The work tackles the control exerted by a sub-seismic fracture network on both secondary porosity and correspondent permeability of outcropping tight carbonates. Taking advantage of excellent 3D ...exposures, located in the Murge Plateau of southern Italy, the fracture network is investigated at different scales of observation. The rock multi-layer is made up of 10's of cm-thick, sub-horizontal, laterally continuous limestone beds crosscut by stratabound fractures, non-stratabound fractures, and small faults named as persistent fracture zones with low amounts of offset. Stratabound fractures consist of bed-perpendicular joints and sheared joints, non-stratabound fractures of incipient, cm-offset, sub-vertical faults, whereas the 10's of cm-offset persistent fracture zones are made up of 10's of m-high, m-thick fractured damage zones. The aforementioned structural elements localize within discrete carbonate units bounded by primary features such as bed surfaces, prominent surfaces and sedimentary breccia horizons. Such interfaces therefore affected the fracture stratigraphy of the limestone rock, and thus impact the fluid flow properties of the carbonate multilayer by compartmentalizing deformation.
In the field, the fracture network is investigated by means of scanline and scan area methodologies to document the orientation, intensity, height distribution, mechanical aperture and roughness of individual fractures exposed along vertical outcrops and pavements of abandoned quarries. Then, Discrete Fracture Network (DFN) models of representative geocellular volumes are built, according to the different scales of analysis, to compute both fracture porosity and correspondent permeability (Kxx, Kyy, Kzz). Results of such a work show that the most prominent non-stratabound fracture set forms the major control on fluid storage and migration at the scales of single beds and bed-packages. At a larger scale, we document that fluid migration mainly occurs along the persistent fracture zones, which enhance the fault-parallel flow. As a whole, the persistent fracture zones form localized fluid conduits embedded within carbonate matrices that show isotropic fluid flow properties.
•The work focuses on a sub-seismic fracture network that crosscuts shallow-water, tight carbonates exposed in southern Italy.•Multi-scale fracture compartmentalization within carbonate units is due to primary mechanical interfaces.•The role exerted by the fracture network on porosity and permeability is assessed at different scales after DFN modelling.
Long COVID is defined as persistency of symptoms, such as exertional dyspnea, twelve weeks after recovery from SARS-CoV-2 infection.
To investigate ventilatory efficiency by the use of ...cardiopulmonary exercise testing (CPET) in patients with exertional dyspnea despite normal basal spirometry after 18 (T18) and 36 months (T36) from COVID-19 pneumonia.
One hundred patients with moderate-critical COVID-19 were prospectively enrolled in our Long COVID program. Medical history, physical examination and lung high-resolution computed tomography (HRCT) were obtained at hospitalization (T0), 3 (T3) and 15 months (T15). All HRCTs were revised using a semi-quantitative CT severity score (CSS). Pulmonary function tests were obtained at T3 and T15. CPET was performed in a subset of patients with residual dyspnea (mMRC ≥ 1), at T18 and at T36.
Remarkably, at CPET, ventilatory efficiency was reduced both at T18 (V’E/V’CO2 slope = 31.4±3.9 SD) and T36 (V’E/V’CO2 slope = 31.28±3.70 SD). Furthermore, we identified positive correlations between V’E/V’CO2 slope at T18 and T36 and both percentage of involvement and CSS at HRCT at T0, T3 and T15. Also, negative linear correlations were found between V’E/V’CO2 slope at T18 and T36 and DLCO at T3 and T15.
At eighteen months from COVID-19 pneumonia, 20 % of subjects still complains of exertional dyspnea. At CPET this may be explained by persistently reduced ventilatory efficiency, possibly related to the degree of lung parenchymal involvement in the acute phase of infection, likely reflecting a damage in the pulmonary circulation.
•Exertional dyspnea persists in 20 % of patients that have suffered moderate to severe COVID19 Pneumonia.•At CPET, reduced ventilatory efficiency is observed at 18 and 36 months follow-up in patients with exertional dyspnea and normal spirometry.•Data on its pathophysiology is limited, and different mechanisms could explain this invalidating symptom. In our study, the finding of high V’E/V’CO2 slope at 18 and 36 months follow-up, and its correlation with the severity of pneumonia at lung HRCT and with the reduction of DLCO, could identify a possible contributing factor for the persistency of exertional dyspnea in these patients, leading to the hypothesis of a link between the initial extension of pneumonia, pulmonary vascular damage and persistency of ventilatory inefficiency at long-term follow-up.
Introduction
Frailty is a critical intermediate status of the aging process including physical, cognitive, and psychosocial phenotypes. We operationalized a biopsychosocial frailty construct, ...estimating its association with mild cognitive impairment (MCI) and its subtypes.
Methods
In 1980, older individuals from the population‐based Italian PRoject on the Epidemiology of Alzheimer's disease (IPREA), we investigated cross‐sectional associations among biopsychosocial frailty, MCI, and its subtypes.
Results
Participants with biopsychosocial frailty showed an increased odds ratio (OR) of MCI OR: 4.36; 95% confidence interval (CI): 2.60‐7.29; Fisher's exact p < 0.01, particularly for nonamnestic MCI single domain (naMCI‐SD, OR:3.28; 95% CI: 1.35‐7.97; Fisher's exact p = 0.02) and for nonamnestic MCI multiple domain (naMCI‐MD, OR:6.92; 95% CI: 3.37‐14.21; Fisher's exact p < 0.01). No statistically significant associations between amnestic MCI single or multiple domain and biopsychosocial frailty were observed.
Discussion
In a large, older Italian cohort, a biopsychosocial frailty phenotype was associated with MCI, in particular, could be associated with some of its subtypes, that is, naMCI‐SD, and naMCI‐MD.
Asymmetric epoxidation represents a hot topic in organic synthesis. In recent years, organocatalysts based on sugar skeletons have been exploited in asymmetric epoxidation to achieve enantiomeric ...pure epoxides. In this work, two different endocyclic ketones derived from glucose and galactose protected with a 4,6-
O
-benzylidene group have been prepared and exploited for Shi-type epoxidation. The two carbohydrates show an opposite preferential stereoselective epoxidation on various olefins, affording the epoxides in high conversions and modest enantioselectivities. DFT calculations disclosed the reasons behind the inversion of selectivity achieved by the two catalysts, showing that a delicate balance between the catalyst conformation, its protecting groups, and the secondary interactions with the substrate govern the final observed results.
Sugar-derived chiral ketones are capable of reversing stereoselectivity in Shi-type epoxidation.
The present study investigated the association between religious and spiritual (RS) practices with the prevalence, severity, and incidence of mental health problems in older adults.
We conducted a ...systematic review and meta-analysis of cross-sectional and longitudinal studies that investigated older adults aged 60+ years and assessed RS using valid scales and questions from valid scales, and mental health according to validated multidimensional or specific instruments. Studies were retrieved from MEDLINE, LILACS, SCOPUS, CINAHL, and AgeLine databases until July 31, 2021. The risk of bias was evaluated using the Newcastle-Ottawa Quality Assessment Scale (NOS). A pooled effect size was calculated based on the log odds ratio (OR) and Z-scores. This study is registered on PROSPERO.
One hundred and two studies that investigated 79.918 community-dwellers, hospitalized, and institutionalized older adults were included. Results indicated that high RS was negatively associated with anxiety and depressive symptoms, while a positive association was observed with life satisfaction, meaning in life, social relations, and psychological well-being. Specifically, people with high spirituality, intrinsic religiosity, and religious affiliation had a lower prevalence of depressive symptoms. In relation to longitudinal analysis, most studies supported that high RS levels were associated with a lower incidence of depressive symptoms and fear of death, as well as better mental health status.
Findings of the present study suggest that RS are significantly associated with mental health in older adults. People with high RS levels had a lower prevalence of anxiety and depressive symptoms, as well as reported greater life satisfaction and psychological well-being, better social relations, and more definite meaning in life. Data provided by an increasing number of longitudinal studies have supported most of these findings.
Understanding the evolution of the B cell response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants is fundamental to design the next generation of vaccines and therapeutics. ...We longitudinally analyze at the single-cell level almost 900 neutralizing human monoclonal antibodies (nAbs) isolated from vaccinated people and from individuals with hybrid and super hybrid immunity (SH), developed after three mRNA vaccine doses and two breakthrough infections. The most potent neutralization and Fc functions against highly mutated variants belong to the SH cohort. Repertoire analysis shows that the original Wuhan antigenic sin drives the convergent expansion of the same B cell germlines in vaccinated and SH cohorts. Only Omicron breakthrough infections expand previously unseen germ lines and generate broadly nAbs by restoring IGHV3-53/3-66 germ lines. Our analyses find that B cells initially expanded by the original antigenic sin continue to play a fundamental role in the evolution of the immune response toward an evolving virus.
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•Omicron infection induces potent neutralization and Fc functions against variants•Neutralization relies on restored germ lines expanded by Wuhan antigenic sin (AS)•AS drives convergent antibody maturation in homologous and heterologous immunity•Omicron infection stretches the antibody repertoire to control SARS-CoV-2 variants
Paciello et al. find that Omicron infection induces the most potent and broad antibody response to SARS-CoV-2 variants. This response relies on restored B cell germ lines expanded by the Wuhan antigenic sin, like IGHV3-53 and 3-66, and on new germ lines expanded to stretch the antibody repertoire to control SARS-CoV-2 variants.
The authors investigated the relationship of metabolic syndrome (MetS) and its individual components with incident dementia in a prospective population-based study with a 3.5-year follow-up.
A total ...of 2097 participants from a sample of 5632 subjects (65-84 years old) from the Italian Longitudinal Study on Ageing were evaluated. MetS was defined according to the Third Adults Treatment Panel of the National Cholesterol Education Program criteria. Dementia, Alzheimer disease (AD) and vascular dementia (VaD) were classified using current published criteria.
MetS subjects (N=918) compared with those without MetS (N=1179) had an increased risk for VaD (1.63% vs 0.85%, adjusted hazard ratio (HR) 3.71, 95% CI 1.40 to 9.83). After excluding 338 subjects with baseline undernutrition, MetS subjects compared with those without MetS had an elevated risk of VaD (adjusted HR, 3.82; 95% CI 1.32 to 11.06). Moreover, those with MetS and high inflammation had a still further higher risk of VaD (multivariate adjusted HR, 9.55; 95% CI 1.17 to 78.17) compared with those without MetS and high inflammation. On the other hand, those with MetS and low inflammation compared with those without MetS and low inflammation did not exhibit a significant increased risk of VaD (adjusted HR, 3.31, 95% CI 0.91 to 12.14). Finally, a synergistic MetS effect versus its individual component effects was verified on the risk of VaD.
In our population, MetS subjects had an elevated risk of VaD that increased after excluding patients with baseline undernutrition and selecting MetS subjects with high inflammation.
Introduction
Liver fibrosis increases progressively with aging and has been associated with poorer cognitive performance in middle‐aged and older adults. We investigated the relationships between a ...non‐invasive score for advanced liver fibrosis (non‐alcoholic fatty liver disease NAFLD fibrosis score NFS) and dementia risk. We also assessed physical frailty, a common geriatric condition which is associated to dementia. We tested the joint effects of physical frailty and fibrosis on dementia incidence.
Methods
A total of 1061 older adults (65 to 84 years), from the Italian Longitudinal Study on Aging, were prospectively evaluated for the risk of dementia in a period between 1992 and 2001. Liver fibrosis was defined according to the NFS. Physical frailty was assessed according to the Fried's criteria. Cox proportional hazards models were used to estimate the short‐ and long‐term risk of overall dementia, associated to the NFS, testing the effect modifier of physical frailty status.
Results
Older adults with only high NFS (F3‐F4) did not exhibit a significant increased risk of overall dementia. Over 8 years of follow‐up, frail older adults with high NFS had an increased risk of overall dementia (hazard ratio HR: 4.23; 95% confidence interval CI: 1.22 to 14.70, P = .023). Finally, physically frail older adults with low albumin serum levels (albumin < 4.3 g/dL) and with advanced liver fibrosis (F3‐F4 NFS) compared to those with lower liver fibrosis score (F0‐F2 NFS) were more likely to have a higher risk of overall dementia in a long term‐period (HR: 16.42; 95% CI: 1.44 to 187.67, P = .024).
Discussion
Advanced liver fibrosis (F3‐F4 NFS) could be a long‐term predictor for overall dementia in people with physical frailty. These findings should encourage a typical geriatric, multidisciplinary assessment which accounts also for the possible co‐presence of frail condition in older adults with chronic liver disease and liver fibrosis.
Cognitive frailty is a condition recently defined by operationalized criteria describing the simultaneous presence of physical frailty and mild cognitive impairment (MCI). Two subtypes for this ...clinical construct have been proposed: "potentially reversible" cognitive frailty (physical frailty plus MCI) and "reversible" cognitive frailty (physical frailty plus pre-MCI subjective cognitive decline). Here the prevalence of a potentially reversible cognitive frailty model was estimated. It was also evaluated if introducing a diagnosis of MCI in older subjects with physical frailty could have an additive role on the risk of dementia, disability, and all-cause mortality in comparison with frailty state or MCI condition alone, with analyses separately performed for inflammatory state.
In 2,373 individuals from the population-based Italian Longitudinal Study on Aging with a 3.5-year-follow-up, we operationally categorized older individuals without dementia into four groups: non-frail/non-MCI, non-frail/MCI, frail/non-MCI, and frail/MCI.
The prevalence of potentially reversible cognitive frailty was 1%, increasing with age and more represented in women than in men, and all groups were associated with significant increased incident rate ratios of dementia, disability, and mortality. A significant difference in rates of disability has been found between the MCI and non-MCI groups (contrasts of adjusted predictions: 0.461; 95% confidence interval: 0.187-0.735) in frail individuals with high inflammatory states (fibrinogen >339 mg/dL).
In older individuals without dementia and with elevated inflammation, a potentially reversible cognitive frailty model could have a significant additional predictive effect on the risk of disability than the single conditions of frailty or MCI.
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