Role of surgical setting and patients-related factors in predicting the occurrence of postoperative pulmonary complications after abdominal surgery

OBJECTIVE: The aim of this retrospective study was to evaluate the role of surgical setting (urgent vs. elective) and approach (open vs. laparoscopic) in affecting postoperative pulmonary complications (PPCs) prevalence in patients undergoing abdominal surgery. PATIENTS AND METHODS: After local Ethical Committee approval, 409 patients who had undergone abdominal surgery between January and December 2014 were included in the final analysis. PPCs were defined as the development of one of the following new findings: respiratory failure, pulmonary infection, aspiration pneumonia, pleural effusion, pneumothorax, atelectasis on chest X-ray, bronchospasm or un-planned urgent re-intubation. RESULTS: PPCs prevalence was greater in urgent (33%) vs. elective setting (7%) (chi(2) with Yates correction: 44; p=0.0001) and in open (6%) vs. laparoscopic approach (1.9%) (chi(2) with Yates correction: 12; p=0.0006). PPCs occurrence was positively correlated with in-hospital mortality (Biserial Correlation r=0.37; p=0.0001). Logistic regression showed that urgent setting (p=0.000), Ariscat (Assess Respiratory Risk in Surgical Patients in Catalonia) score (p=0.004), and age (p=0.01) were predictors of PPCs. A cutoff of 23 for Ariscat score was also identified as determining factor for PPCs occurrence with 94% sensitivity and 29% specificity. CONCLUSIONS: Patients undergoing abdominal surgery in an urgent setting were exposed to a higher risk of PPCs compared to patients scheduled for elective procedures. Ariscat score fitted with PPCs prevalence and older patients were exposed to a higher risk of PPCs. Prospective studies are needed to confirm these result

The VOICE Survey : VST Optical Imaging of the CDFS and ES1 Fields

Indexación: Scopus.We present the VST Optical Imaging of the CDFS and ES1 Fields (VOICE) Survey, a VST INAF Guaranteed Time program designed to provide optical coverage of two 4 deg2 cosmic windows in the Southern hemisphere. VOICE provides the first, multi-band deep optical imaging of these sky regions, thus complementing and enhancing the rich legacy of longer-wavelength surveys with VISTA, Spitzer, Herschel and ATCA available in these areas and paving the way for upcoming observations with facilities such as the LSST, MeerKAT and the SKA. VOICE exploits VST's OmegaCAM optical imaging capabilities and completes the reduction of WFI data available within the ES1 fields as part of the ESO-Spitzer Imaging Extragalactic Survey (ESIS) program providing ugri and uBVR coverage of 4 and 4 deg2 areas within the CDFS and ES1 field respectively. We present the survey's science rationale and observing strategy, the data reduction and multi-wavelength data fusion pipeline. Survey data products and their future updates will be released at http://www.mattiavaccari.net/voice/ and on CDS/VizieR.https://pos.sissa.it/275/026/pd

The path from trigeminal asymmetry to cognitive impairment: a behavioral and molecular study

Trigeminal input exerts acute and chronic effects on the brain, modulating cognitive functions. Here, new data from humans and animals suggest that these effects are caused by trigeminal influences on the Locus Coeruleus (LC). In humans subjects clenching with masseter asymmetric activity, occlusal correction improved cognition, alongside with reductions in pupil size and anisocoria, proxies of LC activity and asymmetry, respectively. Notably, reductions in pupil size at rest on the hypertonic side predicted cognitive improvements. In adult rats, a distal unilateral section of the trigeminal mandibular branch reduced, on the contralateral side, the expression of c-Fos (brainstem) and BDNF (brainstem, hippocampus, frontal cortex). This counterintuitive finding can be explained by the following model: teeth contact perception loss on the lesioned side results in an increased occlusal effort, which enhances afferent inputs from muscle spindles and posterior periodontal receptors, spared by the distal lesion. Such effort leads to a reduced engagement of the intact side, with a corresponding reduction in the afferent inputs to the LC and in c-Fos and BDNF gene expression. In conclusion, acute effects of malocclusion on performance seem mediated by the LC, which could also contribute to the chronic trophic dysfunction induced by loss of trigeminal input

SUDARE-VOICE variability-selection of Active Galaxies in the Chandra Deep Field South and the SERVS/SWIRE region

One of the most peculiar characteristics of Active Galactic Nuclei (AGN) is their variability over all wavelengths. This property has been used in the past to select AGN samples and is foreseen to be one of the detection techniques applied in future multi-epoch surveys, complementing photometric and spectroscopic methods. In this paper, we aim to construct and characterise an AGN sample using a multi-epoch dataset in the r band from the SUDARE-VOICE survey. Our work makes use of the VST monitoring program of an area surrounding the Chandra Deep Field South to select variable sources. We use data spanning a six month period over an area of 2 square degrees, to identify AGN based on their photometric variability. The selected sample includes 175 AGN candidates with magnitude r < 23 mag. We distinguish different classes of variable sources through their lightcurves, as well as X-ray, spectroscopic, SED, optical and IR information overlapping with our survey. We find that 12% of the sample (21/175) is represented by SN. Of the remaining sources, 4% (6/154) are stars, while 66% (102/154) are likely AGNs based on the available diagnostics. We estimate an upper limit to the contamination of the variability selected AGN sample of about 34%, but we point out that restricting the analysis to the sources with available multi-wavelength ancillary information, the purity of our sample is close to 80% (102 AGN out of 128 non-SN sources with multi-wavelength diagnostics). Our work thus confirms the efficiency of the variability selection method in agreement with our previous work on the COSMOS field; in addition we show that the variability approach is roughly consistent with the infrared selection.Comment: Published in A & A, 15 pages, 6 figure

Isotopic reconstruction of the subsistence strategy for a Central Italian Bronze Age community (Pastena cave, 2nd millennium BCE)

The Pastena cave is located in central Italy, and its best-preserved sector is Grotticella W2, which is dated radiometrically to the Early-Middle Bronze Age. The aim of this paper is to explore human diet, animal husbandry, and plant management, analysing the fndings there discovered. Carbon and nitrogen stable isotope analysis was carried out on 40 charred seeds, six faunal remains, and four human individuals, investigating the whole bio-archaeological material available. To the best of our knowledge, this is one of the frst papers presenting stable isotope analysis on carpological remains dated to the Italian Early-Middle Bronze Age. The obtained results are consistent with a diet based on terrestrial protein, mainly on plants, and secondly on animal products. The data suggest that plants, especially broad beans, were partially subjected to human management, while livestock was managed through diferent husbandry strategies. The cooperation between archaeological studies and molecular analysis allows us to contribute to clarifying the economic strategies for a Central Italian community in a scenario that is still poor in published data

Supernova rates from the SUDARE VST-Omegacam search II. Rates in a galaxy sample

This is the second paper of a series in which we present measurements of the Supernova (SN) rates from the SUDARE survey. In this paper, we study the trend of the SN rates with the intrinsic colours, the star formation activity and the mass of the parent galaxies. We have considered a sample of about 130000 galaxies and a SN sample of about 50 events. We found that the SN Ia rate per unit mass is higher by a factor of six in the star-forming galaxies with respect to the passive galaxies. The SN Ia rate per unit mass is also higher in the less massive galaxies that are also younger. These results suggest a distribution of the delay times (DTD) less populated at long delay times than at short delays. The CC SN rate per unit mass is proportional to both the sSFR and the galaxy mass. The trends of the Type Ia and CC SN rates as a function of the sSFR and the galaxy mass that we observed from SUDARE data are in agreement with literature results at different redshifts. The expected number of SNe Ia is in agreement with the observed one for all four DTD models considered both in passive and star-forming galaxies so we can not discriminate between different progenitor scenarios. The expected number of CC SNe is higher than the observed one, suggesting a higher limit for the minimum progenitor mass. We also compare the expected and observed trends of the SN Ia rate with the intrinsic U - J colour of the parent galaxy, assumed as a tracer of the age distribution. While the slope of the relation between the SN Ia rate and the U - J color in star-forming galaxies can be reproduced well by all four DTD models considered, only the steepest of them is able to account for the rates and colour in star-forming and passive galaxies with the same value of the SN Ia production efficiency.Comment: A& A accepte

Global phase time and path integral for the Kantowski--Sachs anisotropic univers

The action functional of the anisotropic Kantowski--Sachs cosmological model is turned into that of an ordinary gauge system. Then a global phase time is identified for the model by imposing canonical gauge conditions, and the quantum transition amplitude is obtained by means of the usual path integral procedure of Fadeev and Popov.Comment: 11 page

Optically variable active galactic nuclei in the 3 yr VST survey of the COSMOS field

The analysis of the variability of active galactic nuclei (AGNs) at different wavelengths and the study of possible correlations among different spectral windows are nowadays a major field of inquiry. Optical variability has been largely used to identify AGNs in multivisit surveys. The strength of a selection based on optical variability lies in the chance to analyze data from surveys of large sky areas by ground-based telescopes. However the effectiveness of optical variability selection, with respect to other multiwavelength techniques, has been poorly studied down to the depth expected from next generation surveys. Here we present the results of our r-band analysis of a sample of 299 optically variable AGN candidates in the VST survey of the COSMOS field, counting 54 visits spread over three observing seasons spanning > 3 yr. This dataset is > 3 times larger in size than the one presented in our previous analysis (De Cicco et al. 2015), and the observing baseline is ~8 times longer. We push towards deeper magnitudes (r(AB) ~23.5 mag) compared to past studies; we make wide use of ancillary multiwavelength catalogs in order to confirm the nature of our AGN candidates, and constrain the accuracy of the method based on spectroscopic and photometric diagnostics. We also perform tests aimed at assessing the relevance of dense sampling in view of future wide-field surveys. We demonstrate that the method allows the selection of high-purity (> 86%) samples. We take advantage of the longer observing baseline to achieve great improvement in the completeness of our sample with respect to X-ray and spectroscopically confirmed samples of AGNs (59%, vs. ~15% in our previous work), as well as in the completeness of unobscured and obscured AGNs. The effectiveness of the method confirms the importance to develop future, more refined techniques for the automated analysis of larger datasets.Comment: 21 pages, 10 figures; accepted for publication in A&

Vitamin D deficiency and tumor aggressiveness in gastroenteropancreatic neuroendocrine tumors

Purpose: Data regarding vitamin D status in patients affected by gastroenteropancreatic (GEP) neuroendocrine tumor (NET) are limited and often showing contrasting results. The aim of the study was to evaluate the incidence of vitamin D deficiency (<20 ng/mL) in GEP-NET patients and compare the 25-hydroxyvitamin D (25(OH)D) levels with clinicopathological parameters and clinical outcome. Methods: A retrospective cross-sectional study including 75 low grade (G1-G2) GEP-NETs and 123 healthy controls matched for age, sex, and body mass index, was performed. Results: GEP-NET patients had significantly lower 25(OH)D levels compared to controls (17.9 ± 7.8 vs 24.2 ± 7.7 ng/mL, p < 0.0001). Ileal NETs were associated to lower 25(OH)D levels compared to other primary tumor sites (p = 0.049) and small bowel resection posed a significant increased risk of severe vitamin D deficiency (OR = 2.81, 95% CI = 1.25–3.37, p = 0.018). No correlation with somatostatin analogs treatment was found. 25(OH)D levels were significantly lower in G2 compared to G1 GEP-NETs (15.6 ± 7.8 vs 19.9 ± 7.4 ng/mL, p = 0.016) and in patients with progressive disease (12.6 ± 5.7 ng/mL) compared to those with stable disease (mean 21.5 ± 8.2 ng/mL, p = 0.001) or tumor free after surgery (19.6 ± 7.3 ng/mL, p = 0.002). Patients with vitamin D deficiency and insufficiency had shorter progression-free survival compared to those with sufficiency (p = 0.014), whereas no correlation was found with disease-specific survival. Conclusions: Vitamin D deficiency is highly prevalent among GEP-NETs and could be associated with high tumor grade and disease progression. Therefore, the monitoring of 25(OH)D levels is relevant in these patients and vitamin D supplementation should be considered in the management of GEP-NET patients with vitamin D deficiency or insufficiency