Edoardo Persico y Giuseppe De Finetti: contradicción y complementariedad del debate italiano en torno a Loos

La labor crítica de Edoardo Persico, orientada a menudo a remarcar el papel educativo de la arquitectura, propuso la obra de Adolf Loos dentro de un discurso no exento de apreciaciones fluctuantes. Por otra parte, Giuseppe de Finetti, único alumno italiano del maestro vienés, procuró avivar el interés de la crítica italiana hacia Loos, llevando a cabo la primera traducción al italiano de sus más influyentes textos teóricos y publicando unos fervorosos relatos que intentaban rescatar la validez y la permanencia de su discurso en el debate arquitectónico moderno. Pese al hecho que Persico y De Finetti expresaban posiciones a veces contrarias en torno a la obra de Loos, sus aportaciones críticas pueden entenderse de forma complementaria en relación con el interés hacia determinados aspectos vivos de la polémica arquitectónica italiana enfocada a la apertura al moderno europeo

Cuando una fotografía se convierte en referente para una nueva arquitectura

Una fotografía puede llegar a ser tan sugerente para un arquitecto hasta convertirse en el referente cultural de su discurso arquitectónico. En efecto las imágenes que pertenecen al bagaje cultural del proyectista generan una herramienta, tal vez subconsciente, capaz de transponerse al proyecto de arquitectura. Para eso no se precisa que la fotografía retraiga una arquitectura construida. Así, a lo largo del camino de la arquitectura del siglo pasado, nos encontramos con proyectos de los que sólo constan algunas fotografías de maqueta y que, sin embargo, han constituido el sustrato fecundo para nuevas aproximaciones proyectuales que han marcado, a su vez, el avance del debate en torno a la arquitectura moderna. La fotografía de la obra primera de Aldo Rossi, la casa ai Ronchi di Versilia, publicada originariamente en Casabella 291 de 1964, representa un caso emblemático de estas interferencias. Se trata de una clara alusión didascálica a Adolf Loos, condensada tanto en términos argumentales como formales en la fotografía de la maqueta de la villa Moissi (Lido de Venecia, 1923), imagen que desde los años treinta ya formaba parte de la iconografía de las publicaciones italianas. De aquella imagen a-temporal y decontextualizada vuelven la desnudez de las fachadas y la articulación de los cuerpos, la simplificación formal y la rotundidad volumétrica. Se hace manifiesta la misma “tensión hacia una forma esencial” que Rossi destacaba para la obra de Adolf Loos, y hasta las fotografías que el mismo arquitecto italiano escogió para su obra parecen forzosamente inspiradas a las conocidas fotos del proyecto loosiano. La imagen que ambos proyectos transmiten es la interpretación culta en un lenguaje moderno del modelo tipológico de la casa mediterránea, la idea de la casa rústica que había llevado Gio Ponti a afirmar que “I moderni d’oggi sono come i «nostri antichi»”.One photograph can be so suggestive for an architect to become the cultural reference of its architectural discourse. Indeed the images which belong to the designer’s cultural background generates a tool, may be in an unconscious way that is able to transpose itself to the architectural design. For that purpose it is not needed that the photograph retracts a constructed architecture. So, along the path of the architecture of the last century, we find projects that only has a few pictures of model, and however, they have constituted the fertile soil for new approaches that have marked, at the same time, the advancing debate on Modern Architecture. The photograph of the first Aldo Rossi´s work, originally published in Casabella 291 in 1964, it represents an emblematic case of these interferences. This is a clear ‘didascalic’ allusion to Adolf Loos, condensed both in plot and in formal terms in the photograph of a model of the Villa Moissi (Lido de Venecia, 1923), picture that since the thirties was part of the iconography of Italian publications. From that timeless and decontextualized image returns the nakedness of the facades and the joint of the elements, the formal simplification and the volumetric rotundity. It becomes manifest the same “tension towards to an essential form”, that Rossi highlighted for the Adolf Loos’s work, and even the photographs that the Italian architect has chosen for his work, they seem necessarily inspired by the well-known photographs of the loosian project. The image that both projects transmit is the cultured interpretation in a modern language of the typological model of the Mediterranean house, the idea of the “casa rústica” that have carried Gio Ponti to affirm that “I moderni d’oggi sono come i «nostri antichi»”

The relationships between vitamin K and cognition: a review of current evidence

Vitamin K is a fat-soluble nutrient discovered in 1935 and its role in blood coagulation has been thoroughly explored. In recent years, studies conducted in vitro and on animals highlighted vitamin K involvement in brain cells development and survival. In particular, vitamin K seems to have an antiapoptotic and anti-inflammatory effect mediated by the activation of Growth Arrest Specific Gene 6 and Protein S. Moreover, this vitamin is involved in sphingolipids metabolism, a class of lipids that participate in the proliferation, differentiation, and survival of brain cells. An altered expression in sphingolipids profile has been related to neuroinflammation and neurodegeneration. This review stems from a growing interest in the role of vitamin K in brain functions, especially in cognition, also in view of an expected increase of prevalence of Alzheimer's disease and other forms of dementia. It collects recent researches that show interesting, even though not definitive, evidence of a direct correlation between vitamin K levels and cognitive performance. Moreover, vitamin K antagonists, used worldwide as oral anticoagulants, according to recent studies may have a negative influence on cognitive domains such as visual memory, verbal fluency and brain volume. The aim of this review is to analyze the evidence of clinical studies carried out up to date on the relationship between vitamin K intake and cognitive performances. The involvement of vitamin K antagonists (VKAs) in declining cognitive performances is also addressed separately

Resting state functional thalamic connectivity abnormalities in patients with post-stroke sleep apnoea: a pilot case-control study

OBJECTIVE: Sleep apnoea is common after stroke, and has adverse effects on the clinical outcome of affected cases. Its pathophysiological mechanisms are only partially known. Increases in brain connectivity after stroke might influence networks involved in arousal modulation and breathing control. The aim of this study was to investigate the resting state functional MRI thalamic hyper connectivity of stroke patients affected by sleep apnoea (SA) with respect to cases not affected, and to healthy controls (HC). PATIENTS AND METHODS: A series of stabilized strokes were submitted to 3T resting state functional MRI imaging and full polysomnography. The ventral-posterior-lateral thalamic nucleus was used as seed. RESULTS: At the between groups comparison analysis, in SA cases versus HC, the regions significantly hyper-connected with the seed were those encoding noxious threats (frontal eye field, somatosensory association, secondary visual cortices). Comparisons between SA cases versus those without SA, revealed in the former group significantly increased connectivity with regions modulating the response to stimuli independently to their potentiality of threat (prefrontal, primary and somatosensory association, superolateral and medial-inferior temporal, associative and secondary occipital ones). Further significantly functionally hyper connections were documented with regions involved also in the modulation of breathing during sleep (pons, midbrain, cerebellum, posterior cingulate cortices), and in the modulation of breathing response to chemical variations (anterior, posterior and para-hippocampal cingulate cortices). CONCLUSIONS: Our preliminary data support the presence of functional hyper connectivity in thalamic circuits modulating sensorial stimuli, in patients with post-stroke sleep apnoea, possibly influencing both their arousal ability and breathing modulation during sleep

fMRI in Bell's Palsy: cortical activation is associated with clinical status in the acute and recovery phases

BACKGROUND: Using functional MRI (fMRI), we explored cortical activation in patients with acute Bell’s palsy (BP) and analyzed its correlates with clinical status in the acute phase, and with 6-monthoutcome. METHODS: 24 right-handed patients with acute BP within 15 days of onset and 24 healthy controls underwent fMRI during performance of unilateral active (hemi-smiling) and passive lip movement tasks with both the paretic and the normal lip. The degree of paresis was evaluated during the acute stage and at the 6-month follow-up using the House-Brackmann (HB) grading scale. Complete recovery was defined as HB grade II or less at the end of the 6-month period. The difference in the HB grade (ΔHB) between the acute stage and the 6-month follow up was used to evaluate clinical improvement. RESULTS: There were 24 patients with unilateral acute BP. HB grades ranged from III to VI. At six months, 11 patients (46%) had completely recovered and 12 (50%) were partially improved. Compared with healthy subjects, BP patients had a significantly greater activation of the frontal areas and the insula ipsilateral to the paretic side. In BP patients, there was an inverse correlation between the activation of the ipsilateral hemisphere when moving the paretic side and the degree of paresis at baseline. An association was also observed between activation and clinical outcome (both complete recovery and ΔHB). CONCLUSIONS: In patients with Bell’s palsy, fMRI may represent a useful tool to predict long-term outcome, guide therapeutic approach, and monitor treatment response

Multimodality Imaging in Sarcomeric Hypertrophic Cardiomyopathy: Get It Right…on Time

Hypertrophic cardiomyopathy (HCM) follows highly variable paradigms and disease-specific patterns of progression towards heart failure, arrhythmias and sudden cardiac death. Therefore, a generalized standard approach, shared with other cardiomyopathies, can be misleading in this setting. A multimodality imaging approach facilitates differential diagnosis of phenocopies and improves clinical and therapeutic management of the disease. However, only a profound knowledge of the progression patterns, including clinical features and imaging data, enables an appropriate use of all these resources in clinical practice. Combinations of various imaging tools and novel techniques of artificial intelligence have a potentially relevant role in diagnosis, clinical management and definition of prognosis. Nonetheless, several barriers persist such as unclear appropriate timing of imaging or universal standardization of measures and normal reference limits. This review provides an overview of the current knowledge on multimodality imaging and potentialities of novel tools, including artificial intelligence, in the management of patients with sarcomeric HCM, highlighting the importance of specific "red alerts" to understand the phenotype-genotype linkage

A meta-analysis of MitraClip combined with medical therapy vs. medical therapy alone for treatment of mitral regurgitation in heart failure patients

Aims: Survival benefit of percutaneous mitral valve repair with the MitraClip over conservative treatment of functional mitral regurgitation (MR) remains unclear. The purpose of this meta-analysis is to compare survival outcomes of MitraClip with those of medical therapy in patients with functional MR. Methods and results: A comprehensive literature search of PubMed, MEDLINE, and Google Scholar was conducted including studies evaluating MitraClip vs. medical therapy with multivariate adjustment and with >80% of patients with functional MR. Death from any cause was the primary endpoint, while freedom from readmission was the secondary one, evaluated with random effects. These analyses were performed at study level and at patient level including only functional MR when available, evaluating the effect of MitraClip in different subgroups according to age, ischaemic aetiology, presence of implantable cardioverter defibrillator/cardiac resynchronization therapy, and left ventricular ejection fraction and volumes. We identified six eligible observational studies including 2121 participants who were treated with MitraClip (n = 833) or conservative therapy (n = 1288). Clinical follow-up was documented at a median of 400 days. At study-level analysis, MitraClip, when compared with medical therapy (P = 0.005), was associated with significant reduction of death (P = 0.002) and of readmission due to cardiac disease. At patient-level analysis, including 344 patients, MitraClip confirmed robust survival benefit over medical therapy for all patients with functional MR and among the most important subgroups. Conclusions: Compared with conservative treatment, MitraClip is associated with a significant survival benefit. Importantly, this superiority is particularly pronounced among patients with functional MR and across all the main subgroups

Evaluation of a Novel Method Using Computed Tomography to Predict New Onset of Atrial Fibrillation or Embolic Events after Transcatheter Aortic Valve Implantation: the Role of Hounsfield Unit Density Ratio in the Left Atrial Appendage

Backgrounds: Evaluation of left atrial appendage (LAA) with angio-computed tomography (CCTA) in order to predict new onset of atrial fibrillation (AF) or embolic events is a new upcoming topic. No previous reported studies are available in patients undergoing transcatheter aortic valve implantation (TAVI). Methods: We analyzed pre-procedural CCTA scans of 325 patients who underwent TAVI performing a linear coefficient of attenuation analyses with Hounsfield units (HU) in LAA. HU in LAA distal and proximal was calculated, as well as the ratio. A sensibility and specificity analyses was conducted in order to identify the optimal cutoff to predict new onset AF or embolic events after TAVI. Results: Patients were divided into 4 groups according to the presence of AF. Baseline clinical and echocardiographic features were similar except for a significantly higher STS score and mitral regurgitation severity in PRE-TAVI AF group (p=0.003 and p=0.002 respectively). HU analyses showed a statistical difference in measure performed in LAA distal and in the HU LAA distal/Proximal ratio, with the lowest value in patients with pre-TAVI AF (p<0.001 and p<0.001 respectively). The ROC analyses found 0.84 as the cut-off for to predict the composite endpoint of new AF or embolic events, with sensitivity of 51% and specificity of 52% (p=0.008). Conclusion: In patients with aortic stenosis (AS), use of LAA assessment with CCTA to predict embolic events or new onset AF is no efficacy and cannot be substituted clinical indications for prevention and therapy of embolic events

Restored perfusion and reduced inflammation in the infarcted heart after grafting stem cells with a hyaluronan-based scaffold

The aim of this study is to investigate the blood perfusion and the inflammatory response of the myocardial infarct area after transplanting a hyaluronan-based scaffold (HYAFF\uae11) with bone marrow mesenchymal stem cells (MSCs). Nine-week-old female pigs were subjected to a permanent left anterior descending coronary artery ligation for 4 weeks. According to the kind of the graft, the swine subjected to myocardial infarction were divided into the HYAFF\uae11, MSCs, HYAFF\uae11/MSCs and untreated groups. The animals were killed 8 weeks after coronary ligation. Scar perfusion, evaluated by Contrast Enhanced Ultrasound echography, was doubled in the HYAFF\uae11/MSCs group and was comparable with the perfusion of the healthy, non-infarcted hearts. The inflammation score of the MSCs and HYAFF\uae11/MSCs groups was near null, revealing the role of the grafted MSCs in attenuating the cell infiltration, but not the foreign reaction strictly localized around the fibres of the scaffold. Apart from the inflammatory response, the native tissue positively interacted with the HYAFF\uae11/MSCs construct modifying the extracellular matrix with a reduced presence of collagene and increased amount of proteoglycans. The border-zone cardiomyocytes also reacted favourably to the graft as a lower degree of cellular damage was found. This study demonstrates that the transplantation in the myocardial infarct area of autologous MSCs supported by a hyaluronan-based scaffold restores blood perfusion and almost completely abolishes the inflammatory process following an infarction. These beneficial effects are superior to those obtained after grafting only the scaffold or MSCs, suggesting that a synergic action was achieved using the cell-integrated polymer construct

Whole brain surface-based morphometry and tract-based spatial statistics in migraine with aura patients: difference between pure visual and complex auras

BackgroundThe migrainous aura has different clinical phenotypes. While the various clinical differences are well-described, little is known about their neurophysiological underpinnings. To elucidate the latter, we compared white matter fiber bundles and gray matter cortical thickness between healthy controls (HC), patients with pure visual auras (MA) and patients with complex neurological auras (MA+). Methods3T MRI data were collected between attacks from 20 patients with MA and 15 with MA+, and compared with those from 19 HCs. We analyzed white matter fiber bundles using tract-based spatial statistics (TBSS) of diffusion tensor imaging (DTI) and cortical thickness with surface-based morphometry of structural MRI data. ResultsTract-based spatial statistics showed no significant difference in diffusivity maps between the three subject groups. As compared to HCs, both MA and MA+ patients had significant cortical thinning in temporal, frontal, insular, postcentral, primary and associative visual areas. In the MA group, the right high-level visual-information-processing areas, including lingual gyrus, and the Rolandic operculum were thicker than in HCs, while in the MA+ group they were thinner. DiscussionThese findings show that migraine with aura is associated with cortical thinning in multiple cortical areas and that the clinical heterogeneity of the aura is reflected by opposite thickness changes in high-level visual-information-processing, sensorimotor and language areas