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Highlights: [•] Used AAM to extract two 2D features masks from facial images and triangulated. [•] Multi-camera system frames stereoscopic images of individuals in different positions. [•] Used weights to compensate landmarks uncertainty. [•] Threshold applied to reduce False Acceptances. [Copyright &y& Elsevier]

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Interleukin-6 (IL-6), a powerful inflammatory mediator, plays a pivotal role in the pathogenesis of insulin resistance and type 2 diabetes. Recently, the IL-6 promoter polymorphism, at position -174 (G > C), has been associated to insulin sensitivity although contrasting data have been reported. The aim of this study was to evaluate the effect of the IL-6-174 G > C polymorphism on insulin resistance. In 238 type 2 diabetic patients without diabetic complications and in 255 control subjects, age and gender-matched, we evaluated the IL-6 -174 G > C genotype, the IL-6 plasma levels and the insulin resistance by the homeostasis model assessment (HOMA). The levels of IL-6 and HOMA were not genotype-dependent and were higher in diabetic patients (p < 0.01). Control subjects, both C+ (CG + CC genotypes) and C- (GG genotype) carriers, showed IL-6 plasma levels significantly related to BMI, fasting insulin and HOMA. The same relationships were found in C+ diabetic carriers. Differently, diabetic C- carriers did not show any relationship between IL-6 levels and all the evaluated variables. Interestingly, all the correlations were dependent on BMI. These findings highlight that IL-6-174 G > C polymorphism affects insulin resistance in type 2 diabetes, where C+ carriers have an insulin resistance 'IL-6-sensitive', while C- carriers do not. The identification of two categories of diabetic patients may, therefore, lead to different therapeutic strategies in the management of insulin resistance. [ABSTRACT FROM AUTHOR]

Abstract: Background.: Screening for oesophageal varices represents an important part of the diagnostic work-up of cirrhotic patients. We have previously shown that the platelet count/spleen diameter ratio is a parameter that can rule out the presence of oesophageal varices safely and in a cost-effective fashion. Aim.: To evaluate the prognostic and diagnostic accuracy of the platelet count/spleen diameter ratio for ruling out the presence of oesophageal varices in the follow-up of a cohort of cirrhotic patients without oesophageal varices at inclusion. Methods.: After initial endoscopy, the 106 cirrhotic patients without oesophageal varices who participated in our previous study were followed-up with annual or biannual surveillance endoscopy. Patients were censored at the time of diagnosis of oesophageal varices or at their last visit, and at that time platelet count and spleen diameter were recorded. Sixty-eight patients made up the study cohort after excluding patients who were lost to follow-up or died before undergoing control endoscopy. Results.: During the follow-up, 27 patients (40%) developed oesophageal varices. Patients with higher baseline platelet count/spleen diameter ratios (p <0.0001) as well as a ratio above 909 were less likely to develop oesophageal varices (p <0.0005). At follow-up, a platelet count/spleen diameter ratio ≤909 had 100% negative predictive value and 84% efficiency in identifying the presence of oesophageal varices. Conclusions.: The use of the platelet count/spleen diameter ratio proved to be an effective means for ruling out the presence of oesophageal varices even in the longitudinal follow-up of patients. [Copyright &y& Elsevier]

Abstract: Patients with inflammatory bowel disease have a higher risk of developing colorectal cancer. The main risk factors for colorectal cancer are not suitable targets for therapeutic intervention, and primary chemoprevention is an intriguing therapeutic option. The analogies between acetyl-salycilic acid and 5-amino-salycilic acid, and the results obtained by using acetyl-salycilic acid as a chemopreventive agent in patients with sporadic colorectal cancer have prompted the study of potential chemopreventive effects of 5-amino-salycilic acid in inflammatory bowel disease. The results of both epidemiological and experimental studies have shown that long-term 5-amino-salycilic acid treatments appear to have a chemopreventive effect. The evidence for this effect is provided by retrospective and case-control studies whose results, however, do not reach the highest grades for evidence-based recommendations. Nevertheless, these results are supported by a series of experimental studies demonstrating the multiplicity of actions of 5-amino-salycilic acid. Although data regarding the chemopreventive effect of 5-amino-salycilic acid may not be rigorous enough to meet the criteria for the highest evidence-based medicine recommendations, we feel that the argument to wait until we have Grade A evidence is not necessarily rational in this case, because discontinuation of 5-amino-salycilic acid treatment to perform a randomised controlled trial would be unethical secondary to their proven efficacy for maintenance treatment. [Copyright &y& Elsevier]

Background: The structural correlates of 201Tl uptake in patients with advanced postischemic pump dysfunction are unclear. There are no good experimental models adequately reflecting the mixture of normal, dysfunctional but viable, and necrotic regions characteristic of chronic ischemic heart disease in human beings.Methods and Results: Four heart transplant candidates with idiopathic dilated cardiomyopathy and seven with ischemic heart disease underwent rest-injection 4-hour redistribution 201Tl single-photon emission computed tomography before surgery. Delayed tracer uptake was categorized into severely reduced (<50%), mildly or moderately reduced (50% to 74%), and normal (> or =75%) and related to echocardiographic wall motion and histologic findings in the hearts excised at transplantation. In idiopathic dilated cardiomyopathy, despite severe wall motion impairment, minimal or mild myocardial damage and homogeneously high 201Tl uptake were found. In ischemic heart disease, wall motion did not discriminate extensive from mild structural damage. 201Tl activity was inversely related to myocardial fibrosis (r = -0.50, p = 0.0001). Severe defects in 201Tl uptake (<50%) predicted extensive (>30%) fibrosis with 83% sensitivity and 63% specificity. Segmental akinesis and apical location resulted in loss of sensitivity (74% and 58%, respectively). No histologic or wall motion abnormality accounted for poor specificity. In the individual patient, more than nine segments determined viable by imaging criteria predicted left ventricular fibrosis of less than 15% with 86% accuracy.Conclusions: This histopathologic-clinical correlative study supports current evidence of good sensitivity but limited specificity of 201Tl rest-redistribution tomographic imaging in the evaluation of viable myocardium. In the individual patient, more than nine viable segments reliably predicted a limited extension of fibrosis. [ABSTRACT FROM AUTHOR]

Abstract: Model-image registration techniques have been used extensively for the measurement of joint kinematics in vivo. These techniques typically utilize an explicit measurement of X-ray projection parameters (principal distance, principal point), which is easily done for prospective studies. However, there is vast opportunity to derive useful information from previously collected clinical radiographic films where the projection parameters are unknown. The purpose of this study was to determine variation in measured knee arthroplasty kinematics when the X-ray projection parameters were unknown, but bounded. Based on the clinical radiographic protocol, a nominal principal point was chosen and eight additional points ±2 and ±5cm in the horizontal and vertical directions were defined. Tibiofemoral kinematics were determined for all nine projection parameter sets for a series of 10 lateral radiographs. In addition, the principal distance was varied ±15cm and tibiofemoral kinematics were determined for these two projection sets. Measured joint kinematics varied less than 0.6° and 0.4mm for ±2cm variations in principal point location, and 0.7° and 0.6mm for ±5cm variations in principal point location. Measured joint kinematics varied less than 0.6° and 0.7mm for ±15cm variations in principal distance. Variation in X-ray principal point and principal distance over clinically bounded ranges has a small effect on knee arthroplasty kinematics computed from model-image registration with high-quality clinical radiographs. [Copyright &y& Elsevier]

Abstract: A Closed Loop Pulsating Heat Pipe made of a copper tube bent into a 2-D serpentine of 32 parallel channels and filled with FC-72, has been tested on ground and in micro/hyper gravity conditions during the 58th ESA Parabolic Flight Campaign. The device has been investigated both in horizontal and in vertical positions and at different heat loads (from 40 to 100 W). Beyond the standard thermal characterization, dynamic investigations have been performed on ground by changing the device orientation at constant heat input levels. Results show that in the vertical position the PHP thermal behavior is strongly affected by the variation of gravity field both on ground and on flight tests. In particular, during a parabolic flight, the first hypergravity period slightly assists the flow motion, while, during microgravity, the device undergoes a sudden temperature increase in the evaporator zone; the following hypergravity phase is then able to bring the PHP back to the previous thermal regime. The PHP in the horizontal position does not show any sensitive thermal variation during the parabola. A further analysis with a tilting bench in the ground lab proves that microgravity thermal behavior is comparable to the horizontal operation on ground: therefore for capillary closed loop pulsating heat pipes microgravity tests are not strictly necessary for the space application assessment. [Copyright &y& Elsevier]

Abstract: Background: The functional characteristics of circulating angiogenic cells (CACs) are impaired in congestive heart failure (CHF) patients, suggesting that CAC dysfunction could contribute to CHF pathogenesis. However, the underlying mechanisms are only partly unraveled. No data are currently available regarding telomere/telomerase system in CACs of CHF patients. Methods: CACs were obtained from 80 subjects: 40 healthy control subjects (CTR) [median age (IQR), 80 (76–85yrs)] and 40 patients affected by post-ischemic cardiomyopathy CHF [median age (IQR), 82 (77–89)]. CAC and leukocyte telomere length, assessed as T/S ratio, and telomerase (TERT) activity were determined in all the enrolled subjects. Specificity and sensitivity of CAC and leukocyte T/S in discriminating between CHF and CTR were evaluated using Receiver Operator Characteristic (ROC) curve analysis and reported as AUC values. CD34+/VEGFR2+ number and pro-inflammatory cytokines plasma levels, such as IL-6 and TNF-α, were also measured. Results: CAC T/S and TERT activity were significantly reduced in CHF patients compared to CTR subjects. In leukocytes, only a significant T/S reduction was observed. AUC values were higher for CAC T/S with respect to leukocyte T/S (AUC=0.89, and AUC=0.73, P<0.01, respectively). In multivariate analysis, leukocyte T/S, CAC T/S, CAC TERT activity and NT-proBNP levels were confirmed as parameters significantly associated with CHF. CD34+/VEGFR2+ number, IL-6 and TNF-α plasma levels were significantly increased in CHF patients. Conclusions: CACs from CHF patients are characterized by telomere/telomerase system impairment, providing new insight into the clinical relevance of CACs in CHF pathogenesis. [Copyright &y& Elsevier]

AIM: Data suggest that 2h hyperglycaemia during an OGTT is less predictive for cardiovascular disease of the glucose 'spike' (the difference between the baseline glucose level and the 'peak' hyperglycaemia during the test). METHODS: A euinsulinemic hyperglycaemic clamp at 10 and 15mmol/l glucose, with or without vitamin C, was given in increasing steps in diabetic and normal subjects. Moreover, a hyperglycaemic clamp, 10mmol/l, was performed in two groups of diabetic patients with different levels of fasting glycaemia. In both the experiments flow mediated dilation and nitrotyrosine were measured. RESULTS: Glucose at 10 and 15mmol/l resulted in a concentration-dependent induction of endothelial dysfunction and oxidative stress. Vitamin C counterbalanced this effect. The increase of glycaemia to 10mmol/l induced a significant endothelial dysfunction and increased nitrotyrosine in both the groups of diabetics with different fasting glycaemia. However, when the delta (the difference between the basal value and the peak value) for endothelial function and nitrotyrosine was evaluated, patients with lower basal values showed a worse outcome. CONCLUSIONS: Our data suggest that at the same level of hyperglycaemia the grading of the endothelial dysfunction is almost super imposable, but clearly worse in terms of delta from fasting glycaemia. [ABSTRACT FROM AUTHOR]