Treatment of atherosclerotic renovascular hypertension: review of observational studies and a meta-analysis of randomized clinical trials.

open9Atherosclerotic renal artery stenosis can cause ischaemic nephropathy and arterial hypertension. We herein review the observational and randomized clinical trials (RCTs) comparing medical and endovascular treatment for control of hypertension and renal function preservation. Using the Population Intervention Comparison Outcome (PICO) strategy, we identified the relevant studies and performed a novel meta-analysis of all RCTs to determine the efficacy and safety of endovascular treatment when compared with medical therapy. The following outcomes were examined: baseline follow-up difference in mean systolic and diastolic blood pressure (BP), serum creatinine, number of drugs at follow-up, incident events (heart failure, stroke, and worsening renal function), mortality, cumulative relative risk of heart failure, stroke, and worsening renal function. Seven studies comprising a total of 2155 patients (1741 available at follow-up) were considered, including the recently reported CORAL Study. Compared with baseline, diastolic BP fell more at follow-up in patients in the endovascular than in the medical treatment arm (standard difference in means -0.21, 95% confidence interval (CI): -0.342 to -0.078, P = 0.002) despite a greater reduction in the mean number of antihypertensive drugs (standard difference in means -0.201, 95% CI: -0.302 to -0.1, P < 0.001). At variance, follow-up changes (from baseline) of systolic BP, serum creatinine, and incident cardiovascular event rates did not differ between treatment arms. Thus, patients with atherosclerotic renal artery stenosis receiving endovascular treatment required less anti-antihypertensive drugs at follow-up than those medically treated. Notwithstanding this, they evidenced a better control of diastolic BP.openopenCaielli P;Frigo AC;Pengo MF;Rossitto G;Maiolino G;Seccia TM;Calò LA;Miotto D;Rossi GPCaielli, P; Frigo, ANNA CHIARA; Pengo, Mf; Rossitto, G; Maiolino, G; Seccia, TERESA MARIA; Calò, La; Miotto, Diego; Rossi, Gianpaol

A microseismic study in a low seismicityarea: the 2001 site-response experimentin the Città di Castello Basin (Italy)

A site response experiment was performed in the basin of Città di Castello (a small town in Central Italy) in May 2001. This study is part of a project on the evaluation of seismic hazard in seismogenic areas funded by the Gruppo Nazionale Difesa dai Terremoti (GNDT). The experiment consisted of a dense fixed transect configuration with most of the stations recording in continuous mode, and several ambient noise measurements both in single station and in array configuration spread over the investigated area. The dense transect was composed of 26 seismic stations in a crosswise configuration with a maximum inter-station distance of 250 m. The stations were deployed in the southern part of the basin, from the eastern bedrock outcrop to the western edge, across the town. About 70 earthquakes were recorded during 10 days of deployment, generally low magnitude or regional events. We located 23 earthquakes and 17 of them were located using the waveform similarity approach at 4 stations outside the target area. These 4 stations were part of a dense temporary seismic network involved in a previous experiment of the same project, aimed at performing a high-resolution picture of the local seismicity. Delay analysis on the recorded waveforms allowed us to infer the basin geometry at depth and estimate the S-wave velocity of sediments. Moreover, we evaluated relative site response along the E-W transect by performing a standard spectral ratio. Amplification factors up to 9 are found inside the basin; at frequencies above 5 Hz stations closer to the edges show higher amplification, whereas stations located in the middle of the basin, where the alluvial sediments are thicker (CD11-CD14), show higher amplification below 5 Hz. We considered the average amplification in two frequency bands (1-5 Hz and 5-10 Hz), representative of the resonance frequency for 2-3 storey buildings and 1 storey houses,respectively. Our results suggest that the potential hazard for 2-3 storey buildings is higher in the center of the basin (amplification factor up to 6), and for 1 storey houses is higher at the edges (amplification factor up to 5)

A 3D velocity model for earthquake location in Campi Flegrei area: application to the 1982-84 uplift event

The uplift crisis of the 1982-1984 in the Campi Flegrei area underlined the importance of seismic surveillance for this volcanic caldera. One of the key elements for an effective seismic network is to make use of a reliable velocity model for earthquake location. In the present work we will discuss criteria for the construction and validation of a new 3D P-wave velocity model for earthquake location in the Campi Flegrei area built from the integration of two high-resolution 3D tomographic images of the region. The model is used for locating a group of earthquakes from the uplift event of the 1982-1984

A geology-based 3D velocity model of the Amatrice Basin (Central Italy)

In this paper we present a new methodological approach which integrates geological and geophysical data into a 3D modelling process to be mainly employed in seismic hazard assessment studies of earthquake-prone areas around the world, as well as in applications for land use and urban planning. As a case study, the reconstruction of a geology-based 3D velocity model of the uppermost hundreds of metres of the Amatrice high-seismic-hazard area is described. The model was constructed using geological (e.g., maps, cross-sections and core-wells) and geophysical (e.g., down-hole, MASW, refraction, and seismic noise measurements) data, which were georeferenced and uploaded into 3D geological modelling software, where faults, stratigraphic boundaries, and geophysical attributes were digitised, checked, hierarchised, and modelled. The performed 3D geological model was parameterised with Vs and Vp velocities and, finally, the environmental noise (i.e., horizontal-to-vertical spectral ratio analysis, HVSR) recorded at some seismic stations was compared with the seismic responses modelled at some nearby control points. In the study area, the proposed geology-based 3D velocity model represents both a new potential geophysical prediction tool for areas devoid of geophysical measurements (i.e. HVSR curves) and a potential input-model for future ground-motion and seismic-wave-propagation simulations aimed at a more precise local seismic response assessment and, consequently, at the development of more realistic seismic hazard scenarios. The model here presented constitutes a first version of the 3D geological-geophysical model for the studied area, which will be improved with new data and more advanced algorithms available in the future

Automatic speech analysis to early detect functional cognitive decline in elderly population

This study aimed at evaluating whether people with a normal cognitive function can be discriminated from subjects with a mild impairment of cognitive function based on a set of acoustic features derived from spontaneous speech. Voice recordings from 90 Italian subjects (age >65 years; group 1: 47 subjects with MMSE>26; group 2: 43 subjects with 20≤ MMSE ≤26) were collected. Voice samples were processed using a MATLAB-based custom software to derive a broad set of known acoustic features. Linear mixed model analyses were performed to select the features able to significantly distinguish between groups. The selected features (% of unvoiced segments, duration of unvoiced segments, % of voice breaks, speech rate, and duration of syllables), alone or in addition to age and years of education, were used to build a learning-based classifier. The leave-one-out cross validation was used for testing and the classifier accuracy was computed. When the voice features were used alone, an overall classification accuracy of 0.73 was achieved. When age and years of education were additionally used, the overall accuracy increased up to 0.80. These performances were lower than the accuracy of 0.86 found in a recent study. However, in that study the classification was based on several tasks, including more cognitive demanding tasks. Our results are encouraging because acoustic features, derived for the first time only from an ecologic continuous speech task, were able to discriminate people with a normal cognitive function from people with a mild cognitive decline. This study poses the basis for the development of a mobile application performing automatic voice analysis on-the-fly during phone calls, which might potentially support the detection of early signs of functional cognitive decline

Campi Flegrei active seismic experiments waveforms compilation

A new experiment called SERAPIS (SEismic Reflection/Refraction Acquisition Project for Imaging complex volcanic Structures) has been planned and carried out, based on off-shore seismic energization and data acquisition on land and on sea-bottom. The experiment was performed in September, 2001 during which the vessel NADIR of IFREMER (equipped with 12, 16-liters airgun) produced more than 5000 air gun shots recorded at a sea-bottom seismograph array of 72 OBS and 62 stations installed on-land. Active seismic refraction DSS (Deep Seismic Soundings) acquired during the surveys conducted in 1980 and 1985 were recovered jointly with seismic data acquired in the Campi Flegrei area in the framework of the MareVes97 (an experiment devoted to the definition of the structure of the Somma-Vesuvio complex) offshore survey. The data set acquired during the SERAPIS experiment has been successfully used to infer 3D images of the volcanic structures of Campi Flegrei and Neapolitan bay. Active seismic waveforms and related P-picks (more than 90000 data) from the SERAPIS experiment are also available in the project data server

TLR4 and NKT Cell Synergy in Immunotherapy against Visceral Leishmaniasis

NKT cells play an important role in autoimmune diseases, tumor surveillance, and infectious diseases, providing in most cases protection against infection. NKT cells are reactive to CD1d presented glycolipid antigens. They can modulate immune responses by promoting the secretion of type 1, type 2, or immune regulatory cytokines. Pathogen-derived signals to dendritic cells mediated via Toll like Receptors (TLR) can be modulated by activated invariant Natural Killer T (iNKT) cells. The terminal β-(1–4)-galactose residues of glycans can modulate host responsiveness in a T helper type-1 direction via IFN-γ and TLRs. We have attempted to develop a defined immunotherapeutic, based on the cooperative action of a TLR ligand and iNKT cell using a mouse model of visceral leishmaniasis. We evaluated the anti-Leishmania immune responses and the protective efficacy of the β-(1–4)-galactose terminal NKT cell ligand glycosphingophospholipid (GSPL) antigen of L. donovani parasites. Our results suggest that TLR4 can function as an upstream sensor for GSPL and provoke intracellular inflammatory signaling necessary for parasite killing. Treatment with GSPL was able to induce a strong effective T cell response that contributed to effective control of acute parasite burden and led to undetectable parasite persistence in the infected animals. These studies for the first time demonstrate the interactions between a TLR ligand and iNKT cell activation in visceral leishmaniasis immunotherapeutic

Molecular mechanisms of cell death: recommendations of the Nomenclature Committee on Cell Death 2018.

Over the past decade, the Nomenclature Committee on Cell Death (NCCD) has formulated guidelines for the definition and interpretation of cell death from morphological, biochemical, and functional perspectives. Since the field continues to expand and novel mechanisms that orchestrate multiple cell death pathways are unveiled, we propose an updated classification of cell death subroutines focusing on mechanistic and essential (as opposed to correlative and dispensable) aspects of the process. As we provide molecularly oriented definitions of terms including intrinsic apoptosis, extrinsic apoptosis, mitochondrial permeability transition (MPT)-driven necrosis, necroptosis, ferroptosis, pyroptosis, parthanatos, entotic cell death, NETotic cell death, lysosome-dependent cell death, autophagy-dependent cell death, immunogenic cell death, cellular senescence, and mitotic catastrophe, we discuss the utility of neologisms that refer to highly specialized instances of these processes. The mission of the NCCD is to provide a widely accepted nomenclature on cell death in support of the continued development of the field