High frequency of inadequate test requests for antiphospholipid antibodies in daily clinical practice

Abstract Background: We have empirically noted that many physicians routinely request anti-phospholipid antibodies (aPL) without a correct clinical indication. The aim of this study was to evaluate retrospectively whether aPL testing at our Thrombosis Centre was justified. Methods: Medical records from 520 subjects for aPL screening tests for various clinical conditions were reviewed. The aPL screening tests were: lupus anticoagulant (LA), anti-cardiolipin antibodies (aCL) and anti-β(2) glycoptotein I (aβ(2) GPI). Requests for aPL screening were divided into justified, potentially justified or not adequately justified. Results: aPL testing requests were considered justified in 358 (69%) patients, potentially justified in 66 (12.6%) and not adequately justified in 96 (18.4%). LA was positive in 65 (18%) of justified requests and in only one (1%) of the 96 potentially justified requests. None of the 66 not adequately justified for aPL testing was positive for LA. aβ(2) ..

Neural regulation of cardiovascular response to exercise: role of central command and peripheral afferents

During dynamic exercise, mechanisms controlling the cardiovascular apparatus operate to provide adequate oxygen to fulfill metabolic demand of exercising muscles and to guarantee metabolic end-products washout. Moreover, arterial blood pressure is regulated to maintain adequate perfusion of the vital organs without excessive pressure variations. The autonomic nervous system adjustments are characterized by a parasympathetic withdrawal and a sympathetic activation. In this review, we briefly summarize neural reflexes operating during dynamic exercise. The main focus of the present review will be on the central command, the arterial baroreflex and chemoreflex, and the exercise pressure reflex. The regulation and integration of these reflexes operating during dynamic exercise and their possible role in the pathophysiology of some cardiovascular diseases are also discusse

Constraints on the environment and energetics of the Broad-Line Ic SN2014ad from deep radio and X-ray observations

Broad-line type Ic Supernovae (BL-Ic SNe) are characterized by high ejecta velocity ($\gtrsim 10^4$ km s$^{-1}$) and are sometimes associated with the relativistic jets typical of long duration ($\gtrsim 2$ s) Gamma-Ray Bursts (L-GRBs). The reason why a small fraction of BL-Ic SNe harbor relativistic jets is not known. Here we present deep X-ray and radio observations of the BL-Ic SN2014ad extending from $13$ to $930$ days post explosion. SN2014ad was not detected at either frequency and has no observational evidence of a GRB counterpart. The proximity of SN2014ad ($d\sim 26$ Mpc) enables very deep constraints on the progenitor mass-loss rate $\dot{M}$ and on the total energy of the fast ejecta $E$. We consider two synchrotron emission scenarios for a wind-like circumstellar medium (CSM): (i) uncollimated non-relativistic ejecta, and (ii) off-axis relativistic jet. Within the first scenario our observations are consistent with GRB-less BL-Ic SNe characterized by a modest energy budget of their fast ejecta ($E \lesssim 10^{45}$ erg), like SNe 2002ap and 2010ay. For jetted explosions, we cannot rule out a GRB with $E \lesssim 10^{51}$ erg (beam-corrected) with a narrow opening angle ($\theta_j \sim 5^{\circ}$) observed moderately off-axis ($\theta_{\rm obs} \gtrsim 30^{\circ}$) and expanding in a very low CSM density ($\dot{M}$ $\lesssim 10^{-6}$ M$_{\odot}$ yr$^{-1}$). Our study shows that off-axis low-energy jets expanding in a low-density medium cannot be ruled out even in the most nearby BL-Ic SNe with extensive deep observations, and might be a common feature of BL-Ic SNe.Comment: 9 pages, 5 figures, accepted in Ap

Infectious agents including COVID-19 and the involvement of blood coagulation and fibrinolysis. A narrative review

Platelets, blood coagulation along with fibrinolysis are greatly involved in the pathophysiology of infectious diseases induced by bacteria, parasites and virus. This phenomenon is not surprising since both the innate immunity and the hemostatic systems are two ancestral mechanisms which closely cooperate favoring host's defense against foreign invaders. However, the excessive response of these systems may be dangerous for the host itself

Design and Evaluation of SmallFloat SIMD extensions to the RISC-V ISA

RISC-V is an open-source instruction set architecture (ISA) with a modular design consisting of a mandatory base part plus optional extensions. The RISC-V 32IMFC ISA configuration has been widely adopted for the design of new-generation, low-power processors. Motivated by the important energy savings that smaller-than-32-bit FP types have enabled in several application domains and related compute platforms, some recent studies have published encouraging early results for their adoption in RISC-V processors. In this paper we introduce a set of ISA extensions for RISC-V 32IMFC, supporting scalar and SIMD operations (fitting the 32-bit register size) for 8-bit and two 16-bit FP types. The proposed extensions are enabled by exposing the new FP types to the standard C/C++ type system and an implementation for the RISC-V GCC compiler is presented. As a further, novel contribution, we extensively characterize the performance and energy savings achievable with the proposed extensions. On average, experimental results show that their adoption provide benefits in terms of performance (1.64 7 speedup for 16-bit and 2.18 7 for 8-bit types) and energy consumption (30% saving for 16-bit and 50% for 8-bit types). We also illustrate an approach based on automatic precision tuning to make effective use of the new FP types

Implicit iterative particle shifting for meshless numerical schemes using kernel basis functions

A novel particle shifting technique (PST) for meshless numerical methods is presented. The proposed methodology uses an implicit iterative particle shifting (IIPS) technique aiming to reduce the spatial particle’ anisotropy, which is associated with the discretization error in meshless numerical schemes based on kernel basis functions. The algorithm controls the particle spatial distribution through an implicit minimization problem, related to the particle concentration gradient and therefore, to the particles’ anisotropy. This results in accurate particle distributions, to demonstrate the effectiveness of the proposed method, the IIPS algorithm is tested within a smoothed particle hydrodynamics (SPH) framework, with static and kinematic cases, by examining the particle distributions and the corresponding spatial accuracy. Further, the computational cost of the proposed methodology is reported and it is shown that it introduces minimal overhead. Moreover, the simulations of the Taylor–Green vortex (TGV), employing a weakly-compressible SPH Navier–Stokes solver, confirmed the superior accuracy of the IIPS in comparison to existing explicit shifting approaches, in simulating internal flows

Thermal issues for the optical transition radiation screen for the ELI-NP compton gamma source

A high brightness electron LINAC is being built in the Compton Gamma Source at the ELI Nuclear Physics facility in Romania. To achieve the design luminosity, a train of 32 bunches, 16 ns spaced, with a nominal charge of 250 pC will collide with a laser beam in two interaction points. Electron beam spot size is measured with Optical Transition Radiation (OTR) profile monitors. In order to measure the beam properties, the OTR screens must sustain the thermal and mechanical stress due to the energy deposited by bunches. This paper is an ANSYS study of the issues due to the high energy transferred to the OTR screens. Thermal multicycle analysis will be shown; each analysis will be followed by a structural analysis in order to investigate the performance of the materia

Differential response to hepatic differentiation stimuli of amniotic epithelial cells isolated from four regions of the amniotic membrane

Human Amniotic Epithelial Cells (hAEC) isolated from term placenta are a promising source for regenerative medicine. However, it has long been debated whether the hAEC population consists of heterogeneous or homogeneous cells. In a previous study, we investigated the characteristics of hAEC isolated from four different regions of the amniotic membrane finding significant heterogeneity. The aim of this study was to evaluate the hepatic differentiation capability of hAEC isolated from these four regions. Human term placentae were collected after caesarean section and hAEC were isolated from four regions of the amniotic membrane (R1-R4, according to their relative distance from the umbilical cord) and treated in hepatic differentiation conditions for 14 days. hAEC-derived hepatocyte-like cells showed marked differences in the expression of hepatic markers: R4 showed higher levels of Albumin and Hepatocyte Nuclear Factor (HNF) 4α whereas R1 expressed higher Cytochrome P450 enzymes, both at the gene and protein level. These preliminary results suggest that hAEC isolated from R1 and R4 of the amniotic membrane are more prone to hepatic differentiation. Therefore, the use of hAEC from a specific region of the amniotic membrane should be taken into consideration as it could have an impact on the outcome of therapeutic applications

Correlated electron-hole plasma in organometal perovskites

Organic-inorganic perovskites are a class of solution-processed semiconductors holding promise for the realization of low-cost efficient solar cells and on-chip lasers. Despite the recent attention they have attracted, fundamental aspects of the photophysics underlying device operation still remain elusive. Here we use photoluminescence and transmission spectroscopy to show that photoexcitations give rise to a conducting plasma of unbound but Coulomb-correlated electron-hole pairs at all excitations of interest for light-energy conversion and stimulated optical amplification. The conductive nature of the photoexcited plasma has crucial consequences for perovskite-based devices: in solar cells, it ensures efficient charge separation and ambipolar transport while, concerning lasing, it provides a low threshold for light amplification and justifies a favourable outlook for the demonstration of an electrically driven laser. We find a significant trap density, whose cross-section for carrier capture is however low, yielding a minor impact on device performance