The “Weight” of Obesity on Arterial Hypertension

The prevalence of obesity and its related diseases are increasing worldwide. This phenomenon has been observed not only in adults but also in adolescents and children. Numerous scientific studies have revealed a direct correlation between the increase in blood pressure and weight gain. In fact, visceral fat can contribute to the rise in blood pressure because it is associated with an increased production of inflammatory cytokines (such as interleukin-1-β, tumor necrosis factor-α and interleukin-6) and inflammatory factors (such as C-reactive protein), inducing endothelial dysfunction and consequently arterial hypertension (AH). Insulin resistance, which develops in obese individuals, may represent an additional risk factor in the onset of AH. Postprandial hyperglycemia is not able to inhibit lipolysis, inducing a greater release of free fatty acids causing metabolic abnormalities, oxidative stress and vascular dysfunction. In this chapter, we will examine the mechanisms that correlate obesity to hypertension, such as the involvement of the sympathetic nervous system, metabolic and renal alterations. Finally, the pharmacological and nutritional treatment of obesity-related hypertension will be described

Cosmic-ray propagation with DRAGON2: II. Nuclear interactions with the interstellar gas

Understanding the isotopic composition of cosmic rays (CRs) observed near Earth represents a milestone towards the identification of their origin. Local fluxes contain all the known stable and long-lived isotopes, reflecting the complex history of primaries and secondaries as they traverse the interstellar medium. For that reason, a numerical code which aims at describing the CR transport in the Galaxy must unavoidably rely on accurate modelling of the production of secondary particles. In this work we provide a detailed description of the nuclear cross sections and decay network as implemented in the forthcoming release of the galactic propagation code DRAGON2. We present the secondary production models implemented in the code and we apply the different prescriptions to compute quantities of interest to interpret local CR fluxes (e.g., nuclear fragmentation timescales, secondary and tertiary source terms). In particular, we develop a nuclear secondary production model aimed at accurately computing the light secondary fluxes (namely: Li, Be, B) above 1 GeV/n. This result is achieved by fitting existing empirical or semi-empirical formalisms to a large sample of measurements in the energy range 100 MeV/n to 100 GeV/n and by considering the contribution of the most relevant decaying isotopes up to iron. Concerning secondary antiparticles (positrons and antiprotons), we describe a collection of models taken from the literature, and provide a detailed quantitative comparison.Comment: 22 pages, 12 figure

Emoty: an Emotionally Sensitive Conversational Agent for People with Neurodevelopmental Disorders

Our research aims at exploiting the advances in conversational technology to support people with Neurodevelopmental Disorder (NDD). NDD is a group of conditions that are characterized by severe deficits in the cognitive, emotional and motor areas and produce severe impairments in communication and social functioning. This paper presents the design, technology and exploratory evaluation of Emoty, a spoken Conversational Agent (CA) created specifically for individuals with NDD. The goal of Emoty is to help these persons enhancing communication abilities related to emotional recognition and expression, which are fundamental in any form of human relationship. The system exploits emotion detection capabilities based on the semantics of the speech by calling the IBM Watson Tone Analyzer API and from the harmonic features of the audio thanks to an “all-of-us” Deep Learning model. The design and evaluation of Emoty are based on the close collaboration among computer engineers and specialists in NDD (psychologists, neurological doctors, educators)

Coupled simulations of the NACIE facility using RELAP5 and ANSYS FLUENT codes

This work deals with the development and preliminarily assessment of a coupling methodology between a modified version of RELAP5/Mod3.3 STH code and FLUENT commercial CFD code, applied to the NACIE (natural circulation experiment) LBE (lead bismuth eutectic) experimental loop (built and located at the ENEA Brasimone research centre). The coupling tool is used to simulate experiments representative of both natural circulation conditions and isothermal gas enhanced (assisted) circulation. Furthermore, an accidental test reproducing an Unprotected Loss of Flow (ULOF) scenario is also simulated and the outcomes are presented. A preliminary sensitivity analysis has shown that, to guarantee a suitable numerical convergence, the assisted circulation tests require a time step one order of magnitude lower compared to natural circulation ones. The comparison between the RELAP5 stand-alone simulations and RELAP5/FLUENT coupled simulations proved the capability to simulate the thermal-hydraulic behaviour of a loop experimental facility for all the examined conditions

Drug interactions of direct oral anticoagulants in elderly patients with cardiometabolic diseases

In the present review we summarized current knowledge about significant interactions (DIs) of direct oral anticoagulants (DOACs) with other medications frequently prescribed to elderly patients with cardiometabolic diseases. Literature search was performed using PubMed from 1990 to October 2020. Randomized clinical trials (RCTs), subgroup analyses from RCTs, longitudinal studies, case series and case reports were included. Only studies in humans were considered. Elderly was defined as ≥75 years. Assessment of DIs with DOACs is often tricky because of the lack of validated tools to routinely assess magnitude of their anti-coagulation effect. Most of reports in the cardiometabolic area regarded the classes of anti-antiarrhythmic, lipid-lowering and platelet-inhibitors drugs, namely drugs that are widely used to reduce cardiovascular risk in patients with common metabolic diseases. Reports about elderly are limited in general, and it is not known whether certain types of DIs occur more frequently in elderly subjects. DIs were more frequently reported in association with dabigatran, which however has been available for a longer period of time compared with other DOACs. In most cases, no complete information about dosages of medications was available. DIs of DOACs leading to adverse events (both ischemic and bleeding ones) were generally facilitated by older age, polymedication and impaired renal function. Further studies should be carried out to properly investigate DIs of DOACs with cardiometabolic drugs in elderly patients, with particular focus on differences between DOACs and the influence of different dosages

Effects of Ultramicronized Palmitoylethanolamide (um-PEA) in COVID-19 Early Stages: A Case-Control Study

Ultramicronized palmitoylethanolamide (um-PEA), a compound with antioxidant, anti-inflammatory and neuroprotective properties, appears to be a potential adjuvant treatment for early stages of Coronavirus disease 2019 (COVID-19). In our study, we enrolled 90 patients with confirmed diagnosis of COVID-19 that were randomized into two groups, homogeneous for age, gender and BMI. The first group received oral supplementation based on um-PEA at a dose of 1800 mg/day for a total of 28 days; the second group was the control group (R.S. 73.20). At baseline (T0) and after 28 days of um-PEA treatment (T1), we monitored: routine laboratory parameters, inflammatory and oxidative stress (OS) biomarkers, lymphocytes subpopulation and COVID-19 serological response. At T1, the um-PEA-treated group presented a significant reduction in inflammation compared to the control group (CRP p = 0.007; IL-6 p = 0.0001; neutrophils to lymphocytes ratio p = 0.044). At T1, the controls showed a significant increase in OS compared to the treated group (FORT p = 0.05). At T1, the um-PEA group exhibited a significant decrease in D-dimer levels (p = 0.0001) and higher levels of IgG against SARS-CoV-2 (p = 0.0001) compared to the controls. Our data demonstrated, in a randomized clinical trial, the beneficial effects of um-PEA in both asymptomatic and mild-symptomatic patients related to reductions in inflammatory state, OS and coagulative cascade alterations

Extra Virgin Olive Oil and Cardiovascular Protection in Chronic Kidney Disease

The high mortality related to chronic kidney disease (CKD) is not only due to the disease itself; in fact, CKD also represents an important risk factor for cardiovascular (CV) morbidity and mortality. Among the functional foods that seems to have cardioprotective action, extra virgin olive oil (EVOO) plays a pivotal health-promoting role. The aim of this study was to evaluate the possible cardioprotective effects of an EVOO containing a very high content (>900 ppm) of minor phenolic compounds (MPCs). The selected EVOO was analyzed by HPLC-DAD-MS to establish the MPC content. The Olea extract obtained from the selected EVOO was tested against the RAW 264.7 cell line in order to investigate its anti-inflammatory activity. We enrolled 40 CKD patients under conservative therapy for in vivo clinical testing. All CKD patients consumed 40 mL/day of raw EVOO for 9 weeks (T1). At baseline (T0) and at T1, we monitored the patients' blood and urinary parameters. The patients' body composition was assessed using bioelectrical impedance analysis and the carotid intima-media thickness (CIMT) using ultrasound imaging. At T1, we observed a decrease in inflammatory parameters, CIMT, and oxidative stress biomarkers. We also noticed improvements in lipid and purine metabolism, atherogenic indices, and body composition. Thus, this study highlighted the cardioprotective action of EVOO in nephropathic patients

Qualitative and Quantitative Assessment of Vascular Changes in Diabetic Macular Edema after Dexamethasone Implant Using Optical Coherence Tomography Angiography

The aim of this study was to investigate retinal and choriocapillaris vessel changes in diabetic macular edema (DME) after the intravitreal dexamethasone implant (IDI) using optical coherence tomography angiography (OCTA). Moreover, a comparison between morphological and functional parameters of DME and healthy patients was performed. Twenty-five eyes of 25 type 2 diabetic retinopathy patients complicated by macular edema (DME group) and 25 healthy subjects (control group) were enrolled. Superficial capillary plexus density (SCPD) and deep capillary plexus density (DCPD) in the foveal and parafoveal areas, choricapillary density (CCD) and optic disc vessel density (ODVD) were detected using OCTA at baseline and after 7, 30, 60, 90 and 120 days post injection. Best corrected visual acuity (BCVA), retinal sensitivity, and central retinal thickness (CMT) were also evaluated in both groups of patients. A statistically significant difference between the two groups (DME and controls) was found in terms of functional (MP, p < 0.001 and BCVA, p < 0.001) and morphological (CMT, p < 0.001; SCPD in the parafoveal area, p < 0.001; DCPD in the foveal area, p < 0.05 and parafoveal area, p < 0.001; CCD, p < 0.001) parameters. After the treatment, SCPD and DCPD in the foveal and parafoveal areas did not modify significantly during the follow up

HLMC Fuel Pin Bundle characterization in CIRCE-ICE pool facility

Abstract. This work, carried out at the DICI of Pisa University, in collaboration with ENEA Brasimone R.C., deals with the analysis and a preliminary discussion of the experimental tests performed in the Integral Circulation Experiment (ICE) configuration of the Circulation Eutectic (CIRCE) facility aiming to investigate the heat transfer in fuel rod bundle. The facility test section basically consists of an electrical bundle (FPS) made up of 37 pins arranged in a hexagonal wrapped lattice with a pitch to diameter ratio of 1.8. Along the FPS active length, two sections were instrumented to monitor the heat transfer coefficient along the bundle as well as the cladding temperatures at different ranks of the sub-channels. In particular, forced circulation condition tests were performed imposing a temperature difference through the FPS and a LBE mass flow rate through the FPS. Nusselt number in the sub-channels was calculated as function of the Peclet number and obtained results were compared to Nusselt numbers computed from correlations available in Heavy Liquid Metals (HLM) literature. Results shown that the Nu is slightly lower in the middle section (section 1) if compared with the ones into the upper section (section 3), and that behaviour is probably due to the turbulence of the flow which seems to be fully developed only in the upper part of the fuel pin bundle. Anyway the Nu number, calculated as function of the Pe number in the range Pe~1500÷3000 (forced circulation condition), matches well the numerical correlation available for HLM fuel pin bundle, (i.e. Ushakov and Mikityuk)

Brown Tumour in a Patient with Secondary Hyperparathyroidism Resistant to Medical Therapy: Case Report on Successful Treatment after Subtotal Parathyroidectomy

Brown tumour represents a serious complication of hyperparathyroidism. Differential diagnosis, based on histological examination, is only presumptive and clinical, radiological and laboratory data are necessary for definitive diagnosis. Here we describe a case of a brown tumour localised in the maxilla due to secondary hyperparathyroidism in a young women with chronic renal failure. Hemodialysis and pharmacological treatment were unsuccessful in controlling secondary hyperparathyroidism making it necessary to proceed with a subtotal parathyroidectomy. The proper timing of the parathyroidectomy and its favourable effect on regression of the brown tumor made it possible to avoid a potentially disfiguring surgical removal of the brown tumor