Cardiac output: A central issue in patients with respiratory extracorporeal support

The iLA-activve® Novalung is a new extracorporeal device specifically designed for lung support in patients with hypercapnic and/or hypoxemic respiratory failure. To date, only low-flow applications for decompensated hypercapnic chronic obstructive pulmonary disease have been reported in the literature. Here, we briefly report three cases of iLA-activve use in patients with hypercapnic-hypoxemic acute lung failure assisted with mid-flow (up to 2.4 L/min) and different single/double venous cannulation. The main findings of our small case series were: firstly, extracorporeal blood flows over 2.0 L/min across the membrane provided clinically satisfying decarboxylation and improved oxygenation; secondly, the ratio between blood flow through the membrane and the patient's cardiac output (CO) was a major determinant for the oxygen increase. The latter could, therefore, be a useful indicator for understanding performance in the complex and multifactorial evaluation of patients with extracorporeal veno-venous lung support

Impact on Glucose Homeostasis: Is Food Biofortified with Molybdenum a Workable Solution? A Two-Arm Study

Diabetes is expected to increase up to 700 million people worldwide with type 2 diabetes being the most frequent. The use of nutritional interventions is one of the most natural approaches for managing the disease. Minerals are of paramount importance in order to preserve and obtain good health and among them molybdenum is an essential component. There are no studies about the consumption of biofortified food with molybdenum on glucose homeostasis but recent studies in humans suggest that molybdenum could exert hypoglycemic effects. The present study aims to assess if consumption of lettuce biofortified with molybdenum influences glucose homeostasis and whether the effects would be due to changes in gastrointestinal hormone levels and specifically Peptide YY (PYY), Glucagon-Like Peptide 1 (GLP-1), Glucagon-Like Peptide 2 (GLP-2), and Gastric Inhibitory Polypeptide (GIP). A cohort of 24 people was supplemented with biofortified lettuce for 12 days. Blood and urine samples were obtained at baseline (T0) and after 12 days (T2) of supplementation. Blood was analyzed for glucose, insulin, insulin resistance, β-cell function, and insulin sensitivity, PYY, GLP-1, GLP-2 and GIP. Urine samples were tested for molybdenum concentration. The results showed that consumption of lettuce biofortified with molybdenum for 12 days did not affect beta cell function but significantly reduced fasting glucose, insulin, insulin resistance and increased insulin sensitivity in healthy people. Consumption of biofortified lettuce did not show any modification in urine concentration of molybdenum among the groups. These data suggest that consumption of lettuce biofortified with molybdenum improves glucose homeostasis and PYY and GIP are involved in the action mechanism

Biofortification: Effect of Iodine Fortified Food in the Healthy Population, Double-Arm Nutritional Study

It is estimated that one-third of the world’s population lives in areas where iodine (I) is scarce and its deficiency is responsible for many related disorders, such as goiter, reproductive failure, hearing loss, growth impairment, congenital I deficiency syndrome, and numerous kinds of brain injury. Mineral deficiencies can be overcome via dietary diversification and mineral supplementation. An alternative or even complementary way is represented by the intake of biofortified foods, which can tackle this lack of micronutrients. In this short-term double-arm nutritional intervention study, a cohort of ten people was supplemented with curly endive leaf biofortified with I and ten people with curly endive without biofortification (Intervention Study on Iodine Biofortification Vegetables (Nutri-I-Food – Full-Text View - ClinicalTrials.gov). The effects on whole-body homeostasis and specifically on I, glucose, lipid, and hepatic, iron metabolism was investigated. Blood samples were obtained at baseline and after 12 days of supplementation with curly endive and compared with controls. Hematochemical and urinary parameters were analyzed at baseline and after 12 days. The results showed that short-term I curly endive intervention did not affect the whole body homeostasis in healthy people and revealed an increase in I concentration in urine samples and an increase in vitamin D, calcium, and potassium concentration in blood samples only in the biofortified cohort respect to controls. This study suggests that short-term consumption of I curly endive crops is safe and could positively impact body health

Fournier's gangrene and intravenous drug abuse. An unusual case report and review of the literature

Fournier's gangrene is a potentially fatal emergency condition characterized by necrotizing fasciitis and supported by an infection of the external genital, perineal and perianal region, with a rapid and progressive spread from subcutaneous fat tissue to fascial planes.In this case report, a 52-year-old man, with a history of hepatitis C-virus (HCV)-related chronic liver disease and cocaine use disorder for which he was receiving methadone maintenance therapy, was admitted to the Emergency Department with necrotic tissue involving the external genitalia.Fournier's gangrene is usually due to compromised host immunity, without a precise cause of bacterial infection; here it is linked to a loco-regional intravenous injection of cocaine. A multimodal approach, including a wide surgical debridement and a postponed skin graft, was needed. Here we report this case, with a narrative review of the literature

Dual-readout Calorimetry

The RD52 Project at CERN is a pure instrumentation experiment whose goal is to understand the fundamental limitations to hadronic energy resolution, and other aspects of energy measurement, in high energy calorimeters. We have found that dual-readout calorimetry provides heretofore unprecedented information event-by-event for energy resolution, linearity of response, ease and robustness of calibration, fidelity of data, and particle identification, including energy lost to binding energy in nuclear break-up. We believe that hadronic energy resolutions of {\sigma}/E $\approx$ 1 - 2% are within reach for dual-readout calorimeters, enabling for the first time comparable measurement preci- sions on electrons, photons, muons, and quarks (jets). We briefly describe our current progress and near-term future plans. Complete information on all aspects of our work is available at the RD52 website http://highenergy.phys.ttu.edu/dream/.Comment: 10 pages, 10 figures, Snowmass White pape

Microenvironment expression in diffuse large B-cell lymphomas

Diffuse large B-cell lymphoma (DLBCL), the most common type of non-Hodgkin lymphoma, is recognized as a heterogeneous disease with distinct molecular subtypes derived from different stages of B-cell differentiation. The contribution of the tumor microenvironment to the pathogenesis and tumor survival of DLBCL is poorly understood. However, several recent studies have yielded intriguing findings and shed some light on the possible roles of the microenvironment. In this retrospective study, data from 29 patients diagnosed with DLBCL between 2009 and 2013 were reviewed. All patients had pathologically confirmed DLBCL and had been treated with the R-CHOP regimen. In these patients, we correlated the expression of CD3 staining for T cells, tryptase staining for mast cells, CD68 for tumor-associated macrophages (TAMs), and CD31 staining for blood vessels. CD68 and tryptase expression, as well as MVD, were increased in chemo-resistant patients compared to chemosensitive patients. Tryptase expression showed a positive correlation with MVD, supporting a role for mast cells in DLBCL tumor angiogenesis, while the CD68 correlation with MVD was not significant, indicating a different role for TAMs rather than angiogenesis in DLBCL. A statistically significant difference was observed in the expression of CD3 in patients with bulky disease. Specifically, a higher expression of CD3 was observed in nonbulky disease patients (mean expression 52.91%, n = 20) compared to bulky disease patients (mean expression 34.9%, n = 9), P value < .05. The reduction in T cells in bulky disease patients contributes to loosen the immune control over the tumor, resulting in an increased cell proliferation, leading to large tumor cell masses, which are predictive of poor prognostic and clinical outcomes. CD3 showed a positive correlation with tryptase and MVD, while multiple regression analysis efficaciously predicted MVD depending on CD3 and tryptase as predictors, supporting a complex interplay between these cells in sustaining tumor angiogenesis in DLBCL patients. The improved understanding of tumor biology and of the role of the tumor microenvironment has led to advances in the diagnosis, classification, prognostics, as well as novel treatments of patients with hematologic malignancies. In particular, translational research, leading to drugs that target the interaction between the tumor microenvironment and malignant cells, has provided many promising new approaches to cancer therapy. Ongoing dynamic and correlation studies of tumor biology and the contribution of the tumor microenvironment should be promoted in the context of novel drug development in order to identify optimal therapies for various lymphomas and improve the curability of these diseases

MULTIDISCIPLINARY STUDY OF SUBSIDENCE AND SINKHOLE OCCURRENCES IN THE ACQUE ALBULE BASIN (ROMA, ITALY)

Abstract We present the results of a combined analysis of remote sensing and geophysical‐geotechnical data carried out in the Acque Albule Basin, a sinkhole prone area located close to the city of Roma, where a wide travertine wedge is present. We carried out geophysical measurements and borehole drillings over two test areas to image the subsoil where paroxysmal surficial dynamics occur. One site is marked by subsidence occurring at least since the early 2000s, whereas the other site hosts the "La Regina" and "Colonnelle" sinkhole lakes, which discharge sulfur‐carbonated waters. The stability of these two sites threatens highway, railway, and airport facilities, and this study helps to assess the geological hazard. For example, InSAR and LiDAR data helped define wide scale subsidence over the last 20 years and previously undetected small‐scale morphologies. Geophysical measurements of the latter revealed shallow and deep dissolution affecting the travertine and driving surficial paroxysmal events. Both study sites were found to lie inside a large depression located at the junction between Jurassic carbonate and Plio‐Pleistocene units in association with paleo karst morphologies in the travertine deposits and affected by the present‐past spillage of sulfurous waters. Given these elements, multidisciplinary geophysical observations are crucial for assessing and mitigating the geological risk and guiding land use planning and management

Nomenclature for renal replacement therapy and blood purification techniques in critically ill patients: practical applications

This article reports the conclusions of the second part of a consensus expert conference on the nomenclature of renal replacement therapy (RRT) techniques currently utilized to manage acute kidney injury and other organ dysfunction syndromes in critically ill patients. A multidisciplinary approach was taken to achieve harmonization of definitions, components, techniques, and operations of the extracorporeal therapies. The article describes the RRT techniques in detail with the relevant technology, procedures, and phases of treatment and key aspects of volume management/fluid balance in critically ill patients. In addition, the article describes recent developments in other extracorporeal therapies, including therapeutic plasma exchange, multiple organ support therapy, liver support, lung support, and blood purification in sepsis. This is a consensus report on nomenclature harmonization in extracorporeal blood purification therapies, such as hemofiltration, plasma exchange, multiple organ support therapies, and blood purification in sepsis