The significance of the slow coronary flow phenomenon (SCFph), as visualized in patients (pts) with angiographically normal coronary arteries, is controversial. Absolute coronary flow reserve (CFR) ...in the left anterior descending coronary artery (LAD), non-invasively assessed by a transthoracic color-guided pulsed-wave Doppler (E-Doppler TTE), is a reliable parameter to assess coronary microcirculatory dysfunction (CMD). Mild and angiographically hidden epicardial atherosclerosis (Hath), as visualized by intracoronary ultrasound (IVUS), which could be the clue to atherosclerotic coronary microvascular involvement, has never been investigated together with CFR in patients. This study was aimed at assessing the value of CFR and HA in explaining the SCFph. Methods. Both non-invasive assessment of CFR in the LAD and corrected TIMI frame count assessment of the coronary contrast runoff were performed in 124 pts with angiographically normal coronary arteries. Among the whole group, 32 patients also underwent intracoronary ultrasounds in the LMCA and LAD, and the maximal plaque burden was assessed (Lesion external elastic (EEM) cross sectional area (CSA)—Lesion Lumen CSA/Lesion EEM CSA * 100). We found that 24 of the 124 pts (group 1) had the SCFph and the remaining 100 had a normal runoff (group 2). CFR, evaluated in both groups, was not significantly different, being 2.79 ± 0.79 (Mean ± SD) in group 1 and 2.90 ± 0.8 in group 2 (p = ns); in the pts also examined by IVUS (32 pts), the SCFph was always associated with hidden atherosclerosis, and a plaque burden of ≥33%. On the contrary, in the normal runoff group, any grade of PB was observed (from no athero to a PB > 70%) and remarkably, 10 pts had no signs of athero or just a minimal plaque burden. This resulted in a ROC curve analysis in which PB < 33% had a high negative predictive value (100%) in ruling out the SCFph. In addition, considering a CFR value < 2.21 as an index of coronary microcirculatory dysfunction, we found CMD in 15 pts (15%) in group 1 and in 7 pts (29%) in group 2 (p = ns). In conclusion, the SCFph is strongly connected to epicardial athero to the extent that the absence of hidden coronary athero has a very high negative predictive power in ruling out SCFph. CFR that is based on an endothelium-independent mechanism remains fairly normal in this condition. An endothelium-dependent microcirculatory constriction at rest due to atherosclerotic involvement of the coronary microvascular network is a possible explanation of the SCFph.
Acute kidney injury (AKI) after transcatheter aortic valve implantation (TAVI) is a frequent complication associated with adverse outcomes and mortality. Various scores have been developed to predict ...this complication in the coronary setting. However, none have ever been tested in a large TAVI population. This study aimed to evaluate the power of four different scores in predicting AKI after TAVI.
Overall, 1535 consecutive TAVI patients from the observational multicentric “Magna Graecia” TAVI registry were included in the analysis. Of the study population, 235 (15.31%) developed AKI early. The Mehran, William Beaumont Hospital, CR4EATME3AD3, and ACEF scores were calculated retrospectively.
The patients who developed TAVI-related AKI had significantly higher absolute values of all risk scores than those who did not. The receiver-operating characteristic analysis also showed a significant correlation between these four scores and AKI, but without a significant difference among all of them (p value = 0.176). Nevertheless, based on their area under the curve values (≤0.604 for all), none had adequate diagnostic accuracy in predicting TAVI-related AKI. Importantly, multivariate analysis identified myocardial revascularization close to the TAVI procedure and implantation of self-expanding prostheses, as well as atrial fibrillation, low-osmolar contrast media administration, corrected contrast medium volume, and any transfusion (p value < 0.05 for all) as independent risk factors for AKI.
Although high values of current AKI risk scores are significantly associated with the development of this complication, these are not sufficiently accurate. Further studies are needed so that a TAVI-dedicated AKI risk score may be created.
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Seagrasses rank among the most productive yet highly threatened ecosystems on Earth. Loss of seagrass habitat because of anthropogenic disturbances and evidence of their limited resilience have ...provided the impetus for investigating and monitoring habitat restoration through transplantation programmes. Although Structure from Motion (SfM) photogrammetry is becoming a more and more relevant technique for mapping underwater environments, no standardised methods currently exist to provide 3-dimensional high spatial resolution and accuracy cartographic products for monitoring seagrass transplantation areas. By synthesizing various remote sensing applications, we provide an underwater SfM-based protocol for monitoring large seagrass restoration areas. The data obtained from consumer-grade red-green-blue (RGB) imagery allowed the fine characterization of the seabed by using 3D dense point clouds and raster layers, including orthophoto mosaics and Digital Surface Models (DSM).
The integration of high spatial resolution underwater imagery with object-based image classification (OBIA) technique provided a new tool to count transplanted Posidonia oceanica fragments and estimate the bottom coverage expressed as a percentage of seabed covered by such fragments. Finally, the resulting digital maps were integrated into Geographic Information Systems (GIS) to run topographic change detection analysis and evaluate the mean height of transplanted fragments and detect fine-scale changes in seabed vector ruggedness measure (VRM). Our study provides a guide for creating large-scale, replicable and ready-to-use products for a broad range of applications aimed at standardizing monitoring protocols in future seagrass restoration actions.
•Seagrass species are essential for marine ecosystems' functioning and services.•Habitat restoration through transplantation is becoming a relevant technique.•We propose for the first time an accurate mapping protocol to remotely monitor seagrass transplantation areas.•High spatial resolution orthomosaics allowed image classification aimed at detecting transplanted seagrass fragments.•3D point cloud comparison allowed multi-temporal geomorphological change detection analysis of the transplantation area.
It has long been thought that severe chronic pain conditions, such as complex regional pain syndrome (CRPS), are not only associated with, but even maintained by a reorganization of the somatotopic ...representation of the affected limb in primary somatosensory cortex (S1). This notion has driven treatments that aim to restore S1 representations in CRPS patients, such as sensory discrimination training and mirror therapy. However, this notion is based on both indirect and incomplete evidence obtained with imaging methods with low spatial resolution. Here, we used fMRI to characterize the S1 representation of the affected and unaffected hand in humans (of either sex) with unilateral CRPS. The cortical area, location, and geometry of the S1 representation of the CRPS hand were largely comparable with those of both the unaffected hand and healthy controls. We found no differential relation between affected versus unaffected hand map measures and clinical measures (pain severity, upper limb disability, disease duration). Thus, if any map reorganization occurs, it does not appear to be directly related to pain and disease severity. These findings compel us to reconsider the cortical mechanisms underlying CRPS and the rationale for interventions that aim to “restore” somatotopic representations to treat pain.
SIGNIFICANCE STATEMENT
This study shows that the spatial map of the fingers in somatosensory cortex is largely preserved in chronic complex regional pain syndrome (CRPS). These findings challenge the treatment rationale for restoring somatotopic representations in complex regional pain syndrome patients.
•Human development along coastal impacts marine ecosystems.•Seagrass suffered degradation due to historical anthropogenic disturbances.•Human-mediated impacts historically co-occurred from 1968 to ...2013 on Giglio Island.•Bayesian modelling and GIS identified the most influential disturbance factors.•Impacts for meadows were associated with harbour expansion, mining and anchoring.
Over the last century, P. oceanica meadows have undergone significant regression along Mediterranean coasts due to anthropogenic disturbances. Using an integrated approach based on historical aerial photography interpretation in GIS environment and Bayesian modelling, we mapped the upper limits of a P. oceanica meadow and identified the most influential disturbance factors acting along the coast of Giglio Island, where several local human-mediated impacts have historically co-occurred from 1968 to 2013. Model selection based on the DIC criterion suggested that the presence of the impacts is suitable for describing the seagrass coverage variation. Similarities in P. oceanica cover within 13 investigated zones were highlighted when considering the most relevant impacts, such as harbour expansion, mining, and anchoring. The detected adverse effects indicate the need for implementing management actions focusing on the present and past sources of impact to reduce their effect on P. oceanica beds actively.
Accurate discrimination of the intensity and spatial location of nociceptive stimuli is essential to guide appropriate behaviour. The ability to discriminate the attributes of sensory stimuli is ...continuously refined by practice, even throughout adulthood - a phenomenon called perceptual learning. In the visual domain, perceptual learning to discriminate one of the features that define a visual stimulus (e.g., its orientation) can transfer to a different feature of the same stimulus (e.g., its contrast). Here, we performed two experiments on 48 volunteers to characterize perceptual learning in nociception, which has been rarely studied. We investigated whether learning to discriminate either the intensity or the location of nociceptive stimuli (1) occurs during practice and is subsequently maintained, (2) requires feedback on performance, and (3) transfers to the other, unpractised stimulus feature. First, we found clear evidence that perceptual learning in discriminating both the intensity and the location of nociceptive stimuli occurs, and is maintained for at least 3 hours after practice. Second, learning occurs only when feedback is provided during practice. Finally, learning is largely confined to the feature for which feedback was provided. We discuss these effects in a predictive coding framework, and consider implications for future studies.
The role of habitat degradation on the spread of the alien green alga Caulerpa cylindracea is reported here by comparing observations achieved through a multi-year assessment on three Mediterraneans ...habitats, namely Posidonia oceanica meadows, Phyllophora crispa turf, and coralligenous reefs. Due to the peculiarity of the study site, both natural-reference and impacted conditions were investigated. C. cylindracea occurred in all the studied habitats under impacted conditions. High susceptibility to the invasion characterized impacted P. oceanica, where Caulerpa cover reached 70.0% in summer months. C. cylindracea cover did not differ significantly among conditions in P. crispa turf, where values never exceeded 5.0%. Conversely, the invasive green algae was low in abundance and patchily distributed in coralligenous reefs. Our results confirmed that habitat loss enhances the spread of C. cylindracea, although with different magnitudes among habitats. Dead matte areas of P. oceanica represented the most vulnerable habitat among those analyzed, whereas coralligenous reefs were less susceptible to the invasion under both the studied conditions.
The need for habitat recovery in coastal areas, especially those subjected to intensive exploitation, has increased because of significant historical loss and alteration of habitats and, therefore, ...adverse ecological impacts. The present study defines a stepwise approach to mitigate habitat loss in deep coastal environments, describing the planning, intervention, and monitoring phases following the Trans Adriatic Pipeline (TAP) laying along the Apulian coast (Adriatic Sea, Italy). Preliminary field activities encompassed morpho-bathymetric data (MBES and SSS), SCUBA and ROV observations to accurately map and characterize the mesophotic reefs built by invertebrates found in the area. The pipeline route interfered with 30 outcrops between 50 and 80 m depth, mostly colonized by 15 taxa/morphological groups. A functional/conservative approach was adopted to recognize the taxa/morphological groups on which to focus the removal and following relocation activities based on their abundance, conservation status, and functional traits. Saturation divers teams, ROV pilot technicians, and researchers collaborated to minimize the physical impact and the loss of organisms due to the pipeline installation. They relocated a total of 899 living portions (
nuclei
) from the 30 interfered reefs on the top of the pipeline. The following monitoring activities, carried out after fourteen months since the intervention, revealed a high mean survival rate (88.1%) and slight variations in the structure of the
nuclei
assemblages. This study represents a paradigmatic case of involvement and support of the private oil and gas sector to mitigate habitat loss in the Mediterranean Sea, and stresses the need for integrated management involving different stakeholders to mitigate the effects of the exploitation of marine resources through
ante operam
assessment and active restoration actions.
Coralligenous reefs are considered as one of the most important benthic ecosystems in the Mediterranean Sea in terms of biodiversity, ecosystem functioning, and aesthetic value. Bryozoans deserve ...special attention within the coralligenous framework fauna: they are among the most common animals, showing high diversity values and playing different functional roles. Distribution, spatial variability, and demographic features of five erect bryozoan taxa Adeonella sp., Myriapora truncata, Pentapora fascialis, Reteporella sp., and Smittina cervicornis were studied in the central Tyrrhenian Sea. Abundance, size, and relationship with other taxa/morphological groups of benthic organisms were studied in coralligenous reefs between 35 and 40 m depth. High density of colonies was reported especially in association to gorgonians and algae dominated assemblages. Size distributions of the five bryozoans were characterized by small colonies; only two species (P. fascialis and S. cervicornis) showed colonies larger than 50 cm2. Structure of coralligenous assemblages and disturbances outlined different ecological requirements of the five studied taxa. Results provide baseline information for monitoring trajectories of change of these organisms in the coralligenous ecosystem. To date, this work represents the first study exploring ecology and distribution patterns of common erect bryozoans in the Mediterranean Sea.
•Bryozoans are extremely abundant in the studied coralligenous reefs.•Small scale spatial variability has been highlight for three species.•The five studied species highlight different ecological requirements.•Human-mediated disturbances lead to different bryozoans coverage.
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