Sepsis is a severe condition characterized by systemic inflammation. One of the most involved organs in sepsis is the heart. On the other hand, heart failure and dysfunction are some of the most ...leading causes of death in septic patients. miRNAs are short single-strand non-coding ribonucleic acids involved in the regulation of gene expression on a post-transcriptional phase, which means they are a part of the epigenetic process. Recently, researchers have found that miRNA expression in tissues and blood differs depending on different conditions. Because of this property, their use as serum sepsis biomarkers has also been explored. A narrative review is carried out to gather and summarize what is known about miRNAs' influence on cardiac dysfunction during sepsis. When reviewing the literature, we found at least 77 miRNAs involved in cardiac inflammation and dysfunction during sepsis. In the future, miRNAs may be used as early sepsis-induced cardiac dysfunction biomarkers or as new drug targets. This could help clinicians to early detect, prevent, and treat cardiac damage. The potential role of miRNAs as new diagnostic tools and therapeutic strategies worth deepening the complex network between non-coding RNA and biological pathways. Additional studies are needed to further investigate their role in sepsis-induced myocardium injury.
Objective To estimate the cumulative radiation exposure and lifetime attributable risk of cancer incidence associated with lung cancer screening using annual low dose computed tomography ...(CT).Design Secondary analysis of data from a lung cancer screening trial and risk-benefit analysis.Setting 10 year, non-randomised, single centre, low dose CT, lung cancer screening trial (COSMOS study) which took place in Milan, Italy in 2004-15 (enrolment in 2004-05). Secondary analysis took place in 2015-16.Participants High risk asymptomatic smokers aged 50 and older, who were current or former smokers (≥20 pack years), and had no history of cancer in the previous five years.Main outcome measures Cumulative radiation exposure from low dose CT and positron emission tomography (PET) CT scans, calculated by dosimetry software; and lifetime attributable risk of cancer incidence, calculated from the Biological Effects of Ionizing Radiation VII (BEIR VII) report.Results Over 10 years, 5203 participants (3439 men, 1764 women) underwent 42 228 low dose CT and 635 PET CT scans. The median cumulative effective dose at the 10th year of screening was 9.3 mSv for men and 13.0 mSv for women. According to participants’ age and sex, the lifetime attributable risk of lung cancer and major cancers after 10 years of CT screening ranged from 5.5 to 1.4 per 10 000 people screened, and from 8.1 to 2.6 per 10 000 people screened, respectively. In women aged 50-54, the lifetime attributable risk of lung cancer and major cancers was about fourfold and threefold higher than for men aged 65 and older, respectively. The numbers of lung cancer and major cancer cases induced by 10 years of screening in our cohort were 1.5 and 2.4, respectively, which corresponded to an additional risk of induced major cancers of 0.05% (2.4/5203). 259 lung cancers were diagnosed in 10 years of screening; one radiation induced major cancer would be expected for every 108 (259/2.4) lung cancers detected through screening.Conclusion Radiation exposure and cancer risk from low dose CT screening for lung cancer, even if non-negligible, can be considered acceptable in light of the substantial mortality reduction associated with screening.
Purpose
To assess the noise characteristics of the new adaptive statistical iterative reconstruction (ASiR‐V) in comparison to ASiR.
Methods
A water phantom was acquired with common clinical scanning ...parameters, at five different levels of CTDIvol. Images were reconstructed with different kernels (STD, SOFT, and BONE), different IR levels (40%, 60%, and 100%) and different slice thickness (ST) (0.625 and 2.5 mm), both for ASiR‐V and ASiR. Noise properties were investigated and noise power spectrum (NPS) was evaluated.
Results
ASiR‐V significantly reduced noise relative to FBP: noise reduction was in the range 23%–60% for a 0.625 mm ST and 12%–64% for the 2.5 mm ST. Above 2 mGy, noise reduction for ASiR‐V had no dependence on dose. Noise reduction for ASIR‐V has dependence on ST, being greater for STD and SOFT kernels at 2.5 mm. For the STD kernel ASiR‐V has greater noise reduction for both ST, if compared to ASiR. For the SOFT kernel, results varies according to dose and ST, while for BONE kernel ASIR‐V shows less noise reduction. NPS for CT Revolution has dose dependent behavior at lower doses. NPS for ASIR‐V and ASiR is similar, showing a shift toward lower frequencies as the IR level increases for STD and SOFT kernels. The NPS is different between ASiR‐V and ASIR with BONE kernel. NPS for ASiR‐V appears to be ST dependent, having a shift toward lower frequencies for 2.5 mm ST.
Conclusions
ASiR‐V showed greater noise reduction than ASiR for STD and SOFT kernels, while keeping the same NPS. For the BONE kernel, ASiR‐V presents a completely different behavior, with less noise reduction and modified NPS. Noise properties of the ASiR‐V are dependent on reconstruction slice thickness. The noise properties of ASiR‐V suggest the need for further measurements and efforts to establish new CT protocols to optimize clinical imaging.
Tsunami deposits present an important archive for understanding tsunami histories and dynamics. Most research in this field has focused on onshore preserved remains, while the offshore deposits have ...received less attention. In 2009, during a coring campaign with the Italian Navy Magnaghi, four 1 m long gravity cores (MG cores) were sampled from the northern part of Augusta Bay, along a transect in 60 to 110 m water depth. These cores were taken in the same area where a core (MS06) was collected in 2007 about 2·3 km offshore Augusta at a water depth of 72 m below sea level. Core MS06 consisted of a 6·7 m long sequence that included 12 anomalous intervals interpreted as the primary effect of tsunami backwash waves in the last 4500 years. In this study, tsunami deposits were identified, based on sedimentology and displaced benthic foraminifera (as for core MS06) reinforced by X‐ray fluorescence data. Two erosional surfaces (L1 and L2) were recognized coupled with grain‐size increase, abundant Posidonia oceanica seagrass remains and a significant amount of Nubecularia lucifuga, an epiphytic sessile benthic foraminifera considered to be transported from the inner shelf. The occurrence of Ti/Ca and Ti/Sr increments, coinciding with peaks in organic matter (Mo incoherent/coherent) suggests terrestrial run‐off coupled with an input of organic matter. The L1 and L2 horizons were attributed to two distinct historical tsunamis (ad 1542 and ad 1693) by indirect age‐estimation methods using 210Pb profiles and the comparison of Volume Magnetic Susceptibility data between MG cores and MS06 cores. One most recent bioturbated horizon (Bh), despite not matching the above listed interpretative features, recorded an important palaeoenvironmental change that may correspond to the ad 1908 tsunami. These findings reinforce the value of offshore sediment records as an underutilized resource for the identification of past tsunamis.
The development of marine-inspired compounds as non-toxic antifouling (AF) agents has been pursued in the last years. Sulfur is the third most common element in seawater. Sulfur is present in ...oxygenated seawater as sulfate anion (SO42−), which is the most stable combination of sulfur in seawater, and several promising AF secondary metabolites with sulfate groups have been described. However, sulfated compounds proved to be an analytical challenge to quantify by HPLC. Taking these facts into consideration, this work presents the development and validation of a method for the quantification of gallic acid persulfate (GAP) in seawater and ultrapure water matrix, based on hydrophilic interaction liquid chromatography (HILIC). This method was used to evaluate GAP stability following several abiotic and biotic degradation assays, and to quantify its release in seawater from room-temperature-vulcanizing polydimethylsiloxane commercial coating. GAP was very stable in several water matrices, even at different pH values and in the presence/absence of marine microorganisms and presented a leaching value lower than 0.5%. This work discloses HILIC as an analytical method to overcome the difficulties in quantifying sulfated compounds in water matrices and highlights the potential of GAP as a promising long-lasting coating.
The origin of tsunamis in the Mediterranean region and its connected seas, including the Marmara Sea, the Black Sea and the SW Iberian Margin in the NE Atlantic Ocean, is reviewed within the ...geological and seismotectonic settings of the region. A variety of historical documentary sources combined with evidence from onshore and offshore geological signatures, geomorphological imprints, observations from selected coastal archeological sites, as well as instrumental records, eyewitnesses accounts and pictorial material, clearly indicate that tsunami sources both seismic and non-seismic (e.g. volcanism, landslides) can be found in all the seas of the region with a variable tsunamigenic potential. Local, regional and basin-wide tsunamis have been documented. An improved map of 22 main tsunamigenic zones and their relative potential for tsunami generation is presented. From west to east, the most important tsunamigenic zones are situated offshore SW Iberia, in the North Algerian margin, in the Tyrrhenian Calabria and Messina Straits, in the western and eastern segments of the Hellenic Arc, in the Corinth Gulf of Central Greece, in the Levantine Sea offshore the Dead Sea Transform Fault and in the eastern side of the Marmara Sea. Important historical examples, including destructive tsunamis associated with large earthquakes, are presented. The mean recurrence of strong tsunamis in the several basins varies greatly but the highest event frequency (1/96years) is observed in the east Mediterranean basin. For most of the historical events it is still unclear which was the causative seismic source and if the tsunami was caused by co-seismic slip, by earthquake-triggered submarine landslides or by a combination of both mechanisms. In pre-historical times, submarine volcanic eruptions (i.e. caldera collapse, massive pyroclastic flows, volcanogenic landslides) and large submarine landslides caused important tsunamis although little is known about their source mechanisms. We conclude that further investigation of the tsunami generation mechanisms is of primary importance in the Mediterranean region. Inputs from tsunami numerical modeling as well as from empirical discrimination criteria for characterizing tsunami sources have been proved particularly effective for recent, well-documented, aseismic landslide tsunamis (e.g., 1963 Corinth Gulf, 1979 Côte d'Azur, 1999 Izmit Bay, 2002 Stromboli volcano). Since the tsunami generation mechanisms are controlled by a variety of factors, and given that the knowledge of past tsunami activity is the cornerstone for undertaking tsunami risk mitigation action, future interdisciplinary research efforts on past tsunamis are needed.
•Tsunamis in the Mediterranean, Marmara Sea, Black Sea and SW Iberia are reviewed.•Historical, geological, archeological and instrumental records are examined.•We evaluate seismic and aseismic generation mechanisms and 22 tsunamigenic zones.•A variety of criteria for tsunami source discrimination are applied.•Strong tsunami repeat time is 90years on average, hazard implications are discussed.
In this paper we presenta morphotectonic study of the Paganica-San Demetrio fault system (PSDFS) responsible for the Mw6.1 April 6, 2009 earthquake (L'Aquila, Central Italy). The discrepancy observed ...between the length of the seismologic-geodetic modeled fault, the limited size of the primary coseismic surface ruptures and the significant morphological expression of the PSDFS stimulated a debate about the maximum rupture length of the PSDFS and its capability to generate larger magnitude events. To image the PSDFS long-term morphological expression and define its surface geometrical arrangement (length, number of fault splays and boundaries), we took advantage of a high-resolution airborne LiDAR dataset. LiDAR topography substantially increased our confidence in detecting even subtle tectonic-controlled morphologies. We define the PSDFS as a ~ 19 km-long fault system that displays a complex structural setting characterized by two different sectors: 1) the Paganica sector to the NW, with a narrow deformation zone, and 2) the San Demetrio sector to SE, where the strain is accommodated by several fault-splays disserting a wider Quaternary basin. We also defined a first-order hierarchy among the numerous fault splays across the PSDFS. The long-term geomorphic expression of the PSDFS suggests that it ruptured also involving the whole 19 km-long structure besides rupturing only small sections, as it occurred in 2009. This suggests a variable slip behavior. Empirical relations applied to this hypothesis allow up to M 6.6 earthquakes along the PSDFS. These results have a critical impart on the seismic hazard assessment of the area when compared with a M 6.1 event as the 2009.
To evaluate the role of clinical scores assessing the risk of disease severity in patients with clinical suspicion of obstructive sleep apnea syndrome (OSA). The hypothesis was tested by applying ...artificial intelligence (AI) to demonstrate its effectiveness in distinguishing between mild-moderate OSA and severe OSA risk.
A support vector machine model (SVM) was developed from the samples included in the analysis (N = 498), and they were split into 75% for training (N = 373) with the remaining for testing (N = 125). Two diagnostic thresholds were selected for OSA severity: mild to moderate (apnea-hypopnea index (AHI) ≥ 5 events/h and AHI < 30 events/h) and severe (AHI ≥ 30 events/h). The algorithms were trained and tested to predict OSA patient severity.
The sensitivity and specificity for the SVM model were 0.93 and 0.80 with an accuracy of 0.86; instead, the logistic regression full mode reported a value of 0.74 and 0.63, respectively, with an accuracy of 0.68. After backward stepwise elimination for features selection, the reduced logistic regression model demonstrated a sensitivity and specificity of 0.79 and 0.56, respectively, and an accuracy of 0.67.
Artificial intelligence could be applied to patients with symptoms related to OSA to identify individuals with a severe OSA risk with clinical-based algorithms in the OSA framework.
Objectives
To evaluate quantification of iodine uptake in metastatic and non-metastatic lymph nodes (LNs) by dual-energy CT (DECT) and to assess if the distribution of iodine within LNs at DECT ...correlates with the pathological structure.
Methods
Ninety LNs from 37 patients (23 with lung and 14 with gynaecological malignancies) were retrospectively selected. Information of LNs sent for statistical analysis included Hounsfield units (HU) at different energy levels; decomposition material densities fat–iodine, iodine–fat, iodine–water, water–iodine. Statistical analysis included evaluation of interobserver variability, material decomposition densities and spatial HU distribution within LNs.
Results
Interobserver agreement was excellent. There was a significant difference in iodine–fat and iodine–water decompositions comparing metastatic and non-metastatic LNs (
p
< 0.001); fat–iodine and water–iodine did not show significant differences. HU distribution showed a significant gradient from centre to periphery within non-metastatic LNs that was significant up to 20–30% from the centre, whereas metastatic LNs showed a more homogeneous distribution of HU, with no significant gradient.
Conclusions
DECT demonstrated a lower iodine uptake in metastatic compared to non-metastatic LNs. Moreover, the internal iodine distribution showed an evident gradient of iodine distribution from centre to periphery in non-metastatic LNs, and a more homogeneous distribution within metastatic LNs, which corresponded to the pathological structure.
Key points
• This study demonstrated a lower iodine uptake in metastatic than non-metastatic LNs.
• Internal distribution of HU was different between metastatic and non-metastatic lymph nodes.
• The intranodal iodine distribution disclosed a remarkable correlation with the histological LN structure.
Cranio-lenticulo-sutural dysplasia (CLSD, OMIM #607812) is a rare genetic condition characterized by late-closing fontanels, skeletal defects, dysmorphisms, and congenital cataracts that are caused ...by bi-allelic or monoallelic variants in the
gene. Autosomal recessive inheritance (AR-CLSD) has been extensively documented in several cases with homozygous or compound heterozygous variants in
, whereas autosomal dominant inheritance (AD-CLSD) involving heterozygous inherited variants has been reported just in three patients. The
gene encodes for one of the main components of a protein coat complex known as coat-protein-complex II (COPII), responsible for the generation of the envelope of the vesicles exported from the endoplasmic reticulum (ER) toward the Golgi complex (GC). AR-CLSD and AD-CLSD exhibit common features, although each form also presents distinctive and peculiar characteristics. Herein, we describe a rare case of a 10-year-old boy with a history of an anterior fontanel that closed only at the age of 9. The patient presents with short proportionate stature, low weight, and neurological impairment, including intellectual disability, global developmental delay, abnormal coordination, dystonia, and motor tics, along with dysmorphisms such as a wide anterior fontanel, hypertelorism, frontal bossing, broad nose, high-arched palate, and micrognathia. Trio clinical exome was performed, and a
heterozygous missense variant in
(p.Arg716Cys) was identified. This is the first reported case of CLSD caused by a
heterozygous missense variant in
presenting specific neurological manifestations never described before. For the first time, we have conducted a comprehensive phenotype-genotype correlation using data from our patient and the eight most well-documented cases in the literature. Our work has allowed us to identify the main specific and characteristic signs of both forms of CLSD (AR-CLSD, AD CLSD), offering valuable insights that can guide physicians in the diagnostic process. Notably, detailed descriptions of neurological features such as intellectual disability, global developmental delay, and motor impairment have not been documented before. Furthermore, our literature overview is crucial in the current landscape of CLSD due to the absence of guidelines for the clinical diagnosis and proper follow-up of these patients, especially during childhood.
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