Search

The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135–15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359–5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138–5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184–5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598–9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090–6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286–5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p p = 0.018; 95% CI 0.138–0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143–0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990). Graphical abstract

Nel corso della sua intera produzione filosofica, solo in due occasioni Schopenhauer riflette esplicitamente e sistematicamente sul misticismo, nel tentativo di determinarne i confini e i limiti rispetto al suo sistema metafisico e, più in generale, rispetto al pensiero filosofico lato sensu. La seguente analisi ha l’obiettivo di stabilire se sia possibile rilevare una definizione univoca del termine misticismo all’interno della sua filosofia, per poi determinare sulla base di essa il particolare rapporto che intercorre tra il misticismo e il nichilismo schopenhaueriano.

Inflammatory myofibroblastic tumor (IMT) is a mesenchymal tumor that can occur at any age. However, it is primarily seen in children, with the most common site being in the lung parenchyma, usually present with rare endobronchial lesions. This case reports the incidence in a 3-year-old girl diagnosed with pericardiac pneumonia treated with antibiotics with no clinical improvement. A chest computed tomography (CT) scan identified a 1.5-cm lesion in the left main bronchus. Bronchoscopy revealed complete obstruction of the left main stem bronchus. A left posterolateral thoracotomy was performed. Additionally, a left sleeve upper bronchial resection was conducted under fibroendoscopic control. Definitive histology confirmed IMT. After 2 years of endoscopic follow-up, there is no evidence of recurrence.

In advanced HER2-positive (HER2+) breast cancer, the new antibody-drug conjugate trastuzumab deruxtecan is more effective compared with trastuzumab emtansine (T-DM1). However, trastuzumab deruxtecan can have considerable toxicities, and the right treatment sequence is unknown. Biomarkers to guide the use of anti-HER2 therapies beyond HER2 status are needed. Here, we evaluated if preestablished levels of ERBB2 mRNA expression according to the HER2DX standardized assay are associated with response and survival following T-DM1. In ERBB2 low, medium, and high groups, the overall response rate was 0%, 29%, and 56%, respectively (P

Osteoporosis is related to dysfunction of the crosstalk between osteoblasts and osteoclasts, the cells involved in the formation and resorption of bone, respectively. Oxidative stress and inflammation are involved in the pathogenesis of osteoporosis. Because of their antioxidant and anti-inflammatory properties, natural compounds such as polyphenols extensively present in fruit, vegetables, wine, tea, extra virgin olive oil, and berries, play an important protective role in disorders of bone metabolism, including osteoporosis. A diet rich in polyphenol-rich fruit and vegetables can reduce bone mineral density loss, decreasing the risk of fracture and preserving lifestyle quality. The aim of the present review is to highlight the principal mechanisms involved in the role played by the main dietary polyphenols in the prevention and/or treatment of osteoporosis.

Background Allogeneic hematopoietic stem-cell transplantation is the standard of care for Hurler syndrome (mucopolysaccharidosis type I, Hurler variant [MPSIH]). However, this treatment is only partially curative and is associated with complications. Methods We are conducting an ongoing study involving eight children with MPSIH. At enrollment, the children lacked a suitable allogeneic donor and had a Developmental Quotient or Intelligence Quotient score above 70 (i.e., none had moderate or severe cognitive impairment). The children received autologous hematopoietic stem and progenitor cells (HSPCs) transduced ex vivo with an alpha-L-iduronidase (IDUA)-encoding lentiviral vector after myeloablative conditioning. Safety and correction of blood IDUA activity up to supraphysiologic levels were the primary end points. Clearance of lysosomal storage material as well as skeletal and neurophysiological development were assessed as secondary and exploratory end points. The planned duration of the study is 5 years. Results We now report interim results. The children's mean (+/- SD) age at the time of HSPC gene therapy was 1.9 +/- 0.5 years. At a median follow-up of 2.10 years, the procedure had a safety profile similar to that known for autologous hematopoietic stem-cell transplantation. All the patients showed prompt and sustained engraftment of gene-corrected cells and had supraphysiologic blood IDUA activity within a month, which was maintained up to the latest follow-up. Urinary glycosaminoglycan (GAG) excretion decreased steeply, reaching normal levels at 12 months in four of five patients who could be evaluated. Previously undetectable levels of IDUA activity in the cerebrospinal fluid became detectable after gene therapy and were associated with local clearance of GAGs. Patients showed stable cognitive performance, stable motor skills corresponding to continued motor development, improved or stable findings on magnetic resonance imaging of the brain and spine, reduced joint stiffness, and normal growth in line with World Health Organization growth charts. Conclusions The delivery of HSPC gene therapy in patients with MPSIH resulted in extensive metabolic correction in peripheral tissues and the central nervous system. (Funded by Fondazione Telethon and others; ClinicalTrials.gov number, ; EudraCT number, .)Hematopoietic Gene Therapy for Hurler Syndrome Eight patients with Hurler syndrome who lacked suitable allogeneic donors received autologous hematopoietic stem and progenitor cells transduced ex vivo with an alpha-L-iduronidase-encoding lentiviral vector. This therapy resulted in extensive metabolic correction in peripheral tissues and the central nervous system.

Diabetes is now one of the most prevalent diseases in the world. Over the next twenty years, the number of affected individuals could reach 693 million. Diabetes is a group of chronic carbohydrate metabolism disorders responsible for increased blood glucose levels. It has several effects on the human body, and over the years can even become disabling, greatly impacting the patient’s quality of life. The most common therapy is based on daily and chronic administration of exogenous insulin, but this is associated with a series of dangerous and potentially fatal complications. Unsurprisingly therefore, over time, studies have explored various alternatives for the treatment of diabetes, not involving the use of insulin, primarily transplantation of the whole pancreas and of the islets of Langerhans. However, neither of these solutions can be applied on a large scale, mainly due to the lack of donors. In recent years, a viable alternative to insulin and to transplantation has emerged through exploration of the use of pluripotent stem cells and their properties. In this review we analyze the state of the art in this field, and the advantages and disadvantages of cell therapies used for reconstruction of the functional unit of the pancreas, the islets of Langerhans.

The pituitary gland is defined as a highly “plastic” gland, capable of adapting to the changing needs of the body over the course of a lifetime. In 1969, the first putative pituitary stem cells were isolated, defined as chromophobe cells because of their inability to secrete/incorporate hormones. Since then, studies have improved and have confirmed the presumed existence of a side population characterized by SOX2 expression in both the anterior and marginal pituitary lobes. From the numerous studies conducted to unravel the biological significance of these stem populations, it is currently believed that these cells, at least in the adult basal gland, are highly quiescent; however, their functions are still not well understood. This review reports the major advances achieved in recent years towards developing protocols for the isolation of pituitary stem cells from healthy tissue and pituitary adenomas, as well as the first studies on their use in regenerative medicine.

The commercially important Atlantic blue crab, Callinectes sapidus, recruits to bays and estuarine habitats from planktonic megalopal larvae throughout the eastern United States. These megalopae engage in vertical and horizontal swimming to reach a location of primary settlement, most commonly seagrass beds. These benthic habitats provide food and shelter for the megalopae as they metamorphose into juveniles. These benefits may be gained from planktonic association as well. Across 4 years and multiple sites in the Northwestern Gulf of Mexico, we record Callinectes megalopae and small juveniles actively clinging to Chrysaora chesapeakei (the Chesapeake Bay Nettle) medusae. Up to 301 individual megalopae were recorded on a single jellyfish. This establishes that C. chesapeakei is used as transport and temporary nursery habitat by the C. sapidus megalopae. This report brings light to a mid-water interaction of a commercially valuable crustacean and a seasonal scyphozoan that may facilitate juvenile recruitment.

Many cyclone detection and tracking methods (CDTMs) have been developed in the past to study the climatology of extratropical cyclones. However, all CDTMs have different approaches in defining and tracking cyclone centers. This naturally leads to cyclone track climatologies with inconsistent physical characteristics. More than that, it is typical for CDTMs to produce a non-negligible number of tracks of weak atmospheric features, which do not correspond to large-scale or mesoscale vortices and can differ significantly between CDTMs. Lack of consensus in CDTM outputs and the inclusion of significant numbers of uncertain tracks therein have long prohibited the production of a commonly accepted reference dataset of extratropical cyclone tracks. Such a dataset could allow comparable results on the analysis of storm track climatologies and could also contribute to the evaluation and improvement of CDTMs. To cover this gap, we present a new methodological approach that combines overlapping tracks from different CDTMs and produces composite tracks that concentrate the agreement of more than one CDTM. In this study we apply this methodology to the outputs of 10 well-established CDTMs which were originally applied to ERA5 reanalysis in the 42-year period of 1979–2020. We tested the sensitivity of our results to the spatiotemporal criteria that identify overlapping cyclone tracks, and for benchmarking reasons, we produced five reference datasets of subjectively tracked cyclones. Results show that climatological numbers of composite tracks are substantially lower than the ones of individual CDTMs, while benchmarking scores remain high (i.e., counting the number of subjectively tracked cyclones captured by the composite tracks). Our results show that composite tracks tend to describe more intense and longer-lasting cyclones with more distinguished early, mature and decay stages than the cyclone tracks produced by individual CDTMs. Ranking the composite tracks according to their confidence level (defined by the number of contributing CDTMs), it is shown that the higher the confidence level, the more intense and long-lasting cyclones are produced. Given the advantage of our methodology in producing cyclone tracks with physically meaningful and distinctive life stages, we propose composite tracks as reference datasets for climatological research in the Mediterranean. The Supplement provides the composite Mediterranean tracks for all confidence levels, and in the conclusion we discuss their adequate use for scientific research and applications.

Cyclones are essential elements of the climate system and water cycle but also major natural hazards in the densely populated Mediterranean basin. In the framework of the COST Action "European network for Mediterranean cyclones in weather and climate - MedCyclones", a model intercomparison project investigates the dynamics and predictability of case studies using modelling setups that are not yet available to operational forecasting systems. The intercomparison involves 10 sets of simulations based on 5 mesoscale models and multiple combinations of physical parameterizations. All sets include the same sensitivity simulations to initial and lateral boundary conditions and horizontal resolution. Here we focus on tropical-like cyclone (Medicane) Ianos that hit Greece in mid September 2020 and was poorly predicted by operational forecasts. Models systematically perform better when initialized from operational IFS analysis data compared to the widely used ERA5 reanalysis. Reducing horizontal grid spacing from 10 km (convection-parameterized) to 2 km (convection-permitting) further improves the cyclone track and intensity. This highlights the critical organization of convection during the early cyclogenesis for the phasing with an upper-level jet. Higher resolution enhances convective activity and favorably preconditions the jet, which controls the subsequent cyclone intensification and evolution.The 10 sets of simulations show robust agreement but also reveal model specificities such as the possible need for a convective parameterization even at 2 km horizontal grid spacing. While they require generalization to other cases of Mediterranean cyclones, the results shall provide guidance for the next generation of global convection-permitting models in weather and climate., The 28th IUGG General Assembly (IUGG2023) (Berlin 2023)

The aim of this work is to investigate the degradation of perovskite solar cells (PSCs) by means of impedance spectroscopy, a highly sensitive characterization technique used to establish the electrical response of a device in a nondestructive manner. In this paper, PSCs with two different electron transport layers (ETLs) are studied: PSCs with undoped SnO2 as an ETL are compared to PSCs with an ETL composed of graphene-doped SnO2 (G-SnO2). Experimental data were collected immediately after fabrication and after one week, monitoring both impedance spectroscopy and dark current-voltage (I-V) curves. It was observed that, in the case of the undoped PSCs, the degradation of the solar cells affected both the AC behavior of the devices, modifying the associated Nyquist plots, and the DC behavior, observable from the dark I-V measurements. Conversely, the solar cells with G-SnO2 showed no variation. Considering the Nyquist plots, a quantitative analysis was performed by comparing the parameters of a proper equivalent circuit model. The results were coherent with those achieved in the DC analysis, thus proving that the analysis of impedance spectra, supported with dark I-V curves, allows one to gain a deeper knowledge of the degradation phenomena of perovskite solar cells. This study opens the door for further improvement of these devices through a better understanding of their electrical behavior.

On 18 September 2020, medicane Ianos hit the western coast of Greece resulting in flooding and severe damage at several coastal locations. In this work, we aim at evaluating its impact on sea conditions and the associated uncertainty through the use of an ensemble of numerical simulations. We applied a coupled wave-current model to an unstructured mesh representing the whole Mediterranean Sea, with a grid resolution increasing in the Ionian Sea along the cyclone path and the landfall area. To investigate the uncertainty of modelling sea levels and waves for such an intense event, we performed a multimodel ensemble of ocean simulations using several coarse (10 km) and high-resolution (2 km) meteorological forcings from different mesoscale models. The performance of the ocean and wave models was evaluated against observations retrieved from fixed monitoring stations and satellites. All model runs emphasized the occurrence of severe sea conditions along the cyclone path and at the coast. Due to the rugged and complex coastline, extreme sea levels are localised at specific coastal sites. However, numerical results show a large spread of the simulated sea conditions for both the sea level and waves highlighting the large uncertainty in simulating this kind of extreme event. The multi-model / multi-physics approach allows us to assess how the uncertainty propagates from meteorological to ocean variables and the subsequent coastal impact. The ensemble mean and standard deviation were combined to prove the hazard scenarios of the potential impact of such an extreme event to be used in a flood risk management plan.

Contains fulltext : 294537.pdf (Publisher’s version ) (Open Access) BACKGROUND: To identify a diagnostic blood transcriptomic signature that distinguishes multisystem inflammatory syndrome in children (MIS-C) from Kawasaki disease (KD), bacterial infections, and viral infections. METHODS: Children presenting with MIS-C to participating hospitals in the United Kingdom and the European Union between April 2020 and April 2021 were prospectively recruited. Whole-blood RNA Sequencing was performed, contrasting the transcriptomes of children with MIS-C (n = 38) to those from children with KD (n = 136), definite bacterial (DB; n = 188) and viral infections (DV; n = 138). Genes significantly differentially expressed (SDE) between MIS-C and comparator groups were identified. Feature selection was used to identify genes that optimally distinguish MIS-C from other diseases, which were subsequently translated into RT-qPCR assays and evaluated in an independent validation set comprising MIS-C (n = 37), KD (n = 19), DB (n = 56), DV (n = 43), and COVID-19 (n = 39). RESULTS: In the discovery set, 5696 genes were SDE between MIS-C and combined comparator disease groups. Five genes were identified as potential MIS-C diagnostic biomarkers (HSPBAP1, VPS37C, TGFB1, MX2, and TRBV11-2), achieving an AUC of 96.8% (95% CI: 94.6%-98.9%) in the discovery set, and were translated into RT-qPCR assays. The RT-qPCR 5-gene signature achieved an AUC of 93.2% (95% CI: 88.3%-97.7%) in the independent validation set when distinguishing MIS-C from KD, DB, and DV. CONCLUSIONS: MIS-C can be distinguished from KD, DB, and DV groups using a 5-gene blood RNA expression signature. The small number of genes in the signature and good performance in both discovery and validation sets should enable the development of a diagnostic test for MIS-C.

International audience; The CarboEurope Regional Experiment Strategy took place in the South West of France in 2005 and 2007 gathering several intensive observation periods to estimate the regional carbon balance. Eddy covariance fluxes, atmospheric CO2 concentrations, and the solar induced fluorescence were measured from both towers and aircraft. Additional meteorological observations were used to evaluate the performance of mesoscale models to simulate the observed concentrations. Top-down and bottom-up methods were applied and evaluated against direct ecosystem measurements, demonstrating the potential and the reliability of the carbon flux estimates over the region. Mesoscale modeling showed promising results by simulating most of the observed atmospheric variability. Inverse methodology was used to optimize the carbon balance over the area. The aircraft fluxes aggregated over large footprints (few km) showed an overall agreement with the final estimates from the inversion and the eddy flux towers. The photosynthesis activity was also correlated to the sun-induced fluorescence from ground based and aircraft measurements. Potential improvement of the continental carbon balance and recommendations for designing future regional observation networks are discussed.

In the last decades, the agroindustry is facing environmental issues due particularly to food loss and waste, requiring a strong orientation towards sustainability and the circular economy (CE) paradigm. This study carries out an investigation of the role of digitalization in serving as a driver to achieve circularity in the agroindustry. A SWOT analysis was performed to assess the strengths and weaknesses (internal factors) and opportunities and threats (external factors) of digitalization in boosting circularity within agroindustry systems and identifying critical factors (CFs). Through the Analytical Network Process (ANP), an evaluation of these CFs was provided, while the Axial-Distance-Based Aggregated Measurement (ADAM) method allowed for the ranking of the strategic alternatives to better inform management decisions. This study provides valuable results that reveal the crucial role of digitalization in boosting circularity within agroindustry, highlighting the most impactful strategies driving the transition towards a circular economy. Linking the high sustainability performance of products to incentives and increasing consumer inclusion and awareness in business dynamics were found to be the most relevant strategies for making agro-industrial supply chains more circular. This study provides recommendations to leadmanagers' and practitioners' decisions towards the adoption of strategies, aimed at making the agro-industrial sector more adherent to the principles of circular economy and sustainability.

Objectives: The primary aim of the study was to explore pain intensity (PI) and pain coping (PC) scores and the relationship between them. The secondary aim was to explore the correlation between PI and PC scores with labour progress, parity, labour acceleration, labour augmentation and maternal satisfaction. Methods: A prospective descriptive correlational study was conducted in a maternity hospital in Northern Italy. The sample included 54 low-risk women in active labour at term of pregnancy. A data record sheet was used to collect the relevant variables and the Italian Birth Satisfaction Scale Revised (I-BSS-R) was administered to participants at least 24 h after birth. Results: In the first labour stage, the average PI score was 6.99 (SD = 1.95) and the average PC score was 6.5 (SD = 2.22). During the second labour stage, the average PI score was 7.75 (SD = 1.74) and the average PC score was 4.97 (SD = 2.76). The average PI score trend increased with labour progress. The average PC score improved between 4 and 7 cm of cervical dilatation. A significant positive correlation between PI scores and oxytocin augmentation (p < 0.001) and labour progression (p < 0.001) was noted. A significant positive correlation between PC scores and oxytocin augmentation (p = 0.02) was also observed. No significant differences were found for maternal satisfaction in regard to PI and PC scores. Conclusion: coping in labour do not solely depend on PI but also on labour progress and oxytocin augmentation. Additional support to empower women to cope with pain may be required in case of labour augmentation.

Diabetic nephropathy is a leading cause of end-stage renal disease, characterized by endothelial dysfunction and a compromised glomerular permeability barrier. Dysregulation of the angiopoietin 1 (ANGPT1)/angiopoietin 2 (ANGPT2) signaling axis is implicated in disease progression. We recently described the discovery of an IgG

Purpose Spent coffee grounds (SCG) are biowastes extensively generated within the coffee supply chain. Nowadays, their disposal represents an increasing environmental concern due to its toxicity and organic nature. With the estimated increase of coffee production and consumption in the upcoming years, there is an imperative need to find a proper reverse option, along with a novel industrial application, which allows for the valorization of this coffee by-product within a circular economy perspective. This study aims at investigating a potential reuse of spent coffee grounds to produce novel construction materials to be used for sustainable buildings. Methods After having illustrated the forward flows within the coffee life cycle and the potential reverse flow options, an evaluation method based on multi-criteria analyses was elaborated to test not only the technical but also the environmental and economic performances of novel materials originating from the incorporation of SCG as an aggregate in natural hydraulic lime and geopolymer-based mortars. Moreover, we focus on the reuse of another waste streams— biomass fly ash—deriving from the paper-pulp industry, rarely investigated in both traditional construction applications and in geopolymer manufacture. The two (geopolymer- and lime-based) mortar typologies are here studied and compared as potential green material for applications in construction, with satisfying engineering performance and high insulation attitude, giving a new life to a common organic waste. Consequently, we compare eight formulations by means of multi-criteria approaches that are nowadays claimed as a useful and effective decision aiding support instrument to assess the development of new sustainable construction materials. They permit to consider simultaneously some controversial and often uncertain aspects like technological (as the usual scientific studies do), environmental, and economic (more difficult to easily approach and evaluate). For this purpose, in this paper, we have analyzed the performance of the novel bio-composite mortars using VIKOR and TOPSIS methods to rank a set of alternatives according to various evaluation criteria that often conflict one with each other. Results Results show that adding spent coffee grounds can efficiently improve the technical and sustainable performances of the novel mortars for different applications in the building sector. The presence of SCG increases water absorption and improves the insulation performance along with an environmental impact reduction. The considered technological properties are highly promising—such as the improvement in thermal insulation. In particular, even the addition of only 5% SCG leads to a significant reduction of the thermal conductivity and consequently to a greater insulating performance. Conclusions To date, most of the available literature on recycling SCG in construction materials do not consider mortar-based applications and, moreover, nor multi-criteria approaches. Therefore, our study proposes itself as an innovative track solution to food waste management lowering the employment of non-renewable natural resources and the costs associated to construction material production. At the same time, a novel and innovative way of such waste disposal is suggested, pursuing the sustainability and substantially reducing the environmental impact of construction and building materials. This study is a fundamental step in assessing the applicability of our designed and produced materials and its potentials to be produced at an industrial scale.

Several Medicanes, which have been previously analyzed in the literature, have been studied using ERA-5 reanalyses to identify the environment in which they develop and possibly distinguish tropical-like cyclones from warm seclusions. Initially, the cyclone phase space was analyzed to identify changes in the environmental characteristics. Subsequently, the temporal evolution of several parameters was considered, including sea surface fluxes, CAPE, coupling index, potential intensity, baroclinicity.Although the results are not consistent for all cyclones, some general characteristics can be identified: cyclones develop in areas of moderate-to-high baroclinicity associated with intense jet streams, while in the mature stage the environment becomes less baroclinic. A general reduction in the horizontal extent of the cyclone can be observed as the cyclones begin to show a shallow warm core. In this phase a progressive reduction of the CAPE can be observed in proximity of the cyclone center. Finally, the wind speed appears strongly underestimated compared to the observations, raising some concerns about the applicability of ERA-5 for the detection of wind features.

An enhanced understanding of Climate Change related implications in the maritime domain is needed in order to improve coastal infrastructure resilience and possible future operations, also in terms of climate security. Although the Mediterranean Sea is a relatively mild basin, it is however characterized by high geopolitical and economic relevance, occasionally showing intense cyclones with tropical-like characteristics known as Tropical-Like Cyclones (TLC). Many studies have highlighted that sea surface temperature (SST) distribution and anomalies play a crucial role in modulating the intense air-sea exchange, hence controlling both development and evolution of TLCs. However, given the complex interplay among ocean mixed layer, heat content and temperature, the role of the mixed layer depth (MLD) is of paramount importance. In this study we investigated the role of both SST anomaly, horizontal gradients and MLD profile on the origin and evolution of a recent record-breaking TLC (named IANOS). This cyclone originated over the southern Ionian Sea from 14 Sept 2020 to 19 Sept 2020, moving over the Central Ionian Sea from south-west to North-East, and made landfall over Greece mainland coast. It developed over a basin where a positive SST anomaly up to 4 °C was detected, which coincided with the sea area where it reached the maximum intensification and strength. We conducted a series of experiments using an atmospheric model (WRF - Weather Research and Forecasting system) driven by underlying SST (standalone configuration), either with daily update or coupled to a simple mixed-layer ocean model (SLAB ocean), with SST calculated at every time step using the SLAB ocean for a given value of the MLD. Sensitivity tests were performed increasing or decreasing MLD depth by 10 m, 30 m, 50 m, 75 m, 100 m, removing the horizontal gradients, removing the SST anomaly. Then, possible past and future climatological scenarios of MLD thickness were identified and tested. Preliminary results show that the MLD influences not only the intensity of the cyclone but also the structure of the precipitation field both in terms of magnitude and location. The fundamental role of the SST anomaly was also found to be essential to provide intense characteristics to IANOS. Results deserve further investigation in particular in the context of climate change scenarios that can provide useful insights into impact on coastal civil and military infrastructures in the whole Mediterranean region.

The accurate retrieval of Solar-Induced chlorophyll Fluorescence (SIF) is a pivotal target for Earth Observation since SIF can be easily monitored through optical remote sensing and provides unique information concerning the vegetation health status. Here, we propose i-φ-MaLe (metti il nome per esteso), a novel algorithm, which couples the Fourier analysis with a supervised machine learning-based procedure trained with the atmosphere-canopy radiative transfer (RT) SCOPE model. i-φ-MaLe is the first method able to simultaneously retrieve, from the vegetation reflectance spectra, the Top Of Canopy SIF spectrum, the SIF spectrum corrected for leaf/canopy reabsorption (i.e. at photosystem level), the quantum efficiency (Fqe) and three canopy-related biophysical parameters (Leaf Area Index - LAI, Chlorophyll content - Cab and APAR) in few milliseconds. Validation procedures, based on the analysis of RT simulations, demonstrated that i-φ-MaLe, in experimental conditions (signal to noise ratio – SNR >= 500), estimates each biophysical parameter and SIF spectrum with a relative root mean square error (RRMSE) lower than 5%. In order to investigate the seasonal and daily dynamics of SIF, LAI, Cab, Fqe and APAR, the method has been also applied to field experimental data collected in the context of the AtmoFLEX and FLEXSense ESA campaigns, both at top-of-canopy (TOC) and tower (~100 meters) levels. Concerning the TOC scenario, the retrieved annual dynamic for SIF spectra has been compared with the results obtained by inversion-based methods, showing a good consistency amongthe different approaches (RRMSE ~ 10%). Moreover, SIF daily and annual dynamics, retrieved by excluding the oxygen spectral bands affected by the atmospheric reabsorption, have been investigated for high tower measurements. . In this context, i-φ-MaLe provided promising results that can integrate and possibly overcome complex and computationally expensive atmospheric compensation techniques actually needed to retrieve fluorescence from oxygen absorptions bands. This study demonstrates a promising potential to exploit ground and tower spectral measurements with advanced processing algorithms, for improving our understanding on the link between canopy structure and physiological functioning of plants. Moreover, i-φ-MaLe can be straightforwardly employed to process reflectance spectra and open new perspectives in fluorescence retrieval at different scales.

From 6 to 8 November 2011, a baroclinic wave moved from North Atlantic to Balearic Sea, produced a cut-off, at all altitudes, and developed into a Tropical-Like Cyclone (TLC) characterized by a deep-warm core. This TLC led to a mean sea level pressure minimum of about 987 hPa, 10 m wind speeds higher than 30 m/s around the eye, and very intense rainfall, especially in the Gulf of Lion and the surrounding areas, close to the mountain chains (floods in Genoa and Elba Island).To explore in details the effect of the sea surface temperature on the TLC development, we employed the coupled modeling system COAWST, which consists of the following models: ROMS for the hydrodynamic part, WRF for the meteorological part and SWAN for the surface wave modeling, using a 5 km horizontal grid over all Mediterranean Sea.COAWST was used with different configurations: Stand Alone (SA) approach using only the atmospheric part, atmosphere-ocean coupled mode (AO), and fully coupled version including also surface waves (AOW). Comparing the three runs, the effects of different simulations on the TLC trajectory are significant only in the later stage of the cyclone lifetime. On the other hand, wind intensity is higher in the SA case w.r.t. both coupled runs. When compared to case AO, winds are about 1 m/s larger, even though the spatial distribution is very similar (possibly because of the lower SST produced by case AO). Case AOW produces less intense winds than SA and AO case in the areas where the wave is most developed (differences are about 2-4 m/s), while winds are more intense nearby the cyclone’s eye. Moreover, the inclusion of the wave model (AOW) has implications in the water column, by increasing the mixing in the ocean, changing the depth of the ocean mixed layer along the track of the TLC, increasing the surface drag and the net heat fluxes from ocean to atmosphere, so that eventually SST in AOW run is colder than in AO.It is observed that SST of the SA case is overestimated compared to the coupled cases, and in particular the best performances are observed using the fully coupled case, with the wave motion implementation. The best description of the SST impacts the cyclone intensity and the amount of precipitation at catchment scale. The vertical profiles show that wave induced mixing modifies the mixed layer structure and cools the water column, removing much of the SST (and Ocean Heat Content) anomaly present in the mixed layer.The date chosen for the run initialization appears important: an earlier initial condition allows to properly simulate the evolution of the cyclone from the cyclogenesis between the inclusion and setting-up of air sea interaction effect, through the coupled models.Warming SST in the Mediterranean Sea induced by climate change might increase TLC frequency and/or intensity, potentially becoming more harmful for coastal populations and infrastractures. Fully coupled AOW models might be better suited for studying such aspects. Funding from the STO Office of Chief Scientist (907EUR30) is gratefully acknowledged.

In the semi-enclosed basin of the Mediterranean Sea, a wide variety of cyclone mechanisms are known to develop, including baroclinic waves coming from the Atlantic, Mediterranean cyclones originating from the cut-off of baroclinic waves, Warm Seclusions, Tropical-Like Cyclones (TLC), Rapid-Cyclogeneses (RC) and Intense Mediterranean Cyclones (IMC). Depending on the cyclone's type, the characteristic frequency of appearance can vary, ranging from tens per month to around 1-1.5 per year, as in the TLC case. RCs are among the rarest and probably most intense and destructive cyclone events that can develop in nature; they usually originate at high latitudes, during wintertime, and mainly over the sea, preferring areas with high Sea Surface Temperature (SST) gradients. It is generally accepted that these events are described by quick drop of pressure, close to 1hPa/hr for 24 hours, within the eye of the cyclone. Several recent studies investigated the formation of RC’s over Mediterranean Basin (MB). RCs formation is an extremely complicated process, and in the MB it is mostly driven by dry air intrusions from the stratosphere and by the trigger of Atmospheric Rivers.Using ERA5 dataset, we firstly conducted a physical and dynamical analysis of the most intense cyclone events occurred in the Mediterranean basin in the period 1979-2020, identifying factors which triggered, generated and contributed to the intensification of such events. According to Sanders’ and Gyakum’s definition of Bergeron, a parameter which describes RCs’ deepening rate and varies from 28mb/(24h) at the pole to 12 mb/(24h) at latitude 25°N, we were able to classify them in the three aforementioned categories. With the help of EOF analysis, we outlined synoptic configuration more likely to drive the phenomena, highlighting the role of SCAND index and NAO-. Moreover, we have investigated the deepening with a new promising approach involving the use of 6 hours timespans, in order to single out the cyclones with higher gradients of pressure and faster evolution in semi enclosed basins. Further analysis is being undertaken to determine the cyclones’ phase and their main morphological characteristics, as well as their correlation with atmospheric rivers and SST anomalies exhibited by the Central Mediterranean Basin.

Background Meningococcus (Neisseria meningitidis) is the causative bacteria of invasive meningococcal disease (IMD), a major cause of meningitis and sepsis. In 2015–16, an outbreak caused by serogroup C meningococci (MenC), belonging to the hyperinvasive strain ST-11(cc-11), resulted in 62 IMD cases in the region of Tuscany, Italy. Aim We aimed to estimate the key outbreak parameters and assess the impact of interventions used in the outbreak response. Methods We developed a susceptible-carrier-susceptible individual-based model of MenC transmission, accounting for transmission in households, schools, discos/clubs and the general community, which was informed by detailed data on the 2015–16 outbreak (derived from epidemiological investigations) and on the implemented control measures. Results The outbreak reproduction number (Re) was 1.35 (95% prediction interval: 1.13–1.47) and the IMD probability was 4.6 for every 1,000 new MenC carriage episodes (95% confidence interval: 1.8–12.2). The interventions, i.e. chemoprophylaxis and vaccination of close contacts of IMD cases as well as age-targeted vaccination, were effective in reducing Re and ending the outbreak. Case-based interventions (including ring vaccination) alone would have been insufficient to achieve outbreak control. The definition of age groups to prioritise vaccination had a critical impact on the effectiveness and efficiency of control measures. Conclusions Our findings suggest that there are no effective alternatives to widespread reactive vaccination during outbreaks of highly transmissible MenC strains. Age-targeted campaigns can increase the effectiveness of vaccination campaigns. These results can be instrumental to define effective guidelines for the control of future meningococcal outbreaks caused by hypervirulent strains.

The Gravity Force to which living beings are subjected on Earth rules the functionality of most biological processes in many tissues. It has been reported that a situation of Microgravity (such as that occurring in space) causes negative effects on living beings. Astronauts returning from space shuttle missions or from the International Space Station have been diagnosed with various health problems, such as bone demineralization, muscle atrophy, cardiovascular deconditioning, and vestibular and sensory imbalance, including impaired visual acuity, altered metabolic and nutritional status, and immune system dysregulation. Microgravity has profound effects also on reproductive functions. Female astronauts, in fact, suppress their cycles during space travels, and effects at the cellular level in the early embryo development and on female gamete maturation have also been observed. The opportunities to use space flights to study the effects of gravity variations are limited because of the high costs and lack of repeatability of the experiments. For these reasons, the use of microgravity simulators for studying, at the cellular level, the effects, such as those, obtained during/after a spatial trip, are developed to confirm that these models can be used in the study of body responses under conditions different from those found in a unitary Gravity environment (1 g). In view of this, this study aimed to investigate in vitro the effects of simulated microgravity on the ultrastructural features of human metaphase II oocytes using a Random Positioning Machine (RPM). We demonstrated for the first time, by Transmission Electron Microscopy analysis, that microgravity might compromise oocyte quality by affecting not only the localization of mitochondria and cortical granules due to a possible alteration of the cytoskeleton but also the function of mitochondria and endoplasmic reticulum since in RPM oocytes we observed a switch in the morphology of smooth endoplasmic reticulum (SER) and associated mitochondria from mitochondria-SER aggregates to mitochondria–vesicle complexes. We concluded that microgravity might negatively affect oocyte quality by interfering in vitro with the normal sequence of morphodynamic events essential for acquiring and maintaining a proper competence to fertilization in human oocytes.

The Soybean Free Air Concentration Enrichment (SoyFACE) facility is the longest running open-air carbon dioxide and ozone enrichment facility in the world. For over two decades, soybean, maize, and other crops have been exposed to the elevated carbon dioxide and ozone concentrations anticipated for late this century. The facility, located in East Central Illinois, USA, exposes crops to different atmospheric concentrations in replicated octagonal ~280 m2 Free Air Concentration Enrichment (FACE) treatment plots. Each FACE plot is paired with an untreated control (ambient) plot. The experiment provides important ground truth data for predicting future crop productivity. Fumigation data from SoyFACE were collected every four seconds throughout each growing season for over two decades. Here, we organize, quality control, and collate 20 years of data to facilitate trend analysis and crop modeling efforts. This paper provides the rationale for and a description of the SoyFACE experiments, along with a summary of the fumigation data and collation process, weather and ambient data collection procedures, and explanations of air pollution metrics and calculations.

Objectives: The aim of this study is to evaluate feasibility of salvage 4-week hypofractionated whole breast radiotherapy (WBRT) in patients with in-breast recurrence after receiving intraoperative radiotherapy with electrons (IOERT) for primary breast cancer (BC). Methods: BC patients who had repeated quadrantectomy underwent modified WBRT with intensity-modulated radiotherapy using Helical Tomotherapy to underdose the IOERT region. This approach, called POLO (Partially Omitted Lobe), excluded the IOERT volume from receiving the full prescription dose. Results: Nine patients were treated with this approach, receiving 45 Gy in 20 fractions. A simultaneous integrated boost of 2.5 Gy in 20 fractions was delivered in 6/9 patients. Dose constraints and planning objectives were reported. No severe toxicity was reported while local control and overall survival were 100%. Conclusion: The POLO approach is technically feasible and capable to achieve a significant reduction of radiation dose delivered to the previous treated IOERT area. Advances in knowledge: The study demonstrates the technical and dosimetric feasibility of conservative salvage whole breast radiotherapy, while sparing the area already treated with IORT, in patients with in-breast recurrence.

PurposeCircular supply chains (CSC) are particularly important for the agri-food sector, which faces strict requirements generated by increased food consumption as a consequence of world population growth, changes in lifestyle, development of consumer society and increasing health awareness. Recent disruptive factors have placed the vulnerability of agri-food supply chains in the spotlight. Therefore, the purpose of this paper was to identify the most manageable groups of risks in order to ensure the smooth operation of agri-food circular supply chains.Design/methodology/approachSeven main risk groups were evaluated in relation to nine criteria. To solve this multi-criteria decision making (MCDM) problem, a novel MCDM model, which integrates the best-worst method (BWM) and the COmprehensive distance-Based RAnking (COBRA) method in a grey environment, was developed.FindingsThree risks were singled out, namely, product features risks, logistics risks and managerial risks. The obtained risks are those whose management would create the most positive effects for the stakeholders and help them achieve their primary goals regarding the circularity of agri-food supply chains.Originality/valueThis study investigates the main characteristics of the CSC in the agri-food sector, identifies, simultaneously explores and ranks all main risk groups associated with them and expands the possibilities for solving these kinds of problems by developing a novel MCDM model. It also identifies the most significant risks, both for individual stakeholders and for all stakeholder groups together.

IntroductionPatients with triple-negative breast cancer (TNBC) achieving a pathological complete response (pCR) after neoadjuvant chemotherapy have a better event-free survival. The role of gut microbiome in early TNBC is underexplored.MethodsMicrobiome was analyzed by 16SrRNA sequencing.ResultsTwenty-five patients with TNBC treated with neoadjuvant anthracycline/taxane-based chemotherapy were included. Fifty-six percent achieved a pCR. Fecal samples were collected before (t0), at 1 (t1), and 8 weeks (t2) from chemotherapy. Overall, 68/75 samples (90.7%) were suitable for microbiome analysis. At t0, pCR group showed a significantly higher α-diversity as compared with no-pCR, (P = .049). The PERMANOVA test on β-diversity highlighted a significant difference in terms of BMI (P = 0.039). Among patients with available matched samples at t0 and t1, no significant variation in microbiome composition was reported over time.ConclusionsFecal microbiome analysis in early TNBC is feasible and deserves further investigation in order to unravel its complex correlation with immunity and cancer.

Plant genomes encode a unique group of papain-type Cysteine EndoPeptidases (CysEPs) containing a KDEL endoplasmic reticulum (ER) retention signal (KDEL-CysEPs or CEPs). CEPs process the cell-wall scaffolding EXTENSIN proteins (EXTs), which regulatede novocell wall formation and cell expansion. Since CEPs are able to cleave EXTs and EXT-related proteins, acting as cell wall-weakening agents, they may play a role in cell elongation.Arabidopsis thalianagenome encodes three CEPs (AtCPE1-AtCEP3). Here we report that the three Arabidopsis CEPs,AtCEP1-AtCEP, are highly expressed in root-hair cell files. Single mutants have no evident root-hair phenotype, butatcep1-3 atcep3-2andatcep1-3 atcep2-2double mutants have longer root hairs (RHs) than wild type (Wt) plants, suggesting that expression ofAtCEPsin root trichoblasts restrains polar elongation of the RH. We provide evidence that the transcription factorNAC1activates AtCEPs expression in roots to limit RH length. Chromatin immunoprecipitation indicates that NAC1 binds the promoter ofAtCEP2and may directly regulate its expression. Indeed, InducibleNAC1overexpression increasesAtCEP1 and AtCEP2transcript levels in roots and leads to reduced RH growth while the loss of functionnac1-2mutation reducesAtCEP1-AtCEP3gene expression and enhances RH growth. Likewise, expression of a dominant chimeric NAC1-SRDX repressor construct leads to increased RH length. Finally, we show that RH cell walls in theatcep1-1 atcep3-2double mutant have reduced levels of EXT secretion/insolubilization, suggesting that the defects in RH elongation are linked to alterations in EXT processing and accumulation. Taken together, our results support the involvement of the NAC1-AtCEP regulatory module in controlling RH polar growth through EXT processing and insolubilization at the cell wall.

Data-driven approaches for molecular diagnostics are emerging as an alternative to perform an accurate and inexpensive multi-pathogen detection. A novel technique called Amplification Curve Analysis (ACA) has been recently developed by coupling machine learning and real-time Polymerase Chain Reaction (qPCR) to enable the simultaneous detection of multiple targets in a single reaction well. However, target classification purely relying on the amplification curve shapes currently faces several challenges, such as distribution discrepancies between different data sources of synthetic DNA and clinical samples (i.e., training vs testing). Optimisation of computational models is required to achieve higher performance of ACA classification in multiplex qPCR through the reduction of those discrepancies. Here, we proposed a novel transformer-based conditional domain adversarial network (T-CDAN) to eliminate data distribution differences between the source domain (synthetic DNA data) and the target domain (clinical isolate data). The labelled training data from the source domain and unlabelled testing data from the target domain are fed into the T-CDAN, which learns both domains’ information simultaneously. After mapping the inputs into a domain-irrelevant space, T-CDAN removes the feature distribution differences and provides a clearer decision boundary for the classifier, resulting in a more accurate pathogen identifi- cation. Evaluation of 198 clinical isolates containing three types of carbapenem-resistant genes (blaNDM , blaIMP and blaOXA-48 ) illustrates a curve-level accuracy of 93.1% and a sample- level accuracy of 97.0% using T-CDAN, showing an accuracy improvement of 20.9% and 4.9% respectively, compared with previous methods. This research emphasises the importance of deep domain adaptation to enable high-level multiplexing in a single qPCR reaction, providing a solid approach to extend qPCR instruments’ capabilities without hardware modification in real- world clinical applications.

Multicriteria decision making (MCDM) is a field that helps decision makers evaluate alternatives based on multiple criteria and encompasses scoring, distance-based, pairwise comparison, and outranking methods. Recent developments have aimed to solve specific problems and overcoming the limitations of previous methods. This paper proposes a new axial-distance-based aggregated measurement (ADAM) method, which is used in combination with the best-worst method (BWM) to evaluate agri-food circular economy (CE)-based business models (BMs) to create a more sustainable and efficient system for producing and consuming food. This paper proposes nine BMs, which were evaluated against eight criteria. The BWM method was used to obtain the criteria weights, while the ADAM method was used to obtain a final ranking of the BMs. The results indicate that a sustainable circular agri-food supply chain is a BM that can bring companies the most significant progress in business and strengthen their position in the market. We concluded that the ADAM method is effective for solving MCDM problems and that, overall, the model is an effective tool for solving the problem defined in this study. The main contributions are the development of a new MCDM method and a hybrid model, the establishment of the framework for evaluation and selection of CE-based BMs, and the identification of the most important ones.

A dedicated warning system can significantly reduce economic and human losses during severe storm events. While in the USA a well-tested warning system exists since many years, a corresponding institutional warning system has not been established so far in Europe. ESTOFEX has been the first attempt of a severe weather forecasting system at a European-scale, very appreciated by the meteorological community, but on a voluntary basis. PRETEMP is an initiative carried on by a group of students and young meteorologists who aim to replicate the ESTOFEX initiative at a national scale: it has been publishing a severe weather outlook specific for Italy every day since 2015. Italy is a country with very complex orography mostly surrounded by the sea. Therefore, a national dedicated warning system may allow to capture local mesoscale features, important for severe storm development, better than an outlook on a continental scale. Like ESTOFEX, PRETEMP is a volunteer group, but it has informal collaboration with local weather agencies: hopefully, in the near future it can be an example for an institutional warning system. The PRETEMP forecast is based on four levels of severity, ranging from level 0 (generic thunderstorms) to level 3 (extremely severe storms).Furthermore, PRETEMP has been collecting severe storm reports from Italy since 2018, exploiting the Storm Report Database created by Meteonetwork, an Italian amateur association. These reports, collected by many volunteers and local meteorological associations, ensure a capillary network of storm spotters: it represents an effective example of citizen science applied to severe weather. They have been automatically submitted to the ESWD (European Severe Weather Database) since 2019 representing the main source of storm reports from Italy. In addition, in case of tornado events, PRETEMP contribute to the path damage reconstruction and tornado classification, in collaboration with ESSL. More recently PRETEMP is testing some forecast verification techniques to increase the reliability of the forecast product and to assess and improve the forecaster performance. Initially the forecast verification was qualitative, based on a simple overlay of storm report locations on the outlook map. PRETEMP is now moving toward a more quantitative approach, testing both dichotomous (to create performance diagrams) and probabilistic approaches (using the Brier Skill Score index), to find the most suitable method to assess the outlooks.

ispartof: CA2RE+ 3. FRAMEWORKS OF DESIGN-DRIVEN RESEARCH pages:187-191 ispartof: pages:187-191 status: Published online