cardiovascular risk factors and sympatho vagal balance importance of time domain heart rate variability

Objective: Cardiovascular Disease (CVD) is the leading cause of death and disability worldwide. sDyregulation of the autonomic nervous system associated with various pathological conditions often occurs in presence of cardiovascular risk factors. Heart Rate Variability (HRV) may be used to assess autonomic imbalances. The aim of our study is to evaluate the correlation between HRV and the main cardiovascular risk factors in subject who underwent digital ambulatory 24 hours Holter ECG monitoring for clinical investigations. Methods: We evaluated time domain parameters of HRV by Holter ECG monitoring in a large population categorized based on the presence or absence of the major cardiovascular risk factors. Results: We found significant differences in time domain parameters of HRV in patients with and without common risk factor for CVD such as diabetes, family history for Coronary Artery Disease and dyslipidemia. We also analyzed our study population based on age and we found a positive correlation with the standard deviation of all NN intervals (SDNN), square root of the mean of the sum of the square of the differences between adjacent NN intervals (RMSSD), mean R-R intervals and by the number of adjacent NN intervals differing by more than 50 ms divided by the total number of all NN intervals (pNN50) and an inverse correlation for the others parameters. Conclusion: Non-modifiable risk factors (age, gender, family history) along with dyslipidemia and diabetes, are related to a change in HRV, while modifiable risk factors (smoking, hypertension, overweight, hyperhomocysteinemia) showed no correlation. This would seem to indicate that the genetic components more than lifestyle habits and behavior act on the nervous control of the heart. Our study shows the possibility to find interesting clinical-prognostic data, analyzing simple parameters obtained from instrumental methods of investigation performed for other clinical reasons

Integration of an Autothermal Outer Electrified Reformer Technology for Methanol Production from Biogas: Enhanced Syngas Quality Production and CO2 Capture and Utilization Assessment

Biogas has emerged as a valid feedstock for biomethanol production from steam reforming. This study investigates an alternative layout based on an auto-thermal electrified reforming assuming a 1 MW equivalent anaerobic digestion plant as a source for methanol synthesis. The process considers an oxy-steam combustion of biogas and direct carbon sequestration with the presence of a reverse water–gas shift reactor to convert CO2 and H2 produced by a solid oxide electrolyzer cell to syngas. Thermal auto-sufficiency is ensured for the reverse water–gas shift reaction through the biogas oxy-combustion, and steam production is met with the integration of heat network recovery, with an overall process total electrical demand. This work compares the proposed process of electrification with standard biogas reforming and data available from the literature. To compare the results, some key performance indicators have been introduced, showing a carbon impact of only 0.04 kgCO2/kgMeOH for the electrified process compared to 1.38 kgCO2/kgMeOH in the case of biogas reforming technology. The auto-thermal electrified design allows for the recovery of 66.32% of the carbon available in the biogas, while a similar electrified process for syngas production reported in literature reaches only 15.34%. The overall energy impact of the simulated scenarios shows 94% of the total energy demand for the auto-thermal scenario associated with the electrolyzer. Finally, the introduction of the new layout is taken into consideration based on the country’s carbon intensity, proving carbon neutrality for values lower than 75 gCO2/kWh and demonstrating the role of renewable energies in the industrial application of the process

Experience with the Quality Assurance of the Superconducting Electrical Circuits of the LHC Machine

The coherence between the powering reference database for the LHC and the Electrical Quality Assurance (ELQA) is guaranteed on the procedural level. However, a challenge remains the coherence between the database, the magnet test and assembly procedures, and the connection of all superconducting circuits in the LHC machine. In this paper, the methods, tooling, and procedures for the ELQA during the assembly phase of the LHC will be presented in view of the practical experience gained in the LHC tunnel. Some examples of detected polarity errors and electrical non-conformities will be presented. The parameters measured at ambient temperature, such as the dielectric insulation of circuits, will be discussed

Automatic System for the D.C. High Voltage Qualification of the Superconducting Electrical Circuits of the LHC Machine

A d.c. high voltage test system has been developed to verify automatically the insulation resistance of the powering circuits of the LHC. In the most complex case, up to 72 circuits share the same volume inside cryogenic lines. Each circuit can have an insulation fault versus any other circuit or versus ground. The system is able to connect up to 80 circuits and apply a voltage up to 2 kV D.C. The leakage current flowing through each circuit is measured within a range of 1 nA to 1.6 mA. The matrix of measurements allows characterizing the paths taken by the currents and locating weak points of the insulation between circuits. The system is composed of a D.C. voltage source and a data acquisition card. The card is able to measure with precision currents and voltages and to drive up to 5 high voltage switching modules offering 16 channels each. A LabVIEW application controls the system for an automatic and safe operation. This paper describes the hardware and software design, the testing methodology and the results obtained during the qualification of the LHC superconducting circuits

The impact of ventral oral graft bulbar urethroplasty on sexual life

Objective: To evaluate the pre- and postoperative aspects of sexual life (SL) in patients with bulbar urethral stricture who underwent ventral oral graft urethroplasty. Methods: Between 2009 and 2010, 52 men (mean age 36 years) were enrolled in our prospective study to ascertain sexual disorders before and after surgery. The validated Male Sexual Health Questionnaire-Long Form (MSHQ-LF) was completed pre- and postoperatively; the unvalidated but adapted Post-Urethroplasty Sexual Questionnaire (PUSQ) was completed postoperatively. Data were compared using the non parametric Wilcoxon test. Results: Before urethroplasty, most of the patients reported sexual disorders, in particular reduced ejaculatory stream (85%); many of them (35%) feared the risk of a postoperative worsening in the quality of SL. After urethroplasty, nobody reported a worsened erection, while most of the patients noticed a significant improvement in erection, ejaculation, relationship with their partner, sexual activity, and desire. Modifications in the scrotoperineal sensitivity were reported by 42% and 15% noticed esthetic changes without impact on SL. All patients reported an improvement in quality of life (QOL) and were satisfied with the outcome of urethroplasty. Conclusion: Urethral stricture disease may be responsible for sexual disorders that have a significant impact upon SL. Patients confessed a marked anxiety tackling urethroplasty and declared that one of their deepest fears regarded a potential further deterioration in the quality of SL. At short-term follow-up, the minimally invasive ventral graft urethroplasty does not cause sexual complications, apart from the post-ejaculation dribbling. On the contrary, this technique showed to restore SL in all its aspects

A puzzling Mule Coin from the Parabita Hoard: a Material Characterisation

In this research, we report on the compositional, microstructural and crystallographic properties of a lead coin which has been regarded for many years as a genuine silver coin minted in the Southern Italy in the course of the 4th century BC. The material characterisation of this object allowed detecting an ancient forging technology, not previously reported, which was meant for the silvering of lead substrates The data collected have disclosed a contemporary counterfeiting procedure based on a metal coating process onto a Pb substrate. This coating has been identified as a bi-layer with a Cu innermost and an Ag outermost visible layer. As far as the coating application technique is concerned, the gathered evidence has clearly indicated that the original appearance of this artifact cannot be explained in terms of any of the established methods for the growth of an artificially silvered coating in classical antiquity. This technology is now being explained in terms of modern, fully non destructive scientific methods.Comment: 9 pages including 8 figures. To be presented at the Cavallino Archaeometry Workshop 2006, Cavallino (Lecce - Italy) - May 22-25, 200

Microalbuminuria and sRAGE in High-Risk Hypertensive Patients Treated with Nifedipine/Telmisartan Combination Treatment: A Substudy of TALENT

Some antihypertensive drugs have also renoprotective and anti-inflammatory properties that go beyond their effect on blood pressure. It has been suggested that microalbuminuria and glomerular filtration rate (GFR) are associated with circulating levels of the soluble form of the receptor, sRAGE (soluble receptor for advanced glycation ends-products). In the present analysis, we used data from the TALENT study to evaluate soluble receptor for advanced glycation end-products (sRAGE) plasma levels in patients with hypertension and high-cardiovascular risk-treated nifedipine and telmisartan in combination. Treatment with nifedipine-telmisartan significantly decreased mean systolic and diastolic ambulatory blood pressure and resulted in a significant increase in sRAGE plasma concentrations after 24 weeks of therapy. We concluded that in hypertensive patients with early-stage renal disease, sRAGE concentrations are not influenced by either microalbuminuria or GFR. Long-term treatment with a combination of nifedipine-telmisartan may have a beneficial effect increasing sRAGE plasma levels, thus exerting an atheroprotective and anti-inflammatory activity

Disposable versus reusable ureteroscopes. A prospective multicenter randomized comparison

Introduction: To compare reusable and disposable flexible ureteroscopes in terms of efficacy and safety for patients undergoing RIRS, with specific reference to post-operative complications and infection rates. Materials and methods: Patients with a renal stone eligible for RIRS were enrolled in this multicenter, randomized, clinical trial study. Patients were randomized into two groups: group A (90 patients) underwent RIRS with a reusable flexible ureteroscope and group B (90 patients) were treated with a disposable one. Results: The patients’ demographics, stones features and preoperative urine cultures were comparable between the groups. The SFRs were not significantly different (86,6% and 90,0% for group A and group B respectively, p = 0.11) and the mean cost for each procedure was comparable (2321 € in group A vs 2543 € in group B, p = 0.09). However, the days of hospitalization and of antibiotic therapy were higher in group A (p ≤ 0.05). The overall complication rate in group A was 8.8% whilst in group B it was 3.3% (p ≤ 0.05); in particular, group A exhibited a greater number of major complications (Clavien score IIIa-V). The overall postoperative infections rate was 16.6% in group A and 3.3% in group B (p ≤ 0.05). Furthermore, none of the patients in group B developed urosepsis or had a positive blood culture, while 3 patients in group A did (p < 0.05). Conclusions: The use of disposable ureteroscopes is characterized by significantly lower post-operative complications and infection rates, while having comparable costs and SFRs vis à vis reusable ureteroscopes

Liposomes loaded with everolimus and coated with hyaluronic acid: A promising approach for lung fibrosis

Chronic lung allograft dysfunction (CLAD) and interstitial lung disease associated with collagen tissue diseases (CTD-ILD) are two end-stage lung disorders in which different chronic triggers induce activation of myo-/fibroblasts (LFs). Everolimus, an mTOR inhibitor, can be adopted as a potential strategy for CLAD and CTD-ILD, however it exerts important side effects. This study aims to exploit nanomedicine to reduce everolimus side effects encapsulating it inside liposomes targeted against LFs, expressing a high rate of CD44. PEGylated liposomes were modified with high molecular weight hyaluronic acid and loaded with everolimus (PEG-LIP(ev)-HA400kDa). Liposomes were tested by in vitro experiments using LFs derived from broncholveolar lavage (BAL) of patients affected by CLAD and CTD-ILD, and on alveolar macrophages (AM) and lymphocytes isolated, respectively, from BAL and peripheral blood. PEG-LIP-HA400kDa demonstrated to be specific for LFs, but not for CD44-negative cells, and after loading everolimus, PEG-LIP(ev)-HA400kDa were able to arrest cell cycle arrest and to decrease phospho-mTOR level. PEG-LIP(ev)-HA400kDa showed anti-inflammatory effect on immune cells. This study opens the possibility to use everolimus in lung fibrotic diseases, demonstrating that our lipids-based vehicles can vehicle everolimus inside cells exerting the same drug molecular effect, not only in LFs, but also in immune cells