Italy). The measurements of the turbulent exchanges of atmospheric particles and gas were performed with an eddy-covariance station located near the busiest road of the town. For the smaller particles, the diurnal evolution of the particle number concentrations and fluxes shows a clear correlation with human activities, in particular vehicular traffic, which is the obvious candidate as the source of the two clear peaks in the CPC concentration in the morning and in the evening. The fluxes were upward for all the measurement period, even though small net deposition was observed for larger particles and during weekend. For the CPC, the correlation with the traffic daily pattern is extremely strong. The city is a continuous particle source. The data analysis seems also to suggest the presence of local urban nucleation events. CO 2 and particle concentrations were larger at low wind velocity, instead, fluxes were larger at high wind velocity. This opposite behaviour suggests that the influence of local urban emissions is larger on fluxes with respect to concentrations. The average daily patterns of CO 2 concentration show an overlap between biogenic cycle and urban emissions. Again, traffic appears to be the dominant source for fluxes and the urban area is a net source of CO 2 ., (Copyright © 2017 Elsevier B.V. All rights reserved.)

In recent years, anti-tumor immunotherapy has shown promising results, and immune-oncology is now emerging as the fourth major wave in the treatment of tumors after radiotherapy, chemotherapy and molecular targeted therapy. Understanding the impact of the immune system on neoplastic cells is crucial to improve its effectiveness against cancer. The stratification of patients who might benefit from immunotherapy as well as the personalization of medicine have contributed to the discovery of new immunotherapeutic targets and molecules. In the present review, we discuss the mechanistic role of histone deacetylase inhibitors (HDACi) as potential immunomodulating agents to treat cancer. Our current understanding of the use of HDACi in combination with various immunotherapeutic approaches, such as immunomodulating agents and cancer vaccines, is also addressed. The potential clinical applications of the growing number of novel epigenetic drugs for cancer immunotherapy are widening, and some of these therapies are already in clinical trials., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Neurologic events after carotid endarterectomy (CEA) require prompt diagnosis and management to avoid potentially catastrophic sequelae. This report describes a 69-year-old gentleman who underwent a left CEA for a high-grade asymptomatic carotid stenosis with concomitant contralateral carotid occlusion. He had transient and crescendo neurologic events in the first 3 postoperative weeks that culminated in right hand weakness and paresthesia, despite dual antiplatelet therapy, maximal anticoagulation, and undergoing stenting of the endarterectomy site. Neurologic events recurred despite these measures and subsequent angiography showed reversible cerebral vasoconstriction syndrome that was successfully managed without further events. Reversible cerebral vasoconstriction syndrome is an unusual but important cause of neurologic events after CEA that requires aggressive and directed medical therapy., (Published by Elsevier Inc.)

Background: Elevated serum levels of asymmetric dimethylarginine (ADMA) are associated with endothelial dysfunction and atherogenesis. In patients with suspected coronary artery disease (CAD), we assessed the correlation of serum ADMA levels with extent and functional significance of coronary atherosclerosis., Methods: We enrolled 281 patients with suspected CAD undergoing coronary angiogram. Angiographic CAD severity was evaluated by Bogaty score. In patients with angiographic evidence of at least one intermediate coronary stenosis (≥50% diameter stenosis), functional significance was assessed by fractional flow reserve (FFR). Blood samples were collected in all patients prior to coronary angiography for measurement of serum ADMA levels., Results: We observed across tertiles of ADMA levels increasingly higher values of both Stenosis Score (2.25±1.70 vs. 2.89±1.99 vs. 2.95±1.82, p=0.016) and Extent Index (0.52±0.32 vs. 0.61±0.39 vs. 0.72±0.47, p=0.003). The association between ADMA levels and Extent Index remained significant after multivariate adjustment (p=0.005). Patients with FFR ≤0.80 in at least one vessel (n=113) had significantly higher ADMA levels compared with patients without functionally significant CAD (0.51 [0.43-0.64] vs. 0.46 [0.39-0.58]μmol/L, p=0.005). Serum ADMA levels were independent predictors of abnormal FFR after adjustment for extent score (odds ratio 7.35, 95% confidence interval 1.05-56.76, p=0.046)., Conclusions: Serum ADMA levels are independent predictors of coronary atherosclerosis extent and functional significance of CAD., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Parkinson's disease is a neurodegenerative disease that causes the death of dopaminergic neurons in the substantia nigra. The resulting dopamine deficiency in the basal ganglia leads to a movement disorder that is characterized by classical parkinsonian motor symptoms. Parkinson's disease is recognized as the most common neurodegenerative disorder after Alzheimer's disease. PD ethiopathogenesis remains to be elucidated and has been connected to genetic, environmental and immunologic conditions. The past decade has provided evidence for a significant role of the immune system in PD pathogenesis, either through inflammation or an autoimmune response. Several autoantibodies directed at antigens associated with PD pathogenesis have been identified in PD patients. This immune activation may be the cause of, rather than a response to, the observed neuronal loss. Parkinsonian motor symptoms include bradykinesia, muscular rigidity and resting tremor. The non-motor features include olfactory dysfunction, cognitive impairment, psychiatric symptoms and autonomic dysfunction. Microscopically, the specific degeneration of dopaminergic neurons in the substantia nigra and the presence of Lewy bodies, which are brain deposits containing a substantial amount of α-synuclein, have been recognized. The progression of Parkinson's disease is characterized by a worsening of motor features; however, as the disease progresses, there is an emergence of complications related to long-term symptomatic treatment. The available therapies for Parkinson's disease only treat the symptoms of the disease. A major goal of Parkinson's disease research is the development of disease-modifying drugs that slow or stop the neurodegenerative process. Drugs that enhance the intracerebral dopamine concentrations or stimulate dopamine receptors remain the mainstay treatment for motor symptoms. Immunomodulatory therapeutic strategies aiming to attenuate PD neurodegeneration have become an attractive option and warrant further investigation., (Copyright © 2016 Elsevier B.V. All rights reserved.)

The evaluation of the contribution of coal-fired thermo-electrical power plants to particulate matter (PM) is important for environmental management, for evaluation of health risks, and for its potential influence on climate. The application of receptor models, based on chemical composition of PM, is not straightforward because the chemical profile of this source is loaded with Si and Al and it is collinear with the profile of crustal particles. In this work, a new methodology, based on Positive Matrix Factorization (PMF) receptor model and Si/Al diagnostic ratio, specifically developed to discriminate the coal-fired power plant contribution from the crustal contribution is discussed. The methodology was applied to daily PM10 samples collected in central Italy in proximity of a large coal-fired power plant. Samples were simultaneously collected at three sites between 2.8 and 5.8km from the power plant: an urban site, an urban background site, and a rural site. Chemical characterization included OC/EC concentrations, by thermo-optical method, ions concentrations (NH4(+), Ca(2+), Mg(2+), Na(+), K(+), Mg(2+), SO4(2-), NO3(-), Cl(-)), by high performances ion chromatography, and metals concentrations (Si, Al, Ti, V, Mn, Fe, Ni, Cu, Zn, Br), by Energy dispersive X-ray Fluorescence (ED-XRF). Results showed an average primary contribution of the power plant of 2% (±1%) in the area studied, with limited differences between the sites. Robustness of the methodology was tested inter-comparing the results with two independent evaluations: the first obtained using the Chemical Mass Balance (CMB) receptor model and the second correlating the Si-Al factor/source contribution of PMF with wind directions and Calpuff/Calmet dispersion model results. The contribution of the power plant to secondary ammonium sulphate was investigated using an approach that integrates dispersion model results and the receptor models (PMF and CMB), a sulphate contribution of 1.5% of PM10 (±0.3%) as average of the three sites was observed., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis predominantly targeting medium-sized arteries. PAN is a rare form of vasculitis, and the precise frequency of this disease is difficult to determine. The major environmental factor associated with PAN is HBV infection. The pathogenesis of "idiopathic PAN" remains enigmatic, although the clinical responses to immunosuppressive therapy support the concept that immunological mechanisms play an active pathogenic role. The spectrum of disease ranges from involving a single organ to polyvisceral failure. Any organ might be affected; however, for reasons that are not understood, PAN does not affect the lungs. In addition to the systemic idiopathic form, called "idiopathic generalized PAN," there are 2 clinical variants of this disease: "cutaneous PAN" and "hepatitis B virus (HBV)-associated PAN". Diagnosis requires the integration of clinical, angiographic, and biopsy findings. The overall prognosis of this disease has been improved in recent decades, primarily reflecting early diagnosis and more effective treatments. Idiopathic generalized PAN should be treated with a combination of glucocorticoids and cyclophosphamide. The treatment of HBV-associated PAN involves a different approach, centered on the use of an antiviral agent to control the infection. The therapy for cutaneous PAN requires a less aggressive approach based on the administration of non-steroidal anti-inflammatory drugs over short periods of time., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Background: Natriuretic peptides are diagnostic/prognostic biomarkers in major cardiovascular diseases. We aimed at assessing the predictive role of N-terminal pro-A-type (NT-proANP) and pro-B-type (NT-proBNP) natriuretic peptides levels toward cardiovascular outcome in both stable and unstable coronary artery disease (CAD) patients after percutaneous coronary intervention (PCI) in a non-primary PCI setting., Methods: A total of 395 patients undergoing PCI with stent implantation for either stable angina (SA) or non ST-elevation acute coronary syndrome (NSTE-ACS) were enrolled. Pre-procedural NT-proANP and NT-proBNP levels were measured. Occurrence of major adverse cardiac events (MACEs), composite of cardiac death, non-fatal myocardial infarction, and clinically driven target lesion revascularization (c-TLR), was the endpoint of the study. Follow up mean time was 48.53±14.69months., Results: MACEs occurred in forty-four patients (11%) during follow up. Both NT-proANP levels [3170 (2210-4630) vs 2283 (1314-3913) fmol/mL, p=0.004] and NT-proBNP levels [729 (356-1353) vs 511 (267-1006) fmol/mL, p=0.04] were significantly higher in patients with MACEs compared to patients without MACEs. Similar results were found when considering hard MACEs (myocardial infarction and cardiac death). NT-proANP levels were significantly higher in patients with c-TLR compared with patients without c-TLR [3705 (2766-5184) vs 2343 (1340-3960) fmol/mL, p=0.021]. At multivariate analysis, NT-proANP levels were a significant predictor of MACEs (HR 1.09, 95% CI 1.03-1.18, p=0.04). Kaplan-Meyer curves revealed that patients with elevated NT-proANP levels (>2.100fmol/mL) had a lower MACE free survival (p=0.003)., Conclusions: Both NT-proANP and NT-proBNP levels were higher in CAD patients experiencing MACEs following PCI in a non-primary setting. Notably, only NT-proANP levels significantly affected prognosis after PCI., (Copyright © 2016 Elsevier Inc. All rights reserved.)