Long-term prediction of adherence to continuous positive air pressure therapy for the treatment of moderate/severe obstructive sleep apnea syndrome

BACKGROUND: Continuous positive airway pressure (CPAP) therapy is a highly effective treatment for obstructive sleep apnea syndrome (OSAS). However, poor adherence is a limiting factor, and a significant proportion of patients are unable to tolerate CPAP. The aim of this study was to determine predictors of long-term non-compliance with CPAP. METHODS: CPAP treatment was prescribed to all consecutive patients with moderate or severe OSAS (AHI ≥15 events/h) (n = 295) who underwent a full-night CPAP titration study at home between February 1, 2002 and December 1, 2016. Adherence was defined as CPAP use for at least 4 h per night and five days per week. Subjects had periodical follow-up visits including clinical and biochemical evaluation and assessment of adherence to CPAP. RESULTS: Median follow-up observation was 74.8 (24.2/110.9) months. The percentage of OSAS patients adhering to CPAP was 41.4% (42.3% in males and 37.0% in females), and prevalence was significantly higher in severe OSAS than in moderate (51.8% vs. 22.1%; p < 0.001; respectively). At multivariate analysis, lower severity of OSAS (HR = 0.66; CI 95 0.46-0.94) p < 0.023), cigarette smoking (HR = 1.72; CI 95 1.13-2.61); p = 0.011), and previous cardiovascular events (HR = 1.95; CI 95 1.03-3.70; p = 0.04) were the only independent predictors of long-term non-adherence to CPAP after controlling for age, gender, and metabolic syndrome. CONCLUSIONS: In our cohort of patients with moderate/severe OSAS who were prescribed CPAP therapy, long-term compliance to treatment was present in less than half of the patients. Adherence was positively associated with OSAS severity and negatively associated with cigarette smoking and previous cardiovascular events at baseline

Voyage et \ue9criture dans le 'Journal' de Julien Green

Abstract Il lavoro analizza il Journal dello scrittore franco-americano nonch\ue9 accademico di Francia Julien Green e il rapporto che instaura tra la scrittura del diarista e quella del romanziere, visto attraverso l\u2019importanza accordata dall\u2019autore al viaggio. Attraverso un genere di tipo autobiografico che presenta le caratteristiche tipiche del genere, Green viaggiatore infatti d\ue0 vita a una descrizione dei luoghi visitati dominata da un immaginario ricco e vario che richiama e amplifica quello dei suoi romanzi: le annotazioni sul viaggio fanno cos\uec comprendere che lo spostamento materiale non \ue8 altro per lui che l\u2019erranza dell\u2019uomo teso a capire se stesso : la contemplazione del mondo cos\uec, attraverso il sogno e l\u2019estasi, si trasforma in una r\ueaverie che annulla il presente e immette il viaggiatore in uno spazio-tempo immemoriale che meglio risponde all\u2019inquietudine del viaggiatore, in un atteggiamento che \ue8 tipico della personalit\ue0 dello scrittore. Il rapporto che si instaura tra la visione del mondo resa possibile dal viaggio e la sua annotazione quotidiana diventa cos\uec essenziale: all\u2019inquietudine che \ue8 all\u2019origine dell\u2019erranza dell\u2019uomo risponde l\u2019attivit\ue0 dell\u2019artista la cui scrittura diventa lo strumento indispensabile per giungere a quella stabilit\ue0 da sempre cercata. Le annotazioni del viaggiatore raccontano la sua passione e la sua curiosit\ue0 per le bellezze del mondo, ma con la scrittura egli pu\uf2 abbandonarsi anche ad altri viaggi e inoltrarsi su quei percorsi immaginari che meglio rispondono alle sue esigenze interiori

Treatment of heart failure with autologous skeletal myoblasts

The management of patients with heart failure is a daily challenge for cardiologists and cardiac surgeons. Pharmacotherapy, atrio-biventricular resynchronization, myocardial revascularization, valve repair techniques, latissimus dorsi cardiomyoplasty, acorn cardiac support device, heart transplantation and mechanical assist devices do not cover all the needs. The recent progress in cellular and molecular biology allows the development of new therapies for heart failure. Transplantation of Autologous Cells: One of the most innovative consists in the transplantation of autologous ex-vivo expanded cells into the myocardium for heart muscle regeneration. This approach is called “cellular cardiomyoplasty”

Piezolelectric Nanocomposite Materials for Mechanical Sensing and Energy Harvesting

This paper explores the design, fabrication, and application of piezoelectric nanocomposite materials, focusing on their utilization in mechanical sensing and energy harvesting. By embedding piezoelectric nanofibers within polymeric matrices, we have developed multifunctional materials with enhanced mechanical properties and significant piezoelectric responses. Two specific applications are highlighted: the integration of piezoelectric composites into prosthetic devices for self-sensing capabilities and the use of PZT (Lead Zirconate Titanate) nanofibers for energy harvesting. The results demonstrate that these materials are promising candidates for next-generation biomedical devices and energy-efficient systems

Activating mutations in genes related to TCR signaling in angioimmunoblastic and other follicular helper T-cell-derived lymphomas.

Angioimmunoblastic T-cell lymphoma (AITL) and other lymphomas derived from follicular T-helper cells (TFH) represent a large proportion of peripheral T-cell lymphomas (PTCLs) with poorly understood pathogenesis and unfavorable treatment results. We investigated a series of 85 patients with AITL (n = 72) or other TFH-derived PTCL (n = 13) by targeted deep sequencing of a gene panel enriched in T-cell receptor (TCR) signaling elements. RHOA mutations were identified in 51 of 85 cases (60%) consisting of the highly recurrent dominant negative G17V variant in most cases and a novel K18N in 3 cases, the latter showing activating properties in in vitro assays. Moreover, half of the patients carried virtually mutually exclusive mutations in other TCR-related genes, most frequently in PLCG1 (14.1%), CD28 (9.4%, exclusively in AITL), PI3K elements (7%), CTNNB1 (6%), and GTF2I (6%). Using in vitro assays in transfected cells, we demonstrated that 9 of 10 PLCG1 and 3 of 3 CARD11 variants induced MALT1 protease activity and increased transcription from NFAT or NF-κB response element reporters, respectively. Collectively, the vast majority of variants in TCR-related genes could be classified as gain-of-function. Accordingly, the samples with mutations in TCR-related genes other than RHOA had transcriptomic profiles enriched in signatures reflecting higher T-cell activation. Although no correlation with presenting clinical features nor significant impact on survival was observed, the presence of TCR-related mutations correlated with early disease progression. Thus, targeting of TCR-related events may hold promise for the treatment of TFH-derived lymphomas

Development and tests of a new prototype detector for the XAFS beamline at Elettra Synchrotron in Trieste

The XAFS beamline at Elettra Synchrotron in Trieste combines X-ray absorption spectroscopy and X-ray diffraction to provide chemically specific structural information of materials. It operates in the energy range 2.4-27 keV by using a silicon double reflection Bragg monochromator. The fluorescence measurement is performed in place of the absorption spectroscopy when the sample transparency is too low for transmission measurements or the element to study is too diluted in the sample. We report on the development and on the preliminary tests of a new prototype detector based on Silicon Drift Detectors technology and the SIRIO ultra low noise front-end ASIC. The new system will be able to reduce drastically the time needed to perform fluorescence measurements, while keeping a short dead time and maintaining an adequate energy resolution to perform spectroscopy. The custom-made silicon sensor and the electronics are designed specifically for the beamline requirements.Comment: Proceeding of the 6YRM 12th-14th Oct 2015 - L'Aquila (Italy). Accepted for publication on Journal of Physics: Conference Serie

Why are Prices Sticky? Evidence from Business Survey Data

This paper offers new insights on the price setting behaviour of German retail firms using a novel dataset that consists of a large panel of monthly business surveys from 1991-2006. The firm-level data allows matching changes in firms' prices to several other firm-characteristics. Moreover, information on price expectations allow analyzing the determinants of price updating. Using univariate and bivariate ordered probit specifications, empirical menu cost models are estimated relating the probability of price adjustment and price updating, respectively, to both time- and state- dependent variables. First, results suggest an important role for state-dependence; changes in the macroeconomic and institutional environment as well as firm-specific factors are significantly related to the timing of price adjustment. These findings imply that price setting models should endogenize the timing of price adjustment in order to generate realistic predictions concerning the transmission of monetary policy. Second, an analysis of price expectations yields similar results providing evidence in favour of state-dependent sticky plan models. Third, intermediate input cost changes are among the most important determinants of price adjustment suggesting that pricing models should explicitly incorporate price setting at different production stages. However, the results show that adjustment to input cost changes takes time indicating "additional stickiness" at the last stage of processing

The imaging properties of the Gas Pixel Detector as a focal plane polarimeter

X-rays are particularly suited to probe the physics of extreme objects. However, despite the enormous improvements of X-ray Astronomy in imaging, spectroscopy and timing, polarimetry remains largely unexplored. We propose the photoelectric polarimeter Gas Pixel Detector (GPD) as an instrument candidate to fill the gap of more than thirty years of lack of measurements. The GPD, in the focus of a telescope, will increase the sensitivity of orders of magnitude. Moreover, since it can measure the energy, the position, the arrival time and the polarization angle of every single photon, allows to perform polarimetry of subsets of data singled out from the spectrum, the light curve or the image of source. The GPD has an intrinsic very fine imaging capability and in this work we report on the calibration campaign carried out in 2012 at the PANTER X-ray test facility of the Max-Planck-Institut f\"ur extraterrestrische Physik of Garching (Germany) in which, for the first time, we coupled it to a JET-X optics module with a focal length of 3.5 m and an angular resolution of 18 arcsec at 4.5 keV. This configuration was proposed in 2012 aboard the X-ray Imaging Polarimetry Explorer (XIPE) in response to the ESA call for a small mission. We derived the imaging and polarimetric performance for extended sources like Pulsar Wind Nebulae and Supernova Remnants as case studies for the XIPE configuration, discussing also possible improvements by coupling the detector with advanced optics, having finer angular resolution and larger effective area, to study with more details extended objects.Comment: Accepted for publication in The Astrophysical Journal Supplemen

Fermi LAT observations of cosmic-ray electrons from 7 GeV to 1 TeV

We present the results of our analysis of cosmic-ray electrons using about 8 million electron candidates detected in the first 12 months on-orbit by the Fermi Large Area Telescope. This work extends our previously-published cosmic-ray electron spectrum down to 7 GeV, giving a spectral range of approximately 2.5 decades up to 1 TeV. We describe in detail the analysis and its validation using beam-test and on-orbit data. In addition, we describe the spectrum measured via a subset of events selected for the best energy resolution as a cross-check on the measurement using the full event sample. Our electron spectrum can be described with a power law $\propto {\rm E}^{-3.08 \pm 0.05}$ with no prominent spectral features within systematic uncertainties. Within the limits of our uncertainties, we can accommodate a slight spectral hardening at around 100 GeV and a slight softening above 500 GeV.Comment: 20 pages, 23 figures, 2 tables, published in Physical Review D 82, 092004 (2010) - contact authors: C. Sgro', A. Moisee

Multiscale properties of polymeric insulating materials: from microscale polarizability to macroscale permittivity

This article presents an innovative and easy way for the calculation of the real part of permittivity for some of the most common insulating materials used for electrical applications, namely: polyethylene (PE), polypropylene (PP), polytetrafluorethylene (PTFE), ethylene-propylene diene monomer (EPDM), polyamide-imide (PAI), and epoxy resin (EP). This is achieved by the implementation and validation of the additivity approach for polarizability, along with the derivation of molecular volumes by means of chemical calculations involving real density of the considered materials. The proposed approach significantly reduces the computational time and effort for the calculation of macroscopic permittivity. Simulated values show good accordance with experimental results, thus validating the approach