Marinetti ultimo mitografo

La ricognizione delle opere composte da Filippo Tommaso Marinetti tra il 1909 e il 1912 è sostenuta da una tesi paradossale: il futurismo di Marinetti non sarebbe un'espressione della modernità, bensì una reazione anti-moderna, che dietro a una superficiale ed entusiastica adesione ad alcune parole d'ordine della seconda rivoluzione industriale nasconderebbe un pessimismo di fondo nei confronti dell'uomo e della storia. In questo senso il futurismo diventa un emblema del ritardo culturale e del gattopardismo italiano, e anticipa l’analoga operazione svolta in politica da Mussolini: dietro un’adesione formale ad alcune istanze della modernità, la preservazione dello Status Quo. Marinetti è descritto come un corpo estraneo rispetto alla cultura scientifica del Novecento: un futurista senza futuro (rarissime in Marinetti sono le proiezioni fantascientifiche). Questo aspetto è particolarmente evidente nelle opere prodotte del triennio 1908-1911, che non solo sono molto diverse dalle opere futuriste successive, ma per alcuni aspetti rappresentano una vera e propria antitesi di ciò che diventerà il futurismo letterario a partire dal 1912, con la pubblicazione del Manifesto tecnico della letteratura futurista e l'invenzione delle parole in libertà. Nelle opere precedenti, a un sostanziale disinteresse per il progressismo tecnologico corrispondeva un'attenzione ossessiva per la corporeità e un ricorso continuo all'allegoria, con effetti particolarmente grotteschi (soprattutto nel romanzo Mafarka le futuriste) nei quali si rilevano tracce di una concezione del mondo di sapore ancora medioevo-rinascimentale. Questa componente regressiva del futurismo marinettiano viene platealmente abbandonata a partire dal 1912, con Zang Tumb Tumb, salvo riaffiorare ciclicamente, come una corrente sotterranea, in altre fasi della sua carriera: nel 1922, ad esempio, con la pubblicazione de Gli indomabili (un’altra opera allegorica, ricca di reminiscenze letterarie). Quella del 1912 è una vera e propria frattura, che nel primo capitolo è indagata sia da un punto di vista storico (attraverso la documentazione epistolare e giornalistica vengono portate alla luce le tensioni che portarono gran parte dei poeti futuristi ad abbandonare il movimento proprio in quell'anno) che da un punto di vista linguistico: sono sottolineate le differenze sostanziali tra la produzione parolibera e quella precedente, e si arrischia anche una spiegazione psicologica della brusca svolta impressa da Marinetti al suo movimento. Nel secondo capitolo viene proposta un'analisi formale e contenutistica della ‘funzione grottesca’ nelle opere di Marinetti. Nel terzo capitolo un'analisi comparata delle incarnazioni della macchine ritratte nelle opere di Marinetti ci svela che quasi sempre in questo autore la macchina è associata al pensiero della morte e a una pulsione masochistica (dominante, quest'ultima, ne Gli indomabili); il che porta ad arrischiare l'ipotesi che l'esperienza futurista, e in particolare il futurismo parolibero posteriore al 1912, sia la rielaborazione di un trauma. Esso può essere interpretato metaforicamente come lo choc del giovane Marinetti, balzato in pochi anni dalle sabbie d'Alessandria d'Egitto alle brume industriali di Milano, ma anche come una reale esperienza traumatica (l'incidente automobilistico del 1908, “mitologizzato” nel primo manifesto, ma che in realtà fu vissuto dall'autore come esperienza realmente perturbante).

Troposphere Calibration Techniques for Deep Space Probe Tracking

Ground-based Earth troposphere calibration systems play an important role in planetary exploration, especially to carry out radio science experiments aimed at the estimation of planetary gravity fields. In these experiments, the main observable is the spacecraft (S/C) range rate, measured from the Doppler shift of an electromagnetic wave transmitted from ground, received by the spacecraft and coherently retransmitted back to ground. If the solar corona and interplanetary plasma noise is already removed from Doppler data, the Earth troposphere remains one of the main error sources in tracking observables. Current Earth media calibration systems at NASA’s Deep Space Network (DSN) stations are based upon a combination of weather data and multidirectional, dual frequency GPS measurements acquired at each station complex. In order to support Cassini’s cruise radio science experiments, a new generation of media calibration systems were developed, driven by the need to achieve the goal of an end-to-end Allan deviation of the radio link in the order of 3×〖10〗^(-15) at 1000 s integration time. The future ESA’s Bepi Colombo mission to Mercury carries scientific instrumentation for radio science experiments (a Ka-band transponder and a three-axis accelerometer) which, in combination with the S/C telecommunication system (a X/X/Ka transponder) will provide the most advanced tracking system ever flown on an interplanetary probe. Current error budget for MORE (Mercury Orbiter Radioscience Experiment) allows the residual uncalibrated troposphere to contribute with a value of 8×〖10〗^(-15) to the two-way Allan deviation at 1000 s integration time. The current standard ESA/ESTRACK calibration system is based on a combination of surface meteorological measurements and mathematical algorithms, capable to reconstruct the Earth troposphere path delay, leaving an uncalibrated component of about 1-2% of the total delay. In order to satisfy the stringent MORE requirements, the short time-scale variations of the Earth troposphere water vapor content must be calibrated at ESA deep space antennas (DSA) with more precise and stable instruments (microwave radiometers). In parallel to this high performance instruments, ESA ground stations should be upgraded to media calibration systems at least capable to calibrate both troposphere path delay components (dry and wet) at sub-centimetre level, in order to reduce S/C navigation uncertainties. The natural choice is to provide a continuous troposphere calibration by processing GNSS data acquired at each complex by dual frequency receivers already installed for station location purposes. The work presented here outlines the troposphere calibration technique to support both Deep Space probe navigation and radio science experiments. After an introduction to deep space tracking techniques, observables and error sources, in Chapter 2 the troposphere path delay is widely investigated, reporting the estimation techniques and the state of the art of the ESA and NASA troposphere calibrations. Chapter 3 deals with an analysis of the status and the performances of the NASA Advanced Media Calibration (AMC) system referred to the Cassini data analysis. Chapter 4 describes the current release of a developed GNSS software (S/W) to estimate the troposphere calibration to be used for ESA S/C navigation purposes. During the development phase of the S/W a test campaign has been undertaken in order to evaluate the S/W performances. A description of the campaign and the main results are reported in Chapter 5. Chapter 6 presents a preliminary analysis of microwave radiometers to be used to support radio science experiments. The analysis has been carried out considering radiometric measurements of the ESA/ESTEC instruments installed in Cabauw (NL) and compared with the requirements of MORE. Finally, Chapter 7 summarizes the results obtained and defines some key technical aspects to be evaluated and taken into account for the development phase of future instrumentation.

Central autonomic control in spontaneously hypertensive rats: a study on phasic phenomena during rapid-eye-movement sleep

The cardiovascular regulation undergoes wide changes in the different states of sleepwake cycle. In particular, the relationship between spontaneous fluctuations in heart period and arterial pressure clearly shows differences between the two sleep states. In non rapid-eye-movement sleep, heart rhythm is under prevalent baroreflex control, whereas in rapid-eye-movement sleep central autonomic commands prevail (Zoccoli et al., 2001). Moreover, during rapid-eye-movement sleep the cardiovascular variables show wide fluctuations around their mean value. In particular, during rapid-eyemovement sleep, the arterial pressure shows phasic hypertensive events which are superimposed upon the tonic level of arterial pressure. These phasic increases in arterial pressure are accompanied by an increase in heart rate (Sei & Morita, 1996; Silvani et al., 2005). Thus, rapid-eye-movement sleep may represent an “autonomic stress test” for the cardiovascular system, able to unmask pathological patterns of cardiovascular regulation (Verrier et al. 2005), but this hypothesis has never been tested experimentally. The aim of this study was to investigate whether rapid-eye-movement sleep may reveal derangements in central autonomic cardiovascular control in an experimental model of essential hypertension. The study was performed in Spontaneously Hypertensive Rats, which represent the most widely used model of essential hypertension, and allow full control of genetic and environmental confounding factors. In particular, we analyzed the cardiovascular, electroencephalogram, and electromyogram changes associated with phasic hypertensive events during rapid-eyemovement sleep in Spontaneously Hypertensive Rats and in their genetic Wistar Kyoto control strain. Moreover, we studied also a group of Spontaneously Hypertensive Rats made phenotypically normotensive by means of a chronic treatment with an angiotensin converting enzyme inhibitor, the Enalapril maleate, from the age of four weeks to the end of the experiment. All rats were implanted with electrodes for electroencephalographic and electromyographic recordings and with an arterial catheter for arterial pressure measurement. After six days for postoperative recovery, the rats were studied for five days, at an age of ten weeks.The study indicated that the peak of mean arterial pressure increase during the phasic hypertensive events in rapid-eye-movement sleep did not differ significantly between Spontaneously Hypertensive Rats and Wistar Kyoto rats, while on the other hand Spontaneously Hypertensive Rats showed a reduced increase in the frequency of theta rhythm and a reduced tachicardia with respect to Wistar Kyoto rats. The same pattern of changes in mean arterial pressure, heart period, and theta frequency was observed between Spontaneously Hypertensive Rats and Spontaneously Hypertensive Rats treated with Enalapril maleate. Spontaneously Hypertensive Rats do not differ from Wistar Kyoto rats only in terms of arterial hypertension, but also due to multiple unknown genetic differences. Spontaneously Hypertensive Rats were developed by selective breeding of Wistar Kyoto rats based only on the level of arterial pressure. However, in this process, multiple genes possibly unrelated to hypertension may have been selected together with the genetic determinants of hypertension (Carley et al., 2000). This study indicated that Spontaneously Hypertensive Rats differ from Wistar Kyoto rats, but not from Spontaneously Hypertensive Rats treated with Enalapril maleate, in terms of arterial pH and theta frequency. This feature may be due to genetic determinants unrelated to hypertension. In sharp contrast, the persistence of differences in the peak of heart period decrease and the peak of theta frequency increase during phasic hypertensive events between Spontaneously Hypertensive Rats and Spontaneously Hypertensive Rats treated with Enalapril maleate demonstrates that the observed reduction in central autonomic control of the cardiovascular system in Spontaneously Hypertensive Rats is not an irreversible consequence of inherited genetic determinants. Rather, the comparison between Spontaneously Hypertensive Rats and Spontaneously Hypertensive Rats treated with Enalapril maleate indicates that the observed differences in central autonomic control are the result of the hypertension per se. This work supports the view that the study of cardiovascular regulation in sleep provides fundamental insight on the pathophysiology of hypertension, and may thus contribute to the understanding of this disease, which is a major health problem in European countries (Wolf-Maier et al., 2003) with its burden of cardiac, vascular, and renal complications.

Identification of Drosophila heart-specific Cis-Regulatory Modules under Hox control

Cardiac morphogenesis is a complex process governed by evolutionarily conserved transcription factors and signaling molecules. The Drosophila cardiac tube is linear, made of 52 pairs of cardiomyocytes (CMs), which express specific transcription factor genes that have human homologues implicated in Congenital Heart Diseases (CHDs) (NKX2-5, GATA4 and TBX5). The Drosophila cardiac tube is linear and composed of a rostral portion named aorta and a caudal one called heart, distinguished by morphological and functional differences controlled by Hox genes, key regulators of axial patterning. Overexpression and inactivation of the Hox gene abdominal-A (abd-A), which is expressed exclusively in the heart, revealed that abd-A controls heart identity. The aim of our work is to isolate the heart-specific cisregulatory sequences of abd-A direct target genes, the realizator genes granting heart identity. In each segment of the heart, four pairs of cardiomyocytes (CMs) express tinman (tin), homologous to NKX2-5, and acquire strong contractile and automatic rhythmic activities. By tyramide amplified FISH, we found that seven genes, encoding ion channels, pumps or transporters, are specifically expressed in the Tin-CMs of the heart. We initially used online available tools to identify their heart-specific cisregutatory modules by looking for Conserved Non-coding Sequences containing clusters of binding sites for various cardiac transcription factors, including Hox proteins. Based on these data we generated several reporter gene constructs and transgenic embryos, but none of them showed reporter gene expression in the heart. In order to identify additional abd-A target genes, we performed microarray experiments comparing the transcriptomes of aorta versus heart and identified 144 genes overexpressed in the heart. In order to find the heart-specific cis-regulatory regions of these target genes we developed a new bioinformatic approach where prediction is based on pattern matching and ordered statistics. We first retrieved Conserved Noncoding Sequences from the alignment between the D.melanogaster and D.pseudobscura genomes. We scored for combinations of conserved occurrences of ABD-A, ABD-B, TIN, PNR, dMEF2, MADS box, T-box and E-box sites and we ranked these results based on two independent strategies. On one hand we ranked the putative cis-regulatory sequences according to best scored ABD-A biding sites, on the other hand we scored according to conservation of binding sites. We integrated and ranked again the two lists obtained independently to produce a final rank. We generated nGFP reporter construct flies for in vivo validation. We identified three 1kblong heart-specific enhancers. By in vivo and in vitro experiments we are determining whether they are direct abd-A targets, demonstrating the role of a Hox gene in the realization of heart identity. The identified abd-A direct target genes may be targets also of the NKX2-5, GATA4 and/or TBX5 homologues tin, pannier and Doc genes, respectively. The identification of sequences coregulated by a Hox protein and the homologues of transcription factors causing CHDs, will provide a mean to test whether these factors function as Hox cofactors granting cardiac specificity to Hox proteins, increasing our knowledge on the molecular mechanisms underlying CHDs. Finally, it may be investigated whether these Hox targets are involved in CHDs.

Studio e validazione di una nuova metodica per la valutazione dello stato di forma

We observed 82 healthy subjects, from both sexes, aged between 19 and 77 years. All subjects performed two different tests: for being scientifically acknowledged, the first one was used as a reference and it was a stress test (CPX). During the entire test, heart rate and gas exchange were recorded continuously; the second, the actual object of this study, was a submaximal test (TOP). Only heart rate was recorded continuously. The main purpose was to determinate an index of physical fitness as result of TOP. CPX test allowed us to individuate anaerobic threshold. We used an incremental protocol of 10/20 Watt/min, different by age. For our TOP test we used an RHC400 UPRIGHT BIKE, by Air Machine. Each subject was monitored for heart frequency. After 2 minutes of resting period there was a first step: 3 minutes of pedalling at a constant rate of 60 RPM, (40 watts for elder subjects and 60 watts for the younger ones). Then, the subject was allowed to rest for a recovery phase of 5 minutes. Third and last step consisted of 3 minutes of pedalling again at 60 RPM but now set to 60 watts for elder subjects and 80 watts for the young subjects. Finally another five minutes of recovery. A good correlation was found between TOP and CPX results especially between punctua l heart rate reserve (HRR’) and anaerobic threshold parameters such as Watt, VO2, VCO2 . HRR’ was obtained by subtracting maximal heart rate during TOP from maximal theoretic heart rate (206,9-(0,67*age)). Data were analyzed through cluster analysis in order to obtain 3 homogeneous groups. The first group contains the least fit subjects (inactive, women, elderly). The other groups contain the “average fit” and the fittest subjects (active, men, younger). Concordance between test resulted in 83,23%. Afterwards, a linear combinations of the most relevant variables gave us a formula to classify people in the correct group. The most relevant result is that this submaximal test is able to discriminate subjects with different physical condition and to provide information (index) about physical fitness through HRR’. Compared to a traditional incremental stress test, the very low load of TOP, short duration and extended resting period, make this new method suitable to very different people. To better define the TOP index, it is necessary to enlarge our subject sample especially by diversifying the age range.

Trasduzione del segnale e poliamine nell'apoptosi di cellule cardiache

Introduction: Apoptotic cell death of cardiomyocytes is involved in several cardiovascular diseases including ischemia, hypertrophy and heart failure, thus representing a potential therapeutic target. Apoptosis of cardiac cells can be induced experimentally by several stimuli including hypoxia, serum withdrawal or combination of both. Several lines of research suggest that neurohormonal mechanisms play a central role in the progression of heart failure. In particular, excessive activation of the sympathetic nervous system or the renin-angiotensin-aldosterone system is known to have deleterious effects on the heart. Recent studies report that norepinephrine (NE), the primary transmitter of sympathetic nervous system, and aldosterone (ALD), which is actively produced in failing human heart, are able to induce apoptosis of rat cardiomyocytes. Polyamines are biogenic amines involved in many cellular processes, including apoptosis. Actually it appears that these molecules can act as promoting, modulating or protective agents in apoptosis depending on apoptotic stimulus and cellular model. We have studied the involvement of polyamines in the apoptosis of cardiac cells induced in a model of simulated ischemia and following treatment with NE or ALD. Methods: H9c2 cardiomyoblasts were exposed to a condition of simulated ischemia, consisting of hypoxia plus serum deprivation. Cardiomyocyte cultures were prepared from 1-3 day-old neonatal Wistar rat hearts. Polyamine depletion was obtained by culturing the cells in the presence of α-difluoromethylornithine (DFMO). Polyamines were separated and quantified in acidic cellular extracts by HPLC after derivatization with dansyl chloride. Caspase activity was measured by the cleavage of the fluorogenic peptide substrate. Ornithine decarboxylase (ODC) activity was measured by estimation of the release of 14C-CO2 from 14C-ornithine. DNA fragmentation was visualized by the method of terminal transferase-mediated dUTP nick end-labeling (TUNEL), and DNA laddering on agarose gel electophoresis. Cytochrome c was detected by immunoflorescent staining. Activation of signal transduction pathways was investigated by western blotting. Results: The results indicate that simulated ischemia, NE and ALD cause an early induction of the activity of ornithine decarboxylase (ODC), the first enzyme in polyamine biosynthesis, followed by a later increase of caspase activity, a family of proteases that execute the death program and induce cell death. This effect was prevented in the presence of DFMO, an irreversible inhibitor of ODC, thus suggesting that polyamines are involved in the execution of the death program activated by these stimuli. In H9c2 cells DFMO inhibits several molecular events related to apoptosis that follow simulated ischemia, such as the release of cytochrome c from mitochondria, down-regulation of Bcl-xL, and DNA fragmentation. The anti-apoptotic protein survivin is down-regulated after ALD or NE treatement and polyamine depletion obtained by DFMO partially opposes survivin decrease. Moreover, a study of key signal transduction pathways governing cell death and survival, revealed an involvement of AMP activated protein kinase (AMPK) and AKT kinase, in the modulation by polyamines of the response of cardiomyocytes to NE. In fact polyamine depleted cells show an altered pattern of AMPK and AKT activation that may contrast apoptosis and appears to result from a differential effect on the specific phosphatases that dephosphorylate and switch off these signaling proteins. Conclusions: These results indicate that polyamines are involved in the execution of the death program activated in cardiac cells by heart failure-related stimuli, like ischemia, ALD and NE, and suggest that their apoptosis facilitating action is mediated by a network of specific phosphatases and kinases.

"Narrativa di frontiera". Fenomenologia di una forma aperta.

«Fiction of frontier». Phenomenology of an open form/voice. Francesco Giustini’s PhD dissertation fits into a genre of research usually neglected by the literary criticism which nevertheless is arousing much interest in recent years: the relationship between Literature and Space. In this context, the specific issue of his work consists in the category of the Frontier including its several implications for the XX century fiction. The preliminary step, at the beginning of the first section of the dissertation, is a semantic analysis: with precision, Giustini describes the meaning of the word “frontier” here declined in a multiplicity of cultural, political and geographical contexts, starting from the American frontier of the pioneers who headed for the West, to the exotic frontiers of the world, with whose the imperialistic colonization has come into contact; from the semi-uninhabited areas like deserts, highlands and virgin forests, to the ethnic frontiers between Indian and white people in South America, since the internal frontiers of the Countries like those ones between the District and the Capital City, the Centre and the Outskirts. In the next step, Giustini wants to focus on a real “ myth of the frontier”, able to nourish cultural and literary imagination. Indeed, the literature has told and chosen the frontier as the scenery for many stories; especially in the 20th Century it made the frontier a problematic space in the light of events and changes that have transformed the perception of space and our relationship with it. Therefore, the dissertation proposes a critical category, it traces the hallmarks of a specific literary phenomenon defined “ Fiction of the frontier” ,present in many literary traditions during the 20th Century. The term “Fiction” (not “Literature” or “Poetics”) does not define a genre but rather a “procedure”, focusing on a constant issue pointed out from the texts examined in this work : the strong call to the act of narration and to its oral traditions. The “Fiction of the Frontier” is perceived as an approach to the world, a way of watching and feeling the objects, an emotion that is lived and told through the story- a story where the narrator ,through his body and his voice, takes the rule of the witness. The following parts, that have an analytic style, are constructed on the basis of this theoretical and methodological reflection. The second section gives a wide range of examples into we can find the figure and the myth of the frontier through the textual analysis which range over several literary traditions. Starting from monographic chapters (Garcia Marquez, Callado, McCarthy), to the comparative reading of couples of texts (Calvino and Verga Llosa, Buzzati and Coetzee, Arguedas and Rulfo). The selection of texts is introduced so as to underline a particular aspect or a form of the frontier at every reading. This section is articulated into thematic voices which recall some actions that can be taken into the ambiguous and liminal space of the frontier (to communicate, to wait, to “trans-culturate”, to imagine, to live in, to not-live in). In this phenomenology, the frontier comes to the light as a physical and concrete element or as a cultural, imaginary, linguistic, ethnic and existential category. In the end, the third section is centered on a more defined and elaborated analysis of two authors, considered as fundamental for the comprehension of the “Fiction of the frontier”: Joseph Conrad and João Guimarães Rosa. Even if they are very different, being part of unlike literary traditions, these two authors show many connections which are pointed by the comparative analysis. Maybe Conrad is the first author that understand the feeling of the frontier , freeing himself from the adventure romance and from the exotic nineteenthcentury tradition. João Guimarães Rosa, in his turn, is the great narrator of Brazilian and South American frontier, he is the man of sertão and of endless spaces of the Centre of Brazil. His production is strongly linked to that one belonged to the author of Heart of Darkness.

Foetal heart rate recording: analysis and comparison of different methodologies

Monitoring foetal health is a very important task in clinical practice to appropriately plan pregnancy management and delivery. In the third trimester of pregnancy, ultrasound cardiotocography is the most employed diagnostic technique: foetal heart rate and uterine contractions signals are simultaneously recorded and analysed in order to ascertain foetal health. Because ultrasound cardiotocography interpretation still lacks of complete reliability, new parameters and methods of interpretation, or alternative methodologies, are necessary to further support physicians’ decisions. To this aim, in this thesis, foetal phonocardiography and electrocardiography are considered as different techniques. Further, variability of foetal heart rate is thoroughly studied. Frequency components and their modifications can be analysed by applying a time-frequency approach, for a distinct understanding of the spectral components and their change over time related to foetal reactions to internal and external stimuli (such as uterine contractions). Such modifications of the power spectrum can be a sign of autonomic nervous system reactions and therefore represent additional, objective information about foetal reactivity and health. However, some limits of ultrasonic cardiotocography still remain, such as in long-term foetal surveillance, which is often recommendable mainly in risky pregnancies. In these cases, the fully non-invasive acoustic recording, foetal phonocardiography, through maternal abdomen, represents a valuable alternative to the ultrasonic cardiotocography. Unfortunately, the so recorded foetal heart sound signal is heavily loaded by noise, thus the determination of the foetal heart rate raises serious signal processing issues. A new algorithm for foetal heart rate estimation from foetal phonocardiographic recordings is presented in this thesis. Different filtering and enhancement techniques, to enhance the first foetal heart sounds, were applied, so that different signal processing techniques were implemented, evaluated and compared, by identifying the strategy characterized on average by the best results. In particular, phonocardiographic signals were recorded simultaneously to ultrasonic cardiotocographic signals in order to compare the two foetal heart rate series (the one estimated by the developed algorithm and the other provided by cardiotocographic device). The algorithm performances were tested on phonocardiographic signals recorded on pregnant women, showing reliable foetal heart rate signals, very close to the ultrasound cardiotocographic recordings, considered as reference. The algorithm was also tested by using a foetal phonocardiographic recording simulator developed and presented in this research thesis. The target was to provide a software for simulating recordings relative to different foetal conditions and recordings situations and to use it as a test tool for comparing and assessing different foetal heart rate extraction algorithms. Since there are few studies about foetal heart sounds time characteristics and frequency content and the available literature is poor and not rigorous in this area, a data collection pilot study was also conducted with the purpose of specifically characterising both foetal and maternal heart sounds. Finally, in this thesis, the use of foetal phonocardiographic and electrocardiographic methodology and their combination, are presented in order to detect foetal heart rate and other functioning anomalies. The developed methodologies, suitable for longer-term assessment, were able to detect heart beat events correctly, such as first and second heart sounds and QRS waves. The detection of such events provides reliable measures of foetal heart rate, potentially information about measurement of the systolic time intervals and foetus circulatory impedance.

NOVI MAGISTRAT Jože Plečnik, progetti per il centro monumentale di Lubiana

This research work analyzes the theme of the architecture of the city and aims at establishing, by studying the urban project of the new town hall in Ljubljana made by the Slovenian architect Jože Plečnik, the idea that the construction of the city must be carried out through a type of architecture directed at the planning of collective urban spaces. The plan for the new town hall building, drew in three versions – 1932, 1939, and 1940-41 –, is part of a large set of plans concerning the area that Plečnik defines to be the “osrčje” (heart) of Ljubljana, that is, the central area within the castle hill and the distinctive arc of the Ljubljanica River, on the eastern boundary of the old “mesto” (town). Among the Plečnik's projects on urban scale for Ljubljana, the above-mentioned plans, unbuilt and scarcely published, must be considered to be ones of the least known, despite their importance in the professional activity of the architect. The work consists of three parts: the first part describes the background of theories and projects which shaped Plečnik's urban culture, during the years of his education in Vienna and before the beginning of the planning activities this work focuses on; the second part studies the plans for the “heart” of the city; the third part investigates the plan for the new town hall building by means of the graphical reconstruction of the three plan versions made by Plečnik, and it provides insights into the relationships among form, significance and motivation of his work. Since the plans have never been built, the digital tridimensional reconstruction of the building models allowed to show unknown spaces and confirm that Architecture has a particular significance when its goal is the planning of collective urban spaces.

Strategie di personalizzazione della terapia di resincronizzazione cardiaca

Solo il 60% dei candidati alla resincronizzazione cardiaca risponde in termini di rimodellamento ventricolare inverso che è il più forte predittore di riduzione della mortalità e delle ospedalizzazioni. Due cause possibili della mancata risposta sono la programmazione del dispositivo e i limiti dell’ approccio transvenoso. Nel corso degli anni di dottorato ho effettuato tre studi per ridurre il numero di non responder. Il primo studio valuta il ritardo interventricolare. Al fine di ottimizzare le risorse e fornire un reale beneficio per il paziente ho ricercato la presenza di predittori di ritardo interventricolare diverso dal simultaneo, impostato nella programmazione di base. L'unico predittore è risultato essere l’ intervallo QRS> 160 ms, quindi ho proposto una flow chart per ottimizzare solo i pazienti che avranno nella programmazione ottimale un intervallo interventricolare non simultaneo. Il secondo lavoro valuta la fissazione attiva del ventricolo sinistro con stent. I dislocamenti, la soglia alta di stimolazione del miocardio e la stimolazione del nervo frenico sono tre problematiche che limitano la stimolazione biventricolare. Abbiamo analizzato più di 200 angiografie per vedere le condizioni anatomiche predisponenti la dislocazione del catetere. Prospetticamente abbiamo deciso di utilizzare uno stent per fissare attivamente il catetere ventricolare sinistro in tutti i pazienti che presentavano le caratteristiche anatomiche favorenti la dislocazione. Non ci sono più state dislocazioni, c’è stata una migliore risposta in termini di rimodellamento ventricolare inverso e non ci sono state modifiche dei parametri elettrici del catetere. Il terzo lavoro ha valutato sicurezza ed efficacia della stimolazione endoventricolare sinistra. Abbiamo impiantato 26 pazienti giudicati non responder alla terapia di resincronizzazione cardiaca. La procedura è risultata sicura, il rischio di complicanze è simile alla stimolazione biventricolare classica, ed efficace nell’arrestare la disfunzione ventricolare sinistra e / o migliorare gli effetti clinici in un follow-up medio.

La cardiomiopatia aritmogena come causa di scompenso cardiaco e trapianto di cuore

Scopo dello studio: la cardiomiopatia aritmogena (CA) è conosciuta come causa di morte improvvisa, la sua relazione con lo scompenso cardiaco (SC) è stata scarsamente indagata. Scopo dello studio è la definizione della prevalenza e incidenza dello SC, nonché della fisiopatologia e delle basi morfologiche che conducono i pazienti con CA a SC e trapianto di cuore. Metodi: abbiamo analizzato retrospettivamente 64 pazienti con diagnosi di CA e confrontato i dati clinici e strumentali dei pazienti con e senza SC (NYHA III-IV). Abbiamo analizzato i cuori espiantati dei pazienti sottoposti a trapianto presso i centri di Bologna e Padova. Risultati: la prevalenza dello SC alla prima osservazione era del 14% e l’incidenza del 2,3% anno-persona. Sedici pazienti (23%) sono stati sottoposti a trapianto. I pazienti con SC erano più giovani all’esordio dei sintomi (46±16 versus 37±12 anni, p=0.04); il ventricolo destro (VD) era più dilatato e ipocinetico all’ecocardiogramma (RVOT 41±6 versus 37±7 mm, p=0.03; diametro telediastolico VD 38±11 versus 28±8 mm, p=0.0001; frazione di accorciamento 23%±7 versus 32%±11, p= 0.002). Il ventricolo sinistro (VS) era lievemente più dilatato (75±29 ml/m2 versus 60±19, p= 0.0017) e globalmente più ipocinetico (frazione di eiezione = 35%±14 versus 57%±12, p= 0.001). Il profilo emodinamico dei pazienti sottoposti a trapianto era caratterizzato da un basso indice cardiaco (1.8±0.2 l/min/m2) con pressione capillare e polmonare tendenzialmente normale (12±8 mmHg e 26±10 mmHg). L’analisi dettagliata dei 36 cuori dei pazienti trapiantati ha mostrato sostituzione fibro-adiposa transmurale nel VD e aree di fibrosi nel VS. Conclusioni: Nella CA lo SC può essere l’unico sintomo alla presentazione e condurre a trapianto un rilevante sottogruppo di pazienti. Chi sviluppa SC è più giovane, ha un interessamento del VD più severo accanto a un costante interessamento del VS, solo lievemente dilatato e ipocinetico, con sostituzione prevalentemente fibrosa.