Predictors of mortality in patients with Eisenmenger syndrome and admission to the lung transplantation waiting list

Background. Patients with Eisenmenger Syndrome (ES) have very severe irreversible pulmonary hypertension but the criteria for admitting such patients to a lung transplantation waiting list (LTWL) is not clear. Indeed it has been demonstrated that the natural survival of patients with ES is better than the survival achieved through lung transplantation: it follows that no guidelines are available for these patients' admission to an LTWL. The aim of our study was to identify possible predictors of mortality in ES patients in order to reserve admission to the LTWL solely for those patients who would otherwise have the lowest probability of survival. Methods. Since 1991, 57 patients with ES from our rehabilitative centre were admitted to the LTWL of the Division of Cardiac Surgery at San Matteo Hospital, University of Pavia. At the time of the retrospective analysis, patients were divided into a group of non-transplanted survivors (27 patients - 47% of the total) and a group who had died prior to transplantation (16 patients - 28% of the total). The 14 transplanted patients (25% of the total) were not considered in the statistical analysis, considering transplantation as an "external event". Unpaired t tests were used to compare the following factors in the survivors and in those who died: sex, "complexity" of the congenital heart disease underlying the ES, previous cardiac surgery, arterial blood gases, pulmonary function and hemodynamic parameters. Moreover, a stepwise discriminant analysis was performed in order to define a possible set of prognostic factors. Results. PaCO2 was higher in those who subsequently died (36.15±7.42 mmHg) compared with those who survived (32.5±5.33 mmHg), although this difference did not reach a statistical significance (p=0.08). Discriminant analysis defined a model in which a) complexity of the congenital heart disease, b) sex (male) and c) cardiac output were predictive of a higher risk of mortality. Conclusions. This new knowledge can be used in the decision of admission to LTWL in ES patients

Smart City : condividere per innovare (e con il rischio di escludere?)

Il contributo ha ad oggetto il tema delle smart cities da un punto di vista giuridico, analizzando le criticit\ue0 che emergono dal diritto positiv

Potential of Manuka Honey as a Natural Polyelectrolyte to Develop Biomimetic Nanostructured Meshes With Antimicrobial Properties

The use of antibiotics has been the cornerstone to prevent bacterial infections; however, the emergency of antibiotic-resistant bacteria is still an open challenge. This work aimed to develop a delivery system for treating soft tissue infections for: (1) reducing the released antimicrobial amount, preventing drug-related systemic side effects; (2) rediscovering the beneficial effects of naturally derived agents; and (3) preserving the substrate functional properties. For the first time, Manuka honey (MH) was proposed as polyelectrolyte within the layer-by-layer assembly. Biomimetic electrospun poly(εcaprolactone) meshes were treated via layer-by-layer assembly to obtain a multilayered nanocoating, consisting of MH as polyanion and poly-(allylamine-hydrochloride) as polycation. Physicochemical characterization demonstrated the successful nanocoating formation. Different cell lines (human immortalized and primary skin fibroblasts, and primary endothelial cells) confirmed positively the membranes cytocompatibility, while bacterial tests using Gram-negative and Gram-positive bacteria demonstrated that the antimicrobial MH activity was dependent on the concentration used and strains tested

Electrodeposited cu thin layers as low cost and effective underlayers for Cu2O photocathodes in photoelectrochemical water electrolysis

Cu2O is one of the most studied semiconductors for photocathodes in photoelectrochemical water splitting (PEC-WS). Its low stability is counterbalanced by good activity, provided that a suitable underlayer/support is used. While Cu2O is mostly studied on Au underlayers, this paper proposes Cu(0) as a low-cost, easy to prepare and highly efficient alternative. Cu and Cu2O can be electrodeposited from the same bath, thus allowing in principle to tune the final material\u2019s physico-chemical properties with high precision with a scalable method. Electrodes and photoelectrodes are studied by means of electrochemical methods (cyclic voltammetry, Pb underpotential deposition) and by ex-situ X-ray absorption spectroscopy (XAS). While the potential applied for the deposition of Cu has no influence on the bulk structure and on the photocurrent displayed by the semiconductor, it plays a role on the dark currents, making this strategy promising for improving the material\u2019s stability. Au/Cu2O and Cu/Cu2O show similar performances, the latter having clear advantages in view of future use in practical applications. The influence of Cu underlayer thickness was also evaluated in terms of obtained photocurrent

Dual-readout Calorimetry

The RD52 Project at CERN is a pure instrumentation experiment whose goal is to understand the fundamental limitations to hadronic energy resolution, and other aspects of energy measurement, in high energy calorimeters. We have found that dual-readout calorimetry provides heretofore unprecedented information event-by-event for energy resolution, linearity of response, ease and robustness of calibration, fidelity of data, and particle identification, including energy lost to binding energy in nuclear break-up. We believe that hadronic energy resolutions of {\sigma}/E $\approx$ 1 - 2% are within reach for dual-readout calorimeters, enabling for the first time comparable measurement preci- sions on electrons, photons, muons, and quarks (jets). We briefly describe our current progress and near-term future plans. Complete information on all aspects of our work is available at the RD52 website http://highenergy.phys.ttu.edu/dream/.Comment: 10 pages, 10 figures, Snowmass White pape

Time-Resolved X-ray Absorption Spectroscopy in (Photo)Electrochemistry

This minireview aims at providing a complete survey concerning the use of X-ray absorption spectroscopy (XAS) for time-resolved studies of electrochemical and photoelectrochemical phenomena. We will see that time resolution can range from the femto-picosecond to the second (or more) scale and that this joins the valuable throughput typical of XAS, which allows for determining the oxidation state of the investigated element, together with its local structure. We will analyze four different techniques that use different approaches to exploit the in real time capabilities of XAS. These are quick-XAS, energy dispersive XAS, pump & probe XAS and fixed-energy X-ray absorption voltammetry. In the conclusions, we will analyze possible future perspectives for these techniques

The Missing Piece: The Structure of the Ti3C2TxMXene and Its Behavior as Negative Electrode in Sodium Ion Batteries

The most common MXene composition Ti3C2Tx (T = F, O) shows outstanding stability as anode for sodium ion batteries (100% of capacity retention after 530 cycles with charge efficiency >99.7%). However, the reversibility of the intercalation/deintercalation process is strongly affected by the synthesis parameters determining, in turn, significant differences in the material structure. This study proposes a new approach to identify the crystal features influencing the performances, using a structural model built with a multitechnique approach that allows exploring the short-range order of the lamella. The model is then used to determine the long-range order by inserting defective elements into the structure. With this strategy it is possible to fit the MXene diffraction patterns, obtain the structural parameters including the stoichiometric composition of the terminations (neutron data), and quantify the structural disorder which can be used to discriminate the phases with the best electrochemical properties