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Agostinetti P, Dal Bello S, Dinh F, Ferrara A, Fincato M, Grando L, Mura M, Murari A, Sartori E, Siragusa M, Siviero F, Veronese F. Conceptual design of the Gas Injection and Vacuum System for DTT NBI. Fusion Engineering and Design 2023. [DOI: 10.1016/j.fusengdes.2023.113638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
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Borgonovi F, Ferrara A, Piacentini M. From asking to observing. Behavioural measures of socio-emotional and motivational skills in large-scale assessments. Soc Sci Res 2023; 112:102874. [PMID: 37061327 DOI: 10.1016/j.ssresearch.2023.102874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 12/24/2022] [Accepted: 03/04/2023] [Indexed: 06/19/2023]
Abstract
Socio-emotional and motivational skills are routinely measured using self-reports in large-scale educational assessments. Measures exploiting test-takers' behaviour during the completion of questionnaires or cognitive tests are increasingly used as alternatives to self-reports in the economics of education literature. We compute behavioural measures of socio-emotional and motivational skills using data from the Programme for International Student Assessment (PISA). We find that these measures capture important aspects of students' academic profiles: some are importantly associated with contemporaneous performance and educational attainment and most measures have a high degree of stability over time. However, these measures are only limitedly correlated among themselves and have low correlations with self-report measures of the same constructs. This is likely a reflection of the fact that behavioural measures are representations of the test taker current 'state', rather than descriptions of the participant view of their own 'trait' like the self-report measures. Moreover, the low correlation across measures suggests that they capture different behavioural responses to the test-taking situation. These differences are still limitedly understood because the measures are constructed ex-post using collateral information collected during the administration of assessments rather than developed ex ante in line with theoretical models of human cognition and affect.
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Affiliation(s)
- F Borgonovi
- Social Research Institute, Institute of Education University College London, United Kingdom; OECD Centre for Skills, Organisation for Economic Cooperation and Development, France.
| | - A Ferrara
- European University Institute, Italy.
| | - M Piacentini
- Directorate for Education and Skills, Organisation for Economic Cooperation and Development, France.
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Borgonovi F, Ferrara A, Piacentini M. Performance decline in a low-stakes test at age 15 and educational attainment at age 25: Cross-country longitudinal evidence. J Adolesc 2021; 92:114-125. [PMID: 34461566 DOI: 10.1016/j.adolescence.2021.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 07/19/2021] [Accepted: 08/16/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Educational attainment is associated with important life outcomes including labour market performance, health status, well-being, civic and political participation. An important question is whether it is possible to identify early those students who lack the achievement motivation that is needed to complete a higher education degree. METHODS Longitudinal follow-ups of representative samples of participants in the 2000 and 2003 Programme for International Student Assessment (PISA) from Australia, Denmark and Switzerland (N = 3110; 1130; and 1962; age = 15 to 27; % females 51%, 51%, 49%; ethnicity/race unknown) were used to identify the association between a measure of effort on a cognitively demanding low-stake task at age 15 - performance decline during the test - and educational attainment at age 25-27. RESULTS A one SD difference in performance decline was associated with a 5-6 percentage point difference in the probability of obtaining tertiary-level qualifications (r = -0.15 in Australia; -0.11 in Denmark and -0.11 in Switzerland). We find no evidence of differences in this relationship across genders, socio-economic status and baseline levels of ability in the three countries. The association between performance decline and educational attainment is homogeneous across these groups. Self-reported measures of achievement motivation were not predictive of educational attainment in the three countries. CONCLUSIONS Our work contributes new longitudinal evidence to the body of research in education employing behavioural measures of motivation and engagement. It can be used to understand the potential long-term consequences of disparities in students' preparation to sustain effort over cognitively demanding tasks.
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Affiliation(s)
- F Borgonovi
- Social Research Institute, Institute of Education University College London, United Kingdom; Organisation for Economic Cooperation and Development, France.
| | - A Ferrara
- European University Institute, Italy.
| | - M Piacentini
- Organisation for Economic Cooperation and Development, France.
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Rosati P, Basa S, Blain AW, Bozzo E, Branchesi M, Christensen L, Ferrara A, Gomboc A, O’Brien PT, Osborne JP, Rossi A, Schüssler F, Spurio M, Stergioulas N, Stratta G, Amati L, Casewell S, Ciolfi R, Ghirlanda G, Grimm S, Guetta D, Harms J, Le Floc’h E, Longo F, Maggiore M, Mereghetti S, Oganesyan G, Salvaterra R, Tanvir NR, Turriziani S, Vergani SD, Balman S, Caruana J, Erkut MH, Guidorzi G, Frontera F, Martin-Carrillo A, Paltani S, Porquet D, Sergijenko O. Synergies of THESEUS with the large facilities of the 2030s and guest observer opportunities. Exp Astron (Dordr) 2021; 52:407-437. [PMID: 35153378 PMCID: PMC8807471 DOI: 10.1007/s10686-021-09764-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 05/12/2021] [Indexed: 06/14/2023]
Abstract
The proposed THESEUS mission will vastly expand the capabilities to monitor the high-energy sky. It will specifically exploit large samples of gamma-ray bursts to probe the early universe back to the first generation of stars, and to advance multi-messenger astrophysics by detecting and localizing the counterparts of gravitational waves and cosmic neutrino sources. The combination and coordination of these activities with multi-wavelength, multi-messenger facilities expected to be operating in the 2030s will open new avenues of exploration in many areas of astrophysics, cosmology and fundamental physics, thus adding considerable strength to the overall scientific impact of THESEUS and these facilities. We discuss here a number of these powerful synergies and guest observer opportunities.
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Affiliation(s)
- P. Rosati
- Department of Physics and Earth Sciences, University of Ferrara, Via G. Saragat, 1, 44122 Ferrara, Italy
| | - S. Basa
- Aix Marseille University, CNRS, CNES, LAM, Marseille, France
| | - A. W. Blain
- School of Physics and Astronomy, University of Leicester, University Road, Leicester, LE1 7RH UK
| | - E. Bozzo
- Department of Astronomy, University of Geneva, Chemin d’Ecogia 16, CH-1290 Versoix, Switzerland
| | - M. Branchesi
- Gran Sasso Science Institute, Viale F. Crispi 7, 67100 L’Aquila, AQ Italy
- INFN, Laboratori Nazionali del Gran Sasso, 67100 Assergi, Italy
| | - L. Christensen
- Niels Bohr Institute, University of Copenhagen, Jagtvej 128, 2200 Copenhagen N, Denmark
| | - A. Ferrara
- Scuola Normale Superiore, Piazza dei Cavalieri 7, 56126 Pisa, Italy
| | - A. Gomboc
- Center for Astrophysics and Cosmology, University of Nova Gorica, Vipavska 13, 5000 Nova Gorica, Slovenia
| | - P. T. O’Brien
- School of Physics and Astronomy, University of Leicester, University Road, Leicester, LE1 7RH UK
| | - J. P. Osborne
- School of Physics and Astronomy, University of Leicester, University Road, Leicester, LE1 7RH UK
| | - A. Rossi
- INAF, Osservatorio di Astrofisica e Scienza dello Spazio, via Piero Gobetti 93/3, 40129 Bologna, Italy
| | - F. Schüssler
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - M. Spurio
- Dipartimento di Fisica e Astronomia dell’Università, Viale Berti Pichat 6/2, 40127 Bologna, Italy
- INFN - Sezione di Bologna, Viale Berti-Pichat 6/2, 40127 Bologna, Italy
| | - N. Stergioulas
- Department of Physics, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - G. Stratta
- INAF, Osservatorio di Astrofisica e Scienza dello Spazio, via Piero Gobetti 93/3, 40129 Bologna, Italy
| | - L. Amati
- INAF, Osservatorio di Astrofisica e Scienza dello Spazio, via Piero Gobetti 93/3, 40129 Bologna, Italy
| | - S. Casewell
- School of Physics and Astronomy, University of Leicester, University Road, Leicester, LE1 7RH UK
| | - R. Ciolfi
- INAF, Osservatorio Astronomico di Padova, Vicolo dell’Osservatorio 5, 35122 Padova, Italy
| | - G. Ghirlanda
- INAF, Osservatorio Astronomico di Brera, Via Bianchi 46, 23807 Merate, LC Italy
| | - S. Grimm
- Gran Sasso Science Institute, Viale F. Crispi 7, 67100 L’Aquila, AQ Italy
- INFN, Laboratori Nazionali del Gran Sasso, 67100 Assergi, Italy
| | - D. Guetta
- ORT Braude, Karmiel, Israel
- Physics Department, University of Ariel, Ariel, West Bank, Israel
| | - J. Harms
- Gran Sasso Science Institute, Viale F. Crispi 7, 67100 L’Aquila, AQ Italy
- INFN, Laboratori Nazionali del Gran Sasso, 67100 Assergi, Italy
| | - E. Le Floc’h
- AIM, CEA-Irfu/DAp, CNRS, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - F. Longo
- Dipartimento di Fisica, Università degli Studi di Trieste and Istituto Nazionale di Fisica Nucleare, Sezione di Trieste, via Valerio 2, 34127 Trieste, Italy
| | - M. Maggiore
- Départment de Physique Théorique and Center for Astroparticle Physics, Université de Genève, 24 quai Ansermet, CH–1211 Genève 4, Switzerland
| | - S. Mereghetti
- INAF, Istituto di Astrofisica Spaziale e Fisica Cosmica, via Alfonso Corti 12, 20133 Milano, Italy
| | - G. Oganesyan
- Gran Sasso Science Institute, Viale F. Crispi 7, 67100 L’Aquila, AQ Italy
- INFN, Laboratori Nazionali del Gran Sasso, 67100 Assergi, Italy
| | - R. Salvaterra
- INAF, Istituto di Astrofisica Spaziale e Fisica Cosmica, via Alfonso Corti 12, 20133 Milano, Italy
| | - N. R. Tanvir
- School of Physics and Astronomy, University of Leicester, University Road, Leicester, LE1 7RH UK
| | - S. Turriziani
- Physics Department, Gubkin Russian State University, 65 Leninsky Prospekt, Moscow, 119991 Russian Federation
| | - S. D. Vergani
- GEPI, Observatoire de Paris, PSL University, CNRS, Place Jules Janssen, 92190 Meudon, France
| | - S. Balman
- Department of Astronomy and Space Sciences, Istanbul University, Faculty of Science, Beyazit, 34119 Istanbul, Turkey
| | - J. Caruana
- Department of Physics and Institute of Space Sciences and Astronomy, University of Malta, Msida, MSD 2080 Malta
| | - M. H. Erkut
- Faculty of Engineering and Natural Sciences, Istanbul Bilgi University, 34060 Istanbul, Turkey
| | - G. Guidorzi
- Department of Physics and Earth Sciences, University of Ferrara, Via G. Saragat, 1, 44122 Ferrara, Italy
| | - F. Frontera
- Department of Physics and Earth Sciences, University of Ferrara, Via G. Saragat, 1, 44122 Ferrara, Italy
| | - A. Martin-Carrillo
- School of Physics and Centre for Space Research, University College Dublin, Dublin 4, Ireland
| | - S. Paltani
- Department of Astronomy, University of Geneva, Chemin d’Ecogia 16, CH-1290 Versoix, Switzerland
| | - D. Porquet
- Aix Marseille University, CNRS, CNES, LAM, Marseille, France
| | - O. Sergijenko
- Astronomical Observatory of Taras Shevchenko National University of Kyiv, Observatorna str., 3, Kyiv, 04053 Ukraine
- Main Astronomical Observatory of the National Academy of Sciences of Ukraine, Zabolotnoho str., 27, Kyiv, 03680 Ukraine
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Baquero-Ruiz M, Coda S, Dolizy F, Duval B, Fasoli A, Ferrara A, Maccallini E, Manini P, Martin Y, Mura M, Reimerdes H, Siviero F. Non-evaporable getter pump operations in the TCV tokamak. Fusion Engineering and Design 2021. [DOI: 10.1016/j.fusengdes.2021.112267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Marino AF, Centurione E, Cofano R, Garau L, Ferrara A, Pannese C, Raimondi A, Verlengia L, Rivolta S, Castelli B. The importance of respecting accreditation indicators to improve quality of care. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Issue
The health and social-care facilities (HSF) of the Lombardy Region provide services specifically conceived for fragile populations, including elderly, disabled, addicts etc. Through its Accreditation Units, the Agency for Health Protection (ATS) in the Metropolitan City of Milan is responsible for overseeing authorization and accreditation indicators of HSFs in all afferent districts. Assessed requirements include the qualitative standard (presence of mandatory professional figures) and the quantitative standard (guaranteed weekly minimum time of care per patient) of operating staff, based on current legislation.
Description of the problem
These standards are evaluated at site-inspection by examining staff qualifications and by matching staff working hours to actual daily presence of patients, randomly selecting a recent past week. The resulting standards may thus not be fully representative of the whole year. In 2019, the Health and Social-care facilities Accreditation Unit of ATS began a retrospective quali-quantitative analysis of health service staffing data for 2017 and 2018. Data were extrapolated from two main databases: “Scheda Struttura”, a data collection tool regarding work hours, qualifications, waiting lists etc. compiled yearly by HSF managers; and economic data detailing reimbursements by the regional health service, based on effective daily presence of patients at the HSF.
Results
Preliminary results relating to 2017 showed that around 4% of HSFs do not guarantee qualitative staffing standards, and almost 30% do not guarantee quantitative staffing standards throughout the year.
Lessons
The proposed tool is useful for emphasizing potentially critical situations and may help define the annual inspection schedule with the aim of continuously improving quality of care among regional HSFs.
Key messages
Data management tools can help local health authorities monitor and identify facilities at risk of falling below the defined standards of care. Qualitative and quantitative analysis of health service staffing is useful for emphasizing potentially critical situations and may help define the annual inspection schedule.
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Affiliation(s)
- A F Marino
- Health and Social-care facilities Accreditation Unit, Agency for Health Protection of the Metropolitan City of Milan, Milan, Italy
| | - E Centurione
- Health and Social-care facilities Accreditation Unit, Agency for Health Protection of the Metropolitan City of Milan, Milan, Italy
| | - R Cofano
- Health and Social-care facilities Accreditation Unit, Agency for Health Protection of the Metropolitan City of Milan, Milan, Italy
| | - L Garau
- Health and Social-care facilities Accreditation Unit, Agency for Health Protection of the Metropolitan City of Milan, Milan, Italy
| | - A Ferrara
- Health and Social-care facilities Accreditation Unit, Agency for Health Protection of the Metropolitan City of Milan, Milan, Italy
| | - C Pannese
- Health and Social-care facilities Accreditation Unit, Agency for Health Protection of the Metropolitan City of Milan, Milan, Italy
| | - A Raimondi
- Health and Social-care facilities Accreditation Unit, Agency for Health Protection of the Metropolitan City of Milan, Milan, Italy
| | - L Verlengia
- Health and Social-care facilities Accreditation Unit, Agency for Health Protection of the Metropolitan City of Milan, Milan, Italy
| | - S Rivolta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - B Castelli
- Health and Social-care facilities Accreditation Unit, Agency for Health Protection of the Metropolitan City of Milan, Milan, Italy
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Castelli B, Centurione E, Marino AF, Garau L, Cofano R, Ferrara A, Pannese C, Raimondi A, Gandolfi CE, Da Re NR. Activation of 574 new Alzheimer’s special care unit beds in the Metropolitan City of Milan. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Issue
Dementia is among the main causes of disability and dependency in the elderly. It was defined a public health priority by the WHO. The health and social-care system of the Lombardy region (SSR) plays a key role in implementing assistance and care pathways specifically designed for fragile populations, including those affected by dementia and Alzheimer's disease, its most common form.
Description of the Problem
The SSR provides residential care options especially conceived for dementia patients, known as Alzheimer's special care units (ASCU). However, waiting lists are concerning, and distribution of these facilities is inconsistent throughout the region. In 2018 there were 981 accredited and SSR-covered ASCU beds in the Metropolitan City of Milan (MCM), translating in 1.26 beds/1000 people aged ≥ 65. With regional legislation (DGR 1046/2018), the SSR proposed activation of new ASCU beds in all territories with less than 2 beds/1000 people aged ≥ 65. The MCM Agency for Health Protection (ATS) thus analyzed the distribution of ASCU beds in afferent districts, defining specific needs for each district. The aim was to fund and activate 574 new ASCU beds homogenously among previously accredited and SSR-covered residential care facilities, reaching the targeted 2 ASCU beds/1000 people aged ≥ 65. Applicant facilities had to respond to specific personnel, technological, therapeutic and structural requirements.
Results
Preliminary results indicate 29 residential care facilities applied for evaluation in 2019. The ATS received and evaluated all applications. Following site-inspection, 8 facilities were deemed inappropriate.
Lessons
In 2019, 21 residential care facilities were approved for funding and activation of 558 new ASCU beds. Residual beds will be funded in 2020. Main messages: Activation of new ASCU beds in 2019 and 2020 increased specialized long-term care beds for dementia patients by almost 60%, allowing a more homogenous distribution among MCM districts.
Key messages
The health and social-care system of the Lombardy region proposed activation of new Alzheimer’s special care units beds in all territories with less than 2 beds/1000 people aged ≥ 65. Activation of 574 new Alzheimer’s special care units beds increased by almost 60%, allowing a more homogenous distribution among Metropolitan City of Milan districts.
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Affiliation(s)
- B Castelli
- Health and Social-care facilities Accreditation Unit, Agency for Health Protection of the Metropolitan City of Milan, Milan, Italy
| | - E Centurione
- Health and Social-care facilities Accreditation Unit, Agency for Health Protection of the Metropolitan City of Milan, Milan, Italy
| | - A F Marino
- Health and Social-care facilities Accreditation Unit, Agency for Health Protection of the Metropolitan City of Milan, Milan, Italy
| | - L Garau
- Health and Social-care facilities Accreditation Unit, Agency for Health Protection of the Metropolitan City of Milan, Milan, Italy
| | - R Cofano
- Health and Social-care facilities Accreditation Unit, Agency for Health Protection of the Metropolitan City of Milan, Milan, Italy
| | - A Ferrara
- Health and Social-care facilities Accreditation Unit, Agency for Health Protection of the Metropolitan City of Milan, Milan, Italy
| | - C Pannese
- Health and Social-care facilities Accreditation Unit, Agency for Health Protection of the Metropolitan City of Milan, Milan, Italy
| | - A Raimondi
- Health and Social-care facilities Accreditation Unit, Agency for Health Protection of the Metropolitan City of Milan, Milan, Italy
| | - C E Gandolfi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - N R Da Re
- PAAPSS Department, Agency for Health Protection of the Metropolitan City of Milan, Milan, Italy
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Diurno F, Numis FG, Porta G, Cirillo F, Maddaluno S, Ragozzino A, De Negri P, Di Gennaro C, Pagano A, Allegorico E, Bressy L, Bosso G, Ferrara A, Serra C, Montisci A, D'Amico M, Schiano Lo Morello S, Di Costanzo G, Tucci AG, Marchetti P, Di Vincenzo U, Sorrentino I, Casciotta A, Fusco M, Buonerba C, Berretta M, Ceccarelli M, Nunnari G, Diessa Y, Cicala S, Facchini G. Eculizumab treatment in patients with COVID-19: preliminary results from real life ASL Napoli 2 Nord experience. Eur Rev Med Pharmacol Sci 2020; 24:4040-4047. [PMID: 32329881 DOI: 10.26355/eurrev_202004_20875] [Citation(s) in RCA: 173] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2)-related pneumonia, referred to as COVID-19 (Coronavirus Disease 19), is a public health emergency as it carries high morbidity, mortality, and has no approved specific pharmacological treatments. In this case series, we aimed to report preliminary data obtained with anti-complement C5 therapy with eculizumab in COVID-19 patients admitted to intensive care unit (ICU) of ASL Napoli 2 Nord. PATIENTS AND METHODS This is a case series of patients with a confirmed diagnosis of SARS-CoV2 infection and severe pneumonia or ARDS who were treated with up to 4 infusions of eculizumab as an off-label agent. Patients were also treated with anticoagulant therapy with Enoxaparin 4000 IU/day via subcutaneous injection, antiviral therapy with Lopinavir 800 mg/day + Ritonavir 200 mg/day, hydroxychloroquine 400 mg/day, ceftriaxone 2 g/day IV, vitamine C 6 g/day for 4 days, and were on Non-Invasive Ventilation (NIV). RESULTS We treated four COVID-19 patients admitted to the intensive care unit because of severe pneumonia or ARDS. All patients successfully recovered after treatment with eculizumab. Eculizumab induced a drop in inflammatory markers. Mean C Reactive Protein levels dropped from 14.6 mg/dl to 3.5 mg/dl and the mean duration of the disease was 12.8 days. CONCLUSIONS Eculizumab has the potential to be a key player in treatment of severe cases of COVID-19. Our results support eculizumab use as an off-label treatment of COVID-19, pending confirmation from the ongoing SOLID-C19 trial.
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Affiliation(s)
- F Diurno
- Department of Emergency and Critical Care, ASL Napoli 2 Nord, "S.M. delle Grazie Hospital", Pozzuoli (NA), Italy.
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Motojima G, Murase T, Shoji M, Ogawa H, Yokota M, Maccallini E, Siviero F, Ferrara A, Mura M, Sakurai H, Masuzaki S, Morisaki T. New installation of in-vessel Non Evaporable Getter (NEG) pumps for the divertor pump in the LHD. Fusion Engineering and Design 2019. [DOI: 10.1016/j.fusengdes.2019.03.164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Adjedj J, Pellicano M, Ferrara A, Xaplanteris P, Ciccarelli G, Viggiano A, Bartunek J, De Bruyne B, Barbato E. Angiographic and hemodynamic effects of myocardial bridge during supine bicycle exercise. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pellicano M, Floré V, Ferrara A, Adjedj J, Barbato E, Wijns W. Edge effect after intracoronary beta radiation brachytherapy and bare metal stent implantation: the pathway for very late stent failure. Minerva Cardiol Angiol 2017; 66:126-127. [DOI: 10.23736/s0026-4725.17.04456-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Tu S, Westra J, Yang J, von Birgelen C, Ferrara A, Pellicano M, Nef H, Tebaldi M, Murasato Y, Lansky A, Barbato E, van der Heijden LC, Reiber JHC, Holm NR, Wijns W. Diagnostic Accuracy of Fast Computational Approaches to Derive Fractional Flow Reserve From Diagnostic Coronary Angiography: The International Multicenter FAVOR Pilot Study. JACC Cardiovasc Interv 2017; 9:2024-2035. [PMID: 27712739 DOI: 10.1016/j.jcin.2016.07.013] [Citation(s) in RCA: 356] [Impact Index Per Article: 50.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 06/25/2016] [Accepted: 06/30/2016] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The aim of this prospective multicenter study was to identify the optimal approach for simple and fast fractional flow reserve (FFR) computation from radiographic coronary angiography, called quantitative flow ratio (QFR). BACKGROUND A novel, rapid computation of QFR pullbacks from 3-dimensional quantitative coronary angiography was developed recently. METHODS QFR was derived from 3 flow models with: 1) fixed empiric hyperemic flow velocity (fixed-flow QFR [fQFR]); 2) modeled hyperemic flow velocity derived from angiography without drug-induced hyperemia (contrast-flow QFR [cQFR]); and 3) measured hyperemic flow velocity derived from angiography during adenosine-induced hyperemia (adenosine-flow QFR [aQFR]). Pressure wire-derived FFR, measured during maximal hyperemia, served as the reference. Separate independent core laboratories analyzed angiographic images and pressure tracings from 8 centers in 7 countries. RESULTS The QFR and FFR from 84 vessels in 73 patients with intermediate coronary lesions were compared. Mean angiographic percent diameter stenosis (DS%) was 46.1 ± 8.9%; 27 vessels (32%) had FFR ≤ 0.80. Good agreement with FFR was observed for fQFR, cQFR, and aQFR, with mean differences of 0.003 ± 0.068 (p = 0.66), 0.001 ± 0.059 (p = 0.90), and -0.001 ± 0.065 (p = 0.90), respectively. The overall diagnostic accuracy for identifying an FFR of ≤0.80 was 80% (95% confidence interval [CI]: 71% to 89%), 86% (95% CI: 78% to 93%), and 87% (95% CI: 80% to 94%). The area under the receiver-operating characteristic curve was higher for cQFR than fQFR (difference: 0.04; 95% CI: 0.01 to 0.08; p < 0.01), but did not differ significantly between cQFR and aQFR (difference: 0.01; 95% CI: -0.04 to 0.06; p = 0.65). Compared with DS%, both cQFR and aQFR increased the area under the receiver-operating characteristic curve by 0.20 (p < 0.01) and 0.19 (p < 0.01). The positive likelihood ratio was 4.8, 8.4, and 8.9 for fQFR, cQFR, and aQFR, with negative likelihood ratio of 0.4, 0.3, and 0.2, respectively. CONCLUSIONS The QFR computation improved the diagnostic accuracy of 3-dimensional quantitative coronary angiography-based identification of stenosis significance. The favorable results of cQFR that does not require pharmacologic hyperemia induction bears the potential of a wider adoption of FFR-based lesion assessment through a reduction in procedure time, risk, and costs.
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Affiliation(s)
- Shengxian Tu
- Biomedical Instrument Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.
| | - Jelmer Westra
- Department of Cardiology, Aarhus University Hospital, Skejby, Denmark
| | - Junqing Yang
- Department of Cardiology, Guangdong General Hospital, Guangzhou, China
| | - Clemens von Birgelen
- Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, and Health Technology and Services Research, MIRA Institute, University of Twente, Enschede, the Netherlands
| | - Angela Ferrara
- Cardiovascular Research Centre, OLV Hospital, Aalst, Belgium
| | - Mariano Pellicano
- Cardiovascular Research Centre, OLV Hospital, Aalst, Belgium; Department of Advanced Biomedical Sciences, University of Naples, Federico II, Naples, Italy
| | - Holger Nef
- Department of Cardiology and Angiology, University of Giessen, Giessen, Germany
| | - Matteo Tebaldi
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy
| | - Yoshinobu Murasato
- Department of Cardiology, Clinical Research Center, Kyushu Medical Center, Fukuoka, Japan
| | - Alexandra Lansky
- Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Emanuele Barbato
- Cardiovascular Research Centre, OLV Hospital, Aalst, Belgium; Department of Advanced Biomedical Sciences, University of Naples, Federico II, Naples, Italy
| | - Liefke C van der Heijden
- Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, and Health Technology and Services Research, MIRA Institute, University of Twente, Enschede, the Netherlands
| | - Johan H C Reiber
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Niels R Holm
- Department of Cardiology, Aarhus University Hospital, Skejby, Denmark
| | - William Wijns
- Cardiovascular Research Centre, OLV Hospital, Aalst, Belgium; The Lambe Institute for Translational Medicine and Curam, National University of Ireland, Galway, and Saolta University Healthcare Group, Galway, Ireland
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Adjedj J, Pellicano M, Ferrara A, Xaplanteris P, Ciccarelli G, Viggiano A, Bartunek J, De Bruyne B, Barbato E. P1736Angiographic and hemodynamic modifications of Myocardial Bridge during supine bicycle exercise. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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14
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Danese A, Stegagno C, Tomelleri G, Piccoli A, Turri G, Carletti M, Variola A, Anselmi M, Mazzucco S, Ferrara A, Bovi P, Micheletti N, Cappellari M, Monaco S, Vassanelli C, Ribichini F. Clinical outcomes of secondary prevention strategies for young patients with cryptogenic stroke and patent foramen ovale. Acta Cardiol 2017; 72:410-418. [PMID: 28705105 DOI: 10.1080/00015385.2017.1307668] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background The aim of this study was to compare the immediate and long-term clinical outcomes of medical therapy and percutaneous patent foramen ovale (PFO) closure as secondary prevention strategies in patients younger than 55 years of age presenting with cryptogenic stroke and PFO. Methods Between January 2006 and April 2015, all patients with the diagnosis of cryptogenic stroke and PFO were analysed and prospectively followed. Stroke was confirmed in 159 out of 309 patients (51%). In the remaining cases, other neurological conditions were found and therefore excluded from further analysis. Patients received PFO closure or medical therapy on the basis of a pre-specified algorithm. Primary outcome was the assessment of recurrent ischaemic events at follow-up. Results Percutaneous PFO closure was performed in 77 patients (48%) and 82 (52%) were treated medically. Mean follow-up was 51.6 ± 34.8 months. Two ischaemic strokes occurred in the medical group only (2.4% vs 0%; P = 0.16) and no complications related to the invasive procedure were observed. Conclusions The diagnosis of stroke in patients with PFO could be confirmed in 50% of cases only, underlining the importance of a multidisciplinary evaluation of these patients. A very low ischaemic recurrence rate was observed in the medical therapy group, suggesting that a personalized treatment based on a prespecified diagnostic algorithm yields good clinical results irrespective of the treatment modality. Given the low number of recurrences, larger cohorts may be needed to prove significant differences.
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Affiliation(s)
- Alessandra Danese
- Department of Neurological, Neuropsychological, Morphological and Movement Sciences, Section of Clinical Neurology, University Hospital of Verona, Italy
| | - Chiara Stegagno
- Division of Neurology, Rovereto Hospital, Trento, Verona, Italy
| | | | - Anna Piccoli
- Division of Cardiology, Department of Medicine, University Hospital of Verona
| | - Giulia Turri
- Department of Neurological, Neuropsychological, Morphological and Movement Sciences, Section of Clinical Neurology, University Hospital of Verona, Italy
| | - Monica Carletti
- Division of Cardiology, Department of Medicine, University Hospital of Verona
| | - Andrea Variola
- Division of Cardiology, Department of Medicine, University Hospital of Verona
| | | | - Sara Mazzucco
- Department of Neurological, Neuropsychological, Morphological and Movement Sciences, Section of Clinical Neurology, University Hospital of Verona, Italy
- Stroke prevention research unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Angela Ferrara
- Division of Cardiology, Department of Medicine, University Hospital of Verona
| | - Paolo Bovi
- Department of Neurosciences, Stroke Unit, Verona Hospital, Verona, Italy
| | - Nicola Micheletti
- Department of Neurosciences, Stroke Unit, Verona Hospital, Verona, Italy
| | - Manuel Cappellari
- Department of Neurosciences, Stroke Unit, Verona Hospital, Verona, Italy
| | - Salvatore Monaco
- Department of Neurological, Neuropsychological, Morphological and Movement Sciences, Section of Clinical Neurology, University Hospital of Verona, Italy
| | - Corrado Vassanelli
- Division of Cardiology, Department of Medicine, University Hospital of Verona
| | - Flavio Ribichini
- Division of Cardiology, Department of Medicine, University Hospital of Verona
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15
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Adjedj J, Xaplanteris P, Toth G, Ferrara A, Pellicano M, Ciccarelli G, Floré V, Barbato E, De Bruyne B. Visual and Quantitative Assessment of Coronary Stenoses at Angiography Versus Fractional Flow Reserve: The Impact of Risk Factors. Circ Cardiovasc Imaging 2017; 10:CIRCIMAGING.117.006243. [PMID: 28687539 DOI: 10.1161/circimaging.117.006243] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Accepted: 05/26/2017] [Indexed: 01/14/2023]
Abstract
BACKGROUND The correlation between angiographic assessment of coronary stenoses and fractional flow reserve (FFR) is weak. Whether and how risk factors impact the diagnostic accuracy of angiography is unknown. We sought to evaluate the diagnostic accuracy of angiography by visual estimate and by quantitative coronary angiography when compared with FFR and evaluate the influence of risk factors (RF) on this accuracy. METHODS AND RESULTS In 1382 coronary stenoses (1104 patients), percent diameter stenosis by visual estimation (DSVE) and by quantitative coronary angiography (DSQCA) was compared with FFR. Patients were divided into 4 subgroups, according to the presence of RFs, and the relationship between DSVE, DSQCA, and FFR was analyzed. Overall, DSVE was significantly higher than DSQCA (P<0.0001); nonetheless, when examined by strata of DS, DSVE was significantly smaller than DSQCA in mild stenoses, although the reverse held true for severe stenoses. Compared with FFR, a large scatter was observed for both DSVE and DSQCA. When using a dichotomous FFR value of 0.80, C statistic was significantly higher for DSVE than for DSQCA (0.712 versus 0.640, respectively; P<0.001). C statistics for DSVE decreased progressively as RFs accumulated (0.776 for ≤1 RF, 0.750 for 2 RFs, 0.713 for 3 RFs and 0.627 for ≥4 RFs; P=0.0053). In addition, in diabetics, the relationship between FFR and angiographic indices was particularly weak (C statistics: 0.524 for DSVE and 0.511 for DSQCA). CONCLUSIONS Overall, DSVE has a better diagnostic accuracy than DSQCA to predict the functional significance of coronary stenosis. The predictive accuracy of angiography is moderate in patients with ≤1 RFs, but weakens as RFs accumulate, especially in diabetics.
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Affiliation(s)
- Julien Adjedj
- From the Cardiovascular Center Aalst, Belgium (J.A., P.X., A.F., M.P., G.C., V.F., E.B., B.D.B.); and Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy (E.B.)
| | - Panagiotis Xaplanteris
- From the Cardiovascular Center Aalst, Belgium (J.A., P.X., A.F., M.P., G.C., V.F., E.B., B.D.B.); and Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy (E.B.)
| | - Gabor Toth
- From the Cardiovascular Center Aalst, Belgium (J.A., P.X., A.F., M.P., G.C., V.F., E.B., B.D.B.); and Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy (E.B.)
| | - Angela Ferrara
- From the Cardiovascular Center Aalst, Belgium (J.A., P.X., A.F., M.P., G.C., V.F., E.B., B.D.B.); and Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy (E.B.)
| | - Mariano Pellicano
- From the Cardiovascular Center Aalst, Belgium (J.A., P.X., A.F., M.P., G.C., V.F., E.B., B.D.B.); and Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy (E.B.)
| | - Giovanni Ciccarelli
- From the Cardiovascular Center Aalst, Belgium (J.A., P.X., A.F., M.P., G.C., V.F., E.B., B.D.B.); and Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy (E.B.)
| | - Vincent Floré
- From the Cardiovascular Center Aalst, Belgium (J.A., P.X., A.F., M.P., G.C., V.F., E.B., B.D.B.); and Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy (E.B.)
| | - Emanuele Barbato
- From the Cardiovascular Center Aalst, Belgium (J.A., P.X., A.F., M.P., G.C., V.F., E.B., B.D.B.); and Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy (E.B.)
| | - Bernard De Bruyne
- From the Cardiovascular Center Aalst, Belgium (J.A., P.X., A.F., M.P., G.C., V.F., E.B., B.D.B.); and Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy (E.B.).
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16
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De Bruyne B, Adjedj J, Xaplanteris P, Ferrara A, Mo Y, Penicka M, Floré V, Pellicano M, Toth G, Barbato E, Duncker DJ, Pijls NH. Saline-Induced Coronary Hyperemia. Circ Cardiovasc Interv 2017; 10:CIRCINTERVENTIONS.116.004719. [DOI: 10.1161/circinterventions.116.004719] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 03/21/2017] [Indexed: 11/16/2022]
Abstract
Background—
During thermodilution-based assessment of volumetric coronary blood flow, we observed that intracoronary infusion of saline increased coronary flow. This study aims to quantify the extent and unravel the mechanisms of saline-induced hyperemia.
Methods and Results—
Thirty-three patients were studied; in 24 patients, intracoronary Doppler flow velocity measurements were performed at rest, after intracoronary adenosine, and during increasing infusion rates of saline at room temperature through a dedicated catheter with 4 lateral side holes. In 9 patients, global longitudinal strain and flow propagation velocity were assessed by transthoracic echocardiography during a prolonged intracoronary saline infusion. Taking adenosine-induced maximal hyperemia as reference, intracoronary infusion of saline at rates of 5, 10, 15, and 20 mL/min induced 6%, 46%, 111%, and 112% of maximal hyperemia, respectively. There was a close agreement of maximal saline- and adenosine-induced coronary flow reserve (intraclass correlation coefficient, 0.922;
P
<0.001). The same infusion rates given through 1 end hole (n=6) or in the contralateral artery (n=6) did not induce a significant increase in flow velocity. Intracoronary saline given on top of an intravenous infusion of adenosine did not further increase flow. Intracoronary saline infusion did not affect blood pressure, systolic, or diastolic left ventricular function. Heart rate decreased by 15% during saline infusion (
P
=0.021).
Conclusions—
Intracoronary infusion of saline at room temperature through a dedicated catheter for coronary thermodilution induces steady-state maximal hyperemia at a flow rate ≥15 mL/min. These findings open new possibilities to measure maximal absolute coronary blood flow and minimal microcirculatory resistance.
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Affiliation(s)
- Bernard De Bruyne
- From the Cardiovascular Center Aalst, Belgium (B.D.B., J.A., P.X., A.F., Y.M., M. Penicka, V.F., M. Pellicano, E.B.); Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy (M. Pellicano, E.B.); University Heart Centre Graz, Austria (G.T.); Experimental Cardiology, Thoraxcenter, Erasmus University Rotterdam, The Netherlands (D.J.D.); Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands (N.H.J.P.); and Department of Biomedical Engineering, Eindhoven
| | - Julien Adjedj
- From the Cardiovascular Center Aalst, Belgium (B.D.B., J.A., P.X., A.F., Y.M., M. Penicka, V.F., M. Pellicano, E.B.); Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy (M. Pellicano, E.B.); University Heart Centre Graz, Austria (G.T.); Experimental Cardiology, Thoraxcenter, Erasmus University Rotterdam, The Netherlands (D.J.D.); Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands (N.H.J.P.); and Department of Biomedical Engineering, Eindhoven
| | - Panagiotis Xaplanteris
- From the Cardiovascular Center Aalst, Belgium (B.D.B., J.A., P.X., A.F., Y.M., M. Penicka, V.F., M. Pellicano, E.B.); Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy (M. Pellicano, E.B.); University Heart Centre Graz, Austria (G.T.); Experimental Cardiology, Thoraxcenter, Erasmus University Rotterdam, The Netherlands (D.J.D.); Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands (N.H.J.P.); and Department of Biomedical Engineering, Eindhoven
| | - Angela Ferrara
- From the Cardiovascular Center Aalst, Belgium (B.D.B., J.A., P.X., A.F., Y.M., M. Penicka, V.F., M. Pellicano, E.B.); Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy (M. Pellicano, E.B.); University Heart Centre Graz, Austria (G.T.); Experimental Cardiology, Thoraxcenter, Erasmus University Rotterdam, The Netherlands (D.J.D.); Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands (N.H.J.P.); and Department of Biomedical Engineering, Eindhoven
| | - Yujing Mo
- From the Cardiovascular Center Aalst, Belgium (B.D.B., J.A., P.X., A.F., Y.M., M. Penicka, V.F., M. Pellicano, E.B.); Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy (M. Pellicano, E.B.); University Heart Centre Graz, Austria (G.T.); Experimental Cardiology, Thoraxcenter, Erasmus University Rotterdam, The Netherlands (D.J.D.); Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands (N.H.J.P.); and Department of Biomedical Engineering, Eindhoven
| | - Martin Penicka
- From the Cardiovascular Center Aalst, Belgium (B.D.B., J.A., P.X., A.F., Y.M., M. Penicka, V.F., M. Pellicano, E.B.); Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy (M. Pellicano, E.B.); University Heart Centre Graz, Austria (G.T.); Experimental Cardiology, Thoraxcenter, Erasmus University Rotterdam, The Netherlands (D.J.D.); Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands (N.H.J.P.); and Department of Biomedical Engineering, Eindhoven
| | - Vincent Floré
- From the Cardiovascular Center Aalst, Belgium (B.D.B., J.A., P.X., A.F., Y.M., M. Penicka, V.F., M. Pellicano, E.B.); Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy (M. Pellicano, E.B.); University Heart Centre Graz, Austria (G.T.); Experimental Cardiology, Thoraxcenter, Erasmus University Rotterdam, The Netherlands (D.J.D.); Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands (N.H.J.P.); and Department of Biomedical Engineering, Eindhoven
| | - Mariano Pellicano
- From the Cardiovascular Center Aalst, Belgium (B.D.B., J.A., P.X., A.F., Y.M., M. Penicka, V.F., M. Pellicano, E.B.); Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy (M. Pellicano, E.B.); University Heart Centre Graz, Austria (G.T.); Experimental Cardiology, Thoraxcenter, Erasmus University Rotterdam, The Netherlands (D.J.D.); Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands (N.H.J.P.); and Department of Biomedical Engineering, Eindhoven
| | - Gabor Toth
- From the Cardiovascular Center Aalst, Belgium (B.D.B., J.A., P.X., A.F., Y.M., M. Penicka, V.F., M. Pellicano, E.B.); Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy (M. Pellicano, E.B.); University Heart Centre Graz, Austria (G.T.); Experimental Cardiology, Thoraxcenter, Erasmus University Rotterdam, The Netherlands (D.J.D.); Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands (N.H.J.P.); and Department of Biomedical Engineering, Eindhoven
| | - Emanuele Barbato
- From the Cardiovascular Center Aalst, Belgium (B.D.B., J.A., P.X., A.F., Y.M., M. Penicka, V.F., M. Pellicano, E.B.); Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy (M. Pellicano, E.B.); University Heart Centre Graz, Austria (G.T.); Experimental Cardiology, Thoraxcenter, Erasmus University Rotterdam, The Netherlands (D.J.D.); Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands (N.H.J.P.); and Department of Biomedical Engineering, Eindhoven
| | - Dirk J. Duncker
- From the Cardiovascular Center Aalst, Belgium (B.D.B., J.A., P.X., A.F., Y.M., M. Penicka, V.F., M. Pellicano, E.B.); Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy (M. Pellicano, E.B.); University Heart Centre Graz, Austria (G.T.); Experimental Cardiology, Thoraxcenter, Erasmus University Rotterdam, The Netherlands (D.J.D.); Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands (N.H.J.P.); and Department of Biomedical Engineering, Eindhoven
| | - Nico H.J. Pijls
- From the Cardiovascular Center Aalst, Belgium (B.D.B., J.A., P.X., A.F., Y.M., M. Penicka, V.F., M. Pellicano, E.B.); Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy (M. Pellicano, E.B.); University Heart Centre Graz, Austria (G.T.); Experimental Cardiology, Thoraxcenter, Erasmus University Rotterdam, The Netherlands (D.J.D.); Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands (N.H.J.P.); and Department of Biomedical Engineering, Eindhoven
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Ehrlich SF, Hedderson MM, Brown SD, Sternfeld B, Chasan-Taber L, Feng J, Adams J, Ching J, Crites Y, Quesenberry CP, Ferrara A. Moderate intensity sports and exercise is associated with glycaemic control in women with gestational diabetes. Diabetes Metab 2017; 43:416-423. [PMID: 28238600 DOI: 10.1016/j.diabet.2017.01.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Revised: 01/12/2017] [Accepted: 01/17/2017] [Indexed: 12/16/2022]
Abstract
AIM To assess the association of regular, unsupervised sports and exercise during pregnancy, by intensity level, with glycaemic control in women with gestational diabetes (GDM). METHODS Prospective cohort study of 971 women who, shortly after being diagnosed with GDM, completed a Pregnancy Physical Activity Questionnaire assessing moderate and vigorous intensity sports and exercise in the past 3 months. Self-monitored capillary glucose values were obtained for the 6-week period following the questionnaire, with optimal glycaemic control defined≥80% values meeting the targets<5.3mmol/L for fasting and <7.8mmol/L 1-hour after meals. Logistic regression estimated the odds of achieving optimal control; linear regression estimated activity level-specific least square mean glucose, as well as between-level mean glucose differences. RESULTS For volume of moderate intensity sports and exercise ([MET×hours]/week), the highest quartile, compared to the lowest, had significantly increased odds of optimal control (OR=1.82 [95% CI: 1.06-3.14] P=0.03). There were significant trends for decreasing mean 1-hour post breakfast, lunch and dinner glycaemia with increasing quartile of moderate activity (all P<0.05). Any participation in vigorous intensity sports and exercise was associated with decreased mean 1-hour post breakfast and lunch glycaemia (both P<0.05). No associations were observed for fasting. CONCLUSION Higher volumes of moderate intensity sports and exercise, reported shortly after GDM diagnosis, were significantly associated with increased odds of achieving glycaemic control. Clinicians should be aware that unsupervised moderate intensity sports and exercise performed in mid-pregnancy aids in subsequent glycaemic control among women with GDM.
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Affiliation(s)
- S F Ehrlich
- Division of research, Kaiser Permanente Northern California, Oakland, CA, USA; Department of Public Health, College of Education, Health and Human Sciences, University of Tennessee, Knoxville, TN, USA.
| | - M M Hedderson
- Division of research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - S D Brown
- Division of research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - B Sternfeld
- Division of research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - L Chasan-Taber
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, USA
| | - J Feng
- Division of research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - J Adams
- Division of research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - J Ching
- Division of Perinatology, Department of Obstetrics and Gynecology, Kaiser Permanente Medical Center, Santa Clara, CA, USA
| | - Y Crites
- Division of Perinatology, Department of Obstetrics and Gynecology, Kaiser Permanente Medical Center, Santa Clara, CA, USA
| | - C P Quesenberry
- Division of research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - A Ferrara
- Division of research, Kaiser Permanente Northern California, Oakland, CA, USA
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Adjedj J, Xamplanteris P, Toth G, Ferrara A, Flore V, Pellicano M, Barbato E, De Bruyne B. Fractional flow reserve (FFR) and angiographic estimation correlation of coronary stenoses: the impact of risk factors. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30065-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hedderson MM, Ferrara A, Avalos LA, Van den Eeden SK, Gunderson EP, Li DK, Altschuler A, Woo S, Rowell S, Choudhary V, Xu F, Flanagan T, Schaefer C, Croen LA. The Kaiser Permanente Northern California research program on genes, environment, and health (RPGEH) pregnancy cohort: study design, methodology and baseline characteristics. BMC Pregnancy Childbirth 2016; 16:381. [PMID: 27899076 PMCID: PMC5129213 DOI: 10.1186/s12884-016-1150-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 11/08/2016] [Indexed: 11/16/2022] Open
Abstract
Background Exposures during the prenatal period may have lasting effects on maternal and child health outcomes. To better understand the effects of the in utero environment on children’s short- and long-term health, large representative pregnancy cohorts with comprehensive information on a broad range of environmental influences (including biological and behavioral) and the ability to link to prenatal, child and maternal health outcomes are needed. The Research Program on Genes, Environment and Health (RPGEH) pregnancy cohort at Kaiser Permanente Northern California (KPNC) was established to create a resource for conducting research to better understand factors influencing women’s and children’s health. Recruitment is integrated into routine clinical prenatal care at KPNC, an integrated health care delivery system. We detail the study design, data collection, and methodologies for establishing this cohort. We also describe the baseline characteristics and the cohort’s representativeness of the underlying pregnant population in KPNC. Methods While recruitment is ongoing, as of October 2014, the RPGEH pregnancy cohort included 16,977 pregnancies (53 % from racial and ethnic minorities). RPGEH pregnancy cohort participants consented to have blood samples obtained in the first trimester (mean gestational age 9.1 weeks ± 4.2 SD) and second trimester (mean gestational age 18.1 weeks ± 5.5 SD) to be stored for future use. Women were invited to complete a questionnaire on health history and lifestyle. Information on women’s clinical and health assessments before, during and after pregnancy and women and children’s health outcomes are available in the health system’s electronic health records, which also allows long-term follow-up. Discussion This large, racially- and ethnically-diverse cohort of pregnancies with prenatal biospecimens and clinical data is a valuable resource for future studies on in utero environmental exposures and maternal and child perinatal and long term health outcomes. The baseline characteristics of RPGEH Pregnancy Cohort demonstrate that it is highly representative of the underlying population living in the broader community in Northern California. Electronic supplementary material The online version of this article (doi:10.1186/s12884-016-1150-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M M Hedderson
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA.
| | - A Ferrara
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - L A Avalos
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - S K Van den Eeden
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - E P Gunderson
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - D K Li
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - A Altschuler
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - S Woo
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - S Rowell
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - V Choudhary
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - F Xu
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - T Flanagan
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - C Schaefer
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - L A Croen
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
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Floré V, Pellicano M, Adjedj J, Ferrara A, Van Der Steen K, Bartunek J. Plaque protrusion compromising bioresorbable coronary scaffold patency. EUROINTERVENTION 2016; 12:873. [PMID: 27639739 DOI: 10.4244/eijv12i7a142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Vincent Floré
- Cardiovascular Center, OLV Clinic Aalst, Aalst, Belgium
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Aminian A, Iglesias JF, Van Mieghem C, Zuffi A, Ferrara A, Manih R, Dolatabadi D, Lalmand J, Saito S. First prospective multicenter experience with the 7 French Glidesheath slender for complex transradial coronary interventions. Catheter Cardiovasc Interv 2016; 89:1014-1020. [DOI: 10.1002/ccd.26773] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 07/22/2016] [Accepted: 08/07/2016] [Indexed: 11/08/2022]
Affiliation(s)
- Adel Aminian
- Centre Hospitalier Universitaire de Charleroi; Charleroi Belgium
| | | | | | - Andrea Zuffi
- Centre Hospitalier Universitaire Vaudois; Lausanne Switzerland
| | | | - Roukos Manih
- Centre Hospitalier Universitaire de Charleroi; Charleroi Belgium
| | | | - Jacques Lalmand
- Centre Hospitalier Universitaire de Charleroi; Charleroi Belgium
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Ferrara A, DI Gioia G, Strisciuglio T, Wijns W, Barbato E. Overview of the clinical trials on bioresorbable vascular scaffold. Minerva Cardioangiol 2016; 64:473-480. [PMID: 27195662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Although several new scaffolds are progressively being investigated and entering the clinical scene, BRS has accumulated the largest experience by far including detailed evaluation of the first patients studied followed almost in parallel by clinical evaluation and worldwide randomized evaluation for non-inferiority against best contemporary metallic DES. Available evidence shows that careful procedural technique is required for proper and safe delivery of the current generation scaffolds. Future studies will indicate whether all or only selected patient or lesion subsets will ultimately benefit from treatment with fully bioresorbable devices.
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Affiliation(s)
- Angela Ferrara
- Cardiovascular Research Center Aalst, OLV Hospital, Aalst, Belgium -
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Adjedj J, Toth GG, Johnson NP, Pellicano M, Ferrara A, Floré V, Di Gioia G, Barbato E, Muller O, De Bruyne B. Intracoronary Adenosine: Dose-Response Relationship With Hyperemia. JACC Cardiovasc Interv 2016; 8:1422-1430. [PMID: 26404193 DOI: 10.1016/j.jcin.2015.04.028] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 03/30/2015] [Accepted: 04/09/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The present study sought to establish the dosage of intracoronary (IC) adenosine associated with minimal side effects and above which no further increase in flow can be expected. BACKGROUND Despite the widespread adoption of IC adenosine in clinical practice, no wide-ranging, dose-response study has been conducted. A recurring debate still exists regarding its optimal dose. METHODS In 30 patients, Doppler-derived flow velocity measurements were obtained in 10 right coronary arteries (RCAs) and 20 left coronary arteries (LCAs) free of stenoses >20% in diameter. Flow velocity was measured at baseline and after 8 ml bolus administrations of arterial blood, saline, contrast medium, and 9 escalating doses of adenosine (4 to 500 μg). The hyperemic value was expressed in percent of the maximum flow velocity reached in a given artery (Q/Qmax, %). RESULTS Q/Qmax did not increase significantly beyond dosages of 60 μg for the RCA and 160 μg for LCA. Heart rate did not change, whereas mean arterial blood pressure decreased by a maximum of 7% (p < 0.05) after bolus injections of IC adenosine. The incidence of transient A-V blocks was 40% after injection of 100 μg in the RCA and was 15% after injection of 200 μg in the LCA. The duration of the plateau reached 12 ± 13 s after injection of 100 μg in the RCA and 21 ± 6 s after the injection of 200 μg in the LCA. A progressive prolongation of the time needed to return to baseline was observed. Hyperemic response after injection of 8 ml of contrast medium reached 65 ± 36% of that achieved after injection of 200 μg of adenosine. CONCLUSIONS This wide-ranging, dose-response study indicates that an IC adenosine bolus injection of 100 μg in the RCA and 200 μg in the LCA induces maximum hyperemia while being associated with minimal side effects.
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Affiliation(s)
- Julien Adjedj
- Cardiovascular Centre Aalst, OLV Clinic Aalst, Aalst, Belgium
| | - Gabor G Toth
- Cardiovascular Centre Aalst, OLV Clinic Aalst, Aalst, Belgium
| | - Nils P Johnson
- Weatherhead PET Center for Preventing and Reversing Atherosclerosis, Division of Cardiology, Department of Medicine, University of Texas Medical School and Memorial Hermann Hospital, Houston, Texas
| | | | - Angela Ferrara
- Cardiovascular Centre Aalst, OLV Clinic Aalst, Aalst, Belgium
| | - Vincent Floré
- Cardiovascular Centre Aalst, OLV Clinic Aalst, Aalst, Belgium
| | | | | | - Olivier Muller
- Department of Cardiology, Hopital Cantonal Universitaire Vaudois, Lausanne, Switzerland
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van Lavieren MA, van de Hoef TP, Sjauw KD, Piek JJ, Ferrara A, De Bruyne B, Gould KL. How should I treat a patient with refractory angina and a single stenosis with normal FFR but abnormal CFR? EUROINTERVENTION 2016; 11:125-8. [PMID: 25982657 DOI: 10.4244/eijv11i1a23] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Martijn A van Lavieren
- AMC Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Di Gioia G, Pellicano M, Toth GG, Casselman F, Adjedj J, Van Praet F, Ferrara A, Stockman B, Degrieck I, Bartunek J, Trimarco B, Wijns W, De Bruyne B, Barbato E. Fractional Flow Reserve-Guided Revascularization in Patients With Aortic Stenosis. Am J Cardiol 2016; 117:1511-5. [PMID: 26976789 DOI: 10.1016/j.amjcard.2016.02.023] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 02/08/2016] [Accepted: 02/08/2016] [Indexed: 11/30/2022]
Abstract
Fractional flow reserve (FFR) has never been investigated in patients with aortic stenosis (AS). From 2002 to 2010, we identified 106 patients with AS and coronary artery disease with at least one intermediate lesion treated according to FFR guidance. We matched 212 contemporary control patients with AS in which revascularization was decided on angiography only. More patients in the FFR-guided group underwent percutaneous coronary intervention (24% vs 13%; p = 0.019), whereas there was a trend toward less coronary artery bypass grafting (CABG) performed. After FFR, the number of diseased vessels was downgraded within the FFR-guided group (from 1.85 ± 0.97 to 1.48 ± 1; p <0.01) and compared with the angio-guided group (1.48 ± 1 vs 1.8 ± 0.97; p <0.01). Less aortic valve replacement was reported in the FFR-guided group (46% vs 57%; p = 0.056). In patients who underwent CABG, less venous conduits (0.5 ± 0.69 vs 0.73 ± 0.76; p = 0.05) and anastomoses (0.61 ± 0.85 vs 0.94 ± 1; p = 0.032) were necessary in the FFR-guided group. Up to 5 years, we found no difference in major adverse cardiac events (38% vs 39%; p = 0.98), overall death (32% vs 31%; p = 0.68), nonfatal myocardial infarction (2% vs 2%; p = 0.79), and revascularization (8% vs 7%; p = 0.76) between the 2 groups. In conclusion, FFR guidance impacts the management of selected patients with moderate or severe AS and coronary artery disease by resulting into deferral of aortic valve replacement, more patients treated with percutaneous coronary intervention, and in patients treated with CABG, into less venous grafts and anastomoses without increasing adverse event rates up to 5 years.
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Affiliation(s)
- Giuseppe Di Gioia
- Cardiovascular Center Aalst, Onze-Lieve-Vrouw Hospital, Aalst, Belgium; Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy
| | - Mariano Pellicano
- Cardiovascular Center Aalst, Onze-Lieve-Vrouw Hospital, Aalst, Belgium; Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy
| | - Gabor G Toth
- Cardiovascular Center Aalst, Onze-Lieve-Vrouw Hospital, Aalst, Belgium; University Heart Center Graz, Medical University Graz, Graz, Austria
| | - Filip Casselman
- Cardiovascular Center Aalst, Onze-Lieve-Vrouw Hospital, Aalst, Belgium
| | - Julien Adjedj
- Cardiovascular Center Aalst, Onze-Lieve-Vrouw Hospital, Aalst, Belgium
| | - Frank Van Praet
- Cardiovascular Center Aalst, Onze-Lieve-Vrouw Hospital, Aalst, Belgium
| | - Angela Ferrara
- Cardiovascular Center Aalst, Onze-Lieve-Vrouw Hospital, Aalst, Belgium
| | - Bernard Stockman
- Cardiovascular Center Aalst, Onze-Lieve-Vrouw Hospital, Aalst, Belgium
| | - Ivan Degrieck
- Cardiovascular Center Aalst, Onze-Lieve-Vrouw Hospital, Aalst, Belgium
| | - Jozef Bartunek
- Cardiovascular Center Aalst, Onze-Lieve-Vrouw Hospital, Aalst, Belgium
| | - Bruno Trimarco
- Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy
| | - William Wijns
- Cardiovascular Center Aalst, Onze-Lieve-Vrouw Hospital, Aalst, Belgium
| | - Bernard De Bruyne
- Cardiovascular Center Aalst, Onze-Lieve-Vrouw Hospital, Aalst, Belgium
| | - Emanuele Barbato
- Cardiovascular Center Aalst, Onze-Lieve-Vrouw Hospital, Aalst, Belgium; Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy.
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Adjedj J, De Bruyne B, Floré V, Di Gioia G, Ferrara A, Pellicano M, Toth GG, Bartunek J, Vanderheyden M, Heyndrickx GR, Wijns W, Barbato E. Significance of Intermediate Values of Fractional Flow Reserve in Patients With Coronary Artery Disease. Circulation 2016; 133:502-8. [DOI: 10.1161/circulationaha.115.018747] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 12/21/2015] [Indexed: 11/16/2022]
Affiliation(s)
- Julien Adjedj
- From Cardiovascular Research Center Aalst OLV Clinic, Aalst, Belgium (J.A., B.D.B., V.F., G.D.G., A.F., M.P., G.G.T., J.B., M.V., G.R.H., W.W., E.B.); Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Italy (G.D.G., M.P., E.B.); and University Heart Centre Graz, Medical University Graz, Austria (G.G.T.)
| | - Bernard De Bruyne
- From Cardiovascular Research Center Aalst OLV Clinic, Aalst, Belgium (J.A., B.D.B., V.F., G.D.G., A.F., M.P., G.G.T., J.B., M.V., G.R.H., W.W., E.B.); Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Italy (G.D.G., M.P., E.B.); and University Heart Centre Graz, Medical University Graz, Austria (G.G.T.)
| | - Vincent Floré
- From Cardiovascular Research Center Aalst OLV Clinic, Aalst, Belgium (J.A., B.D.B., V.F., G.D.G., A.F., M.P., G.G.T., J.B., M.V., G.R.H., W.W., E.B.); Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Italy (G.D.G., M.P., E.B.); and University Heart Centre Graz, Medical University Graz, Austria (G.G.T.)
| | - Giuseppe Di Gioia
- From Cardiovascular Research Center Aalst OLV Clinic, Aalst, Belgium (J.A., B.D.B., V.F., G.D.G., A.F., M.P., G.G.T., J.B., M.V., G.R.H., W.W., E.B.); Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Italy (G.D.G., M.P., E.B.); and University Heart Centre Graz, Medical University Graz, Austria (G.G.T.)
| | - Angela Ferrara
- From Cardiovascular Research Center Aalst OLV Clinic, Aalst, Belgium (J.A., B.D.B., V.F., G.D.G., A.F., M.P., G.G.T., J.B., M.V., G.R.H., W.W., E.B.); Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Italy (G.D.G., M.P., E.B.); and University Heart Centre Graz, Medical University Graz, Austria (G.G.T.)
| | - Mariano Pellicano
- From Cardiovascular Research Center Aalst OLV Clinic, Aalst, Belgium (J.A., B.D.B., V.F., G.D.G., A.F., M.P., G.G.T., J.B., M.V., G.R.H., W.W., E.B.); Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Italy (G.D.G., M.P., E.B.); and University Heart Centre Graz, Medical University Graz, Austria (G.G.T.)
| | - Gabor G. Toth
- From Cardiovascular Research Center Aalst OLV Clinic, Aalst, Belgium (J.A., B.D.B., V.F., G.D.G., A.F., M.P., G.G.T., J.B., M.V., G.R.H., W.W., E.B.); Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Italy (G.D.G., M.P., E.B.); and University Heart Centre Graz, Medical University Graz, Austria (G.G.T.)
| | - Jozef Bartunek
- From Cardiovascular Research Center Aalst OLV Clinic, Aalst, Belgium (J.A., B.D.B., V.F., G.D.G., A.F., M.P., G.G.T., J.B., M.V., G.R.H., W.W., E.B.); Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Italy (G.D.G., M.P., E.B.); and University Heart Centre Graz, Medical University Graz, Austria (G.G.T.)
| | - Marc Vanderheyden
- From Cardiovascular Research Center Aalst OLV Clinic, Aalst, Belgium (J.A., B.D.B., V.F., G.D.G., A.F., M.P., G.G.T., J.B., M.V., G.R.H., W.W., E.B.); Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Italy (G.D.G., M.P., E.B.); and University Heart Centre Graz, Medical University Graz, Austria (G.G.T.)
| | - Guy R. Heyndrickx
- From Cardiovascular Research Center Aalst OLV Clinic, Aalst, Belgium (J.A., B.D.B., V.F., G.D.G., A.F., M.P., G.G.T., J.B., M.V., G.R.H., W.W., E.B.); Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Italy (G.D.G., M.P., E.B.); and University Heart Centre Graz, Medical University Graz, Austria (G.G.T.)
| | - William Wijns
- From Cardiovascular Research Center Aalst OLV Clinic, Aalst, Belgium (J.A., B.D.B., V.F., G.D.G., A.F., M.P., G.G.T., J.B., M.V., G.R.H., W.W., E.B.); Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Italy (G.D.G., M.P., E.B.); and University Heart Centre Graz, Medical University Graz, Austria (G.G.T.)
| | - Emanuele Barbato
- From Cardiovascular Research Center Aalst OLV Clinic, Aalst, Belgium (J.A., B.D.B., V.F., G.D.G., A.F., M.P., G.G.T., J.B., M.V., G.R.H., W.W., E.B.); Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Italy (G.D.G., M.P., E.B.); and University Heart Centre Graz, Medical University Graz, Austria (G.G.T.)
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Affiliation(s)
- Julien Adjedj
- Cardiovascular Research Centre Aalst, OLV Clinic, Moorselbaan, 164, Aalst B-9300, Belgium
| | - Angela Ferrara
- Cardiovascular Research Centre Aalst, OLV Clinic, Moorselbaan, 164, Aalst B-9300, Belgium
| | - Martin Penicka
- Cardiovascular Research Centre Aalst, OLV Clinic, Moorselbaan, 164, Aalst B-9300, Belgium
| | - Carlos Van Mieghem
- Cardiovascular Research Centre Aalst, OLV Clinic, Moorselbaan, 164, Aalst B-9300, Belgium
| | - William Wijns
- Cardiovascular Research Centre Aalst, OLV Clinic, Moorselbaan, 164, Aalst B-9300, Belgium
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Adjedj J, Toth G, Pellicano M, Ferrara A, Flore V, Di Gioia G, Barbato E, Bruyne BD, Wijns W. 0255: Reversed Single String technique for coronary bifurcation stenting– first report in vitro case demonstrations. Archives of Cardiovascular Diseases Supplements 2016. [DOI: 10.1016/s1878-6480(16)30036-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Adjedj J, Toth G, Pellicano M, Gioia GD, Ferrara A, Flore V, Johnson N, Muller O, Barbato E, Bruyne BD. 0041: Contrast-induced microvascular dilatation: implications for fractional flow reserve measurements. Archives of Cardiovascular Diseases Supplements 2016. [DOI: 10.1016/s1878-6480(16)30029-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Adjedj J, Flore V, Gioia GD, Ferrara A, Pellicano M, Toth G, Wijns W, Bruyne BD, Barbato E. 0043: FFR Gray zone and clinical outcome. Archives of Cardiovascular Diseases Supplements 2016. [DOI: 10.1016/s1878-6480(16)30026-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Casselman F, Van der Merwe J, Ferrara A, Barbato E. The present day potential role of fractional flow reserve-guided coronary artery bypass graft surgery. J Thorac Cardiovasc Surg 2015; 151:926-32. [PMID: 26806476 DOI: 10.1016/j.jtcvs.2015.12.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 09/07/2015] [Accepted: 12/12/2015] [Indexed: 01/12/2023]
Abstract
The favorable impact of fractional flow reserve measurements on the decision-making and overall outcomes of percutaneous coronary artery intervention is well established. However, the clinical application of fractional flow reserve in surgical revascularizations is still debated. The purpose of this article is to provide a comprehensive review on the current potential role of fractional flow reserve guidance in coronary artery bypass grafting.
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Affiliation(s)
| | | | | | - Emanuele Barbato
- Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium; Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy
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Adjedj J, Floré V, Toth GG, Ferrara A, Pellicano M, Barbato E, De Bruyne B. TCT-308 Continuous intracoronary infusion of saline at room temperature induces steady state maximal hyperemia. J Am Coll Cardiol 2015. [DOI: 10.1016/j.jacc.2015.08.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Adjedj J, Toth GG, Ferrara A, Pellicano M, Floré V, Barbato E, De Bruyne B. TCT-307 Validation of a novel catheter for thermodilution-derived measurement of absolute coronary blood flow and microvascular resistances. J Am Coll Cardiol 2015. [DOI: 10.1016/j.jacc.2015.08.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Zimmermann FM, Ferrara A, Johnson NP, van Nunen LX, Escaned J, Albertsson P, Erbel R, Legrand V, Gwon HC, Remkes WS, Stella PR, van Schaardenburgh P, Bech GJW, De Bruyne B, Pijls NH. Deferral vs. performance of percutaneous coronary intervention of functionally non-significant coronary stenosis: 15-year follow-up of the DEFER trial. Eur Heart J 2015; 36:3182-8. [DOI: 10.1093/eurheartj/ehv452] [Citation(s) in RCA: 315] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 08/14/2015] [Indexed: 02/06/2023] Open
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Fede A, Zivelonghi C, Benfari G, Pesarini G, Pighi M, Ferrara A, Piccoli A, Ariotti S, Ferrero V, Mura DD, Battistoni M, Vassanelli C, Ribichini F. iFR-FFR comparison in daily practice. J Cardiovasc Med (Hagerstown) 2015; 16:625-31. [DOI: 10.2459/jcm.0000000000000272] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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G Toth G, Pyxaras S, Mortier P, De Vroey F, Di Gioia G, Adjedj J, Pellicano M, Ferrara A, De Schryver T, Van Hoorebeke L, Verhegghe B, Barbato E, De Bruyne B, De Beule M, Wijns W. Single String Technique for Coronary Bifurcation Stenting: Detailed Technical Evaluation and Feasibility Analysis. JACC Cardiovasc Interv 2015; 8:949-59. [PMID: 26003016 DOI: 10.1016/j.jcin.2015.01.037] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 01/20/2015] [Accepted: 01/29/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The study aimed to evaluate the adequacy and feasibility of the single string bifurcation stenting technique. BACKGROUND Double-stent techniques may be required for complex bifurcations. Currently applied methods all have their morphological or structural limitations with respect to wall coverage, multiple strut layers, and apposition rate. METHODS Single string is a novel method in which, first, the side branch (SB) stent is deployed with a single stent cell protruding into the main branch (MB). Second, the MB stent is deployed across this protruding stent cell. The procedure is completed by final kissing balloon dilation. The single string technique was first tested in vitro (n = 20) and next applied in patients (n = 11) with complex bifurcation stenoses. RESULTS All procedures were performed successfully, crossing a single stent cell in 100%. Procedure duration was 23.0 ± 7.9 min, and the fluoroscopy time was 9.4 ± 3.5 min. The results were evaluated by optical coherence tomography, showing fully apposed struts in 83.0 ± 9.2% in the bifurcation area. Residual area obstruction in the MB was 6.4 ± 5.6% and 25.0 ± 16.9% in the SB, as evaluated by micro computed tomography. All the human cases were performed successfully with excellent angiographic results: the residual area stenosis was 27 ± 8% and 29 ± 10% in the MB and in the SB, respectively, by 3-dimensional quantitative coronary angiography. No relevant periprocedural enzyme increase was observed. During follow-up (6 ± 4 months), no adverse clinical events (death, myocardial infarction, target vessel revascularization) were noted. CONCLUSIONS The single string technique for complex bifurcation dilation was shown to be adequate in vitro and feasible in humans, with favorable results in terms of stent overlap, malapposition rate, and low residual obstruction in both the MB and SB.
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Affiliation(s)
- Gabor G Toth
- Cardiovascular Research Centre Aalst, OLV Clinic, Aalst, Belgium; University Heart Centre Graz, Medical University of Graz, Graz, Austria
| | | | - Peter Mortier
- FEops Besloten Vennootschap met Beperkte Aansprakelijkheid, Ghent, Belgium; IBiTech-bioMMeda, IMinds Medical IT, Ghent University, Ghent, Belgium
| | | | - Giuseppe Di Gioia
- Cardiovascular Research Centre Aalst, OLV Clinic, Aalst, Belgium; Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - Julien Adjedj
- Cardiovascular Research Centre Aalst, OLV Clinic, Aalst, Belgium
| | | | - Angela Ferrara
- Cardiovascular Research Centre Aalst, OLV Clinic, Aalst, Belgium
| | | | | | - Benedict Verhegghe
- FEops Besloten Vennootschap met Beperkte Aansprakelijkheid, Ghent, Belgium; IBiTech-bioMMeda, IMinds Medical IT, Ghent University, Ghent, Belgium
| | - Emanuele Barbato
- Cardiovascular Research Centre Aalst, OLV Clinic, Aalst, Belgium; Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | | | - Matthieu De Beule
- FEops Besloten Vennootschap met Beperkte Aansprakelijkheid, Ghent, Belgium; IBiTech-bioMMeda, IMinds Medical IT, Ghent University, Ghent, Belgium
| | - William Wijns
- Cardiovascular Research Centre Aalst, OLV Clinic, Aalst, Belgium.
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Linden J, Plumier JC, Fassotte L, Ferrara A. Focal cerebral ischemia impairs motivation in a progressive FR schedule of reinforcement in mice. Behav Brain Res 2014; 279:82-6. [PMID: 25446765 DOI: 10.1016/j.bbr.2014.10.042] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 10/25/2014] [Accepted: 10/29/2014] [Indexed: 11/26/2022]
Abstract
Characterization of functional outcome in animal stroke models is essential to improve preclinical drug screenings. Operant procedures showed promising results for the identification of long-lasting functional deficits. In particular, a suppression of lever-pressing in high ratio schedules has been consistently found in rodent models of ischemic stroke. In the present work, we attempted to replicate these isolated observations, by submitting C57Bl/6J mice to a progressive fixed-ratio schedule of reinforcement three weeks after MCAO or sham surgery. Results showed a significant lever-pressing impairment in the MCAO group. Motivational factors (longer post-reinforcement pause, lesser appeal for food rewards) seemed accountable for the deficit, while motor abilities appeared preserved. These findings resemble fatigue-like states experienced by stroke survivors and may be used as long-term measures of behavioral outcome following experimental stroke.
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Affiliation(s)
- J Linden
- Département de Psychologie: Cognition et Comportement, Université de Liège, Belgium.
| | - J-C Plumier
- Département de Biologie, Ecologie et Evolution, Université de Liège, Belgium
| | - L Fassotte
- Département de Biologie, Ecologie et Evolution, Université de Liège, Belgium
| | - A Ferrara
- Département de Psychologie: Cognition et Comportement, Université de Liège, Belgium
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Pesarini G, Pighi M, Ariotti S, Ferrara A, Vassanelli C, Ribichini FL. TCT-261 Long-Term Prospective Outcome Analysis in High-Risk Patients for Contrast-Induced Acute Kidney Injury. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.07.303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ehrlich SF, Hedderson MM, Quesenberry CP, Feng J, Brown SD, Crites Y, Ferrara A. Post-partum weight loss and glucose metabolism in women with gestational diabetes: the DEBI Study. Diabet Med 2014; 31:862-7. [PMID: 24597974 PMCID: PMC4065174 DOI: 10.1111/dme.12425] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 12/10/2013] [Accepted: 02/27/2014] [Indexed: 01/18/2023]
Abstract
AIMS Women with gestational diabetes are at high risk for developing diabetes; post-partum weight loss may reduce the risk of diabetes. We evaluated the association of post-partum weight change with changes in glucose, insulin and homeostasis model assessment of insulin resistance in a subsample (n = 72) of participants from Diet Exercise and Breastfeeding Intervention (DEBI), a randomized pilot trial of lifestyle intervention for women with gestational diabetes. METHODS Glucose and insulin were measured fasting and 2 h after an oral glucose tolerance test at 6 weeks and 12 months post-partum. Women were categorized by weight change (lost > 2 kg vs. maintained/gained) between 6 weeks and 12 months post-partum. RESULTS Compared with women who maintained or gained weight, women who lost > 2 kg experienced significantly lower increases in fasting glucose [age-adjusted means: 0.1 mmol/l (95% CI -0.03 to 0.3) vs. 0.4 mmol/l (95% CI 0.3-0.6); P < 0.01] and 2-h insulin [10.0 pmol/l (95% CI -56.9 to 76.9) vs. 181.2 pmol/l (95% CI 108.3-506.9); P < 0.01] and a significant reduction in 2-h glucose [-0.9 mmol/l (95% CI -1.4 to -0.3) vs. 0.3 mmol/l (95% CI -0.3 to 0.9); P < 0.01]. In multiple linear regression models adjusted for age, Hispanic ethnicity, medication use, meeting the Institute of Medicine's recommendations for gestational weight gain, breastfeeding and randomized group, a 1-kg increase in weight was significantly associated with increases in fasting and 2-h glucose (P < 0.05), but was not associated with insulin or homeostasis model assessment of insulin resistance. CONCLUSIONS In women with gestational diabetes, modest post-partum weight loss may be associated with improvements in glucose metabolism.
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Affiliation(s)
- S F Ehrlich
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
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Modesto M, Michelini S, Stefanini I, Ferrara A, Tacconi S, Biavati B, Mattarelli P. Bifidobacterium aesculapii sp. nov., from the faeces of the baby common marmoset (Callithrix jacchus). Int J Syst Evol Microbiol 2014; 64:2819-2827. [PMID: 24867172 DOI: 10.1099/ijs.0.056937-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Six Gram-positive-staining, microaerophilic, non-spore-forming, fructose-6-phosphate phosphoketolase-positive bacterial strains with a peculiar morphology were isolated from faecal samples of baby common marmosets (Callithrix jacchus). Cells of these strains showed a morphology not reported previously for a bifidobacterial species, which resembled a coiled snake, always coiled or ring shaped or forming a 'Y' shape. Strains MRM 3/1(T) and MRM 4/2 were chosen as representative strains and characterized further. The bacteria utilized a wide range of carbohydrates and produced urease. Glucose was fermented to acetate and lactate. Strain MRM 3/1(T) showed a peptidoglycan type unique among members of the genus Bifidobacterium. The DNA base composition was 64.7 mol% G+C. Almost-complete 16S rRNA, hsp60, clpC and rpoB gene sequences were obtained and phylogenetic relationships were determined. Comparative analysis of 16S rRNA gene sequences showed that strains MRM 3/1(T) and MRM 4/2 had the highest similarities to Bifidobacterium scardovii DSM 13734(T) (94.6%) and Bifidobacterium stellenboschense DSM 23968(T) (94.5%). Analysis of hsp60 showed that both strains were closely related to B. stellenboschense DSM 23968(T) (97.5% similarity); however, despite this high degree of similarity, our isolates could be distinguished from B. stellenboschense DSM 23968(T) by low levels of DNA-DNA relatedness (30.4% with MRM 3/1(T)). Strains MRM 3/1(T) and MRM 4/2 were located in an actinobacterial cluster and were more closely related to the genus Bifidobacterium than to other genera in the family Bifidobacteriaceae. On the basis of these results, strains MRM 3/1(T) and MRM 4/2 represent a novel species within the genus Bifidobacterium, for which the name Bifidobacterium aesculapii sp. nov. is proposed; the type strain is MRM 3/1(T) ( = DSM 26737(T) = JCM 18761(T)).
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Affiliation(s)
- M Modesto
- Department of Agricultural Sciences, University of Bologna, Italy
| | - S Michelini
- Department of Agricultural Sciences, University of Bologna, Italy
| | - I Stefanini
- Department of Agricultural Sciences, University of Bologna, Italy
| | | | | | - B Biavati
- Department of Agricultural Sciences, University of Bologna, Italy
| | - P Mattarelli
- Department of Agricultural Sciences, University of Bologna, Italy
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Massaro M, Caló R, Rinaldi E, Battista C, Ghezzani F, Miccoli M, Di Maggio D, Ferrara A, Morciano I, Nibio A, Ragusa A, Cucci F. Cardiac involvement in acute thrombotic thrombocytopenic purpura: a case of conduction system defect. Transfus Apher Sci 2014. [DOI: 10.1016/s1473-0502(14)50052-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
The aim of this study is to propose setups for in vitro assessment of RFID (radiofrequency identification) interference on pacemakers (PM). The voltage induced at the input stage of the PM by low-frequency (LF) and high-frequency (HF) RFID transmitters has been used to quantify the amount of the interference. A commercial PM was modified in order to measure the voltage at its input stage when exposed to a sinusoidal signal at 125 kHz and 13.56 MHz. At both frequencies, two antennas with different dimensions (diameter = 10 cm and 30 cm, respectively) were used to generate the interfering field, and the induced voltage was measured between the lead tip and the PM case (unipolar voltage), and between the tip and ring electrodes (bipolar voltage). The typical lead configurations adopted in similar studies or proposed by international standards, as well as lead paths closer to actual physiological implants were tested. At 125 kHz, the worst-case condition differs for the two antennas: the 10 cm antenna induced the highest voltage in the two-loop spiral configuration, whereas the 30 cm antenna in the 225 cm(2) loop configuration. At 13.56 MHz, the highest voltage was observed for both the antennas in the 225 cm(2) loop configuration. Bipolar voltages were found to be lower than the unipolar voltages induced in the same configurations, this difference being not as high as one could expect from theoretical considerations. The worst-case scenario, in terms of the induced voltage at the PM input stage, has been identified both for LF and HF readers, and for two sizes of transmitting antennas. These findings may provide the basis for the definition of a standard implant configuration and a lead path to test the EMI effects of LF and HF RFID transmitters on active implantable devices.
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Affiliation(s)
- E Mattei
- Department of Technologies and Health, Italian National Institute of Health, Roma, Italy.
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Auricchio F, Conti M, Ferrara A, Morganti S, Reali A. Patient-specific finite element analysis of carotid artery stenting: a focus on vessel modeling. Int J Numer Method Biomed Eng 2013; 29:645-664. [PMID: 23729192 DOI: 10.1002/cnm.2511] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Revised: 07/25/2012] [Accepted: 08/13/2012] [Indexed: 06/02/2023]
Abstract
Finite element analysis is nowadays a well-assessed technique to investigate the impact of stenting on vessel wall and, given the rapid progression of both medical imaging techniques and computational methods, the challenge of using the simulation of carotid artery stenting as procedure planning tool to support the clinical practice can be approached. Within this context, the present study investigates the impact of carotid stent apposition on carotid artery anatomy by means of patient-specific finite element analysis. In particular, we focus on the influence of the vessel constitutive model on the prediction of carotid artery wall tensional state of lumen gain and of vessel straightening. For this purpose, we consider, for a given stent design and CA anatomy, two constitutive models for the CA wall, that is, a hyperelastic isotropic versus a fiber-reinforced hyperelastic anisotropic model. Despite both models producing similar patterns with respect to stress distribution, the anisotropic model predicts a higher vessel straightening and a more evident discontinuity of the lumen area near the stent ends as observed in the clinical practice. Although still affected by several simplifications, the present study can be considered as further step toward a realistic simulation of carotid artery stenting.
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Affiliation(s)
- F Auricchio
- Department of Civil Engineering and Architecture, Structural Mechanics Division, University of Pavia, Via Ferrata 1, 27100 Pavia, Italy
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Ribichini F, Tomai F, Pesarini G, Zivelonghi C, Rognoni A, De Luca G, Boccuzzi G, Presbitero P, Ferrero V, Ghini AS, Marino P, Vassanelli C, Ribichini F, Ferrero V, Pesarini G, Dal Dosso S, Vassanelli C, Tanguay JF, Tomai F, Presbitero P, Minelli M, Marino P, Anselmi M, Abukarsh R, Cima A, Ferrara A, Ferrero V, Menegatti G, Molinari G, Pesarini G, Ribichini F, Sparta D, Altamura L, Aurigemma C, Beraldi M, Corvo P, De Luca L, De Persio G, Ghini AS, Pastori F, Pellanda J, Petrolini A, Skossyreva O, Tomai. Ospedale F, Ospedale S, Bosco G, Boccuzzi G, Colangelo S, Garbo R, Minelli M, Noussan P, Belli G, Presbitero P, Rossi M, Soregaroli D, Zavalloni D, De Luca G, Franchi E, Leverone M, Rognoni A, Brunelleschi S, Feola M, Trinita OS, Menegatti G, Noussan P, Giovanni OS, Zanolla L, Magnani C. Long-term clinical follow-up of the multicentre, randomized study to test immunosuppressive therapy with oral prednisone for the prevention of restenosis after percutaneous coronary interventions: Cortisone plus BMS or DES veRsus BMS alone to EliminAte Restenosis (CEREA-DES). Eur Heart J 2013; 34:1740-8. [DOI: 10.1093/eurheartj/eht079] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Mitra S, Ferrara A, Choudhury TR. The escape fraction of ionizing photons from high-redshift galaxies from data-constrained reionization models. ACTA ACUST UNITED AC 2012. [DOI: 10.1093/mnrasl/sls001] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
AIMS It has long been hypothesized that natural selection would favour a reproductive strategy biased towards females under adverse circumstances in order to maximize the number of surviving grandchildren. An excess of daughters in women with Type 1 diabetes and a greater likelihood of gestational diabetes in women carrying male fetuses have also been reported. This study aims to compare the sex ratio across categories of maternal glycaemia. METHODS Among 288,009 mother-infant pairs delivering at Kaiser Permanente Northern California in 1996-2008, sex ratios were calculated for the following categories: pregravid diabetes, gestational diabetes, mild pregnancy hyperglycaemia (defined as an abnormal screening but normal diagnostic test for gestational diabetes) and normoglycaemia. Odds ratios for delivering a male were estimated with logistic regression; normoglycaemic pregnancies comprised the reference. RESULTS Women with pregravid diabetes delivered the fewest males (ratio male/female = 1.01), followed by women with normoglycaemic pregnancies and those with an abnormal screening only (both sex ratios = 1.05); women with gestational diabetes delivered the most males (sex ratio = 1.07). Odds ratio estimates suggested the same pattern, but none attained statistical significance. CONCLUSIONS The crude sex ratios in this cohort suggest a possible gradient by category of maternal glycaemia. Women with gestational diabetes, a condition characterized by excessive fuel substrates, appear to deliver more males. Women with pregravid diabetes delivered the fewest males, possibly reflecting the unfavourable state of chronic disease.
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Affiliation(s)
- S F Ehrlich
- Division of Research, Kaiser Permanente of Northern California, Oakland, California 94612, USA.
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Auricchio F, Conti M, Ferrara A, Morganti S, Reali A. Patient-specific simulation of a stentless aortic valve implant: the impact of fibres on leaflet performance. Comput Methods Biomech Biomed Engin 2012; 17:277-85. [DOI: 10.1080/10255842.2012.681645] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Bajocco S, De Angelis A, Perini L, Ferrara A, Salvati L. The impact of land use/land cover changes on land degradation dynamics: a Mediterranean case study. Environ Manage 2012; 49:980-989. [PMID: 22419398 DOI: 10.1007/s00267-012-9831-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Accepted: 01/25/2012] [Indexed: 05/31/2023]
Abstract
In the last decades, due to climate changes, soil deterioration, and Land Use/Land Cover Changes (LULCCs), land degradation risk has become one of the most important ecological issues at the global level. Land degradation involves two interlocking systems: the natural ecosystem and the socio-economic system. The complexity of land degradation processes should be addressed using a multidisciplinary approach. Therefore, the aim of this work is to assess diachronically land degradation dynamics under changing land covers. This paper analyzes LULCCs and the parallel increase in the level of land sensitivity to degradation along the coastal belt of Sardinia (Italy), a typical Mediterranean region where human pressure affects the landscape characteristics through fires, intensive agricultural practices, land abandonment, urban sprawl, and tourism concentration. Results reveal that two factors mainly affect the level of land sensitivity to degradation in the study area: (i) land abandonment and (ii) unsustainable use of rural and peri-urban areas. Taken together, these factors represent the primary cause of the LULCCs observed in coastal Sardinia. By linking the structural features of the Mediterranean landscape with its functional land degradation dynamics over time, these results contribute to orienting policies for sustainable land management in Mediterranean coastal areas.
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Affiliation(s)
- S Bajocco
- Unit for Climatology and Meteorology in Agriculture (CRA-CMA), Italian National Agricultural Research Council, Via del Caravita 7a, 00186 Rome, RM, Italy.
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50
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Affiliation(s)
- Giuliana Righi
- a Institute of Biomolecular Chemistry (CNR), Department of Chemistry , Sapienza University , Rome, Italy
| | - Angela Ferrara
- a Institute of Biomolecular Chemistry (CNR), Department of Chemistry , Sapienza University , Rome, Italy
| | - Alessandra Mari
- a Institute of Biomolecular Chemistry (CNR), Department of Chemistry , Sapienza University , Rome, Italy
| | - Paolo Bovicelli
- b Institute of Biomolecular Chemistry (CNR) , Sassari, Italy
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