Endovascular treatment of spontaneous isolated abdominal aortic dissection

Isolated abdominal aortic dissection is a rare clinical disease representing only 1.3% of all dissections. There are a few case series reported in the literature. The causes of this pathology can be spontaneous, iatrogenic, or traumatic. Most patients are asymptomatic and symptoms are usually abdominal or back pain, while claudication and lower limb ischemia are rare. Surgical and endovascular treatment are two valid options with acceptable results. We herein describe nine cases of symptomatic spontaneous isolated abdominal aortic dissection, out of which four successfully were treated with an endovascular approach between July 2003 and July 2013. All patients were men, smokers, symptomatic (either abdominal or back pain or lower limb ischemia), with a history of high blood pressure, with a medical history negative for concomitant aneurysmatic dilatation or previous endovascular intervention. Diagnosis of isolated abdominal aortic dissection were established by contrast-enhanced computed tomography angiography (CTA) of the thoracic and abdominal aorta. All nine patients initially underwent medical treatment. In four symptomatic cases, non-responsive to medical therapy, bare-metal stents or stent grafts were successfully positioned. All patients completed a CTA follow-up of at least 12 months, during which they remained symptom-free. Endovascular management of this condition is associated with a high rate of technical success and a low mortality; therefore, it can be considered the treatment of choice when it is feasible

Web-based system for assessing risk factors for falls in community-dwelling elderly people using the Analytic Hierarchy Process

Falls occur frequently among older people and represent the most common cause of injury-related morbidity and mortality in later life. Preventing falls is an important way to reduce injuries, hospitalizations, and injury-related morbidity and mortality among older people. The research literature has identified hundreds of risk factors for falls among elderly people. Prioritizing risk factors for falls is useful for designing effective and efficacious prevention programs. The aim of this study was to use the Analytic Hierarchy Process to develop a hierarchy of risk factors for falls based on the knowledge and experience of experts working in this field

The use of classification and regression tree to predict 15-year survival in community-dwelling older people

Previous research has identified various risk factors for mortality in older people. The aim of this paper was to use Classification and Regression Tree to predict 15-year survival in community-dwelling older people. Data were obtained from a United Kingdom representative sample of 1042 community-dwelling people aged 65 and over. Outcome was time from 1985 interview to death or censorship on February 29, 2000. Classification and Regression Tree is a non-parametric technique widely used in medical domain classification. We applied CART to the set of risk-factors identified in a previous research. The selected CART model is based on age, dose of drug prescribed and handgrip measures. It predicts survival with a sensitivity rate of 76.3% and a specificity rate of 66.3%. The selection of variables are consistent with previous research. Finally, we observed the range of risk factors and their combination associated with increased and decreased mortality

Design, Implementation and Testing of a Network-Based Earthquake Early Warning System in Greece

In this study we implemented and tested the Earthquake Early Warning system PRESTo (PRobabilistic and Evolutionary early warning System, Satriano et al., 2011) on the Greek Ionian islands of Lefkada, Zakynthos and Kefalonia. PRESTo is a free and open source platform for regional Earthquake Early Warning developed at the University of Naples Federico II, which is currently under experimentation in Southern Italy, in the area covered by the Irpinia Seismic Network. The three Ionian islands selected for this study are located on the North-Western part of the Hellenic trench. Here the seismicity rate and the seismic hazard, coupled with the vulnerability of existing critical infrastructures, make this region among the highest seismic risk areas in Europe, where the application of Earthquake Early Warning systems may become a useful strategy to mitigate the potential damage caused by earthquakes. Here we studied the feasibility of implementing an Earthquake Early Warning system on an existing seismic network, which was not specifically made for earthquake early warning purposes, and evaluated the performance of the system, using a data set of real-earthquake recordings. We first describe the technical details of the implementation of PRESTo in the area of interest, including the preliminary parameter configuration and the empirical scaling relationship calibration. Then we evaluated the performance of the system through the off-line analysis of a database of real earthquake records belonging to the most recent M > 4.0 earthquakes occurred in the area. We evaluated the performance in terms of source parameter estimation (location, magnitude), accuracy of ground shaking prediction and lead-time analysis. Finally, we show the preliminary results of the real-time application of PRESTo, performed during the period 01–31 July 2019

Measurement of IEC Groups and Subgroups Using Advanced Spectrum Estimation Methods

The International Electrotechnical Commission (IEC) standards characterize the waveform distortions in power systems with the amplitudes of harmonic and interharmonic groups and subgroups. These groups/subgroups utilize the waveform spectral components obtained from a fixed frequency resolution discrete Fourier transform (DFT). Using the IEC standards allows for a compromise among the different goals, such as the needs for accuracy, simplification, and unification. In some cases, however, the power-system waveforms are characterized by spectral components that the DFT cannot capture with enough accuracy due to the fixed frequency resolution and/or the spectral leakage phenomenon. This paper investigates the possibility of a group/subgroup evaluation using the following advanced spectrum estimation methods: adaptive Prony, estimation of signal parameters via rotational invariance techniques, and root MUltiple-SIgnal Classification (MUSIC). These adaptive methods use variable lengths of time windows of analysis to ensure the best fit of the waveforms; they are not characterized by the fixed frequency resolution and do not suffer from the spectral leakage phenomenon. This paper also presents the results of the applications of these methods to three test waveforms, to current and voltage waveforms obtained from simulations of a real dc arc-furnace plant, and to waveforms measured at the point of common coupling of the low-voltage network supplying a high-performance laser printer

Construction of a synthetic infectious cDNA clone of Grapevine Algerian latent virus (GALV-Nf) and its biological activity in Nicotiana benthamiana and grapevine plants

Background: Grapevine Algerian latent virus (GALV) is a tombusvirus first isolated in 1989 from an Algerian grapevine (Vitis spp.) plant and more recently from water samples and commercial nipplefruit and statice plants. No further reports of natural GALV infections in grapevine have been published in the last two decades, and artificial inoculations of grapevine plants have not been reported. We developed and tested a synthetic GALV construct for the inoculation of Nicotiana benthamiana plants and different grapevine genotypes to investigate the ability of this virus to infect and spread systemically in different hosts. Methods: We carried out a phylogenetic analysis of all known GALV sequences and an epidemiological survey of grapevine samples to detect the virus. A GALV-Nf clone under the control of the T7 promoter was chemically synthesized based on the full-length sequence of the nipplefruit isolate GALV-Nf, the only available sequence at the time the project was conceived, and the infectious transcripts were tested in N. benthamiana plants. A GALV-Nf-based binary vector was then developed for the agroinoculation of N. benthamiana and grapevine plants. Infections were confirmed by serological and molecular analysis and the resulting ultrastructural changes were investigated in both species. Results: Sequence analysis showed that the GALV coat protein is highly conserved among diverse isolates. The first epidemiological survey of cDNAs collected from 152 grapevine plants with virus-like symptoms did not reveal the presence of GALV in any of the samples. The agroinoculation of N. benthamiana and grapevine plants with the GALV-Nf binary vector promoted efficient infections, as revealed by serological and molecular analysis. The GALV-Nf infection of grapevine plants was characterized in more detail by inoculating different cultivars, revealing distinct patterns of symptom development. Ultrastructural changes induced by GALV-Nf in N. benthamiana were similar to those induced by tombusviruses in other hosts, but the cytopathological alterations in grapevine plants were less severe. Conclusions: This is the first report describing the development of a synthetic GALV-Nf cDNA clone, its artificial transmission to grapevine plants and the resulting symptoms and cytopathological alterations

Uptake and effects of a mixture of widely used therapeutic drugs in Eruca sativa L. and Zea mays L. plants

Pharmaceutically active compounds (PACs) are continuously dispersed into the environment due to human and veterinary use, giving rise to their potential accumulation in edible plants. In this study, Eruca sativa L. and Zea mays L. were selected to determine the potential uptake and accumulation of eight different PACs (Salbutamol, Atenolol, Lincomycin, Cyclophosphamide, Carbamazepine, Bezafibrate, Ofloxacin and Ranitidine) designed for human use. To mimic environmental conditions, the plants were grown in pots and irrigated with water spiked with a mixture of PACs at concentrations found in Italian wastewaters and rivers. Moreover, 10 7 and 100 7 concentrations of these pharmaceuticals were also tested. The presence of the pharmaceuticals was tested in the edible parts of the plants, namely leaves for E. sativa and grains for Z. mays. Quantification was performed by liquid chromatography mass spectroscopy (LC/MS/MS). In the grains of 100 7 treated Z. mays, only atenolol, lincomycin and carbamazepine were above the limit of detection (LOD). At the same concentration in E. sativa plants the uptake of all PACs was >LOD. Lincomycin and oflaxacin were above the limit of quantitation in all conditions tested in E. sativa. The results suggest that uptake of some pharmaceuticals from the soil may indeed be a potential transport route to plants and that these environmental pollutants can reach different edible parts of the selected crops. Measurements of the concentrations of these pharmaceuticals in plant materials were used to model potential adult human exposure to these compounds. The results indicate that under the current experimental conditions, crops exposed to the selected pharmaceutical mixture would not have any negative effects on human health. Moreover, no significant differences in the growth of E. sativa or Z. mays plants irrigated with PAC-spiked vs. non-spiked water were observed

Practical points of attention beyond instructions for use with the Zenith fenestrated stent graft.

Fenestrated stent grafting for endovascular repair (F-EVAR) aims to treat patients with abdominal aortic aneurysms that are unsuitable for standard EVAR because of a short or absent infrarenal neck. F-EVAR has been used initially in patients with higher surgical risk with pararenal abdominal aortic aneurysms, but F-EVAR is now increasingly considered a treatment alternative to open surgery in anatomically suitable patients. F-EVAR has benefitted from ongoing technical refinements and accumulating clinical experience but remains a relatively complex procedure. Correct indication, accurate preoperative planning, and meticulous execution are the key to long-term success. Considering the growing interest in F-EVAR worldwide, including the United States, we discuss current indications and provide advice for planning and technical execution on the basis of the senior authors' 13 years of experience