Aortic regurgitation in athletes. Pieces of the puzzle we have so far omitted

The prevalence of valvular heart disease (VHD) rises with age, reaching 11.7% in individuals older than 75 years.1 In young individuals, VHD is usually related to the presence of a congenital valve abnormality, as bicuspid aortic valve (BAV) or mitral valve prolapse. This is also the case for athletes, where in the presence of these abnormalities few restrictions exist in eligibility for competitive sports participation, even if a strict follow-up would be desirable. BAV is the most common congenital valve abnormality (1%) found in the general population and in athletes. BAV is more prevalent in males and it can lead to aortic regurgitation (AR), aortic stenosis and/or aortic root dilation. At present, no definitive studies have proved that intensive sports participation could worsen the progression of BAV and limited data are available on athletes

Kink Localization under Asymmetric Double-Well Potential

We study diffuse phase interfaces under asymmetric double-well potential energies with degenerate minima and demonstrate that the limiting sharp profile, for small interface energy cost, on a finite space interval is in general not symmetric and its position depends exclusively on the second derivatives of the potential energy at the two minima (phases). We discuss an application of the general result to porous media in the regime of solid-fluid segregation under an applied pressure and describe the interface between a fluid-rich and a fluid-poor phase. Asymmetric double-well potential energies are also relevant in a very different field of physics as that of Brownian motors. An intriguing analogy between our result and the direction of the dc soliton current in asymmetric substrate driven Brownian motors is pointed out

Economic impact of remote monitoring on ordinary follow-up of implantable cardioverter defibrillators as compared with conventional in-hospital visits: a single-center prospective and randomized study

Few data are available on actual follow-up costs of remote monitoring (RM) of implantable defibrillators (ICD). Our study aimed at assessing current direct costs of 1-year ICD follow-up based on RM compared with conventional quarterly in-hospital follow-ups. Methods and results Patients (N=233) with indications for ICD were consecutively recruited and randomized at implant to be followed up for 1 year with standard quarterly inhospital visits or by RM with one in-hospital visit at 12 months, unless additional in-hospital visits were required due to specific patient conditions or RM alarms. Costs were calculated distinguishing between provider and patient costs, excluding RM device and service cost. The frequency of scheduled in-hospital visits was lower in the RM group than in the control arm. Follow-up required 47 min per patient/year in the RM arm versus 86 min in the control arm (p=0.03) for involved physicians, generating cost estimates for the provider of USD 45 and USD 83 per patient/- year, respectively. Costs for nurses were comparable. Overall, the costs associated with RM and standard follow-up were USD 103±27 and 154±21 per patient/year, respectively (p=0.01). RM was cost-saving for the patients: USD 97±121 per patient/year in the RM group versus 287± 160 per patient/year (p=0.0001). Conclusion The time spent by the hospital staff was significantly reduced in the RM group. If the costs for the device and service are not charged to patients or the provider, patients could save about USD 190 per patient/year while the hospital could save USD 51 per patient/year

Densely populated settings: the challenge of siting geological facilities for deep geothermics, CO2 and natural gas storage, and radioactive waste disposal Underground Coexistence and Synergies for a Sound Energy Mix in the Post-Kyoto Era

The abstracts herein – collected for the 34th Course of the International School of Geophysics, held in Erice, Italy (“Ettore Majorana” Foundation and Centre for Scientific Culture, 25-30 September, 2010) – focus on geophysical, geological and geochemical methods applied to the planning of the soundest energy mix in densely populated countries, where the coexistence of different technologies requires unique underground facilities and resources. In the framework of IEA and EU programmes, where the concepts of “smart grids” and “smart cities” are prevailing, we rather propose the concept of “smart region” planning the use of both underground and surface areas in a new social-energetic paradigm of “zero kilometer” life. The coexistence of geological storage of CO2 and natural gas, geothermics and, possibly, nuclear waste temporary storage (near surface or geological) is today necessary owing to the progressive decrease of space and resources. In this context, the following technologies turn out to be very important: renewables (geothermal energy), nuclear power, clean coal technologies via CO2 Capture and Storage (CCS), Enhanced Oil Recovery (EOR), Enhanced Coal Bed Methane (ECBM), non-conventional gas exploitation, and seasonal storage of natural gas (also for strategic reserves). These technologies have been recently emphasized in Italy by the Ministry of Economic Development and by the Ministry of the Environment and Territory, as well as by research institutions such as INGV and CNR. Key topics addressed during the Course were: • Geological storage and disposal: assessment of available volume and structures. • Subsurface geological resources: management of potential conflicts among various technologies. • Geological site characterization and risk assessment for policy makers and regulators: the role of the energy industry. • New high tech frontiers for geothermal power production. • New concepts in nuclear waste disposal. • Numerical simulation software for geothermal exploration, geological storage and nuclear waste disposal. • Sharing subsurface data coming from oil & gas and geothermal exploration. • High resolution characterization of shallow aquifers and reservoirs: multi-strata exploitation by different energy technologies. • Case histories and natural analogues: “learning by doing” and “acceptable risk” concepts. The 34th Course of the International School of Geophysics is dedicated to students and young contract researchers starting their carreers in a period of energetic-environmental global crisis. Although their scientific contribution is of high quality, they are usually underpaid in public research institutions with respect to volatile staff of some international organizations who, making use of the results of governmentfunded research, make final decisions on low-carbon energy technologies

CD73 expression in normal, hyperplastic, and neoplastic thyroid: a systematic evaluation revealing CD73 overexpression as a feature of papillary carcinomas.

CD73 converts AMP to adenosine, an immunosuppressive metabolite that promotes tumorigenesis. This study presents a systematic evaluation of CD73 expression in benign, hyperplastic, and neoplastic thyroid. CD73 expression was assessed by immunohistochemistry in 142 thyroid samples. CD73 was expressed in normal thyroid (3/6) and goiter (5/6), with an apical pattern and mild intensity. Apical and mild CD73 expression was also present in oncocytic cell adenomas/carcinomas (9/10; 5/8) and in follicular adenomas/carcinomas (12/18; 23/27). In contrast, papillary thyroid carcinomas featured extensive and intense CD73 staining (49/50) (vs. normal thyroid/goiter, p < 0.001). Seven of nine anaplastic carcinomas were CD73-positive with heterogeneous extensiveness of staining. Medullary and poorly differentiated carcinomas were mostly CD73-negative (1/6; 2/2). These results were corroborated by NT5E mRNA profiling. Papillary carcinomas feature enhanced CD73 protein and mRNA expression with distinct and intense staining, more pronounced in the invasive fronts of the tumors

Erectile function recovery after laparoscopic decompression of pudendal artery and nerve: a documented case report

The aim of this article is to report the effectiveness of laparoscopic decompression of pudendal artery (PA) and nerve for erectile dysfunction (ED) restoration. A 32-year-old man consulted for a long-term complaint of ED not responsive to medical therapy. Endocrine screening and neurological evaluation did not show any abnormalities. Color Doppler ultrasound revealed the absence of blood flow in the right PA. After failure of conservative treatments and in accordance to the patient’s desire, laparoscopic pudendal artery decompression was performed. The patient reported significant amelioration of ED one month after surgery. At 8-months follow-up, Doppler ultrasound showed complete revascularization of the right PA

Long-Term Sports Practice and Atrial Fibrillation: An Updated Review of a Complex Relationship

Atrial fibrillation (AF) is the most common sustained arrhythmia in clinical practice, and it is an enormous burden worldwide because of its high morbidity, disability and mortality. It is generally acknowledged that physical activity (PA) is strongly associated with a significant reduction in the risk of cardiovascular (CV) disease and all-cause mortality. Moreover, it has been observed that moderate and regular physical activity has the potential to reduce the risk of AF, in addition to improving overall well-being. Nevertheless, some studies have associated intense physical activity with an increased risk of AF. This paper aims to review the main related literature to investigate the association between PA and AF incidence and draw pathophysiological and epidemiological conclusions

A Multi-Disciplinary Approach to the Study of Large Rock Avalanches Combining Remote Sensing, GIS and Field Surveys: The Case of the Scanno Landslide, Italy

This is the final version. Available from MDPI via the DOI in this record.This research aims to highlight the importance of adopting a multi-disciplinary approach to understanding the factors controlling large rock avalanches using the Scanno landslide, Italy, as a case study. The study area is the Mount Genzana, Abruzzi Central Apennines, characterized by the regional Difesa-Mount Genzana-Vallone delle Masserie fault zone. The Scanno landslide is famous for its role in the formation of the Scanno Lake. The landslide is characterized by a wide exposed scar, which was interpreted in previous studies as the intersection of high-angle joints and an outcropping bedding plane on which the landslide failed sometime between the Upper Pleistocene and the Holocene. In this study, the Scanno landslide was investigated through the integration of geological, geomechanical and geomorphological surveys. Remote sensing techniques were used to enrich the conventionally gathered datasets, while Geographic Information Systems (GIS) were used to integrate, manage and investigate the data. The results of the authors investigation show that the outcropping landslide scar can be interpreted as a low-angle fault, associated with the Difesa-Mount Genzana-Vallone delle Masserie fault zone, which di ers from previous investigations and interpretations of the area. The low-angle fault provides the basal failure surface of the landslide, with two systematic high-angle joint sets acting as lateral release and back scarp surfaces, respectively. In light of these new findings, pre- and post-failure models of the area have been created. The models were generated in GIS by combining LiDAR (Light Detection and Ranging) and geophysics data acquired on the landslide body and through bathymetric survey data of the Scanno Lake. Using the pre- and post-failure models it was possible to estimate the approximate volume of the landslide. Finally, back-analyses using static and dynamic limit equilibrium methods is also used to show the possible influence of medium-to-high magnitude seismic events in triggering the Scanno landslide

Clinical correlation among male infertility and overall male health: a systematic review of the literature

Purpose: Ongoing evidence has suggested the role of male factor infertility as a potential predictor of mortality and general health status. The aim of the present review is to update the current knowledge base regarding the association between male factor infertility and general health through a critical review of the literature. Materials and Methods: A systematic review of the literature was carried out from inception to November 2019 in order to evaluate significant associations between male infertility and adverse health outcomes such as cardiovascular, oncologic, metabolic and autoimmune diseases as well as overall mortality. Results: In all, 27 studies met inclusion criteria and were critically examined. Five studies examined male infertility and cardiovascular disease risk, 11 examined oncologic risk (e.g., overall cancer risk, testis and prostate cancer), 8 examined aggregate chronic medical diseases and 5 infertility related to incidence of mortality, for a total of 599,807 men diagnosed with any male factor infertility covering a period from 1916 to 2016. Conclusions: A man’s fertility and overall health appear to be interconnected. Therefore, a diagnosis of male infertility may allow a window into future comorbidity and/or mortality which may help guide clinical decisions and counseling. Several possible etiologies such as genetic, epigenetic, developmental, and lifestyle-based factors need to be further evaluated in order to establish the underlying mechanisms between male infertility and health