From field to fermentation: characterisation and application of non-dairy cultures in dairy foods

This thesis investigates the phenotypic and genotypic diversity of non-dairy L. lactis strains and their application to dairy fermentations. A bank of non-dairy lactococci were isolated from grass, vegetables and the bovine rumen. Subsequent analysis of these L. lactis strains revealed seven strains to possess cremoris genotypes which did not correlate with their observed phenotypes. Multi-locus sequence typing (MLST) and average nucleotide identity (ANI) highlighted the genetic diversity of lactis and cremoris subspecies. The application of these non-dairy lactococci to cheese production was also assessed. In milk, non-dairy strains formed diverse volatile profiles and selected strains were used as adjuncts in a mini Gouda-type cheese system. Sensory analysis showed non-dairy strains to be strongly associated with the development of off-flavours and bitterness. However, microfluidisation appeared to reduce bitterness. A novel bacteriophage, ɸL47, was isolated using the grass isolate L. lactis ssp. cremoris DPC6860 as a host. The phage, a member of the Siphoviridae, possessed a long tail fiber, previously unseen in dairy lactococcal phages. Genome sequencing revealed ɸL47 to be the largest sequenced lactococcal phage to date and owing to the high % similarity with ɸ949, a second member of the 949 group. Finally, to identify and characterise specific genes which may be important in niche adaptation and for applications to dairy fermentations, comparative genome sequence analysis was performed on L. lactis from corn (DPC6853), the bovine rumen (DPC6853) and grass (DPC6860). This study highlights the contribution of niche specialisation to the intra-species diversity of L. lactis and the adaptation of this organism to different environments. In summary this thesis describes the genetic diversity of L. lactis strains from outside the dairy environment and their potential application in dairy fermentations.

Diversity and Stability in Food Webs : Impacts of Non-Equilibrium Dynamics, Topology and Variation

With progressive climate change, the preservation of biodiversity is becoming increasingly important. Only if the gene pool is large enough and requirements of species are diverse, there will be species that can adapt to the changing circumstances. To maintain biodiversity, we must understand the consequences of the various strategies. Mathematical models of population dynamics could provide prognoses. However, a model that would reproduce and explain the mechanisms behind the diversity of species that we observe experimentally and in nature is still needed. A combination of theoretical models with detailed experiments is needed to test biological processes in models and compare predictions with outcomes in reality. In this thesis, several food webs are modeled and analyzed. Among others, models are formulated of laboratory experiments performed in the Zoological Institute of the University of Cologne. Numerical data of the simulations is in good agreement with the real experimental results. Via numerical simulations it can be demonstrated that few assumptions are necessary to reproduce in a model the sustained oscillations of the population size that experiments show. However, analysis indicates that species "thrown together by chance" are not very likely to survive together over long periods. Even larger food nets do not show significantly different outcomes and prove how extraordinary and complicated natural diversity is. In order to produce such a coexistence of randomly selected species—as the experiment does—models require additional information about biological processes or restrictions on the assumptions. Another explanation for the observed coexistence is a slow extinction that takes longer than the observation time. Simulated species survive a comparable period of time before they die out eventually. Interestingly, it can be stated that the same models allow the survival of several species in equilibrium and thus do not follow the so-called competitive exclusion principle. This state of equilibrium is more fragile, however, to changes in nutrient supply than the oscillating coexistence. Overall, the studies show, that having a diverse system means that population numbers are probably oscillating, and on the other hand oscillating population numbers stabilize a food web both against demographic noise as well as against changes of the habitat. Model predictions can certainly not be converted at their face value into policies for real ecosystems. But the stabilizing character of fluctuations should be considered in the regulations of animal populations.

Le principe québécois de l'impartageabilité de la réserve des coopératives non financières: discussion critique autour du maintien ou de la suppression

La réserve générale interdite de partage entre les membres est un avoir obligatoire, impartageable tout au long de l’existence de la coopérative et sujet à la «dévolution désintéressée en cas de liquidation ou de dissolution». Cette réserve fonctionne comme un levier de soutien au développement de la coopérative et du mouvement coopératif dans son ensemble. Le principe de l’impartageabilité de la réserve est l’interdiction faite à toutes les coopératives du Québec de partager la réserve générale entre tous les membres et l’interdiction de la diminuer, notamment par l’attribution d’une ristourne tout au long de l’existence de la coopérative. En effet, l’impartageabilité de la réserve se fonde sur l’idée que la coopérative n’a pas pour but l’accumulation des capitaux afin de les répartir entre les membres, mais il s’agit de la création d’un capital collectif qui bénéficie à tous les adhérents présents et futurs. Si le concept de l’impartageabilité de la réserve interdit donc le partage de la réserve tout au long de l’existence de la coopérative, cette même interdiction prend le nom de la dévolution désintéressée de l’actif net au moment de la disparition de la coopérative. Cette dévolution désintéressée signifie l’interdiction faite à toutes les coopératives non financières de partager le solde de l’actif lors de la disparition (dissolution ou liquidation) de la coopérative à l’exception des coopératives agricoles qui peuvent décider dans ce cas, de distribuer le solde de l’actif aux membres sans qu’on sache les raisons de cette exception. Par ailleurs, l’impartageabilité de la réserve est considérée comme un simple inconvénient juridique pour les membres et a connu quelques réécritures dans les législations sur les coopératives sans qu’on connaisse vraiment les raisons de ces modifications. L’objectif de notre thèse est d’engager une discussion critique autour du questionnement central suivant : au regard du cadre juridique actuel sur les coopératives, le principe de l’impartageabilité de la réserve doit être maintenu comme tel dans la Loi sur les coopératives, ou être tout simplement supprimé, comme dans la société par actions, où il est inexistant sans que cette suppression ne porte atteinte à la notion juridique de la coopérative? Plus précisément, quel est ce cadre juridique et quels sont les motifs qui peuvent plaider en faveur du maintien ou de la suppression du principe de l’impartageabilité de la réserve? Pour répondre à cette question, cette thèse se divise en deux parties. La première partie explore le cadre juridique des coopératives non financières au Québec en comparaison avec certains concepts juridiques issus d’autres législations. Elle étudie les fondements juridiques sous-jacents à l’impartageabilité de la réserve en droit québécois des coopératives non financières. La deuxième partie réalise une discussion critique autour de l’histoire du principe de l’impartageabilité de la réserve (ch. 3), des différents arguments juridiques disponibles (ch. 4) et d’hypothèses articulées autour des effets concrets disponibles (ch. 5). Elle explore ces dimensions au soutien du maintien ou non de l’impartageabilité de la réserve de la législation actuelle sur les coopératives non financières. Bien que la recherche effectuée conduise à une réponse nuancée, l'ensemble des résultats milite plutôt en faveur du maintien du principe de l'impartageabilité de la réserve. Au préalable, l’observation des fondements juridiques des concepts sous-jacents à l’impartageabilité de la réserve en droit québécois des coopératives non financières a permis de comprendre les concepts sous-jacents à ce principe avant de répondre à la question autour de son maintien ou de sa suppression de la législation actuelle sur les coopératives. La discussion réalisée a permis de souligner l’importance d’une réalité de base assez évidente : ce principe permet de préserver la réserve, utile au développement de la coopérative et du mouvement coopératif dans son ensemble. De plus, ce principe de l’impartageabilité de la réserve s’inscrit dans le cadre de la vocation sociale de la coopérative, qui n’a pas pour but la maximisation du profit pécuniaire. L’impartageabilité de la réserve s’inscrit également dans le cadre de la cohérence du droit québécois des coopératives avec la notion de coopérative telle que définie par le mouvement coopératif québécois et l’ACI tout en répondant aux finalités historiques d’équité entre les générations et de solidarité. Enfin, même si la discussion des arguments tirés des illustrations de données comptables et de quelques entretiens réalisés avec certains membres actifs du mouvement coopératif ne permet pas de mener à toute conclusion ferme, il ressort que l’impartageabilité de la réserve ne freinerait pas la tendance à la hausse des investissements et du chiffre d’affaires des coopératives non financières. Cette interdiction constituerait même un mécanisme d’autofinancement de la coopérative et un symbole de solidarité.

EPA Radon Risk Assessment Table for Smokers and Non-Smokers

This chart gives the long term effects of radon on smokers and non-smokers.

Élaboration d'un plan de gestion des matières résiduelles - Communauté de Long Point First Nation, Winneway

L’objectif de cet essai repose sur l’élaboration d’un plan de gestion des matières résiduelles pour la communauté algonquine de Long Point First Nation, située dans la Municipalité régionale de comté de Témiscamingue. La Politique québécoise de gestion des matières résiduelles n’établit pas clairement à qui revient la responsabilité d’une saine gestion dans le cas des communautés autochtones. Le flou législatif derrière cet enjeu ne fait qu’accentuer l’isolement de ces communautés dans leur aspiration à développer des actions précises et à les concrétiser. Pourtant, le milieu autochtone se doit de poursuivre la voie de l’amélioration continue de son administration à ce sujet puisque celui-ci participe également au bilan provincial. Cet essai s’inscrit dans le but précis d’accompagner Long Point First Nation dans son cheminement vers une gestion éclairée de ses matières résiduelles. La communauté de Long Point First Nation a introduit la collecte sélective depuis quelques années déjà et en assure elle-même sa gestion. Néanmoins, elle est aux prises avec des situations problématiques limitant la gestion adéquate de ses matières résiduelles. L’éloignement géographique, les partenariats laborieux, les coûts élevés reliés à la gestion et l’instabilité au niveau de la collecte hebdomadaire freinent sa facilité administrative et son déploiement. L’usage des dépôts sauvages pour éliminer les matières non collectées amplifie les problèmes environnementaux et de santé publique. La désuétude de certaines installations et l’absence de campagnes usuelles d’information, de sensibilisation et d’éducation n’assurent pas une gestion optimale ni sa pérennité. Un plan d’action a été réalisé dans le but ultime de contrer ces enjeux. Ce plan priorise deux objectifs fondamentaux, celui d’instaurer un système de récupération des matières organiques au niveau résidentiel et celui de développer des infrastructures pouvant accueillir les matières résiduelles non collectées par la collecte sélective actuellement en place. En plus de ces priorités, cinq autres objectifs sont mis de l’avant, soit le regroupement d’informations concernant la gestion des matières résiduelles et son suivi, la qualité de gestion de la collecte municipale, l’assurance de la qualité environnementale de son territoire, l’affinement du tri des matières recyclables et l’amélioration de la transmission d’informations auprès des résidents. Le tout représente un essai se voulant pragmatique colligeant objectifs et mesures afin d’élaborer un plan d’action réaliste à caractère environnemental.

The role of non-coding RNA in the development of pulmonary arterial hypertension

Pulmonary arterial hypertension (PAH) is a progressive disease of the small pulmonary arteries, characterised by pulmonary vascular remodelling due to excessive proliferation and resistance to apoptosis of pulmonary artery endothelial cells (PAECs) and pulmonary artery smooth muscle cells (PASMCs). The increased pulmonary vascular resistance and elevated pulmonary artery pressures result in right heart failure and premature death. Germline mutations of the bone morphogenetic protein receptor-2 (bmpr2) gene, a receptor of the transforming growth factor beta (TGF-β) superfamily, account for approximately 75%-80% of the cases of heritable form of PAH (HPAH) and 20% of sporadic cases or idiopathic PAH (IPAH). IPAH patients without known bmpr2 mutations show reduced expression of BMPR2. However only ~ 20% of bmpr2-mutation carriers will develop the disease, due to an incomplete penetrance, thus the need for a ‘second hit’ including other genetic and/or environmental factors is accepted. Diagnosis of PAH occurs most frequently when patients have reached an advanced stage of disease. Although modern PAH therapies can markedly improve a patient’s symptoms and slow the rate of clinical deterioration, the mortality rate from PAH remains unacceptably high. Therefore, the development of novel therapeutic approaches is required for the treatment of this multifaceted disease. Noncoding RNAs (ncRNAs) include microRNAs (miRNAs) and long noncoding RNAs (lncRNAs). MiRNAs are ~ 22 nucleotide long and act as negative regulators of gene ex-pression via degradation or translational inhibition of their target mRNAs. Previous studies showed extensive evidence for the role of miRNAs in the development of PAH. LncRNAs are transcribed RNA molecules greater than 200 nucleotides in length. Similar to classical mRNA, lncRNAs are translated by RNA polymerase II and are generally alternatively spliced and polyadenylated. LncRNAs are highly versatile and function to regulate gene expression by diverse mechanisms. Unlike miRNAs, which exhibit well-defined actions in negatively regulating gene expression via the 3’-UTR of mRNAs, lncRNAs play more diverse and unpredictable regulatory roles. Although a number of lncRNAs have been intensively investigated in the cancer field, studies of the role of lncRNAs in vascular diseases such as PAH are still at a very early stage. The aim of this study was to investigate the involvement of specific ncRNAs in the development of PAH using experimental animal models and cell culture. The first ncRNA we focused on was miR-143, which is up-regulated in the lung and right ventricle tissues of various animal models of PH, as well as in the lungs and PASMCs of PAH patients. We show that genetic ablation of miR-143 is protective against the development of chronic hypoxia induced PH in mice, assessed via measurement of right ventricular systolic pressure (RVSP), right ventricular hypertrophy (RVH) and pulmonary vascular remodelling. We further report that knockdown of miR-143-3p in WT mice via anti-miR-143-3p administration prior to exposure of mice to chronic hypoxia significantly decreases certain indices of PH (RVSP) although no significant changes in RVH and pulmo-nary vascular remodelling were observed. However, a reversal study using antimiR-143-3p treatment to modulate miR-143-3p demonstrated a protective effect on RVSP, RVH, and muscularisation of pulmonary arteries in the mouse chronic hypoxia induced PH model. In vitro experiments showed that miR-143-3p overexpression promotes PASMC migration and inhibits PASMC apoptosis, while knockdown miR-143-3p elicits the opposite effect, with no effects observed on cellular proliferation. Interestingly, miR-143-3p-enriched exosomes derived from PASMCs mediated cell-to-cell communication between PASMCs and PAECs, contributing to the pro-migratory and pro-angiogenic phenotype of PAECs that underlies the pathogenesis of PAH. Previous work has shown that miR-145-5p expression is upregulated in the chronic hypoxia induced mouse model of PH, as well as in PAH patients. Genetic ablation and pharmacological inhibition (subcutaneous injection) of miR-145-5p exert a protective against the de-velopment of PAH. In order to explore the potential for alternative, more lung targeted delivery strategies, miR-145-5p expression was inhibited in WT mice using intranasal-delivered antimiR-145-5p both prior to and post exposure to chronic hypoxia. The decreased expression of miR-145-5p in lung showed no beneficial effect on the development of PH compared with control antimiRNA treated mice exposed to chronic hypoxia. Thus, miR-143-3p modulated both cellular and exosome-mediated responses in pulmonary vascular cells, while the inhibition of miR-143-3p prevented the development of experimental pulmonary hypertension. We focused on two lncRNAs in this project: Myocardin-induced Smooth Muscle Long noncoding RNA, Inducer of Differentiation (MYOSLID) and non-annotated Myolnc16, which were identified from RNA sequencing studies in human coronary artery smooth muscle cells (HCASMCs) that overexpress myocardin. MYOSLID was significantly in-creased in PASMCs from patients with IPAH compared to healthy controls and increased in circulating endothelial progenitor cells (EPCs) from bmpr2 mutant PAH patients. Exposure of PASMCs to hypoxia in vitro led to a significant upregulation in MYOSLID expres-sion. MYOSLID expression was also induced by treatment of PASMC with BMP4, TGF-β and PDGF, which are known to be triggers of PAH in vitro. Small interfering RNA (siR-NA)-mediated knockdown MYOSLID inhibited migration and induced cell apoptosis without affecting cell proliferation and upregulated several genes in the BMP pathway in-cluding bmpr1α, bmpr2, id1, and id3. Modulation of MYOSLID also affected expression of BMPR2 at the protein level. In addition, MYOSLID knockdown affected the BMP-Smad and BMP-non-Smad signalling pathways in PASMCs assessed by phosphorylation of Smad1/5/9 and ERK1/2, respectively. In PAECs, MYOSLID expression was also induced by hypoxia exposure, VEGF and FGF2 treatment. In addition, MYOSLID knockdown sig-nificantly decreased the proliferation of PAECs. Thus, MYOSLID may be a novel modulator in pulmonary vascular cell functions, likely through the BMP-Smad and –non-Smad pathways. Treatment of PASMCs with inflammatory cytokines (IL-1 and TNF-α) significantly in-duced the expression of Myolnc16 at a very early time point. Knockdown of Myolnc16 in vitro decreased the expression of il-6, and upregulated the expression of il-1 and il-8 in PASMCs. Moreover, the expression levels of chemokines (cxcl1, cxcl6 and cxcl8) were sig-nificantly decreased with Myolnc16 knockdown. In addition, Myolnc16 knockdown decreased the MAP kinase signalling pathway assessed by phosphorylation of ERK1/2 and p38 MAPK and inhibited cell migration and proliferation in PASMCs. Thus, Myolnc16 may a novel modulator of PASMCs functions through anti-inflammatory signalling pathways. In summary, in this thesis we have demonstrated how miR-143-3p plays a protective role in the development of PH both in vivo animal models and patients, as well as in vitro cell cul-ture. Moreover, we have showed the role of two novel lncRNAs in pulmonary vascular cells. These ncRNAs represent potential novel therapeutic targets for the treatment of PAH with further work addressing to investigate the target genes, and the pathways modulated by these ncRNAs during the development of PAH.

Do Global CO2 Emissions from Fossil-Fuel Consumption Exhibit Long Memory? A Fractional Integration Analysis

In this article we use an autoregressive fractionally integrated moving average approach to measure the degree of fractional integration of aggregate world CO2 emissions and its five components – coal, oil, gas, cement, and gas flaring. We find that all variables are stationary and mean reverting, but exhibit long-term memory. Our results suggest that both coal and oil combustion emissions have the weakest degree of long-range dependence, while emissions from gas and gas flaring have the strongest. With evidence of long memory, we conclude that transitory policy shocks are likely to have long-lasting effects, but not permanent effects. Accordingly, permanent effects on CO2 emissions require a more permanent policy stance. In this context, if one were to rely only on testing for stationarity and non-stationarity, one would likely conclude in favour of non-stationarity, and therefore that even transitory policy shocks

Practical Management of the Endangered African Wild Dog (Lycaon Pictus): Implementation of Research Methodologies, Management Tools and Validation of Non-Invasive Endocrinology Applications

The porpoise of this study was to implement research methodologies and assess the effectiveness and impact of management tools to promote best practices for the long term conservation of the endangered African wild dog (Lycaon pictus). Different methods were included in the project framework to investigate and expand the applicability of these methodologies to free-ranging African wild dogs in the southern African region: ethology, behavioural endocrinology and ecology field methodologies were tested and implemented. Additionally, research was performed to test the effectiveness and implication of a contraceptive implant (Suprenolin) as a management tool for the species of a subpopulation hosted in fenced areas. Attention was especially given to social structure and survival of treated packs. This research provides useful tools and advances the applicability of these methods for field studies, standardizing and improving research instruments in the field of conservation biology and behavioural endocrinology. Results reported here provide effective methodologies to expand the applicability of non-invasive endocrine assessment to previously prohibited fields, and validation of sampling methods for faecal hormone analysis. The final aim was to fill a knowledge gap on behaviours of the species and provide a common ground for future researchers to apply non-invasive methods to this species research and to test the effectiveness of the contraception on a managed metapopulation.

Abstractive Long Document Summarization: Studio e Sperimentazione di Modelli Generativi Retrieval-Augmented

In questa tesi si trattano lo studio e la sperimentazione di un modello generativo retrieval-augmented, basato su Transformers, per il task di Abstractive Summarization su lunghe sentenze legali. La sintesi automatica del testo (Automatic Text Summarization) è diventata un task di Natural Language Processing (NLP) molto importante oggigiorno, visto il grandissimo numero di dati provenienti dal web e banche dati. Inoltre, essa permette di automatizzare un processo molto oneroso per gli esperti, specialmente nel settore legale, in cui i documenti sono lunghi e complicati, per cui difficili e dispendiosi da riassumere. I modelli allo stato dell’arte dell’Automatic Text Summarization sono basati su soluzioni di Deep Learning, in particolare sui Transformers, che rappresentano l’architettura più consolidata per task di NLP. Il modello proposto in questa tesi rappresenta una soluzione per la Long Document Summarization, ossia per generare riassunti di lunghe sequenze testuali. In particolare, l’architettura si basa sul modello RAG (Retrieval-Augmented Generation), recentemente introdotto dal team di ricerca Facebook AI per il task di Question Answering. L’obiettivo consiste nel modificare l’architettura RAG al fine di renderla adatta al task di Abstractive Long Document Summarization. In dettaglio, si vuole sfruttare e testare la memoria non parametrica del modello, con lo scopo di arricchire la rappresentazione del testo di input da riassumere. A tal fine, sono state sperimentate diverse configurazioni del modello su diverse tipologie di esperimenti e sono stati valutati i riassunti generati con diverse metriche automatiche.

Long-period oscillations in GPS Up time series. Study over the European/Mediterranean area

The surface of the Earth is subjected to vertical deformations caused by geophysical and geological processes which can be monitored by Global Positioning System (GPS) observations. The purpose of this work is to investigate GPS height time series to identify interannual signals affecting the Earth’s surface over the European and Mediterranean area, during the period 2001-2019. Thirty-six homogeneously distributed GPS stations were selected from the online dataset made available by the Nevada Geodetic Laboratory (NGL) on the basis of the length and quality of the data series. The Principal Component Analysis (PCA) is the technique applied to extract the main patterns of the space and time variability of the GPS Up coordinate. The time series were studied by means of a frequency analysis using a periodogram and the real-valued Morlet wavelet. The periodogram is used to identify the dominant frequencies and the spectral density of the investigated signals; the second one is applied to identify the signals in the time domain and the relevant periodicities. This study has identified, over European and Mediterranean area, the presence of interannual non-linear signals with a period of 2-to-4 years, possibly related to atmospheric and hydrological loading displacements and to climate phenomena, such as El Niño Southern Oscillation (ENSO). A clear signal with a period of about six years is present in the vertical component of the GPS time series, likely explainable by the gravitational coupling between the Earth’s mantle and the inner core. Moreover, signals with a period in the order of 8-9 years, might be explained by mantle-inner core gravity coupling and the cycle of the lunar perigee, and a signal of 18.6 years, likely associated to lunar nodal cycle, were identified through the wavelet spectrum. However, these last two signals need further confirmation because the present length of the GPS time series is still too short when compared to the periods involved.

Induction of Hebbian associative plasticity through paired non-invasive brain stimulation of premotor-motor areas to elucidate the network's functional role

The ventral premotor cortex (PMv) is believed to play a pivotal role in a multitude of visuomotor behaviors, such as sensory-guided goal-directed visuomotor transformations, arbitrary visuomotor mapping, and hyper-learnt visuomotor associations underlying automatic imitative tendencies. All these functions are likely carried out through the copious projections connecting PMv to the primary motor cortex (M1). Yet, causal evidence investigating the functional relevance of the PMv-M1 network remains elusive and scarce. In the studies reported in this thesis we addressed this issue using a transcranial magnetic stimulation (TMS) protocol called cortico-cortical paired associative stimulation (ccPAS), which relies on multisite stimulation to induce Hebbian spike-timing dependent plasticity (STDP) by repeatedly stimulating the pathway connecting two target areas to manipulate their connectivity. Firstly, we show that ccPAS protocols informed by both short- and long-latency PMv-M1 interactions effectively modulate connectivity between the two nodes. Then, by pre-activating the network to apply ccPAS in a state-dependent manner, we were able to selectively target specific functional visuo-motor pathways, demonstrating the relevance of PMv-M1 connectivity to arbitrary visuomotor mapping. Subsequently, we addressed the PMv-to-M1 role in automatic imitation, and demonstrated that its connectivity manipulation has a corresponding impact on automatic imitative tendencies. Finally, by combining dual-coil TMS connectivity assessments and ccPAS in young and elderly individuals, we traced effective connectivity of premotor-motor networks and tested their plasticity and relevance to manual dexterity and force in healthy ageing. Our findings provide unprecedent causal evidence of the functional role of the PMv-to-M1 network in young and elderly individuals. The studies presented in this thesis suggest that ccPAS can effectively modulate the strength of connectivity between targeted areas, and coherently manipulate a networks’ behavioral output. Results open new research prospects into the causal role of cortico-cortical connectivity, and provide necessary information to the development of clinical interventions based on connectivity manipulation.

The frozen elephant trunk technique for the treatment of complex aortic arch and descending thoracic aorta pathologies: long term outcomes and distal reintervention

Background: The frozen elephant trunk(FET) technique is one of the last evolution in the treatment of complex pathologies of the aortic arch and the descending thoracic aorta.Materials and methods: Between January 2007 and March 2021, a total of 396 patients underwent total aortic arch replacements with the FET technique in our centre.The main indications were thoracic aortic aneurysm(n=104,28.2%), chronic aortic dissection(n=224,53.4%) and acute aortic dissection(n=68, 18.4%). We divided the population in two groups according the position of the distal anastomosis (zone 2 vs zone 3) and the length of the stent graft (< 150 mm vs > 150 mm): conservative group (Zone 2 anastomosis + stent length < 150mm, n. 140 pts) and aggressive group (zone 3 anastomosis + stent length > 150mm, n. 141). Results: The overall 30-day mortality rate was 13%(48/369); the risk factor analysis showed that an aggressive approach was neither a risk factor for major complication (permanent dialysis, tracheostomy, bowel malperfusion and permanent paraplegia) neither for 30-day mortality. The survival rate at 1, 5,10 and 15 years was 87.7%,75%,61.3% and 58.4% respectively. During the follow up, an aortic reintervention was performed in 122 patients (38%), 5 patients received a non-aortic cardiac surgery. Freedom from aortic reintervention at 1-,5- and 10-year was 77%,54% and 44% respectively. The freedom from aortic reintervention was higher in the ‘aggressive’ group (62.5%vs40.0% at 5 years, log-rank=0.056). An aggressive approach was not protective for aortic reintervention at follow up and for death at follow up. Conclusions: The FET technique represents a feasible and efficient option in the treatment of complex thoracic aortic pathologies. An aortic reintervention after FET is very common and the decision-making approach should consider and balance the higher risk of an aggressive approach in terms of post-operative complication versus the higher risk of a second aortic reintervention at follow-up.

Diffusive models and chaos indicators for non-linear betatron motion in circular hadron accelerators

Understanding the complex dynamics of beam-halo formation and evolution in circular particle accelerators is crucial for the design of current and future rings, particularly those utilizing superconducting magnets such as the CERN Large Hadron Collider (LHC), its luminosity upgrade HL-LHC, and the proposed Future Circular Hadron Collider (FCC-hh). A recent diffusive framework, which describes the evolution of the beam distribution by means of a Fokker-Planck equation, with diffusion coefficient derived from the Nekhoroshev theorem, has been proposed to describe the long-term behaviour of beam dynamics and particle losses. In this thesis, we discuss the theoretical foundations of this framework, and propose the implementation of an original measurement protocol based on collimator scans in view of measuring the Nekhoroshev-like diffusive coefficient by means of beam loss data. The available LHC collimator scan data, unfortunately collected without the proposed measurement protocol, have been successfully analysed using the proposed framework. This approach is also applied to datasets from detailed measurements of the impact on the beam losses of so-called long-range beam-beam compensators also at the LHC. Furthermore, dynamic indicators have been studied as a tool for exploring the phase-space properties of realistic accelerator lattices in single-particle tracking simulations. By first examining the classification performance of known and new indicators in detecting the chaotic character of initial conditions for a modulated Hénon map and then applying this knowledge to study the properties of realistic accelerator lattices, we tried to identify a connection between the presence of chaotic regions in the phase space and Nekhoroshev-like diffusive behaviour, providing new tools to the accelerator physics community.

Valutazione non invasiva dell'epatopatia Fontan indotta

Introduzione: L’intervento di Fontan comporta un aumento istantaneo della pressione venosa centrale che causa, nel medio-lungo termine, una forma di epatopatia specifica detta FALD. Il monitoraggio della FALD è complesso ma potrebbe consentire di bloccarne o rallentarne l’insorgenza. Lo studio ha valutato l’efficacia delle modalità di monitoraggio non invasivo. Materiale e metodi: Sei pazienti (età media 24 anni) operati presso l’IRCCS Azienda Ospedaliero Universitaria di Bologna sono stati sottoposti a RMN 4D-Flow e ad Ecodoppler epatico. Sono stati raccolti i dati anagrafici, morfologici, anamnestici e i markers sierologici per il calcolo degli scores MELD-XI, APRI, FIB4, i valori di Shear Stress assiale e circonferenziale e gli indici di pulsatilità e resistenza delle arterie epatica e renale. Risultati: Il tempo trascorso tra la Fontan e lo studio è stato di 17,8 anni. Età media alla Fontan 6,8 anni. Tutti i pazienti avevano un quadro compatibile con epatopatia. I markers sierologici e gli scores MELD-XI,APRI e FIB4 si sono dimostrati di scarsa utilità. All’ecografia tutti i pazienti avevano ecostruttura irregolare, splenomegalia e valori elevati di pulsatilità e resistenza dell’arteria epatica e splenica. La rigidità epatica media è stata di 12,4 Kpa. Alla RMN 4DF lo Shear stress assiale è stato massimo a livello del condotto (0,16 Pa) e minimo a livello delle vene sovra epatiche (0,05 Pa). Lo Shear Stress si è mostrato massimo nei pazienti con emodinamica sfavorevole e peggior quadro ecografico addominale, evidenziando aree di inefficienza energetica. Conclusioni: La combinazione delle diagnostiche di imaging non invasive potrebbe rivelarsi adeguata per il monitoraggio della FALD. In particolare, la RMN 4D Flow potrebbe rivelare aree di inefficienza energetica predisponenti alla FALD. Questo potrebbe indirizzare in modo specifico la terapia dei pazienti operati o addirittura indurre la modifica del disegno della Fontan verso forme più efficienti.

Hypertensive disorders of pregnancy and long-term cardiovascular health and outcomes

Introduction The maternal vasculature undergoes significant adaptations during pregnancy to meet the increased metabolic demands of the developing fetus. These adaptations include increased cardiac output and blood volume, as well as reduced systemic vascular resistance. In Hypertensive disorders of pregnancy (HDP) there is an impaired cardiovascular adaptation to pregnancy with effects extending beyond pregnancy. In the present study we aimed to characterize long-term cardiovascular status of women who suffered from HDP. Methods Fifty-eight women who attended at least one post-partum visit and a follow-up visit after at least 5 years from delivery were enrolled in the study. Exclusion criteria included multiple pregnancy, fetal genetic or congenital abnormalities, maternal history of organ transplantation, or chronic renal failure (eGFR≤45ml/min/1.73m2). In the follow-up visit participants underwent a complete cardiovascular assessment including echocardiography and multiparametric vascular function assessment. Results and Discussion Two major cardiovascular events, one stroke and one myocardial infarction, occurred both in women with index-pregnancy complicated by preeclampsia (PE). While not statistically significant, women with HDP-non-PE and PE displayed a trend towards an increased risk of developing composite cardiovascular outcome, and women with PE tended to experience it sooner. Nearly half of the women with a history of HDP, whether PE or HDP-non-PE, developed chronic hypertension. Some women also developed hyperuricemia, chronic kidney disease (CKD), and type 2 diabetes at follow- up, most of them had a previous history of PE. Structural and functional cardiac changes were observed in a few cases, especially among women with PE, and vascular dysfunction was more common in women with a history of HDP compared to those with normotensive pregnancies. Results of the present study adds on literature on long-term cardiovascular impact of HDP and further emphasize the importance of a timely follow-up of women who suffered from HDP and particularly PE.