Left atrial anomalous muscular band as incidental finding during video-assisted mitral surgery

Congenital fibromuscular bands have been described inleft ventricle or right atrium and have been diagnosed by echocardiography and CT scan. The first report of anomalous band in the left atrium was described in 1897 by Rollestone (1). We hereby present a case of a patient with an incidental finding of left atrial band during a minimally invasive mitral surgery procedure

Chemical outbreak for tobacco mosaic virus control

Tobacco mosaic virus (TMV) represents a paradigm in virology, and its control may open the way to effective treatment against phytoviruses. However, the use of chemicals to eliminate the virus from infected plants is very difficult. In this state of the art survey we include trials on a) natural compounds derived from organisms, b) synthetic compounds and c) plant or microorganism extracts, from 2006 to 2015. Plants have been the main source of natural products for anti-TMV tests in the last ten years, and Nicotiana tabacum was the main focus of research, particularly between 2014-2015. Since 2012, there has been a great increase in publications (+45%) and identified compounds (+241%). Between 2012-2015, an average of 31 papers were published and 140 compounds were tested each year, compared to 9 papers and 26 compounds in 2006-2011. Unfortunately, there is little information on the action mechanisms of newly discovered or modified compounds. Cross references to the basic structure of compounds is provided in this review. This chemical outbreak this massive interest in chemical solutions to TMV could be due to the increasing availability of instruments for the analysis of organic compounds. Alternatively Another explanation could be that the chemistry advances in synthesis, which have provided countless drugs with potential benefits for TMV control, have overwhelmed overloaded the plant pathology screening needed to discriminate between compounds and to provide useful agrochemicals for farmers

Surgical embolectomy for acute massive pulmonary embolism: state of the art

Massive pulmonary embolism (PE) is a severe condition that can potentially lead to death caused by right ventricular (RV) failure and the consequent cardiogenic shock. Despite the fact thrombolysis is often administrated to critical patients to increase pulmonary perfusion and to reduce RV afterload, surgical treatment represents another valid option in case of failure or contraindications to thrombolytic therapy. Correct risk stratification and multidisciplinary proactive teams are critical factors to dramatically decrease the mortality of this global health burden. In fact, the worldwide incidence of PE is 60–70 per 100,000, with a mortality ranging from 1% for small PE to 65% for massive PE. This review provides an overview of the diagnosis and management of this highly lethal pathology, with a focus on the surgical approaches at the state of the art

Cerebrovascular complications and infective endocarditis. impact of available evidence on clinical outcome

Infective endocarditis (IE) is a life-threatening disease. Its epidemiological profile has substantially changed in recent years although 1-year mortality is still high. Despite advances in medical therapy and surgical technique, there is still uncertainty on the best management and on the timing of surgical intervention. The objective of this review is to produce further insight intothe short- and long-term outcomes of patients with IE, with a focus on those presenting cerebrovascular complications

1-Hour OGTT Plasma Glucose as a Marker of Progressive Deterioration of Insulin Secretion and Action in Pregnant Women

Considering old GDM diagnostic criteria, alterations in insulin secretion and action are present in women with GDM as well as in women with one abnormal value (OAV) during OGTT. Our aim is to assess if changes in insulin action and secretion during pregnancy are related to 1-hour plasma glucose concentration during OGTT. We evaluated 3 h/100 g OGTT in 4,053 pregnant women, dividing our population on the basis of 20 mg/dL increment of plasma glucose concentration at 1 h OGTT generating 5 groups (<120 mg/dL, n = 661; 120–139 mg/dL, n = 710; 140–159 mg/dL, n = 912; 160–179 mg/dL, n = 885; and ≥180 mg/dL, n = 996). We calculated incremental area under glucose (AUCgluc) and insulin curves (AUCins), indexes of insulin secretion (HOMA-B), and insulin sensitivity (HOMA-R), AUCins/AUCgluc. AUCgluc and AUCins progressively increased according to 1-hour plasma glucose concentrations (both P < 0.0001 for trend). HOMA-B progressively declined (P < 0.001), and HOMA-R progressively increased across the five groups. AUCins/AUCgluc decreased in a linear manner across the 5 groups (P < 0.001). Analysing the groups with 1-hour value <180 mg/dL, defects in insulin secretion (HOMA-B: −29.7%) and sensitivity (HOMA-R: +15%) indexes were still apparent (all P < 0.001). Progressive increase in 1-hour OGTT is associated with deterioration of glucose tolerance and alterations in indexes of insulin action and secretion

Detection of grapevine yellows symptoms in Vitis vinifera L. with artificial intelligence

Abstract Grapevine yellows (GY) are a significant threat to grapes due to the severe symptoms and lack of treatments. Conventional diagnosis of the phytoplasmas associated to GYs relies on symptom identification, due to sensitivity limits of diagnostic tools (e.g. real time PCR) in asymptomatic vines, where the low concentration of the pathogen or its erratic distribution can lead to a high rate of false-negatives. GY's primary symptoms are leaf discoloration and irregular wood ripening, which can be easily confused for symptoms of other diseases making recognition a difficult task. Herein, we present a novel system, utilizing convolutional neural networks, for end-to-end detection of GY in red grape vine (cv. Sangiovese), using color images of leaf clippings. The diagnostic test detailed in this work does not require the user to be an expert at identifying GY. Data augmentation strategies make the system robust to alignment errors during data capture. When applied to the task of recognizing GY from digital images of leaf clippings—amongst many other diseases and a healthy control—the system has a sensitivity of 98.96% and a specificity of 99.40%. Deep learning has 35.97% and 9.88% better predictive value (PPV) when recognizing GY from sight, than a baseline system without deep learning and trained humans respectively. We evaluate six neural network architectures: AlexNet, GoogLeNet, Inception v3, ResNet-50, ResNet-101 and SqueezeNet. We find ResNet-50 to be the best compromise of accuracy and training cost. The trained neural networks, code to reproduce the experiments, and data of leaf clipping images are available on the internet. This work will advance the frontier of GY detection by improving detection speed, enabling a more effective response to the disease

Evaluation of the Photocatalytic Activity of a Cordierite-Honeycomb-Supported TiO2 Film with a Liquid&#8211;Solid Photoreactor

Anatase nanoparticles in suspension have demonstrated high photoactivity that can be exploited for pollutant removal in water phases. The main drawback of this system is the difficulty of recovering (and eventually reusing) the nanoparticles after their use, and the possible interference of inorganic salts (e.g., sulfates) that can reduce the performance of the photocatalyst. The present work describes the development of a cordierite-honeycomb-supported TiO2 film to eliminate the problems of catalyst recovery. The catalyst was then tested against phenol in the presence of increasing concentrations of sulfates in a specially developed recirculating modular photoreactor, able to accommodate the supported catalyst and scalable for application at industrial level. The effect of SO42&minus; was evaluated at different concentrations, showing a slight deactivation only at very high sulfate concentration (&ge;3 g L&minus;1). Lastly, in the framework of the EU project Project &Ocirc;, the catalyst was tested in the treatment of real wastewater from a textile company containing a relevant concentration of sulfates, highlighting the stability of the photocatalyst

The role of ankle plantar flexion in the monitoring of diabetic patients at risk of foot ulcer

Limited ankle joint mobility (AJM) is a major risk factor for ulcers and a useful parameter for monitoring the health of patients with diabetes. The aim of this study was to test the feasibility and usefulness of evaluating AJM for monitoring ulcerative risk. AJM in plantar (PF) and dorsiflexion (DF) was evaluated in 99 patients with diabetes, type1/type2: 50/49, (58/41;M/F), and 59 healthy controls (32:27/M:F). Patients and controls were divided into 6 groups by age and neuropathy: 32 young patients (group YD), mean age 12.4±2.0 yr, 29 young controls (group YC), mean age 11.4 ± 3.3 yr, 38 elderly patients without neuropathy (group ED), mean age 58.5 ±10.3 yr, 15 neuropathic patients without history of foot ulcer (group ND), mean age 62.1 ± 7.9 yr, 14 neuropathic patients with history of foot ulcer (group NUD), mean age 64 ± 8.4 yrs, and 30 elderly healthy controls (group EC), mean age 60.3 ± 6.4 yr. AJM was evaluated by an inclinometer with the patient lying supine, the subtalar joint in neutral position and with the ankle in the position freely taken at the beginning. The knee, corresponding to the evaluated ankle, was extended and put over a rigid 5-cm high support. Diabetes duration was respectively: group YD 5.5 ± 3.5 yr, ED 16.5 ± 10.6 yr; ND 18.2 ± 13.1 yr and NUD 13.7 ± 9.6 yr. The NUD group showed a more significant AJM reduction in DF and PF than all other groups (p < 0.005). The reduction was 40.1% compared to the EC group and 46.9% compared to the YC group (78.1 ± 18.4 vs 147.2 ± 19.1, 130.4 ± 15.1). Only the DF was significantly reduced in the NUD group compared to the ED group (p < 0.001). The YD had more reduced AJM in both movements compared to the young controls (YC) (p < 0.001) with PF more reduced than DF (30.9% vs 15.5%). Among patients and controls the elderly groups had significant reduction of only DF (EC vs YC p < 0.001; ED vs YD p < 0.05). As in previous studies, these results confirm that an AJM reduction of about 40% (28-32) in patients with diabetic neuropathy can be considered as a threshold for ulcer risk. The method used permits direct evaluation of AJM in plantar flexion that seems to show an early reduction in diabetic subjects, thereby providing useful information for patient monitoring

Musculoskeletal manifestations of diabetes mellitus: the role of exercise therapy in the treatment of limited joint mobility, muscle weakness and reduced gait speed

It is well known that limited joint mobility of the ankle and foot, impaired muscular performance and reduced gait speed are risk factors for ulceration in diabetic foot. The aim of this study was to evaluate the effect of an experimental protocol of exercise therapy on joint mobility, muscular strength and gait speed in a group of longterm diabetic subjects. The protocol consisted of a 12-week supervised training program; both joint mobility and muscular strength at the ankle were measured before and after exercise therapy by an inclinometer and isometric dynamometers respectively, in 26 diabetic subjects and compared to 17 healthy controls. Ankle joint mobility in plantar flexion was reduced about 36% and dorsal flexion by about 23% in diabetic subjects compared to controls (p&lt;0.001), but significantly increased after exercise therapy (p&lt;0.001 for both). Ankle muscular strength in plantar flexion was reduced by about 51% and in dorsal flexion by 30% in diabetic patients compared to controls, but these also significantly increased after exercise therapy (p&lt;0.001). Consequently, patients’ walking speed increased after exercise therapy by 0.28 m/s (p&lt;0.001). A 12-week supervised program of exercise therapy significantly improves joint mobility, muscular performance and walking speed in diabetic patients--thus limiting one of the pathogenic factors of diabetic foot and potentially preventing disabilit