In this paper, we present several study cases focused on marine, oceanographic, and atmospheric environments, which would greatly benefit from the use of a deployable system for small satellite ...observations. As opposed to the large standard ones, small satellites have become an effective and affordable alternative access to space, owing to their lower costs, innovative design and technology, and higher revisiting times, when launched in a constellation configuration. One of the biggest challenges is created by the small satellite instrumentation working in the visible (VIS), infrared (IR), and microwave (MW) spectral ranges, for which the resolution of the acquired data depends on the physical dimension of the telescope and the antenna collecting the signal. In this respect, a deployable payload, fitting the limited size and mass imposed by the small satellite architecture, once unfolded in space, can reach performances similar to those of larger satellites. In this study, we show how ecology and Earth Observations can benefit from data acquired by small satellites, and how they can be further improved thanks to deployable payloads. We focus on DORA—Deployable Optics for Remote sensing Applications—in the VIS to TIR spectral range, and on a planned application in the MW spectral range, and we carry out a radiometric analysis to verify its performances for Earth Observation studies.
The Ross Sea exhibits the largest continental shelf and it is considered to be the most productive region in Antarctica, with phytoplankton communities that have so far been considered to be driven ...by the seasonal dynamics of the polynya, producing the picture of what is considered as the classical Antarctic food web. Nevertheless, the Ross Sea is made up of a complex mosaic of sub-systems, with physical, chemical, and biological features that change on different temporal and spatial scales. Thus, we investigated the phytoplankton community structure of the Ross Sea with a spatial scale, considering the different ecological sub-systems of the region. The total phytoplankton biomass, maximum quantum efficiency (Fv/Fm), size classes, and main functional groups were analyzed in relation to physical–chemical properties of the water column during the austral summer of 2017. Data from our study showed productivity differences between polynyas and other areas, with high values of biomass in Terra Nova Bay (up to 272 mg chl a m
–2
) and the south-central Ross Sea (up to 177 mg chl a m
–2
) that contrast with the HNLC nature of the off-shore waters during summer. Diatoms were the dominant group in all the studied subsystems (relative proportion ≥ 50%) except the southern one, where they coexisted with haptophytes with a similar percentage. Additionally, the upper mixed layer depth seemed to influence the level of biomass rather than the dominance of different functional groups. However, relatively high percentages of dinoflagellates (∼30%) were observed in the area near Cape Adare. The temporal variability observed at the repeatedly sampled stations differed among the sub-systems, suggesting the importance of Long-Term Ecological Research (L-TER) sites in monitoring and studying the dynamics of such an important system for the global carbon cycle as the Ross Sea. Our results provide new insights into the spatial distribution and structure of phytoplankton communities, with different sub-systems following alternative pathways for primary production, identifiable by the use of appropriate sampling scales.
Purpose
Angiogenic markers in neuroendocrine neoplasms (NENs) have recently received increasing attention, but their clinical role remains unclear. The aim of this study was to evaluate the role of ...angiogenic markers in NEN aggressiveness and prognosis.
Methods
We performed a prospective observational study including 46 consecutive patients with proven NENs of pulmonary (45.65%) and gastro-entero-pancreatic (GEP) (54.35%) origin and 29 healthy controls. Circulating pro-angiogenic factors were measured by ELISA assay. ANG2 tissue expression was evaluated in a subgroup of ten patients by immunohistochemistry.
Results
The study demonstrated a significantly higher level of ANG2, ANG1, sTIE2, and PROK2 in patients affected by NENs compared to controls. In the NENs’ group we measured that: (i) ANG2 levels were higher in poorly vs well-differentiated NENs: 4.85 (2.75–7.42) vs 3.16 (1.66–6.36) ng/ml,
p
= 0.046 and in tumor stage 3–4 compared to stage 1–2: 4.24 (2.66–8.72) vs 2.73 (1.53–5.70),
p
= 0.044; (ii) ANG2 and PROK2 were significantly higher in patents with progressive disease compared to stable disease: ANG2 = 6.26 (3.98–10.99) vs 2.73 (1.65–4.36) pg/ml,
p
= 0.001; PROK2 = 29.19 (28.42–32.25) vs 28.37 (28.14–28.91) pg/ml,
p
= 0.035. Immunohistochemistry confirmed ANG2 expression in tumor specimens.
Conclusions
We documented higher levels of angiogenic markers in NENs, with an association between ANG2 serum levels and NENs morphology and staging. In both GEP and lung NENs, ANG2 and PROK2 are higher in case of tumor progression, suggesting a potential role as prognostic markers in NENs patients.
Introduction:
Pheochromocytomas (PCCs), paragangliomas (PGLs), ganglioneuroblastomas (GNBs), and ganglioneuromas (GNs) are neuroendocrine neoplasms (NENs) that were thought to share a common ...embryologic origin from neural crest cells. However, they rarely occur concurrently and recurrently. We describe the case of a 40-years-old woman with “composite PCC-GN” and multiple NENs and neuroblastic tumors.
Case presentation:
The patient was first referred to our department at the age of 15 years for paroxysmal hypertension, headache, sweating, and watery diarrhea. Her personal history included the diagnosis of a pelvic GNB with lumbar–aortic lymph node metastases at 11 months. Her family history was positive for cerebral glioblastoma multiforme (father). An abdominal ultrasound showed a right adrenal mass that histologically was a “composite adrenal PCC-GN.” The symptoms disappeared after surgery. At the age of 20 years, the symptoms returned: computed tomography (CT) and 131I-metaiodobenzylguanidine (MIBG) scintigraphy showed an inter-aortocaval mass, found histologically to be an inter-aortocaval PGL. Her symptoms reappeared again at 28 years: CT and magnetic resonance imaging revealed four left adrenal gland nodules, found histologically to be multifocal PCCs with some atypia. Genetic screening for
VHL, RET, NF1, Tp53, SDHD, SDHB, SDHC, SDHAF2, SDHAF3, SDHA
, and
TMEM127
was negative. Mutational analysis of the
MAX
gene revealed the presence of a novel heterozygous variant, c299G>C (p.Arg100Pro, NM_002382.5) that the bioinformatics prediction programs defined as noxious and causative of pathology.
Conclusion:
This report represents the first description of a co-occurrence of multiple composite PCC-GN and neuroblastic tumors. The long timeline of the presentation of the NENs/neuroblastic tumors from infancy to adulthood requires a lifelong follow-up for this patient. Moreover, the importance of this case lies in the presence of a novel
MAX
gene variant deleterious, harmful, and causative of pathology, confirmed by Sanger sequencing and never been associated before with multiple composite PCC-GN. The present case underlines the importance of precision medicine and molecular diagnoses for hereditary pheochromocytomas and paragangliomas, suggesting that when they occur in early childhood, it is necessary to perform an extensive genetic investigation and a lifelong follow-up.
Nonadherence to therapy negatively impacts mortality and quality of life and results in suboptimal efficacy of treatment regimens, threats to patient safety, and increased healthcare costs for ...disease management. Mobile health solutions can offer users instruments that can promote therapeutic adherence. The objective of this review is to investigate the impact mobile health systems have on therapeutic adherence. Specifically, we want to map the main systems used, the functions implemented, and the different methods of adherence detection used. For this purpose, a scoping review was conducted. The following databases were consulted: PubMed, Cochrane Library, EBSCO (including APA PsycINFO, CINAHL Plus with Full Text, ERIC), including English-language studies published in the last 10 years (2012-2022). The main mobile health systems used are as follows: applications, automated messaging, interactive voice response, and mobile video games. The main features implemented to support medication management were as follows: reminders, self-monitoring instruments, educational support, and caregiver involvement. In conclusion, the use of interactive mobile health instruments intended for use by the patient and/or caregiver can improve objectively and subjectively detected therapeutic adherence. The use of these systems in the therapeutic pathway of users, with a special focus on people with comorbidities and in polypharmacy treatment, represents a challenge to improve caregiver health.
•Myocardial early gadolinium enhancement is a MRI criterion to diagnose myocarditis.•EGE thresholds suggested by “Lake-Louise” consensus refer to conventional standard-relaxivity Gd-chelates.•High ...relaxivity contrast agents offer comparable results to standard-relaxivity Gd-chelates.•EGEr threshold implemented using standard-relaxivity chelates may be applied using Gadobenate dimeglumine.•EGE is the weakest MRI parameter for diagnosing myocarditis.
Global early gadolinium enhancement (EGE) is an accepted cardiac magnetic resonance (CMR) criterion for diagnosis of myocarditis. However, recommended enhancement thresholds are based specifically on standard-relaxivity Gd-chelates. We evaluated the performance of a high relaxivity MR contrast agent for detection of myocardial hyperemia in patients referred for endomyocardial biopsy (EMB).
We retrospectively enrolled 54 patients (mean age: 44.1 years range=18–77years; 72% men) with suspected myocarditis who underwent CMR and EMB within four weeks of clinical onset. CMR imaging protocol included T2-weighted short tau inversion-recovery sequence, EGE and late gadolinium enhanced (LGE) imaging.
For EGE imaging, free-breathing ECG-gated turbo spin echo T1-weighted (TSE T1w) sequences were acquired before and within the first three minutes after gadobenate dimeglumine (0.1mmol/Kg) administration. The ratio (EGEr) between myocardial and musculoskeletal early enhancement was calculated. Myocardial edema, EGE and late gadolinium enhancement (LGE) were correlated with EMB results. Receiver operating characteristic (ROC) curve analysis of EGE values was applied on the overall population.
EMB revealed myocarditis in 34/54 patients. Sensitivity, specificity and accuracy values of 0.61, 0.85 and 0.70, respectively, were obtained for a standard EGE threshold (EGEr>4.0). ROC analysis revealed an area under the curve of 0.701 for EGEr (IC95%:0.556–0.846, p=0.014) and 0.706 for absolute enhancement (IC95%:0.563–0.849, p=0.012).
Sensitivity, specificity and accuracy values were 0.67, 0.80 and 0.72, respectively, for myocardial edema and 0.76, 0.75 and 0.76, respectively, for LGE.
High relaxivity contrast agents provide comparable results to standard-relaxivity chelates for EGE assessment in diagnosing myocarditis.
The case reported the rapid remission of disease recurrence achieved adding foscarnet, a DNA polymerase inhibitor that interacts with fibroblast growth factor 2, to low molecular weight heparin and ...sunitinib for the first time in a patient with an anaplastic thyroid cancer (ATC).
A 65-year-old woman with a multinodular goiter referred for a rapid enlargement of a nodule. Histological examination revealed an ATC with a little area of papillary thyroid cancer (PTC). The patient was resistant to selective single-target treatment.
Immunophenotyping and gene analyses found a significant increase in FGF2 and FGFR1 expression in the primary ATC area (FGF2 = 38.2 ± 6.2% in ATC vs 34.6 ± 6.0% in the differentiated area of PTC, P < 0.05; FGFR1: 41.7 ± 6.0% in ATC vs 34.4 ± 4.2% in PTC, P < 0.001) and in metastatic neck lymph nodes (P < 0.001 vs normal control tissues). Unlike conventional imaging, F-FDG PET/CT with PERCIST 1.0 criteria promptly and quantitatively detected disease recurrence and remission before and after multitarget therapy, combining anatomic, metabolic, and functional data.
Foscarnet was administered given the positivity for FGF2, FGFR1 and FGFR4 in ATC. Low molecular wight heparin and Sunitinib were coadministere to limiti metastatic progression and on neck tumor masse, respectively.
The rationale for the clinical response to this innovative multitarget association with foscarnet is based on the histological and genetic finding that fibroblast growth factors and their receptor super-family are up-regulated in the primary anaplastic thyroid tumor and in the metastatic lymph node of our patient.
We propose that fibroblast growth factors and their receptor super-family play a key role as potential therapeutic targets in anaplastic thyroid cancer and the positive relevance of this suggestion for patient care, especially for an individualized management.
One of the key processes of the thermohaline circulation is the water mass transformation caused by the external forcing and the continuing renewal and stratification of the water column. In this ...context the marginal seas, such as the Mediterranean Sea, the Arctic Sea, the Greenland Sea, etc., play a fundamental role by supplying the global ocean with dense water. In particular, the Mediterranean Water (MW) is one of the intermediate-type water masses observed in the North Atlantic. It consists of a mixture of Levantine Intermediate Water (LIW) and deep waters produced within the Mediterranean basin and flows into the Atlantic Ocean through the narrow Strait of Gibraltar. The Gulf of Cadiz is the transition sub-basin where the pure MW undergoes, for the first time, a strong mixing and entrainment with the Atlantic water. The MW lies between 700 and 1400
m depth characterized, albeit density compensated, by significant salt and temperature anomalies, with Δ
S∼1–2 and Δ
T∼2–3
°C with respect to the overlying North Atlantic Central water. In the present work new temperature and salinity observations have shown seasonal, interannual and decadal variations. Changes in water properties of MW outflow were found, with an average value of 0.16
°C/decade and 0.05 in salinity per decade over the last 50 years (1948–1999). Even though the data set is not regularly distributed in time, it seems to be clear that the layer thickness ventilated by MW increases almost regularly in time, but with an evident acceleration in the last three decades: about 1000
m thickness and with salinity ranging between 36.0 and 37.0. In order to explain these variability and trends, some possible mechanisms are taken into consideration, in particular those related to the variability of Mediterranean thermohaline circulation and the physics of the Gibraltar Strait.
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