Impact of structural features of very thin stents implanted in unprotected left main or coronary bifurcations on clinical outcomes

Objectives: To evaluate the independent clinical impact of stent structural features in a large cohort of patients undergoing unprotected left main (ULM) or coronary bifurcation percutaneous coronary intervention (PCI) with a range of very thin strut stents. Background: Clinical impact of structural features of contemporary stents remains to be defined. Methods: All consecutive patients enrolled in the veRy thin stents for patients with left mAIn or bifurcatioN in real life (RAIN) registry were included. The following stent structural features were studied: antiproliferative drugs (everolimus vs. sirolimus vs. zotarolimus), strut material (platinum-chromium vs. cobalt-chromium), polymer (bioresorbable vs. durable), number of crowns (<8 vs. ≥8) and number of connectors (<3 vs. ≥3). For small diameter stents (≤2.5 mm), struct thickness (74 vs. 80/81 μm) was also tested. Target lesion failure (TLF), a composite of target lesion revascularization and stent thrombosis, was the primary endpoint. Multivariate analysis was performed with Cox regression models. Results: Out of 2,707 patients, 110 (4.1%) experienced a TLF event after 16 months (12–18). After adjustment for confounders, an increased number of connectors (adjusted hazard ratio [adj-HR] 0.62, 95% confidence interval (CI) 0.39–0.99, p =.04) reduced risk of TLF, driven by stents with ≥2.5 mm diameter (HR 0.54, 95% CI 0.32–0.93, p =.02). This independent relationship was lost for stents with diameter <2.5 mm, where only strut thickness appeared to impact. Conversely, no independent relationship of polymer type, number of crowns, and the specific limus-family eluted drug with outcomes was observed. Conclusions: Among a range of contemporary very thin stent models, an increased number of connectors improved device-related outcomes in this investigated high-risk procedural setting

Timber-concrete hybrid innovations : A framework to evaluate economical and technical factors for the construction market

Nowadays, the focus of the construction market is on sustainability aspects, for which purpose, the employment of wood seems promising. Nevertheless, in countries having high potentiality like Sweden, the timber construction market finds difficulties in growing. The reason lies in the lack of standards for design and industrialization and on the strong competition of the concrete industry. The timber-concrete hybrid solution is presented in this study as a solution beneficial for both the timber and the concrete markets: the former would benefit of a pulling action towards standardization and larger market, while the latter would fulfil the environment-friendly requirements and better differentiate in the competitive landscape. Therefore, the objective of this thesis is to provide a framework to evaluate innovations in construction market, highlighting the characteristic issues related to the matching of timber and concrete constructions, and detecting the main economic and technical factors to help in the decision-making process. This framework will help to organize and evaluate all the information and the boundary conditions about the introduction of a concrete-timber hybrid construction solution, which eventually would enhance the timber construction market itself through a preliminary association with concrete market. Firstly, some consideration on the market areas and on the general perceptions towards the timber construction are presented; then, the focus is moved onto the dynamics of concrete and timber supply chains, highlighting similarities, diversities, and possible reciprocal benefits, to finally detect the market indicators to be considered for a decision-making path related to the timber-concrete hybrid construction. From the technical side, a conceptual design is proposed, considering the industrialization of such hybrid solution. Annex A shows how standardization and modularity of the products would enable compatibility and interchangeability between timber and concrete, on account of the open system within the construction market. Annex B displays a schematic picture of how the exploitation of timber and concrete’ properties, with the industrialization of these two materials, can be best employed for a hybrid building. A preliminary technical evaluation of the timber-concrete hybrid is carried out by dividing the building into modular units and focusing on the main systems (horizontal loadbearing system, vertical loadbearing system, external envelope, inner partitions), while making consideration on structural design, fire protection, building technology details, building service systems integration, construction plan, and costs. The innovations within the construction market are often hindered by the fear to undertake a high-risk project. The proposed framework allows to increase the awareness on the general factors to be evaluated, and to undertake a gradual adoption of the “new” timber construction solution. The key points underlying the whole timber-concrete hybrid problem are standardization and modularity, necessary for a quality-oriented production. Further studies need to be carried out with an applicative intent: application of the general framework to real cases and pilot projects; automatic tools for the design and construction optimization including economic and technical factors; innovative and original hybrid solutions, which better exploit the timber-concrete synergy

Micro transitions or breathers in L alanine?

The lattice dynamics of crystalline L Alanine shows some unusual features tentatively assigned to a localization of vibrational energy. But other properties alternatively suggest the existence of a second order phase transition undetected by previous crystallographic work. In this paper we present the results of a high resolution X ray diffraction study of L Alanine down to 10 K made at the ESRF beam line ID10A, together with new structure determinations at intermediate temperatures. The data rule out the hypothesis of a conventional structural phase transition. No change in the space group symmetry is observed and an anomalous decrease of the ?c? lattice parameter by discrete steps is shown when heating the crystal from 10 K to room temperature. This effect could be ascribed to a progressive conformational change of the NH3 group of the zwitterionic molecule. The analysis of the physical properties of crystalline L Alanine suggests the existence of a strong dynamic Jahn Teller like effect due to the NH3 charge lattice coupling. This would explain both the splitting of some vibrational states and the properties related to a microscopic lattice instability like the depolarization onset of transmitted light below 250 K

“Social dangerousness and incurability in schizophrenia”: Results of an educational intervention for medical and psychology students

This study explored the influence of an educational intervention addressing common prejudices and scientific evidence about schizophrenia on medical and psychology students’ views of this disorder. The intervention - consisting in two three-hour lessons with an interval of a week between - was run at first for medical students and then for psychology students. Participants’ views of schizophrenia were assessed at baseline vs. at post intervention by matched questionnaires. At medical school, participation was voluntary and also included a six-month online re-assessment, while at psychology school, participation was mandatory. A total of 211 students attended the educational initiative. At post intervention assessment, students more frequently mentioned psychosocial causes of schizophrenia, and more firmly believed that recovery in schizophrenia is possible and that persons with this disorder are not unpredictable and dangerous vs. their baseline assessment. The online six-month assessment confirmed favourable changes in medical students’ views found at post intervention. These results confirm that an educational intervention including personal experiences and scientific evidence can be successful in reducing students’ prejudices toward persons with schizophrenia

Micro-transitions or breathers in L-alanine?

The lattice dynamics of crystalline L-alanine shows unusual features tentatively assigned to a localization of vibrational energy. However, other properties alternatively suggest the existence of a second order phase transition undetected in previous crystallographic work. In this paper, we present the results of a high resolution X-ray diffraction study down to 10 K, together with new structure determinations at intermediate temperatures. The data rule out the hypothesis of a conventional structural phase transition. No change in the space group symmetry is observed and an anomalous decrease of the lattice parameter c in discrete steps is discovered when heating the crystal from 10 K to room temperature. It could be ascribed to a progressive conformational change of the NH$_{3}^{+}$ group of the zwitterionic molecule. An analysis of the physical properties of crystalline L-alanine suggests the existence of a strong dynamic Jahn-Teller-like effect owing to the NH$_{3}^{+}$ charge-lattice coupling. This would explain both the splitting of some vibrational states and properties related to a microscopic lattice instability like the onset of depolarization in the transmitted light below ~250 K

Contrarrestar el estigma hacia las personas con esquizofrenia en el ámbito sanitario: una experiencia piloto en una muestra de estudiantes italianos de medicina

The article is based of the concern about the negative effects, found in many international publications, that stigma has on the quality of care that people with schizophrenia receive in the field of health services, in connection with their physical health, often deteriorated. As a result of the lack of knowledge about the causes and characteristics of this disease and the misconceptions that many professionals share with the general population about the dangerousness and lack of recovery of the people affected by this disorder, they are usually subject of lack of respect and poor care into general health services.Very important to improve the information and correct erroneous attitudes is the period of training of professionals and in this regard are presented the first results of a pilot project, developed between students of Medicine of an Italian University, consisting in a brief course on stigma and schizophrenia. Although the results must be confirmed by other studies, they noted the evident positive changes occurring in the knowledge and attitudes of students with a brief educational intervention, associated with the participation of users, also confirming other international studies

Fully automated synthesis of peptide-oligonucleotide conjugates

An efficient synthetic strategy for the on-line preparation of oligonucleotide-peptide conjugates is here presented

high Prevalence of Primary Antibiotic Resistance in Helicobacter pylori Isolates in Italy

Abstract Background & Aims: H. pylori eradication with standard therapies is decreasing worldwide, mainly because of increased primary antibiotic resistance rates. We aimed to assess primary resistance in H. pylori isolates towards the most used antibiotics in clinical practice. methods: The study enrolled consecutive, dyspeptic, adult patients, never treated for H. pylori, who had underwent upper endoscopy. Gastric biopsies were taken for standard histology, and two further antral biopsies were used for H. pylori culture. Minimal inhibitory concentrations (MIC) 651, 658 and 651 mg/L were used as break point for clarithromycin, metronidazole, and levofloxacin resistance, respectively. Results: Bacterial culture was successful in 145 (94%) out of 154 infected patients. Resistance towards at least one antibiotic was detected in 111 (76.6%) isolated, and multiple antibiotic resistance in 35.2% of cases. Primary resistance towards clarithromycin, metronidazole, and levofloxacin was detected in 51 (35.2%), 86 (59.3%), and in 32 isolated (22.1%), respectively. Levofloxacin resistance was significantly associated with the male sex (OR: 11.3, 95% CI = 1.2-103; P = 0.03), whilst females were at a higher risk of being infected with bacterial strains harbouring a double clarithromycin and metronidazole resistance (OR: 4.9, 95% CI = 1.2-19.8, P = 0.02). Conclusion: Our data indicate a very high primary resistance rate towards the most used antibiotics in H. pylori isolates. The efficacy of standard eradication therapies is expected to further decreas