Variability of orographic enhancement of precipitation in the Alpine region

Climate change impacts are non uniformly distributed over the globe. Mountains have a peculiar response to large scale variations, documented by elevation gradients of surface temperature increase observed over many mountain ranges in the last decades. Significant changes of precipitation are expected in the changing climate and orographic effects are important in determining the amount of rainfall at a given location. It thus becomes particularly important to understand how orographic precipitation responds to global warming and to anthropogenic forcing. Here, using a large rain gauge dataset over the European Alpine region, we show that the distribution of annual precipitation among the lowlands and the mountains has varied over time, with an increase of the precipitation at the high elevations compared to the low elevations starting in the mid 20 century and peaking in the 1980s. The simultaneous increase and peak of anthropogenic aerosol load is discussed as a possible source for this interdecadal change. These results provide new insights to further our understanding and improve predictions of anthropic effects on mountain precipitations, which are fundamental for water security and management

A non-targeted metabolomics study on Xylella fastidiosa infected olive plants grown under controlled conditions

In the last decade, the bacterial pathogen Xylella fastidiosa has devastated olive trees throughout Apulia region (Southern Italy) in the form of the disease called “Olive Quick Decline Syndrome” (OQDS). This study describes changes in the metabolic profile due to the infection by X. fastidiosa subsp. pauca ST53 in artificially inoculated young olive plants of the susceptible variety Cellina di Nardò. The test plants, grown in a thermo-conditioned greenhouse, were also co-inoculated with some xylem-inhabiting fungi known to largely occur in OQDS-affected trees, in order to partially reproduce field conditions in terms of biotic stress. The investigations were performed by combining NMR spectroscopy and MS spectrometry with a non-targeted approach for the analysis of leaf extracts. Statistical analysis revealed that Xylella-infected plants were characterized by higher amounts of malic acid, formic acid, mannitol, and sucrose than in Xylella-non-infected ones, whereas it revealed slightly lower amounts of oleuropein. Attention was paid to mannitol which may play a central role in sustaining the survival of the olive tree against bacterial infection. This study contributes to describe a set of metabolites playing a possible role as markers in the infections by X. fastidiosa in olive

Revision reverse shoulder arthroplasty in failed shoulder arthroplasties for rotator cuff deficiency

PURPOSE: the aim of this systematic literature review is to report clinical outcomes of reverse shoulder arthroplasty (RSA) used as a revision surgery following failure of the primary implant due to rotator cuff insufficiency. METHODS: a systematic review was performed using the following key words: revision, shoulder, rotator cuff deficiency, outcome assessment, treatment outcome, complications. Studies eligible for inclusion in the review were clinical trials investigating patients in whom a primary shoulder arthroplasty implant with an incompetent rotator cuff was replaced with a reverse shoulder prosthesis. RESULTS: nine articles were identified and further reviewed. The results refer to a total of 226 shoulders that were treated with RSA as revision surgery. The patients in the studies had a mean age ranging from 64 to 72 years and the longest follow-up was 3.8 years. Improvements in function and reduction of pain were shown by many studies, but the mean Constant score ranged from 44.2 to 56. High complication rates (of up to 62%) were recorded, and a mean reoperation rate of 27.5%. CONCLUSIONS: RSA as revision surgery for patients with rotator cuff deficiency is a valid option, and often the only solution available, but it should be limited to elderly patients with poor function and severe pain. LEVEL OF EVIDENCE: level IV, systematic review of level I-IV studies

Regenerative Medicine in Rotator Cuff Injuries

Rotator cuff injuries are a common source of shoulder pathology and result in an important decrease in quality of patient life. Given the frequency of these injuries, as well as the relatively poor result of surgical intervention, it is not surprising that new and innovative strategies like tissue engineering have become more appealing. Tissue-engineering strategies involve the use of cells and/or bioactive factors to promote tendon regeneration via natural processes. The ability of numerous growth factors to affect tendon healing has been extensively analyzed in vitro and in animal models, showing promising results. Platelet-rich plasma (PRP) is a whole blood fraction which contains several growth factors. Controlled clinical studies using different autologous PRP formulations have provided controversial results. However, favourable structural healing rates have been observed for surgical repair of small and medium rotator cuff tears. Cell-based approaches have also been suggested to enhance tendon healing. Bone marrow is a well known source of mesenchymal stem cells (MSCs). Recently, ex vivo human studies have isolated and cultured distinct populations of MSCs from rotator cuff tendons, long head of the biceps tendon, subacromial bursa, and glenohumeral synovia. Stem cells therapies represent a novel frontier in the management of rotator cuff disease that required further basic and clinical research

Repair versus shaving of partial-thickness articular-sided tears of the upper subscapularis tendon : a prospective randomized controlled trial

Purpose: The purpose of this study was to evaluate whether treating partial-thickness articular-sided tears of the upper subscapularis (ssC) tendon with a dedicated suture anchor would result in an internal rotation strength improvement compared with simple shaving of the ssC tendon and footprint. Methods: Twenty-six patients with a limited ssC tendon tear (equal or inferior to the most superior centimeter) in association with a posterosuperior cuff lesion were prospectively randomized to two treatments: repair with a dedicated suture anchor versus shaving of the tendon and footprint. the patients also underwent long head of the biceps (LHB) treatment and posterosuperior cuff tear repair. in each patient the following parameters were measured both preoperatively and at a minimum follow-up of 2.5 years: strength in internal rotation in the bear-hug testing position (using a digital tensiometer), DAsH score and Constant scores. MRi assessment of tendon healing was performed at the final follow-up. Results: Twenty of the 26 patients (76%) were reviewed after a mean follow-up time of 42 months: 11 patients had undergone ssC tendon repair and nine simple shaving. At final follow-up no significant differences were found between the repaired and shaving group in strength in internal rotation (9.5 \ub1 3.8 kg versus 10.3\ub15.4 kg; p=0.7). the DAsH score and Constant score also failed to show significant differences between the two groups. Furthermore, no significant difference in ssC tendon healing rate was observed on MRi evaluation. Conclusions: Partial-thickness articular-sided tear of the upper ssC tendon in association with a posterosuperior rotator cuff repair and LHB treatment, when limited to the superior centimeter of the ssC tendon, shows a comparable performance in terms of strength in internal rotation either after simple shaving or a tendon-to-bone repair. Level of evidence: Level II, prospective comparative study

On the importance of the convergence to climate attractors

Ensemble approaches are becoming widely used in climate research. In contrast to weather forecast, however, in the climatic context one is interested in long-time properties, those arising on the scale of several decades. The well-known strong internal variability of the climate system implies the existence of a related dynamical attractor with chaotic properties. Under the condition of climate change this should be a snapshot attractor, naturally arising in an ensemble-based framework. Although ensemble averages can be evaluated at any instant of time, results obtained during the process of convergence of the ensemble towards the attractor are not relevant from the point of view of climate. In simulations, therefore, attention should be paid to whether the convergence to the attractor has taken place. We point out that this convergence is of exponential character, therefore, in a finite amount of time after initialization relevant results can be obtained. The role of the time scale separation due to the presence of the deep ocean is discussed from the point of view of ensemble simulations

From fuzzy to annotated semantic web languages

The aim of this chapter is to present a detailed, selfcontained and comprehensive account of the state of the art in representing and reasoning with fuzzy knowledge in Semantic Web Languages such as triple languages RDF/RDFS, conceptual languages of the OWL 2 family and rule languages. We further show how one may generalise them to so-called annotation domains, that cover also e.g. temporal and provenance extensions

Isolation and characterization of 2 new human rotator cuff and long head of biceps tendon cells possessing stem cell-like self-renewal and multipotential differentiation capacity

BACKGROUND: Stem cell therapy is expected to offer new alternatives to the traditional therapies of rotator cuff tendon tears. In particular, resident, tissue-specific, adult stem cells seem to have a higher regenerative potential for the tissue where they reside. HYPOTHESIS: Rotator cuff tendon and long head of the biceps tendon possess a resident stem cell population that, when properly stimulated, may be induced to proliferate, thus being potentially usable for tendon regeneration. STUDY DESIGN: Controlled laboratory study. METHODS: Human tendon samples from the supraspinatus and the long head of the biceps were collected during rotator cuff tendon surgeries from 26 patients, washed with phosphate-buffered saline, cut into small pieces, and digested with collagenase type I and dispase. After centrifugation, cell pellets were resuspended in appropriate culture medium and plated. Adherent cells were cultured, phenotypically characterized, and then compared with human bone marrow stromal cells (BMSCs), as an example of adult stem cells, and human dermal fibroblasts, as normal proliferating cells with no stem cell properties. RESULTS: Two new adult stem cell populations from the supraspinatus and long head of the biceps tendons were isolated, characterized, and cultured in vitro. Cells showed adult stem cell characteristics (ie, they were self-renewing in vitro, clonogenic, and multipotent), as they could be induced to differentiate into different cell types--namely, osteoblasts, adipocytes, and skeletal muscle cells. CONCLUSION: This work demonstrated that human rotator cuff tendon stem cells and human long head of the biceps tendon stem cells can be isolated and possess a high regenerative potential, which is comparable with that of BMSCs. Moreover, comparative analysis of the sphingolipid pattern of isolated cells with that of BMSCs and fibroblasts revealed the possibility of using this class of lipids as new possible markers of the cell differentiation status. CLINICAL RELEVANCE: Rotator cuff and long head of the biceps tendons contain a stem cell population that can proliferate in vitro and could constitute an easily accessible stem cell source to develop novel therapies for tendon regeneration