Should reduction of increased short-term blood pressure variability be a target of antihypertensive therapy?

It has long been known that blood pressure (BP) is characterized by marked short-term fluctuations occurring within a 24-h period and also by long-term oscillations occurring over more prolonged periods of time. An increased short-term blood pressure variability (BPV) appears to importantly contribute to target organ damage and to the enhanced cardiovascular risk of hypertensive patients, over and above the effect of an increase in mean BP levels. Reducing 24-h mean BP is the main aim of antihypertensive therapy, but initial data are available that additional cardiovascular protection can be achieved by reducing BPV. However, to definitively prove the prognostic role of short-term BPV and the need for its control by treatment, evidence is still needed from intervention trials aimed at demonstrating that by reducing BPV through administration of antihypertensive drugs, a reduction in organ damage and in the rate of cardiovascular events can be obtained

Study of the thermo-mechanical performances of the EU-DEMO Water-Cooled Lead Lithium Left Outboard Blanket segment

The development of a sound conceptual design for the Water-Cooled Lead Lithium Breeding Blanket (WCLL BB) is pivotal to make a breakthrough towards the selection of the driver blanket concept for the EU-DEMO. To this goal, a research campaign has been launched over the last years at the University of Palermo, in close cooperation with ENEA Brasimone, under the umbrella of EUROfusion. In this frame, the analysis of the thermo-mechanical behaviour of the WCLL Left Outboard Blanket (LOB) segment is being performed. In a first phase, the assessment of the segment's overall structural performances was addressed, allowing the investigation of its global response under the selected loading scenarios. On this basis, the local structural analysis of the central region and of the upper and lower regions presenting geometric discontinuities (namely those regions where the stiffeners numbers changes) is presented in this paper, with the aim of assessing in detail their structural behaviour under the nominal BB operating conditions as well as steady-state accidental loading scenarios. Adopting the sub-modelling technique, the displacement field calculated in previous LOB global structural analysis can be mapped and applied at the boundaries of each local model. Moreover, it is possible to include there some structural details missing in the global analysis, like the Segment Box cooling channels. In this way, it is possible to study the thermo-mechanical behaviour of these regions in detail, assuming at the borders the mechanical action of the rest of the structure. The assessment has been performed in compliance with the RCC-MRx code, adopting the set of criteria on the basis of the nature of the considered loading scenario. The obtained results showed a promising structural behaviour of the segment and highlighted the necessity to revise the attachment system layout, which originates excessive deformation leading to the prediction of high stress

Thermomechanical and Thermofluid-Dynamic Coupled Analysis of the Top Cap Region of the Water-Cooled Lithium Lead Breeding Blanket for the EU DEMO Fusion Reactor

In the EU, the Water-Cooled Lithium Lead (WCLL) Breeding Blanket (BB) concept is one of the candidates for the design of the DEMO reactor. From the past campaign of analysis emerged that the thermal-induced stress led to the failure in the verification of the RCC-MRx structural criteria. Hence, in this paper the classic conceptual design approach, based on a pure FEM thermal and structural analysis, is compared to a coupled thermofluid-dynamic/structural one. Even though the coupled approach requires tremendous modelling effort and computational burden, it surely allows determining the thermal field with a higher level of detail than the FEM analysis. Therefore, in this work, the focus is put on the impact of a more detailed thermal field on the DEMO WCLL BB global structural performances, focusing on the Top Cap region of its Central Outboard Blanket segment. The obtained results have allowed confirming the soundness of the design solution of the Top Cap region, except for concerns arising on the mass flow rate distribution. Moreover, results have shown that, globally, the pure FEM approach allows for obtaining more conservative results than the coupled one. This is a positive outcome in sight of the follow-up of the DEMO WCLL BB design, as it will be still possible adopting the pure FEM approach to quickly down-select design alternatives, using the most onerous coupled approach to finalise the most promising

Linear Responses in Time-dependent Hartree-Fock-Bogoliubov Method with Gogny Interaction

A numerical method to integrate the time-dependent Hartree-Fock Bogoliubov (TDHFB) equations with Gogny interaction is proposed. The feasibility of the TDHFB code is illustrated by the conservation of the energy, particle numbers, and center-of-mass in the small amplitude vibrations of oxygen 20. The TDHFB code is applied to the isoscalar quadrupole and/or isovector dipole vibrations in the linear (small amplitude) region in oxygen isotopes (masses A = 18,20,22 and 24), titanium isotopes (A = 44,50,52 and 54), neon isotope (A = 26), and magnesium isotopes (A = 24 and 34). The isoscalar quadrupole and isovector dipole strength functions are calculated from the expectation values of the isoscalar quadrupole and isovector dipole moments.Comment: 10 pages, 13 figure

Barriers to primary care responsiveness to poverty as a risk factor for health

<p>Abstract</p> <p>Background</p> <p>Poverty is widely recognized as a major determinant of poor health, and this link has been extensively studied and verified. Despite the strong evidentiary link, little work has been done to determine what primary care health providers can do to address their patients' income as a risk to their health. This qualitative study explores the barriers to primary care responsiveness to poverty as a health issue in a well-resourced jurisdiction with near-universal health care insurance coverage.</p> <p>Methods</p> <p>One to one interviews were conducted with twelve experts on poverty and health in primary care in Ontario, Canada. Participants included family physicians, specialist physicians, nurse practitioners, community workers, advocates, policy experts and researchers. The interviews were analysed for anticipated and emergent themes.</p> <p>Results</p> <p>This study reveals provider- and patient-centred structural, attitudinal, and knowledge-based barriers to addressing poverty as a risk to health. While many of its findings reinforce previous work in this area, this study's findings point to a number of areas front line primary care providers could target to address their patients' poverty. These include a lack of provider understanding of the lived reality of poverty, leading to a failure to collect adequate data about patients' social circumstances, and to the development of inappropriate care plans. Participants also pointed to prejudicial attitudes among providers, a failure of primary care disciplines to incorporate approaches to poverty as a standard of care, and a lack of knowledge of concrete steps providers can take to address patients' poverty.</p> <p>Conclusions</p> <p>While this study reinforces, in a well-resourced jurisdiction such as Ontario, the previously reported existence of significant barriers to addressing income as a health issue within primary care, the findings point to the possibility of front line primary care providers taking direct steps to address the health risks posed by poverty. The consistent direction and replicability of these findings point to a refocusing of the research agenda toward an examination of interventions to decrease the health impacts of poverty.</p

Un parco rurale tra memoria e contemporaneità

Nell’intento di affrontare alcuni dei problemi che caratterizzano il territorio delle aree interne della Sicilia - abbandono delle campagne, spopolamento dei centri abitati, declino economico e sociale - il contributo propone una strategia che miri a instaurare relazioni materiali e immateriali di lunga distanza. I presupposti si fondano sulla sollecitazione offerta, tra il 1933 e il 1937, dalla porzione di territorio rurale a cerniera delle province di Agrigento, Caltanissetta e Palermo come esempio di sperimentazione di appoderamento sparso, secondi i principi dell’assetto del Latifondo Siciliano quando si ritenne opportuno definire un sistema di borghi a struttura gerarchica per intervallare l’immobilismo di servizi e la vasta estensione. Pro¬ponendosi come archetipo all’interno di un più esteso progetto di paesaggio, il parco rurale proposto propone la messa in rete di tali borghi rurali con le risorse naturali e culturali, nell’intento di coinvolgere - in nome della multifunzionalità (Magnaghi, 2010) - anche l’offerta eno-gastronomica, facendo quindi leva sul valore del patrimonio immateriale. Il parco rurale, reso permeabile grazie ad interventi di riqualificazione infrastrutturale volti a un attraversamento “lento”, è concepito come un nuovo spazio aperto ad azioni di iniziativa pubblico-privata con significati e valenze innovative: rappresenta, infatti, il luogo, in senso geografico e concettuale, nel quale attivare forme di attività partendo dalla condivisione di un patrimonio che potrebbe fungere da elemento rafforzativo del senso di appartenenza della comunità insediata. Nell’ambito dell’area studiata, i borghi rurali preesistenti acquistano nuovi ruoli e funzioni in un sistema policentrico e multipolare, dove i caratteri propri del territorio divengono le¬va di uno sviluppo fondato sulla storia, la creatività, l’innovazione e la ricerca, con evidenti ricadute anche in termini di tutela paesaggistica e ambientale