La inclusión diferencial de los solicitantes de asilo en Italia.

This article aims to critically analyze the reception system for asylum seekers in Italy as a device for “differential inclusion” of migrants on the southern edge of Europe. To defend this argument, first, we will analyze the evolution and the main characteristics of this system, as well as its most recent transformations from 2011. Secondly, we will observe that the three main segments of the reception system can be found on a scale that goes from the greatest exclusion to the greatest inclusion. In third and last place, we will observe that the reception “best practices” also present an ambivalent character, producing a continuous tension between the two poles of reception and integration.Este trabajo pretende analizar críticamente el sistema de acogida de los solicitantes de asilo en Italia como dispositivo de “inclusión diferencial” de los migrantes en los confines meridionales de Europa. Para defender este argumento, en primer lugar, analizaremos la evolución y las principales características de ese sistema, además de sus transformaciones más recientes a partir del 2011. En segundo lugar, observaremos que los tres segmentos principales del sistema de acogida pueden hallarse en una escala que va desde la mayor exclusión a la mayor inclusión. En tercer y último lugar, observaremos que también las “mejores prácticas” de acogida presentan un carácter ambivalente que produce una continua tensión entre los dos polos de la acogida y de la integración

Visualization of coronary arteries and coronary stents by low dose 320-slice multi-detector computed tomography in a patient with atrial fibrillation

Abstract Cardiac multi-detector computed tomography (MDCT) is widely used in the diagnosis of coronary disease. However, the predictive value of this technique is limited in the presence of atrial fibrillation and coronary stents. Here we present a case showing the ability of the new 320-slice MDCT to assess coronary anatomy in a patient with atrial fibrillation and coronary stents

Transcatheter aortic valve implantation results are not superimposable to surgery in patients with aortic stenosis at low surgical risk

Background: The aim of this meta-analysis was to compare the impact of transcatheter aortic valve implantation (TAVI) vs. surgical aortic valve replacement (SAVR) in patients with severe aortic valve stenosis at low surgical risk. Methods: All randomized controlled trials (RCTs) and observational studies (Obs) published from January 2014 until March 31st, 2020 were retrieved through the PubMed computerized database and at the site https://www.clinicaltrials.com. The relative risk (RR) with the 95% confidence interval (CI) was used to evaluate the effect of the intervention under comparison. The primary endpoints were all-cause 30-day mortality and 1-year mortality. The 30-day safety endpoints were: stroke, acute kidney injury stage 2 or 3, major bleeding, moderate/severe paravalvular leak, need for new permanent pacemaker (PM) implantation. Results: After detailed review 9 studies, related to 4 RCTs and 5 Obs, were selected. The overall analysis of RCTs plus Obs showed a significantly lower 30-day mortality for TAVI (RR = 0.55; 95% CI 0.45–0.68, p < 0.00001; I2 = 0%). However, an increased risk of new PM implantation (RR = 2.87; 95% CI 2.01–3.67, p < 0.00001, I2 = 0%) and of paravalvular leak (RR = 7.28; 95% CI 3.83–13.81, p < 0.00001, I2 = 0%) was observed in TAVI compared to SAVR. On the contrary, a lower incidence of major bleeding (RR = 0.38; 95% CI 0.27–0.54, p < 0.00001, I2 = 0%) and of acute kidney injury was observed (RR = 0.33; 95% CI 0.19–0.56, p < 0.0001, I2 = 0%) in TAVI. Conclusions: TAVI and SVAR in the treatment of AS in the patients at low surgical risk are not superimposable. In particular, if 30-day and 1-year mortality, major bleeding and acute kidney injury were significantly lower for TAVI, the need of new PM implantation and paravalvular leak were significantly lower in SAVR. Consequently, we suggest the need of more trials to evaluate the effectiveness of TAVI as routine therapeutic procedure in the treatment of patients with low surgical risk AS

Search for gravitational-lensing signatures in the full third observing run of the LIGO-Virgo network

Gravitational lensing by massive objects along the line of sight to the source causes distortions of gravitational wave-signals; such distortions may reveal information about fundamental physics, cosmology and astrophysics. In this work, we have extended the search for lensing signatures to all binary black hole events from the third observing run of the LIGO--Virgo network. We search for repeated signals from strong lensing by 1) performing targeted searches for subthreshold signals, 2) calculating the degree of overlap amongst the intrinsic parameters and sky location of pairs of signals, 3) comparing the similarities of the spectrograms amongst pairs of signals, and 4) performing dual-signal Bayesian analysis that takes into account selection effects and astrophysical knowledge. We also search for distortions to the gravitational waveform caused by 1) frequency-independent phase shifts in strongly lensed images, and 2) frequency-dependent modulation of the amplitude and phase due to point masses. None of these searches yields significant evidence for lensing. Finally, we use the non-detection of gravitational-wave lensing to constrain the lensing rate based on the latest merger-rate estimates and the fraction of dark matter composed of compact objects

Search for eccentric black hole coalescences during the third observing run of LIGO and Virgo

Despite the growing number of confident binary black hole coalescences observed through gravitational waves so far, the astrophysical origin of these binaries remains uncertain. Orbital eccentricity is one of the clearest tracers of binary formation channels. Identifying binary eccentricity, however, remains challenging due to the limited availability of gravitational waveforms that include effects of eccentricity. Here, we present observational results for a waveform-independent search sensitive to eccentric black hole coalescences, covering the third observing run (O3) of the LIGO and Virgo detectors. We identified no new high-significance candidates beyond those that were already identified with searches focusing on quasi-circular binaries. We determine the sensitivity of our search to high-mass (total mass M>70 M⊙) binaries covering eccentricities up to 0.3 at 15 Hz orbital frequency, and use this to compare model predictions to search results. Assuming all detections are indeed quasi-circular, for our fiducial population model, we place an upper limit for the merger rate density of high-mass binaries with eccentricities 0<e≤0.3 at 0.33 Gpc−3 yr−1 at 90\% confidence level

Ultralight vector dark matter search using data from the KAGRA O3GK run

Among the various candidates for dark matter (DM), ultralight vector DM can be probed by laser interferometric gravitational wave detectors through the measurement of oscillating length changes in the arm cavities. In this context, KAGRA has a unique feature due to differing compositions of its mirrors, enhancing the signal of vector DM in the length change in the auxiliary channels. Here we present the result of a search for U(1)B−L gauge boson DM using the KAGRA data from auxiliary length channels during the first joint observation run together with GEO600. By applying our search pipeline, which takes into account the stochastic nature of ultralight DM, upper bounds on the coupling strength between the U(1)B−L gauge boson and ordinary matter are obtained for a range of DM masses. While our constraints are less stringent than those derived from previous experiments, this study demonstrates the applicability of our method to the lower-mass vector DM search, which is made difficult in this measurement by the short observation time compared to the auto-correlation time scale of DM

Optimal drug treatment of systolic hypertension in the elderly.

Approximately two-thirds of the elderly population has hypertension, mainly of the isolated systolic hypertension (ISH) type. However, while large-scale, randomized controlled intervention trials have demonstrated that treatment of ISH reduces rates of total mortality, cardiovascular mortality and stroke in older hypertensives, control of ISH in the elderly remains poor. The aim of this review of drug treatment of ISH in the elderly is to provide a succinct, practical and clinically orientated guide that summarizes international recommendations and practices with special emphasis on newer approaches. Knowledge of pathophysiological changes in older subjects (decreased elastic artery compliance, reduced plasma renin activity, increased salt sensitivity) and evidence from epidemiological surveys and randomized controlled trials give clear clues that thiazide(-like) diuretics and long-acting dihydropyridine calcium channel antagonists are the drugs of choice in the treatment of ISH. Thus, based on this evidence, American, European and international guidelines for hypertension management still offer the best available recommendations for optimal treatment of ISH in the elderly. Newer combination treatments, especially the fixed combination of a dihydropyridine calcium channel antagonist and an ACE inhibitor, have valuable benefits in terms of efficacy and tolerability. Use of nitrates added to other antihypertensive medications can provide the practising physician with a further unconventional therapeutic strategy

Semeiotica Fisica Cardiovascolare

La semeiotica cardiovascolare viene presentata, con prospettiva moderna, al laureando in medicina tradizionalmente orientato secondo le tappe dell’anamnesi orientata ai sintomi e dell’esame obiettivo suddiviso in ispezione, palpazione, percussione, auscultazione

Semeiotica Fisica Cardiovascolare in Patologia integrata medico-chirurgica 1. Vol. 1: Malattie dell'apparato cardiovascolare

criteri e metodi di semeiotica fisica cardiovascolar