Dobutamine-atropine stress echocardiography and clinical data for predicting late cardiac events in patients with suspected coronary artery disease

purpose: To compare the relative value of clinical variables with dobutamine-atropine stress echocardiography to predict cardiac events during long-term follow-up. Dobutamine stress echocardiography is increasingly used for the detection of coronary artery disease, but little is known of its prognostic value. patients and methods: A total of 430 patients (310 men; mean age 61 years, range 22 to 90) were enrolled in the study. Patients were referred for chest pain complaints and were unable to perform an adequate exercise stress test. All patients underwent dobutamine-atropine stress test (incremental dobutamine infusion: 10 to 40 μ/kg/minute, continued with atropine 0.25 to 1 mg intravenously if necessary to achieve 85% of the age predicted maximal heart rate, without symptoms or signs of ischemia) and clinical cardiac evaluation. Follow-up was 17 ± 5 months, with a minimum of 6 months; 3 patients were lost to follow-up. Cardiac events were defined as cardiac death, nonfatal myocardial infarc

Seroprevalence of sars-cov-2 antibodies in adults and healthcare workers in southern italy

Background: This study was carried out to estimate the seroprevalence of SARS-CoV-2 antibodies in a Southern Italian population. Methods: The study was performed among students and workers of the University of Campania “Luigi Vanvitelli” and the relative Teaching Hospital. Participants were invited to undergo a blood sampling, an interview or to complete a self-administered questionnaire. Results: A total of 140 participants (5.8%) tested positive for SARS-CoV-2 antibodies. Positive SARS-CoV-2 test results increased significantly during the months of testing, and those who had had at least one symptom among fever, cough, dyspnea, loss of taste or smell and who had had contact with a family member/cohabitant with confirmed COVID-19 were more likely to test positive. Faculty members were less likely to have a positive test result compared to the healthcare workers (HCWs). Among HCWs, physicians showed the lowest rate of seroconversion (5.2%) compared to nurses (8.9%) and other categories (10%). Nurses and other HCWs compared to the physicians, those who had had at least one symptom among fever, cough, dyspnea, loss of taste or smell, and who had had contact with a family member/cohabitant with confirmed COVID-19 were more likely to test positive. Conclusions: The results have demonstrated that SARS-CoV-2 infection is rapidly spreading even in Southern Italy and confirm the substantial role of seroprevalence studies for the assessment of SARS-CoV-2 infection circulation and potential for further spreading

The CABB dataset: A multimodal corpus of communicative interactions for behavioural and neural analyses

We present a dataset of behavioural and fMRI observations acquired in the context of humans involved in multimodal referential communication. The dataset contains audio/video and motion-tracking recordings of face-to-face, task-based communicative interactions in Dutch, as well as behavioural and neural correlates of participants’ representations of dialogue referents. Seventy-one pairs of unacquainted participants performed two interleaved interactional tasks in which they described and located 16 novel geometrical objects (i.e., Fribbles) yielding spontaneous interactions of about one hour. We share high-quality video (from three cameras), audio (from head-mounted microphones), and motion-tracking (Kinect) data, as well as speech transcripts of the interactions. Before and after engaging in the face-to-face communicative interactions, participants’ individual representations of the 16 Fribbles were estimated. Behaviourally, participants provided a written description (one to three words) for each Fribble and positioned them along 29 independent conceptual dimensions (e.g., rounded, human, audible). Neurally, fMRI signal evoked by each Fribble was measured during a one-back working-memory task. To enable functional hyperalignment across participants, the dataset also includes fMRI measurements obtained during visual presentation of eight animated movies (35 minutes total). We present analyses for the various types of data demonstrating their quality and consistency with earlier research. Besides high-resolution multimodal interactional data, this dataset includes different correlates of communicative referents, obtained before and after face-to-face dialogue, allowing for novel investigations into the relation between communicative behaviours and the representational space shared by communicators. This unique combination of data can be used for research in neuroscience, psychology, linguistics, and beyond

Valsartan for prevention of recurrent atrial fibrillation

BACKGROUND: Atrial fibrillation is the most common cardiac arrhythmia, and no current therapy is ideal for control of this condition. Experimental studies suggest that angiotensin II-receptor blockers (ARBs) can influence atrial remodeling, and some clinical studies suggest that they may prevent atrial fibrillation. METHODS: We conducted a large, randomized, prospective, placebo-controlled, multicenter trial to test whether the ARB valsartan could reduce the recurrence of atrial fibrillation. We enrolled patients who were in sinus rhythm but had had either two or more documented episodes of atrial fibrillation in the previous 6 months or successful cardioversion for atrial fibrillation in the previous 2 weeks. To be eligible, patients also had to have underlying cardiovascular disease, diabetes, or left atrial enlargement. Patients were randomly assigned to receive valsartan or placebo. The two primary end points were the time to a first recurrence of atrial fibrillation and the proportion of patients who had more than one recurrence of atrial fibrillation over the course of 1 year. RESULTS: A total of 1442 patients were enrolled in the study. Atrial fibrillation recurred in 371 of the 722 patients (51.4%) in the valsartan group, as compared with 375 of 720 (52.1%) in the placebo group (adjusted hazard ratio, 0.97; 96% confidence interval [CI], 0.83 to 1.14; P = 0.73). More than one episode of atrial fibrillation occurred in 194 of 722 patients (26.9%) in the valsartan group and in 201 of 720 (27.9%) in the placebo group (adjusted odds ratio, 0.89; 99% CI, 0.64 to 1.23; P = 0.34). The results were similar in all predefined subgroups of patients, including those who were not receiving angiotensin-converting-enzyme inhibitors. CONCLUSIONS: Treatment with valsartan was not associated with a reduction in the incidence of recurrent atrial fibrillation

Vaccination against hepatitis b virus: are Italian medical students sufficiently protected after the public vaccination programme?

The development of a vaccine against hepatitis B virus (HBV) has been a major achievement in terms of prevention of HBV infection. For the present study, we analysed the long-term immunogenicity and effectiveness of HBV vaccination among healthcare students with different working seniorities.Background: The development of a vaccine against hepatitis B virus (HBV) has been a major achievement in terms of prevention of HBV infection. For the present study, we analysed the long-term immunogenicity and effectiveness of HBV vaccination among healthcare students with different working seniorities. Methods: A cross-sectional study of undergraduate and postgraduate students attending the Medical School of the Second University of Naples was conducted between September 2012 and December 2014. HBV serum markers were determined and multivariate logistic regression analysis was used to identify factors associated with the level of long-term immunogenicity. Results: Of the 2,932 subjects evaluated, only 33 (1.1 %) declared no history of vaccination. All vaccinated subjects were HBsAg/anti-HBc negative, 459 of which had an anti-HBs titre <10 IU/L. The latter were younger, more likely to be attending a healthcare profession school (i.e., dental hygienists, nursing, paediatric nursing, radiography and midwifery) than a medical school (at either undergraduate or postgraduate level) and more likely to have been vaccinated in infancy. Conclusion: The results of this study suggest that assessment of HBV serum markers in workers potentially exposed to hospital infections is useful to identify small numbers of unvaccinated subjects or vaccinated subjects with low antibody titre, all of whom should be referred to a booster series of vaccinations

USURA E MODUS. IL PROBLEMA DEL SOVRAINDEBITAMENTO DAL MONDO ANTICO ALL'ATTUALITA'

Il libro Usura e modus. Il problema del sovraindebitamento dal mondo antico all’attualità non riguarda solo il fenomeno dell’usura, ma abbraccia il tema, di più ampio respiro, della misura dei debiti e in particolare degli interessi dovuti a fronte del prestito di danaro. Si scorge un sottile filo conduttore: il sovraindebitamento non è dannoso soltanto per il debitore insolvente ma anche per il creditore, se il peso che grava sul debitore diventa insopportabile e quindi il credito non può essere soddisfatto. I rischi che ne derivano, quando questa situazione colpisce larghi strati della società, sono anche per l’ordine pubblico, la libertà e la democrazia, come i tanti episodi via via ricordati nel lavoro lasciano intendere.La monografia è divisa in tre capitoli. Il primo, intitolato Usura e avaritia, attraverso l’esame delle fonti evidenzia il collegamento fra la brama smodata di denaro (avaritia) e la pratica del prestito ad interesse non finalizzata alla produzione o allo scambio: una pratica, nei cui riguardi, a Platone e soprattutto ad Aristotele risalgono le basi “filosofiche” di un atteggiamento di “ripugnanza”. Attraverso un vasto panorama di testimonianze si ricostruisce sia il susseguirsi a Roma dei provvedimenti normativi in materia di prestiti con gli interessi (c.d. leges fenebres), sia di quegli interventi talora diretti alla cancellazione o dilazione dei debiti. Non mancano episodi tratti dalle fonti che si prestano ad una comparazione storica con la situazione attuale. Un caso di particolare interesse è quello della crisi di liquidità provocata da debiti eccessivi che determinarono di conseguenza un blocco del credito sotto Tiberio, il quale vi pose rimedio con efficaci iniziative. Il discorso prosegue con la rassegna dei procedimenti e delle pene contro gli usurai. Dalla trattazione emerge un contrasto tra prassi e divieto di prestare denaro a interesse: il che suscita dubbi in ordine alla certezza e assolutezza del divieto. Il secondo capitolo si caratterizza per l’analisi dei brani dei giuristi romani dai quali emerge l’esistenza sia di una “misura legittima” (modus legitimus) che di una “misura ragionevole” (modus probabilis) degli interessi: criteri che il mos regionis, come risulta da alcuni testi, orienta nel loro concreto modo di operare. Si passa poi all’esame dei provvedimenti imperiali in materia di tassi di interesse. Vista nel suo complesso la legislazione, soprattutto quella di cui è artefice Giustiniano, tende a favorire i debitori ora con forme di alleggerimento dell’ammontare dei debiti, ora rendendone più agevole l’adempimento. Il terzo capitolo chiude il lavoro con uno sguardo all’attualità segnata dalla crisi economica internazionale: una situazione in buona parte determinata da debiti eccessivi contratti sia dagli Stati che dai privati. Una pericolosa bolla finanziaria nella quale l’entità dei debiti è progressivamente cresciuta a causa di vari fattori. Uno di questi è l’anatocismo, che in Italia ha avuto “peculiari vicende”. Recenti orientamenti giurisprudenziali consentono anche una corretta interpretazione della normativa antiusura formatasi negli anni, a cominciare dalla L. 108 del 1996. Il libro si conclude con uno sguardo alle contromisure – e spicca l’exceptio doli generalis, di cui è chiara la matrice romanistica - alle quali possono fare ricorso i debitori per difendersi quando il rapporto contrattuale presenta vistosi squilibri