An integrated reconstruction of the multiannual wave pattern in the gulf of naples (South-Eastern Tyrrhenian Sea, Western Mediterranean Sea)

Surface gravity waves retrieved by a network of HF (High Frequency) radars and measured in situ by an ADCP (Acoustic Doppler Current Profiler) current meter connected to an elastic beacon were used to carry out a multiple-year characterization of the wave field of the Gulf of Naples (south-eastern Tyrrhenian Sea, western Mediterranean). The aim of the work was to create a climatology of the study area and to demonstrate the potential of an integrated platform for coastal studies. The patterns recorded by the different instruments were in agreement with the wave climatology of the southern Tyrrhenian Sea as well as with previous scores for the same area. The results presented in this work also highlight seasonal and interannual consistency in the wave patterns for each site. In a wider context, this study demonstrates the potential of HF radars as long-term monitoring tools of the wave field in coastal basins, and supports the development of integrated observatories to address large-scale scientific challenges such as coastal ocean dynamics and the impact of global change on the local dynamics

Unarousable child with a short bowel

Unarousable child with short bowel: A 4-year-old boy was admitted with progressive lethargy of a few hours' duration and no other symptoms. His medical history was relevant for short bowel syndrome (SBS), following neonatal volvulus, with residual bowel length of 23 cm and intact ileocecal valve. He had similar self-limiting episodes in the past, after weaning parenteral nutrition, especially after eating large meals. The day before, he had consumed a large amount of apples. Arterial blood gas (ABG) analysis showed metabolic acidosis with normal lactacidaemia (pH 7.09, pCO2 19 mm Hg, pO2 101 mm Hg, HCO3 5.8 mmol/L, BE -24, anion gap 29.4, chloride 116 mmol/L, L-lactate level 4 mmol/L). On admission, the child could be awakened, but he was confused with slurred speech (Glasgow Coma Scale 14), with a body temperature of 37 C°, a heart rate of 125 beats/min and a respiratory rate of 38 breaths/min. The abdomen was distended, without guarding and with normal bowel sounds. Blood glucose levels were normal, as well as white blood cell count, liver and kidney function test and C reactive protein. An abdominal ultrasound ruled out an intussusception. An abdominal X-ray was performed too (seefigure 1). Figure 1 Abdominal distension with gas and bloating. Questions: Which is the most likely diagnosis? Encephalitis D-lactic acidosis Dehydration with third space fluid collection and acidosis Hereditary fructose intolerance. How is this diagnosis confirmed? D lactic dosage Breath test for bacterial overgrowth Urine organic acid dosage Search for reductive substances in the stools. How should this patient be managed? Intravenous fluids to facilitate D-lactic excretion Restrict carbohydrates in the diet Intravenous bicarbonates Antibiotic treatment to reduce bowel bacterial overgrowth. Answers can be found on page 2

Theophylline as a precision therapy in a young girl with PIK3R1 immunodeficiency

Based on its phosphatidylinositol 3-kinase-delta (PI3Kd) inhibitory properties, theophylline was administered to a young girl with activated PI3Kd syndrome (APDS). We report reduced frequency of infections, decreased lymphoproliferation, and noticeable changes in immunophenotype, encouraging further trials with theophylline in children with APDS

Reconstructing individual responses to direct questions: a new method for reconstructing malingered responses

Introduction: The false consensus effect consists of an overestimation of how common a subject opinion is among other people. This research demonstrates that individual endorsement of questions may be predicted by estimating peers’ responses to the same question. Moreover, we aim to demonstrate how this prediction can be used to reconstruct the individual’s response to a single item as well as the overall response to all of the items, making the technique suitable and effective for malingering detection. Method: We have validated the procedure of reconstructing individual responses from peers’ estimation in two separate studies, one addressing anxiety-related questions and the other to the Dark Triad. The questionnaires, adapted to our scopes, were submitted to the groups of participants for a total of 187 subjects across both studies. Machine learning models were used to estimate the results. Results: According to the results, individual responses to a single question requiring a “yes” or “no” response are predicted with 70–80% accuracy. The overall participant-predicted score on all questions (total test score) is predicted with a correlation of 0.7–0.77 with actual results. Discussion: The application of the false consensus effect format is a promising procedure for reconstructing truthful responses in forensic settings when the respondent is highly likely to alter his true (genuine) response and true responses to the tests are missing

Executive function abnormalities in pathological gamblers

Background: Pathological gambling (PG) is an impulse control disorder characterized by persistent and maladaptive gambling behaviors with disruptive consequences for familial, occupational and social functions. The pathophysiology of PG is still unclear, but it is hypothesized that it might include environmental factors coupled with a genetic vulnerability and dysfunctions of different neurotransmitters and selected brain areas. Our study aimed to evaluate a group of patients suffering from PG by means of some neuropsychological tests in order to explore the brain areas related to the disorder. Methods: Twenty outpatients (15 men, 5 women), with a diagnosis of PG according to DSM-IV criteria, were included in the study and evaluated with a battery of neuropsychological tests: the Wisconsin Card Sorting Test (WCST), the Wechsler Memory Scale revised (WMS-R) and the Verbal Associative Fluency Test (FAS). The results obtained in the patients were compared with normative values of matched healthy control subjects. Results: The PG patients showed alterations at the WCST only, in particular they had a great difficulty in finding alternative methods of problem-solving and showed a decrease, rather than an increase, in efficiency, as they progressed through the consecutive phases of the test. The mean scores of the other tests were within the normal range. Conclusion: Our findings showed that patients affected by PG, in spite of normal intellectual, linguistic and visual-spatial abilities, had abnormalities emerging from the WCST, in particular they could not learn from their mistakes and look for alternative solutions. Our results would seem to confirm an altered functioning of the prefrontal areas which might provoke a sort of cognitive "rigidity" that might predispose to the development of impulsive and/or compulsive behaviors, such as those typical of PG. © 2008 Marazziti et al; licensee BioMed Central Ltd

Current exposure of Italian women of reproductive age to PFOS and PFOA: a human biomonitoring study

Perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) concentrations were determined in serum samples collected in 2011-2012 from 549 nulliparous Italian women of reproductive age who resided in six different Italian Regions. Assessment of exposure to perfluorinated compounds was part of a large human biomonitoring study (Project Life Plus "Womenbiopop") that aimed at examining the exposure of women of reproductive age to priority organic pollutants. The median concentrations of PFOS and PFOA were 2.43, and 1.55ngg-1, respectively. Significant differences in the concentrations of both compounds were observed among the six Regions. Women from central Italy had the highest levels of both compounds, followed by women from northern Italy, and southern Italy. No differences in the PFOS concentrations were found between women from urban/industrial areas and women from rural areas, whereas the levels of PFOA were significantly higher in women residing in urban/industrial areas than in women residing in rural areas. Taken together, the observed concentrations confirm that the overall exposure of the Italian population is among the lowest observed in industrialized countries. A downward temporal trend in exposure was observed for both compounds when comparing the results from the present study with those assessed in a study conducted in 2008

SAT0461 SHORT-TERM MONITORING OF DENOSUMAB EFFECT IN BREAST CANCER PATIENTS RECEIVING AROMATASE INHIBITORS USING REMS TECHNOLOGY ON LUMBAR SPINE

Background:Aromatase inhibitor (AI) therapy in women with estrogen receptor-positive (ER+) breast cancer (BC) causes accelerated bone loss and increased risk of osteoporosis and fractures as side effects. Denosumab (i.e. 60 mg twice a year) is a viable therapy against bone resorption, but the short-term monitoring of bone mineral density (BMD) change with time is still an unmet clinical need, since the current techniques (including dual-energy X-ray absorptiometry, DXA) require 1-2 years between two consecutive measurements [1]. Radiofrequency Echographic Multi Spectrometry (REMS), with high performance in terms of precision and repeatability [2], might be used in this setting of patients for short-term monitoring of bone health-related parameters.Objectives:The objective is the short-term monitoring of the effect of AIs with/without denosumab on bone health in BC patients using REMS and DXA scans at lumbar spine.Methods:Post-menopausal ER+ BC patients treated with adjuvant AIs were recruited. Two subgroups were identified, whether receiving also 60 mg of denosumab therapy every 6 months or not (named Group A and Group B, respectively). All patients underwent baseline DXA and REMS lumbar spine scans at time T0, previous to the first AI therapy, and after 12 months (time T1). REMS scan only was repeated also at 18 months (T2), since a 6-month interval between two consecutive scans is not recommended for DXA. The bone mineral density (BMD) was measured with both techniques.Results:Overall, 254 ER+ BC patients were enrolled (127 per group). The effect of denosumab on BMD is reported in Table. The BMD values obtained by DXA and REMS were not significantly different at T0 and T1, whereas the difference between Group A and B at T1 was statistically significant (p<0.001) both for REMS and DXA. At T2, REMS confirmed the increasing trend of BMD for Group A and the decreasing one for Group B, and the difference between groups was statistically significant (p<0.001). For each time point and each group, there were not statistically significant differences between DXA and REMS.Conclusion:Several studies have shown the effect of denosumab on BMD over a period not less than 2 years from the start of treatment. This study showed the feasibility of short-term follow-up using REMS lumbar spine scans at 6-month time steps.References:[1]Diez-Perez A et al, Aging Clin Exp Res 2019;31(10):1375–89[2]Di Paola M et al, Osteoporos Int 2018;30:391–402Table 1.BMD values, expressed as g/cm2, measured by DXA and REMS for Group A (patients receiving AIs only) and Group B (patients receiving AIs and denosumab) at baseline (T0), 12 months (T1) and 18 months (T2) from the start of therapy. Results are presented as median values with 25thand 75thpercentiles. P-values are obtained with a Mann-Whitney test.DXAREMSScan timeGroup AGroup BpGroup AGroup BpT00.840 (0.719-0.959)0.867 (0.723-0.958)0.990.833 (0.708-0.949)0.855 (0.714-0.973)0.77T10.823 (0.702-0.944)0.889 (0.749-0.990)0.0030.819 (0.691-0.927)0.887 (0.740-1.018)<0.001T2---0.801 (0.679-0.909)0.899 (0.754-1.020)<0.001Note:The authorsD. Ciardo, M. Ciccarese, F. Conversano, M. Di Paola, R. Forcignanò, A. Grimaldi, F.A. Lombardi, M. Muratore and P. Pisaniare listed in alphabetical orderDisclosure of Interests:None declare

How Covid-19 changed the epidemiology of febrile urinary tract infections in children in the emergency department during the first outbreak

Background: The first Covid-19 pandemic affected the epidemiology of several diseases. A general reduction in the emergency department (ED) accesses was observed during this period, both in adult and pediatric contexts. Methods: This retrospective study was conducted on the behalf of the Italian Society of Pediatric Nephrology (SINePe) in 17 Italian pediatric EDs in March and April 2020, comparing them with data from the same periods in 2018 and 2019. The total number of pediatric (age 0–18 years) ED visits, the number of febrile urinary tract infection (UTI) diagnoses, and clinical and laboratory parameters were retrospectively collected. Results: The total number of febrile UTI diagnoses was 339 (73 in 2020, 140 in 2019, and 126 in 2018). During the first Covid-19 pandemic, the total number of ED visits decreased by 75.1%, the total number of febrile UTI diagnoses by 45.1%, with an increase in the UTI diagnosis rate (+ 121.7%). The data collected revealed an increased rate of patients with two or more days of fever before admission (p = 0.02), a significant increase in hospitalization rate (+ 17.5%, p = 0.008) and also in values of C reactive protein (CRP) (p = 0.006). In 2020, intravenous antibiotics use was significantly higher than in 2018 and 2019 (+ 15%, p = 0.025). Urine cultures showed higher Pseudomonas aeruginosa and Enterococcus faecalis percentages and lower rates of Escherichia coli (p = 0.02). Conclusions: The first wave of the Covid-19 pandemic had an essential impact on managing febrile UTIs in the ED, causing an absolute reduction of cases referring to the ED but with higher clinical severity. Children with febrile UTI were more severely ill than the previous two years, probably due to delayed access caused by the fear of potential hospital-acquired Sars-Cov-2 infection. The possible increase in consequent kidney scarring in this population should be considered

Magnetically Shielded Miniature Hall Thruster: Design Improvement and Performance Analysis

ABSTRACT: Magnetic shielding has been shown to dramatically reduce discharge channel wall erosion of high powered Hall thrusters, thereby increasing their useful lifetimes. However, unique challenges exist for developing a low power magnetically shielded Hall thruster. A previously tested 4 cm magnetically shielded miniature Hall thruster demonstrated low performance of its magnetic circuit, resulting in an asymmetric field topology, low thrust, and low efficiency. A 6 cm magnetically shielded Hall thruster was developed to improve upon the 4 cm design. The 6 cm device, which generated a symmetric and fully shielded field topology, was tested at 30 operating conditions ranging from 160 W to nearly 750 W. Visual observation of the plasma and discharge channel during and after operation was used to assess the level of magnetic shielding that was achieved. Hall2De plasma simulations were also used to offer further evidence of magnetic shielding. Thrust stand measurements provided thrust, anode specific impulse, and anode efficiency data at each operating condition. Pole face erosion, which is believed to be associated with the 6 cm thruster&apos;s non-optimized magnetic shielding field topology and strength, identify the near-term challenges to resolve before long lifetimes and high efficiencies can be achieved in low power Hall thrusters

Neutrino Detection with Inclined Air Showers

The possibilities of detecting high energy neutrinos through inclined showers produced in the atmosphere are addressed with an emphasis on the detection of air showers by arrays of particle detectors. Rates of inclined showers produced by both down-going neutrino interactions and by up-coming $\tau$ decays from earth-skimming neutrinos as a function of shower energy are calculated with analytical methods using two sample neutrino fluxes with different spectral indices. The relative contributions from different flavors and charged, neutral current and resonant interactions are compared for down-going neutrinos interacting in the atmosphere. No detailed description of detectors is attempted but rough energy thresholds are implemented to establish the ranges of energies which are more suitable for neutrino detection through inclined showers. Down-going and up-coming rates are compared.Comment: Submitted to New Journal of Physic