(In)soliti luoghi: Progetti condivisi di riattivazione locale

Capacità di muoversi o mutare velocemente, variabilità, instabilità, incostanza, ma anche vivacità e versatilità, hanno assunto un’importanza particolare nelle pratiche artistiche attuali, e hanno dato vita a un insieme estremamente mutevole e fluttuante di eventi temporanei e reti di relazioni. Se è sempre più vero, come afferma Jacqueline Ceresoli, che “siamo nomadi camaleontici che diventano la città in cui vivono” , il bisogno di radicamento, o quantomeno il tentativo di appropriarsi anche temporaneamente di un luogo, rendendolo più accogliente e reinterpretandolo secondo un’idea personale del dimorare, sono aspetti che la contemporaneità non ha del tutto cancellato. La vita relazionale che un individuo conduce e il suo essere parte di un gruppo ne segnano profondamente l’identità e assumono particolare rilevanza in luoghi, spesso interstiziali, in cui vengono attuate forme di progettazione artistica o architettonica partecipata. L’arte, in particolare, ha la capacità di catalizzare l’attenzione, coinvolgere in modo empatico, svelare energie nascoste. Irrompe in territori pubblici suscitando impressioni, reazioni, costringendo a riflettere sull’uso e l’appropriatezza degli spazi, e invitando a riscoprire il piacere e i vantaggi di una dimensione comunitaria del vivere la città, fatta di dialoghi, incontri, esperienze fisiche e percettive autentiche. L’articolo svilupperà questi temi a partire da una serie di chiavi di lettura – “Sguardi: lo spirito in moto”, “Alto voltaggio, bassa frequenza: impatti variabili”, “Trame reattive” – illustrate con esempi che rivelano in modo evidente come arte, architettura del paesaggio e degli interni, design, si possano alleare per favorire il recupero di una socialità che si sta perdendo, attraverso azioni di progettazione partecipata. L’autorialità diviene condivisa, si perde la possibilità di discernere in modo chiaro il contributo individuale, ma è la natura stessa di questi progetti che sposta l’attenzione su mire diverse dalla visibilità personale; punta a stimolare l’emergere di un’identità collettiva fiera della propria capacità creativa e dell’esser parte di un progetto di trasformazione che si erge a voce di una tipicità culturale. Ad artisti e progettisti viene affidato il ruolo, non semplice, di provocatori e mediatori

Europe and Contentious Cultural Heritages

This second issue of TRACES Journal has been designed as a dialogue among the scientific coordinators of some of the most recent European Union’s flagship research projects focusing on museums and heritage studies, including some recently concluded programmes as well as some newer researches launched under the H2020 umbrella. We called upon them to question what roles heritage can and should play to address social division and crisis in Europe. We asked them about the focus and the scope of their projects and their relevance in view of contemporary social, political and economic issues affecting Europe and its inhabitants; the expected impact of their research as well as the influence of EU political and funding agendas on the framing of their programme, its lines of enquiry and methods

Comparison of Early and Long-Term Outcomes After Transcatheter Aortic Valve Implantation in Patients with New York Heart Association Functional Class IV to those in Class III and Less

Our aim was to investigate the impact of a baseline New York Heart Association (NYHA) class IV on clinical outcomes of a large real-world population who underwent transcatheter aortic valve implantation (TAVI). The primary end points were all-cause mortality, cardiovascular mortality, and re-hospitalization, evaluated at the longest available follow-up and by means of a 3-month landmark analysis. The secondary end points were: change in NYHA class, left ventricular ejection fraction, pulmonary pressure and mitral regurgitation. Out of 2,467 patients, 271 (11%) had a NYHA functional class IV at the admission. The latter had higher Society of Thoracic Surgeons (STS) score (9.2% vs 5.5%; p < 0.001) compared to NYHA ≤ III patients, owing to more comorbidities (prior myocardial infarction, severe long-term kidney disease, atrial fibrillation, left ventricular dysfunction, significant mitral regurgitation, pulmonary hypertension). Device success was similar between the two groups (93.7% vs 94.5%; p = 0.583). At a median follow-up of 15 months (interquartile range 4 to 36 months) a lower freedom from primary end points was observed among NYHA IV versus NYHA ≤ III group (survival from all-cause death: 52% vs 58.4%; p = 0.002; survival from cardiovascular death: 72.5% vs 76.5%; p = 0.091; freedom from re-hospitalization: 81.5% vs 85.4%; p = 0.038). However, after adjustment for baseline imbalance, NYHA IV did not influence the relative risk of long-term primary end points. A 3-month landmark analysis showed that NYHA IV independently predicted 3-month all-cause and cardiovascular mortality (hazard ratio: 1.77; 95% CI [1.10 to 2.83]; p = 0.018 and hazard ratio: 1.64; 95% CI [1.03 to 2.59]; p = 0.036, respectively). Instead, after 3-month follow-up NYHA IV did not affect the risk of primary end points. A significant improvement of the secondary end points was noted in both NYHA IV and NYHA ≤≤ III groups. In conclusion, the presence of NYHA class IV in TAVI candidates was associated to a significant increased risk of mortality within 3 months. Patients with baseline NYHA IV who survived at 3 months had a long-term outcome comparable to that of other subjects. Left ventricular systolic function, pulmonary pressure, and mitral insufficiency significantly improved after TAVI regardless of baseline NYHA class IV

Transcathether aortic valve implantation with the new repositionable self-expandable Evolut R versus CoreValve system: A case-matched comparison

Background: Despite promising results following transcatheter aortic valve implantation (TAVI), several relevant challenges still remain. To overcome these issues, new generation devices have been developed. The purpose of the present study was to determine whether TAVI with the new self-expanding repositionable Evolut R offers potential benefits compared to the preceding CoreValve, using propensity matching. Methods: Between June 2007 and November 2015, 2148 consecutive patients undergoing TAVI either CoreValve (n = 1846) or Evolut R (n = 302) were prospectively included in the Italian TAVI ClinicalService® project. For the purpose of our analysis 211 patients treated with the Evolut R were matched to 211 patients treated with the CoreValve. An independent core laboratory reviewed all angiographic procedural data and an independent clinical events committee adjudicated all events. Results: Patients treated with Evolut R experienced higher 1-year overall survival (log rank test p = 0.045) and a significantly lower incidence of major vascular access complications, bleeding events and acute kidney injury compared to patients treated with the CoreValve. Recapture manoeuvres to optimize valve deployment were performed 44 times, allowing a less implantation depth for the Evolut R. As a consequence, the rate of more than mild paravalvular leak and new permanent pacemaker was lower in patients receiving the Evolut R. Conclusion: In this matched comparison of high surgical risk patients undergoing TAVI, the use of Evolut R was associated with a significant survival benefit at 1. year compared with the CoreValve. This was driven by lower incidence of periprocedural complications and higher rates of correct anatomic positioning

Risk of progression in chronic phase-chronic myeloid leukemia patients eligible for tyrosine kinase inhibitor discontinuation: Final analysis of the TFR-PRO study

Disease progression to accelerated/blast phase (AP/BP) in patients with chronic phase chronic myeloid leukemia (CP-CML) after treatment discontinuation (TD) has never been systematically reported in clinical trials. However, recent reports of several such cases has raised concern. To estimate the risk of AP/BP among TD-eligible patients, we conducted TFR-PRO, a cohort retro-prospective study: 870 CP-CML patients eligible for TD formed a discontinuation cohort (505 patients) and a reference one (365 patients). The primary objective was the time adjusted rate (TAR) of progression in relation to TD. Secondary endpoints included the TAR of molecular relapse, that is, loss of major molecular response (MMR). With a median follow up of 5.5 years and 5188.2 person-years available, no events occurred in the TD cohort. One event of progression was registered 55 months after the end of TD, when the patient was contributing to the reference cohort. The TAR of progression was 0.019/100 person-years (95% CI [0.003-0.138]) in the overall group; 0.0 (95% CI [0-0.163]) in the discontinuation cohort; and 0.030 (95% CI [0.004-0.215]) in the reference cohort. These differences are not statistically significant. Molecular relapses occurred in 172/505 (34.1%) patients after TD, and in 64/365 (17.5%) patients in the reference cohort, p < .0001. Similar rates were observed in TD patients in first, second or third line of treatment. CML progression in patients eligible for TD is rare and not related to TD. Fears about the risk of disease progression among patients attempting TD should be dissipated

TRIPLETE: A randomised phase III study of modified FOLFOXIRI plus panitumumab versus mFOLFOX6 plus panitumumab as initial therapy for patients with unresectable RAS and BRAF wild-type metastatic colorectal cancer

FOLFOXIRI plus bevacizumab is considered a standard option in the upfront treatment of clinically selected patients with metastatic colorectal cancer irrespective of RAS and BRAF molecular status. The randomised MACBETH and VOLFI studies showed that a modified FOLFOXIRI regimen in combination with cetuximab or panitumumab, respectively, achieved high therapeutic activity in RAS and BRAF wild-type patients with an acceptable toxicity profile. Drawing from these considerations, we designed TRIPLETE study aiming at comparing two different chemotherapy backbones (mFOLFOXIRI or mFOLFOX6) in combination with panitumumab in the first-line treatment of patients with RAS and BRAF wild-type metastatic colorectal cancer. Methods This is a prospective, open-label, multicentre phase III trial in which initially unresectable and previously untreated RAS and BRAF wild-type metastatic colorectal cancer patients are randomised to receive a standard treatment with mFOLFOX6 plus panitumumab or an experimental regimen with modified FOLFOXIRI (irinotecan 150 mg/m 2, oxaliplatin 85 mg/m 2, L-leucovorin 200 mg/m 2, 5-fluoruracil 2400 mg/m 2 48-hour continuous infusion) plus panitumumab up to 12 cycles, followed by panitumumab plus 5-fluorouracil and L-leucovorin until disease progression. The primary endpoint is overall response rate according to RECIST 1.1 criteria. Discussion The relative benefit of chemotherapy intensification when using an anti-EGFR-based regimen in molecularly selected patients is unknown; TRIPLETE study aims at filling this gap of knowledge. The study is sponsored by the Gruppo Oncologico Nord Ovest Cooperative Group and is currently ongoing at 42 Italian centres. Clinical trial information NCT03231722

Ecosistemi per la ricerca Atti Convegno ACNP/NILDE Trieste, 22-23 maggio 2014

Il secondo convegno congiunto ACNP / NILDE: ecosistemi per la ricerca è stato ospitato dal 22 al 23 maggio 2014 dall’Università di Trieste. Sotto gli auspici della stessa Università di Trieste e degli altri enti di ricerca del Friuli Venezia Giulia1 sono stati affrontati in un’ottica internazionale i temi del rapporto tra cataloghi collettivi e servizi interbibliotecari, e il più generale ambito dei servizi bibliografici per la ricerca scientifica. ACNP e NILDE possono essere considerati un vero e proprio ecosistema. Le biblioteche e i bibliotecari collaborano tra di loro in maniera reciproca e secondo modalità interconnesse, offrendo agli utenti servizi sempre più evoluti e dinamici. Questo ecosistema, essendo aperto, mette i propri servizi a disposizione della ricerca scientifica in senso generale. Il convegno di Trieste ha offerto l’occasione di investigare e proporre soluzioni innovative, interconnessioni e relazioni nuove e più proficue. Il convegno ha presentato alcune rilevanti esperienze internazionali in tema di servizi interbibliotecari e cataloghi collettivi e la prosecuzione di attività che erano state proposte come spunti di ispirazione nel convegno precedente2 inoltre si sono condotte delle riflessioni sulle nuove esigenze dell’utenza. Una ultima parte è dedicata alla illustrazione degli sviluppi tecnici e le prospettive future di ACNP e di NILDE. Hanno partecipato all’evento oltre 200 colleghi italiani e stranieri ed i relatori dei 18 contributi provenivano da Italia, Germania, Austria, Grecia, Slovenia e Stati Uniti. Il carattere di confronto e di condivisione delle esperienze tipico della realtà partecipativa di ACNP e NILDE, è emerso anche in questa occasione nella tavola rotonda - di cui viene riportato un resoconto dettagliato - che ha affrontato il tema della valutazione della ricerca dal punto di vista delle biblioteche. Inoltre, la molto partecipata sessione poster ha ospitato 13 lavori- anch’essi riportati nel volume - incentrati oltre che su ACNP e NILDE anche sul tema ricerca e sistema biblioteca, dando ottimi spunti di partecipazione, dialogo e confronto sulle diverse realtà in cui operiamo

Roadmap on thermoelectricity

The increasing energy demand and the ever more pressing need for clean technologies of energy conversion pose one of the most urgent and complicated issues of our age. Thermoelectricity, namely the direct conversion of waste heat into electricity, is a promising technique based on a long-standing physical phenomenon, which still has not fully developed its potential, mainly due to the low efficiency of the process. In order to improve the thermoelectric performance, a huge effort is being made by physicists, materials scientists and engineers, with the primary aims of better understanding the fundamental issues ruling the improvement of the thermoelectric figure of merit, and finally building the most efficient thermoelectric devices. In this Roadmap an overview is given about the most recent experimental and computational results obtained within the Italian research community on the optimization of composition and morphology of some thermoelectric materials, as well as on the design of thermoelectric and hybrid thermoelectric/photovoltaic devices

Refinement of the diagnostic approach for the identification of children and adolescents affected by familial hypercholesterolemia: Evidence from the LIPIGEN study

Background and aims: We aimed to describe the limitations of familiar hypercholesterolemia (FH) diagnosis in childhood based on the presence of the typical features of FH, such as physical sings of cholesterol accumulation and personal or family history of premature cardiovascular disease or hypercholesterolemia, comparing their prevalence in the adult and paediatric FH population, and to illustrate how additional information can lead to a more effective diagnosis of FH at a younger age.Methods: From the Italian LIPIGEN cohort, we selected 1188 (>= 18 years) and 708 (<18 years) genetically-confirmed heterozygous FH, with no missing personal FH features. The prevalence of personal and familial FH features was compared between the two groups. For a sub-group of the paediatric cohort (N = 374), data about premature coronary heart disease (CHD) in second-degree family members were also included in the evaluation.Results: The lower prevalence of typical FH features in children/adolescents vs adults was confirmed: the prevalence of tendon xanthoma was 2.1% vs 13.1%, and arcus cornealis was present in 1.6% vs 11.2% of the cohorts, respectively. No children presented clinical history of premature CHD or cerebral/peripheral vascular disease compared to 8.8% and 5.6% of adults, respectively. The prevalence of premature CHD in first-degree relatives was significantly higher in adults compared to children/adolescents (38.9% vs 19.7%). In the sub-cohort analysis, a premature CHD event in parents was reported in 63 out of 374 subjects (16.8%), but the percentage increased to 54.0% extending the evaluation also to second-degree relatives.Conclusions: In children, the typical FH features are clearly less informative than in adults. A more thorough data collection, adding information about second-degree relatives, could improve the diagnosis of FH at younger age

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