Iconic Turns in Deontic Wor(l)ds. From Visual Rules to Optical Dispositives

These pages are a brief contribution dedicated to the exploration of the rel- evance of images for legal discourse. Considering the specific field of road traffic regula- tion, the paper shows, starting from Michel Foucault’s seminal research on the concept of “dispositive”, how the use of images produced by visual devices such as surveillance cameras or satellite navigators has gradually integrated legislation mainly composed of “graphic rules” (road signs). A passage destined to create a new order of an extra-legal nature that profoundly affects the construction of new forms of subjectivity

Alternatives to Transplantation in the Treatment of Heart Failure: New Diagnostic and Therapeutic Insights

none4siThe aim of our current special issue was to present a series of original researches and reviews on recent advances in the diagnosis, medical therapy, and surgical approaches of heart failure. As reported in the introductive review of Agnetti et al., cardiovascular disease is the leading cause of mortality in the US and in westernized countries with ischemic heart disease accounting for the majority of these deaths. Paradoxically, the improvements in the medical and surgical treatments of acute coronary syndromes are leading to an increasing number of “survivors” who are then developing heart failure. Despite considerable advances in its management, the gold standard for the treatment of end-stage heart failure patients remains heart transplantation. Nevertheless, this procedure can be o ered only to a small percentage of patients who could bene t from a new heart due to the limited availability of donor organs. e authors reported in this comprehensive review the evaluation of the safety and e cacy of innovative approaches in the diagnosis and treatment of patients refrac- tory to standard medical therapy and excluded from cardiac transplantation lists.mixedNicolini, Francesco; Piepoli, Massimo F.; Agnetti, Giulio; Siniscalchi, GiuseppeNicolini, Francesco; Piepoli, Massimo F.; Agnetti, Giulio; Siniscalchi, Giusepp

New Insights in the Diagnosis and Treatment of Heart Failure

Cardiovascular disease is the leading cause of mortality in the US and in westernized countries with ischemic heart disease accounting for the majority of these deaths. Paradoxically, the improvements in the medical and surgical treatments of acute coronary syndrome are leading to an increasing number of "survivors" who are then developing heart failure. Despite considerable advances in its management, the gold standard for the treatment of end-stage heart failure patients remains heart transplantation. Nevertheless, this procedure can be offered only to a small percentage of patients who could benefit from a new heart due to the limited availability of donor organs. The aim of this review is to evaluate the safety and efficacy of innovative approaches in the diagnosis and treatment of patients refractory to standard medical therapy and excluded from cardiac transplantation lists

Percutaneous reduction of septal-to-lateral mitral annular distance to increase mitral leaflet coaptation length: Preclinical study results.

Percutaneous indirect annuloplasty has emerged as a treatment strategy for functional/ischemic mitral regurgitation. This study sought to evaluate the feasibility of percutaneous indirect annuloplasty technique using a new device. The device has 3 components: the "saddle" inserted into the great cardiac vein, the "plug" positioned in the left ventricular outflow tract, and the "bridge," a transatrial suture connecting the 2 holding elements. The aim was to shorten the septal-to-lateral distance of the mitral annulus by pulling on the saddle element. The procedure was performed through venous access in healthy adult sheep. A dedicated catheter holding a needle was used to deploy the saddle into the great cardiac vein and pierce its wall toward the left atrium to deploy the expanded polytetrafluoroethylene suture that is part of the bridge. A catheter for transseptal puncture was inserted for crossing the interatrial septum and piercing the aortic-mitral curtain, thereby allowing the plug to be deployed. The plug was held in place by the second part of the expanded polytetrafluoroethylene bridge. The 2 parts of the bridge were then joined to reduce the septal-to-lateral mitral annular distance. The septal-to-lateral distance and the coaptation length at P2 level were measured before and after the procedure using echocardiography. Overall, 10 animals were treated, 7 successfully. The mean procedure duration was 110 ± 81 minutes. Septal-to-lateral distance decreased from 3.8 mm to 2.6 mm (30%), and maximum increase of mitral leaflet coaptation was 4 mm. This new approach seems promising for percutaneous treatment of functional mitral regurgitation

Magneto-seismic interpretation of subsurface volcanism in the Gaeta Gulf (Italy, Tyrrhenian Sea)

The occurrence of a former subaerial volcanic edifice off the Volturno River (Tyrrhenian Sea, Gulf of Gaeta) in the 41°N parallel is suggested by joint interpretation of multichannel seismic lines and ship-borne magnetic data. In the Campanian region igneous (volcanic) rocks are very close to the carbonate Mesozoic basement and seismics cannot always discriminate between them. A joint seismic-magnetic analysis was very effective in assessing the lithological nature of the bodies evidenced by both geophysical methods. Distortion analysis showed that the main magnetic source in the area is characterised by a not normal-polarity direction of the magnetization, similar to other Pleistocene volcanoes in the Tyrrhenian region. Hence we argued that the overall magmatic emplacement for this source occurred during a reverse-polarity chron, very likely the 0.78-1.78 Ma time span. This magnetically-derived time constraint is in agreement with seismic stratigraphy that shows that the entire volcano is sealed by the Volturno River prograding delta from Middle Pleistocene to Present in age. Our interpreted volcano belongs to a set of inferred onshore and offshore volcanic edifices all lying along the 41°N paralle

A new magnetotelluric monitoring network operating in Agri Valley (Southern Italy): study of stability of apparent resistivity estimates

Variations detected in geophysical, especially electromagnetic, parameters in seismic active areas have been sometimes attributed to modifications of the stress field. Among the different geophysical methods, magnetotellurics (MT) could be one of the most effective because it allows us to explore down to seismogenic depths. Continuous MT recording could allow us to evaluate whether possible variations are significantly correlated with the seismic activity of investigated area. To assess the significance of such observations we must be able to say how well an apparent resistivity curve should be reproduced when measurements are repeated at a later time. To do this properly it is essential to know that the estimated error bars accurately represent the true uncertainties in comparing the transfer functions. In this work we will show the preliminary results obtained from the analysis of the data coming from the new MT monitoring network installed in Agri Valley. This analysis gives us the possibility: i) to better study the temporal stability of the signals, ii) to better discriminate the noise affecting the measures by remote reference estimation. The performed analysis disclosed a relatively low degree of noise in the investigated area, which is a promising condition for monitoring

Atrial assist device, a new alternative to lifelong anticoagulation?

OBJECTIVE: Atrial fibrillation is a very common heart arrhythmia, associated with a five-fold increase in the risk of embolic strokes. Treatment strategies encompass palliative drugs or surgical procedures all of which can restore sinus rhythm. Unfortunately, atria often fail to recover their mechanical function and patients therefore require lifelong anticoagulation therapy. A motorless volume displacing device (Atripump) based on artificial muscle technology, positioned on the external surface of atrium could avoid the need of oral anticoagulation and its haemorrhagic complications. An animal study was conducted in order to assess the haemodynamic effects that such a pump could provide. METHODS: Atripump is a dome-shape siliconecoated nitinol actuator sewn on the external surface of the atrium. It is driven by a pacemaker-like control unit. Five non-anticoagulated sheep were selected for this experiment. The right atrium was surgically exposed, the device sutured and connected. Haemodynamic parameters and intracardiac ultrasound (ICUS) data were recorded in each animal and under three conditions; baseline; atrial fibrillation (AF); atripump assisted AF (aaAF). RESULTS: In two animals, after 20 min of AF, small thrombi appeared in the right atrial appendix and were washed out once the pump was turned on. Assistance also enhanced atrial ejection fraction. 31% baseline; 5% during AF; 20% under aaAF. Right atrial systolic surfaces (cm2) were; 5.2 +/- 0.3 baseline; 6.2 +/- 0.1 AF; 5.4 +/- 0.3 aaAF. CONCLUSION: This compact and reliable pump seems to restore the atrial "kick" and prevents embolic events. It could avoid long-term anticoagulation therapy and open new hopes in the care of end-stage heart failure

A new magnetotelluric monitoring network operating in Agri Valley (Southern Italy): study of stability of apparent resistivity estimates

Variations detected in geophysical, especially electromagnetic, parameters in seismic active areas have been sometimes attributed to modifications of the stress field. Among the different geophysical methods, magnetotellurics (MT) could be one of the most effective because it allows us to explore down to seismogenic depths. Continuous MT recording could allow us to evaluate whether possible variations are significantly correlated with the seismic activity of investigated area. To assess the significance of such observations we must be able to say how well an apparent resistivity curve should be reproduced when measurements are repeated at a later time. To do this properly it is essential to know that the estimated error bars accurately represent the true uncertainties in comparing the transfer functions. In this work we will show the preliminary results obtained from the analysis of the data coming from the new MT monitoring network installed in Agri Valley. This analysis gives us the possibility: i) to better study the temporal stability of the signals, ii) to better discriminate the noise affecting the measures by remote reference estimation. The performed analysis disclosed a relatively low degree of noise in the investigated area, which is a promising condition for monitoring