Sentinel Lymph Node Analysis in Colorectal Cancer Patients Using One-Step Nucleic Acid Amplification in Combination With Fluorescence and Indocyanine Green

Purpose: Analysis of the sentinel lymph node (SLN) in colorectal cancer (CRC) patients was proposed for more accurate staging and tailored lymphadenectomy. The aim of this study was to assess the ability to predict lymph node (LN) involvement through analysis of the SLN with a one-step nucleic acid (OSNA) technique in combination with peritumoral injection of indocyanine green (ICG) and near-infrared (NIR) lymphangiography in CRC patients. Methods: A total of 34 patients were enrolled. Overall, 51 LNs were analyzed with OSNA. LNs of 17 patients (50%) were examined simultaneously with hematoxylin and eosin (H&E) and OSNA. Results: SLN analysis of 17 patients examined with H&E and OSNA revealed that OSNA had a higher sensitivity (1 vs. 0.55), higher negative predictive value (1 vs. 0.66) and higher accuracy (100% vs. 76.4%) in predicting LN involvement. Overall, OSNA showed a sensitivity of 0.69, specificity of 1, accuracy of 88.2%, and stage migration of 8.8%. Compared to those who were OSNA (−), OSNA (+) patients had a greater number of LN metastases (4.8 vs. 0.16, P = 0.04), higher G3 rate (44.4% vs. 4%, P = 0.01), more advanced stage of disease (stage III: 77.8% vs. 16%; P = 0.00) and were more rapidly subjected to adjuvant chemotherapy (39.1 days vs. 50.2 days, P = 0.01). Conclusion: SLN analysis with OSNA in combination with ICG-NIR lymphangiography is feasible and can detect LN involvement in CRC patients. Furthermore, it allows for more accurate staging reducing the delay between surgery and adjuvant chemotherap

Time Scale Effects and Interactions of Rainfall Erosivity and Cover Management Factors on Vineyard Soil Loss Erosion in the Semi-Arid Area of Southern Sicily

Several authors describe the effectiveness of cover crop management practice as an important tool to prevent soil erosion, but at the same time, they stress on the high soil loss variability due to the interaction of several factors characterized by large uncertainty. In this paper the Revised Universal Soil Loss Equation (RUSLE) model is applied to two Sicilian vineyards that are characterized by different topographic factors; one is subjected to Conventional Practice (CP) and the other to Best Management Practice (BMP). By using climatic input data at a high temporal scale resolution for the rainfall erosivity (R) factor, and remotely sensed imagery for the cover and management (C) factor, the importance of an appropriate R and C factor assessment and their inter and intra-annual interactions in determining soil erosion variability are showed. Different temporal analysis at ten-year, seasonal, monthly and event scales showed that results at events scales allow evidencing the interacting factors that determine erosion risk features which at other temporal scales of resolution can be hidden. The impact of BMP in preventing soil erosion is described in terms of average saved soil loss over the 10-year period of observation. The evaluation of soil erosion at a different temporal scale and its implications can help stakeholders and scientists formulate better soil conservation practices and agricultural management, and also consider that erosivity rates are expected to raise for the increase of rainfall intensity linked to climate change

Aridity index, soil erosion and climate drive no-till ecosystem services trade-off in Mediterranean arable land

Despite the relevant literature on the advantages of no-till (NT) management, the world area under NT is only 10% of the arable land, probably due to several limiting factors as climate, soil types, farming systems and yield. Soil conservation practices and particularly NT soil management are able to provide many ecosystem services (ESs). This paper suggests a framework to determine the area distribution of soil erosion control and food security ESs trade-offs furnished by NT, starting from the potential soil erosion and aridity index maps. The interaction between the potential soil erosion and the aridity index showed that different trade-offs and synergies of multiple ESs may occur and need to be interpreted. The yield success probability of NT with respect to CT (P(NT)) and soil erosion tolerance (SET) were considered to determine four classes of the NT adaptability index, which represent the NT ability to support multiple ESs, under the environmental condition. For 2020 as a baseline, and 2050 as a future scenario, in between latitudes 35◦ and 47◦, an analysis was carried out, focusing on the arable lands of five European Mediterranean countries (France, Greece, Italy, Portugal and Spain), which are potentially cropped with durum wheat. Results showed that, for the considered arable land area, under NT soil management and from a food security point of view, the potential durum wheat area, under climate change pressure, slightly increases, if residues are retained. On the contrary, if residues are removed, the potential durum wheat area is very limited for both the baseline and the 2050 scenario. The area distribution corresponding to the NT adaptability index classes could be suitable for stakeholders to modulate payments for agri-environmental measures, based on the actual provided ESs

No-Till Soil Organic Carbon Sequestration Patterns as Affected by Climate and Soil Erosion in the Arable Land of Mediterranean Europe

No-tillage (NT) has been considered an agronomic tool to sequester soil organic carbon (SOC) and match the 4p1000 initiative requirements of conservative soil management. Recently, some doubts have emerged about the NT effect on SOC sequestration, often because observations and experimental data vary widely depending on climate and geographic characteristics. Therefore, a suitable SOC accounting method is needed that considers climate and morphology interactions. In this study, the yearly ratio between SOC in NT and conventional tillage (CT) (RRNT/CT) collected in a previous study for flat (96 samples) and sloping (44 samples) paired sites was used to map the overestimation of SOC sequestration. It was assumed that there would be an overestimation of NT capacity in sloping fields due to lower erosion processes with respect to CT. Towards this aim, Geographical Information System (GIS) techniques and an extensive input database of high spatial resolution maps were used in a simplified procedure to assess the overestimation of SOC stocks due to the sloping conditions and spatial variability of the Aridity Index (AI). Moreover, this also made it possible to quantify the effects of adopting NT practices on soil carbon sequestration compared to CT practices. The method was applied to the arable lands of five Mediterranean countries (France, Greece, Italy, Portugal and Spain) ranging between the 35° and 46° latitude. The results showed an overestimation of SOC sequestration, when the AI and soil erosion were considered. The average overestimation rate in the studied Mediterranean areas was 0.11 Mg ha−1 yr−1. Carbon stock overestimation ranged from 34 to 1417 Gg for Portugal and Italy, respectively. Even if overestimation is considered, 4p1000 goals are often reached, especially in the more arid areas. The findings of this research allowed us to map the areas suitable to meet the 4p1000 that could be achieved by adopting conservative practices such as NT

Comorbidities, Cardiovascular Therapies, and COVID-19 Mortality: A Nationwide, Italian Observational Study (ItaliCO)

Background: Italy has one of the world\u2019s oldest populations, and suffered one the highest death tolls from Coronavirus disease 2019 (COVID-19) worldwide. Older people with cardiovascular diseases (CVDs), and in particular hypertension, are at higher risk of hospitalization and death for COVID-19. Whether hypertensionmedicationsmay increase the risk for death in older COVID 19 inpatients at the highest risk for the disease is currently unknown. Methods: Data from 5,625 COVID-19 inpatients were manually extracted from medical charts from 61 hospitals across Italy. From the initial 5,625 patients, 3,179 were included in the study as they were either discharged or deceased at the time of the data analysis. Primary outcome was inpatient death or recovery. Mixed effects logistic regression models were adjusted for sex, age, and number of comorbidities, with a random effect for site. Results: A large proportion of participating inpatients were 65 years old (58%), male (68%), non-smokers (93%) with comorbidities (66%). Each additional comorbidity increased the risk of death by 35% [adjOR = 1.35 (1.2, 1.5) p < 0.001]. Use of ACE inhibitors, ARBs, beta-blockers or Ca-antagonists was not associated with significantly increased risk of death. There was a marginal negative association between ARB use and death, and a marginal positive association between diuretic use and death. Conclusions: This Italian nationwide observational study of COVID-19 inpatients, the majority of which 65 years old, indicates that there is a linear direct relationship between the number of comorbidities and the risk of death. Among CVDs, hypertension and pre-existing cardiomyopathy were significantly associated with risk of death. The use of hypertension medications reported to be safe in younger cohorts, do not contribute significantly to increased COVID-19 related deaths in an older population that suffered one of the highest death tolls worldwide

Comorbidities, cardiovascular therapies, and COVID-19 mortality: A nationwide, italian observational study (ItaliCO)

Background: Italy has one of the world’s oldest populations, and suffered one the highest death tolls from Coronavirus disease 2019 (COVID-19) worldwide. Older people with cardiovascular diseases (CVDs), and in particular hypertension, are at higher risk of hospitalization and death for COVID-19. Whether hypertensionmedicationsmay increase the risk for death in older COVID 19 inpatients at the highest risk for the disease is currently unknown. Methods: Data from 5,625 COVID-19 inpatients were manually extracted from medical charts from 61 hospitals across Italy. From the initial 5,625 patients, 3,179 were included in the study as they were either discharged or deceased at the time of the data analysis. Primary outcome was inpatient death or recovery. Mixed effects logistic regression models were adjusted for sex, age, and number of comorbidities, with a random effect for site. Results: A large proportion of participating inpatients were ≥65 years old (58%), male (68%), non-smokers (93%) with comorbidities (66%). Each additional comorbidity increased the risk of death by 35% [adjOR = 1.35 (1.2, 1.5) p < 0.001]. Use of ACE inhibitors, ARBs, beta-blockers or Ca-antagonists was not associated with significantly increased risk of death. There was a marginal negative association between ARB use and death, and a marginal positive association between diuretic use and death. Conclusions: This Italian nationwide observational study of COVID-19 inpatients, the majority of which ≥65 years old, indicates that there is a linear direct relationship between the number of comorbidities and the risk of death. Among CVDs, hypertension and pre-existing cardiomyopathy were significantly associated with risk of death. The use of hypertension medications reported to be safe in younger cohorts, do not contribute significantly to increased COVID-19 related deaths in an older population that suffered one of the highest death tolls worldwide