Papers by Giovanni Villani
Springer eBooks, 2003
Thromboembolism is the major complication in atrial fibrillation (AF), and its prevention constit... more Thromboembolism is the major complication in atrial fibrillation (AF), and its prevention constitutes a major challenge in the modern treatment of this common arrhythmia. The embolic risk is not equal in all subgroups of AF patients but relates to the underlying heart condition: while nonrheumatic AF carries a 5.6-fold embolic risk, arrhythmia of rheumatic origin carries a 17.6-fold risk in comparison with healthy controls. However, nonrheumatic AF is responsible for the larger percentage of strokes (15%-20% of cerebrovascular accidents of ischemic origin). Another important factor affecting the risk of thromboembolism is age: cerebrovascular accidents associated with AF represent 6.7% of the total number of cerebrovascular accidents in the 50- to 59-year-old group and 36.2% in the over 80-year-old group [1, 2].
Cardiac Arrhythmias 1999 - Vol.1, 2000
Electrical cardioversion is actually the more effective way to convert persistent atrial fibrilla... more Electrical cardioversion is actually the more effective way to convert persistent atrial fibrillation to sinus rhythm. The success rate of electric cardioversion is 75%–93% [1, 2]. The efficacy of the procedure mainly depends on atrial fibrillation duration and left atrial size. The success rate is about 90% in patients with atrial fibrillation duration of less than 1 year and 50% in patients with atrial fibrillation of 5 years duration [3]. Also patients with left atrial enlargement have less probability of returning to sinus rhythm or of maintaining sinus rhythm after successful cardioversion.
Cardiac Arrhythmias 1997, 1998
The parasympathetic nervous system modulates the electrophysiological properties of most structur... more The parasympathetic nervous system modulates the electrophysiological properties of most structures involved in normal cardiac function and in experimental and human arrhythmias. However in vivo it is actually difficult to evaluate the pure vagal effect since sympatho-vagal interactions are specifically involved in modulating the electrophysiological parameters. The not universally accepted concept of dividing the atrial fibrillation episodes in vagal and sympathetic induced ones is mainly based on anecdotal cases and on clinical preselected models.
European Heart Journal, Aug 2, 2013
in clinical background and lesion background except that age was higher in the IABP group (62±15 ... more in clinical background and lesion background except that age was higher in the IABP group (62±15 vs 72±13, p =0.0006). In addition the one year mortality rate of PCPS group was significantly higher than the IABP group as shown below. Conclusion: The one year mortality after PCI with a mechanical support device for shock AMI patients was high. New devices and strategies are needed to improve the clinical outcome of shock AMI.
Springer eBooks, Jul 8, 2006
The prophylactic treatment for many patients with atrial fibrillation (AF) remains unsatisfactory... more The prophylactic treatment for many patients with atrial fibrillation (AF) remains unsatisfactory. The ideal anti-arrhythmic drug for the prevention of recurrences of both AF after cardioversion and paroxysmal AF is still a long way off. AF has an high propensity to recur, and only one-quarter of patients who undergo successful cardioversion remain in sinus rhythm at 1 year if no additional therapy is used [1]. Since the publication of studies documenting that certain class I drugs may increase mortality in high-risk post-infarction patients, basic science and clinical studies have focused on class III anti-arrhythmic drugs. Class III agents remain the focus of drug development efforts because they lack negative haemodynamic effects, affect both atrial and ventricular tissue, and can be administered as either parenteral or oral preparations. Amiodarone is one of the most effective, and is associated with a comparatively low risk of drug-induced pro-arrhythmia, probably due to its multiple pharmacological actions on cardiac ion channels and receptors. However, amiodarone is associated with significant extra-cardiac side effects, and this has driven development of amiodarone analogues [2]. Developers of newer anti-arrhythmic agents have focused on identifying anti-arrhythmic medications with the following characteristics: appropriate modification of the arrhythmia substrate, suppression of arrhythmia triggers, efficacy in pathological tissues and states, positive rate dependency, appropriate pharmacokinetics, equally effective oral and parenteral formulations of similar efficacy in arrhythmias and their surrogates, few side effects, positive frequency blocking actions, and cardiac-selective ion channel block
European Heart Journal, Aug 1, 2017
Global heart, Dec 1, 2018
maintained therapeutic effort (75.1AE12.8 vs. 70.9AE13.6 years, p¼0.003) and died less commonly d... more maintained therapeutic effort (75.1AE12.8 vs. 70.9AE13.6 years, p¼0.003) and died less commonly due to cardiac causes (89 non-cardiac deaths in patients with life support limitation [95.7%] vs. 303 cardiac deaths in those with a maintained therapeutic effort [74.5%]). A total of 328 patients (65.6%) received comfort measures before death, and opioids were the most frequent drugs used for this purpose. Vasoactive drugs and inotropes were used in 387 patients (77.4%) during admission, and even in the last day of life (158 patients, 31.6%). The therapeutic management was substantially different according to the diagnosis at admission (table). Patients who died in a conventional ward received more often comfort measures before dying compared to those admitted to the Cardiac Intensive Care Unit (121 patients [82.9%] vs. 208 patients [58.8%], p<0.001). Patients who did not receive relief treatments before death were younger (72.0AE14.2 vs. 75.4AE12.3, p¼0.0061). Conclusion: Limitation of life support is carried out in the majority of patients who die in a Cardiology Department, especially in those admitted for decompensated heart failure.
Risks
Wind energy projects represent, currently, a valid opportunity to support United Nations Sustaina... more Wind energy projects represent, currently, a valid opportunity to support United Nations Sustainable Development Goal 7. However, these projects can appear financially unattractive considering the unfavorable meteorological conditions, uncertain electricity market price, uncertain market demand, unpredictable project performance, riskiness of investment stages, etc. This paper provides a real options pricing model applied for the evaluation of a wind farm project to include the uncertainty that can affect future performance. The methodology proposed uses a compound call option model with two barriers applied, respectively, to the twofold phase framework that would act as a sort of up-and-in barrier. The compound call option model allows us to valuate the managerial flexibility to proceed with the following investment stages depending on the success of the previous ones and, through the barriers, the methodology gives the investor the opportunity to consider some profitability thresh...
Annals of Operations Research
In the last decades, the production of fuel ethanol from corn has spread as a valid renewable alt... more In the last decades, the production of fuel ethanol from corn has spread as a valid renewable alternative to pursue sustainability goals. However the uncertain nature of both input (corn) and output (gasoline) prices, together with price dependent operational decisions, combine to make this difficult plant valuation require a real options approach. Moreover, this project is characterized by various sequential stages that contribute to increase its valuation difficulties. The purpose of this paper is to provide a reliable valuation methodology of a corn ethanol plant project able to consider the characteristics of the project. We apply the compound Real Options Approach to price a corn ethanol plant project considering that the corn and gasoline prices both follow a skew-geometric Brownian motion. We also propose a case study to show a real implementation of our theoretical model. The results show that the corn ethanol plant is financially attractive as renewable investment since the...
Quality & Quantity
In most cases, the valuation of the investments characterized by various stages with a high level... more In most cases, the valuation of the investments characterized by various stages with a high level of uncertainty is done through the compound real option valuation (ROV). This decision making support can consider various types of uncertainty that can affects these investment phases, such as that linked to technology. Specifically, within the category of uncertain investments there are the broadband opportunities that can be valued as real options in order to quantify the risks associated with the investment. However, since ROV theory has no definitive way to determine model parameters based on market information, we propose one that can adjust them dynamically. In this paper, to include this aspect in the project valuation, we have unified the ROV with the sentiment analysis, a natural language processing technique that allows us to quantify the polarity of expressions in natural language numerically. In particular, the inherent risks related to the different phases of the project c...
Quality & Quantity
Broadband projects nowadays represent a valid investment alternative to pursuing smart city goals... more Broadband projects nowadays represent a valid investment alternative to pursuing smart city goals, particularly considering the rapid development that has affected the telecommunications industry. However, for potential investors, the valuation of these projects is a demanding activity because they are characterized by the uncertainty of future user demands, the competition risk, and the sequential nature of investment. In this paper we propose an innovative methodology to valuate the broadband projects taking into account these three peculiarities. This model consists of combining the compound real options approach (ROA), able to price the sequential uncertain projects, with the Options Game (OG) approach used in the literature to valuate uncertain investments affected by competition risk. This paper contributes to the existing literature by expanding the OG model to fit the broadband characteristics in discrete time. We also propose a case study to implement the theoretical approa...
Neural Computing and Applications
In financial markets, sentiment analysis on natural language sentences can improve forecasting. M... more In financial markets, sentiment analysis on natural language sentences can improve forecasting. Many investors rely on information extracted from newspapers or their feelings. Therefore, this information is expressed in their language. Sentiment analysis models classify sentences (or entire texts) with their polarity (positive, negative, or neutral) and derive a sentiment score. In this paper, we use this sentiment (polarity) score to improve the forecasting of stocks and use it as a new “view” in the Black and Litterman model. This score is related to various events (both positive and negative) that have affected some stocks. The sentences used to determine the scores are taken from articles published in Financial Times (an international financial newspaper). To improve the forecast using this average sentiment score, we use a Monte Carlo method to generate a series of possible paths for several trading hours after the article was published to discretize (or approximate) the Wiener...
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Giornale italiano di cardiologia, 2020
Takotsubo syndrome (TTS) is one of the causes of myocardial infarction with non-obstructive coron... more Takotsubo syndrome (TTS) is one of the causes of myocardial infarction with non-obstructive coronary arteries, and is often triggered by physical events (e.g. acute respiratory failure), or emotional events (e.g. loss of a family member, cardiac stress induced by an acute illness). SARS-CoV-2 pneumonia currently represents a worldwide health problem; the correlations between cardiovascular disease, myocardial injury and SARS-CoV-2 infection are still unclear, but initial data show that myocardial damage represents a negative prognostic factor. Myocardial injury during SARS-CoV-2, as defined by a pathological rise in circulating troponin levels, is not an uncommon complication in hospitalized patients, and is significantly more frequent in intensive care unit patients and among those who died. In this setting, myocardial injury is mainly secondary to type 2 myocardial infarction (mismatch in myocardial oxygen supply and demand during respiratory failure); other causes include myocard...
Computational Economics, 2021
We consider a differential game which models the competition between a genuine and a counterfeit ... more We consider a differential game which models the competition between a genuine and a counterfeit producer. The genuine manufacturer acts as a leader, first announcing the price of the product and the investments in advertising. After observing the leader’s decisions, the counterfeiter sets the selling price of the fakes. We assume that the demand of the good is driven by the brand-name goodwill. We calculate the Stackelberg feedback equilibria and the social welfare, defined by the unweighted sum of the genuine and fakes consumers, the profit of the genuine firm, minus the enforcement costs borne by the social planner. The purpose of this paper is twofold. Firstly we study the dependence of social welfare on the amount of the fines established in the IPR law and monitoring efforts. Then, we compare prices, profits and social welfare under Nash and Stackelberg framework.
European Heart Journal, 2020
Introduction Out-of-hospital cardiac arrest (OHCA) is a leading cause of death worldwide; it acco... more Introduction Out-of-hospital cardiac arrest (OHCA) is a leading cause of death worldwide; it accounts for up to 50% of all cardiovascular deaths.It is well established that ambient air pollution triggers fatal and non-fatal cardiovascular events. However, the impact of air pollution on OHCA is still controversial. The objective of this study was to investigate the impact of short-term exposure to outdoor air pollutants on the incidence of OHCA in the urban area of Piacenza, Italy, one of the most polluted area in Europe. Methods From 01/01/2010 to 31/12/2017 day-by-day PM10 and PM2.5 levels, as well as climatic data, were extracted from Environmental Protection Agency (ARPA) local monitoring stations. OHCA were extracted from the prospective registry of Community-based automated external defibrillator Cardiac arrest “Progetto Vita”. OHCA data were included: audio recordings, event information and ECG tracings. Logistic regression analysis was used to estimate the association between...
European Heart Journal Supplements, 2003
Thromboembolism is the major complication in atrial fibrillation, prevention of which constitutes... more Thromboembolism is the major complication in atrial fibrillation, prevention of which constitutes a major challenge in the modern treatment of this common arrhythmia. Treatment with oral anticoagulation is considered the 'gold standard', although several controversial issues have been raised concerning its use in all subgroups of patients affected by atrial fibrillation. In this review, the 'state of the art' treatment strategies in this important and potentially lethal clinical complication are discussed, with particular attention given to issues that remain unresolved. Finally, current proven and accepted therapeutic approaches are presented.
Circulation, Nov 11, 2016
Introduction: Chest compressions (CC) are unquestioned as appropriate and beneficial during rescu... more Introduction: Chest compressions (CC) are unquestioned as appropriate and beneficial during rescuing attempts of out-of-hospital cardiac arrest (OOHCA). However, adverse consequences from CC are well documented and CC share many aspects with commotio cordis, a well-known cause of VF induction. Hypothesis: To test the association between CC and VF recurrences (VFr) after a successful shock in OOHCA. Methods: The Progetto Vita database, prospectively collecting data on all resuscitation efforts in the Piacenza province (Italy), was used for the present analysis. All data concerning the resuscitation were prospectively collected according to the Utstein recommendations. From the 461 OOHCA found in a shockable rhythm, only those with both good ECG tracings and good quality audio recordings (160) were included in the analysis. VFr was defined as related to CC when the onset of VFr occurred during the actual CC artifact or immediately after. Otherwise, it was defined as spontaneous. The conduct of CC was confir...
Giornale italiano di cardiologia, May 1, 2000
Europace, 2001
The aim of this study was to compare athal defibrillation thresholds (ADFT) for refractory perman... more The aim of this study was to compare athal defibrillation thresholds (ADFT) for refractory permanent atrial fibrigation (AF) between the new Physio-Contml LifePek 12 3D (PC) bipheeic defibdlletor and the Vent~ex HVS-02 (I-IV} using transvenous low energy shocks.
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Papers by Giovanni Villani