Energy and technological refurbishment of the School of Architecture Valle Giulia, Rome

Modern architecture built in historical urban contexts represents a demanding issue when its energy efficiency should be improved. Indeed, the strongest efforts have to be made to maintain the architectural identity and its harmony with the surrounding cultural heritage. This study deals with the main building of the School of Architecture Valle Giulia in Rome, designed by Enrico Del Debbio in the 30’s. Further constraints are related to several interventions of airspace expansion starting from 1958 which involved the building starting from 1958. So, preservation would mean highlighting its historic change but, adapting the built environment to the contemporary users’ needs. As above-mentioned, the building belongs to the Valle delle Accademie, within the historic park of Villa Borghese, so that to acquire landscaping values. Those latter ones call for ulterior requirements when any new design process is conceived. The study provides a global renewal of the building accounting for the current low Indoor Environmental Quality in both summer and winter seasons and the lack of suitability to the contemporary University student’s needs. The interaction between building performance and HVAC systems was studied by collecting data and architectural surveys conducted by all the architects who modified the building. This procedure was chosen since thermo-physical investigations are considered destructive due to required perforations to identify the actual wall layers. Moreover, thermographic surveys were carried out to validate the modelled building response. The result of the study is the identification of viable interventions to improve the accessibility and fruition of the building as well as its energy performance. A specific cost-benefit analysis was done to prioritize the design options along with considering the measures needed to preserve all the architectural features and values

Identification of Cdk8 and Cdkn2d as New Prame-Target Genes in 2C-like Embryonic Stem Cells

Embryonic stem cells (ESCs) present a characteristic pluripotency heterogeneity correspondent to specific metastates. We recently demonstrated that retinoic acid (RA) induces an increase in a specific 2C-like metastate marked by target genes specific to the two-cell embryo stage in preimplantation. Prame (Preferentially expressed antigen in melanoma) is one of the principal actors of the pluripotency stage with a specific role in RA responsiveness. Additionally, PRAME is overexpressed in a variety of cancers, but its molecular functions are poorly understood. To further investigate Prame’s downstream targets, we used a chromatin immunoprecipitation sequencing (ChIP-seq) assay in RA-enriched 2C-like metastates and identified two specific target genes, Cdk8 and Cdkn2d, bound by Prame. These two targets, involved in cancer dedifferentiation and pluripotency, have been further validated in RA-resistant ESCs. Here, we observed for the first time that Prame controls the Cdk8 and Cdkn2d genes in ESCs after RA treatment, shedding light on the regulatory network behind the establishment of naïve pluripotency

Fifteen years trends of cardiogenic shock and mortality in patients with diabetes and acute coronary syndromes

PURPOSE: Our study was intended to examine time trends of management and mortality of acute coronary syndrome patients with associated diabetes mellitus. METHODS: We analyzed data from 5 nationwide registries established between 2001 and 2014, including consecutive acute coronary syndrome patients admitted to the Italian Intensive Cardiac Care Units. RESULTS: Of 28,225 participants, 8521 (30.2%) had diabetes: as compared with patients without diabetes, they were older and had significantly higher rates of prior myocardial infarction and comorbidities (all P < .0001). Prevalence of diabetes and comorbidities increased over time (P for trend < .0001). Cardiogenic shock rates were higher in patients with diabetes, as compared with those without diabetes (7.8% vs 2.8%, P < .0001), and decreased significantly over time only in patients without diabetes (P = .007). Revascularization rates increased over time in patients both with and without diabetes (both P for trend < .0001), although with persistingly lower rates in patients with diabetes. All-cause in-hospital mortality was higher in patients with diabetes (5.4 vs 2.5%, respectively, P < .0001) and decreased more consistently in patients without diabetes (P for trend = .007 and < .0001, respectively). At multivariable analysis, diabetes remains an independent predictor of both cardiogenic shock (odds ratio 2.03; 95% confidence interval, 1.77-2.32; P < .0001) and mortality (odds ratio 1.95; 95% confidence interval, 1.69-2.26; P < .0001). CONCLUSIONS: Despite significant mortality reductions observed over 15 years in acute coronary syndromes, patients with diabetes continue to show threefold higher rates of cardiogenic shock and lower revascularization rates as compared with patients without diabetes. These findings may explain the persistingly higher mortality of patients with diabetes and acute coronary syndromes

Efeito da somatotropina bovina recombinante (RBST) sobre a curva de lactação de vacas da raça holandesas.

Foi conduzido um estudo com o objetivo de avaliar os efeitos da aplicaç ão de rBST sobre a curva de lactação de vacas da raça Holandesa. O experimento foi desenvolvido no sistema de produção de leite do Centro de Pesquisa de Pecuária do Sudeste (Embrapa Pecuária Sudeste), em São Carlos, durante o período de abril a dezembro de 1999. Foram avaliadas 41 vacas, dos 60 aos 150 dias de lactação, distribuídas em um delineamento inteiramente casualizado, em três tratamentos: sem aplicação de rBST (controle) ? 15 vacas; aplicação de rBST 60 dias após o parto (rBST-60) ? 15 vacas; e aplicação de rBST 100 dias após o parto (rBST- 100) ? 11 vacas. Foram realizadas análises de regressão da produção de leite em função dos dias de lactação. A aplicação de rBST aos 60 dias de lactação apresentou maior resposta no aumento da produção de leite e menor queda na produção. Com relação ao tratamento rBST-100, foi verificada uma estabilização seguida da diminuição menos acentuada na curva de lactação quando comparado com o tratamento controle. Todos os tratamentos apresentaram diminuição na produção de leite em função dos dias de lactação. No tratamento com rBST-60 durante o período de 75 a 120 dias de lactação, a cada dia da lactação, a produção de leite diminuiu 25,7 g, enquanto que para o mesmo período no tratamento controle, a produção decresceu 80,9 g/dia. A suplementação com rBST aumentou a persistência de lactação e a produção de leite quando administrada aos 60 dias pós -parto

Efeito da somatotropina bovina recombinante (RBST) sobre a produção de leite e gordura em vacas da raça Holandesas.

Este estudo foi conduzido com o objetivo de avaliar os efeitos da aplicação de somatotropina bovina recombinante (rBST) sobre a produção de leite e gordura de vacas da raça Holandesa, durante os 60 aos 150 dias de lactação. O experimento foi desenvolvido no sistema de produção de leite do Centro de Pesquisa de Pecuária do Sudeste (Embrapa Pecuária Sudeste), em São Carlos, durante o período de abril a dezembro de 1999. Foram utilizadas 41 vacas distribuídas em um delineamento inteiramente casualizado, em três tratamentos: sem aplicação de rBST (controle) ? 15 vacas; aplicação de rBST 60 dias após o parto (rBST-60) ? 15 vacas; e aplicação de rBST 100 dias após o parto (rBST-100) ? 11 vacas. Foram realizadas análises de variância para as variáveis produção de leite; produção de leite corrigida a 4% de gordura e produção de gordura, tanto em porcentagem como em kg/dia. A suplementação com rBST aos 60 dias apresentou significativo aumento na produção de leite e na produção de leite corrigida em relação ao tratamento controle, entretanto esse fato não foi verificado para o tratamento com rBST aos 100 dias. Não ocorreram efeitos significativos da aplicação de rBST sobre a produção de gordura no leite, em % e em kg/dia. A suplementação com rBST aumentou a produção de leite e a produção de leite corrigida a 4% de gordura quando administrada aos 60 dias pós -parto. Não foram observados efeitos da suplementação de rBST sobre a porcentagem e produção de gordura do leite

Cryopreservation and characterization of canine preantral follicles

The aim of this study was to define the population, morphological and ultrastructural characteristics of bitch preantral follicles (PAFs) and to compare the effects on the morphology of PAF of two cryopreservation techniques - slow freezing (SF) and vitrification (V) - of bitches' ovarian tissue. The average population (number per ovary) of PAFs was 48,541 ± 18,366, where 94.25% were primordial (45,145 ± 16,076). The average diameter of the primordial follicles was 27.5 ± 4.2 μm. The overall percentage of morphologically normal PAFs was 93.66 ± 6.81% for the control group, 86.16 ± 11.05% after SF and 68.14 ± 12.75% after V. The percentage of normal primordial follicles was 96.69 ± 4.72% in control, 89.51 ± 10.39% in SF and 75.32 ± 9.23% in V. There was no significant difference in the overall percentage of normal PAFs among SF and the control. However, slow frozen follicles presented ultrastructural damage, while vitrified primordial and primary follicles were well preserved. In conclusion, although slow freezing seemed to be a good preserving method, vitrification was more effective than slow freezing in preserving the ultrastructure of primordial and primary follicles of bitches

Anti-remodelling effect of canrenone in patients with mild chronic heart failure (AREA IN-CHF study): final results

AIMS: To test whether canrenone, an aldosterone receptor antagonist, improves left ventricular (LV) remodelling in NYHA class II heart failure (HF). Aldosterone receptor antagonists improve outcome in severe HF, but no information is available in NYHA class II. METHODS AND RESULTS: AREA IN-CHF is a randomized, double-blind, placebo-controlled study testing canrenone on top of optimal treatment in NYHA class II HF with low ejection fraction (EF) to assess 12-month changes in LV end-diastolic volume (LVEDV). Brain natriuretic peptide (BNP) was also measured. Information was available for 188 subjects on canrenone and 194 on placebo. Left ventricular end-diastolic volume was similarly reduced (-18%) in both arms, but EF increased more (P = 0.04) in the canrenone (from 40% to 45%) than in the placebo arm (from 40-43%). Brain natriuretic peptide (n = 331) decreased more in the canrenone (-37%) than in the placebo arm (-8%; P < 0.0001), paralleling a significant reduction in left atrial dimensions (-4% vs. 0.2%; P = 0.02). The composite endpoint of cardiac death and hospitalization was significantly lower in the canrenone arm (8% vs. 15%; P = 0.02). CONCLUSION: Canrenone on top of optimal treatment for HF did not have additional effects on LVEDV, but it increased EF, and reduced left atrial size and circulating BNP, with potential beneficial effects on outcome. A large-scale randomized study should be implemented to confirm benefits on cardiovascular outcomes in patients with HF in NYHA class I

High-Sensitivity C-Reactive Protein and Acute Kidney Injury in Patients with Acute Myocardial Infarction: A Prospective Observational Study

Background. Accumulating evidence suggests that inflammation plays a key role in acute kidney injury (AKI) pathogenesis. We explored the relationship between high-sensitivity C-reactive protein (hs-CRP) and AKI in acute myocardial infarction (AMI). Methods. We prospectively included 2,063 AMI patients in whom hs-CRP was measured at admission. AKI incidence and a clinical composite of in-hospital death, cardiogenic shock, and acute pulmonary edema were the study endpoints. Results. Two-hundred-thirty-four (11%) patients developed AKI. hs-CRP levels were higher in AKI patients (45 \ub1 87 vs. 16 \ub1 41 mg/L; p &lt; 0.0001). The incidence and severity of AKI, as well as the rate of the composite endpoint, increased in parallel with hs-CRP quartiles (p for trend &lt;0.0001 for all comparisons). A significant correlation was found between hs-CRP and the maximal increase of serum creatinine (R = 0.23; p &lt; 0.0001). The AUC of hs-CRP for AKI prediction was 0.69 (p &lt; 0.001). At reclassification analysis, addition of hs-CRP allowed to properly reclassify 14% of patients when added to creatinine and 8% of patients when added to a clinical model. Conclusions. In AMI, admission hs-CRP is closely associated with AKI development and severity, and with in-hospital outcomes. Future research should focus on whether prophylactic renal strategies in patients with high hs-CRP might prevent AKI and improve outcome

Sentinel node biopsy for breast cancer: is it already a standard of care? A survey of current practice in an Italian region

BACKGROUND: Although sentinel node biopsy (SNB) is becoming the standard approach for axillary staging in patients with small breast cancer, criteria for patient selection and some technical aspects of the procedure have yet to be clearly defined. The aim of the present survey was therefore to investigate the way in which SNB is used by general surgeons working in the Veneto region, Italy. METHODS: A 29-item questionnaire regarding various aspects of SNB practice was mailed to surgeons in charge of breast surgery in all the 56 surgical centres of the region. RESULTS: The rate of response to the questionnaire was 82.1% (n = 46); 69.6% (n = 32) of the respondents routinely perform SNB in their clinical practice. Most of the interviewed surgeons (93.5%) expressed the belief that the acceptable false negative rate should be ≤5%. However, among the surgeons who perform SNB, only 34.4% performed more than 20 SNB during the learning phase. Indications are limited to tumours of ≤1 cm by 31.2% (n = 10) of respondents, ≤2 cm by 46.9% (n = 15) and ≤3 cm by 21.9% (n = 7). Almost all respondents (93.7%) agreed that a clinically positive axilla is a contraindication to SNB, while opinions differed widely concerning other potential contraindications. In most of the centres considered, SN identification is undertaken on the day before surgery using a subdermal injection of 30–50 MBq of 99mTc-albumin-nanocolloid followed by lymphoscintigraphy. CONCLUSIONS: SNB is currently performed in the majority of hospitals in the Veneto region. However, the training phase and criteria used for patient selection differ from centre to centre. Certified training courses and shared guidelines are therefore highly desirable