Re: Reflections on the COVID-19 Pandemic

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Role of ventricular tachycardia ablation in arrhythmogenic right ventricular cardiomyopathy

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is characterized by progressive fibro-fatty replacement of the myocardium that represents the substrate for recurrent sustained ventricular tachycardia (VT). These arrhythmias characterize the clinical course of a sizeable proportion of patients and have significant implications for their quality of life and long-term prognosis. Antiarrhythmic drugs are often poorly tolerated and usually provide incomplete control of arrhythmia relapses. Catheter ablation is a potentially effective strategy to treat frequent VT episodes and ICD shocks in ARVC patients. The aims of this review are to discuss the electrophysiological and electroanatomic substrates of ventricular tachycardia in patients with ARVC and to analyze the role of catheter ablation in their management with particular reference to selection of patients, technical issues, potential complications and outcomes

Laser irradiated foam targets: absorption and radiative properties

An experimental campaign to characterize the laser radiation absorption of foam targets and the subsequent emission of radiation from the produced plasma was carried out in the ABC facility of the ENEA Research Center in Frascati (Rome). Different targets have been used: plastic in solid or foam state and aluminium targets. The activated different diagnostics allowed to evaluate the plasma temperature, the density distribution, the fast particle spectrum and the yield of the X-Ray radiation emitted by the plasma for the different targets. These results confirm the foam homogenization action on laser-plasma interaction, mainly attributable to the volume absorption of the laser radiation propagating in such structured materials. These results were compared with simulation absorption models of the laser propagating into a foam target

Meta-analysis of the effects of venous super-drainage in deep inferior epigastric artery perforator flaps for breast reconstruction

INTRODUCTION: Venous congestion is the most common vascular complication of the deep inferior epigastric artery perforator (DIEP) flaps. Adding a second venous drainage by anastomosing a flap vein and a recipient vein (super-drainage) is considered the solution of choice. Evidence to support this procedure, had not yet been confirmed by an analysis of the literature. We aimed to provide this evidence.MATERIALS AND METHODS: We searched the literature (MedLine, Scopus, EMBASE, Cochrane Library, and Google Scholar), for studies discussing venous congestion and venous super-drainage in DIEP flap for breast reconstruction. Thirteen of the 35 articles compared results between one or two venous anastomoses. Meta-analysis was performed following PRISMA guidelines. Pooled risk ratio (RRs) for congestion, fat necrosis, partial necrosis, and total necrosis with corresponding 95% confidence intervals (CI) were calculated using a fixed-effect model with the Mantel-Haenszel method. The need to return to surgery (95% CI) was estimated with a random effect model using the DerSimonian and Liard method.RESULTS: We showed a statistically significant advantage of super-drainage to reduce the venous congestion of the flap (RR: 0.12, 95% CI: 0.04-0.34, p-value <.001), partial flap necrosis (RR: 0.50, 95% CI: 0.30-0.84, p-value .008), total flap necrosis (RR: 0.31, 95% CI: 0.11-0.85, p-value .023), and the need to take the patient back to surgery for perfusion-related complications (RR: 0.45, 95% CI: 0.21-0.99, p value .048).CONCLUSIONS: Performing a second venous anastomosis between the SIEV and a recipient vein (venous superdrainage) reduces venous congestion and related complications in DIEP flaps for breast reconstruction

Diagnostic Methodologies of Laser-Initiated 11B(p,α)2α Fusion Reactions

The detection of the ionic products of low-rate fusion reactions, and in particular of the 11B(p,α)2α, is one of the recognized main problems in experiments where these reactions are initiated by tailored interaction of intense and high-energy lasers with matter. A thorough description of this important issue, with a critical comparison of the diagnostic opportunities, is indeed so far. In this work, we describe the common diagnostic methodologies used for the detection of the alpha particles generated by the 11B(p,α)2α reaction and, for each, we outline advantages and limitations, with considerations that can also be applied to other low-rate fusion reactions. We show here that, in general, the univocal characterization of the α products coming from this reaction can be achieved by the simultaneous use of several diagnostic tools placed in close proximity

Meta-analysis of the effects of venous super-drainage in deep inferior epigastric artery perforator flaps for breast reconstruction

Venous congestion is the most common vascular complication of the deep inferior epigastric artery perforator (DIEP) flaps. Adding a second venous drainage by anastomosing a flap vein and a recipient vein (super-drainage) is considered the solution of choice. Evidence to support this procedure, had not yet been confirmed by an analysis of the literature. We aimed to provide this evidence

Simultaneous observation of ultrafast electron and proton beams in TNSA

The interaction of ultra-intense high-power lasers with solid-state targets has been largely studied for the past 20 years as a future compact proton and ion source. Indeed, the huge potential established on the target surface by the escaping electrons provides accelerating gradients of TV/m. This process, called target normal sheath acceleration, involves a large number of phenomena and is very difficult to study because of the picosecond scale dynamics. At the SPARC_LAB Test Facility, the high-power laser FLAME is employed in experiments with solid targets, aiming to study possible correlations between ballistic fast electrons and accelerated protons. In detail, we have installed in the interaction chamber two different diagnostics, each one devoted to characterizing one beam. The first relies on electro-optic sampling, and it has been adopted to completely characterize the ultrafast electron components. On the other hand, a time-of-flight detector, based on chemical-vapour-deposited diamond, has allowed us to retrieve the proton energy spectrum. In this work, we report preliminary studies about simultaneous temporal resolved measurements of both the first forerunner escaping electrons and the accelerated protons for different laser parameters

Combined Orthoplastic Approach in Fracture-Related Infections of the Distal Tibia

This series reports on the treatment of distal tibia (DT) fracture-related infections (FRI) with a combined orthoplastic approach. Thirteen patients were included. In eight patients with extensive bone involvement and in those with a non-healed fracture, the DT was resected ("staged approach"). In five cases, the DT was preserved ("single-stage approach"). A wide debridement was performed, and the cavity was filled with antibiotic-loaded PerOssal beads. All patients had a soft-tissue defect covered by a free vascularized flap (anterolateral thigh perforator flap in eight cases, latissimus dorsi flap in five). At the final follow-up (mean 25 months, range, 13-37), no infection recurrence was observed. In one patient, the persistence of infection was observed, and the patient underwent a repeated debridement. In two cases, a voluminous hematoma was observed. However, none of these complications impacted the final outcome. The successful treatment of FRI depends on proper debridement and obliteration of dead spaces with a flap. Therefore, when dealing with DT FRI, debridement of infected bone and soft tissues must be as radical as required, with no fear of the need for massive reconstructions

SEEDS, simultaneous recordings of high-density EMG and finger joint angles during multiple hand movements

We present the SurfacE Electromyographic with hanD kinematicS (SEEDS) database. It contains electromyographic (EMG) signals and hand kinematics recorded from the forearm muscles of 25 non-disabled subjects while performing 13 different movements at normal and slow-paced speeds. EMG signals were recorded with a high-density 126-channel array centered on the extrinsic flexors of the fingers and 8 further electrodes placed on the extrinsic extensor muscles. A data-glove was used to record 18 angles from the joints of the wrist and fingers. The correct synchronisation of the data-glove and the EMG was ascertained and the resulting data were further validated by implementing a simple classification of the movements. These data can be used to test experimental hypotheses regarding EMG and hand kinematics. Our database allows for the extraction of the neural drive as well as performing electrode selection from the high-density EMG signals. Moreover, the hand kinematic signals allow the development of proportional methods of control of the hand in addition to the more traditional movement classification approaches