Does warfarin prevent venous thromboembolic events in aPL-positive patients?

Yes, warfarin is effective in the secondary prevention of venous thromboembolic events (VTEs) for patients positive for lupus anticoagulant or anticardiolipin antibody (also known as antiphospholipid antibodies [aPL]) (strength of recommendation [SOR]: B, single cohort study, extrapolation from other RCTs). Patients should be treated for at least a year (SOR: C, consensus statement), and possibly indefinitely, with warfarin (SOR: B, small clinical trials and cohort studies). Moderate-intensity therapy (international normalized ratio [INR] range, 2.0-3.0) appears to be the best balance between risks and benefits (SOR: B, based on meta-analysis of 2 small randomized control trials

EXPERIENCES OF UAV SURVEYS APPLIED TO ENVIRONMENTAL RISK MANAGEMENT

In this paper the results of some surveys carried out in an area of Apulian territory affected by serious environmental hazard are presented. Unmanned Aerial Vehicles (UAV) are emerging as a key engineering tool for future environmental survey tasks. UAVs are increasingly seen as an attractive low-cost alternative or supplement to aerial and terrestrial photogrammetry due to their low cost, flexibility, availability and readiness for duty. In addition, UAVs can be operated in hazardous or temporarily inaccessible locations, that makes them very suitable for the assessment and management of environmental risk conditions. In order to verify the reliability of these technologies an UAV survey and A LIDAR survey have been carried outalong about 1 km of coast in the Salento peninsula, near the towns of San Foca, Torre dellOrso and SantAndrea( Lecce, Southern Italy). This area is affected by serious environmental risks due to the presence of dangerous rocky cliffs named falesie. The UAV platform was equipped with a photogrammetric measurement system that allowed us to obtain a mobile mapping of the fractured fronts of dangerous rocky cliffs. UAV-images data have been processed using dedicated software (AgisoftPhotoscan). The point clouds obtained from both the UAV and LIDAR surveys have been processed using Cloud Compare software, with the aim of testing the UAV results with respect to the LIDAR ones. The total error obtained was of centimeter-order that is a very satisfactory result. The environmental information has been arranged in an ArcGIS platform in order to assess the risk levels. The possibility to repeat the survey at time intervals more or less close together depending on the measured levels of risk and to compare the output allows following the trend of the dangerous phenomena. In conclusion, for inaccessible locations of dangerous rocky bodies the UAV survey coupled with GIS methodology proved to be a key engineering tool for the management of environmental risks

Robot-aided neurorehabilitation in sub-acute and chronic stroke: Does spontaneous recovery have a limited impact on outcome?

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Integrated geophysical and geological investigations applied to sedimentary rock mass characterization

The Salento Peninsula (south-eastern Italy) is characterized by sedimentary rocks. The carbonatic nature of the rocks means they are affected by karst phenomena, forming such features as sinkholes, collapsed dolines and caverns, as a result of chemical leaching of carbonates by percolating water. The instability of these phenomena often produces land subsidence problems. The importance of these events is increasing due to growing urbanization, numerous quarries affecting both the subsoil and the surface, and an important coastline characterized by cliffs. This paper focuses on geological and geophysical methods for the characterization of soft sedimentary rock, and presents the results of a study carried out in an urban area of Salento. Taking the Q system derived by Barton (2002) as the starting point for the rock mass classification, a new approach and a modification of the Barton method are proposed. The new equation proposed for the classification of sedimentary rock mass (Qsrm) takes account of the permeability of the rock masses, the geometry of the exposed rock face and their types (for example, quarry face, coastal cliff or cavity), the nature of the lithotypes that constitute the exposed sequence, and their structure and texture. This study revises the correlation between Vp and Q derived by Barton (2002), deriving a new empirical equation correlating P-wave velocities and Qsrm values in soft sedimentary rock. We also present a case history in which stratigraphical surveys, Electrical Resistivity Tomography (ERT), and seismic surveys were applied to in situ investigations of subsidence phenomena in an urban area to estimate rock mass quality. Our work shows that in the analysis of ground safety it is important to establish the rock mass quality of the subsurface structures; geophysical exploration can thus play a key role in the assessment of subsidence risk

Investigation of the neural control of cough and cough suppression in humans using functional brain imaging

Excessive coughing is one of the mostcommonreasons for seeking medical advice, yet the available therapies for treating cough disorders are inadequate. Humans can voluntarily cough, choose to suppress their cough, and are acutely aware of an irritation that is present in their airways. This indicates a significant level of behavioral and conscious control over the basic cough reflex pathway. However, very little is known about the neural basis for higher brain regulation of coughing. The aim of the present study was to use functional brain imaging in healthy humans to describe the supramedullary control of cough and cough suppression. Our data show that the brain circuitry activated during coughing in response to capsaicin-evoked airways irritation is not simply a function of voluntarily initiated coughing and the perception of airways irritation. Rather, activations in several brain regions, including the posterior insula and posterior cingulate cortex, define the unique attributes of an evoked cough. Furthermore, the active suppression of irritant-evoked coughing is also associated with a unique pattern of brain activity, including an involvement of the anterior insula, anterior mid-cingulate cortex, and inferior frontal gyrus. These data demonstrate for the first time that evoked cough is not solely a brainstem-mediated reflex response to irritation of the airways, but rather requires active facilitation by cortical regions, and is further regulated by distinct higher order inhibitory processes. Copyright © 2011 the authors

evaluation of upper limb sense of position in healthy individuals and patients after stroke

The aims of this study were to develop and evaluate reliability of a quantitative assessment tool for upper limb sense of position on the horizontal plane. We evaluated 15 healthy individuals (controls) and 9 stroke patients. A robotic device passively moved one arm of the blindfolded participant who had to actively move his/her opposite hand to the mirror location in the workspace. Upper-limb's position was evaluated by a digital camera. The position of the passive hand was compared with the active hand's 'mirror' position. Performance metrics were then computed to measure the mean absolute errors, error variability, spatial contraction/expansion, and systematic shifts. No significant differences were observed between dominant and non-dominant active arms of controls. All performance parameters of the post-stroke group differed significantly from those of controls. This tool can provide a quantitative measure of upper limb sense of position, therefore allowing detection of changes due to rehabilitation