Hot topics in congenital heart disease and new insight into ventricular non-compaction

n/

The Purpose-in-Life Scale (PILS) : internal consistency reliability, concurrent validity and construct validity among Catholic priests in Italy

The Purpose in Life Scale was designed to provide a 12-item unidimensional measure of purpose in life employing a five-point Likert rating for each item. The present study supports the psychometric properties of the Italian translation of this instrument among 155 Catholic priests (mean age = 46 years, SD = 12.16). Internal consistency reliability generated an alpha coefficient of .90. The first factor generated by principal component analysis accounted for 49.5% of variance. Concurrent validity against the Purpose in Life Test was supported by a correlation of .63. Construct validity was supported by a correlation of .54 with the Satisfaction in Ministry Scale and by a correlation of -.51 with the Scale of Emotional Exhaustion in Ministry. These properties commend the scale for future use among Catholic priests

Innovative management of end-stage heart failure in infants: understanding the mechanism of myocardial rehabilitation after pulmonary artery banding in an experimental rodent model of induced dilated cardiomyopathy

openBackground: Pediatric Heart Failure (HF) cause by Dilated Cardiomyopathy (DCM) is an important cause of morbidity and mortality in childhood. Patients usually undergo mechanical circulatory support (MCS), waiting for heart transplant (HTx), which is a sub-optimal option. Following the Giessen protocol conceived by Schranz et al., since 2015 the Pulmonary Artery Banding (PAB) strategy has been used at our Institution to treat end-stage heart failure (ESHF) in patients with preserved right-ventricle function, as a bridge to transplant or functional recovery. Aim of the study: this study combines both a clinical (1) and experimental (2) research. The former aims to assess the current results of PAB across Europe and Asia. The latter aims to investigate the PAB’s effect on a Sprague-Dawley rat model. Materials and methods: The clinical part (1) is a multicentric retrospective international study enrolling infants and children admitted for ESHF and consequent DCM, not responding to conventional medical management. Among exclusion criteria: biventricular failure, the age over 5 years, the lack of parental consent. Clinical, echocardiographic and CMRI data were collected together on a common database (REDcap). The PAB-efficacy-index was defined as the overall freedom from death/VAD/HTx. Experimentally (2), for the first time in literature, we evaluated, on 46 Sprague-Dawely “young” and “adult” rats, the PAB’s effect in two models of DCM (Doxorubicin-induced one and the temporary surgical LAD-ligation-induced one), through echocardiographic, histological and genetic examinations. In collaboration with the ICGEB of Trieste, we also assessed the PAB-induced cardiomyocyte proliferation on 6 healthy juvenile Sprague-Dawley rats, through the injection of Adeno-Associated-Virus (AAV) vector fluorescent-based reporter systems and a nucleoside analogue (EdU). Results: Part 1. 31 patients (18 males) underwent PAB at a median age of 210d (IQR: 131-357). Complications occurred in 14 pts (47%). Early reinterventions include: ECMO in 1 patient, VAD in 3, delayed chest closure in 7 and surgical PAB tightening in 4. Early deaths were 4 (13%). At a median follow-up of 2,9 years (IQR: 1,20-4,85) one late death and 3 effective HTxs (two preceded by VAD, one by rescue ECMO+VAD) occurred. At the last follow-up echo (median time 32.2 months, IQR: 14.95-55.13), EF improved until the median value of 60% (IQR: 53.75-63.25) from 25% (IQR: 17.5-27.75) on admission (pholm-adj.= 2.69e-09). Left ventricular end-diastolic diameter’s Z-score reduced from a median value of 9.72 (IQR: 6.55-12.63) on admission to 2.52 (IQR: 0.07-3.07) (pholm-adj.= 1.91e-05). The PAB-Efficacy-Index was 74.2%, while overall survival (HTx included) was 84%. Females had greater overall survival from death/VAD/HTx than males (p=0.045). Patients under 12 months of age faced less risk of undergoing VAD application than patients over 12 months of age (p=0.012). Part 2. The DOX-induced rat DCM model is only partially adequate. The impaired contractile function was confirmed through two-dimensional echocardiography, whereas no clear evidence was detected histologically or by molecular tests. Rats undergoing PAB after DOX showed improved contractile function. Instead, temporary LAD-ligation was not sufficient to estabilish a model of rat DCM. The pilot study involving fluorescent reporter systems confirm the PAB-induced cardiomyocyte proliferation in the LV and the myocardial regeneration. Conclusions: PAB, together with aggressive anti-congestive medical management, turned out to be an effective procedure in the treatment of ESHF in infants and children with preserved RV function, serving as a bridge to functional recovery or transplant. Establishing experimental rat DCM models is challenging, but the positive effect of PAB can be confirmed, at least through echo assessment, in the DOX-induced model. PAB-induced cardiomyocyte proliferation in the LV seems corroborated

Histone code, human growth and cancer

Epigenetics refers to all heritable changes, which are not dependent on alterations of DNA primary structure [1]. Among them, histone post-translational modifications (HPTMs) play a crucial role in regulating gene expression. Histones are core chromatin components, organized in cylindrical structures. The nucleosome is the fundamental chromatin unit: it is made of appreciatively 150 bp. DNA wrapped around a cylindrical histone core [2]. Histone N-terminal tails protrude from this compact structure, and may be modified by several HPTMs (acetylation, methylation, phosphorylation…). Each modification occurs on a specific residue, and is mediated by an enzymatic complex. Since HPTMs dictate DNA-chromatin binding and gene activity, it has been proposed that a complex histone code orchestrates gen

Neuroendocrine prostate cancer: long noncoding RNAs to treat an incurable cancer – an interview with Dr Francesco Crea

Francesco Crea speaks to Lucy Chard, Commissioning Editor. Dr Crea’s lab studies the role of epigenetic factors and noncoding RNA in cancer initiation and progression. While working at the National Cancer Institute (USA), Dr Crea has demonstrated that polycomb-targeting drugs eradicate prostate cancer stem cells. While working at the BC Cancer Agency (Canada), Dr Crea discovered and patented PCAT18, a long noncoding RNA involved in prostate cancer metastasis. Dr Crea has received awards from the American Society of Clinical Oncology, from the Prostate Cancer Program and from Prostate Cancer Foundation BC. He is also an Editorial Board member for Epigenomics. His team is currently working on developing new biomarkers and therapeutic targets for incurable prostate and breast cancers

Arrhythmia-associated risk: from cardiac arrest to stroke and dementia

n/

Integrating practice based and neuroscientific perspectives on the impact of digital technology on contemporary narrative dramaturgy, investigated through live simulation exercises

University of Technology, Sydney. Faculty of Arts and Social Sciences.The collision of the dramatic and narrative arts with digital technology has seen the emergence of distinct narrative experiences incorporating new attributes such as interactivity and participant’s agency within the unfolding of the work. The disruption caused by these innovations and attributes has been hotly debated in many creative industry forums and further reinforced in theoretical discussions focussing on narrative and interactivity, a case in point being the ‘story versus game’ debates waged between the narratologists and the ludologists. As a director and deviser of live performance, my own use of digital technology in productions throughout the 1990s generated concomitant dramaturgical dilemmas regarding the changing structure of narrative and the shifting role of the audience. From the outset of my investigations into these challenges it was clear there was a critical problem to be addressed. Temporality, and the ordering of experience and events in time, provides the foundation of storytelling and narrative dramaturgy. While conventional story structure is predicated on a reflective, re-telling of experience, games and many emerging forms appear to be contingent on a form of lived experience and enactment. This doctorate examines particular aspects of narrative understanding as it is affected by the emergence of these new modes of dramaturgy and performance. Given that the new developments seemed to be challenging western dramatic conventions, in particular the key Aristotelian tenet of representation, I guided my research with this question: ‘How is this technological disruption renegotiating our traditional Aristotelian sense of time and presence?’ This thesis investigates the question from a neuroscientific perspective, integrating practice-based understandings and creative experimentation with neurobiological insights from Antonio Damasio, Francisco Varela and Benjamin Libet. It does so under the supposition that the shifts in narrative composition might in fact be reflective of how we process information. Further, it puts forward the proposal that we might enhance our understanding of contemporary narrative experiences by considering a model of dramaturgy that is informed by this understanding of the brain’s processing mechanisms. In order to test this proposal I firstly set up a live simulation as an example of a technologized and interactive performed narrative, and then I distil four creative micro narratives from that simulation. I then analyse and discuss the micro narratives as forms of neurobiological sense making, potentially indicative of a compositional structure based on an alternate, neurobiological temporal dynamic. The creative experiment and research findings (delivered in the exegesis) suggest the emergence of a new dramaturgical aesthetic and poetic of time; one that is predicated on a neurobiological dramaturgy distinguished by subjectivity, embodiment, enactment and above all, ‘presentness’

The U.S. Coast Guard

The U.S. Coast Guard is a flexible and effective force for national security in an era when the demands for adaptive and agile capabilities have increased dramatically. The growing awareness of the need for heightened international maritime security, the challenges of the Global War on Terrorism, the growth and reshaping of maritime trade, other security trends and dynamics, and ex- panded humanitarian-response needs have all but ensured the emergence of the Coast Guard—the smallest of the five U.S. armed forces—as a vital force for America’s twenty-first-century security and safety, as well as for safeguarding good order throughout the maritime domain

Introduzione e commento a Carnelutti

Il lavoro è un commento ed una introduzione al parere redatto dal prof. Francesco Carnelutti, conservato in un carteggio del febbraio del 1930, reperibile presso l’archivio di Stato di Trieste negli atti generali della prefettura di Trieste ed inserito nella Busta 705/548. Il prof. Francesco Carnelutti si sofferma anche sulla situazione giuridica dei caolari esistenti sulle “motte” e li ritiene accessione della facoltà di pesca e precari, in base ad un ragionamento che si sofferma su due punti distinti. Preme notare come egli avendo negato l’esistenza dell’uso civico , quale logica conseguenza, non configuri nessun diritto di indennità spettante ai pescatori gradesi.. Si osserva come nel medesimo carteggio, si ritrovi, invece, una conclusione un po’ diversa alla diatriba riguardante il Fossalon

Needling Around: Discovering the Factors Affecting Physician Opinion on Acupuncture

This paper investigates the effects of the independent variables, age, exposure to acupuncture, knowledge of acupuncture, level of religiosity, physician referrals for acupuncture and physicians type of practice on the dependent variable, opinion of acupuncture. Using bivariate cross-tabulations, gamma and linear regression analysis, exposure, knowledge and physician referrals were found to have a significant relationship with opinion of acupuncture. The self-administered questionnaire was mailed to all physicians and surgeons of the Bloomington! Normal IL community who were listed in the April 1998 GTE phonebook. Respondent\u27s ages ranged from 29 to 95 years old, the mean equaling 46.4 years old. Four types of practices were identified; 24.5% of respondents were surgeons, 7.5% were chiropractors, 34% were generalists such as internal medicine or general practitioners and 34% were specialists such as podiatrists or cardiologists. Seventy-eight percent of physicians had been exposed to acupuncture and 40% reported having above average to high knowledge of acupuncture, while 30.9% and 29.1 % reported having average and low to below average knowledge, respectively. This study indicates that the majority of respondents (66.7%) had a high opinion of acupuncture. This study is important because the more that is known about physician\u27s opinions on acupuncture and the factors that affect it, the easier it will be to help move acupuncture fully into mainstream medicine