The promotion of sustainable regeneration : varying interpretations and valuations among practitioners in the Lee Valley

This research has developed out of an interest in exploring the relationship between the promotion of sustainability within regeneration as a high-level policy commitment, and the actual process of definition of sustainability policy goals at the local level. The research has been informed by the idea that the notion of sustainable development is characterised by a key ideological dimension, given by the fact that people hold different ideas about the role of the environment and the direction of societal development. In addition, the notion that sustainability refers to a complex and dynamic condition related to the viability of the relationship between societies and the environment over a long time is central to the conceptualisation of the research topic. These ideas have led to the examination of two main questions. First how different interpretations of sustainable development inform the process of the formulation of sustainable development policy goals within regeneration. Second, how the actors' valuation of regeneration objectives contribute to shaping the relationship between societies and the environment. The research shows how ambiguities and lack of clarity in the definition of the basic policy goal have left scope for different players in the implementation process to identify their own interpretations of its meaning. This has taken place under the influence of the culture of their organisation, their own agency's policy priorities and of the activities and interests defined by the processes in which they are engaged. Findings suggest that given the wide range of policy themes coming together under regeneration policy, the various policy discourses, championed by different groups of actors, concur in the definition of the regeneration agenda. With respect to the promotion of sustainability the co-existence of different policy discourses results in the creation of discrete and contextual actors' accounts where the environmental dimension of regeneration initiatives is defined and circumscribed. In particular, the analysis of the actors' valuation of regeneration objectives and of the environmental transformations that such objectives entail, offers an interesting insight into the power of discourses to reinforce certain arguments, at the expense of others. In addition, it demonstrates how the social processes, in which the actors are involved, shape their valuation of regeneration objectives and overall their understanding of sustainable development policy goals.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Long-term follow-up of adventitial cyst surgical excision in external iliac vein

Adventitial cystic disease of the venous system is an extremely rare condition. Forty-five cases have been described in the literature during the last 70 years, but they may not be representative of the real incidence of this pathologic process. We report a case of an adventitial cyst compressing the right external iliac vein and presenting with edema of the ipsilateral leg. Ultrasound imaging and computed tomography angiography showed the typical features of cystic disease and venous stenosis. Cyst excision was performed with a double surgical access. No perioperative complications were reported. There was no recurrence at 4-year follow-up

Through-and-through femorofemoral wire retrograde technique for the E-nside precannulated inner branch thoracoabdominal stent graft

The E-nside multibranched stent graft (Jotec GmbH, Hechingen, Germany) is the first and only off-the-shelf thoracoabdominal prosthesis with precannulated inner branches. Usually, after the device deployment, target vessel stenting will be facilitated by antegrade inner branch cannulation to retrieve the precannulated guide. In the literature, the use of antegrade access has been associated with the potential risk of cerebral and systemic embolization. Therefore, other retrograde techniques have been described. We have reported a new retrograde approach using a precannulated through-and-through femorofemoral wire technique for target vessel catheterization

Open conversion following Nellix Endovascular Aneurysm Sealing (EVAS)

The Nellix Endovascular Aneurysm Sealing (EVAS) System (Endologix, Irvine, California, USA) was presented as a novel concept in the treatment of abdominal aortic aneurysm (AAA). After numerous adverse events, the device has been voluntarily withdrawn from the market by the manufacturer. The purpose of this video is to describe the technical approach of a successful explantation of the Nellix endograft in a patient who underwent EVAS for AAA. The patient\u2019s consent for publication was obtained

Extensive congenital asymptomatic renal arteriovenous malformation

Renal arteriovenous malformations (AVM) are abnormal communications between the intrarenal arterial and venous systems. These lesions may present with a wide range of signs and symptoms, including hypertension and hematuria. We report a case of a 71-year-old woman with incidentally diagnosis of asymptomatic right renal AVM

Lectin Pathway of Complement Activation Is Associated with Vulnerability of Atherosclerotic Plaques

Inflammatory mechanisms may be involved in atherosclerotic plaque rupture. By using a novel histology-based method to quantify plaque instability here, we assess whether lectin pathway (LP) of complement activation, a major inflammation arm, could represent an index of plaque instability. Plaques from 42 consecutive patients undergoing carotid endarterectomy were stained with hematoxylin-eosin and the lipid core, cholesterol clefts, hemorrhagic content, thickness of tunica media, and intima, including or not infiltration of cellular debris and cholesterol, were determined. The presence of ficolin-1, -2, and -3 and mannose-binding lectin (MBL), LP initiators, was assessed in the plaques by immunofluorescence and in plasma by ELISA. LP activation was assessed in plasma by functional in vitro assays. Patients presenting low stenosis (≤75%) had higher hemorrhagic content than those with high stenosis (>75%), indicating increased erosion. Increased hemorrhagic content and tunica media thickness, as well as decreased lipid core and infiltrated content were associated with vulnerable plaques and therefore used to establish a plaque vulnerability score that allowed to classify patients according to plaque vulnerability. Ficolins and MBL were found both in plaques’ necrotic core and tunica media. Patients with vulnerable plaques showed decreased plasma levels and intraplaque deposition of ficolin-2. Symptomatic patients experiencing a transient ischemic attack had lower plasma levels of ficolin-1. We show that the LP initiators are present within the plaques and their circulating levels change in atherosclerotic patients. In particular, we show that decreased ficolin-2 levels are associated with rupture-prone vulnerable plaques, indicating its potential use as marker for cardiovascular risk assessment in atherosclerotic patients

Ocular pharmacological and biochemical profiles of 6-thioguanine: a drug repurposing study

Introduction:The purine analog 6-thioguanine (6TG), an old drug approved in the 60s to treat acute myeloid leukemia (AML), was tested in the diabetic retinopathy (DR) experimental in vivo setting along with a molecular modeling approach.Methods:A computational analysis was performed to investigate the interaction of 6TG with MC1R and MC5R. This was confirmed in human umbilical vein endothelial cells (HUVECs) exposed to high glucose (25 mM) for 24 h. Cell viability in HUVECs exposed to high glucose and treated with 6TG (0.05–0.5–5 µM) was performed. To assess tube formation, HUVECs were treated for 24 h with 6TG 5 µM and AGRP (0.5–1–5 µM) or PG20N (0.5–1–5–10 µM), which are MC1R and MC5R antagonists, respectively. For the in vivo DR setting, diabetes was induced in C57BL/6J mice through a single streptozotocin (STZ) injection. After 2, 6, and 10 weeks, diabetic and control mice received 6TG intravitreally (0.5–1–2.5 mg/kg) alone or in combination with AGRP or PG20N. Fluorescein angiography (FA) was performed after 4 and 14 weeks after the onset of diabetes. After 14 weeks, mice were euthanized, and immunohistochemical analysis was performed to assess retinal levels of CD34, a marker of endothelial progenitor cell formation during neo-angiogenesis.Results:The computational analysis evidenced a more stable binding of 6TG binding at MC5R than MC1R. This was confirmed by the tube formation assay in HUVECs exposed to high glucose. Indeed, the anti-angiogenic activity of 6TG was eradicated by a higher dose of the MC5R antagonist PG20N (10 µM) compared to the MC1R antagonist AGRP (5 µM). The retinal anti-angiogenic effect of 6TG was evident also in diabetic mice, showing a reduction in retinal vascular alterations by FA analysis. This effect was not observed in diabetic mice receiving 6TG in combination with AGRP or PG20N. Accordingly, retinal CD34 staining was reduced in diabetic mice treated with 6TG. Conversely, it was not decreased in diabetic mice receiving 6TG combined with AGRP or PG20N.Conclusion:6TG evidenced a marked anti-angiogenic activity in HUVECs exposed to high glucose and in mice with DR. This seems to be mediated by MC1R and MC5R retinal receptors

La prospettiva biopsicosociale nella rappresentazione dei medici di medicina generale di Roma

Il testo affronta il delicato tema della crisi economica e sociale analizzando le ricadute sui sistemi sanitari e sui cittadini in termini di equità e di umanizzazione delle cure, alla luce dell’attuale scenario socio-sanitario generato (anche) dalla digital society. Sono raccolti qui i contributi di esperti del mondo del lavoro e dell’università presentati in occasione del Convegno organizzato dalla Società Italiana di Sociologia della Salute (SISS), tenutosi a Roma il 29 maggio 2014. Cardini della riflessione sono la social innovation, la ‘crisi del sistema’ e la possibilità di un suo superamento: quali sono le modifiche attuabili in futuro per ridurre la complessità del ‘sistema sanitario’ in epoca di deterritorializzazione delle strutture sanitarie e di  digital m-care