Non-permanent GPS data for regional-scale kinematics: reliable deformation rate before the 6 April, 2009, earthquake in the L'Aquila area

A GPS-based geodetic study at a regional scale requires the availability of a dense network that is characterized by 10 km to 30 km spacing, typically followed in a few continuous GPS stations (CGPSs) and several non-permanent GPS stations (NPSs). As short observation times do not allow adequate noise modeling, NPS data need specific processing where the main differences between NPSs and CGPSs are taken into account: primarily time-series length and antenna repositioning error. The GPS data collected in the 1999-2007 time-span from non-permanent measurement campaigns in the central Apennine area (Italy) that was recently hit by the Mw 6.3 L'Aquila earthquake (April 6, 2009) are here further analyzed to compute a reliable strain-rate field at a regional scale. Moreover, areas characterized by different kinematics are recognized, and a complete characterization of the regional-scale kinematics is attempted. These new data can be interpreted as indicators from the viewpoint of seismic risk assessment

Lipoprotein(a) Genotype Influences the Clinical Diagnosis of Familial Hypercholesterolemia

: Background Evidence suggests that LPA risk genotypes are a possible contributor to the clinical diagnosis of familial hypercholesterolemia (FH). This study aimed at determining the prevalence of LPA risk variants in adult individuals with FH enrolled in the Italian LIPIGEN (Lipid Transport Disorders Italian Genetic Network) study, with (FH/M+) or without (FH/M-) a causative genetic variant. Methods and Results An lp(a) [lipoprotein(a)] genetic score was calculated by summing the number risk-increasing alleles inherited at rs3798220 and rs10455872 variants. Overall, in the 4.6% of 1695 patients with clinically diagnosed FH, the phenotype was not explained by a monogenic or polygenic cause but by genotype associated with high lp(a) levels. Among 765 subjects with FH/M- and 930 subjects with FH/M+, 133 (17.4%) and 95 (10.2%) were characterized by 1 copy of either rs10455872 or rs3798220 or 2 copies of either rs10455872 or rs3798220 (lp(a) score ≥1). Subjects with FH/M- also had lower mean levels of pretreatment low-density lipoprotein cholesterol than individuals with FH/M+ (t test for difference in means between FH/M- and FH/M+ groups <0.0001); however, subjects with FH/M- and lp(a) score ≥1 had higher mean (SD) pretreatment low-density lipoprotein cholesterol levels (223.47 [50.40] mg/dL) compared with subjects with FH/M- and lp(a) score=0 (219.38 [54.54] mg/dL for), although not statistically significant. The adjustment of low-density lipoprotein cholesterol levels based on lp(a) concentration reduced from 68% to 42% the proportion of subjects with low-density lipoprotein cholesterol level ≥190 mg/dL (or from 68% to 50%, considering a more conservative formula). Conclusions Our study supports the importance of measuring lp(a) to perform the diagnosis of FH appropriately and to exclude that the observed phenotype is driven by elevated levels of lp(a) before performing the genetic test for FH

The Role of Registers in Increasing Knowledge and Improving Management of Children and Adolescents Affected by Familial Hypercholesterolemia: the LIPIGEN Pediatric Group

Pathology registers can be a useful tool to overcome obstacles in the identification and management of familial hypercholesterolemia since childhood. In 2018, the LIPIGEN pediatric group was constituted within the Italian LIPIGEN study to focus on FH subjects under 18 years. This work aimed at discussing its recent progress and early outcomes. Demographic, biochemical, and genetic baseline characteristics were collected, with an in-depth analysis of the genetic defects. The analysis was carried out on 1,602 children and adolescents (mean age at baseline 9.9 ± 4.0 years), and almost the whole cohort underwent the genetic test (93.3%). Overall, the untreated mean value of LDL-C was 220.0 ± 97.2 mg/dl, with an increasing gradient from subjects with a negative (N = 317; mean untreated LDL-C = 159.9 ± 47.7 mg/dl), inconclusive (N = 125; mean untreated LDL-C = 166.4 ± 56.5 mg/dl), or positive (N = 1,053; mean untreated LDL-C = 246.5 ± 102.1 mg/dl) genetic diagnosis of FH. In the latter group, the LDL-C values presented a great variability based on the number and the biological impact of involved causative variants. The LIPIGEN pediatric group represents one of the largest cohorts of children with FH, allowing the deepening of the characterization of their baseline and genetic features, providing the basis for further longitudinal investigations for complete details

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

Transizione alla genitorialità nelle donne con patologie autoimmuni: individuazione di fattori psicosociali protettivi e di rischio

In presenza di patologia autoimmune materna, la nascita di un figlio è un evento complesso da un punto di vista sia fisico sia psicologico. Questo studio, rivolto a coppie in cui la donna è affetta da malattia autoimmune, intende individuare variabili personali, relazionali e contestuali in grado di influenzare il benessere dei futuri genitori e il loro legame con il figlio. Il disegno è longitudinale, con somministrazione di questionari e interviste in gravidanza (2°-3° trimestre) e nella fase postnatale (3-4 mesi dopo il parto). Il contributo illustra dei risultati preliminari, relativi a 34 gestanti su misure di attaccamento prenatale (PAI, Müller 1993; MAAS, Condon, 1993) e romantico (ECR–R, Fraley et al., 2000), adattamento diadico (DAS, Spanier 1976), disregolazione emotiva (DERS, Gratz & Roemer, 2004), caregiving dei propri genitori (PBI, Parker et al., 1979), supporto sociale (MSPSS, Zimet et al., 1988), depressione (CES-D, Radloff 1977), fiducia nelle figure sanitarie (HCR Trust Scale, Bova et al., 2006). È emersa una correlazione significativa positiva tra attaccamento prenatale e cura fornita dalla figura paterna durante infanzia e adolescenza. Inoltre, a livelli più alti di disregolazione emotiva sono associati livelli più alti di depressione, ansia ed evitamento relazionale, livelli più bassi di supporto sociale percepito, cura parentale nell’infanzia e nell’adolescenza, consenso e coesione nella relazione di coppia. Questi primi dati suggeriscono che il ricordo di un caregiving paterno caratterizzato da affetto, calore, empatia e intimità funge da fattore protettivo rispetto al formarsi dell’attaccamento prenatale materno, mentre la disregolazione emotiva rappresenta un fattore di rischio in grado di minare il benessere psicologico delle gestanti. Emerge l’importanza di comprendere l’impatto della malattia autoimmune sulla ridefinizione degli equilibri psichici genitoriali al fine di migliorare le buone prassi nell’assistenza psicologica alle gestanti

PREGNANCY AND AUTOIMMUNE DISEASES: EXPLORING THE MOTHER’S MENTAL WORLD

Autoimmune disease mainly affects women in their reproductive years and has a significant impact on childbearing. Pregnancy can induce an improvement of the mother’s symptomatology in some kinf of diseases such as rheumatoid arthritis, while exacerbating or having no effect on other autoimmune diseases as sclerosys multiple (Borchers et al, 2010). This “uncertainty” can affect the process of psychological transformation and reorganization, which leads to the acquisition of a maternal identity sustained by a mental representation of the self as a mother and of the future baby, although he or she is still unborn (Ammaniti et al, 1999; RaphaelLeff, 2010). The quality of the mother-fetus emotional bond is considered particularly important for the subsequent attachment relationship and the psychological development of the infant (Ammaniti et al, 2013; Benoit et al, 1997). At the last thrimester of pregnancy 10 women with different autoimmune diseases (sclerosys multiple, lupus erythematosus, type 1 diabetes), and 10 nonrisk women were interviewed using the “Interview of Maternal Representations during Pregnancy-Revised Version” (IRMAG-R; Ammaniti & Tambelli, 2010). All interviews were audiotaped, transcribed verbatim, and analyzed by using qualitative content analysis in Atlas.ti. Two independent judges coded 5/20 interviews; agreement was >80%. The women with autoimmune disease, compared to nonrisk women, were more ambivalent toward pregnancy, were less able to recognize physical and psychological changes and to imagine the child. These are considered risk factors which could negatively affect the postnatal caregiving system (Van Bussel et al, 2009). These results focus on the importance of early multidisciplinary interventions that can support expectant women when they show signs of relationship difficulties with their infants prior to his/her birth

A Pilot Study of the Relationship Between Pregnancy and Autoimmune Disease: Exploring the Mother’s Psychological Process

Autoimmune disease mainly affects women in their reproductive years and has a significant impact on childbearing. Pregnancy can induce an improvement of the mother’s symptomatology in some diseases such as rheumatoid arthritis while exacerbating or having no effect on other autoimmune diseases as multiple sclerosis (Borchers et al., 2010). This uncertainty can affect the process of psychological reorganization, which leads to the achievement of a maternal identity. The quality of the mother-fetus emotional bond is considered particularly relevant for the subsequent attachment relationship and the psychological development of the infant (Ammaniti et al., 2013). In the last trimester of pregnancy, 15 women with different autoimmune diseases were interviewed using the IRMAG-R (Ammaniti and Tambelli, 2010). They also completed a battery comprising: PAI (Della Vedova et al., 2008); MAAS (Busonera et al., 2016); DAS (Gentili et al., 2002); PBI (Scinto et al., 1999); MSPSS (Prezza and Principato, 2002); DERS, (Giromini et al., 2012); CES-D (Fava, 1983); HCR-TS (Bova et al., 2012). All interviews were audiotaped, transcribed verbatim, and analyzed by Atlas.ti. The results show that women with autoimmune disease were ambivalent toward pregnancy, had high levels of depression, had difficulties in recognizing physical and psychological changes, and had difficulties in imagining the child. These are considered risk factors that could negatively affect the postnatal mother-infant relationship. These results focus on the importance of early multidisciplinary interventions that can support expectant women when they show signs of relationship difficulties with their infants prior to his/her birth

Multitemporal laser scanner-based observation of the Mt. Vesuvius crater: Characterization of overall geometry and recognition of landslide events

Results of observations of the Mt. Vesuvius caldera, carried out by means of terrestrial laser scanning (TLS) in May 2005, October 2006 and June 2009, are reported here. In each survey the whole crater was acquired with 17/20 scans from 6 different viewpoints and the corresponding digital surface models were generated and registered into the UTM-WGS84 reference frame. In this way, a comparison between the multitemporal models leads to an evaluation of the occurred changes. The deformation maps, i.e. the contouring plots of the differences between the models along the direction of maximum variations, showed a progressive mass loss due to rock-falls from the NE vertical crater wall whose area was about View the MathML source5000m2. The TLS data also showed the accumulation at the bottom. The volume loss which occurred from 2005 to 2009, was computed by subtraction of volumes defined with respect to reference planes parallel to the caldera walls and was estimated to be View the MathML source20300m3. The volume uncertainties due to registration errors, subsampling noise effects, and effects due to choice of the reference plane, were also estimated. Some results were also interpreted on the basis of micro-seismic and meteorological data in order to plan a monitoring technique where seismic signals related to rock-fall and/or signals of intense rainfalls are used as alarms for fast TLS surveys able to characterize the corresponding changes of the caldera walls. The proposed methodology, in particular the simple but effective approach used in the estimation of volume uncertainties, can be applied to each rock slope instability phenomenon, regardless of the particular environmen