Mini-extracorporeal circulation minimizes coagulation abnormalities and ameliorates pulmonary outcome in coronary artery bypass grafting surgery

Hemostasis is impaired during CABG and coagulation abnormalities often result in clinically relevant organ dysfunctions, eventually increasing morbidity and mortality rates. Fifteen consecutive patients with coronary artery disease submitted to conventional extracorporeal circulation (cECC) have been compared with 15 matched patients, using mini-ECC (MECC). Postoperative lung function was evaluated according to gas exchange, intubation time and lung injury score. In the MECC group, thrombin-antithrombin complex levels (TaTc), prothrombin fragments (PF1+2) formation and thromboelastography (TEG) clotting times were lower compared to the cECC group (p=0.002 and p<0.001, respectively) whereas postoperative blood loss was higher in the cECC group (p=0.030) and more patients required blood transfusion (p=0.020). In the MECC group, postoperative gas exchange values were better, intubation time shorter and lung injury score lower (p<0.001 for all comparisons). Our study suggests that MECC induces less coagulation disorders, leading to lower postoperative blood loss and better postoperative lung function. This approach may be advantageous in high-risk patients. © The Author(s) 2013

Superhydrophobic coatings as anti-icing systems for small aircraft

Traditional anti-icing/de-icing systems, i.e., thermal and pneumatic, in most cases require a power consumption not always allowable in small aircraft. Therefore, the use of passive systems, able to delay the ice formation, or reduce the ice adhesion strength once formed, with no additional energy consumption, can be considered as the most promising solution to solve the problem of the ice formation, most of all, for small aircraft. In some cases, the combination of a traditional icing protection system (electrical, pneumatic, and thermal) and the passive coatings can be considered as a strategic instrument to reduce the energy consumption. The effort of the present work was to develop a superhydrophobic coating, able to reduce the surface free energy (SFE) and the work of adhesion (WA) of substrates, by a simplified and non-expensive method. The developed coating, applied as a common paint with an aerograph, is able to reduce the SFE of substrates by 99% and the WA by 94%. The effects of both chemistry and surface morphology on the wettability of surfaces were also studied. In the reference samples, the higher the roughness, the lower the SFE and the WA. In coated samples with roughness ranging from 0.4 and 3 μm no relevant variations in water contact angle, nor in SFE andWA were observed

Drop test simulation and validation of a full composite fuselage section of a regional aircraft

Abstract In the aircraft industry, the use of fiber reinforced materials for primary structural components over metallic parts has increased up to more than 50% in the recent years, because of their high strength and high modulus to weight ratios, high fatigue and corrosion resistance. Currently, the need of lowering weight and fuel consumption is pushing the world's largest aircraft manufacturers in the design and building of structures entirely made of composites. Fuselage structure plays an important role in absorbing the kinetic energy during a crash. Through the deformation, crushing and damage of fuselage sub-floor structure, a survivable space inside the cabin area should be preserved during and after a crash impact in order to minimize the risk of passengers' injuries. In this work, a Finite Element (FE) model of a full-scale 95% composites made fuselage section of a regional aircraft under vertical drop test is presented. The experiment, conducted by the Italian Aerospace Research Centre (CIRA) with an actual impact velocity of 9.14 m/s in according to the FAR/CS 25, has been numerically simulated. Two ATDs (Anthropomorphic Test Dummies), both 50th percentile, seats and belts have been modelled to reproduce the experimental setup. The results of the simulation, performed by using LS-DYNA® explicit FE code, have been validated by correlation with the experimental ones. Such comparisons highlight that a good agreement has been achieved. The presented FE model allows verifying the structural behavior under a dynamic load condition and also estimating the passive safety capabilities of the designed structure. Since the experiment is expensive and non-repeatable, a FE model can be used for Certification by Analysis purposes since, if established, it is able to virtually demonstrate the compliance to the airworthiness rules

MAPK15 protects from oxidative stress-dependent cellular senescence by inducing the mitophagic process

Mitochondria are the major source of reactive oxygen species (ROS), whose aberrant production by dysfunctional mitochondria leads to oxidative stress, thus contributing to aging as well as neurodegenerative disorders and cancer. Cells efficiently eliminate damaged mitochondria through a selective type of autophagy, named mitophagy. Here, we demonstrate the involvement of the atypical MAP kinase family member MAPK15 in cellular senescence, by preserving mitochondrial quality, thanks to its ability to control mitophagy and, therefore, prevent oxidative stress. We indeed demonstrate that reduced MAPK15 expression strongly decreases mitochondrial respiration and ATP production, while increasing mitochondrial ROS levels. We show that MAPK15 controls the mitophagic process by stimulating ULK1-dependent PRKN Ser108 phosphorylation and inducing the recruitment of damaged mitochondria to autophagosomal and lysosomal compartments, thus leading to a reduction of their mass, but also by participating in the reorganization of the mitochondrial network that usually anticipates their disposal. Consequently, MAPK15-dependent mitophagy protects cells from accumulating nuclear DNA damage due to mitochondrial ROS and, consequently, from senescence deriving from this chronic DNA insult. Indeed, we ultimately demonstrate that MAPK15 protects primary human airway epithelial cells from senescence, establishing a new specific role for MAPK15 in controlling mitochondrial fitness by efficient disposal of old and damaged organelles and suggesting this kinase as a new potential therapeutic target in diverse age-associated human diseases

The FHP01 DDX3X helicase inhibitor exerts potent anti-tumor activity in vivo in breast cancer pre-clinical models

Inhibition of DDX3X expression or activity reduces proliferation in cells from various tumor tissues, in particular in breast cancer, and its expression often correlates to tumor aggressiveness. This makes DDX3X a prominent candidate for the design of drugs for novel personalized therapeutic strategies. Starting from an in silico drug discovery approach, a group of molecules has been selected by molecular docking at the RNA binding site of DDX3X. Here, the most promising among them, FHP01, was evaluated in breast cancer preclinical models. Specifically, FHP01 exhibited very effective antiproliferative and killing activity against different breast cancer cell types, among which those from triple-negative breast cancer (TNBC). Interestingly, FHP01 also inhibited WNT signaling, a key tumorigenic pathway already correlated to DDX3X functions in breast cancer model cell lines. Ultimately, FHP01 also caused a significant reduction, in vivo, in the growth of MDA MB 231- derived TNBC xenograft models. Importantly, FHP01 showed good bioavailability and no toxicity on normal peripheral blood mononuclear cells in vitro and on several mouse tissues in vivo. Overall, our data suggest that the use of FHP01 and its related compounds may represent a novel therapeutic approach with high potential against breast cancer, including the triple-negative subtype usually correlated to the most unfavorable outcomes because of the lack of available targeted therapies

Myocardial fibrosis and diastolic dysfunction in patients on chronic haemodialysis

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Expression pattern of perilipins in human brain during aging and in Alzheimer's disease

Aims: Perilipins are conserved proteins that decorate intracellular lipid droplets and are essential for lipid metabolism. To date, there is limited knowledge on their expression in human brain or their involvement in brain aging and neurodegeneration. The aim of this study was to characterise the expression levels of perilipins (Plin1–Plin5) in different cerebral areas from subjects of different age, with or without signs of neurodegeneration. Methods: We performed real-time RT-PCR, western blotting, immunohistochemistry and confocal microscopy analyses in autoptic brain samples of frontal and temporal cortex, cerebellum and hippocampus from subjects ranging from 33 to 104 years of age, with or without histological signs of neurodegeneration. To test the possible relationship between Plins and inflammation, correlation analysis with IL-6 expression was also performed. Results: Plin2, Plin3 and Plin5, but not Plin1 and Plin4, are expressed in the considered brain areas with different intensities. Plin2 appears to be expressed more in grey matter, particularly in neurons in all the areas analysed, whereas Plin3 and Plin5 appear to be expressed more in white matter. Plin3 seems to be expressed more in astrocytes. Only Plin2 expression is higher in old subjects and patients with early tauopathy or Alzheimer's disease and is associated with IL-6 expression. Conclusions: Perilipins are expressed in human brain but only Plin2 appears to be modulated with age and neurodegeneration and linked to an inflammatory state. We propose that the accumulation of lipid droplets decorated with Plin2 occurs during brain aging and that this accumulation may be an early marker and initial step of inflammation and neurodegeneration

Cardiac surgery practice during the COVID-19 outbreak: A regionwide survey

Background: Health systems worldwide have been overburdened by the "COVID-19 surge". Consequently, strategies to remodulate non-COVID medical and surgical care had to be developed. Knowledge of the impact of COVID surge on cardiac surgery practice is mainstem. Present study aims to evaluate the regional practice pattern during lockdown in Campania. Methods: A multicenter regional observational 26-question survey was conducted, including all adult cardiac surgery units in Campania, Italy, to assess how surgical practice has changed during COVID-19 national lockdown. Results: All centers adopted specific protocols for screening patients and personnel. A significant reduction in the number of dedicated intensive care unit (ICU) beds (-30.0%±38.1%, range: 0-100%) and cardiac operating rooms (-22.2%±26.4%, range: 0-50%) along with personnel relocation to other departments was disclosed (anesthesiologists -5.8%±11.1%, range: 0-33.3%; perfusionists -5.6%±16.7%, range: 0-50%; nurses -4.8%±13.2%, range: 0-40%; cardiologists -3.2%±9.5%, range: 0-28.6%). Cardiac surgeons were never reallocated to other services. Globally, we witnessed dramatically lower adult cardiac surgery case volumes (335 vs. 667 procedures, P<0.001), as institutions and surgeons followed guidelines to curtail non-urgent operations. Conclusions: This regional survey demonstrates major changes in practice as a response to the COVID-19 pandemic. In this respect, this experience might lead to the development of permanent systems-based plans for future pandemic and may effectively help policy decision making when prioritizing healthcare resource reallocation during and after the pandemic