The Case for a Sustained Greenland Ice Sheet-Ocean Observing System (GrIOOS)

Rapid mass loss from the Greenland Ice Sheet (GrIS) is affecting sea level and, through increased freshwater and sediment discharge, ocean circulation, sea-ice, biogeochemistry, and marine ecosystems around Greenland. Key to interpreting ongoing and projecting future ice loss, and its impact on the ocean, is understanding exchanges of heat, freshwater, and nutrients that occur at the GrIS marine margins. Processes governing these exchanges are not well understood because of limited observations from the regions where glaciers terminate into the ocean and the challenge of modeling the spatial and temporal scales involved. Thus, notwithstanding their importance, ice sheet/ocean exchanges are poorly represented or not accounted for in models used for projection studies. Widespread community consensus maintains that concurrent and long-term records of glaciological, oceanic, and atmospheric parameters at the ice sheet/ocean margins are key to addressing this knowledge gap by informing understanding, and constraining and validating models. Through a series of workshops and documents endorsed by the community-at-large, a framework for an international, collaborative, Greenland Ice sheet-Ocean Observing System (GrIOOS), that addresses the needs of society in relation to a changing GrIS, has been proposed. This system would consist of a set of ocean, glacier, and atmosphere essential variables to be collected at a number of diverse sites around Greenland for a minimum of two decades. Internationally agreed upon data protocols and data sharing policies would guarantee uniformity and availability of the information for the broader community. Its development, maintenance, and funding will require close international collaboration. Engagement of end-users, local people, and groups already active in these areas, as well as synergy with ongoing, related, or complementary networks will be key to its success and effectiveness

Macular Microvascular Modifications in Progressive Lamellar Macular Holes

Lamellar macular holes (LMHs) may show morphological and functional deterioration over time, yet no definite prognostic factor for progression has been identified. Since neurovascular retinal unit impairment may take part in neurodegeneration, we compare progressive LMHs to stable ones in optical coherence tomography (OCT) angiography parameters. Methods: OCT B scans of eyes with LMH were analyzed to detect the presence of tissue loss (TL) over time, allowing us to identify a TL group and a stable (ST) group (14 patients each). The best corrected visual acuity (BCVA) at each considered imaging time point was collected. Lastly, patients underwent macular OCT angiography. Results: BCVA at last follow up was significantly reduced in the TL group compared to both the ST group and TL group baseline assessment. SCP foveal vessel density (VD), SCP and deep capillary plexus (DCP) perfusion density (PD) and parafoveal PD were lower in the TL group. Linear correlations between quantitative TL over time and parafoveal PD in SCP and between the speed of TL and BCVA variation during follow up were also detected. Conclusions: TL in LMHs is associated with both OCT angiography modifications and BCVA deterioration over time. We suggest these findings to be a manifestation of foveal Muller cell impairment in progressive LMHs

A Dedicated Nutritional Care Program NUTRICARE to reduce malnutrition in institutionalised dysphagic older people: A quasi-experimental study

Aims and objectives: To assess the effects of a texture-modified food program for dysphagia on the nutritional, biochemical and functional profile in a cohort of institutionalised older people in Italy. Background: Dysphagic institutionalised older people, often also affected by dementia, are frequently exposed to malnutrition. Malnutrition in older people has negative effects on mortality, days of hospitalisation, infection, wound healing and risk of pressure injuries. Therefore, it is very important to prevent malnutrition in this frail population. Design: A pre-post study without a control group. Methods: The study included 479 dysphagic institutionalised older people from 20 nursing homes. Anthropometrical, biochemical, nutritional and functional parameters were collected retrospectively, 6 months before the study intervention, at time zero and, prospectively for 6 months after implementing the NUTRICARE food programme, for a total of nine evaluations. The NUTRICARE programme includes meals without nutritional supplementation, and personalised levels of density, viscosity, texture and particle size. Results: The total mean body mass index of our sample passed from 17.88-19.00; body weight averagely improved by 7.19%, as well as their nutritional and biochemical profiles. There was a progressive improvement of total protein and serum albumin values. Nutritional parameters (serum transferrin and lymphocytes) displayed similar changes. Plasma lymphocytes reached normal levels in 98.23% of the sample. Plasma creatinine levels remained steady throughout the study and within the normal range. No side effects were reported. Conclusion: The NUTRICARE food programme with a adequate proteins, calories, balanced nutritional and bromatological properties, and appropriate texture and palatability significantly improved the nutritional, biochemical and functional profile in a cohort of institutionalised dysphagic older people. Relevance to clinical practice: The introduction of a balanced nutritional programme, using high-quality natural ingredients, appropriate texture and palatability can significantly improve health and quality of life in dysphagic older people

Ventricular arrhythmias in Takotsubo Syndrome: incidence, predictors and clinical outcomes

AIMS: To investigate predictors of the occurrence of subacute ventricular arrhythmias (VAs), defined as any VAs presenting after 48\u200ah from admission in patients with Takotsubo Syndrome (TTS), and to evaluate the related in-hospital mortality.METHODS: This is a retrospective single-center study enrolling patients admitted between 2012 and 2017 with TTS according to International Takotsubo diagnostic criteria. Data collection included ECG on admission and at 48\u200ah, telemetry monitoring and transthoracic echocardiogram.RESULTS: We enrolled 93 patients; during in-hospital stay (mean 14\u200a\ub1\u200a16 days) subacute VAs occurred in 25% of patients (VAs group). Life-threatening VAs occurred in 6% of patients (3 sustained ventricular tachycardia, 1 torsade de pointes, 1 ventricular fibrillation) and not life-threatening VAs in 19% (6 non-sustained ventricular tachycardia and 12 premature ventricular contractions\u200a>\u200a2000 in 24\u200ah). Mortality was higher in the VAs than in the non-VAs group (P\u200a=\u200a0.03), without differences in terms of life-threatening and not life-threatening subacute VAs (P\u200a=\u200a0.65) and VAs on admission (P\u200a=\u200a0.25). Logistic regression identified the following independent predictors of subacute VAs occurrence: VAs on admission {odds ratio [OR] 22.5 (3.9-131.8), P\u200a=\u200a0.001]}, New York Heart Association (NYHA) class III-IV on admission [OR 6.7 (1.3- 34.0), P\u200a=\u200a0.021] and QTc at 48\u200ah [OR 1.01 (1.00-1.03), P\u200a=\u200a0.046].CONCLUSION: TTS patients with VAs and NYHA class III-IV on admission and higher QTc at 48\u200ah are at increased risk of subacute VAs occurrence, associated with higher in-hospital mortality. Awareness of this potential complication is critical for proper patients management

Challenges to understand the dynamic response of Greenland's marine terminating glaciers to oceanic and atmospheric forcing

The recent retreat and speedup of outlet glaciers, as well as enhanced surface melting around the ice sheet margin, have increased Greenland's contribution to sea level rise to 0.6±0.1 mm/yr and its discharge of freshwater into the North Atlantic. The widespread, near-synchronous glacier retreat, and its coincidence with a period of oceanic and atmospheric warming, suggest a common climate driver. Evidence points to the marine margins of these glaciers as the region from which changes propagated inland. Yet the forcings and mechanisms behind these dynamic responses are poorly understood and either missing or crudely parameterized in climate and ice sheet models. Resulting projected sea level rise contributions from Greenland by 2100 remain highly uncertain. This paper summarizes current state of knowledge and highlights key physical aspects of Greenland's coupled ice-sheet/ocean/atmosphere system. Three research thrusts are identified to yield fundamental insights into ice sheet, ocean, sea ice and atmosphere interactions, their role in Earth's climate system, and probable trajectories of future changes: (1) focused process studies addressing critical glacier, ocean, atmosphere and coupled dynamics; (2) sustained observations at key sites; and (3) inclusion of relevant dynamics in Earth System Models. Understanding the dynamic response of Greenland's glaciers to climate forcing constitutes both a scientific and technological frontier given the challenges of obtaining the appropriate measurements from the glaciers' marine termini and the complexity of the dynamics involved, including the coupling of the ocean, atmosphere, glacier and sea ice systems. Interdisciplinary and international cooperation are crucial to making progress on this novel and complex problem

Borders, Migration and Globalization. An Interdisciplinary Perspective

Nowadays the reality of migrations defines the policies both of host and origin countries, invades the everyday life of all of us, dominates the pubòic language, builds new borders, and destroys others. The borders are a multifaceted concept that adapts to different disciplinary languages , that includes and covers unlike realities and for this reason represents a useful gimmick to deal with a theme, migrations, that in turn needs numerous perspectives of analysis to be adequately faced. borders can have the concreteness of geographical, political and bureaucratic barriers, or they may be methaphorical barrierrs: identity, prejudices, culture. through territories and consciences, they mark a space that includes and excludes at the same time

Disegnare, attraversare, cancellare i confini. una prospettiva interdisciplinare

Il concetto di confine è un concetto poliedrico , che si adatta a linguaggi disciplinari diversi , che comprende e copre realtà dissimili e per tale ragione rappresenta un escamotage utile per affrontare un tema, quello delle migrazioni, che a sua volta reclama , per essere adeguatamente affrontato, prospettive di analisi molteplici