Global and Regional Ventricular Repolarization Study by Body Surface Potential Mapping in Patients with Left Bundle-Branch Block and Heart Failure Undergoing Cardiac Resynchronization Therapy

Background: The controversial effects promoted by cardiac resynchronization therapy (CRT) on the ventricular repolarization (VR) have motivated VR evaluation by body surface potential mapping (BSPM) in CRT patients. Methods: Fifty-two CRT patients, mean age 58.8 +/- 12.3 years, 31 male, LVEF 27.5 +/- 9.2, NYHA III-IV heart failure with QRS181.5 +/- 14.2 ms, underwent 87-lead BSPM in sinus rhythm (BASELINE) and biventricular pacing (BIV). Measurements of mean and corrected QT intervals and dispersion, mean and corrected T peak end intervals and their dispersion, and JT intervals characterized global and regional (RV, Intermediate, and LV regions) ventricular repolarization response. Results: Global QTm (P < 0.001) and QTcm (P < 0.05) were decreased in BIV; QTm was similar across regions in both modes (P = ns); QTcm values were lower in RV/LV than in Intermediate region in BASELINE and BIV (P < 0.001); only RV/Septum showed a significant difference (P < 0.01) in the BIV mode. QTD values both of BASELINE (P < 0.01) and BIV (P < 0.001) were greater in the Intermediate than in the LV region. CRT effect significantly reduced global/regional QTm and QTcm values. QTD was globally decreased in RV/LV (Intermediate: P = ns). BIV mode significantly reduced global T peak end mean and corrected intervals and their dispersion. JT values were not significant. Conclusions: Ventricular repolarization parameters QTm, QTcm, and QTD global/regional values, as assessed by BSPM, were reduced in patients under CRT with severe HF and LBBB. Greater recovery impairment in the Intermediate region was detected by the smaller variation of its dispersion.

Natural Membranes for Application in Biomedical Devices

Polymers from natural sources are particularly useful as biomaterials for medical devices applications. In this study, the results of characterization of a gelatin network electrolyte doped with europium triflate (Eu(CF3SO3)(3)) are described. The unusual electronic properties of the trivalent lanthanide ions make them well suited as luminescent reporter groups, with many applications in biotechnology. Samples of solvent-free electrolytes were prepared with a range of guest salt concentration. Materials based on Eu(CF3SO3)(3) were obtained as mechanically robust, flexible, transparent, and completely amorphous films. Samples were characterized by thermal analysis (thermo-gravimetry analysis (TGA) and differential scanning calorimetry (DSC), electrochemical stability, scanning electronmicroscopy (SEM), and photoluminescence spectroscopy.

Enhancement of Electrical Conductivity in Plasticized Chitosan Based Membranes

Plasticized natural macromolecules-based polymer electrolyte samples were prepared and characterized. The plasticization of chitosonium acetate with glycerol increased the ionic conductivity value from 3.0 x 10(-7) S/cm to 1.1 x 10(-5) S/cm. The conductivity temperature relationship of the samples exhibits either VTF or Arrhenius type depending on the glycerol concentration in the sample. The dielectric studies evidencing the relaxation process in the plasticized sample at low frequency region are due to the electric polarization effect. Moreover, the samples were transparent in the Vis region, showed thermal stability up to 160 degrees C and good surface uniformity.

Sodium Alginate-Based Ionic Conducting Membranes

The present study investigates gel polymer electrolytes (GPEs) based on sodium alginate plasticized with glycerol containing either CH3COOH or LiClO4. The membranes showed ionic conductivity results of 3.1 x 10(-4) S/cm for the samples with LiClO4 and 8.7x10(-5) S/cm for the samples with CH3COOH at room temperature. The samples also showed thermal stability up to 160 degrees C, transparency of up to 90%, surface uniformity and adhesion to glass and steel. Moreover, Dynamic Mechanical Analysis revealed two relaxations for both samples and the Ea values were between 18 and 36 kJ/mol. All the results obtained indicate that alginate-based GPEs can be used as electrolytes in electrochemical devices.

An electrochemical gas sensor based on paper supported room temperature ionic liquids

A sensitive and fast-responding membrane-free amperometric gas sensor is described, consisting of a small filter paper foil soaked with a room temperature ionic liquid (RTIL), upon which three electrodes are screen printed with carbon ink, using a suitable mask. It takes advantage of the high electrical conductivity and negligible vapour pressure of RTILs as well as their easy immobilization into a porous and inexpensive supporting material such as paper. Moreover, thanks to a careful control of the preparation procedure, a very close contact between the RTIL and electrode material can be achieved so as to allow gaseous analytes to undergo charge transfer just as soon as they reach the three-phase sites where the electrode material, paper supported RTIL and gas phase meet. Thus, the adverse effect on recorded currents of slow steps such as analyte diffusion and dissolution in a solvent is avoided. To evaluate the performance of this device, it was used as a wall-jet amperometric detector for flow injection analysis of 1-butanethiol vapours, adopted as the model gaseous analyte, present in headspace samples in equilibrium with aqueous solutions at controlled concentrations. With this purpose, the RTIL soaked paper electrochemical detector (RTIL-PED) was assembled by using 1-butyl-3-methylimidazolium bis(trifluoromethanesulfonyl) imide as the wicking RTIL and printing the working electrode with carbon ink doped with cobalt(II) phthalocyanine, to profit from its ability to electrocatalyze thiol oxidation. The results obtained were quite satisfactory (detection limit: 0.5 mu M; dynamic range: 2-200 mu M, both referring to solution concentrations; correlation coefficient: 0.998; repeatability: +/- 7% RSD; long-term stability: 9%), thus suggesting the possible use of this device for manifold applications.

Gellan Gum-LiI Gel Polymer Electrolytes

Gellan-based polymer electrolytes (PEs), doped with lithium iodide (LiI), were prepared and their electrical properties were characterized. The samples are thermally stable up to 234 degrees C and exhibit ionic conductivity of 3.8 x 10(-4) S/cm at room temperature for the sample doped with 40 wt% of LiI. Addition of 10 wt% of glycerol promotes an increase of the ionic conductivity to 1.5 x 10(-3) S/cm, which remains stable up to 100 degrees C. The activation energies of 2.4 to 12.4 kJ/mol were derived from the Arrhenius model. The repeated ionic conductivity measurements as a function of temperature show that these membranes can be reversibly used between the room temperature and 100 degrees C.

Ion-Conducting Membranes Based on Gelatin and Containing LiI/I-2 for Electrochromic Devices

Ionic conducting membranes of gelatin plasticized with glycerol and containing LiI/I-2 have been obtained and characterized by X-ray diffraction measurements, UV-Vis-NIR spectroscopy, thermal analysis and impedance spectroscopy. The transparent (80-90% in the visible range) membranes showed ionic conductivity value of 5 x 10(-5) S/cm at room temperature, which increased to 3 x 10(-3) S/cm at 80 degrees C. All the ionic conductivity measurements as a function of temperature showed VTF dependence and activation energy of 8 kJ/mol. These samples also showed low glass transition temperature of -76 degrees C. Moreover the samples were predominantly amorphous. The membranes applied to small electrochromic devices showed 20% of color change from colored to bleached states during more than 70 cronoamperometric cycles.

Il gruppo dei punti razionali sulle curve ellittiche

Il primo capitolo espone nozioni generali sulle varietà e sulle curve algebriche, sulle mappe fra di esse e su alcune proprietà geometriche importanti per caratterizzare le curve ellittiche. Il secondo capitolo propone un'introduzione allo studio geometrico e algebrico di tali curve. Il terzo e il quarto capitolo affrontano lo studio dei punti a coordinate razionali, per curve definite prima su campi locali e poi su campi globali: l'insieme di tali punti è un gruppo. Il risultato fondamentale, contenuto nel teorema di Mordell-Weil, è che tale gruppo è finitamente generato. Tutto il quarto capitolo propone i risultati necessari per la dimostrazione di tale affermazione.

Teorie e immagini del governo "misto" nel Cinquecento: i casi di Gasparo Contarini, Donato Giannotti, Paolo Paruta e Traiano Boccalini

This doctoral dissertation faces the debated topic of the traditions of Republicanism in the Modern Age assuming, as a point of view, the problem of the "mixed" government. The research therefore dwells upon the use of this model in Sixteenth-Century Italy, also in connection with the historical events of two standard Republics such as Florence and Venice. The work focuses on Donato Giannotti (1492-1573), Gasparo Contarini (1483-1542) and Paolo Paruta (1540-1598), as the main figures in order to reconstruct the debate on "mixed" constitution: in them, decisive in the attention paid to the peculiar structure of the Venetian Republic, the only of a certain dimension and power to survive after 1530. The research takes into account also the writings of Traiano Boccalini (1556-1613): he himself, though being involved in the same topics of debate, sets for some aspects his considerations in the framework of a new theme, that of Reason of State.

I sensi spirituali nel Liber di Angela da Foligno. La metafora del "gusto" nel Liber di Angela da Foligno e nella mistica femminile francescana tra XIII e XIV secolo.

Angela da Foligno’s Liber is a fundamental text for the scholar of Women Mystics between the XIIIth and the XIVth century in Italy and all over Europe, and it has been chosen in my research because of its originality, with refer of its feminine and franciscan essence. Angela teaches to the italian hagiographic tradition the internal point of view of the holy woman, who becomes the teller of her both ordinary and extraordinary experiences. After giving references about the religious and social historical universe in evolution during the XIIth century, my research proceeds with a linguistic and rhetorical analysis based upon the Liber. I have been searching in Angela’s text and in contemporary italian feminine hagiography the sensory metaphor of “tasting”. That kind of metaphor has an ancient memory and, thanks to the Origene’s studies - the Christian Father of the IIIrd century - we can easily recognize it already in the Bible; Origene identifies the sensory metaphor as a rhetoric system, able to exemplify the God learning process of soul. Theory of “spiritual senses”, theory of vision and rhetoric, evolving from the IIIrd to the XIIIth century, are the theological and linguistic heritage of our feminine and franciscan literature. Inside of that, the metaphor of “tasting” moves and changes, therefore becoming the favourite way of mystics to represent the contact of their souls with God.

Alle origini del «romanzo giudiziario» italiano: la figura del delinquente tra letteratura, diritto e scienze mediche

In questo lavoro si conduce un’indagine sulle relazioni tra letteratura, diritto e scienze mediche all’interno del romanzo cosiddetto "giudiziario", sviluppatosi in Italia nel periodo compreso tra l’Unità e i primi anni del XX secolo. La nostra analisi si concentra in particolare sulla costruzione della figura del delinquente, intesa come prodotto specifico della suddetta relazione interdisciplinare. In questa prospettiva, abbiamo rilevato che la caratterizzazione di tale figura costituisce il principale tra i procedimenti narrativi osservabili in vari romanzi del periodo postunitario. Concentrandoci inoltre sulla definizione del genere, abbiamo affrontato l’ormai annoso dibattito sulla nascita (quando non sull’esistenza stessa) del poliziesco italiano, dimostrando come solo all’interno di una stretta relazione tra letteratura, diritto e scienze mediche sia possibile cogliere a pieno il valore di questi romanzi nel processo di costruzione dell’identità nazionale. Il lavoro è diviso in due parti. Nella prima, di carattere storico, si propone una nuova definizione del genere "giudiziario", dopo aver vagliato e discusso le ipotesi sino ad ora avanzate dalla critica. Nella seconda parte si affrontano due casi di studio esemplari: La colonia felice di Carlo Dossi e Il romanzo di Misdea di Edoardo Scarfoglio. Su ognuno di essi abbiamo condotto un’accurata analisi testuale, che ci ha permesso di esaminare la caratterizzazione delle diverse figure delinquenti dimostrando l’efficacia del metodo interdisciplinare adottato con particolare riguardo alle teorie di Cesare Lombroso.

Benign neonatal sleep myoclonus: a review of the literature

OBJECTIVE: Neurologically normal term infants sometimes present with repetitive, rhythmic myoclonic jerks that occur during sleep. The condition, which is traditionally resolved by 3 months of age with no sequelae, is termed benign neonatal sleep myoclonus. The goal of this review was to synthesize the published literature on benign neonatal sleep myoclonus. METHODS: The US National Library of Medicine database and the Web-based search engine Google, through June 2009, were used as data sources. All articles published after the seminal description in 1982 as full-length articles or letters were collected. Reports that were published in languages other than English, French, German, Italian, Portuguese, or Spanish were not considered. RESULTS: We included 24 reports in which 164 term-born (96%) or near-term-born (4%) infants were described. Neonatal sleep myoclonus occurred in all sleep stages, disappeared after arousal, and was induced by rocking the infant or repetitive sound stimuli. Furthermore, in affected infants, jerks stopped or even worsened by holding the limbs or on medication with antiepileptic drugs. Finally, benign neonatal sleep myoclonus did not resolve by 3 months of age in one-third of the infants. CONCLUSIONS: This review provides new insights into the clinical features and natural course of benign neonatal sleep myoclonus. The most significant limitation of the review comes from the small number of reported cases.

New insights in the pathogenesis of high-altitude pulmonary edema

High-altitude pulmonary edema is a life-threatening condition occurring in predisposed but otherwise healthy individuals. It therefore permits the study of underlying mechanisms of pulmonary edema in the absence of confounding factors such as coexisting cardiovascular or pulmonary disease, and/or drug therapy. There is evidence that some degree of asymptomatic alveolar fluid accumulation may represent a normal phenomenon in healthy humans shortly after arrival at high altitude. Two fundamental mechanisms then determine whether this fluid accumulation is cleared or whether it progresses to HAPE: the quantity of liquid escaping from the pulmonary vasculature and the rate of its clearance by the alveolar respiratory epithelium. The former is directly related to the degree of hypoxia-induced pulmonary hypertension, whereas the latter is determined by the alveolar epithelial sodium transport. Here, we will review evidence that, in HAPE-prone subjects, impaired pulmonary endothelial and epithelial NO synthesis and/or bioavailability may represent a central underlying defect predisposing to exaggerated hypoxic pulmonary vasoconstriction and, in turn, capillary stress failure and alveolar fluid flooding. We will then demonstrate that exaggerated pulmonary hypertension, although possibly a conditio sine qua non, may not always be sufficient to induce HAPE and how defective alveolar fluid clearance may represent a second important pathogenic mechanism.

Measurement issues in trials of pediatric acute diarrheal diseases: a systematic review

BACKGROUND: Worldwide, diarrheal diseases rank second among conditions that afflict children. Despite the disease burden, there is limited consensus on how to define and measure pediatric acute diarrhea in trials. OBJECTIVES: In RCTs of children involving acute diarrhea as the primary outcome, we documented (1) how acute diarrhea and its resolution were defined, (2) all primary outcomes, (3) the psychometric properties of instruments used to measure acute diarrhea and (4) the methodologic quality of included trials, as reported. METHODS: We searched CENTRAL, Embase, Global Health, and Medline from inception to February 2009. English-language RCTs of children younger than 19 years that measured acute diarrhea as a primary outcome were chosen. RESULTS: We identified 138 RCTs reporting on 1 or more primary outcomes related to pediatric acute diarrhea/diseases. Included trials used 64 unique definitions of diarrhea, 69 unique definitions of diarrhea resolution, and 46 unique primary outcomes. The majority of included trials evaluated short-term clinical disease activity (incidence and duration of diarrhea), laboratory outcomes, or a composite of these end points. Thirty-two trials used instruments (eg, single and multidomain scoring systems) to support assessment of disease activity. Of these, 3 trials stated that their instrument was valid; however, none of the trials (or their citations) reported evidence of this validity. The overall methodologic quality of included trials was good. CONCLUSIONS: Even in what would be considered methodologically sound clinical trials, definitions of diarrhea, primary outcomes, and instruments employed in RCTs of pediatric acute diarrhea are heterogeneous, lack evidence of validity, and focus on indices that may not be important to participants.