De Sio Research Articles

Reasons for Meaningful Human Control

”Meaningful human control” is a term invented in the political and legal debate on autonomous weapons system, but it is nowadays also used in many other contexts. It is supposed to specify conditions under which an artificial system is under the right kind of control to avoid responsibility gaps: that is, situations in which no moral agent is responsible. Santoni de Sio and Van den Hoven have recently suggested a framework that can be used by system designers to operationalize this kind of control. It is the purpose of this paper to facilitate further operationalization of ”meaningful human control”.This paper consists of two parts. In the first part I resolve an ambiguity that plagues current operationalizations of MHC. One of the design conditions says that the system should track the reasons of the relevant agents. This condition is ambiguous between the kind of reasons involved. On one interpretation it says that a system should track motivating reasons, while it is concerned with normative reasons on the other. Current participants in the debate interpret the framework as being concerned with (something in the vicinity of) motivating reasons. I argue against this interpretation by showing that meaningful human control requires that a system tracks normative reasons. Moreover, I maintain that an operationalization of meaningful human control that fails to track the right kind of reasons is morally problematic.When this is properly understood, it can be shown that the framework of MHC is committed to the agent-relativity of reasons. More precisely, I argue in the second part of this paper that if the tracking condition of MHC plays an important role in responsibility attribution (as the proponents of the view maintain), then the framework is incompatible with first-order normative theories that hold that normative reasons are agent-neutral (such as many versions of consequentialism). In the final section I present three ways forward for the proponent of MHC as reason-responsiveness.

Europe matters … upon closer investigation: a novel approach for analysing individual-level determinants of vote choice across first- and second-order elections, applied to 2019 Italy

AbstractAre European Parliament (EP) elections still second-order? In this article, we test the classical model at the individual level in contrast to an alternative ‘Europe matters’ model, by investigating the relative importance of domestic vs. European Union (EU)-related issues among voter-level determinants of aggregate second-order effects, that is, individual party change. We do so by relying on an original, CAWI pre-electoral survey featuring a distinctively large (30) number of both domestic and EU-related, positional and valence issues, with issue attitudes measured according to the innovative ICCP scheme (De Sio and Lachat 2020) which includes issue positions, issue priorities and respondents' assessment of party credibility on both positional and valence goals. Leveraging the concept of ‘normal vote’, we estimate multivariate models of electoral defections from normal voting separately for general and European elections, based on issue party credibility. This allows us to assess: (a) the distinctiveness of the two electoral arenas in terms of issue content; and (b) the relative impact of EU-related and domestic issues on defections of Italian voters. Our findings show that although second-order effects are still relevant in accounting for results in EP elections, vote choice in the latter is also partly due to specific effects of certain policy issues, including some related to the European dimension. This indicates that EP elections have their own political content, for which Europe matters even after controlling for the importance that EU-related issues have acquired in national elections.

Meaningful human control as reason-responsiveness: the case of dual-mode vehicles

In this paper, in line with the general framework of value-sensitive design, we aim to operationalize the general concept of “Meaningful Human Control” (MHC) in order to pave the way for its translation into more specific design requirements. In particular, we focus on the operationalization of the first of the two conditions (Santoni de Sio and Van den Hoven 2018) investigated: the so-called ‘tracking’ condition. Our investigation is led in relation to one specific subcase of automated system: dual-mode driving systems (e.g. Tesla ‘autopilot’). First, we connect and compare meaningful human control with a concept of control very popular in engineering and traffic psychology (Michon 1985), and we explain to what extent tracking resembles and differs from it. This will help clarifying the extent to which the idea of meaningful human control is connected to, but also goes beyond, current notions of control in engineering and psychology. Second, we take the systematic analysis of practical reasoning as traditionally presented in the philosophy of human action (Anscombe, Bratman, Mele) and we adapt it to offer a general framework where different types of reasons and agents are identified according to their relation to an automated system’s behaviour. This framework is meant to help explaining what reasons and what agents (should) play a role in controlling a given system, thereby enabling policy makers to produce usable guidelines and engineers to design systems that properly respond to selected human reasons. In the final part, we discuss a practical example of how our framework could be employed in designing automated driving systems.

Coherent Charge Transfer Exciton Formation in Regioregular P3HT: A Quantum Dynamical Study.

The ultrafast formation of charge transfer excitons (CTXs) in regioregular poly(3-hexyl thiophene) (rrP3HT) domains is elucidated by electronic structure and quantum dynamical studies of an aggregate model system comprising five stacked quaterthiophene units. Using a multistate vibronic coupling Hamiltonian parametrized by TDDFT calculations for 13 electronic states of Frenkel and CTX type, along with 78 vibrational modes, quantum dynamical simulations are carried out using the Multi-Layer Multi-Configuration Time-Dependent Hartree (ML-MCTDH) method. In line with time-resolved spectroscopic results [ De Sio , A. ; et al. Nat. Commun. 2016 , 7 , 13742 ], it is found that CTX formation occurs immediately upon photoexcitation, accompanied by sustained regular oscillations with a ∼22 fs periodicity. These coherent features, whose presence may seem surprising in a high-dimensional aggregate or thin film material, can be traced back to a dominant vibronic signature of CC stretch-type high-frequency modes. These vibrational signatures are found to be enhanced due to a collective vibronic response that is prompted by the initial generation of a delocalized bright exciton and its subsequent relaxation, by internal conversion, to a polaronic local exciton ground state.

Enhancing the Nature-of-Activities Account of Enhancement

Many find it intuitive that those who use enhancements like steroids and Adderall in Olympic weightlifting and education are due less praise than those who perform equally well without using these enhancements. Nonetheless, it is not easy to coherently explain why one might be justifiably due less praise for using these technologies to enhance one’s performance. Justifications for this intuition which rely on concerns regarding authenticity, cheating, or shifts in who is responsible for the performance face serious problems. Santoni de Sio et al., however, have recently defended a justification for this intuition which avoids the problems competing justifications face; the nature-of-activities justification. This justification relies on a conceptual analysis of the nature of activities and does not require the defense of any particular ethical stance concerning the use of enhancements. Santoni de Sio et al. claim that the success of the nature-of-activities account requires distinguishing between practice-oriented activities and goal-directed activities. I, however, show that this distinction is both deeply problematic and unnecessary. After exposing the weaknesses of Santoni de Sio et al.’s original account, I defend a simpler and less problematic version of the nature-of-activities account. The revised account is capable of both justifying this intuition of less praise and allowing one to determine when enhancements should be deemed permissible, impermissible, or obligatory for a given activity.

Legal Necessity, Pareto Efficiency & Justified Killing in Autonomous Vehicle Collisions

Suppose a driverless car encounters a scenario where (i) harm to at least one person is unavoidable and (ii) a choice about how to distribute harms between different persons is required. How should the driverless car be programmed to behave in this situation? I call this the moral design problem. Santoni de Sio (Ethical Theory Moral Pract 20:411–429, 2017) defends a legal-philosophical approach to this problem, which aims to bring us to a consensus on the moral design problem despite our disagreements about which moral principles provide the correct account of justified harm. He then articulates an answer to the moral design problem based on the legal doctrine of necessity. In this paper, I argue that Santoni de Sio’s answer to the moral design problem does not achieve the aim of the legal-philosophical approach. This is because his answer relies on moral principles which, at least, utilitarians have reason to reject. I then articulate an alternative reading of the doctrine of necessity, and construct a partial answer to the moral design problem based on this. I argue that utilitarians, contractualists and deontologists can agree on this partial answer, even if they disagree about which moral principles offer the correct account of justified harm.

Plasmonic coupling induced by growing processes of metal nanoparticles in wrinkled structures and driven by mechanical strain applied to a polidimethisiloxisilane template

Plasmonic coupling induced by growing processes of metal nanoparticles in wrinkled structures and driven by mechanical strain applied to a polidimethisiloxisilane template

Optical properties of gold nanorods macro-structure: a numerical study

In this contribution, a numerical study of the optical properties of closely-packed gold nanorods was performed. The studied nano-objects are experimentally grown on a tilted polydimethylsiloxane (PDMS) substrate by using physical vapor deposition (PVD). This method creates nanorods tilted to a certain angle with respect to the substrate normal. This geometry allows exciting both transverse and longitudinal modes of the rods. As demonstrated in a previous experimental work, such PVD-grown nano-objects show promising possibilities both as strain gauges or strain-tunable metamaterials if fabricated on a stretchable dielectric substrate. This numerical study is based on experimental data from previous work and pushes further the subject by approaching an optimized nano-structure allowing better strain-sensitivity (particularly by changing the auto-organization of the said nanorods). Full Text: PDF ReferencesJ.W.M. Chon, C. Bullen, P. Zijlstra, M. Gu, "Spectral encoding on Gold Nanorods Doped in a Silica Sol?Gel Matrix and Its Application to High-Density Optical Data Storage", Adv. Funct. Mater. 17, 875 (2007). CrossRef C.-C. Chen, Y.-P. Lin, C.-W. Wang, H.-C. Tzeng, C.-H. Wu, Y.-C. Chen, C.-P. Chen, L.-C. Chen, Y.-C. Wu, "DNA?Gold Nanorod Conjugates for Remote Control of Localized Gene Expression by near Infrared Irradiation", J. Am. Chem. Soc. 128, 3709 (2006). CrossRef J.N. Anker, W.P. Hall, O. Lyandres, N.C. Shah, J. Zhao, R.P. Van Duyne, "Biosensing with plasmonic nanosensors", Nat. Mater 7, 442 (2008). CrossRef B. Sepulveda, P.C. Angelome, L.M. Lechuga, L.M. Liz-Marzan?, "LSPR-based nanobiosensors", Nano Today 4, 244 (2009). CrossRef A. Haes, R.P. Van Duyne, "A Nanoscale Optical Biosensor: Sensitivity and Selectivity of an Approach Based on the Localized Surface Plasmon Resonance Spectroscopy of Triangular Silver Nanoparticles", J. Am. Chem. Soc. 124, 10596 (2002). CrossRef J.C. Riboh, A.J. Haes, A.D. McFarland, C.R. Yonzon, R.P. Van Duyne, "A Nanoscale Optical Biosensor: Real-Time Immunoassay in Physiological Buffer Enabled by Improved Nanoparticle Adhesion", J. Phys. Chem. B 107, 1772 (2003). CrossRef C.R. Yonzon, E. Jeoung, S. Zou, G.C. Schatz, M. Mrksich, R.P. Van Duyne, "A Comparative Analysis of Localized and Propagating Surface Plasmon Resonance Sensors: The Binding of Concanavalin A to a Monosaccharide Functionalized Self-Assembled Monolayer", J. Am. Chem. Soc. 126, 12669 (2004). CrossRef A.J. Haes, L. Chang, W.L. Klein, R.P. Van Duyne, "Detection of a Biomarker for Alzheimer's Disease from Synthetic and Clinical Samples Using a Nanoscale Optical Biosensor", J. Am. Chem. Soc. 127, 2264 (2005). CrossRef R. Caputo, G. Palermo, M.Infusino L. De Sio, "Liquid Crystals as an Active Medium: Novel Possibilities in Plasmonics", Nanospectroscopy 1, 40 (2015). CrossRef T. Maurer, J. Marae-Djouda, U. Cataldi, A. Gontier, G. Montay, Y. Madi, B. Panicaud, D. Macias, P.-M. Adam, G. Lév?que, T. Bürgi, R. Caputo, "The beginnings of plasmomechanics: towards plasmonic strain sensors", Frontiers of Materials Science 9, 170 (2015). CrossRef X. Niu, S. P. Stagon, H. Huang, J.K. Baldwin, A. Misra, "Smallest Metallic Nanorods Using Physical Vapor Deposition", Phys. Rev. Lett. 110 136102 (2013). CrossRef Lumerical Solutions, Inc. DirectLink P.K. Jain, W. Huang, M.A.El-Sayed, "On the Universal Scaling Behavior of the Distance Decay of Plasmon Coupling in Metal Nanoparticle Pairs: A Plasmon Ruler Equation", Nanoletters 7, 2080 (2007). CrossRef P.K. Jain, M.A. El-Sayed, "Plasmonic coupling in noble metal nanostructures", Chem. Phys. Letters 487, 153 (2010). CrossRef

The risks and opportunities of Europe: How issue yield explains (non-)reactions to the financial crisis

The financial crisis subjected the EU to its first truly serious stress test. A majority of citizens is now opposed to further integration. But party systems have barely adjusted, instead perpetuating traditional patterns of an evasive mainstream with Euroskeptic fringes. To explain this unexpected outcome we draw on issue yield (De Sio and Weber, 2014), a general model of political competition that unites public opinion, party unity and electoral support. Issue yield highlights how the crisis affected risks and opportunities differently for pro- and anti-integration parties. For such an asymmetric constellation, the model predicts the muffled choices supplied by most parties on EU matters. We use the European Election Studies 2009/2014 and the Chapel Hill Expert Surveys 2010/2014 to document these patterns.

MP85-19 URINARY PEPTIDOME AND PROTEOME ALTERATIONS RELATED TO TUMOR PROGRESSION AND INVASION IN RCC

You have accessJournal of UrologyKidney Cancer: Basic Research & Pathophysiology II1 Apr 2016MP85-19 URINARY PEPTIDOME AND PROTEOME ALTERATIONS RELATED TO TUMOR PROGRESSION AND INVASION IN RCC Clizia Chinello, Marco Grasso, Marta Cazzaniga, Gabriele De Sio, Angelica Grasso, Bernardo Rocco, Andrew Smith, Italo Zoppis, Giancarlo Mauri, and Fulvio Magni Clizia ChinelloClizia Chinello More articles by this author , Marco GrassoMarco Grasso More articles by this author , Marta CazzanigaMarta Cazzaniga More articles by this author , Gabriele De SioGabriele De Sio More articles by this author , Angelica GrassoAngelica Grasso More articles by this author , Bernardo RoccoBernardo Rocco More articles by this author , Andrew SmithAndrew Smith More articles by this author , Italo ZoppisItalo Zoppis More articles by this author , Giancarlo MauriGiancarlo Mauri More articles by this author , and Fulvio MagniFulvio Magni More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2285AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Up to now, for renal cell carcinoma (RCC), tumor size and growth rate are the most used prognostic factors at diagnosis likely being related with potential progressive neoplasms. Moreover, the degree of the free tumor extension into renal vessel seems to contribute to disease-free survival and to influence prognosis. Thus, firstly, in order to highlight urinary peptidome signatures that might reflect kidney cancer progression, a systematic investigation by MALDI profiling was carried out identifying endogenous peptides that show a correlation between their abundance in urine and pT, tumor size and grade. Secondly, in order to explore proteome changes reflecting the local tumor infiltration through vena cava, a label-free nLC MS/MS was performed in trypsinized urine from subjects affected by RCC at different level of invasion (vascular endothelium/vein/ thrombosis). METHODS Peptidomic evaluation of tumor progression was performed in 117 RCC urine samples, through the application of C8 functionalized magnetic beads purification followed by MALDI-TOF and statistical analysis for group comparisons and correlations. nLC-ESI-MS/MS was used for peptide identification. Urine proteome investigation correlated to different renal vein invasion extent was carried out by label-free nLC MS/MS strategy using FASP digested pools of 3 groups. Statistical evaluation was obtained by Progenesis QI for Proteomics. RESULTS 15 endogenous peptides showed a statistically significant correlation between their urinary concentration and tumor size (only 3 negatively), 26 with pT (only 6 negatively), and only 5 with grade (only 1 positively). Most of them were differentially represented in urine of RCC patients compared to controls and for some of them varied according to pT or stage. Identity of several of them are likely to confirm their possible role in tumor progression. Proteomic labelfree approach regarding tumor invasion allowed to select 671 protein IDs significantly altered in at least one of the 3 group comparisons (fold change=2). 12 of them showed a progressive increase from the endothelium wall infiltration to thrombosis CONCLUSIONS These methodological approaches applied to urine may provide useful keys to highlight alterations triggered by RCC aggressiveness or vascular neoplastic infiltration from endothelial layer to vein ostium obstruction, better understand tumor protein handling aspects, and describe such a dynamic system as growing cancer cells are. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1105 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Clizia Chinello More articles by this author Marco Grasso More articles by this author Marta Cazzaniga More articles by this author Gabriele De Sio More articles by this author Angelica Grasso More articles by this author Bernardo Rocco More articles by this author Andrew Smith More articles by this author Italo Zoppis More articles by this author Giancarlo Mauri More articles by this author Fulvio Magni More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

KAP1 regulates gene networks controlling T‐cell development and responsiveness

Chromatin remodeling at specific genomic loci controls lymphoid differentiation. Here, we investigated the role played in this process by Kruppel-associated box (KRAB)-associated protein 1 (KAP1), the universal cofactor of KRAB-zinc finger proteins (ZFPs), a tetrapod-restricted family of transcriptional repressors. T-cell-specific Kap1-deleted mice displayed a significant expansion of immature thymocytes, imbalances in CD4(+)/CD8(+) cell ratios, and altered responses to TCR and TGFβ stimulation when compared to littermate KAP1 control mice. Transcriptome and chromatin studies revealed that KAP1 binds T-cell-specific cis-acting regulatory elements marked by the H3K9me3 repressive mark and enriched in Ikaros/NuRD complexes. Also, KAP1 directly controls the expression of several genes involved in TCR and cytokine signaling. Among these, regulation of FoxO1 seems to play a major role in this system. Likely responsible for tethering KAP1 to at least part of its genomic targets, a small number of KRAB-ZFPs are selectively expressed in T-lymphoid cells. These results reveal the so far unsuspected yet important role of KAP1-mediated epigenetic regulation in T-lymphocyte differentiation and activation.

V1563 NEEDLESCOPIC RADICAL PROSTATECTOMY

You have accessJournal of UrologyInfertility, Sexual Dysfunction, Trauma & Teaching Technique1 Apr 2012V1563 NEEDLESCOPIC RADICAL PROSTATECTOMY Carlos Oliveira, Ricardo Autorino, Marco De Sio, and Estevão Lima Carlos OliveiraCarlos Oliveira Braga, Portugal More articles by this author , Ricardo AutorinoRicardo Autorino Cleveland, OH More articles by this author , Marco De SioMarco De Sio Naples, Italy More articles by this author , and Estevão LimaEstevão Lima Braga, Portugal More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1334AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In an effort to further enhance the advantages of laparoscopic surgery, more less-invasive methods have been developed. The surgical community is continuously exploring new ways to achieve this goal. With this objective in mind we present a needlescopic radical prostatectomy. The objective is to go a step further in mininal invasive surgery, achieving a reduction in the lenght of the incision using a easily applicable technique in daily practive. METHODS Demonstrative video of the surgical technique of a needlescopic radical prostatectomy in a 57 year old male patient diagnosed with prostate cancer. RESULTS A needlescopic radical prostatectomy was performed using a 5mm videoscope and 3mm surgical instruments. We used also a 10mm port. The operative time was 97 minutes. The blood loss was vestigial. There was no pos-operative complication and the length of stay was 2 days. At 3 months follow-up the patient is continent, experiencing mild erectile dysfunction and with minimal scar. CONCLUSIONS Needlescopic radical prostatectomy is a safe, feasible and reproducible procedure. Like other procedures designed to further minimize the laparoscopic technique (LESS, NOTES) Needlescopic surgery achieves excellent cosmetic results without compromising the patient outcome. The scar is minimal. It has the advantage over the latter of being more easily applicable in daily practice, as it does not require a major adaptation of the surgical technique. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e633 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Carlos Oliveira Braga, Portugal More articles by this author Ricardo Autorino Cleveland, OH More articles by this author Marco De Sio Naples, Italy More articles by this author Estevão Lima Braga, Portugal More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Evaluation of Residual Promoter Activity in γ-Retroviral Self-inactivating (SIN) Vectors

Therapeutic gene delivery mediated by retroviral vectors has the advantage of stable integration into the host genome. A major safety concern for gene delivery achieved by murine leukemia virus (MLV)-based retroviral vectors is the activation of adjacent cellular genes including oncogenes following integration into the host genome. Self-inactivating (SIN) vectors lacking viral enhancers/promoters in their 3' long terminal repeat (LTR) have been proposed as a means of overcoming this safety concern. However the MLV-based SIN vectors currently used by laboratories to assess insertional mutagenesis, integration site selection, and the potency of transgene expression are not uniform in the composition of their 3' LTRs. We constructed a series of SIN vectors representative of the currently employed vectors, but lacking an internal promoter. Green fluorescent protein (GFP) was used as a reporter gene. Target cells exposed to these vectors were evaluated for number of integrants and GFP expression at the messenger RNA (mRNA) level and protein level. We found that viral promoter activity in the 3' LTR is not attenuated in many currently employed SIN vectors. These results suggest that the influence of strong residual promoter activity should be taken into consideration when interpreting experimental results obtained using SIN vectors in gene therapy research.

Effects of Intensive Lifestyle Changes on Erectile Dysfunction in Men

Limited data are available supporting the notion that treatment of lifestyle risk factors may improve erectile dysfunction (ED). In the present study, we analyzed the effect of a program of changing in lifestyle designed to improve erectile function in subjects with ED or at increasing risk for ED. Men were identified in our database of subjects participating in randomized controlled trials evaluating the effect of lifestyle changes. A total of 209 subjects were randomly assigned to one of the two treatment groups. The 104 men randomly assigned to the intervention program received detailed advice about how to reduce body weight, improve quality of diet, and increase physical activity. The 105 subjects in the control group were given general information about healthy food choices and general guidance on increasing their level of physical activity. Changes in erectile function score (International Index of Erectile Function-5 [IIEF-5]; items 5, 15, 4, 2, and 7 from the full-scale IIEF-15) and dependence of the restoration of erectile function on the changes in lifestyle that were achieved. Erectile function score improved in the intervention group. At baseline, 35 subjects in the intervention group and 38 subjects in the control group had normal erectile function (34% and 36%, respectively). After 2 years, these figures were 58 subjects in the intervention group and 40 subjects in the control group, respectively (56% and 38%, P = 0.015). There was a strong correlation between the success score and restoration of erectile function. It is possible to achieve an improvement of erectile function in men at risk by means of nonpharmacological intervention aiming at weight loss and increasing physical activity.

Circulating CD34+KDR+ Endothelial Progenitor Cells Correlate with Erectile Function and Endothelial Function in Overweight Men

Bone marrow-derived endothelial progenitor cells (EPCs) circulate in the peripheral blood and are involved in endothelial homeostasis and repair. The aim of this study was to assess the circulating levels of different EPC phenotypes in overweight men with or without erectile dysfunction (ED). As endothelial dysfunction is considered a necessary link with ED, endothelium-dependent vasodilation and its relation with EPCs were also investigated. We studied 30, otherwise healthy, overweight subjects with symptomatic ED for at least 6 months, and 30 age- and weight-matched subjects without ED. Erectile function was assessed by completing the International Index of Erectile Function (IIEF-5), which consists of items 5, 15, 4, 2, and 7 from the full-scale IIEF-15. Seven subpopulations of EPCs were determined by flow cytometry on the basis of the surface expression of CD34, CD133, and KDR antigens: CD34(+), CD133(+), KDR(+), CD34(+)CD133(+), CD34(+)KDR(+), CD133(+)KDR(+), and CD34(+)CD133(+)KDR(+). Endothelium-dependent flow-mediated dilation (FMD) was evaluated in the right brachial artery with a high-resolution ultrasound machine following reactive hyperemia. CD34(+)KDR(+) cell count was significantly lower in men with ED as compared with men without ED (63.1 +/- 4 vs. 92.4 +/- 6 cells/10(6) events, mean +/- standard error, P < 0.01). There was a significant direct correlation between circulating CD34(+)KDR(+) cells and the IIEF score (r = 0.44; P = 0.01): men with the severe form of ED presented the lowest level of circulating EPC CD34(+)KDR(+) cells. No significant correlation was found between the circulating levels of the other EPC phenotypes and the IIEF score. There was a significant correlation between CD34(+)KDR(+) cell count and FMD (r = 0.45; P = 0.01), but not between FMD and the other phenotypes. Circulating levels of CD34(+)KDR(+) EPC are reduced in overweight subjects with ED and correlate with the severity of ED. Other EPC phenotypes are not related to ED, suggesting that the CD34(+)KDR(+) phenotype of EPCs may be preferred in future studies.

Re: Iori et al.: Bipolar Transurethral Resection of the Prostate: Clinical and Urodynamic Evaluation. (Urology 2008;71:252–255)

We appreciate the interest and comments of Autorino and De Sio for our report on urodynamic evaluation of patients treated with bipolar transurethral prostatic resection (TURP). However, we believe that some aspects of our report should be clarified according to their comments. First, in our study, we observed a significant reduction in the irrigation and catheterization time in patients treated with plasma kinetic TURP (PK-TURP) compared with those treated with standard TURP. However, because of our practice of discharging patients from the hospital ≥8 hours after catheter removal and after they have passed clear urine and not discharging patients after 6 pm, we observed no change in terms of the postoperative hospital stay between the 2 techniques.

Re: Iori F, Franco G, Leonardo C, et al. Bipolar Transurethral Resection of the Prostate: Clinical and Urodynamic Evaluation (Urology 2008;71:252-255)

We read with great interest the report by Iori et al. 1 Iori F. Franco G. Leonardo C. et al. Bipolar transurethral resection of prostate: Clinical and urodynamic evaluation. Urology. 2008; 71: 252-255 Abstract Full Text Full Text PDF PubMed Scopus (47) Google Scholar evaluating the clinical effectiveness of transurethral resection of the prostate (TURP) with the bipolar Gyrus Plasmakinetic System. Some issues raised in their report deserve comment. Re: Iori et al.: Bipolar Transurethral Resection of the Prostate: Clinical and Urodynamic Evaluation. (Urology 2008;71:252–255)UrologyVol. 72Issue 5PreviewWe appreciate the interest and comments of Autorino and De Sio for our report on urodynamic evaluation of patients treated with bipolar transurethral prostatic resection (TURP). However, we believe that some aspects of our report should be clarified according to their comments. First, in our study, we observed a significant reduction in the irrigation and catheterization time in patients treated with plasma kinetic TURP (PK-TURP) compared with those treated with standard TURP. However, because of our practice of discharging patients from the hospital ≥8 hours after catheter removal and after they have passed clear urine and not discharging patients after 6 pm, we observed no change in terms of the postoperative hospital stay between the 2 techniques. Full-Text PDF

Phenotypic Assessment of Endothelial Microparticles in Diabetic and Nondiabetic Men with Erectile Dysfunction

Endothelial microparticles (EMPs) may play a role as biomarkers of vascular injury. EMPs are higher in men with diabetes diabetic men with erectile dysfunction (ED) than in nondiabetic potent men. The aim of this study was to quantize different phenotypic circulating EMP levels among diabetic and nondiabetic patients with ED, and to determine whether EMPs are released as a result of activation or apoptosis. We studied 30 type 2 diabetic and 24 nondiabetic subjects with symptomatic ED from at least 6 months, and 20 nondiabetic men without ED matched for age and weight with diabetic and nondiabetic subjects. Erectile function was assessed by completing the International Index of Erectile Function (IEEF)-5, which consists of Items 5, 15, 4, 2, and 7 from the full-scale IIEF-15. A score of 21 or less indicates the presence of ED. EMP levels in plasma were quantified by flow cytometry. Markers for apoptosis (platelet/endothelial cell adhesion molecule 1/CD31 antigen) and activation (E-selectin/CD62E antigen) were compared. Endothelium-dependent flow-mediated dilation (FMD) was evaluated in the right brachial artery with a high-resolution ultrasound machine following reactive hyperemia. Diabetic patients were found to have the highest levels of EMP31+; diabetic and nondiabetic men with ED were found to have significantly higher levels of EMP62+ than nondiabetic men without ED. The EMP62/EMP31 ratio, an index of endothelial activation (high ratio) or apoptosis (low ratio), was lowest in diabetic men with ED (0.20). In the whole group of 54 men with ED (diabetic and nondiabetic), there was an inverse correlation between FMD and the number of circulating EMPs (P < 0.05). The presence of diabetes in subjects with ED is associated with a different pattern of endothelial cell injury. The phenotypic assessment of EMPs in diabetic patients with ED is consistent with increased apoptotic activity.

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Hypoadiponectinemia

Hypertension is a public health challenge of increasing importance because of its high frequency and concomitant risk of cardiovascular and renal disease. It has been estimated that the worldwide prevalence of hypertension was 972 million in 2000, and this number will increase by 60% by the year 2025.1 A large body of evidence indicates that the increasing prevalence of hypertension is sustained by the escalation of overweight and obesity. Actually, most hypertensive patients are also overweight or obese,2 and this may contribute to further deteriorate their cardiovascular risk profile. Similar to hypertension, obesity is independently associated with numerous adverse cardiovascular outcomes, and, most importantly, adipose tissue expansion and hypertension have a synergistic negative impact on cardiovascular prognosis. Hence, the hypertension–obesity pandemic imposes today a considerable burden on societies and healthcare systems that one can reasonably expect to increase further in the next years. The importance of preventing hypertension underscores the critical role of a better understanding of the most common mechanisms underlying its development. The association between obesity and hypertension has been recognized for many decades,2 and an almost linear relation appears between body mass index and systolic and diastolic blood pressures, at least over a body mass index range from 16 to 31 kg/m2.3 Also, risk estimates from the Framingham Heart Study suggest that ≈78% of the hypertension cases in men and 65% in women can be directly attributed to obesity.4 Further evidence for a consistent link between adiposity and hypertension comes from studies showing that weight gain is almost invariably associated with an increase in blood pressure. The increase in blood pressure is closely related to the magnitude of weight gain, and even moderate weight gain is associated with an increased risk of developing hypertension.5 In addition, even modest weight …