Comparison of Baseline Characteristics and Outcomes in Men Versus Women With Aortic Stenosis Undergoing Transcatheter Aortic Valve Implantation

Female gender has been linked to increased risk of adverse events after surgical aortic valve replacement; however, the evidence regarding the role of gender differences on clinical outcomes in patients who underwent transcatheter aortic valve implantation (TAVI) is still debated. This retrospective study included 910 consecutive patients with severe, symptomatic aortic stenosis who underwent TAVI in 2 institutions from January 2012 to July 2016. The primary end point was all-cause mortality at 1 year after TAVI in women versus men. Women had a higher incidence of in-hospital vascular complications (7.8% vs 4.1%) and major or life-threatening bleeding (4.0% vs 1.6%) than men. At 1 year, women showed a lower mortality rate than men (7.0% vs 12.7%, adjusted hazard ratio [HR] 0.42, 95% confidence interval [CI] [0.23 to 0.76], p = 0.004). When stratifying by specific subgroups of interest, the survival benefit in women persisted in (1) patients with a Society of Thoracic Surgery risk score ≤ 8 (adjusted HR 0.35, 95% CI [0.14 to 0.88], p = 0.026); (2) patients treated with first-generation devices (adjusted HR 0.46, 95% CI [0.24 to 0.86], p = 0.016); and (3) patients treated with balloon-expandable valves (adjusted HR 0.40, 95% CI [0.19 to 0.86], p = 0.019). In conclusion, in this large patient cohort, women had lower 1-year mortality after TAVI than men, particularly with an STS score ≤ 8, or treated with first-generation and balloon-expandable devices

The Subsurface Geology and Landscape Evolution of the Volturno Coastal Plain, Italy: Interplay between Tectonics and Sea-Level Changes during the Quaternary

The Volturno alluvial-coastal plain is a relevant feature of the Tyrrhenian side of Southern Italy. Its plan-view squared shape is due to Pliocene-Quaternary block-faulting of the western flank of the south-Apennines chain. On the basis of the stratigraphic analysis of almost 700 borehole logs and new geomorphological survey, an accurate paleoenvironmental reconstruction before and after the Campania Ignimbrite (CI; about 40 ky) eruption is here presented. Tectonics and eustatic forcing have been both taken into account to completely picture the evolution of the coastal plain during Late Quaternary times. The upper Pleistocene-Holocene infill of the Volturno plain has been here re-organized in a new stratigraphic framework, which includes seven depositional units. Structural analysis showed that two sets of faults displaced the CI, so accounting for recent tectonic activity. Yet Late Quaternary tectonics is rather mild, as evidenced by the decametric vertical separations operated by those faults. The average slip rate, which would represent the tectonic subsidence rate of the plain, is about 0.5 mm/year. A grid of cross sections shows the stratigraphic architecture which resulted from interactions among eustatic changes, tectonics and sedimentary input variations. On the basis of boreholes analysis, the trend of the CI roof was reconstructed. An asymmetrical shape of its ancient morphology - with a steeper slope toward the north-west border - and the lack of coincidence between the present course of the Volturno River and the main buried bedrock incision, are significant achievements of this study. Finally, the morpho-evolutionary path of the Volturno plain has been discussed

Fuzzy logic on quantum annealers

Quantum computation is going to revolutionize the world of computing by enabling the design of massive parallel algorithms that solve hard problems in an efficient way, thanks to the exploitation of quantum mechanics effects, such as superposition, entanglement and interference. These computational improvements could strongly influence the way how fuzzy systems are designed and used in contexts, such as big data, where computational efficiency represents a non-negligible constraint to be taken into account. In order to pave the way towards this innovative scenario, this paper introduces a novel representation of fuzzy sets and operators based on Quadratic Unconstrained Binary Optimization (QUBO) problems, so as to enable the implementation of fuzzy inference engines on a type of quantum computers known as quantum annealers

Small fragments sodium sulfated hyaluronate, more than hyaluronic acid, reduces LPS-induced cytokine/chemokine levels in HaCaT cells

Hyaluronic acid (HA) is a linear non-sulphated glycosaminoglycan, used in dermatology as a biomaterial for bioengineering purposes, temporary dermal filler, stimulation of wound healing as well as drug vehicle in topical formulations. In addition to the well-characterized structural properties, extensive research on HA has revealed a range of vastly immunemodulatory effects, dependent on its size. In this in vitro study we investigated the ability of HA-S3, a small fragment HA (MW, molecular weight: 68 kDa) with degree of sulphatation of 3 and of HA fraction (MW:210 kDa) to reduce the bacterial induced inflammatory response in spontaneous immortalized keratinocytes. To this purpose, HaCaT cells were treated for 24 hours with 25 µg/ml of E. Coli derived bacterial lipopolysaccharide (LPS) in absence or presence of small fragment HA-S3 or HA. Cell viability was thereafter assessed using trypan blue stain and interleukin (IL)-8, IL-1β and tumor necrosis factor alpha (TNF-α) concentrations were determined in cell supernatants by single enzyme-linked immunoadsorbent assay (ELISA). Our results showed that cell viability was not affected either by HA-S3 or HA which in turn were able to reduce LPS-induced mortality. HA and especially HA-S3 were able to significantly reduce LPS-induced pro-inflammatory cytokines. Our observation might suggest new perspectives in the development of HA-S3 containing topical products able to modulate cutaneous inflammatory response

Fuzzy inference on quantum annealers

Quantum computers can potentially perform certain types of optimisation problems much more efficiently than classical computers, making them a promising tool for solving complex fuzzy logic problems. In two recent developments, based on solving Quadratic Unconstrained Binary Optimization (QUBO) problems on a type of quantum computers known as quantum annealers, we have introduced novel representations of a) fuzzy sets; b) implementations of some basic fuzzy logic operators (union, intersection, alpha-cut and maximum) and; c) the centroid defuzzification. In this paper, the previous works are further extended by presenting an implementation of Mamdani inference on the quantum annealer machines. We first present how the fuzzy rules can be formulated for such an implementation, then we present how to cascade different quantum-fuzzy operators in order to implement the quantum-fuzzy inference, and finally, a sample implementation of the inference on a real quantum computer is demonstrated. Having the main components of a rule-based fuzzy logic system implemented on quantum computers, this paper provides an integrated solution for implementing a whole fuzzy rule-based system on quantum computers

Heart failure with preserved ejection fraction in humans and mice:Embracing clinical complexity in mouse models

Heart failure (HF) with preserved ejection fraction (HFpEF) is a multifactorial disease accounting for a large and increasing proportion of all clinical HF presentations. As a clinical syndrome, HFpEF is characterized by typical signs and symptoms of HF, a distinct cardiac phenotype and raised natriuretic peptides. Non-cardiac comorbidities frequently co-exist and contribute to the pathophysiology of HFpEF. To date, no therapy has proven to improve outcomes in HFpEF, with drug development hampered, at least partly, by lack of consensus on appropriate standards for pre-clinical HFpEF models. Recently, two clinical algorithms (HFA-PEFF and H(2)FPEF scores) have been developed to improve and standardize the diagnosis of HFpEF. In this review, we evaluate the translational utility of HFpEF mouse models in the context of these HFpEF scores. We systematically recorded evidence of symptoms and signs of HF or clinical HFpEF features and included several cardiac and extra-cardiac parameters as well as age and sex for each HFpEF mouse model. We found that most of the pre-clinical HFpEF models do not meet the HFpEF clinical criteria, although some multifactorial models resemble human HFpEF to a reasonable extent. We therefore conclude that to optimize the translational value of mouse models to human HFpEF, a novel approach for the development of pre-clinical HFpEF models is needed, taking into account the complex HFpEF pathophysiology in humans

Use of statins in lower extremity artery disease: a review

BACKGROUND: Lower extremity artery disease (LE-PAD) is one of the most common manifestations of atherosclerosis, particularly in elderly patients, and it is related to a high cardiovascular risk. DESCRIPTION: It is well established that statin therapy is characterized by crucial benefits on cardiovascular system by limiting atherosclerotic progression and reducing cardiovascular events and mortality. A growing body of evidence support efficacy of statins in LE-PAD due to the ability of both reducing cardiovascular risk and improving walking distance and, hence, quality of life. Consequently, statin therapy should be considered in all LE-PAD patients and new LDL-cholesterol targets should be reached. CONCLUSIONS: Our opinion is that statin therapy remains still underutilized or with inadequate dosage, so therapy of LE-PAD patients should be improved to obtain all the demonstrated benefits of statin