Total occlusion of the abdominal aorta in a patient with renal failure and refractory hypertension: a case report

Total occlusion of the abdominal aorta is unusual, and potentially catastrophic. It occurs in patients with advanced atherosclerotic occlusive disease, and can cause severe ischemic manifestations, depending on the site of obstruction. Prompt and appropriate diagnostic and therapeutic approaches are important whenever this condition is suspected, in order to avoid a fatal outcome. The development of a complex network of collaterals may prevent the manifestation of acute ischemic phenomena, and cause a delay in diagnosis and treatment. Here we report the clinical case of a 59-year-old man who was referred to our Department for evaluation of renal failure and refractory hypertension. Ultrasonography and 99mTc-DTPA scintigraphy showed a shrunken, non-functioning left kidney, while CT angiography and aortography showed the complete occlusion of the aorta from below the right renal artery down to the bifurcation of both common iliac arteries, with a critical stenosis of the origin of the right renal artery, an occlusion of the left renal artery as well as of the origin of the inferior mesenteric artery. The patient was referred to the surgery department for aorto-bifemoral bypass surgery and re-implantation of the right renal artery

AngioJet® rheolytic thrombectomy for acute superficial femoral artery stent or femoropopliteal by-pass thrombosis

Thrombosis of superficial femoral artery (SFA) nitinol stents or polytetrafluoroethylene (PTFE) femoropopliteal bypass grafts after discontinuation of antiplatelet therapy is an emergent clinical challenge of acute limb ischemia (ALI), requiring immediate percutaneous intervention. Currently, there is no evidence-based approach for the management of such complications. We describe the cases of two patients presenting with ALI due to nitinol stent thrombosis after discontinuation of antiplatelet therapy and the case of a patient presenting with ALI due to PTFE femoropopliteal graft thrombosis in which limb salvage was obtained by AngioJet® rheolytic thrombectomy and re-stenting. In both cases, the thrombus was successfully removed using the Possis AngioJet® mechanical thrombectomy catheter and percutaneous transluminal angioplasty (PTA) was performed to recanalize two femoropopliteal nitinol stents and a femoropopliteal PTFE graft. In both cases, optimal angiographic result was obtained. To the best of our knowledge, these are the first three cases reporting the use of the AngioJet rheolytic thrombectomy in ALI due to stent or graft thrombosis. Taken together, these cases suggest that AngioJet® rheolytic thrombectomy might represent a novel effective strategy in the percutaneous treatment of stent or graft thrombosis determining ALI

The Aeolus Data Innovation and Science Cluster

The Data Innovation and Science Cluster (DISC) is a core element of ESA's data quality strategy for the Aeolus mission, which was launched in August 2018. Aeolus provides for the first-time global observations of vertical profiles of horizontal wind information by using the first Doppler wind lidar in space. The Aeolus DISC is responsible for monitoring and improving the quality of the Aeolus aerosol and wind products, for the upgrade of the operational processors as well as for impact studies and support of data usage. It has been responsible for multiple significant processor upgrades which reduced the systematic error of the Aeolus observations drastically. Only due to the efforts of the Aeolus DISC team members prior to and after launch, the systematic error of the Aeolus wind products could be reduced to a global average below 1 m/s which was an important pre-requisite for making the data available to the public in May 2020 and for its use in operational weather prediction. In 2020, the reprocessing of earlier acquired Aeolus data, another important task of the Aeolus DISC, also started. In this way, also observations from June to December 2019 with significantly better quality could be made available to the public, and more data will follow this and next year. Without the thorough preparations and close collaboration between ESA and the Aeolus DISC over the past decade, many of these achievements would not have been possible

Data quality of Aeolus wind measurements

The European Space Agency (ESA)'s Earth Explorer Aeolus was launched in August 2018 carrying the world's first spaceborne wind lidar, the Atmospheric Laser Doppler Instrument (ALADIN). ALADIN uses a high spectral resolution Doppler wind lidar operating at 355nm to determine profiles of line-of-sight wind components in near-real-time (NRT). ALADIN samples the atmosphere from 30km altitude down to the Earth's surface or to the level where the lidar signal is attenuated by optically thick clouds. The global wind profiles provided by ALADIN help to improve weather forecasting and the understanding of atmospheric dynamics as they fill observational gaps in vertically resolved wind profiles mainly in the tropics, southern hemisphere, and over the northern hemisphere oceans. Since 2020, multiple national and international weather centres (e.g. ECMWF, DWD, Météo France, MetOffice) assimilate Aeolus observations in their operational forecasting. Additionally, the scientific exploitation of the Aeolus dataset has started. A main prerequisite for beneficial impact and scientific exploitation is data of sufficient quality. Such high data quality has been achieved through close collaboration of all involved parties within the Aeolus Data Innovation and Science Cluster (DISC), which was established after launch to study and improve the data quality of Aeolus products. The tasks of the Aeolus DISC include the instrument and platform monitoring, calibration, characterization, retrieval algorithm refinement, processor evolution, quality monitoring, product validation, and impact assessment for NWP. The achievements of the Aeolus DISC for the NRT data quality and the one currently available reprocessed dataset will be presented. The data quality of the Aeolus wind measurements will be described and an outlook on planned improvements of the dataset and processors will be provided

Credit Rationing with Symmetric Information

Without denying the importance of asymmetric information, this article purports the view that credit rationing may also originate from a lender's inability to classify loan applicants in proper risk categories. This effect is particularly strong when novel technologies are involved. Furthermore, its relevance may increase with the importance assigned to internal rating systems by the Basel accord. This article presents a measure of the inadequacy of a lender's classification criteria to the qualitative features of prospective borrowers. Even without information asymmetries, credit rationing may occur if this quantity reaches too high a value. Furthermore, some general principles are outlined, that may be used by lenders in order to change their classification criteria

The persistent shadow of the supermassive black hole of M 87

In April 2019, the Event Horizon Telescope (EHT) Collaboration reported the first-ever event-horizon-scale images of a black hole, resolving the central compact radio source in the giant elliptical galaxy M 87. These images reveal a ring with a southerly brightness distribution and a diameter of ∼42 μas, consistent with the predicted size and shape of a shadow produced by the gravitationally lensed emission around a supermassive black hole. These results were obtained as part of the April 2017 EHT observation campaign, using a global very long baseline interferometric radio array operating at a wavelength of 1.3 mm. Here, we present results based on the second EHT observing campaign, taking place in April 2018 with an improved array, wider frequency coverage, and increased bandwidth. In particular, the additional baselines provided by the Greenland telescope improved the coverage of the array. Multiyear EHT observations provide independent snapshots of the horizon-scale emission, allowing us to confirm the persistence, size, and shape of the black hole shadow, and constrain the intrinsic structural variability of the accretion flow. We have confirmed the presence of an asymmetric ring structure, brighter in the southwest, with a median diameter of 43.3−3.1+1.5 μas. The diameter of the 2018 ring is remarkably consistent with the diameter obtained from the previous 2017 observations. On the other hand, the position angle of the brightness asymmetry in 2018 is shifted by about 30° relative to 2017. The perennial persistence of the ring and its diameter robustly support the interpretation that the ring is formed by lensed emission surrounding a Kerr black hole with a mass ∼6.5 × 109 M⊙. The significant change in the ring brightness asymmetry implies a spin axis that is more consistent with the position angle of the large-scale jet

Le guidelines EBA su concessione e monitoraggio dei prestiti: profili critici e implicazioni per banche e debitori

Le EBA-GL LOM richiedono di avere una visione integrata strategico-finanziaria, prospettica, e a non breve termine, del debitore. Alle banche e alle autorità di vigilanza (per una serie di aspetti critici irrisolti) è richiesto di ridefinire il ruolo dell’analisi e della previsione finanziaria, il rapporto con i rating interni e con il modello di business complessivo della banca. EBA-GL LOM require a forward looking single customer view that integrates strategic and financial perspectives on a medium term horizon. Banks and supervisors (for a number of unresolved critical issues), have to redesign the role of financial analysis and plans, and relations with internal ratings and with the overall bank business model

Analisi finanziaria e processi del credito dopo le linee-guida Eba : analisi di bilancio, previsione finanziaria, stress test su schemi Cebi e riassetto dei processi

No abstract availabl

Le determinanti del prezzo dei finanziamenti per la gestione del patrimonio immobiliare pubblico

Il pricing risk adjusted nel finanziamento bancario della gestione del patrimonio immobiliare pubblic