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Infections with endocardial vegetation or the exuberant growth of neoendothelialization tissue (cloth –tissue overgrowth) in heart valve prostheses lead, among other complications, to the malfunction of the prostheses themselves due to obstruction. Among the diagnostic methods available to us, to achieve the diagnosis of prosthetic dysfunction, in recent years three–dimensional transesophageal echocardiography (3D TTE) has become increasingly imposed. We present two clinical cases of patients admitted to our Cardiology department Case 1: Patient of 62 years old, hospitalized for established congestive heart failure. In 2006 he underwent ascending aorta replacement with Dacron 28 prosthesis and aortic valve replacement with mechanical prosthesis (Sorin 25) for aortic bicuspid and ascending aortic aneurysm. During the last follow–up was observed a slight increase in the value of intraprosthetic gradients, as well as a variability in INR values. Physical examination showed signs of heart failure (NT–ProBNP >1000 pg/ml); normal inflammation indices (PCR Conclusions 3D TTE is a method of rapid and safe execution that can be exploited not only pre– or intraoperatively but also to settle diagnostic suspicions not clarified by traditional 2d methods, even managing to distinguish cloth deposits from vegetation / abscesses.

The caseous calcification of the mitral annulus (CCMA) is a rare degenerative condition of the mitral valve (0.067% prevalence in the general population) that generally affects older women with hypertension, chronic kidney disease and dyslipidemia. Usually CCMA is asymptomatic and it is associated with mild to moderate mitral regurgitation and it can cause severe mitral valve dysfunction that requires surgical treatment. CASE 1: A 84–year–old woman, with arterial hypertension, was evaluated in our clinic to perform a transthoracic echocardiogram (TTE) for a previous finding of heart murmur. TTE reveled at the level of the posterior mitral annulus a hyperechoic roundish formation with a central eco–shiny area with a maximum diameter of 20x20 mm. A tridimensional trans–esophageal echocardiography (3D TEE) allowed a better characterization of the mass showing well–defined contours, adhered to the posterior mitral annulus, systolic dislocation of the anterior mitral leaflet, with slight mitral regurgitation. Considering the morphological characteristics of the mass we concluded for a presumptive diagnosis of CMAC. We recommended regular follow–up to the patient. After 6 and 12 months the mass did not change in size and echostructure. CASE 2: An 88–year–old woman with chronic kidney disease, high blood pressure and chronic ischemic heart disease was admitted to our ward for acute heart failure. TTE showed a large an echodense mass (43 × 19 mm) involving the posterior mitral annulus, with a central echo–lucent area. A 3D TEE was performed with better mass characterization: involvement of the entire posterior mitral ring, reduced movement of the posterior mitral flap, anterior mitral flap with normal morphology and normal mobility. In consideration of the echocardiographic characteristics we concluded for the presence of CMAC. We discharged the patient with indication for a regular clinical and echocardiographic follow–up. Conclusions The 3D TTE provides adequate morphostructural information that allows in most cases to characterize the CCAM. When the transthoracic approach is difficult due to poor acoustic windows, 3D TEE can be used. Only in rare cases it is necessary to use second–level diagnostic tests such as CT and Cardiac Magnetic Resonance Imaging.

Although the contingent valuation literature emphasizes the importance of controlling for respondents’ consequentiality perceptions, this literature has rarely accounted for the difference between payment and policy consequentiality. We examine the influence of a randomly assigned tax amount on consequentiality self-reports and their potential endogeneity using data from a single dichotomous choice survey about reducing marine plastic pollution in Norway. Results show that consequentiality perceptions are a function of the tax amount, with payment consequentiality decreasing and policy consequentiality increasing with higher tax amounts. We discuss the challenge of finding valid instruments to address the potential endogeneity of consequentiality perceptions

Introduction: Dual energy X-ray absorptiometry (DXA) is a clinically proven method for measuring bone mineral density (BMD) in the lumbar spine, hip, femoral neck, and forearm. It is used for manag...

OBJECTIVE Orthotopic liver transplant recipients are at high risk of fragility fractures both in pre-liver transplant (pre-LT) and in the immediate posttransplant (post-LT) period. The aims of this study were to identify risk factors associated with post-LT fracture and identify factors that contribute to changes in bone mineral density (BMD) in post-LT as they relate to the risk of fracture in the immediate post-LT period. METHODS We conducted a retrospective cohort study of first-time LT recipients who had BMD testing within 2-year pre-LT and 1-year post-LT. We assessed factors associated with immediate post-LT fracture using logistic regression models and linear regression models. RESULTS New fractures occurred in 41/286 (14.3%) of LT recipients during the first year following LT. In multivariate analysis, we noted an increased odds of fracture for patients with prior history of fracture (P < .001), patients who were older (P = .03), patients with higher end-stage liver disease score (P = .03), and patients with lower BMD. After adjustment for multiple testing, only a history of prior fracture was statistically significant. CONCLUSION Our study demonstrated that prior fracture at any site was associated with developing a new fracture in the first year post-LT.

The liver plays an important role in bone and mineral metabolism of patients with end-stage liver disease. These patients are known to have an increased risk of osteoporosis and fractures before liver transplant (LT) with reported fracture incidence of 10-56%. The cause is multifactorial, which includes their underlying liver disease, chronic illness, vitamin D deficiency, and hyponatremia. The impact of hyperglycemia and diabetes mellitus on bone health in liver transplant recipients is not known. Hypothesis: Hyperglycemia increases risk of fracture and osteoporosis in pre- LT patients undergoing LT. Methods: To answer this question, we did a retrospective chart review of consecutive first time, single organ LT recipients at our institution from 2011-2014, who had BMD performed prior to transplantation. We identified 393 patients but included only 209 patients who carried a diagnosis of hyperglycemia or diabetes (type 2 DM, type 1 DM, steroid induced DM and hyperglycemia). BMD was defined based on WHO criteria as Normal, osteopenia and osteoporosis. Hemoglobin A1C was divided into 4 quartiles (A1C ≤5.6%, 5.7-6.4%, 6.5-7.9%, and ≥8%); fasting blood glucose was defined as any venous glucose checked before 9am and labeled as a fasting lab in the chart. Fasting blood glucose was divided into those with BG200 mg/dL. We chose labs closest to the transplant date. Pre LT fracture was compared with hemoglobin A1C and BMD as well as fasting glucose. STATA statistical program was used to calculate Fisher T-test. Results: Baseline characteristics of our cohort were as follows. Median BMI was 27.9 (16.2, 45.6). Majority had hepatitis C (33%), NASH 12%, and alcoholic liver disease 23%. Average MELD score was 15 (6-40). Average wait time to transplant was 90 days. 29% of patients had normal BMD, 46% osteopenia and 25% osteoporosis. From the total 209 patients reviewed, 17 had a fracture prior to transplant of which 14/17 had vertebral fractures. The only variable that correlated with risk of fracture was hemoglobin A1C. Higher level of Hemoglobin A1C correlated with the presence of fracture p= 0.04. BMD did not correlate with fracture p= 0.28. There was no association between BMD and Fasting glucose level p=0.55. There was no correlation between fasting glucose and risk of fracture p=0.44. Discussion: This study suggests that a correlation between the presence of pre LT fracture and HgA1C exists. Other factors such as BMD and fasting BG did not correlate with fracture. Those with higher hemoglobin A1C prior to liver transplant might be at risk for fracture compared to those without diabetes or hyperglycemia (A1C

This paper analyses the effect of inducing institutional and value learning in a choice experiment survey concerning food safety. Respondents were subjected to two types of treatments, namely Advance Disclosure (ADV) and Instructional Choice Set (ICS). Employing a split-sample setup, we test the effect of providing ICS and ADV in two treatment groups relative to a control group where learning is not induced. We further test and compare the effects of ADV and ICS directly against each other. We find some evidence that ICS reduces institutional uncertainty as intended. Moreover, the results suggest that both ICS and ADV could potentially remove a gender-specific status-quo bias. This article is protected by copyright. All rights reserved

This article is grounded in public choice theory and develops a framework to explain how non-benevolent behavior on the part of public regulators and the resulting lack of collaboration between different agencies have been affecting aquaculture growth. Although regulators are assumed to work for the best interest of the people, they can have their own rational agendas; such as career advancement, self-aggrandizement and loyalty for a particular political ideology. We show that when officials are non-benevolent and agencies have unequal relative decision-making power, it is likely that a more powerful agency dictates policies in favor of its own agenda, even when such policies may not necessarily lead to optimal social welfare. In the case of aquaculture, higher relative power of a pro-environment agency leads to underdevelopment of the sector, as is the case in developed countries, whereas larger relative power of a pro-industry agency leads to higher growth, as is the case in developing countries.

Background Thyroid cancer often recurs in the neck. Well-differentiated thyroid cancer metastasizes to the neck in about 40%, and recurs after surgery in about 20%-30%. Surgery is the treatment of choice, with biochemical remission in 21-66%, but some patients are poor surgical candidates or refuse surgery, and permanent nerve injury and hypoparathyroidism are substantial complications. The 2018 National Comprehensive Cancer Network (NCCN) guidelines state that in select patients with unresectable, non-radioiodine-avid, and progressive disease, local therapies such as ultrasound guided ethanol ablation (EA) can be considered. Recent systematic reviews have confirmed the efficacy and safety of EA, and show that this minimally invasive therapy compares favorably to surgical resection in non-randomized studies. Objectives To determine the rate, type, and outcomes of nerve injury after EA for neck metastases from thyroid cancer. Methods IRB approval was obtained. Retrospective review of medical records of all EA performed from March 2004 through August 2018. Data collected included sex, age, histologic type of thyroid cancer, date of all EA sessions, and number of tumor sites injected per EA session. Nerve injury was defined as a neurologic deficit with immediate onset after ethanol injection that lasted beyond the effect of local anesthetic. Diagnosis was made based on symptoms and functional deficit as described during follow up phone calls or visits. Confirmatory laryngoscopy was not performed. Results During the 14 year period 104 patients received EA; 64 females with mean age 60 (range 23-90) and 40 males with mean age 54 (range 24-85). A total of 298 sites were treated (lymph nodes and local extra-nodal recurrence) in 169 ethanol injection sessions (mean 1.8, range 1-7). Histologic diagnosis was papillary in 89.4% (classic 87, follicular variant 4, tall cell variant 2), medullary 6 (5.8%), and follicular 4.8% (follicular 1, Hurthle cell variant 4). Recurrent laryngeal nerve (RLN) deficit occurred in 2, superior laryngeal nerve (SLN) deficit in 1 and sympathetic deficit in 1. Nerve injury occurred in 4/104 patients (3.8%), 4/169 EA sessions (2.4%), and 4/298 EA sites (1.3%). All EA with nerve injury were in level VI, including a very deep injection associated with the sympathetic chain injury. The dysphonia from two RLN injuries recovered fully at 1 week and at 3 months. One SLN injury had no hoarseness but could not project a loud voice while singing with his church choir and recovered in 1 month. The one patient with ptosis recovered almost completely, did not notice any residual problems, but physical examination demonstrated a subtle difference in palpebral elevation 1 year after EA. Conclusion Nerve injuries after EA are infrequent and most resolve completely within 3 months.

Context: Tumor induced osteomalacia related to anaplastic thyroid cancer has never been reported. Objective: We describe a case of tumor induced osteomalacia (TIO) in a patient with a fibroblast growth factor 23 (FGF-23) secreting anaplastic thyroid carcinoma. The current imaging modalities are reviewed. Design and intervention: Clinical, biochemical, and radiological assessments were done, including computer tomography (CT) of the neck and skull to thigh positron emission tomography (PET)/CT. The patient underwent surgical tumor debulking three days after presentation due to airway compromise. Molecular studies of the resected tissue were performed using reverse transcriptase–polymerase chain reaction (RT-PCR) and gel electrophoresis for the phosphaturic mesenchymal tumor FGF-23. Results: Resected tissue demonstrated features of anaplastic thyroid cancer with positive markers for FGF-23 protein, consistent with a FGF-23 secreting paraneoplastic tumor. The patient's metastatic burden rapidly progressed as demonstrated by a dramatic rise in serum FGF-23 levels and worsening hypophosphatemia in concert with progression of the metastatic lesions on PET/CT. Conclusion: We believe that our patient's rapidly progressive anaplastic thyroid cancer was responsible for persistent hypophosphatemia and osteomalacia, substantiated by the finding of FGF-23 protein within the thyroid tumor cells. Our case indicates that anaplastic thyroid cancer can cause TIO. Keywords: Anaplastic thyroid cancer, Tumor induced osteomalacia, FGF 23, Hypophosphatemia, Osteomalacia

Most small-scale soil maps report dominant typological units and allow only a partial appraisal of pedodiversity since territories with similar dominant soils can actually possess different pedodiversity. This is particularly true at the national scale, where a great wealth of soil information collected at more detailed scales is generalized. A methodology was set up, which aimed at preserving pedodiversity in upscaling soil maps by using geomatic techniques and the World Reference Base for soil resources (WRB). The main source of information was the soil system geodatabase of Italy, storing information of soil typological units and soilscapes at the 1:500,000 reference scale. Qualitative aggregation of soil taxa followed upscaling rules aimed at (i) maintaining the information about pedogenetic processes and (ii) grouping soilscapes showing recurrent patterns of soil forming processes. The upscaling methodology can be summarized in seven steps as follows: (1) soil forming processes selection, retrieved from soil typological units stored in the national database; (2) upscaling soil systems and creation of broad soil regions at 1:5,000,000 reference scale; (3) semantic upscaling of typological units to form taxa showing different soil forming processes; (4) ranking and associating soil forming processes; (5) geography upscaling of soil systems geometry to form polygons at 1:1,000,000 reference scale, called subregions; (6) ranking subregions according to their extension; (7) naming subregions by ranking the taxa according to the number of soil typological units. The soil subregion map reported 47 map unit and 148 taxa, belonging to 22 reference soil group of WRB and showing from one to four qualifiers. Each map unit had from 2 to 18 taxa, for a total of 317 occurrences. Thirty taxa had 3 or more occurrences, while the remaining took place in one or two subregions only. Diversity indices scored a very high Shannon's H ′ = 5.35 on an H max = 5.76 for the whole country. The value of the Evenness index ( E ) was 0.93. The map of Shannon's H highlighted that the highest pedodiversity in Italy is preserved in the northernmost part of the Alps, in the coastal plains of Central and Southern Italy, and in some hilly lands of Central Italy. On the other hand, large plains of Northern Italy and mountainous areas of the Central and Southern Italy keep low pedodiversity. The comparison of the results with studies on vegetation diversity and land degradation and desertification suggested the existence of linkages between pedodiversity, biodiversity, and the current and past management of agricultural and forest ecosystems.

During the last three decades, aquaculture has been the fastest growing animal-food-producing sector in the world, accounting for half of the present seafood supply. However, there is a significant growth disparity among aquaculture-producing countries. The reasons why some countries have achieved remarkable growth in aquaculture while others have stagnated or even declined have not been determined. In this article, we investigate whether environmental regulations have an impact on aquaculture growth. Using a cross-country regression analysis, we show that stringent environmental regulations are negatively related to aquaculture growth, whereas GDP growth has a positive effect. Countries often face a difficult balancing act between growth and environmental considerations when devising regulations. Our empirical results suggest that stricter environmental regulations in developed countries have contributed to lower growth rates and that these countries are falling behind emerging and developing eco...

Anaplastic thyroid cancer is one of the most lethal malignancies, with dismal prognosis, resistance to multimodal treatments and a median survival of only 5-6 months. Advances in the discovery of genetic pathway aberrations involved in this aggressive disease have been made, and multiple novel therapies targeting these pathways are undergoing clinical trials. So far, there is no single effective treatment for this disease; however, multimodal therapies with a combination of surgery, radiation and chemotherapy hold some promise. We conducted a PubMed search using the words thyroid neoplasm, anaplastic thyroid carcinoma, anaplastic thyroid cancer and anaplastic thyroid neoplasm, revealing 1673 publications. We review the pathophysiology, current treatments and advances made in identifying the alterations in genetic pathways, as well as novel therapies targeting these pathways.

The present paper deals with the new underground lines under construction in Catania (Italy). The analysed network is under construction with EPBs-TBM machine. the TBM used is a Dual Mode Machine. In order to update the tunneling method with the soil profile, a detailed geotechnical characterization is very important, in particular when a strong lithological alteration during excavation is present (such as in the analysed case history), because tunneling method can be OF (Open-Face) mode for rock formation or EPB (Earth Pressure Balance) mode for cohesive and/or incoherent soil. This paper shows a new methodology to validate the hypothesized soil profile based on a comparison between data obtained by the geotechnical survey and data achieved by HVSR tests on the vibrations induced by TBM on the surface during tunneling. A further comparison is made between data by HVSR tests and by an electric tomography.

To review literature and present a schematic approach to hypophosphatasia (HPP) evaluation and management applicable to practicing physicians to ease its recognition and diagnosis.Studies were obtained from online databases PubMed and MEDLINE using keyword 'hypophosphatasia.'HPP is a rare disease characterized by low serum alkaline phosphatase along with diverse musculoskeletal symptoms that mimic different disorders. To date, the prevalence of HPP and its impact on adults has been unrecognized. There is lack of evidence from larger and long-term studies examining the adult type of this condition.It is essential to increase awareness on the complexity of the pathophysiology and clinical features of HPP, which causes debilitating physical conditions that severely affects quality of life. A better comprehension of adult forms of HPP is essential to reduce a delay in diagnosis as well as ensure suitable management.ALP = alkaline phosphatase; HPP = hypophosphatasia; PEA = phosphorethanolamine; PLP = pyridoxal-5-phosphate; PPi = inorganic pyrophosphate; TNSALP/TNAP = tissue-nonspecific alkaline phosphatase.

Increased plastic consumption and poor waste management have resulted in litter representing an ever-increasing threat to the marine environment. To identify sources and evaluate mitigation measures, beach litter has been monitored. Using data from two citizen science protocols (CSPs) and OSPAR monitoring of Norwegian beaches, this study 1) identifies the most abundant litter types, 2) compares OSPAR to citizen science data, and 3) examines how to improve the management relevance of beach litter data. The dominant litter types were; food and drink- and fishery related items, and unidentifiable plastic pieces. Data from CSPs are consistent with OSPAR data in abundance and diversity, although few OSPAR beaches limit verification of CSP data. In contrast to OSPAR, the CSPs estimate the weight of the litter. CSPs lack important variables which could explain why some litter types are abundant in some particular areas. The latter could be improved by recording GPS positions.

The potential ability of the Vis-NIR (350 - 2500 nm) laboratory spectroscopy for prediction of soil properties has been demonstrated in the literature. The aim of this work was to predict different soil properties of soils collected in Mugan plain (Azerbaijan) using PLSR models and cross-validation. Carbonatation and salinisation are the main pedogenetic processes in Muganplain, therefore there is a need to monitor total carbonates and soil electrical conductivity (EC). The result of work was positive and both total carbonates and EC showed the best result (SE = 2.90, R2-0.90 and SE-0.09, R2-0.82, respectively). This parameter using PLSR, SOM (SE-0.54, R2-0.83), CEC (SE-0.43, R2-0.62), and Total P (SE-0.50, R2-0.73) is predicted and result is over optimist. Total N (SE-0.04, R2-0.44), and pH (SE-0.02, R2-0.51) demonstrated low prediction quality.

Anaplastic thyroid cancer (ATC) is rare and associated with a short life expectancy. The majority of patients have coexisting differentiated thyroid carcinoma or long standing history of goiter. Al...

Background: Assessments of age-specifc mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Afairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. Methods: The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specifc mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in diferent components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. Findings: Globally, 18·7% (95% uncertainty interval 18·4-19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2-59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5-49·6) to 70·5 years (70·1-70·8) for men and from 52·9 years (51·7-54·0) to 75·6 years (75·3-75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5-51·7) for men in the Central African Republic to 87·6 years (86·9-88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3-238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6-42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2-5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. Interpretation: This analysis of age-sex-specifc mortality shows that there are remarkably complex patterns in population mortality across countries. The fndings of this study highlight global successes, such as the large decline in under-5 mortality, which refects signifcant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing. © 2018 The Author(s).

During the last three decades, it has been shown that copepods are a superior live feed for marine finfish larvae compared to other commonly used live feed items, such as Artemia and rotifers. The use of copepods, which have a better biochemical composition, increases survival rate, improves growth condition, reduces mal-pigmentation and allows breeding of 'new' marine finfish species. However, copepods are not yet commercially produced and therefore not widely used in the aquaculture industry. One of the bottlenecks for large-scale production has been lack of economic knowledge on the feasibility of producing copepods for commercial application. This is the first empirical study to investigate the economic feasibility of copepod production for commercial use. To this end, a standard cost-benefit analysis based on a prototype production facility of Acartia tonsa (Dana) eggs at Roskilde University, Denmark, is employed. The result reveals that commercial production of copepods is economically feasible considering the existing market prices on both copepods and competing live feed items such as rotifers. The study provides valuable information for businesses who consider investing in live feed production for marine finfish aquaculture. Furthermore, the study also highlights the economic benefits of production and utilization of copepods on productivity and species diversification in marine finfish aquaculture.

This article analyses the challenges of different live-feed regimes for the rearing of marine finfish larvae and discusses the potential alternative live feeds to avert a future live-feed trap. Live feeds are indispensable for the successful rearing of larvae of most marine fish species. Brine shrimps (Artemia) and rotifers comprise the live feeds of choice in marine aquaculture today. However, their nutritional composition is deficient in especially essential fatty acids, and enrichment with fish oil is needed. Fish oil is considered a limited resource owing to its origin in fully exploited wild fish stocks. Moreover, fluctuations of the natural population of Artemia will, most likely, influence future availability and prices. This emphasizes the need for optimal exploitation of available live-feed resources and development of new sustainable alternatives, such as copepods. An array of solutions to these problems are presented to avoid a future live-feed trap and to reduce dependence on limited resources that influence future production possibilities, species diversification, price volatility and productivity in the aquaculture sector.

Despite its remoteness, marine plastic pollution is a significant environmental problem in the Arctic. In Svalbard, for example, plastics are found on the shorelines, in the water column, on the ocean floor and in the ice. Organisms have been observed to be entangled in nets and ingestion of plastics has been documented in a range of organisms. Notably almost all Arctic bird species have been found to have ingested plastic, with Northern fulmars being particularly affected, with 89% of samples recorded as having ingested plastic. Identification and valuation of ecosystem services affected by marine plastic pollution can provide input for decision makers in evaluating and comparing management policies concerning this unique environment. This study employs the contingent valuation method (CVM) for eliciting the willingness to pay (WTP) of Norwegian households for reducing marine plastic pollution around the archipelago of Svalbard. An Integrated Choice and Latent Variable model (ICLV) is employed to explore attitudinal determinants of WTP. We find an average WTP for an initiative to reduce marine plastics of NOK 5,485 (USD 642) per household per year. The ICLV results reveal that people who are relatively more concerned about marine plastic pollution and who deem the proposed initiative effective are willing to pay more (up to 85 % and 50 %, respectively). The use of ICLV models in CVM and recommendations for future research are discussed.

Hypoparathyroidism is a rare endocrine disorder in which parathyroid hormone (PTH) production is abnormally low or absent, resulting in low serum calcium and increased serum phosphorus. The most common cause of hypoparathyroidism is parathyroid gland injury or inadvertent removal during thyroid surgery. Current treatments include supplementation with calcium and active vitamin D, with goal albumin-corrected serum calcium level in the low-normal range of 8-9mg/dl. Complications of the disease include renal dysfunction, nephrocalcinosis, kidney stones, extracellular calcifications of the basal ganglia, and posterior subcapsular cataracts, as well as low bone turnover and increased bone density. Until January 2015, hypoparathyroidism was the only classic endocrine disease without an available hormone replacement. Recombinant human PTH 1-84, full length parathyroid hormone, is now available for a selected group of patients with the disease who are not well controlled on the current standard therapy of calcium and active vitamin D. In addition, the role of PTH replacement on quality of life, intracerebral calcifications, cataracts, improving bone turnover, and reduction of renal complications of the disease remains to be further investigated.

The biological benefits of copepods as live feed for marine finfish larvae have already been well established in the literature. Copepods have better biochemical compositions that improve growth, reduce malpigmentations and allow successful farming of ‘new’ marine finfish species. However, their current usage is quite limited. One of the reasons has been lack of economic knowledge concerning the cost-effectiveness of copepod application compared to other commonly used feed items such as the brine shrimp Artemia. In this study, a cost-effectiveness analysis is made on two alternative live feed items (copepods and Artemia) in juvenile turbot farming. Unit cost of production and profit are compared between the two feeding regimes using a unique data set from an existing turbot fry production facility in Denmark. The result reveals that copepods are not only biochemically superior but they are also economically a cost-effective alternative. Thus, a commercial use of copepods will significantly reduce the production costs for turbot. Furthermore, the unexploited economic potential can be utilized for the successful farming of other high-valued marine finfish species such as tuna, flounders, cod, sole and halibut. Generally, the biochemical superiority coupled with economic benefits can lead to the commercial utilization of copepods as complementary live feed in the short run and in some situations as a substitute in the long run.

Land use strongly influences soil properties and unsuitable practices lead to degradation of soil and environmental quality. The aim of this study was to assess the impact of different land uses on some chemical properties of soils developed from Pliocene clays, within hilly environments of central and southern Italy. The areas investigated are located in Vicarello di Volterra (Pisa, Tuscany), S. Quirico d’Orcia (Siena, Tuscany) and Soveria Simeri (Catanzaro, Calabria). Within each area different land uses were compared, including a natural ecosystem (Mediterranean bush), a perennial grass or pasture and an intensive crop (wheat, as monoculture or in rotation). The soils were sampled at 0.0–0.1, 0.1–0.2 and 0.2–0.4 m depth and analysed for particle size, pH, bulk density, cation exchange capacity and exchangeable cations, total organic carbon (TOC) and humified carbon (HC) concentrations, organic carbon stock and total N. The stratification ratio of soil organic carbon was calculated to characterize soil organic carbon distribution with depth. At all sites, soil under Mediterranean bush contained the largest amounts of TOC (as both concentration and stock), HC, total N and exchangeable K, together with the highest cation exchange capacity and the lowest pH values. The decrease in soil OC stock with land use change from natural to agricultural ecosystem was 65–85% to 0.1 m depth, 55–82% to 0.2 m depth and 44–76% to 0.4 m depth, with the lowest decrements for perennial grass from S. Quirico and the highest decrement for continuous wheat from Soveria Simeri. Continuous wheat cropping, based on conventional tillage, proved to be the least sustainable land use. At Soveria Simeri, the organic carbon content under pasture was not significantly larger than under wheat cultivation, probably because of grazing mismanagement; however, organic carbon under pasture was more humified. At S. Quirico, the perennial grass resulted in a significant increase in soil organic carbon at the soil surface relative to the wheat cultivation, while at Vicarello no differences were observed between alfalfa/wheat rotation and perennial grass. Our results lead to the questioning of sustainability of intensive cereal farming and uncontrolled grazing in the considered environments, emphasizing the need for greater attention to conservative land managements.

Soils can possess heritage characteristics and can be classified according to their “cultural value”. “Pedosites”, likewise “geosites”, are important for science and teaching, for tourism and recreation, provide elements in the Environmental Impact Analysis, and enhance the awareness of population towards the value of the land where they live. Pedosite richness and diversity are a resource of a territory that should be evaluated and considered in land planning. The methodology used to evaluate and group pedosites of Italy, and the software developed to collect such information and create a specific geodatabase, are presented in this paper as an example for use in other countries. An Italian geodatabase storing 726 pedosites was created. Soil profiles as cultural heritage were: (i) palaeosols, (ii) soils from archaeological and palaeontological sites, (iii) soils displaying natural or anthropic processes and benchmarks of classifications. Pedosites as soilscapes were: (i) cultural landscapes; (ii) soilscapes determining the amenity of a panorama; (iii) soilscapes in fragile environmental balance; (iv) soilscapes that contribute to the outliving of particular ecosystems. The criteria for the evaluation of pedosites and the suggestions for their protection were indicated as follows: (i) area and (ii) type of scientific interest, (iii) state of conservation, (iv) type and (v) intensity of risk, (vi) level of knowledge, (vii) geological age, (viii) protection and (ix) proposed protection, (x) accessibility, (xi) visibility, (xii) exposure, (xiii) observability. The geodatabase can be used at different scales. Two maps, at national and local levels, exemplify the methodology and show how to use the geodatabase for didactic purposes or the creation of integrated Geoparks. Pedosite indices of diversity highlight the greater pedosite variety in the soil regions of Mediterranean Italy.

Unsteadiness, dizziness and vertigo occur more frequently in hypertensive subjects, compared to the normal ones. This study evaluated the influence of hypertension on balance tests, performed on posturographic platform. The study pool consisted of 112 persons aged 65 and older (65 hypertensives), their mean age was 72.9+/-0.5, scored on the Mini Mental State Examination (MMSE) greater than 24, were able to perform self-care activities, to walk independently for at least 400 m and were free from major diseases. Subjective dizziness and vertigo were assessed by means of Sickness-Impact-Profile-Questionnaire (SIPQ). The static posturographic tests were performed on a vertical force platform, from which the center of foot pressure (COP) positions and displacements were recorded. In balance tests three standardized positions were utilized: feet 30 degrees apart, semitandem and tandem. Subjects with hypertension complained more frequently dizziness and vertigo (41.5% vs. 21.3%). The track-length and COP-velocity were associated with age in all the balance tests. In semitandem and tandem positions, the medio-lateral sway distance significantly increased in elderly subjects compared to young controls. No difference, however, was found in balance tests between normotensive and hypertensive subjects. Those with uncomplicated hypertension compared with normo-tensive subjects, although complaining more frequently symptoms of postural instability, did not show worse performances in static posturographic tests.

This study presents the main results and the methodology used in the creation of the atlas of the risk of desertification in Italy. A desertified area was defined as an unproductive area for agricultural or forestry use, due to soil degradation processes. An area at risk of desertification was a tract of the earth's surface which is vulnerable or sensitive to the processes of desertification. In a vulnerable land, environmental characteristics are close to that of a desertified area, but some factors (e.g. vegetation cover or irrigation), successfully mitigate the desertification process. On the other hand, sensitive land is a surface where the process leading to desertification is active, although the land is not yet unproductive. The DPSIR (Driving force-Pressure-State-Impact-Response) framework has been adopted as a reference. Using the national soil information system and socio-economic layers, an atlas of indicators of desertification risks was created, which was organized into different soil degradation systems. 51.8 per cent of Italy was considered to be at potential risk of desertification. Some 21.3 per cent of Italy (41.1 per cent of the area at potential risk) featured land degradation phenomena. Specifically, 4.3 per cent of Italy is already unproductive; 4.7 per cent is sensitive and 12.3 per cent is vulnerable. In the territory at potential risk of desertification, unproductive lands, plus areas vulnerable or sensitive to soil erosion, are at least the 19 per cent. Areas affected by aridity also sum up to 19 per cent. Salt-affected soils in Italy are estimated to cover >1 million ha. Irrigation can mitigate soil aridity and salinization, nevertheless, only about 15 per cent of the sensitive and vulnerable lands of southern Italy are actually equipped with irrigation networks. Copyright © 2009 John Wiley & Sons, Ltd.

Introduction - Posatirelin (L-pyro-2-amino adipyl-L-leucil-L-prolinamide) a new synthetic tripeptide with cholinergic, catecholaminergic and neurotrophic properties, was investigated in the treatment of Alzheimer's disease. Material and methods - A multicentre, double-blind study vs citicoline (reference drug) and ascorbic acid (inactive drug) was carried out in elderly patients suffering from late-onset Alzheimer's disease. The once daily intramuscular treatment lasted for three months followed by one-month oral treatment with a placebo. Subscales and factors of GBS (Gottfries-Brane-Steen) Rating Scale were identified as primary measures for efficacy assessment. Results - At the end of the treatment, GBS subscale and factor scores assessing intellectual and emotional impairments, orientation and memory, ability to perform activities of daily living, depression-anxiety, attention and motivation were improved in the posatirelin group, showing significant differences with respect to the citicoline and/or ascorbic acid groups. Tolerability was good in all groups. Conclusions - The improvement in the GBS Rating Scale scores observed in the posatirelin group is clinically relevant. It is worth verifying the drug-induced functional improvements, in further studies with large samples.