Unraveling pedestrian mobility on a road network using ICTs data during great tourist events

Tourist flows in historical cities are continuously growing in a globalized world and adequate governance processes, politics and tools are necessary in order to reduce impacts on the urban livability and to guarantee the preservation of cultural heritage. The ICTs offer the possibility of collecting large amount of data that can point out and quantify some statistical and dynamic properties of human mobility emerging from the individual behavior and referring to a whole road network. In this paper we analyze a new dataset that has been collected by the Italian mobile phone company TIM, which contains the GPS positions of a relevant sample of mobile devices when they actively connected to the cell phone network. Our aim is to propose innovative tools allowing to study properties of pedestrian mobility on the whole road network. Venice is a paradigmatic example for the impact of tourist flows on the resident life quality and on the preservation of cultural heritage. The GPS data provide anonymized georeferenced information on the displacements of the devices. After a filtering procedure, we develop specific algorithms able to reconstruct the daily mobility paths on the whole Venice road network. The statistical analysis of the mobility paths suggests the existence of a travel time budget for the mobility and points out the role of the rest times in the empirical relation between the mobility time and the corresponding path length. We succeed to highlight two connected mobility subnetworks extracted from the whole road network, that are able to explain the majority of the observed mobility. Our approach shows the existence of characteristic mobility paths in Venice for the tourists and for the residents. Moreover the data analysis highlights the different mobility features of the considered case studies and it allows to detect the mobility paths associated to different points of interest. Finally we have disaggregated the Italian and foreigner categories to study their different mobility behaviors

Proceedings of the Fifth Italian Conference on Computational Linguistics CLiC-it 2018

On behalf of the Program Committee, a very warm welcome to the Fifth Italian Conference on Computational Linguistics (CLiC-­‐it 2018). This edition of the conference is held in Torino. The conference is locally organised by the University of Torino and hosted into its prestigious main lecture hall “Cavallerizza Reale”. The CLiC-­‐it conference series is an initiative of the Italian Association for Computational Linguistics (AILC) which, after five years of activity, has clearly established itself as the premier national forum for research and development in the fields of Computational Linguistics and Natural Language Processing, where leading researchers and practitioners from academia and industry meet to share their research results, experiences, and challenges

376 Incomplete functional revascularization is associated with adverse clinical outcomes after TAVI

Abstract Aims Whether incomplete functional revascularization has an impact on the clinical outcome of patients treated with transcatheter aortic valve implantation (TAVI) is still unknown. We aim to assess the prognostic value of residual functional Syntax score (rFSS) in a cohort of patients undergoing TAVI. Methods and results One-hundred-twenty-four patients (229 lesions) with severe aortic stenosis and coronary artery disease (CAD) underwent fractional flow reserve (FFR)-guided revascularization. The primary endpoint of the study was the composite of cardiac death, myocardial infarction and revascularization at last available follow-up after TAVI. Median Syntax score (SS) and Functional Syntax score (FSS) at baseline were 7 (range 5–12) and 0 (range 0–7) respectively. After revascularization or deferral according to FFR, residual SS (rSS) and rFSS were 5 (range 0–8) and 0 (range 0–0), respectively. At COX regression analysis, angiographic incomplete revascularization (rSS = 0) was not associated with the primary endpoint (HR: 1.26; 95% CI: 0.40; 3.95; P-value 0.698), whereas functional incomplete revascularization was associated with worse event-free survival at Follow-up after adjusting for clinical confounders (HR: 3.74, 95% CI: 1.02–13.75, P = 0.047). Conclusions Incomplete functional revascularization is associated with adverse clinical outcome after TAVI. rFSS may be regarded as a treatment goal for patients with CAD undergoing TAVI. Further studies are warranted to confirm our hypothesis. 376 Central FigureMACEs free survival analysis of patients stratified according to complete revascularization vs. incomplete revascularization assessed according to anatomy (residual SYNTAX score) (A) or physiology (residual functional SYNTAX score) (B). </jats:sec

363 Old but fashioned: IVUS and chromaflo guidance for definition of thrombosis mechanism

Abstract Aims Plaque rupture and plaque erosion are the main causes of coronary thrombosis. While the first one involves fibrous cap disruption, the second one is caused by loss of endothelial continuity. In selected cases with evidence of plaque erosion, antithrombotic therapy without stenting has been suggested as a possible option. OCT is considered the gold standard for definition of thrombosis mechanism and has recently been included in algorithms for evaluation and management of patients with ACS. Also, high definition IVUS was compared with OCT in defining plaque erosion showing promising results. However, the cost and the large amount of contrast medium needed for OCT performance make these diagnostic tools of scarce applicability in daily practice. Methods and results We herein describe the case of a young man acceding to the Cath Lab with the diagnosis of NSTEMI. After baseline angiography and IVUS confirmed presence of Thrombus (Figure 1A and B), thromboaspiration was successfully performed (Figure 1D). The definition of thrombosis mechanism, revealing plaque rupture, was then performed with IVUS and ChromaFlo devices (Figure 1C and E). Also, IVUS was used to optimize stent implantation. Conclusions Although requiring further confirmations, we believe that in selected cases IVUS and ChromaFlo could provide a more applicable first-line diagnostic tool to define thrombosis mechanism. 363 Figure 1Baseline angiographic and IVUS evaluation confirming presence of coronary thrombus (A, B). After successful performance of thromboaspiration (D), plaque rupture was revealed by IVUS and ChromaFlo (C). </jats:sec

374 Volume of contrast to creatinine clearance ratio predicts early mortality and AKI after TAVI

Abstract Aims The volume of contrast to creatinine clearance ratio (CV/CrCl) is a useful indicator of the risk of acute kidney injury (AKI) in patients undergoing percutaneous interventional procedures. Association between CV/CrCl and adverse outcome after transcatheter aortic valve implantation (TAVI) was suggested but it is not well established. Methods and results A large retrospective multicentre cohort of 1381 patients treated with TAVI was analysed to assess the association between CV/CrCl and the risk of AKI and mortality at 90 days and one year after TAVI. Patients receiving renal replacement therapy at the time of TAVI were excluded. CV/CrCl was associated with the risk of AKI and 90 days mortality after TAVI after adjustment for age, sex, diabetes, baseline left ventricular function, baseline chronic kidney disease (CKD), previous myocardial infarction and peripheral vascular disease (HR: 1.16, 95% CI: 1.09–1.22, P &amp;lt; 0.0001). Importantly, CV/CrCl was associated with the adverse outcome independently from the presence of baseline CKD (p for interaction = 0.22). CV/CrCl was independently associated with the individual components of the composite primary outcome including AKI (OR: 1.18, 95% CI: 1.08–1.28, P &amp;lt; 0.0001) and 90 days mortality (HR: 1.90, 95% CI: 1.01–3.60, P = 0.047) after TAVI. AKI (HR: 1.94, 95% CI: 1.21–3.11, P = 0.006) but not CV/CrCl was associated with the risk of 1-year mortality after TAVI. Conclusions CV/CrCl is associated with excess renal damage and early mortality after TAVI. Procedural strategies to minimize the CV/CrCl during TAVI may improve early clinical outcomes in patients undergoing TAVI. </jats:sec

Long-term variations of FFR and iFR after transcatheter aortic valve implantation

Long-term variations of fractional flow reserve (FFR) and instantaneous wave-free-ratio (iFR) after transcatheter aortic valve implantation (TAVI) have not been previously assessed. A total of 23 coronary lesions in 14 patients with aortic stenosis (AS) underwent physiology assessment at baseline, immediately after TAVI and at 14(7-29) months of follow-up. The angiographic severity of the lesions did not progress at follow-up (54[45-64] vs 54[49-63], p&nbsp;=&nbsp;.53). Overall, FFR (0.87[0.85-0.92] vs 0.88[0.82-0.92], p&nbsp;=&nbsp;.45) and iFR (0.88[0.85-0.96] vs 0.91[0.86-0.97], p&nbsp;=&nbsp;.30) did not change significantly compared with the baseline. FFR decreased in 3(13%) lesions with abnormal baseline value, whereas it remained stable in lesions with FFR&nbsp;&gt;&nbsp;0.80. Conversely, iFR did not show a systematic trend at long-term after TAVI. However, iFR demonstrated a higher reclassification rate at follow-up compared with FFR (p&nbsp;=&nbsp;.02). In conclusions, in this exploratory study, only minor variations of coronary physiology indices were observed at long-term after TAVI. Nevertheless, caution should be exercised in the interpretation of borderline FFR and iFR values in severe AS

377 Optimal timing for percutaneous coronary interventions in patients undergoing TAVI

Abstract Aims PCI timing in patients undergoing TAVI is still controversial, with most cases treated before TAVI, because of concerns about potential ischaemic complications during valve replacement. This study aims to compare procedural and in-hospital outcomes in patients undergoing PCI before or after TAVI. Methods and results Patients undergoing TAVI and PCI from 2010 to 2021 at Verona University Hospital were included. High-risk PCI were defined when performed in unprotected left main, proximal left anterior descending, proximal dominant right coronary artery or in 3-vessel disease. The primary endpoint was the cumulative incidence of any TAVI procedural complication and in-hospital adverse events (VARC-3 criteria). 129/940 TAVI patients underwent PCI was performed before TAVI in 33.4% of cases. Most patients (76.4%) were at high-risk. The primary endpoint occurred in 30.2% PCI pre-TAVI vs. 23.3% post-TAVI (HR: 0.72; 95% CI: 0.26–2.86; P = 0.671); and in 37.9% vs. 18.5% respectively, among high-risk PCI (HR: 1.62; 95% CI: 0.86–3.76; P = 0.102). At 24 months, MACCE-free survival was comparable (PCI pre-TAVI 91.7% vs. post-TAVI 97.5%, HR: 0.88, 95% CI: 0.13–4.77, P = 0.765). Conclusions PCI performed after TAVI does not expose patients to higher risks of peri-procedural or long-term complications when compared with pre-TAVI procedures, even in presence of high-risk lesions. 377 FigureAn example of post-TAVI high risk PCI. Pre-TAVI coronary angiography showed ostial left main critical lesion (A). After Symetis Aortic valve deployment, balloon angioplasty and stent implantation were performed (B and C) with good final angiographic result (D). </jats:sec

Management of failed stenting of the unprotected left main coronary artery

Percutaneous coronary intervention (PCI) is increasingly accepted as treatment for unprotected left main coronary artery (ULMCA) disease especially in those patients who are unsuitable for cardiac surgery. Treatment of any stent failure is associated with increased complexity and worse clinical outcomes when compared with de novo lesion revascularization. Intracoronary imaging has provided new insight into mechanisms of stent failure and treatment options have developed considerably over the last decade. There is paucity of evidence on the management strategy for stent failure in the specific setting of ULMCA. Treating any left main with PCI requires careful consideration and consequently treatment of failed stents in ULMCA is complex and provides unique challenges. Consequently, we provide an overview of ULMCA stent failure, proposing a tailored algorithm to guide best management and decision in daily clinical practice, with a special focus on intracoronary imaging characterization of causal mechanisms and specific technical and procedural considerations