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L Degli Esposti,1 M Andretta,2 G Di Pasquale,3 M Gambera,4 S Saragoni,1 V Perrone,1 S Buda1 1CliCon S.r.l. Health, Economics & Outcomes Research, Ravenna, Italy; 2Local Pharmaceutical Service, Verona Local Health Authority, Verona, Italy; 3Department of Cardiology, Maggiore Hospital, Bologna, Italy; 4Local Pharmaceutical Service, Bergamo Local Health Authority, Bergamo, ItalyCorrespondence: V PerroneCliCon S.r.l, Health, Economics and Outcomes Research, Via Salara, 36, Ravenna 48100, ItalyTel +39 054438393Fax +39 0544212699Email valentina.perrone@clicon.itObjectives: 1) To evaluate anticoagulation treatment patterns and health care resource use in adult patients with a discharge diagnosis of non-valvular atrial fibrillation (NVAF) in an Italian real-world setting and 2) to describe the characteristics of NVAF patients in relation to treatment.Design: A retrospective cohort study in a “real-world” setting.Setting: Data were analysed by integrating administrative databases that included approximately 2,000,000 individuals assisted by the National Health System from two Italian Local Health Units.Participants: All adult patients with at least one hospital discharge or ≥2 outpatient visits with a diagnosis code for NVAF from 1/01/2011 to 31/12/2015 were included.Main outcome measures: Anticoagulation treatment patterns, health care resource use and major bleeding events that occurred during the follow-up period were evaluated.Results: 32,863 NVAF patients were included, of whom 7,831 had at least one prescription of oral anticoagulants. Among them, 6,876 patients were vitamin K antagonists (VKA) users and 955 were non-vitamin K antagonist oral anticoagulant (NOAC) users at index date (ID). During the follow-up period, the use of antiplatelet drugs was higher among VKA-naïve users than the NOAC-naïve users. Among NOAC users, 76.1% showed an adherence level ≥80% during follow-up. The rate of bleeding events resulted higher for VKA patients compared to NOAC patients. The unadjusted incidence rate was 10.46 per 1000 person-year for VKA patients and 4.55 per 1,000 person-years for NOAC patients. The overall annual cost (in term of drugs, hospitalisations and outpatient specialist services) was € 5,156.13 for VKA and € 4,630.57 for NOAC.Conclusion: This unselected cohort study, on NVAF patients being prescribed oral anticoagulants, highlights that VKA was largely prescribed and the great majority of patients on NOACs were adherent to treatment. Most of the OAC patients still received antiplatelet agents in combination, and in NOAC patients, we registered a lower number of bleeding events compared with VKA.Keywords: non-valvular atrial fibrillation, vitamin K antagonists, non-vitamin K antagonist oral anticoagulants, anticoagulation treatment patterns, real-world setting

Objectives 1) To evaluate anticoagulation treatment patterns and health care resource use in adult patients with a discharge diagnosis of non-valvular atrial fibrillation (NVAF) in an Italian real-world setting and 2) to describe the characteristics of NVAF patients in relation to treatment. Design A retrospective cohort study in a "real-world" setting. Setting Data were analysed by integrating administrative databases that included approximately 2,000,000 individuals assisted by the National Health System from two Italian Local Health Units. Participants All adult patients with at least one hospital discharge or ≥2 outpatient visits with a diagnosis code for NVAF from 1/01/2011 to 31/12/2015 were included. Main outcome measures Anticoagulation treatment patterns, health care resource use and major bleeding events that occurred during the follow-up period were evaluated. Results 32,863 NVAF patients were included, of whom 7,831 had at least one prescription of oral anticoagulants. Among them, 6,876 patients were vitamin K antagonists (VKA) users and 955 were non-vitamin K antagonist oral anticoagulant (NOAC) users at index date (ID). During the follow-up period, the use of antiplatelet drugs was higher among VKA-naive users than the NOAC-naive users. Among NOAC users, 76.1% showed an adherence level ≥80% during follow-up. The rate of bleeding events resulted higher for VKA patients compared to NOAC patients. The unadjusted incidence rate was 10.46 per 1000 person-year for VKA patients and 4.55 per 1,000 person-years for NOAC patients. The overall annual cost (in term of drugs, hospitalisations and outpatient specialist services) was € 5,156.13 for VKA and € 4,630.57 for NOAC. Conclusion This unselected cohort study, on NVAF patients being prescribed oral anticoagulants, highlights that VKA was largely prescribed and the great majority of patients on NOACs were adherent to treatment. Most of the OAC patients still received antiplatelet agents in combination, and in NOAC patients, we registered a lower number of bleeding events compared with VKA.

The Editors' Network of the European Society of Cardiology (ESC) provides a dynamic forum for editorial discussions and endorses the recommendations of the International Committee of Medical Journal Editors (ICMJE) to improve the scientific quality of biomedical journals. Authorship confers credit and important academic rewards. Recently, however, the ICMJE emphasized that authorship also requires responsibility and accountability. These issues are now covered by the new (fourth) criterion for authorship. Authors should agree to be accountable and ensure that questions regarding the accuracy and integrity of the entire work will be appropriately addressed. This review discusses the implications of this paradigm shift on authorship requirements with the aim of increasing awareness on good scientific and editorial practices.

In this papers the possibility of realizing fractional capacitors by using carbon black nanostructured dielectrics is investigated. Capacitors have been realized by varying the percentage of distributed carbon black. The frequency analysis of the capacitors has been, therefore, performed. The Bode diagrams outline that this class of devices shows a non integer order behavior. Moreover, a dependance between the curing temperature and the fractional order has been shown.

In this paper, a novel fractional-order element (FOE) is modeled in a wide frequency range. The FOE is based on a green biopolymer, i.e., bacterial cellulose (BC), infused with ionic liquids (ILs). The modeling is performed in the frequency domain and a lumped-circuit model is proposed. The model is an evolution with respect to a simpler one already introduced by the authors, for a narrower frequency range. Results show that ILs generate a quite complex frequency domain behavior, which can be described in the framework of FOEs. Furthermore, results on the time stability of the device under investigation are given.

Under the aegis of the ongoing international Oplontis Project we carried out organic residue analyses on thirteen samples from eleven Dressel 2–4 amphorae recovered at Villa B at Oplontis (Torre Annunziata, Southern Italy) in order to identify their content and to characterize their visible lining. Although the content of Dressel 2–4 amphorae is usually thought to be wine, no residue analyses have been carried out until now to verify it. Analyses were carried out with Gas chromatography coupled to mass spectrometry. The results of the analyses indicate that all the amphorae were coated with Pinaceae products which had undergone different stages of preparation. Moreover, they confirm that Dressel 2–4 contained wine, or its derivatives, as wine markers were identified in all the samples. The data we obtained demonstrated that the amphorae analyzed were not new vessels, expressly made to trade the wine produced in the surrounding area, but were ready to be reused.

Background Approximately 10% of patients presenting with myocardial infarction (MI) do not have obstructive coronary artery disease (MINOCA). The role of antiplatelet therapy and outcomes in this group remain unclear. We assessed prognosis and the effect of an intensified clopidogrel regimen in MINOCA patients. Methods We analyzed data from the CURRENT-OASIS 7 trial, which randomized 25,086 patients with acute coronary syndromes (ACS) referred for early intervention to receive either double-dose (600mg day 1; 150mg days 2–7; then 75mg daily) or standard-dose (300mg day 1; then 75mg daily) clopidogrel. We evaluated clinical outcomes at 30-days in patients with versus without obstructive CAD and in relation to standard versus double-dose clopidogrel. Results Overall, 23,783 MI patients were included, of which 1,599 (6.7%) had MINOCA. MINOCA patients were younger, more frequently presented with non-ST-segment elevation MI and had fewer comorbidities. Rates of all-cause mortality (0.7% versus 2.4%, p=0.0046), cardiovascular mortality (0.6 versus 2.2%, p=0.0056), repeat MI (0.5% versus 2.3%, p=0.0009) and major bleedings (0.7% versus 2.5%, p=0.0001) were significantly lower among patients with MINOCA versus those with obstructive CAD. Compared with the standard-dose clopidogrel regimen, the double-dose regimen appeared to increase the risk of cardiovascular death, MI or stroke in MINOCA patients (0.8% versus 2.1%, hazard ratio (HR) 2.74, P=0.033). There was no difference in those with obstructive CAD (4.7% versus 4.4%, HR 0.93, P=0.226; P-for-interaction=0.023) (see Figure 1A). Major bleeding did not occur more frequently in MINOCA patients with double- versus standard-dose clopidogrel regimen (0.7% versus 0.6%, (HR 1.16 (95% CI 0.35–3.80), p=0.805), but their rate was higher In MI patients with obstructive CAD (2.7% versus 2.2% (HR 1.26 (95% CI 1.06–1.49), p=0.008) (Figure 1B). Figure 1A & B Conclusions Compared to MI patients with obstructive CAD, patients presenting with MINOCA represent a distinct cohort, which is generally younger, has a higher NSTEMI prevalence and fewer comorbidities. Their risk for adverse events, especially repeat MI, stroke, death, and bleeding, is low ( Acknowledgement/Funding The CURRENT-OASIS 7 trial was sponsored by Sanofi-Aventis and Bristol-Myers Squibb.

In this paper, we propose and demonstrate the possibility of using Bacterial Cellulose (BC), a bio-derived polymer, for the realization of fractional order electronic devices. BC, unlike plant-derived cellulose, is produced by some genera of bacteria, if a suitable culture is maintained. Compared to plant-derived cellulose, BC can be obtained with a green and low-energy production process, which does not produce pollutants nor carbon composites. BC is used as the bulk in a capacitor-like structure. The device impedance has been investigated and experimental evidence of its fractional nature is given. A model is proposed and a possible explanation of the involved phenomena is provided.

In this paper, Fractional Order Elements (FOEs), fabricated by using a carbon black nano structured dielectrics, are presented. FOEs have been realized by varying different fabrication parameters such as the percentage of carbon black, the curing temperature, and the solvent type. Results on the experimental frequency characterization of one FOE device are given. The FOE has been, then, used for demonstrating the possibility of realizing a fractional order RC filter. The frequency analysis of the RC filter shows the coherence of the fractional order between the FOE and corresponding RC circuit.

In this paper a low cost CO2 sensor realized on a plastic substrate is presented. The sensor is realized by the deposition of a double layer of PEDOT/PSS (CLEVIOS™ PHCV4, by H.C. Starck) and Graphene on InterDigiTed electrodes printed onto a PET (PolyEthylene Terephthalate) substrate. The InterDigiTed electrodes have been realized by inkjet printing a conductive pattern of a silver nano-particle solution (Metalon® JS-B15P by Novacentrix), through a commercial EPSON® inkjet printer. The sensing principle of the sensor exploits the change in electrical conductivity of graphene due to gas molecules adsorbtion. A device responsivity, at 30 °C, of 45 μOhm/ppm and a sensitivity of 100 ppm have been obtained respectively. Compared to solutions proposed in the literature, the inkjet printed device here presented has advantages related to its low cost, flexibility and low demanding fabrication. The device flexibility is crucial for application requiring the device shaping to irregular surfaces, such as dresses or food packaging.

During the earthquake emergency which involved Emilia Romagna Region (Italy) since 20th of May 2012, the Italian Civil Protection Department (DPC) undertook, with prevention purposes, an extensive survey on the ordinary buildings of the historic centre of the town of Ferrara, around 30 km far from the epicentral area. The activity, carried out in close cooperation with local authorities, was aimed at enhancing the seismic emergency response of the town in case of a possible further seismic event, as well as collecting technical information on the structural characteristics of the buildings, to be elaborated and hence used for further prevention purposes. Innovative element of the project was the use of two joint survey operative tools, consisting of the AeDES form used by DPC for post-earthquake usability assessments (2007) and AS form (specific for historical building blocks) which have been experimentally combined in this occasion. Activities were coordinated by DPC and carried out in collaboration with the Architecture Department of the University of Ferrara, which provided an operative and scientific support in the whole development of the work.

In this paper, a novel class of ionic electroactive nanocomposites, named Ionic Polymer-Polymer Metal Composites (IP 2 MCs) is introduced. IP 2 MCs are capable of electromechanical transduction and, therefore, they are suitable to be used as nanocomposite artificial muscles. They represent an evolution of a class of totally polymeric ionic electroactive polymers, named Ionic Polymer Composites (IP 2 Cs), previously proposed by some of the Authors. Compared to the parent technology, IP 2 MCs exploit both the beneficial effects of electrodes based on polymeric conductors and the use of noble metal (Pt) nanoparticles. The deposition of platinum nanoparticles is obtained through a green chemical reduction process. The fabrication process, and the influence of the novel nanocomposite electrode on the thermal, mechanical, and electromechanical behavior of green IP 2 MCs are described together with a comparison with the properties of Ionic Polymer Metal Composites (IPMCs) and IP 2 Cs. Reported results allow concluding that electroactive devices, with performances comparable with those of IPMC actuators, can be obtained. Eventually, the production procedure is more environmental friendly, cheaper and faster than the corresponding technique used for IPMC fabrication.

Branching morphogenesis is essential for the formation of salivary glands, kidneys, lungs, and many other organs during development, but the mechanisms underlying this process are not adequately understood. Microarray and other gene expression methods have been powerful approaches for identifying candidate genes that potentially regulate branching morphogenesis. However, functional validation of the proposed roles for these genes has been severely hampered by the absence of efficient techniques to genetically manipulate cells within embryonic organs. Using ex vivo cultured embryonic mouse submandibular glands (SMGs) as models to study branching morphogenesis, we have identified new vectors for viral gene transfer with high efficiency and cell-type specificity to developing SMGs. We screened adenovirus, lentivirus, and 11 types of adeno-associated viruses (AAV) for their ability to transduce embryonic day 12 or 13 SMGs. We identified two AAV types, AAV2 and bovine AAV (BAAV), that are selective in targeting expression differentially to SMG epithelial and mesenchymal cell populations, respectively. Transduction of SMG epithelia with self-complementary (sc) AAV2 expressing fibroblast growth factor 7 (Fgf7) supported gland survival and enhanced SMG branching morphogenesis. Our findings represent, to our knowledge, the first successful selective gene targeting to epithelial vs. mesenchymal cells in an organ undergoing branching morphogenesis.

Bovine adeno-associated virus (BAAV) can enter a cell either through a transcytosis or transduction pathway. We previously demonstrated that particles entering via the transcytosis pathway can be redirected to transduce the cell by blocking particle exocytosis with tannic acid (TA). To investigate whether this approach is useful in lung gene therapy applications, we tested the effect of TA on BAAV transduction in cystic fibrosis airway epithelia in vitro, and in mouse lung in vivo. Our findings suggest that BAAV transcytosis can occur in vivo and that treatment with TA reduces transcytosis and increases lung transduction. TA treatment did not impair the sorting and the activity of the BAAV expressed cystic fibrosis transmembrane regulator membrane protein.

Oral Diseases (2010) 17, 77–82 Objectives: Published studies of gene transfer to mouse salivary glands have not employed the parotid glands. Parotid glands are the likely target tissue for most clinical applications of salivary gene transfer. The purpose of the present study was to develop a convenient and reproducible method of retroductal gene transfer to mouse parotid glands. Methods: The volume for vector delivery was assessed by infusion of Toluidine Blue into Stensen’s ducts of Balb/c mice after direct intraoral cannulation. Recombinant, serotype 5 adenoviral vectors, encoding either firefly luciferase or human erythropoietin (hEpo), were constructed and then administered to parotid glands (107 vector particles/gland). Transgene expression in vivo was measured by enzyme activity (luciferase) or an enzyme-linked immunosorbent assay (hEpo). Vector biodistribution was measured by real-time quantitative (Q) PCR. Results: The chosen volume for mouse parotid vector delivery was 20 μL. Little vector was detected outside of the targeted glands, with both QPCR and luciferase assays. Transgene expression was readily detected in glands (luciferase, hEpo), and serum and saliva (hEpo). Most secreted hEpo was detected in saliva. Conclusion: These studies show that mouse parotid glands can be conveniently and reproducibly targeted for gene transfer, and should be useful for pre-clinical studies with many murine disease models.

A new class of materials called ionic polymer-polymer composites has been investigated to demonstrate the sensing and acting capabilities of these all-organic structures. Samples have been realized by covering Nafion membranes, with Orgacon 3040 conducting polymer as electrode material. Membranes whose electrodes were manufactured using the drop-casting technique exhibited the best electromechanical performances. Sensors have been tested in a dedicated experimental setup to model their electromechanical transduction behavior. Thus, the obtained model has been validated.

All fats, including saturated fatty acids, have important roles in the body. However, the most important fats are those that the body cannot make and thus must come from the food we eat. These essential fatty acids (EFAs) are based on linoleic acid (omega-6 group) and alpha-linolenic acid (omega-3 group). We need both groups of essential fatty acids to survive. For various reasons EFA deficiency is common in the general population, as is a disproportionate intake of omega-6 fatty acids over omega-3 fatty acids. As such, it is important to eat the right foods to make sure that you're taking in enough and the right kinds of the essential fatty acids. However, there is much more to the story. Studies have shown that increasing the intake of certain essential fatty acids, either alone or in combination with other fats and compounds, can increase health, help in treating certain diseases, and even improve body composition, mental and physical performance.

Styrene and montmorillonite organically modified with imidazolium surfactants (MMT) at various alkyl chain lengths (C12, C16 and C18) were used to prepare the corresponding PS/MMT/C12, PS/MMT/C16 and PS/MMT/C18 nanocomposites by in situ polymerization. XRD and TEM analyses evidenced the formation of both intercalated and exfoliated structures. The glass transition temperatures (Tg) of nanocomposites, as well as that of neat PS, were obtained by DSC measurements. The thermal degradations were carried out in the scanning mode, in both inert and oxidative environments, and the initial temperatures of decomposition (Ti) and the apparent activation energies of degradation (Ea) were determined. Due to an oxidative degradation mechanism, the Ti and Ea values in air atmosphere were lower than those under nitrogen.

The Holocene palaeofires in Southern America has been generally attributed to climate until the middle Holocene and to human activities for later periods. Soil charcoal analysis and extensive AMS dating were carried out on six soil profiles, between 3400 and 3900 m a.s.l. in the Guandera Biological Reserve (Western Cordillera Real, North Ecuador). AMS results showed an ordered stratification of charcoals allowing a fire history reconstruction over the last 11,700 cal BP. The reported fire occurrences fit well with Holocene global scale arid periods. The association between fires and climate signals suggested a marginal role of humans in the environmental history of the studied area. Here, the human inference started at ca 2500 cal BP, but became considerable only in the last millennium.

The present work outlines a methodological framework for “ordering” through progressive levels of analyses different evaluation models concerning the seismic vulnerability at urban scale, with respect to the possibl e final objectives: seismic scenarios, emergency or urban planning , as far as seismic mitigation or economical estimates. The research work has been developed within the URBISIT Project, funded by Italian Civil Department (DPC). The paper illustrates t he general framework governing each assessment level and the mutual relation between each of them. Following, e ach level of analyses is systematically described also through some recent applications , carried out o n some representative Italian urban centres . In the end, a correlation among different assessment levels is carried out in order to better fo cus the usability of each model as well as its reliability with respect to the possible objectives . Finally some conclusions are drawn and possible developmen t of the research outlined.

Le presenti linee guida sono state redatte con lo scopo di fornire un supporto ai tecnici impegnati nella redazione di progetti di intervento per strutture classificate con esito E a seguito del sisma del 6 aprile 2009; in particolare, si pone l???attenzione sui criteri da utilizzare per la progettazione del piano di prove sui materiali e sui terreni nel rispetto delle prescrizioni di legge vigenti.

The present study represents the first attempt of reconstructing fire history through soil charcoal dating. The investigated area is located in the Guandera Biological Reserve (western Cordillera Real, northern Ecuador). Six AMS radiocarbon dating, performed at the base of five soil profiles allowed a fire phase to be identified during the Pleistocene-Holocene transition. A strong correspondence was highlighted between the age of the Guandera fires and the El Abra stadial, which is considered the Younger Dryas equivalent in South America. This local evidence of fires contributes to define the geographic area in which the El Abra stadial was recorded and suggests a wider use of the soil charcoal analysis. © 2009 Elsevier B.V.

This paper presents a summary about the research activity performed on characterizations and modeling of new polymeric transducers. More specifically, Ionic Polymer–Metal Composites (IPMCs) have been widely explored and a new class of totally organic transducers: Ionic Polymer-Polymer Composites (IP2Cs) have been introduced. The manufacturing technique, the electromechanical characterization and modeling of these polymeric transducers are described.

Ionic polymer polymer composites (IP2Cs) are all-organic electroactive polymers (EAPs) that show sensing and actuation capabilities when a deformation or a voltage is applied, respectively. They are fabricated starting from an ionic polymer coated on both sides with a conducting polymer as electrode element. In this work, poly(3,4-ethylendioxytiophene)–poly-(styrenesulfonate) (PEDOT/PSS) has been polymerized directly on Nafion®117 membrane and devices have been manufactured varying the polymerization time. Water and ethylene glycol (EG) have been used as solvents. The obtained IP2Cs have been characterized using thermal and mechanical analyses and electromechanically tested. The results have shown that in IP2Cs manufactured by polymerization in situ the PEDOT/PSS layer adheres very strongly on the Nafion®117 film, improving the possibility of rehydrating the devices after use. Moreover, taking into account that the different polymerization times influence the uniformity of the surface of the organic electrode and, consequently, both device stiffness and electrode conductivity, the structure–property relationships of the obtained devices have been investigated. The influence of the different solvents inside the devices has also been studied when IP2Cs have been used as actuators or sensors. Reported results show that it is possible to modulate the performances of IP2Cs by varying some manufacture parameters and the solvent.

Antiplatelet therapy is the cornerstone of the pharmacologic management of patients with acute coronary syndrome (ACS). Over the last years, several studies have evaluated old and new oral or intravenous antiplatelet agents in ACS patients. In particular, research was focused on assessing superiority of two novel platelet adenosine diphosphate (ADP) P2Y12 receptor antagonists (i.e. prasugrel and ticagrelor) over clopidogrel. Several large randomized controlled trials have been undertaken in this setting and a wide variety of pre-specified and post hoc analyses are available that evaluated the potential benefits of novel antiplatelet therapies in different subsets of patients with ACS. The aim of this document is to review recent data on the use of current antiplatelet agents for in-hospital treatment of ACS patients. For each drug or class of drugs, strong evidence and/or areas of uncertainty that warrant further research are highlighted by examining 10 subgroups of patients with ACS.

The USGS-PAGER Project is devoted to rapidly assess the consequences of severe earthquakes in the world. To improve the inventory and the vulnerability estimate, USGS made recourse to the EERI World Housing Encyclopedia (WHE) project, a web-based network of experts from around the world. A small group of experts, established by EERI, drafted a simple form to collect information at national level. For each country it was required to select the most significant construction types and to provide both the value of the collapse probability conditional upon seismic intensity and the fraction of population that lives and works in these construction types. Italy participated to the project and the Italian form was filled by the Seismic Risk Office-DPC. Several other research units accepted to participate to the project: RU-Genoa, RU-Naples, RU-Padua, RU-Pavia/Eucentre, RU-Potenza. The paper presents the contribution of the Italian Research Units to the PAGER project, providing an insight into the used methodologies and a comparison of the results.

The degradations of five aromatic thermoplastics, containing carbonyl, ether and sulfone linkages and in whose repeating units the –ArCONaphCOAr– moiety (where Ar=1,4 substituted phenylene; Naph=2,6 substituted naphthalene) was present, were performed under N 2 flow in dynamic heating conditions. The obtained results suggested that degradations occurred through random chain scission followed by branching and crosslinking, which partially superimposed with the initial process. The Kissinger method was used to determine the apparent activation energy ( E a ) associated with the first degradation stage, and double linear relationships, attributable to slow diffusion of degradation products in the melt, were found in some cases. A thermal stability classification among the studied polymers was made on the basis of the obtained E a values. This classification was compared with those previously obtained for two analogous groups of thermoplastics and some correlations between thermal stability and polymer chain structure were drawn.

A series of new poly(arylene ether ketone)s and poly(arylene ether sulfone)s, obtained starting from dihydroxynaphthalene isomers, have been prepared by solution condensation polymerization. The polymers, having inherent viscosities from 0.20 to 0.77 dl g −1 , have been obtained in quantitative yields, had excellent thermal stability as shown by 10% weight loss temperatures in nitrogen and air (above 460 and 430°C, respectively) and high glass transition temperatures (in the range 151–278°C). X-ray diffraction patterns confirmed the semicrystalline character of some polymers. The location of the naphthalene-ether bond appears to affect the polymer properties.