501 research outputs found

    Addressing Peripherality in Italy: A Critical Comparison between Inner Areas and Territorial Capital-Based Evaluations

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    As highlighted by the UN 2030 Agenda, sustainable development is a complex and multidimensional issue that can be effectively implemented and reached at the local level. This implies the evaluation of differences and disparities between territories in order to define local priorities and support cohesion policy objectives. This need has been addressed by the Italian "National Strategy for Inner Areas", which aims to support the growth of territories with a continuous economic and population decline. However, Inner Areas are identified by a set of indicators related to the low accessibility to Services of General Interest, neglecting other important factors that contribute to this condition. This paper proposes a critical analysis of this measurement and of the related "territorialization" of Inner Areas, by introducing a more comprehensive assessment model based on the concept of Territorial Capital (TC), which highlights a more nuanced understanding of complexities and diversities related to the potential development of a territory. In particular, the proposed model evaluates eight TC dimensions (human, social, cognitive, infrastructural, productive, relational, environmental and settlement capital), which cover a broad spectrum of Sustainable Development Goals (SDGs). In order to accurately demonstrate the differences between the results of the two evaluation methods, this paper presents the results of a case study application concerning all 377 municipalities, which compose the Autonomous Region of Sardinia (Italy). The findings of this study confirm the potential of an approach based on the Territorial Capital for place-based policymaking. TC, in fact, can become relevant for defining local priorities and supporting complex decisions, allowing governments to better design and tailor interventions for the effective and efficient management of available resources. Furthermore, these results pose new questions for future research developments in the field of sustainable and equitable development

    Comparison of outcomes in patients with abandoned versus extracted implantable cardioverter defibrillator leads

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    SummaryBackgroundDespite the increased number of implantable cardioverter defibrillator (ICD) recipients and the frequent need for device upgrading and/or occurrence of lead malfunction, the optimal approach to managing abandoned leads remains debated. Aims To determine the rate and type of complications related to either abandoned or extracted ICD leads. Methods Patients with abandoned or extracted leads were identified retrospectively. Patient medical records were reviewed to assess long-term lead or device malfunction, defibrillation test values before and after lead abandonment or extraction, and appropriateness of delivered shocks and subsequent surgical procedures related to devices or leads. Results A total of 58 ICD patients with 47 extracted and 34 abandoned leads were identified. After a mean follow-up of 3.2 ± 2.6 years, the defibrillation test was not affected by either abandoned or extracted leads (23.4 ± 6.6 J vs 25.4 ± 4.9 J, respectively; P = 0.24). There were no differences in the number of ICD-related surgical procedures after extracting versus abandoning leads (22% vs 12%, respectively; P = 0.3) or in the thromboembolic event rate (7.7% vs 6.3%; P = 0.83). During follow-up, no differences in the occurrence of major complications or appropriate/inappropriate shocks were observed between patients with or without abandoned leads. Conclusion We observed no difference in rates of immediate or medium-term complications between extracting versus abandoning leads. Lead abandonment remains an alternative and safe option when extraction does not appear mandatory according to the age of the leads or experience of the operating centre

    Nothophytophthora gen. nov., a new sister genus of Phytophthora from natural and semi-natural ecosystem

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    During various surveys of Phytophthora diversity in Europe, Chile and Vietnam slow growing oomycete isolates were obtained from rhizosphere soil samples and small streams in natural and planted forest stands. Phylogenetic analyses of sequences from the nuclear ITS, LSU, β-tubulin and HSP90 loci and the mitochondrial cox1 and NADH1 genes revealed they belong to six new species of a new genus, officially described here as Nothophytophthora gen. nov., which clustered as sister group to Phytophthora. Nothophytophthora species share numerous morphological characters with Phytophthora: persistent (all Nothophytophthora spp.) and caducous (N. caduca, N. chlamydospora, N. valdiviana, N. vietnamensis) sporangia with variable shapes, internal differentiation of zoospores and internal, nested and extended (N. caduca, N. chlamydospora) and external (all Nothophytophthora spp.) sporangial proliferation; smooth-walled oogonia with amphigynous (N. amphigynosa) and paragynous (N. amphigynosa, N. intricata, N. vietnamensis) attachment of the antheridia; chlamydospores (N. chlamydospora) and hyphal swellings. Main differing features of the new genus are the presence of a conspicuous, opaque plug inside the sporangiophore close to the base of most mature sporangia in all known Nothophytophthora species and intraspecific co-occurrence of caducity and non-papillate sporangia with internal nested and extended proliferation in several Nothophytophthora species. Comparisons of morphological structures of both genera allow hypotheses about the morphology and ecology of their common ancestor which are discussed. Production of caducous sporangia by N. caduca, N. chlamydospora and N. valdiviana from Valdivian rainforests and N. vietnamensis from a mountain forest in Vietnam suggests a partially aerial lifestyle as adaptation to these humid habitats. Presence of tree dieback in all forests from which Nothophytophthora spp. were recovered and partial sporangial caducity of several Nothophytophthora species indicate a pathogenic rather than a saprophytic lifestyle. Isolation tests from symptomatic plant tissues in these forests and pathogenicity tests are urgently required to clarify the lifestyle of the six Nothophytophthora species.info:eu-repo/semantics/publishedVersio

    High-Level Expression of Various Apolipoprotein (a) Isoforms by "Transferrinfection". The Role of Kringle IV Sequences in the Extracellular Association with Low-Density Lipoprotein

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    Characterization of the assembly of lipoprotein(a) [Lp(a)] is of fundamental importance to understanding the biosynthesis and metabolism of this atherogenic lipoprotein. Since no established cell lines exist that express Lp(a) or apolipoprotein(a) [apo(a)], a "transferrinfection" system for apo(a) was developed utilizing adenovirus receptor- and transferrin receptor-mediated DNA uptake into cells. Using this method, different apo(a) cDNA constructions of variable length, due to the presence of 3, 5, 7, 9, 15, or 18 internal kringle IV sequences, were expressed in cos-7 cells or CHO cells. All constructions contained kringle IV-36, which includes the only unpaired cysteine residue (Cys-4057) in apo(a). r-Apo(a) was synthesized as a precursor and secreted as mature apolipoprotein into the medium. When medium containing r-apo(a) with 9, 15, or 18 kringle IV repeats was mixed with normal human plasma LDL, stable complexes formed that had a bouyant density typical of Lp(a). Association was substantially decreased if Cys-4057 on r-apo(a) was replaced by Arg by site-directed mutagenesis or if Cys-4057 was chemically modified. Lack of association was also observed with r-apo(a) containing only 3, 5, or 7 kringle IV repeats without "unique kringle IV sequences", although Cys-4057 was present in all of these constructions. Synthesis and secretion of r-apo(a) was not dependent on its sialic acid content. r-Apo(a) was expressed even more efficiently in sialylation-defective CHO cells than in wild-type CHO cells. In transfected CHO cells defective in the addition of N-acetylglucosamine, apo(a) secretion was found to be decreased by 50%. Extracellular association with LDL was not affected by the carbohydrate moiety of r-apo(a), indicating a protein-protein interaction between r-apo(a) and apoB. These results show that, besides kringle IV-36, other kringle IV sequences are necessary for the extracellular association of r-apo(a) with LDL. Changes in the carbohydrate moiety of apo(a), however, do not affect complex formation

    Accuracy of synovial fluid analysis compared to histology for the identification of calcium pyrophosphate crystals: An ancillary study of the OMERACT US working group - CPPD subgroup

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    The aim of this study was to evaluate the accuracy of synovial fluid analysis in the identification of calcium pyrophosphate dihydrate crystals compared to microscopic analysis of joint tissues as the reference standard. This is an ancillary study of an international, multicentre cross-sectional study performed by the calcium pyrophosphate deposition disease (CPPD) subgroup of the OMERACT Ultrasound working group. Consecutive patients with knee osteoarthritis (OA) waiting for total knee replacement surgery were enrolled in the study from 2 participating centres in Mexico and Romania. During the surgical procedures, synovial fluid, menisci and hyaline cartilage were collected and analysed within 48 hours from surgery under transmitted light microscopy and compensated polarised light microscopy for the presence/absence of calcium pyrophosphate crystals. All slides were analysed by expert examiners on site, blinded to other findings. A dichotomic score (absence/presence) was used for scoring both synovial fluid and tissues. Microscopic analysis of knee tissues was considered the gold standard. Sensitivity, specificity, accuracy, positive and negative predictive values of synovial fluid analysis in the identification of calcium pyrophosphate crystals were calculated.15 patients (53% female, mean age 68 yo +/- 8.4) with OA of grade 3 or 4 according to Kellgren-Lawrence scoring were enrolled. 12 patients (80%) were positive for calcium pyrophosphate crystals at the synovial fluid analysis and 14 (93%) at the tissue microscopic analysis. The overall diagnostic accuracy of synovial fluid analysis compared with histology for CPPD was 87%, with a sensitivity of 86% and a specificity of 100%, the positive predictive value was 100% and the negative predictive value was 33%.In conclusion synovial fluid analysis proved to be an accurate test for the identification of calcium pyrophosphate dihydrate crystals in patients with advanced OA
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