From laboratory to bedside: a case report of a concise and pragmatic approach on heart failure

Heart failure is one of the most common and intensely studied diseases in the world. Nevertheless, it is considered a difficult condition to diagnose and manage.This case report, starting from the description of a brief clinical case, aims to directly and concisely explain the most important steps, from laboratory to bedside, in the diagnosis and management of heart failure disease. Physicians can rely on some laboratory tests (e.g., natriuretic peptides) and instrumental exams to diagnose and manage the patients in everyday medical practice. Finally, this article highlights that a multidisciplinary team management can improve the clinical status and the quality of life, thus preventing hospital admission and reducing mortality in patients with heart failure

Criteria and instruments of appropriateness in primary care

The World Health Organization describes three particular features to assess the appropriateness of most medical services provided by clinicians during typical primary care visits: equity, efficacy and effectiveness. But many others aspects are involved and primary care physicians provide a wide range of services, most of which have not been studied sufficiently to develop explicit criteria for appropriateness. This articles describes meaning and characteristics of appropriateness in primary care and underlines the most important difficulties met by general practitioners, from the so called “disease mongering” to the application of the results of trials into the real clinical practice

Layer-resolved imaging of domain wall interactions in magnetic tunnel junction-like trilayers

We have performed a layer-resolved, microscopic study of interactions between domain walls in two magnetic layers separated by a non-magnetic one, using high-resolution x-ray photoemission electron microscopy. Domain walls in the hard magnetic Co layer of a Co/Al2O3/FeNi trilayer with in-plane uniaxial anisotropy strongly modify the local magnetization direction in the soft magnetic FeNi layer. The stray fields associated to the domain walls lead to an antiparallel coupling between the local Co and FeNi moments. For domain walls parallel to the easy magnetization axis this interaction is limited to the domain wall region itself. For strongly charged (head-on or tail-to-tail) walls, the antiparallel coupling dominates the interaction over radial distances up to several micrometers from the centre of the domain wall.Comment: Published version, J. Phys.: Condens. Matter 19, 476204 (2007

Dataset of analyzes performed to determine the level and timing of selected organic pollutants’ inputs in sediments of the Lake of Cavazzo (Italy)

This data article presents the dataset collected for selected organic pollutants in the framework of a larger research project aimed at assessing the effects of different environmental stressors (natural and anthropogenic) in sediments of the Lake of Cavazzo, a basin of glacial origin located in a seismically active region of the Italian Eastern Alps. Information relative to sampling strategy and operations, location of sampling sites, sedimentary chronological benchmarks, and profiles of RGB (Red-Green-Blue) color code determined from high resolution photos taken at cores CAV-04 and CAV-06 are reported, together with analytical data for 15 polycyclic aromatic hydrocarbons, 21 polychlorinated biphenyls’ congeners (including the non-Aroclor CB-11), 14 polybrominated diphenyl ethers’ congeners, and 22 organochlorine pesticides, whose concentrations were determined by Gas Chromatography coupled both to Low-Resolution and High-Resolution Mass Spectrometry. Interpretation of this dataset is fully discussed in the companion article by Pizzini et al. (2022) and relys on the multi-proxy analysis of sediment samples presented in Polonia et al. (2021) that highlighted lake stratigraphy and major changes occurring at a decadal scale since the 1950s

Sustainability of using vineyard pruning residues as an energy source: Combustion performances and environmental impact

Open burning of agricultural waste is still a common practice as it is a rapid method for waste disposal, although natural biomass, including agriculture residues, can be exploited as a renewable energy source. We assessed the viability and sustainability of using vineyard pruning residues, as wood chips, for energy conversion. Wood chips, obtained from vineyards in the Prosecco DOCG region (Italy), were characterized in terms of chemical composition, calorific value, ash content and humidity. Combustion tests were performed in a medium-size biomass boiler (maximum power 500 kW) to assess the viability of the approach in terms of sustainable steady-state combustion. Primary emissions of both macro- and micro-pollutants were measured to assess the environmental impact. An analytical method was purposely developed for the determination of polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) and in three matrices: fly ashes, condensate and gas. The results showed that vineyard pruning residues can be used for energy conversion in medium- and large-scale biomass boilers. Primary emissions of measured pollutants were all below limit values set by current European legislation except for particulate matter, for which current available abatement technologies are required to contain emissions, abatement technologies are required to contain emissions, thus making the use of vineyard pruning residues unsuitable for combustion in domestic appliances where such technologies are not installed. Bottom ashes produced during combustion were also characterized to assess whether they can be recycled in the vineyard as soil amendments/fertilizer. Copper content in combustion ashes exceeded limit values for ashes to be used as fertilizers in agricultural fields for some European countries but not for others, indicating that ashes may need to be disposed as waste

Impiego degli Inibitori della Pompa protonica (IPP) in Piemonte: indagine sulle abitudini prescrittive dei Medici di Medicina Generale

Proton Pump Inhibitors (PPIs) (Omeprazole, Lansoprazole, Pantoprazole, Rabeprazole and Esomeprazole), one of the most commonly prescribed classes of medications in the primary care setting, are considered a major advance in the treatment of acid-peptic diseases. In Italy PPIs are reimbursed by National Health Service on the basis of CUF (Commissione Unica del Farmaco) 1 and 48 Notes. In 2002 and 2003 a significant increase in PPIs consumption and expenditure have been documented, showing differences between regions. The aim of this study is to investigate and monitor, at regional level, type and entity of PPIs use through a drug utilization study, evaluating prescribing behaviour and compliance of PPIs treatments with CUF Notes indications. The study has been carried out on a sample of 436 General Practitioners belonging to 22 Piemonte's ASL (Aziende Sanitarie Locali). The data analysis shows that acid-related pathologies are significantly more common in patients with at least 50 years of age and the most frequent condition is represented by gastroesophageal reflux disease. Despite the general conditions of PPIs use by General Practitioners in terms of duration and dosage of therapy result in most cases (from 49% to 80% for duration and from 54% to 97% for dosage) compliant with what proposed by CUF Notes, in some cases the same CUF Notes indications seem to be not observed. Consequently the Piemonte Region has decided to plan a guideline on PPIs rational use. Such guideline, expected to be introduced in the regional area, may also be considered as an instrument able to lead to a more appropriate expenditure for this drug class. Moreover, in order to control PPIs expenditure, pharmacoeconomic methodologies can be applied allowing to identify the most cost - effective active substance and therapeutic scheme, overcoming CUF Notes which consider all PPIs use under the same reimbursement conditions

Room temperature chiral magnetic skyrmion in ultrathin magnetic nanostructures

Magnetic skyrmions are chiral spin structures with a whirling configuration. Their topological properties, nanometer size and the fact that they can be moved by small current densities have opened a new paradigm for the manipulation of magnetisation at the nanoscale. To date, chiral skyrmion structures have been experimentally demonstrated only in bulk materials and in epitaxial ultrathin films and under external magnetic field or at low temperature. Here, we report on the observation of stable skyrmions in sputtered ultrathin Pt/Co/MgO nanostructures, at room temperature and zero applied magnetic field. We use high lateral resolution X-ray magnetic circular dichroism microscopy to image their chiral N\'eel internal structure which we explain as due to the large strength of the Dzyaloshinskii-Moriya interaction as revealed by spin wave spectroscopy measurements. Our results are substantiated by micromagnetic simulations and numerical models, which allow the identification of the physical mechanisms governing the size and stability of the skyrmions.Comment: Submitted version. Extended version to appear in Nature Nanotechnolog

European recommendations on practices in pediatric neuroradiology: consensus document from the European Society of Neuroradiology (ESNR), European Society of Paediatric Radiology (ESPR) and European Union of Medical Specialists Division of Neuroradiology (UEMS)

Pediatric neuroradiology is a subspecialty within radiology, with possible pathways to train within the discipline from neuroradiology or pediatric radiology. Formalized pediatric neuroradiology training programs are not available in most European countries. We aimed to construct a European consensus document providing recommendations for the safe practice of pediatric neuroradiology. We particularly emphasize imaging techniques that should be available, optimal site conditions and facilities, recommended team requirements and specific indications and protocol modifications for each imaging modality employed for pediatric neuroradiology studies. The present document serves as guidance to the optimal setup and organization for carrying out pediatric neuroradiology diagnostic and interventional procedures. Clinical activities should always be carried out in full agreement with national provisions and regulations. Continued education of all parties involved is a requisite for preserving pediatric neuroradiology practice at a high level