Microbial risk factors of cardiovascular and cerebrovascular diseases: potential therapeutic options

Infection and inflammation may have a crucial role in the pathogenesis of atherosclerosis. This hypothesis is supported by an increasing number of reports on the interaction between chronic infection, inflammation, and atherogenesis. Assessment of serological and inflammatory markers of infection may be useful adjuncts in identifying those patients who are at a higher risk of developing vascular events, and in whom more aggressive treatments might be warranted

A principle-based approach to AI: the case for European Union and Italy

As Artificial Intelligence (AI) becomes more and more pervasive in our everyday life, new questions arise about its ethical and social impacts. Such issues concern all stakeholders involved in or committed to the design, implementation, deployment, and use of the technology. The present document addresses these preoccupations by introducing and discussing a set of practical obligations and recommendations for the development of applications and systems based on AI techniques. With this work we hope to contribute to spreading awareness on the many social challenges posed by AI and encouraging the establishment of good practices throughout the relevant social areas. As points of novelty, the paper elaborates on an integrated view that combines both human rights and ethical concepts to reap the benefits of the two approaches. Moreover, it proposes innovative recommendations, such as those on redress and governance, which add further insight to the debate. Finally, it incorporates a specific focus on the Italian Constitution, thus offering an example of how core legislations of Member States might contribute to further specify and enrich the EU normative framework on AI

Clinical Pharmacology and Vascular Risk

Pharmacological treatment and several drugs of abuse have been associated with ischemic heart disease (IHD) and cerebrovascular diseases (CVD). However, there is a paucity of data on the independent risk of vascular disease (VD) associated with pharmacological treatment and no controlled trials demonstrating a reduction in risk with abstinence

USO de Adjuvantes (caf 09, Caf 01 e Mpl) Mucosa-compatíveis na Formulação de Vacinas Contra a Leishmaniose Viceral.

A leishmaniose visceral é umas das doenças infecto-parasitária endêmica em diversos países dentre deles o Brasil, que atinge os seres humanos e outros vertebrados. Seu tratamento é feito com fármacos específicos (pentavelentes antimonais, anfoterecina B, pentamidinas e miltefosina) de alta toxicidade, causando efeitos colaterais nos pacientes, sendo assim é necessária um busca por alternativas para controlar a doença. Nesse contexto, as vacinas de mucosa tem sido promissoras devido à sua especificidade na ativação do sistema imunológico associado ao baixo custo e simples administração. A vacinação por via mucosa contra leishmaniose visceral, proposto por este estudo, utiliza uma vacina composta por antígenos totais de L. amazonensis (LaAg) em associação com adjuvantes, como CAF01, CAF09 e MPL, os quais são eficazes em gerar uma forte resposta imunológica mediante ao estimulo de TLR1, 2, 4 e/ou TLR9. Nesse contexto, avaliamos os efeitos imunogênicos e protetores da administração intranasal de nossa vacina em camundongos BALB/c desafiados por L. infantum chagasi. Nossos resultados mostraram uma resposta promissora da vacina em conjunto com dois adjuvantes, CAF01 e MPL, levando a uma diminuição da carga parasitaria 60 veze menos no caso do baço e 30 vezes menos no fígado dos animais, assim como um aumento na expressão de óxido nítrico (80μM) baço e (150 μM ) fígado e também a presença de citocinas inflamatórias ex-vivo IL-4 e IFN-γ. Observamos também um aumento na linfoproliferação de células CD8+ em cultura de esplenócitos. Dessa forma, podemos determinar a efetividade de nossa vacina de estudo de base em camundongos BALB/c, podendo, a partir de próximos estudos

Stroke care in Italy: An overview of strategies to manage acute stroke in COVID-19 time

Purpose: To analyse structural and non-structural modifications of acute stroke care pathways undertaken at healthcare institutions across the regions of Italy due to the coronavirus disease 2019 (COVID-19) pandemic. Methods: Research on National decrees specific for the pandemic was carried out. The stroke pathways of four Italian regions from North to South, such as Lombardy, Veneto, Lazio and Campania, were analysed before and after the pandemic outbreak. Findings: On 29 February 2020, the Italian Minister of Health issued national guidelines on how to address the COVID-19 emergency. Stroke management was affected and required changes, basically resulting in the need to prioritise the ongoing COVID-19 emergency. In the most affected regions, the closure of departments and hospitals led to a complete reorganisation of previously functioning stroke networks. With the closure of several Stroke Units and Stroke Centres, the transportation time to hospital lengthened significantly, especially for the outlying populations. Discussion: The COVID-19 pandemic outbreak has been spreading rapidly in Italy and placing an overwhelming burden on healthcare systems. In response to this, political and healthcare decision-makers worked together to develop and implement efforts to sustain the national healthcare system while fighting the pandemic. Stroke care pathways changed during the pandemic and different organisational models were applied in the most affected regions. Conclusions: Stroke treatment pathways will need to be redesigned so to guarantee that severe and acute disease patients do not lose their rights to the access and delivery of care during the COVID-19 pandemics

The Selena-Rise Open Risk Package

Today, a considerable number of non-commercial seismic risk analysis tools are available. The happy circumstance that the tools are free is likely a result of the fact that the group of potential users or customers is small and with limited funds which are not sufficient for the distribution of commercial or proprietary seismic risk assessment software. Aware of the need for non-proprietary and open-source software for seismic risk and loss computation, the International Centre for Geohazards (ICG), through NORSAR (Norway) and the University of Alicante (Spain), began the development of the tool SELENA in 2004. The current version 4.1 of SELENA (Seismic Loss Estimation using a Logic Tree Approach; Molina et al., 2009), initially coded in MATLAB, has recently been translated into C. Thus, the code can be compiled as a stand-alone binary, which is then independent of MATLAB and its toolboxes. Furthermore, the code has been adapted in such a way that it can even be run in the free (open-source) MATLAB clone Octave. In order to make it even more attractive to use SELENA, the separate software tool RISe (Risk Illustrator for SELENA; Lang and Gutiérrez, 2009) has been developed to allow easy conversion of the geo-referenced SELENA input and output files into Google Earth kml-files. Since it is linked to the Google Earth visualization, the user automatically takes full advantage of the partly highresolution satellite images provided by Google Earth. This is particularly important in situations where other commercial GIS packages do not provide a high resolution database, or for developing countries where many cities and municipalities cannot be displayed on high resolution base maps other than Google Earth satellite images. RISe is customized to SELENA’s file structure, and it is further intended to assist the user during the different stages of the risk computation process. Like SELENA, RISe is openly distributed through NORSAR’s webpage www.norsar.no The open SELENA-RISe package is a powerful tool to conduct earthquake risk and loss computations at the level of geographical units (such as census tracts). Since SELENA offers a range of options to the user and is open to any user-defined input data, its application for scientific and analytical purposes is facilitated. In contrast, more practical applications of SELENA are enabled through its Google Earth interface RISe. This allows for easy identification of more vulnerable building typologies or building areas through a simple graphical visualization of inventory data and computation results. Further, SELENA-RISe can be used within cost benefit analyses since the impact of parameter changes (e.g. of building vulnerability) on final damage and loss estimates can be investigated and directly illustrated

Dietary polyphenols and non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD), which is emerging as a major public health issue worldwide, is characterized by a wide spectrum of liver disorders, ranging from simple fat accumulation in hepatocytes, also known as steatosis, to non-alcoholic steatohepatitis (NASH) and cirrhosis. At present, the pharmacological treatment of NAFLD is still debated and dietary strategies for the prevention and the treatment of this condition are strongly considered. Polyphenols are a group of plant-derived compounds whose anti-inflammatory and antioxidant properties are associated with a low prevalence of metabolic diseases, including obesity, hypertension, and insulin resistance. Since inflammation and oxidative stress are the main risk factors involved in the pathogenesis of NAFLD, recent studies suggest that the consumption of polyphenol-rich diets is involved in the prevention and treatment of NAFLD. However, few clinical trials are available on human subjects with NAFLD. Here, we reviewed the emerging existing evidence on the potential use of polyphenols to treat NAFLD. After introducing the physiopathology of NAFLD, we focused on the most investigated phenolic compounds in the setting of NAFLD and described their potential benefits, starting from basic science studies to animal models and human trials

Neurology training around the world

Lancet Neurol. 2003 Sep;2(9):572-9. Neurology training around the world. Hooker J, Eccher M, Lakshminarayan K, Souza-Lima FC, Rejdak K, Kwiecinski H, Corea F, Lima JM. The National Hospital for Neurology and Neurosurgery, Queen Square, WC1N 3BG, London, UK. Comment in: Lancet Neurol. 2003 Oct;2(10):594; discussion 594

Air pollution and the incidence of ischaemic and haemorrhagic stroke in the South London Stroke Register: a case-cross-over analysis.

BACKGROUND: Few European studies investigating associations between short-term exposure to air pollution and incident stroke have considered stroke subtypes. Using information from the South London Stroke Register for 2005-2012, we investigated associations between daily concentrations of gaseous and particulate air pollutants and incident stroke subtypes in an ethnically diverse area of London, UK. METHODS: Modelled daily pollutant concentrations based on a combination of measurements and dispersion modelling were linked at postcode level to incident stroke events stratified by haemorrhagic and ischaemic subtypes. The data were analysed using a time-stratified case-cross-over approach. Conditional logistic regression models included natural cubic splines for daily mean temperature and daily mean relative humidity, a binary term for public holidays and a sine-cosine annual cycle. Of primary interest were same day mean concentrations of particulate matter <2.5 and <10 µm in diameter (PM2.5, PM10), ozone (O3), nitrogen dioxide (NO2) and NO2+nitrogen oxide (NOX). RESULTS: Our analysis was based on 1758 incident strokes (1311 were ischaemic and 256 were haemorrhagic). We found no evidence of an association between all stroke or ischaemic stroke and same day exposure to PM2.5, PM10, O3, NO2 or NOX. For haemorrhagic stroke, we found a negative association with PM10 suggestive of a 14.6% (95% CI 0.7% to 26.5%) fall in risk per 10 µg/m(3) increase in pollutant. CONCLUSIONS: Using data from the South London Stroke Register, we found no evidence of a positive association between outdoor air pollution and incident stroke or its subtypes. These results, though in contrast to recent meta-analyses, are not inconsistent with the mixed findings of other UK studies