Etiological diagnosis, prognostic significance and role of electrophysiological study in patients with Brugada ECG and syncope.

BACKGROUND: Syncope is considered a risk factor for life-threatening arrhythmias in Brugada patients. Distinguishing a benign syncope from one due to ventricular arrhythmias is often difficult, unless an ECG is recorded during the episode. Aim of the study was to analyze the characteristics of syncopal episodes in a large population of Brugada patients and evaluate the role of electrophysiological study (EPS) and the prognosis in the different subgroups. METHODS AND RESULTS: One hundred ninety-five Brugada patients with history of syncope were considered. Syncope were classified as neurally mediated (group 1, 61%) or unexplained (group 2, 39%) on the basis of personal and family history, clinical features, triggers, situations, associated signs, concomitant therapy. Most patients underwent EPS; they received ICD or implantable loop-recorder on the basis of the result of investigations and physician's judgment. At 62±45months of mean follow-up, group 1 showed a significantly lower incidence of arrhythmic events (2%) as compared to group 2 (9%, p<0.001). Group 2 patients with positive EPS showed the highest risk of arrhythmic events (27%). No ventricular events occurred in subjects with negative EPS. CONCLUSION: Etiological definition of syncope in Brugada patients is important, as it allows identifying two groups with different outcome. Patients with unexplained syncope and ventricular fibrillation induced at EPS have the highest risk of arrhythmic events. Patients presenting with neurally mediated syncope showed a prognosis similar to that of the asymptomatic and the role of EPS in this group is unproven

Moderate-intensity exercise alters markers of alternative activation in circulating monocytes in females: a putative role for PPARγ

Monocytes may be primed towards differentiation into classically activated M1 macrophages or alternatively activated M2 macrophages. M1 macrophages greatly contribute to the inflammation which promotes insulin resistance, whereas M2 macrophages resolve inflammation. We have previously shown that exercise increases M2 marker expression in mixed mononuclear cells, possibly via activation of the nuclear transcription factor PPARγ. However, these effects have not been demonstrated specifically within monocytes. Thus, we aimed to investigate whether moderate-intensity exercise elicited similar effects on monocytic M1/M2 marker expression and PPARγ activity to those reported previously in mononuclear cells, so as to further elucidate the mechanisms by which exercise may alter inflammatory status and, accordingly, prevent insulin resistance

Management of a Malpractice Dental Implant Case in a Patient with History of Oral Bisphosphonates Intake: A Case Report and Narrative Review of Recent Findings

The present article aims to describe the management of a malpractice dental implant case in a patient with a history of oral bisphosphonates (BF) intake (alendronic acid every 15 days for 20 years) and to perform a narrative review of recently published articles (2019–2023) on the topic. A female patient rehabilitated with 18 nails in the mandible 20 years ago underwent two surgeries; the first one included the explantation of the nails; the second one included the insertion of two implants in the anterior region. At the last follow-up (21 months from the first surgery and 15 months from the second one) no complications nor episodes of bisphosphonate-related osteonecrosis of the jaw (BRONJ) were highlighted. Furthermore, 12 recent articles on the topic were reported and a narrative review was performed. Based on the narrative analysis, the topic related to dental implants in patients with BF intake seems to remain controversial. Most of the findings highlight how the evidence on both the safety of the treatment and the possibility to foresee the risk of onset based on preoperative factors seem to be scarce. The case described in the present article did not report any complications nor episodes of BRONJ. However, evidence from a single case report is scarce and more clinical trials are required to deepen the knowledge on the topic

Classifying A-field and B-field configurations in the presence of D-branes

We "solve" the Freed-Witten anomaly equation, i.e., we find a geometrical classification of the B-field and A-field configurations in the presence of D-branes that are anomaly-free. The mathematical setting being provided by the geometry of gerbes, we find that the allowed configurations are jointly described by a coset of a certain hypercohomology group. We then describe in detail various cases that arise according to such classification. As is well-known, only under suitable hypotheses the A-field turns out to be a connection on a canonical gauge bundle. However, even in these cases, there is a residual freedom in the choice of the bundle, naturally arising from the hypercohomological description. For a B-field which is flat on a D-brane, fractional or irrational charges of subbranes naturally appear; for a suitable gauge choice, they can be seen as arising from "gauge bundles with not integral Chern class": we give a precise geometric interpretation of these objects.Comment: 28 pages, no figure

Game Workers and the Empire: Unionisation in the UK Video Game Industry

This article investigates some of the key debates that have emerged within the nascent union organising project Game Workers Unite, with a specific focus on its UK branch (GWU UK). The analysis is based on a period of participatory observation and a series of interviews with board members of GWU UK. This article evaluates Game Workers Unite (GWU) in relation to other recent attempts at unionising the game industry. It concludes that the strategies adopted to counter the hyper-visibility and individualisation of the game worker are key contributions of GWU in contemporary video game labour. This article draws on the work of Dyer-Witheford and de Peuter (2009) Games of empire: Global capitalism and video games to evaluate the historical specificity of GWU and the importance of the organisation for the contemporary video game industry

Quantum ESPRESSO toward the exascale

Quantum ESPRESSO is an open-source distribution of computer codes for quantum-mechanical materials modeling, based on density-functional theory, pseudopotentials, and plane waves, and renowned for its performance on a wide range of hardware architectures, from laptops to massively parallel computers, as well as for the breadth of its applications. In this paper, we present a motivation and brief review of the ongoing effort to port Quantum ESPRESSO onto heterogeneous architectures based on hardware accelerators, which will overcome the energy constraints that are currently hindering the way toward exascale computing