SH-wave reflection seismic survey at the Patigno landslide: integration with a previously acquired P-wave seismic profile

Seismic investigation on landslide is hampered by several factors that could prevent the use of the reflection seismic method to characterize the subsurface architecture (Jongmans and Garambois, 2007). Moreover, acquisition and processing of reflection seismic data are more time consuming compared with other geophysical techniques such as refraction seismic and electrical resistivity tomography (ERT), leading inevitably to higher costs. Notwithstanding these difficulties, recently some attempts to delineate the deep slip surface of large landslides have been carried out using P-wave reflection seismic surveys (Apuani et al., 2012; Stucchi and Mazzotti, 2009; Stucchi et al., 2014;). P-wave reflection seismic method is effective in imaging the slip surface at a depth sufficiently greater than the seismic wavelength, whereas, for very shallow horizons, it suffers from the limited resolution that can be obtained by the use of compressional waves. In this regards, SH-waves can be used to overcome this limitation (Deidda and Balia, 2001; Guy, 2006; Pugin et al., 2006,), but they require a specifically-designed energy source for waves generation, geophones measuring horizontal components of particles motion and an accurate choice of acquisition parameters. On the contrary, due to attenuation, the depth of investigation for SHwaves can be lower than for P-waves (Pugin et al., 2006). Therefore the geological understanding of a mass movement can take advantage of a combined use of both these geophysical methodologies. This is the case of the Patigno landslide, a great landslide located in the upper basin of Magra River, in the Northern Appennines, Italy (Fig.1), where a P-wave study carried out in the last years (Stucchi et al., 2014) was able to image the deepest discontinuity of the landslide body at around 40-50 m depth, but no description of the shallower layers can be inferred. Because these surface layers are the slip surfaces of quick reactivation movements of the landslide, an SH high-resolution reflection seismic survey was planned along the previous P-wave profile (Fig.1). This new survey associated to the P-wave investigation allows a more robust description of the landslide body, from the deepest discontinuity up to the very shallow portions of the landslide. This work describes the planning, acquisition and processing of the SH reflection seismic survey, and also gives a possible combined interpretation of both P and SH seismic images

Development and First Validation of a Disease Activity Score for Gout

Objective: To develop a new composite disease activity score for gout and provide its first validation. Methods: Disease activity has been defined as the ongoing presence of urate deposits that lead to acute arthritis and joint damage. Every measure for each Outcome Measures in Rheumatology core domain was considered. A 3-step approach (factor analysis, linear discriminant analysis, and linear regression) was applied to derive the Gout Activity Score (GAS). Decision to change treatment or 6-month flare count were used as the surrogate criteria of high disease activity. Baseline and 12-month followup data of 446 patients included in the Kick-Off of the Italian Network for Gout cohort were used. Construct- and criterion-related validity were tested. External validation on an independent sample is reported. Results: Factor analysis identified 5 factors: patient-reported outcomes, joint examination, flares, tophi, and serum uric acid (sUA). Discriminant function analysis resulted in a correct classification of 79%. Linear regression analysis identified a first candidate GAS including 12-month flare count, sUA, visual analog scale (VAS) of pain, VAS global activity assessment, swollen and tender joint counts, and a cumulative measure of tophi. Alternative scores were also developed. The developed GAS demonstrated a good correlation with functional disability (criterion validity) and discrimination between patient- and physician-reported measures of active disease (construct validity). The results were reproduced in the external sample. Conclusion: This study developed and validated a composite measure of disease activity in gout. Further testing is required to confirm its generalizability, responsiveness, and usefulness in assisting with clinical decisions

Cardiogenic necrotizing enterocolitis: a clinically distinct entity from classical necrotizing enterocolitis

AIM: The main purpose of this study was to investigate if necrotizing enterocolitis (NEC) has a different presentation and outcome in patients with congenital heart defect (CHD) (cardiogenic NEC) from those without (classical NEC). MATERIALS AND METHODS:  A systematic review of the literature on the characteristics of infants with NEC and CHD was performed by three independent investigators using a defined strategy (PubMed, Cochrane, Embase, and Web of Science). A meta-analysis was conducted on studies comparing NEC in infants with CHD and non-CHD infants using RevMan 5.3. RESULTS:  Systematic review: Of 7,291 abstracts screened, 126 full-text articles were analyzed and 51 studies were included. NEC had an incidence of 5.1% in CHD infants (7,728/151,046, range 0-24%) and 0.8% in non-CHD infants (26,430/3,256,891, range 0.1-8.9%; p < 0.0001). In very low birth weight infants, NEC occurred in 6.3% of CHD patients (6,361/100,454pts) and in 8.9% of non-CHD (23,201/257,794pts; p < 0.0001). In CHD cases, NEC occurred before cardiac surgery in 48% cases and surgery for NEC was required in 31% infants (2,037/6,683). Meta-analysis: In eight comparative studies, the incidence of NEC was higher in CHD infants (6%, 768/13,145) than in infants with no CHD (0.9%, 32,625/3,354,323pts; p < 0.00001, odds ratio [OR] 1.84, 95% confidence interval [CI] 1.7-1.9). The overall mortality was higher in infants with CHD and NEC (38%, 243/640) than in those without CHD (27%, 6651/24810; p < 0.00001, OR 3.4, 95% CI 2.8-4.1). CONCLUSION:  This is the first evidence-based study showing that infants with cardiogenic NEC have different demographics and outcomes than those with classical NEC. The risk of developing NEC and the mortality rate are higher among infants with CHD than in those without. Conversely, the need for intestinal surgery is lower in babies with cardiogenic NEC than in those with classical NEC. Further studies are needed to establish preventative and management interventions that are specific to infants with or at risk of developing cardiogenic NEC

SH-wave Seismic Reflection at the Patigno Landslide and Integration with P-wave Reflection Data

In this work we describe the acquisition and processing, up to the depth migrated image, of an SH-wave reflection seismic survey carried out on a complex deep seated landslide located in the Northern Apennines in Italy. We also show a comparison with a recently acquired P-wave seismic reflection profile that investigates the same landslide body. The P-wave survey was able to delineate the deep sliding discontinuity, but was unable to give a detailed description of the small reactivation slip surfaces delineating minor landslides at shallow depths, that are responsible of the major observed damages. Our experience shows that the combined use of both P-waves and SH-waves offers the possibility to obtain detailed insights of the whole landslide body from the deepest discontinuity up to the very shallow portion of the landslide, overcoming the limitations due to the low resolution of P-wave method for imaging shallow horizons and the low investigation depth of SH-wave method. The deeper knowledge of the landslide internal setting that can be gained by a joint application of both methodologies is of primary importance to plan adequate and effective defence strategies

Gout impacts on function and health-related quality of life beyond associated risk factors and medical conditions : results from the KING observational study of the Italian Society for Rheumatology (SIR)

Introduction: Gout is the most prevalent arthritis and significantly impacts on function and quality of life. Given that gout associates with disabling comorbid conditions, it is not clear whether such a complex of diseases accounts for the increased disability or if gout may play a role by itself. This study aims to evaluate the specific influence of gout and disease-related features on functional disability and health-related quality of life (HRQoL) in patients with gout followed in rheumatology clinics.Methods: A random sample of patients was drawn from clinical registries of 30 rheumatology clinics across Italy. Sociodemographic, general health and gout-specific variables were collected. Functional disability and HRQoL were assessed by the health assessment questionnaire (HAQ) and the Physical and Mental Component Summary scores (PCS and MCS) of the Short Form-36 (SF-36). Crude and adjusted ordinal logistic and linear regression models were applied to investigate the specific contribution of different variables on HAQ and SF-36 scores. Results are presented as odds ratio (OR) or mean difference (MD) and 95% confidence intervals.Results: Out of 446 patients with gout, 90% were males with a mean age of 63.9 years and median disease duration of 3.8 years; the majority of patients were overweight or obese, and with several comorbidities; 21.1% showed at least moderate disability; the PCS score was significantly lower than expected age- and gender-matched samples in the general population, while MCS score was not. After adjusting for potential sociodemographic and general-health confounders, gout-specific variables significantly impacted on HAQ, including polyarticular involvement OR 3.82 (1.63, 8.95), presence of tophi OR 1.92 (1.07, 3.43) and recent attacks OR 2.20 (1.27, 3.81). Consistent results were found for PCS. The impairment of PCS compared to the general population was limited to patients with features of chronic gout. MCS was only affected by recent attacks (MD -2.72 [-4.58, -0.86]) and corticosteroid treatment (-3.39 [-5.30,-1.48]).Conclusions: The data from the KING study confirm that gout impacts on disability and provide evidence for an independent association of gout and gout-related features with functional outcome and HRQoL. This result supports the need to improve specific treatment in gout. \ua9 2013 Scir\ue8 et al.; licensee BioMed Central Ltd

Gout impacts on function and health-related quality of life beyond associated risk factors and medical conditions: results from the KING observational study of the Italian Society for Rheumatology (SIR)

Introduction: Gout is the most prevalent arthritis and significantly impacts on function and quality of life. Given that gout associates with disabling comorbid conditions, it is not clear whether such a complex of diseases accounts for the increased disability or if gout may play a role by itself. This study aims to evaluate the specific influence of gout and disease-related features on functional disability and health-related quality of life (HRQoL) in patients with gout followed in rheumatology clinics. Methods: A random sample of patients was drawn from clinical registries of 30 rheumatology clinics across Italy. Sociodemographic, general health and gout-specific variables were collected. Functional disability and HRQoL were assessed by the health assessment questionnaire (HAQ) and the Physical and Mental Component Summary scores (PCS and MCS) of the Short Form-36 (SF-36). Crude and adjusted ordinal logistic and linear regression models were applied to investigate the specific contribution of different variables on HAQ and SF-36 scores. Results are presented as odds ratio (OR) or mean difference (MD) and 95% confidence intervals. Results: Out of 446 patients with gout, 90% were males with a mean age of 63.9 years and median disease duration of 3.8 years; the majority of patients were overweight or obese, and with several comorbidities; 21.1% showed at least moderate disability; the PCS score was significantly lower than expected age- and gender-matched samples in the general population, while MCS score was not. After adjusting for potential sociodemographic and general-health confounders, gout-specific variables significantly impacted on HAQ, including polyarticular involvement OR 3.82 (1.63, 8.95), presence of tophi OR 1.92 (1.07, 3.43) and recent attacks OR 2.20 (1.27, 3.81). Consistent results were found for PCS. The impairment of PCS compared to the general population was limited to patients with features of chronic gout. MCS was only affected by recent attacks (MD -2.72 [-4.58, -0.86]) and corticosteroid treatment (-3.39 [-5.30,-1.48]). Conclusions: The data from the KING study confirm that gout impacts on disability and provide evidence for an independent association of gout and gout-related features with functional outcome and HRQoL. This result supports the need to improve specific treatment in gout