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We calculate the pair susceptibility of an attractive spin-polarized Fermi gas in the normal phase, as a function of the pair momentum. Close to unitarity, we find a strong enhancement of Fulde-Ferrell-Larkin-Ovchinnikov (FFLO) pairing fluctuations over an extended region of the temperature-polarization phase diagram, which manifests itself as a pronounced peak in the pair-momentum distribution at a finite pair momentum. This peak should be amenable to experimental observation at achievable temperatures in a box-like trapping potential, as a fingerprint of FFLO pairing. Our calculations rest on a self-consistent t-matrix approach which, for the unitary balanced Fermi gas, has been validated against experimental data for several thermodynamic quantities., 11 pages, 7 figures; includes calculations for a realistic box-like trapping potential

In a recent paper (2019 Phys. Rev. A 99, 053617), the total number of fermion pairs in a spin-balanced two-component Fermi gas of 6Li atoms was experimentally probed in the normal phase above the superfluid critical temperature, in order to investigate the sectors of pseudogap and preformed-pair in the temperature–coupling phase diagram. Here, we present a theoretical account of these experimental results in terms of an ab initio self-consistent t-matrix calculation, which emphasizes the role of the pair-correlation function between opposite-spin fermions at equilibrium. Good agreement is found between the available experimental data and the theoretical results obtained with no adjustable parameter., publishedVersion

The diagrammatic t-matrix approximation has often been adopted to describe a dilute Fermi gas. This approximation, originally considered by Galitskii for a repulsive inter-particle interaction (Galitskii-1958), has later been widely utilized for an attractive Fermi gas to describe the BCS-BEC crossover from strongly overlapping Cooper pairs in weak coupling to non-overlapping composite bosons in strong coupling. Several variants of the $t$-matrix approximation have been considered in the literature, which are distinguished by the degree of self-consistency allowed in the building blocks of the diagrammatic structure. Here, we perform a systematic and comparative study of all possible variants on the degree of self-consistency for the $t$-matrix approximation in an attractive Fermi gas, which enables us to confront their outcomes for thermodynamic and dynamical quantities on the same footing in an unbiased way. For definiteness, only the normal phase above the superfluid critical temperature is considered. The dispute that can be raised in this context, about the adequateness of introducing progressive degrees of self-consistency over and above the non-self-consistent $t$-matrix approximation for an attractive Fermi gas, parallels the recent interest in the literature on assessing the importance of various degrees of self-consistency in the context of semiconductors and insulators., 20 pages, 13 figures

Objective To analyse the content of the interventions reported in studies investigating the applicability and efficacy of Argentine tango in participants with Idiopathic Parkinson Disease. Methods Independent reviewers searched databases (PubMed, CINAHL, EMBASE, PsycINFO, and PEDro) from their inception to November 2019. Eligible studies were randomised, controlled and uncontrolled clinical trials, and case reports. Main outcome measure The Template for Intervention Description and Replication guidelines and checklist were used to assess quality and quantity of the content of Argentine tango interventions’ description. Results We found 21 papers investigating the applicability and efficacy of Argentine tango in participants with Idiopathic Parkinson Disease. Completeness of the reporting of intervention was satisfying. The intervention is intended to affect a variety of aspects of functioning relevant to individuals with Idiopathic Parkinson Disease. Detailed information on the intervention's procedure and dosing is usually provided. The delivery of the Tango dance program was predominantly extensive; however, the intervention has been provided with various approaches and showed to be very adaptable. Attrition- and adherence- rates described are acceptable. The Adapted Tango dance program is the earliest and most researched modality of tango intervention in participants with Idiopathic Parkinson Disease. Conclusions Argentine tango is appropriately described in the studies investigating the applicability and efficacy of the intervention in participants with Idiopathic Parkinson Disease. However, the reporting could be ameliorated.

Evaluating and testing hydration status is increasingly requested by rehabilitation, sport, military and performance-related activities. Besides commonly used biochemical hydration assessment markers within blood and urine, which have their advantages and limitations in collection and evaluating hydration status, there are other potential markers present within saliva, sweat or tear. This literature review focuses on body fluids saliva, sweat and tear compared to blood and urine regarding practicality and hydration status influenced by fluid restriction and/or physical activity. The selected articles included healthy subjects, biochemical hydration assessment markers and a well-described (de)hydration procedure. The included studies (n=16) revealed that the setting and the method of collecting respectively accessing body fluids are particularly important aspects to choose the optimal hydration marker. To obtain a sample of saliva is one of the simplest ways to collect body fluids. During exercise and heat exposures, saliva composition might be an effective index but seems to be highly variable. The collection of sweat is a more extensive and time-consuming technique making it more difficult to evaluate dehydration and to make a statement about the hydration status at a particular time. The collection procedure of tear fluid is easy to access and causes very little discomfort to the subject. Tear osmolarity increases with dehydration in parallel to alterations in plasma osmolality and urine-specific gravity. But at the individual level, its sensitivity has to be further determined.

Introduction Obstructive sleep apnea is a growing worldwide health problem. The landmark feature of OSA is a chronic intermittent hypoxia (CIH) responsible for multiple organ damages including heart diseases. CIH profoundly alters both visceral adipose tissue (VAT) and heart structures and functions, but little is known regarding their interactions in the context of CIH. We recently showed that VAT senescence drives myocardial alterations through the release of profibrotic factors in aged mice. Thus, we aim at demonstrating that CIH induces a premature vWAT senescent phenotype, responsible for subsequent heart dysfunction. Methods In a first series of animals, ten-week old C57BL6 male mice (n = 10/group) were exposed to 14 days CIH protocol (8 hours daily, 5–21% cyclic inspired oxygen fraction, 60 seconds per cycle). In another series, mice were submitted to VAT surgical lipectomy or sham-surgery (n = 10/group) and then exposed to the same CIH protocol. VAT and heart were assessed by histology for fibrosis (Sirius red), cell hypertrophy (wheat-germ agglutinin) and reactive oxygen species (ROS) (4-HNE), and markers of senescence (p16, p21, p53), inflammation (CD68, Tnfa, Serpine1), fibrosis (Col1a1) and hypertrophy were also evaluated by RT-qPCR and western blot. Results CIH induced an increased macrophage infiltration in VAT, along with an increased expression of senescence markers, ROS production and gene expression of inflammatory and fibrogenic markers. This was associated with CIH-induced myocardial interstitial fibrosis and upregulation of profibrotic gene expression in myocardium. Interestingly, VAT lipectomy prevented CIH-induced myocardial fibrosis. Conclusion Short-term exposure to CIH is sufficient to induce both VAT remodelling, characterized by oxidative stress, inflammation and fibrosis, and cardiac interstitial fibrosis that was prevented by VAT lipectomy. This strongly suggest a causal crosstalk between CIH-induced VAT senescence and cardiac remodeling.

Dynamics of skyrmions [1] and of magnetic edge dislocations [2] in thin films is a new fascinating field of micromagnetism where the comprehension of topology-related properties is challenging for fundamental studies and for spintronic applications. The dynamics and particularly the trajectories of these objects are intimately linked to the subjacent magnetic interactions of the system and to the consequent topology. As a matter of facts, skyrmion trajectories follow a "Hall-like" motion perpendicular the magnetic field gradient. This can be a drawback, for the use of magnetic skyrmions as information carriers in spintronic devices, because touching the sample edges in constricted geometries can cause the skyrmion destruction. Here, we focus on magnetic edge dislocations whose particular topology makes them follow a straight trajectory when submitted to an external magnetic field. Indeed, In thin magnetic films with perpendicular magnetic anisotropy, an up-down stripe-domain structure can be originated, on a mesoscopic scale comparable with film thickness (around 100 nm), by the competition between short-range exchange coupling and long-range magnetic dipolar interaction.[3] Even in the absence of quenched disorder, topological defects can develop in the stripe pattern due to large amplitude fluctuations occurring in two dimensions.[4] Here we investigate the dynamic behaviour of magnetic edge dislocations in a Nitrogen-implanted Fe film. Combining evidence from magnetic force microscopy data, micromagnetic simulations and a theory based on the Thiele equation, the defects were found to undergo a straight displacement when a moderate magnetic field is applied in plane along the stripes axis. The displacement may be either in the direction of the applied field or in the opposite direction, depending on whether the distribution of the in-plane magnetization in the topological magnetic defect is head-to-head or tail-to-tail, but irrespective of the out-of-plane magnetization in the domains. A relationship is established between the straight character of the motion and the vanishing of the topological charge for the stripe pattern, suggesting that topological defects in FeN films might be used for future spintronic devices intrinsically free from the undesired skyrmion Hall effect. References: [1] A. Dussaux, P. Schoenherr, K. Koumpouras, J. Chico, K. Chang, L. Lorenzelli, N. Kanazawa, Y. Tokura, M. Garst, A. Bergman, C. L. Degen & D. Meier Nature Communications 7, 12430 (2016) [2] Fert, A., Cros, V. & Sampaio, J. Skyrmions on the track. Nat. Nanotech. 8, 152-156 (2013). [3] S. Tacchi, S. Fin, G. Carlotti, G. Gubbiotti, M. Madami, M. Barturen, Massimiliano Marangolo, Mahmoud Eddrief, D. Bisero, A. Rettori, M. G. Pini Physical Review B : Condensed matter and materials physics, American Physical Society, 2014, 89 (2), pp.024411. [4] C. Blanco-Roldán, C. Quirós, A. Sorrentino, A. Hierro-Rodríguez, L. M. Álvarez-Prado, R. Valcárcel, M. Duch, N. Torras, J. Esteve, J. I. Martín, M. Vélez, J. M. Alameda, E. Pereiro & S. Ferrer Nature Communications 6, 8196 (2015).

Summary. Background: The management of venous thromboembolism (VTE) requires an initial treatment with unfractionated heparin (UFH) or low-molecular-weight heparin (LMWH), followed by oral anticoagulants (OA) for at least 3 months. OA treatment however, requires laboratory monitoring of anticoagulation, carries a definite risk of bleeding, and may be contraindicated in some patients. As an alternative to vitamin K antagonists, subcutaneous LMWH has been proposed and evaluated in randomized clinical trials, but they are all small studies that lack the power to establish if these two treatment modalities are equivalent in efficacy or safety. Objectives: The objective of this review was to evaluate the efficacy (VTE recurrence) and safety (bleeds and deaths) of long-term treatment of VTE with LMWH compared with OA. A secondary endpoint was to evaluate the effect of LMWH on cancer mortality. Methods: Computerized searches of MedLine and EmBase were performed. In addition, randomized clinical trials were located through personal communication with colleagues, and through the manual scanning of meeting proceedings and reference lists of relevant studies. When necessary, the authors of the selected papers were called to obtain additional information. Two reviewers (AI and FG) reviewed and extracted data independently using a standard form. The primary analysis was performed for efficacy and safety endpoints on an intention-to-treat basis for the study period of randomized treatment. A meta-regression analysis was used to investigate the relationship between daily dose and clinical outcome. Results: Seven studies that fulfillled our predefined criteria were identified, for a total of 1379 patients. When all studies were combined, a statistically non-significant reduction in the risk of VTE (OR 0.66; 95% confidence interval [CI] 0.41, 1.07) and in the risk of major bleeding (OR 0.45; 95% CI 0.18, 1.11) in favor of LMWH treatment was found. No difference in total mortality (OR 1.19; 95% CI 0.78, 1.83) or in cancer-related mortality was observed between the LMWH and the OA treatment. Conclusions: The results of this meta-analysis indicate that a 3-month course of LMWH is as effective and safe as a corresponding period of OA treatment, and may thus be considered as a valuable alternative option for patients in whom OA treatment appears contraindicated or problematic.

This study is part of a research program that aims to develop a constitutive three-dimensional model of the periodontal ligament (PDL) through the identification of pertinent material parameters. As part of this program, bovine PDL was utilized to establish stress-strain responses under tensile and compressive loading conditions. Fresh bovine molars were secured, frozen and prepared to appropriate dimensional specifications. Bar-shaped specimens that comprised portions of dentine, PDL and bone were produced. Push-pull tests were conducted using a specifically constructed loading machine. Full range monotonic stress-strain diagrams were generated. The effect of a rate increase on cyclic S-E diagrams was also determined. The influence of specimen thickness was expressed in terms of modulus of elasticity, strength, uniaxial maximizer strain, and strain energy density. The overall load-response was heavily hysteretic in compression. On the tensile side, after a steep rise, the curve tended to flatten out asymptotically. Variations in rate that spanned four orders of magnitude had no effect on reciprocal load responses. The E-modulus was in the 4-8 MPa range, the strength of the PDL was 1-2 MPa, the maximizer strain was at 45-60% and the strain energy density ranged between 0.3 and 0.4 MPa.

Although intravenous (i.v.) heparin is widely used as the first line treatment for cerebral venous and sinus thrombosis (CVST), the most appropriate therapy for this disease is still controversial. We report 2 cases of CVST who were successfully treated by means of loco-regional thrombolysis with urokinase. In the first case we chose this treatment instead of i.v. heparin because clinical conditions of the patient appeared critical for life on hospital admission; in the second case loco-regional thrombolysis was performed because a full-dose heparin treatment over 8 days failed to improve the clinical picture of the patient. In the literature, there are no established criteria for the use of loco-regional thrombolysis in CVST. On the basis of our own experience and few previous reports on the matter, we suggest that loco-regional thrombolysis should be considered an appropriate treatment for CVST when patients are at life risk, when an involvement of deep cerebral veins is present or when, after full heparinization, patients are doing poorly clinically.

Resin-based laboratory dental composites for prosthetic restorations have been developed in the past years as a cost-effective alternative to conventional porcelain-fused-to-metal or full ceramic restorations. The fracture toughness at different stress states (K(Ic), K(IIc), and mixed-modes K(I), K(II) ) was assessed for three laboratory dental composite resins used for prosthetic restorations that were aged up to 12 months in a food simulating fluid (10% ethanol) at 37 degrees C. The materials were mainly di- methacrylate based resins reinforced with submicron glass filler particles. The Brazilian disk test was used on precracked chevron-notched specimens, and different stress states were obtained by angulating the precracked chevron notch relative to the diametral compressive loading direction. The stress intensity factors were calculated using Atkinson et al.'s relation. For all three materials, mode I fracture toughness values ranged between 0.48-0.64 MPa. m(0.5) and mode II values ranged between 0.93-1.2 MPa. m(0.5). Overall, aging time and storage media had little effect on toughness. Considering the inherently low toughness of these restorative materials, their use should be limited to low stress masticatory areas.

SummarySafety and efficacy of the thrombolytic agent pro-urokinase (pro-UK) in the treatment of deep vein thrombosis of the lower limbs (DVT) have been investigated in an open, uncontrolled, pilot study. Fifteen patients were infused with 800.000 IU (5 mg)/h of pro-UK over 24 h (120 mg), together with unfractionated heparin adjusted to maintain the activated partial thromboplastin time between 1.5 and 2.5 times the basal value. Efficacy was assessed comparing venographic changes in the 11 evaluable limbs before and after pro-UK infusion. The Marder score decreased from a median pre-thrombolysis value of 28 (range 4-40) to 16 (3-38) (p

SummaryTo evaluate the role of low-molecular weight heparin (LMWH) as an alternative to oral anticoagulants in the prevention of recurrent venous thromboembolism, we compared in a randomized trial conventional warfarin treatment with a three-month course of enoxaparin 4000 anti-Xa units once a day subcutaneously. 187 patients with symptomatic deep-vein thrombosis (DVT), diagnosed by strain-gauge plethysmography plus D-dimer latex assay and confirmed by venography in most cases, were treated with full-dose subcutaneous heparin for ten days and then randomized to secondary prophylaxis. During the 3-month treatment period, 6 of the 93 patients who received LMWH (6%) and 4 of the 94 patients on warfarin (4%) had symptomatic recurrence of venous thromboembolism confirmed by objective testing (p = 0.5; 95% confidence interval [Cl] for the difference, -3% to 7%). Four patients in the LMWH group had bleeding complications as compared with 12 in the warfarin group (p = 0.04; 95% Cl for the difference, 4% to 14%). In the 9-month follow-up period, during which 34 patients on warfarin prolonged treatment for other 3 months and 14 up to one year, 10 patients in the enoxaparin group and 4 patients in the warfarin group suffered a documented recurrence of venous thromboembolism. Of these 14 late recurrences, just one occurred in patients with postoperative DVT. After one year there were 16 recurrences (17%) in the LMWH group and 8 (9%) in the warfarin group (p = 0.07; 95% Cl for the difference, 1% to 16%).These results confirm the potential of LMWH as an alternative to oral anticoagulants in this setting, and suggest to evaluate in a prospective study a slightly higher dose of enoxaparin in patients with postoperative DVT.

The diagnostic value of a latex D-dimer test combined with strain-gauge plethysmography (SGP) was assessed in 425 patients referred to our vascular laboratory because of clinically suspected deep-vein thrombosis (DVT) of lower limbs, using venography as the reference standard. The inpatient/outpatient ratio was 236 189 . Adequate venograms were obtained in 401 patients and a DVT was diagnosed in 195 (49%). SGP results were borderline in 38 patients. In the 363 unequivocal cases, sensitivity of SGP was 88% and specificity 90%. The sensitivity of D-dimer latex test was 78% and the specificity 88%. Out of the 363 unequivocal cases, D-dimer test results were discordant with SGP in 88 cases, of whom 60% had DVT and 40% had not, and concordant in 275. The sensitivity of concordant results was 98% ( 124 127 ) and specificity 97% ( 143 148 ). Compared with strain-gauge plethysmography (plus venography in case of borderline results), the combined approach reduced the diagnostic errors (false positive plus false negative results) from 10% ( 40 401 ; 95% confidence interval, 7–13%) to 2% ( 8 401 ; 95% CI, 0.6–3.4%) albeit requiring a greater number of venographies, from 9% ( 38 401 ; 95% CI, 7–12%) to 31% ( 126 401 ; 95% CI, 27–36%). Most calf DVT (94%) were identified. We conclude that this test combination is valuable in the diagnosis of DVT in symptomatic patients, because of the high accuracy of concordant test results. Venography is required in case of borderline or discordant results.

Thiazolidinediones (TZD) have been shown to down-regulate prostate-specific antigen (PSA) levels in prostate cancer cell lines and decrease PSA velocity among prostate cancer patients; however, the effect of TZDs on serum PSA levels among men with diabetes at risk for prostate cancer is unknown. We conducted a retrospective cohort study of veterans receiving care for diabetes between 1999 and 2005 to determine if TZD use affects PSA levels in veterans at risk for prostate cancer. Eligible patients were male, ≥45 years old, taking at least one oral antidiabetic medication, and with two or more recorded PSA values. Patients with a prior history of prostate cancer or prostatectomy were excluded. Of the 13,791 patients included in the adjusted analysis, 2,016 (14.6%) were prescribed a TZD. No effect of cumulative TZD dose on change in PSA was detected (P = 0.26). Increased TZD exposure was not associated with a change in PSA, suggesting that TZD treatment for diabetes is unlikely to affect prostate cancer detection. (Cancer Epidemiol Biomarkers Prev 2009;18(6):1937–8)

A reconfigurable and simultaneous dual band Galileo/GPS front-end receiver has been realized on 0.13-mum RFCMOS technology. The front-end uses only one fixed frequency PLL and VCO on a superheterodyne architecture to down-convert two RF (radio frequency) signals into two IF (intermediate frequency) signals in the range of 50 MHz to 150 Mhz. L1 and E1 signals are directly converted on one channel with one mixing stage. L2, E6, E5, E5a, E5b signals are down-converted with a double stage (two mixers) conversion. The two IF down-converted channels are filtered and then undersampled by two on chip ADC (analog to digital converter). The satellite channels can be selected and reconfigured only by changing the ADC sampling frequency according to the frequency plan and the off chip RF/IF filters. No PLL and VCO reconfiguration is need.

Recent years have seen an exponential increase of DVD equipped and navigation assisted cars. Nowadays a car trip can be both entertaining for passengers and computer assisted for drivers. In a further integration of automotive and information technologies, cars will be able to communicate to each other and to the Internet supporting safety, infotainment and pollution prevention applications. The research area which investigates topics, Vehicular Ad hoc NETworks (VANETs), is being widely investigated by both industry and academia. Position information plays a central role in many communication routing schemes designed for VANETs. This trend is justified by the feasibility of algorithms that route packets based on geographical proximity to the destination and by the widespread availability of navigation systems in cars. Geographical information is usually assumed accurate and precise. None of the algorithms available in literature, to the best of our knowledge, take into account possible position estimation errors. This paper is a first step in assessing the precision of a commercial GPS receiver for the support of vehicular communications. As we shall see, the performance of the receiver under investigation heavily depends on the type of urban area within this is employed. We believe that a strong understanding of the accuracy of such estimates is important to improve the performance and reliability of a vehicular network infrastructure. © IEEE.

Gli Autori valutano it ruolo della tomografia computerizzata nello studio della patologia encefalica neonatale; viene presentata una casistica di quadri TC riguardanti le malformazioni, la patologia emorragica ed ipossico-ischemica e le forme tumorali. Pur non volendo confrontare in tale sede la TC con le altre tecniche a disposizione, viene ricordato l'impiego sempre maggiore degli ultrasuoni nell'approccio diagnostico alla patologia encefalica neonatale. Viene sottolineata l'attuale validità della TC, e per lo studio dell'anatomia dell'encefalo del neonato a termine e pretermine, e per il riconoscimento dei quadri patologici, quali le emorragie della fossa cranica posteriore e negli spazi subaracnoidei, la patologia ipossico-ischemica e alcune forme malformative.

Summary271 patients with acute symptomatic deep venous thrombosis of lower limbs, confirmed by strain-gauge plethysmography and/ or venography, were randomly assigned to receive intermittent subcutaneous heparin calcium or heparin sodium by continuous intravenous infusion for 6–10 days. Heparin dosage was adjusted to maintain activated partial thromboplastin time values (Throm-bofax reagent) at 1.3–1.9 times the basal ones. Strain-gauge plethysmography was repeated at the end of heparin treatment, and evaluation of therapy was performed by comparing the indexes of venous hemodynamics and by assessing the incidence of pulmonary embolism and of bleeding complications.In the intravenous group, Maximal Venous Outflow (MVO) increased from 20.8 ± 12.8 to 28.4 ± 17.5 ml/min per 100 ml of tissue and Venous Capacitance (VC) from 1.39 ± 0.92 to 1.94 ± 1.0 ml/100 ml of tissue (mean ± SD). In the subcutaneous group, MVO increased from 21.0 ± 12.7 to 27.5 ± 18.1 and VC from 1.60 ± 0.86 to 2.06 ± 1.0. The median improvement of MVO and VC were 22% and 36% respectively in the IV group and 20% and 24% in the SC group. Clinical pulmonary embolism occurred in 2 patients in the intravenous group (1 fatal) and in 4 in the subcutaneous group (1 fatal). 9 major bleeding complications occurred in the intravenous group (1 fatal) and 5 in the subcutaneous group (1 fatal). The differences were not significant at the statistical analysis.The results suggest that subcutaneous intermittent heparin has a comparable efficacy to continuous intravenous heparin in the treatment of deep venous thrombosis.To the same conclusion points an overview of the seven randomized trials which compared these treatment modalities.

Sexuality and affectivity constitute a complex phenomenon involving many spheres: biological, psychological and social. To investigate these aspects, we distributed a dedicated questionnaire, followed by an interview, to 130 elderly residents in Milan and 100 in Monza. The answers indicated that the elderly communicate their emotions regarding the affective and sexual sphere, with different levels of desire for physical contact. The main variables were sex, age, marital status, co-morbidity and poly-pharmacotherapy, the perception of health status and of oneself, past experiences, cultural conditioning and social factors.

Introduction L’obesite se caracterise par une accumulation excessive de masse grasse ainsi qu’un etat inflammatoire chronique evoluant a bas bruit. Dans ce contexte, le stockage et le sensing nutritionnel representent un veritable challenge metabolique au niveau systemique et cellulaire. Parmi les processus biologiques susceptibles de contribuer aux alterations meta-inflammatoires caracteristiques de l’obesite, nous etudions l’autophagie, processus lysosomal permettant la degradation des organites cellulaires, lie au flux nutritionnel ainsi qu’a la regulation de la signalisation pro-inflammatoire. Patients et methodes Nous avons analyse les variations du flux de degradation autophagique dans des adipocytes isoles provenant de tissus adipeux preleves chez des patients obeses, obeses traites par chirurgie bariatrique, ou non obeses, ainsi que dans des adipocytes en culture dans lesquels des vecteurs viraux permettent de moduler l’expression de proteines regulatrices. Resultats Nous observons une diminution de l’activite autophagique adipocy-taire des sujets obeses comparee aux sujets non obeses, et une correlation inverse entre hypertrophie adipocytaire et activite autophagique suggerant un lien avec le stockage lipidique. Nous avons teste l’implication d’un candidat, la kinase DAPK2 (Death Associated Protein Kinase 2) exprimee preferentiellement dans les adipocytes et dont l’expression est fortement reduite dans le tissu adipeux des sujets obeses. L’inhibition de cette kinase induit une diminution de l’activite autophagique tandis qu’une surexpression augmente le processus dans des lignees adipocytaires. Nous observons egalement une restauration partielle et concomitante de l’activite autophagique et de l’expression genique de DAPK2 apres perte de poids induite par chirurgie bariatrique chez les sujets obeses, ren-forcant le role de cette kinase dans la regulation de l’autophagie et l’homeostasie adipocytaire. Conclusion Nos resultats montrent un lien entre l’expression de DAPK2 et le niveau d’activite autophagique dans les adipocytes. Ils suggerent qu’un defaut de regulation de l’activite de cette kinase pourrait contribuer a la dysfonction adipocytaire dans l’obesite. Declaration d’interet Les auteurs declarent ne pas avoir d’interet direct ou indirect (financier ou en nature) avec un organisme prive, industriel ou commercial en relation avec le sujet presente.

Ferromagnetic materials based on the Heusler alloy Ni 2 MnGa have been recognized as interesting actuating materials. Large strains can be obtained by applying an external magnetic field acting on the reorientation of the mesoscopic structure of martensite. Even if a great part of the investigation has been performed on single crystals, an interest exists for the development of polycrystalline technology. It has been recognized that, in order to balance the strong uncoupling effect due to the large number of fixed interfaces (e.g. the grain boundaries), the polycrystalline sample should have some texture. This should result in some pre-orientation of the twinned martensitic structure and, if possible, in a modification of the random distribution of the easy axis orientation within the material. Strong material texturing can be obtained basically by using directional solidification, rapid solidification techniques or plastic deformation. The effects of directional solidification, and of melt spinning have been evaluated in the past. In the present work, we report on successfully plastic deformation of polycrystalline NiMnGa alloys. In literature, there are few (if any) papers devoted to this topic. The great brittleness of the alloy at room temperature is well known. The rare attempts performed to deform the material are reported as failures. The approach used here is based on the hot working of NiMnGa ingots in special metallic cans filled with Argon and sealed. Hot deformation of a 7×7×40 mm 3 small slab down to 1.25×11.9×130 mm 3 was successful. Even after this severe plastic deformation, it was possible to easily remove the deformed material from the special can. The structural and functional characterization of the final product, which maintained the martensitic transformation, will be presented and discussed.

The mechanical response of the bovine periodontal ligament (PDL) subjected to uniaxial tension and compression is reported. Several sections normal to the longitudinal axis of bovine incisors and molars were extracted from different depths. Specimens with dimensions 10 x 5 x 2 mm including dentine, PDL and alveolar bone were obtained from these sections. Scanning electron microscopy suggested a strong similarity between the bovine PDL and the human PDL microstructure described in the literature. The prepared specimens were tested in a custom made uniaxial testing machine. They were clamped on their bone and dentine extremities and immersed in a saline solution at 37 degrees C. Stress-strain curves indicated that the PDL is characterized by a non-linear and time-dependent mechanical behaviour with the typical features of collagenous soft tissues. The curves exhibited hysteresis and preconditioning effects. The mechanical parameters evaluated in tension were maximum tangent modulus, strength, maximizer strain and strain energy density. For the molars, all these parameters increased with depth except for the apical region. For the incisors, all parameters increased with depth except ultimate strain which decreased. It was assumed that collagen fibre density and orientation were responsible for these findings.

Although intravenous (i.v.) heparin is widely used as the first line treatment for cerebral venous and sinus thrombosis (CVST), the most appropriate therapy for this disease is still controversial. We report 2 cases of CVST who were successfully treated by means of loco-regional thrombolysis with urokinase. In the first case we chose this treatment instead of i.v. heparin because clinical conditions of the patient appeared critical for life on hospital admission; in the second case loco-regional thrombolysis was performed because a full-dose heparin treatment over 8 days failed to improve the clinical picture of the patient. In the literature, there are no established criteria for the use of loco-regional thrombolysis in CVST. On the basis of our own experience and few previous reports on the matter, we suggest that loco-regional thrombolysis should be considered an appropriate treatment for CVST when patients are at life risk, when an involvement of deep cerebral veins is present or when, after full heparinization, patients are doing poorly clinically.

Resin-based laboratory dental composites for prosthetic restorations have been developed in the past years as a cost-effective alternative to conventional porcelain-fused-to-metal or full ceramic restorations. The fracture toughness at different stress states (K(Ic), K(IIc), and mixed-modes K(I), K(II) ) was assessed for three laboratory dental composite resins used for prosthetic restorations that were aged up to 12 months in a food simulating fluid (10% ethanol) at 37 degrees C. The materials were mainly di- methacrylate based resins reinforced with submicron glass filler particles. The Brazilian disk test was used on precracked chevron-notched specimens, and different stress states were obtained by angulating the precracked chevron notch relative to the diametral compressive loading direction. The stress intensity factors were calculated using Atkinson et al.'s relation. For all three materials, mode I fracture toughness values ranged between 0.48-0.64 MPa. m(0.5) and mode II values ranged between 0.93-1.2 MPa. m(0.5). Overall, aging time and storage media had little effect on toughness. Considering the inherently low toughness of these restorative materials, their use should be limited to low stress masticatory areas.

The cardioversion of atrial fibrillation is linked to a substantial risk of systemic embolization. In an effort to reduce it, the American College of Chest Physicians (ACCP) periodically publishes guidelines for the use of anticoagulation in the conversion of atrial fibrillation.Determination of the physician's compliance with the recommendations of the "Fourth ACCP Consensus Conference on Antithrombotic Therapy".The charts of people admitted to a community hospital in 1998 with a diagnosis of atrial fibrillation (n = 202) were evaluated retrospectively. Consideration was given to the ACCP's recommendation to give anticoagulants 3 weeks before and 4 weeks after elective cardioversion to patients who had been in atrial fibrillation for more than 2 days.Ninety-one of the 202 patients admitted with atrial fibrillation reported the onset of arrhythmia more than 48 hours before. Thirty-four of them underwent elective cardioversion and 13 cases (33%) went without anticoagulation in the preceding 2 weeks. Of these 13 cases, 8 were patients aged over 75 (range 78-88, mean 84). After sinus rhythm had been restored in 30 people (spontaneously in 5 of them), the anticoagulant therapy was not administered during the 4 recommended weeks in 10 people (33%), all of them over 75 (range 77.94, mean 84).Anticoagulation for cardioversion of atrial fibrillation is underused, especially among elderly patients. In order not to let age itself be an obstacle to the correct treatment of patients with high embolic risk, our efforts must be improved in order to identify the correct therapeutic choice in each particular case. Initiatives aimed at identifying and removing any impediment to the application of guidelines may contribute to stimulating physicians in the process of evaluating the quality of hospital treatment.

The last decade has witnessed substantial progress in the prevention and treatment of venous thromboembolism. However, the risk of deep vein thrombosis remains high in trauma patients and those undergoing orthopaedic surgery despite use of the best available prophylaxis. Existing antithrombotics also carry a significant risk of bleeding and other adverse effects, including heparin-induced thrombocytopenia (HIT). More effective and safer anticoagulants are therefore needed. Current approaches for improving the benefit:risk ratio of antithrombotic therapy include the development of indirect thrombin inhibitors with a high anti-Xa:anti-IIa activity ratio, and the use of direct thrombin inhibitors. Novel indirect thrombin inhibitors under investigation include pentasaccharide and the heparinoid danaparoid. These agents may offer reduced bleeding risk compared with conventional therapies, but there is no evidence of greater antithrombotic efficacy. However, due to low cross-reactivity with anti-heparin-platelet factor 4 antibodies, danaparoid and pentasaccharide may prove valuable in the management of HIT. Theoretically, the antithrombotic effect of direct thrombin inhibitors may be greater than that of indirect inhibitors because direct inhibitors are not dependent on endogenous cofactors and are able to inhibit both free and clot-bound thrombin. Direct inhibitors of the active site of thrombin and recombinant variants of hirudin, originally derived from the medicinal leech, are currently under investigation. Early data on lepirudin and desirudin suggest that recombinant hirudins may have clinical applications in thromboprophylaxis for high-risk patients, acute cardiology indications and HIT.

Diagnosis of acute deep vein thrombosis (DVT) and of pulmonary embolism (PE) is often difficult: symptomatic patients are usually investigated employing several diagnostic tests, which should be appropriately selected and sequenced, taking into account their sensitivity, specificity, safety and cost. The objective of this paper is to evaluate the performance of the new diagnostic tests and their combination in rational diagnostic strategies.A literature review was made using a Medline(R) database search for the period 1988-1998 on the following key words in various combinations: diagnosis, diagnostic strategy, venous thrombosis, pulmonary embolism, venous thromboembolism. Results of a new study by our group on diagnosis of DVT in hospitalized patients are also discussed.In patients with symptoms or signs suggestive of DVT, compression ultrasound (CUS) appears to be the diagnostic test of first choice, since it is a noninvasive test with high specificity and sensitivity for proximal DVT (about 97%). When CUS gives a negative result it is usually recommended that the test is repeated after one week, since its sensitivity for calf DVT is poor. The positive and negative predictive values (PPV and NPV) of CUS in symptomatic outpatients can be improved if adequate consideration is given to clinical diagnosis, using a standardized model (ref. #9), which allows symptomatic outpatients to be categorized as having a high, moderate or low probability of DVT. In case of agreement between clinical diagnosis and CUS results, no further testing is needed: patients with high or intermediate clinical probability and positive CUS results are treated, while in patients with low clinical probability and negative CUS results the diagnosis of DVT is excluded. In the case of discrepancy between clinical diagnosis and CUS results, D-dimer test and/or venography are requested. However in patients who develop signs or symptoms of DVT in the hospital the clinical model does not work, and diagnosis should be based on an appropriate mix of CUS, D-dimer (DD) test and venography. In patients presenting with signs or symptoms of pulmonary embolism, the ventilation/perfusion (V/P) lung scan remains a pivotal diagnostic test, and pulmonary angiography the reference standard, but both methods have limitations and in recent years other diagnostic tests such as echocardiography, helical (or spiral) computerized tomography, and magnetic resonance imaging have been introduced into clinical practice. Moreover, all four diagnostic tools mentioned for DVT diagnosis can be considered. Several diagnostic strategies have been proposed and evaluated in comparative studies but there is still debate over the most efficient test combination or sequence.Diagnostic strategies which include adequate consideration of clinical diagnosis using standardized models have the potential of being more efficient for outpatients (but not for inpatients) with symptoms or signs suggesting DVT of lower limbs. For patients with suspected PE, several diagnostic strategies have been assessed: V/P lung scan remains a pivotal diagnostic test, but its limitations have been increasingly recognized and newer non-invasive techniques are gaining credit. A consensus is still to be reached over the most appropriate combination of diagnostic tests.

Cerebral venous and sinus thrombosis (CVST) is still considered a severe clinical problem that is difficult to diagnose and manage and is linked to a poor prognosis. Nonetheless, conventional cerebral angiography and magnetic resonance imaging (MRI), or more recently, MR angiography allow a more rapid and precise diagnosis, and prognosis has improved with the use of anticoagulant treatment. We report 23 cases of CVST consecutively admitted to the Institute of Neurology of the University of Parma during the period 1990-1997. In all cases diagnosis was confirmed by means of MRI or conventional angiography of brain vessels. Among the patients, 22 were female and 1 was male. In all patients, plasma levels of protein C, protein S, antithrombin III (ATIII) and antiphospholipid antibodies (APA) were evaluated. In 15 of 23 patients, the presence of factor V Leiden mutation was also determined, and found positive in 3 patients (20%). Of the 22 female patients, 15 (68%) were on low-oestrogen (containing less than 50 microg oestrogen) oral contraceptive (OC) treatment. This percentage of OC use by patients with CVST is much higher than that of the rest of the female Italian population. OC use was associated with the presence of factor V Leiden mutation in two cases, with a deficiency of protein C in 1 case and a deficiency of protein S in another.Whether low-oestrogen Ocs may induce cerebral thromboembolic events is an open matter. According to our data, it may be argued that Ocs, even if at low oestrogen content, represent a major risk factor for CVST. The use of Ocs, as is the case for systemic venous thromboembolic events, may further increase the risk of CVST in women carrying the factor V Leiden mutation or other inherited hyperthrombotic conditions.