Mapping and monitoring geomorphological processes in mountainous areas using PSI data: Central Pyrenees case study

In this paper the Stable Point Network technique, an established Persistent Scatterer InSAR (PSI) technique, (SPN), has been applied for the first time to the analysis of several geomorphological processes present in the Gállego river basin (Central Pyrenees, Spain). The SPN coherence based approach has been used to process three different SAR images datasets covering two temporal periods: 1995 to 2001 and 2001 to 2007. This approach has permitted the detection of more than 40 000 natural ground targets or Persistent Scatterers (PSs) in the study area, characterised by the presence of vegetation and a low urban density. Derived displacement maps have permitted the detection and monitoring of deformations in landslides, alluvial fans and erosive areas. In the first section, the study area is introduced. Then the specifics of the SPN processing are presented. The deformation results estimated with the SPN technique for the different processed datasets are compared and analysed with previous available geo-information. Then several detailed studies are presented to illustrate the processes detected by the satellite based analysis. In addition, a comparison between the performance of ERS and ENVISAT satellites with terrestrial SAR has demonstrates that these are complementary techniques, which can be integrated in order to monitor deformation processes, like landslides, that over the same monitoring area may show very different ranges of movement. The most relevant conclusions of this work are finally discussed

Compressional and Shear Waves Tests Through Upper Sheet of Low Angle Thrust Fault

Compressional and shear wave tests were conducted on the upper thrust sheet of the low angle Little Salmon thrust fault. The study was conducted on the campus of the College of the Redwoods. The campus is located approximately 8 miles south of Eureka and 24 miles north-northeast of Cape Mendocino and the Mendocino Triple Junction (MTJ) in Northern California. The MTJ is the point of transition from strike-slip faulting of the San Andreas transform system to low-angle reverse (thrust) faulting and folding associated with the convergent margin of the Cascadia Subduction Zone. The campus is located on the southwest limb of the Humboldt Hill anticline, one of the folds in the fold and thrust belt. The Little Salmon fault zone is a low angle thrust fault that day lights on the south side of the campus and then projects underneath striking northwest and dipping northeast. A boring was drilled down to the fault plane located at a depth of 200 ft. in the upper thrust block to develop a mode1 of the stratification as well as the material properties. The boring also revealed the trunk of a redwood tree located at a depth of 180 feet. Results of compressional and shear wave velocities as a function of depth that were determined using an downhole geophysical technique. Results indicated two shear wave velocity units. Unit 1 was from 0 to 120 ft. with a shear wave velocity ranging from 950- 1400 fps. Unit 2 ranged from 120 to 190 ft. with a shear wave velocity ranging from 2300 to 2600 fps. Compression wave velocity measurements obtained from the same test boring also depict a change in velocity in the 100 to 120 foot range. A response spectra was generated based on this in-situ mode1 using SHARE91 and compared against one developed using the Boore, Joyner and Fumal empirical model

Ground deformation detection of the greater area of Thessaloniki (Northern Greece) using radar interferometry techniques

In the present study SAR interferometric techniques (stacking of conventional interferograms and Permanent Scatterers), using images from satellites ERS-1 and 2, have been applied to the region of Thessaloniki (northern Greece). The period covered by the images is 1992–2000. Both techniques gave good quantitative and qualitative results. The interferometric products were used to study ground surface deformation phenomena that could be related to the local tectonic context, the exploitation of underground water and sediments compaction. <br><br> The city of Thessaloniki shows relatively stable ground conditions. Subsidence in four locations, mainly in the area surrounding the city of Thessaloniki, has been detected and assessed. Two of the sites (Sindos-Kalochori and Langadhas) were already known from previous studies as subsiding areas, using ground base measurements. On the contrary the other two sites in the northern suburbs of Thessaloniki (Oreokastro) and in the south-east (airport area) were unknown as areas of subsidence. A further investigation based on fieldwork is needed in these two areas. Finally, an attempt to interpret the observed deformation, according to the geological regime of the area and its anthropogenic activities, has been carried out

Characteristics and outcome of patients with newly diagnosed advanced or metastatic lung cancer admitted to intensive care units (ICUs)

BACKGROUND: Although patients with advanced or metastatic lung cancer have poor prognosis, admission to the ICU for management of life-threatening complications has increased over the years. Patients with newly diagnosed lung cancer appear as good candidates for ICU admission, but more robust information to assist decisions is lacking. The aim of our study was to evaluate the prognosis of newly diagnosed unresectable lung cancer patients. METHODS: A retrospective multicentric study analyzed the outcome of patients admitted to the ICU with a newly diagnosed lung cancer (diagnosis within the month) between 2010 and 2013. RESULTS: Out of the 100 patients, 30 had small cell lung cancer (SCLC) and 70 had non-small cell lung cancer. (Thirty patients had already been treated with oncologic treatments.) Mechanical ventilation (MV) was performed for 81 patients. Seventeen patients received emergency chemotherapy during their ICU stay. ICU, hospital, 3- and 6-month mortality were, respectively, 47, 60, 67 and 71%. Hospital mortality was 60% when invasive MV was used alone, 71% when MV and vasopressors were needed and 83% when MV, vasopressors and hemodialysis were required. In multivariate analysis, hospital mortality was associated with metastatic disease (OR 4.22 [1.4-12.4]; p = 0.008), need for invasive MV (OR 4.20 [1.11-16.2]; p = 0.030), while chemotherapy in ICU was associated with survival (OR 0.23, [0.07-0.81]; p = 0.020). CONCLUSION: This study shows that ICU management can be appropriate for selected newly diagnosed patients with advanced lung cancer, and chemotherapy might improve outcome for patients with SCLC admitted for cancer-related complications. Nevertheless, tumors' characteristics, numbers and types of organ dysfunction should be taken into account in the decisional process before admitting these patients in ICU.Peer reviewe

Reduced innate immune response to a Staphylococcus aureus small colony variant compared to its wild-type parent strain

Background: Staphylococcus aureus (S. aureus) small colony variants (SCVs) can survive within the host intracellular milieu and are associated with chronic relapsing infections. However, it is unknown whether host invasion rates and immune responses differ between SCVs and their wild-type counterparts. This study used a stable S. aureus SCV (WCH-SK2SCV) developed from a clinical isolate (WCH-SK2WT) in inflammation-relevant conditions. Intracellular infection rates as well as host immune responses to WCH-SK2WT and WCH-SK2SCV infections were investigated. Method: NuLi-1 cells were infected with either WCH-SK2WT or WCH-SK2SCV, and the intracellular infection rate was determined over time. mRNA expression of cells infected with each strain intra- and extra-cellularly was analyzed using a microfluidic qPCR array to generate an expression profile of thirty-nine genes involved in the host immune response. Results: No difference was found in the intracellular infection rate between WCH-SK2WT and WCH-SK2SCV. Whereas, extracellular infection induced a robust pro-inflammatory response, intracellular infection elicited a modest response. Intracellular WCH-SK2WT infection induced mRNA expression of TLR2, pro-inflammatory cytokines (IL1B, IL6, and IL12) and tissue remodeling factors (MMP9). In contrast, intracellular WCH-SK2SCV infection induced up regulation of only TLR2. Conclusions: Whereas, host intracellular infection rates of WCH-SK2SCV and WCH-SK2WT were similar, WCH-SK2SCV intracellular infection induced a less widespread up regulation of pro-inflammatory and tissue remodeling factors in comparison to intracellular WCH-SK2WT infection. These findings support the current view that SCVs are able to evade host immune detection to allow their own survival.Judy J.J. Ou, Amanda J. Drilling, Clare Cooksley, Ahmed Bassiouni, Stephen P. Kidd, Alkis J. Psaltis, Peter J. Wormald and Sarah Vreugd

Post-operative critical care management of patients undergoing cytoreductive surgery and heated intraperitoneal chemotherapy (HIPEC)

<p>Abstract</p> <p>Background</p> <p>Cytoreductive surgery (CRS) and Heated Intraperitoneal Chemotherapy (HIPEC) results in a number of physiological changes with effects on the cardiovascular system, oxygen consumption and coagulation. The Critical Care interventions required by this cohort of patients have not yet been quantified.</p> <p>Methods</p> <p>This retrospective audit examines the experience of a Specialist Tertiary Centre in England over an 18 month period (January 2009-June 2010) during which 69 patients underwent CRS and HIPEC. All patients were extubated in the operating theatre and transferred to the Critical Care Unit (CCU) for initial post-operative management.</p> <p>Results</p> <p>Patients needed to remain on the CCU for 2.4 days (0.8-7.8). There were no 30 day mortalities. The majority of patients (70.1%) did not require post-operative organ support. 2 patients who developed pneumonia post-operatively required respiratory support. 18 (26.1%) patients required vasopressor support with norepinephrine with a mean duration of 13.94 hours (5-51 hours) and mean dose of 0.04 mcg/kg/min. Post-operative coagulopathy peaked at 24 hours. A significant drop in serum albumin was observed.</p> <p>Conclusion</p> <p>The degree of organ support required post-operatively is minimal. Early extubation is efficacious with the aid of epidural analgesia. Critical Care monitoring for 48 hours is desirable in view of the post-operative challenges.</p

Staphylococcus aureus biofilm properties and chronic rhinosinusitis severity scores correlate positively with total CD4+ T-cell frequencies and inversely with its Th1, Th17 and regulatory cell frequencies.

OnlinePublChronic rhinosinusitis (CRS) represents chronic inflammation of the sinus mucosa characterised by dysfunction of the sinuses' natural defence mechanisms and induction of different inflammatory pathways ranging from a Th1 to a Th2 predominant polarisation. Recalcitrant CRS is associated with Staphylococcus aureus dominant mucosal biofilms; however, S. aureus colonisation of the sinonasal mucosa has also been observed in healthy individuals challenging the significance of S. aureus in CRS pathogenesis. We aimed to investigate the relationship between CRS key inflammatory markers, S. aureus biofilm properties/virulence genes and the severity of the disease. Tissue samples were collected during endoscopic sinus surgery from the ethmoid sinuses of CRS patients with (CRSwNP) and without (CRSsNP) nasal polyps and controls (n = 59). CD3+ T-cell subset frequencies and key inflammatory markers of CD4+ helper T cells were determined using FACS analysis. Sinonasal S. aureus clinical isolates were isolated (n = 26), sequenced and grown into biofilm in vitro, followed by determining their properties, including metabolic activity, biomass, colony-forming units and exoprotein production. Disease severity was assessed using Lund-Mackay radiologic scores, Lund-Kennedy endoscopic scores and SNOT22 quality of life scores. Our results showed that S. aureus biofilm properties and CRS severity scores correlated positively with total CD4+ T-cell frequencies but looking into CD4+ T-cell subsets showed an inverse correlation with Th1 and Th17 cell frequencies. CD4+ T-cell frequencies were higher in patients harbouring lukF.PV-positive S. aureus while its regulatory and Th17 cell subset frequencies were lower in patients carrying sea- and sarT/U-positive S. aureus. Recalcitrant CRS is characterised by increased S. aureus biofilm properties in relation to increased total CD4+ helper T-cell frequencies and reduced frequencies of its Th1, Th17 and regulatory T-cell subsets. These findings offer insights into the pathophysiology of CRS and could lead to the development of more targeted therapies.Gohar Shaghayegh, Clare Cooksley, George Bouras, Roshan Nepal, Ghais Houtak, Beula Subashini Panchatcharam, Kevin Aaron Fenix, Alkis James Psaltis, Peter-John Wormald, Sarah Vreugd

Prevention of adhesions post-abdominal surgery: Assessing the safety and efficacy of Chitogel with Deferiprone in a rat model

Introduction: Adhesions are often considered to be an inevitable consequence of abdominal and pelvic surgery, jeopardizing the medium and long-term success of these procedures. Numerous strategies have been tested to reduce adhesion formation, however, to date, no surgical or medical therapeutic approaches have been successful in its prevention. This study demonstrates the safety and efficacy of Chitogel with Deferiprone and/or antibacterial Gallium Protoporphyrin in different concentrations in preventing adhesion formation after abdominal surgery. Materials and Methods: DS: 112 adult (8-10 week old) male Wistar albino rats were subjected to midline laparotomy and caecal abrasion, with 48 rats having an additional enterotomy and suturing. Kaolin (0.005g/ml) was applied to further accelerate adhesion formation. The abrasion model rats were randomized to receive saline, Chitogel, or Chitogel plus Deferiprone (5, 10 or 20 mM), together with Gallium Protoporphyrin (250μg/mL). The abrasion with enterotomy rats were randomised to receive saline, Chitogel or Chitogel with Deferiprone (1 or 5 mM). At day 21, rats were euthanised, and adhesions graded macroscopically and microscopically; the tensile strength of the repaired caecum was determined by an investigator blinded to the treatment groups. Results: Chitogel with Deferiprone 5 mM significantly reduced adhesion formation (p<0.01) when pathologically assessed in a rat abrasion model. Chitogel with Deferiprone 5 mM and 1 mM also significantly reduced adhesions (p<0.05) after abrasion with enterotomy. Def-Chitogel 1mM treatment did not weaken the enterotomy site with treated sites having significantly better tensile strength compared to control saline treated enterotomy rats. Conclusions: Chitogel with Deferiprone 1 mM constitutes an effective preventative anti-adhesion barrier after abdominal surgery in a rat model. Moreover, this therapeutic combination of agents is safe and does not weaken the healing of the sutured enterotomy site.Rajan Sundaresan Vediappan, Catherine Bennett, Clare Cooksley, John Finnie, Markus Trochsler, Ryan D. Quarrington, Claire F. Jones, Ahmed Bassiouni, Stephen Moratti, Alkis J. Psaltis, Guy Maddern, Sarah Vreugde, P.J. Wormal

Acute management of the endocrine complications of checkpoint inhibitor therapy

Immunotherapy treatment with checkpoint inhibitors (CPI) (CTLA-4 and PD-1 inhibitors) significantly improves survival in a number of cancers. Treatment can be limited by immune-mediated adverse effects including endocrinopathies such as hypophysitis, adrenalitis, thyroiditis and diabetes mellitus. If endocrinopathies (particularly hypocortisolemia) are not recognized early, they can be fatal. The diagnosis and management of endocrinopathies can be complicated by simultaneous multi-organ immune adverse effects. Here, we present Endocrine Emergency Guidance for the acute management of the endocrine complications of checkpoint inhibitor therapy, the first specialty-specific guidance with Endocrinology, Oncology and Acute Medicine input and endorsed by the Society for Endocrinology Clinical Committee. We present algorithms for management: endocrine assessment and management of patients in the first 24 hours who present life-threateningly unwell (CTCAE grade 3–4) and the appropriate management of mild-moderately unwell patients (CTCAE grade 1–2) presenting with features compatible with an endocrinopathy. Other important considerations in relation to hypohysitis and the maintenance of glucocorticoid therapy are discussed

Peg-interferon lambda treatment induces robust innate and adaptive immunity in chronic hepatitis B patients

IFN-lambda (IFNλ) is a member of the type III IFN family and is reported to possess anti-pathogen, anti-cancer, and immunomodulatory properties; however, there are limited data regarding its impact on host immune responses in vivo. We performed longitudinal and comprehensive immunosurveillance to assess the ability of pegylated (peg)-IFNλ to augment antiviral host immunity as part of a clinical trial assessing the efficacy of peg-IFNλ in chronic hepatitis B (CHB) patients. These patients were pretreated with directly acting antiviral therapy (entecavir) for 12 weeks with subsequent addition of peg-IFNλ for up to 32 weeks. In a subgroup of patients, the addition of peg-IFNλ provoked high serum levels of antiviral cytokine IL-18. We also observed the enhancement of natural killer cell polyfunctionality and the recovery of a pan-genotypic HBV-specific CD4+ T cells producing IFN-γ with maintenance of HBV-specific CD8+ T cell antiviral and cytotoxic activities. It was only in these patients that we observed strong virological control with reductions in both viral replication and HBV antigen levels. Here, we show for the first time that in vivo peg-IFNλ displays significant immunostimulatory properties with improvements in the main effectors mediating anti-HBV immunity. Interestingly, the maintenance in HBV-specific CD8+ T cells in the presence of peg-IFNλ is in contrast to previous studies showing that peg-IFNa treatment for CHB results in a detrimental effect on the functionality of this important antiviral T cell compartment