Balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension: experience of four years in a single centre

Background: Balloon pulmonary angioplasty (BPA) has recently been developed as an alternative and less- invasive treatment strategy for chronic thromboembolic pulmonary hypertension (CTEPH), but therapeutic efficacy and technical safety of the technique have to be established. Aim: effects of BPA on patients with inoperable disease or residual pulmonary hypertension (PH) after pulmonary endarterectomy (PEA). Methods: From June 2015 to September 2019 we enrolled symptomatic (NYHA ≥ II) inoperable CTEPH patients and patients with residual PH after PEA. At baseline, immediately before the first BPA session and 3-6 months after last BPA session all patients underwent clinical evaluation, six-minute walking distance and right heart catheterization. For comparisons Friedman test (with Bonferroni post-hoc pairwise analysis) was used. Survival curves were done with Kaplan Meier method. Results: Forty-seven patients [male 45%, median age 68 (51-74) years, 40 inoperable and 7 with residual PH after PEA] were treated for a total of 136 sessions (median number of sessions for each patient: 2); during each session we treated 2 (2-3) vessels; BPA significantly improved symptoms (NYHA III-IV from 85 to 42%), exercise capacity (from 425 to 446 m) and hemodynamic profile (reduction of mean pulmonary arterial pressure from 41 to 35 mmHg and of pulmonary vascular resistance from 7.1 to 4.7 WU). Five pulmonary artery dissection and 2 hemoptysis with clinical impairment were documented; 33 patients had lung injury (radiographic opacity with/without hemoptysis and/or hypoxemia), 7 patients had access site complications. Five patients died during follow-up (none within 30 days from the procedure) because of sepsis (1), heart failure (1), cancer (1), arrhythmic storm (1) and sudden death in a patient with severe coronary atherosclerosis (1). Conclusions: BPA is a safe and effective treatment able to improve symptoms and hemodynamic profile in inoperable CTEPH patients and in patients with residual PH after PEA

The health potential of urban water: Future scenarios on local risks and opportunities

Although cities can be characterised as sources of economic, environmental and social challenges, they can also be part of the solution for healthy and sustainable societies. While most cities are situated close to water, whether inland waterways, lakes, or the sea, these blue spaces are not integrated into urban planning to their full potential and their public health impacts are not always recognised by planning authorities. Furthermore, cities face future challenges regarding climate change, socio-economic developments like tourism, urbanization, and rising social inequalities. The development of healthy blue spaces can support cities in their pursuit of ways to confront these challenges. Interdisciplinary and transdisciplinary analyses of the local impacts of these trends and promising interventions have been scarce to date. This study explores the use of such methodology by presenting experiences related to five European cities: Amsterdam, Barcelona, Plymouth, Tallinn and Thessaloniki, using an interactive and participative approach with local experts and stakeholders. Future scenarios have been developed based on the question: How can blue spaces contribute to a healthier city population, given the long term trends? The results highlight the importance of addressing the local context when seeking sustainable solutions for cities. The future scenarios deliver information that could serve as useful input for local planning processes

The health potential of urban water: Future scenarios on local risks and opportunities

This is the final version. Available on open access from Elsevier via the DOI in this recordAlthough cities can be characterised as sources of economic, environmental and social challenges, they can also be part of the solution for healthy and sustainable societies. While most cities are situated close to water, whether inland waterways, lakes, or the sea, these blue spaces are not integrated into urban planning to their full potential and their public health impacts are not always recognised by planning authorities. Furthermore, cities face future challenges regarding climate change, socio-economic developments like tourism, urbanization, and rising social inequalities. The development of healthy blue spaces can support cities in their pursuit of ways to confront these challenges. Interdisciplinary and transdisciplinary analyses of the local impacts of these trends and promising interventions have been scarce to date. This study explores the use of such methodology by presenting experiences related to five European cities: Amsterdam, Barcelona, Plymouth, Tallinn and Thessaloniki, using an interactive and participative approach with local experts and stakeholders. Future scenarios have been developed based on the question: How can blue spaces contribute to a healthier city population, given the long term trends? The results highlight the importance of addressing the local context when seeking sustainable solutions for cities. The future scenarios deliver information that could serve as useful input for local planning processes.European Union Horizon 202

Phenotyping Green and Roasted Beans of Nicaraguan Coffea Arabica Varieties Processed with Different Post-Harvest Practices

Metabolomic tecniques have already been used to characterize two of the most common coffee species, C. arabica and C. canephora, but no studies have focused on the characterization of green and roasted coffee varieties of a certain species. We aim to provide, using NMR-based metabolomics, detailed and comprehensive information regarding the compositional differences of seven coffee varieties (C. arabica) of green and roasted coffee bean batches from Nicaragua. We also evaluated how different varieties react to the same post-harvest procedures such as fermentation time, type of drying and roasting. The characterization of the metabolomic profile of seven different Arabica varieties (Bourbon-typica), allowed us also to assess the possible use of an NMR spectra of bean aqueous extracts to recognize the farm of origin, even considering different farms from the same geographical area (Nueva Segovia). Here, we also evaluated the effect of post-harvest procedures such as fermentation time and type of drying on green and roasted coffee, suggesting that post-harvest procedures can be responsible for different flavours. This study provides proof of concept for the ability of NMR to phenotype coffee, helping to authenticate and optimise the best way of processing coffee