C-peptide: a predictor of cardiovascular mortality in subjects with established atherosclerotic disease

Aim: Insulin resistance and type 2 diabetes are independent risk factors for cardiovascular diseases. Levels of C-peptide are increased in these patients and its role in the atherosclerosis progression was studied in vitro and in vivo over the past years. To evaluate the possible use of C-peptide as cardiovascular biomarkers, we designed an observational study in which we enrolled patients with mono- or poly-vascular atherosclerotic disease. Methods: We recruited 431 patients with stable atherosclerosis and performed a yearly follow-up to estimate the cardiovascular and total mortality and cardiovascular events. Results: We performed a mean follow-up of 56months on 268 patients. A multivariate Cox analysis showed that C-peptide significantly increased the risk of cardiovascular mortality [Hazard Ratio: 1.29 (95% confidence interval: 1.02-1.65, p<0.03513)] after adjustment for age, sex, diabetes treatment, estimated glomerular filtration rate and known diabetes status. Furthermore, levels of C-peptide were significantly correlated with metabolic parameters and atherogenic factors. Conclusion: C-peptide was associated with cardiovascular mortality independently of known diabetes status in a cohort of patients with chronic atherosclerotic disease. Future studies using C-peptide into a reclassification approach might be undertaken to consider its potential as a cardiovascular disease biomarker

Safety and Efficacy of Endoscopic Retrograde Cholangiopancreatography in Patients with Post-Liver Transplant Biliary Complications: Results of a Cohort Study with Long-Term Follow-Up

BACKGROUND/AIMS: Endoscopic retrograde cholangiopancreatography (ERCP) is the standard approach for the management of biliary complications in liver transplant patients; however, its safety and efficacy have not been established in this setting. This study was performed to evaluate the safety and long-term efficacy of ERCP in transplant patients. METHODS: The case reports of 1,500 liver transplant patients were reviewed. Orthotopic liver transplantation (OLT) patients were matched 1:2 with non-OLT patients and followed-up for long-term outcome (median, 7.4 years). RESULTS: Of the 1,500 liver transplant patients, 94 (6.3%) underwent 150 ERCPs after OLT. Anastomotic strictures were present in 45 patients, biliary stones in 24, biliary leaks in 7, papillary stenosis in 2, and primary sclerosing cholangitis in 1. An ERCP success rate of 90.7% was achieved; biliary stenting led to resolution of the bile leak in 7/7 (100%) patients, and biliary stones were removed in 21/24 (87.5%) patients. In addition, 34 of 45 patients with anastomotic stricture underwent endoscopic dilation. We obtained complete resolution in 22/34 (64.7%) patients. OLT patients did not show a higher probability of complications (odds ratio [OR], 1.04), of pancreatitis (OR, 0.80) or of bleeding (OR, 1.34). CONCLUSIONS: ERCP is safe and effective for the treatment of post-OLT biliary complications, has a low rate of pancreatitis and results in a durable effect

Predicción y alerta temprana de incendios forestales mediante integración de WSN e imágenes satelitales en un método de reducción de incertidumbre guiado por datos

Los incendios forestales son unos de los fenómenos naturales que más perjuicios causan en nuestro país y en el mundo, generando pérdidas de vidas humanas, daños en la propiedad, la flora, la fauna, el suelo, entre otros. Debido a esto, se considera de interés desarrollar herramientas, sistemas, métodos, estrategias, entre otros, que permitan minimizar los efectos negativos causados por éstos. El presente proyecto pretende realizar un aporte significativo en esta área, dado que propone integrar información de diferentes fuentes, en un método paralelo de reducción de incertidumbre guiado por datos aplicado a la predicción y alerta temprana de incendios forestales. Las fuentes de información estarán conformadas por: redes de sensores inalámbricos, imágenes satelitales, históricos de incendios forestales, entre otros. Dicha integración permitirá determinar la ocurrencia precoz de los incendios forestales antes de que estos se magnifiquen, y además permitirá reducir la incertidumbre de algunas de las variables dinámicas que alimentan al modelo de predicción de comportamiento de incendio, impactando de forma positiva en la calidad de predicción del sistema.Eje: Arquitectura, Redes y Sistemas Operativos.Red de Universidades con Carreras en Informátic

Chiti, Martini e gli albori della storia della musica

Girolamo Chiti (1679-1759), maestro di cappella at San Giovanni in Laterano and epigone of the so-called “Roman school”, was one of the most assiduous correspondents of Father Giambattista Martini. Indeed, the two exchanged over four hundred letters in the course of fourteen years, between 1745 and 1759. Based on an examination of this correspondence, the article scrutinizes the fundamental help Chiti offered to Martini in preparing his Storia della musica, on the one hand helping to locate and continuously sending precious materials such as treatises on musical theory and ancient and modern compositions while on the other hand engaging in a fruitful exchange of ideas on music, especially sacred music. Although both were convinced that the foundation of composition lay in counterpoint treatises and sixteenth-century polyphony, the ideas and work of Chiti and Martini reveal that they were not conservatives, opponents of modernity, but rather two personalities participating in an authentic eighteenth-century spirit.Girolamo Chiti (1679-1759), maestro di cappella di S. Giovanni in Laterano ed epigono della cosiddetta “scuola romana”, fu uno dei più assidui corrispondenti di padre Giambattista Martini. Nell’arco di quattordici anni, tra il 1745 e il ’59, infatti, i due si scambiarono oltre quattrocento lettere. Grazie a questa corrispondenza, l’articolo approfondisce il fondamentale aiuto offerto da Chiti a Martini alla stesura della sua storia della musica, da un lato, con il reperimento e il continuo invio di preziosi materiali, quali trattati di teoria musicale e musiche antiche e moderne; dall’altro, con il fecondo scambio di idee sulla musica, in particolare sacra. Pur convinti che i fondamenti della composizione andassero colti nei trattati di contrappunto e nella polifonia cinquecentesca, alla luce delle loro idee e del loro operato, Chiti e Martini si rivelano non come conservatori, oppositori della modernità, ma come due personalità partecipi di un autentico spirito settecentesco

« Alexius Romanorum nobilissimus » dagli altari alle scene. Il Sant'Alessio di Rospigliosi/Landi : contesto, drammaturgia e recezione di una « historia sacra »

Alla vicenda di sant’Alessio è ispirato – come è noto – il primo dramma per musica di carattere agiografico dato a Roma, con musica di S. Landi, su libretto di G. Rospigliosi. In questo contributo vengono chiariti i diversi contesti in cui l’opera andò in scena in tre diverse occasioni a palazzo Barberini (1629, 1632, 1634), la novità drammaturgica rispetto ai drammi per musica del tempo, e i collegamenti con il genere spagnolo della comedia de santos. Viene poi esaminata la recezione del soggetto, in qualche misura influenzata dal dramma rospigliosiano : dal Sant’Alessio (1663) su libretto di A. Spagna, primo oratorio di soggetto agiografico, all’omonimo oratorio di P. F. Bernini, messo in musica da B. Pasquini (1675), al dramma Alessio, messo in musica dallo stesso compositore e rappresentato al Seminario romano (1690). Benché non fosse fra i soggetti più comuni nella librettistica del tempo, Alessio rimase a lungo un soggetto fra i più amati dalla nobiltà romana.Sant’Alessio, on a libretto by Giulio Rospigliosi set to music by Stefano Landi, was the first opera on a hagiographic subject to be performed in Rome. This article aims at clarifying the different contexts within which the opera was performed on three different occasions (1629, 1632, 1634), and highlighting the dramaturgical novelty of the work as compared to the operas of the age, as well as its connection with the Spanish theatrical genre of comedia de santos. In addition, the article deals with the reception of the subject, which was influenced, to some extent, by Rospigliosi’s libretto : from the Sant’Alessio (1663) by Arcangelo Spagna – the first oratorio on a hagiographic subject – to the homonymous oratorio by Pietro Filippo Bernini set to music by Bernardo Pasquini (1675), to the opera Alessio, set to music by the same composer and performed in the Seminario romano (1690). Although Alessio was a rather unusual subject for opera and oratorio librettos, it remained for a long time a favourite subject of the Roman nobility

Lung Segmentation and Characterization in COVID-19 Patients for Assessing Pulmonary Thromboembolism: An Approach Based on Deep Learning and Radiomics

The COVID-19 pandemic is inevitably changing the world in a dramatic way, and the role of computed tomography (CT) scans can be pivotal for the prognosis of COVID-19 patients. Since the start of the pandemic, great care has been given to the relationship between interstitial pneumonia caused by the infection and the onset of thromboembolic phenomena. In this preliminary study, we collected n = 20 CT scans from the Polyclinic of Bari, all from patients positive with COVID-19, nine of which developed pulmonary thromboembolism (PTE). For eight CT scans, we obtained masks of the lesions caused by the infection, annotated by expert radiologists; whereas for the other four CT scans, we obtained masks of the lungs (including both healthy parenchyma and lesions). We developed a deep learning-based segmentation model that utilizes convolutional neural networks (CNNs) in order to accurately segment the lung and lesions. By considering the images from publicly available datasets, we also realized a training set composed of 32 CT scans and a validation set of 10 CT scans. The results obtained from the segmentation task are promising, allowing to reach a Dice coefficient higher than 97%, posing the basis for analysis concerning the assessment of PTE onset. We characterized the segmented region in order to individuate radiomic features that can be useful for the prognosis of PTE. Out of 919 extracted radiomic features, we found that 109 present different distributions according to the Mann–Whitney U test with corrected p-values less than 0.01. Lastly, nine uncorrelated features were retained that can be exploited to realize a prognostic signature

Endovascular Thrombectomy of a Renal Artery Chimney Stent-Graft Using the Solitaire Recanalization Device

The chimney graft technique is gaining popularity as an alternative endovascular treatment for juxtarenal aneurysms not suitable for standard or fenestrated endovascular aneurysm repair (EVAR).1–6 Despite excellent technical success,1,3–6 limited data are available regarding the long-term effectiveness of the technique, particularly in terms of chimney stent occlusion. This complication may have catastrophic consequences and represents a challenge for any endovascular approach, requiring in most the cases an open surgical bypass to restore vessel patency. Donas et al.1 used open thrombectomy to treat a renal chimney graft thrombosis. We encountered a symptomatic acute thrombosis of a renal chimney stent-graft, which we successfully treated with endovascular thrombectomy using a recanalization device that, in a recent article in the JEVT, proved useful in treating acute popliteal thrombosis.

An experimental investigation of the mechanical properties and failure mode of 3D stitched composites

Mechanical behavior and failure modes of three-dimensional (3D) stitched composites were experimentally investigated. In addition, a comparative analysis between these materials and equivalent laminates (2D) was accomplished. The 3D composite plates were manufactured using sheets of glass fiber manually sewn with aramid tows and molded with epoxy resin by vacuum-assisted resin transfer molding. Three-points bending, Charpy impact, double cantilever beam (DCB), and short-beam shear (SBS) mechanical tests were carried out on both types of materials. The DCB test results revealed that the action of reinforcement tows inhibited the propagation of the delamination cracks, which led to an increase in the fracture toughness of the 3D composites. However, the damage caused by the stitching process, such as fiber breakage and misalignment as well as crimping, and resin-rich regions, was responsible for reducing the flexural and shear properties of these materials. In addition, it was revealed that the stitching did not influence the impact toughness, although it prevented delamination from quick propagation, avoiding a catastrophic failure, which enhanced the damage tolerance of these materials, mainly for aeronautical applications

Music for a Dead King. The image of Philip IV and Charles II of Spain and the music for the royal funeral

The minutes of the Diocesan Synod held in Toledo in 1682 contain an explanation of the customs relating to funeral ceremonies in the Catholic kingdoms: ‘It is an ancient and holy custom that the bodies of the faithful are taken to be buried publicly with the cross, […] ecclesiastical accompaniment before the coffin, singing of psalms and prayers, sounding of bells […] being so mysterious, this act benefits the souls of the dead and constitutes a warning and an example for the living’. The role of music was fundamental in these ceremonies, even more so in royal funerals. Music was expected to represent the gravity and solemnity of the moment – the past – but also the majesty of the deceased. Music was thus a relevant element in the creation and transmission of the king’s image in every period of his life, from birth to death. Fortunately, and in spite of the destruction of the Real Alcázar and the archive of the Spanish Royal Chapel in 1734, we have some important examples of the funeral repertoire – liturgical (Officium Defunctorum, Requiem mass) and paraliturgical (motets, Spanish tones) – intended for the Spanish royalty in the seventeenth century. The study of these sources reveals some interesting changes in the composition of funeral music between the time of Philip IV (d. 1665) and his son Charles II (d. 1700). These musical changes suggest new nuances in the image of death and the image of the Monarchy. This article proposes an overview of the above aspects of royal funerals, through some specific examples

Applications of new radiological scores: the Node-rads in colon cancer staging

PurposeThe study focuses on the evaluation of the new Node Reporting and Data System 1.0 (Node-rads) scoring accuracy in the assessment of metastatic lymph nodes (LN) in patients with colon carcinoma.Material and methodsFrom April 2021 to May 2022, retrospective chart reviews were performed on 67 preoperative CT (Computed Tomography) of patients undergoing excisional surgery for colon cancer at the Polyclinic of Bari, Italy. Primary endpoints were to assess lymph node size and configuration to express the likelihood of a metastatic site adopting the Node-rads score system, whose categories of risk are defined from 1 (very low) to 5 (very high). The nodal postsurgical histological evaluation was the gold standard. The relationship between Node-rads score, LN size, configuration criteria (texture, border and shape) and the presence of histological metastases was statistically evaluated.ResultsAll surgical specimens examined had correlation with Node-rads score. They were significantly more likely to present nodes micrometastasis those patients with (a) spherical LN shape (82.8%), (b) with lymph node necrosis (100%), (c) irregular borders (87%) and (d) the LN short axis more than 10 mm (61.9%).ConclusionsOur experience highlights how the Node-rads system proposes an intuitive and effective definition of criteria to standardize the lymph node radiological reports in colon cancer disease. Further studies are needed to streamline the classification of the nodal and peripheral LN in all the oncological imaging