A Novel Measurement-Based Method for Assessing Global Warming Mitigation via High-Albedo Solutions

Global warming mitigation via terrestrial albedo increase has been widely investigated in literature; the proposed methodologies relate CO2 compensation to albedo increase generally via the concept of Radiative Forcing (RF). However, literature methods calculate RF by averaged input data, without considering RF variation due to many local and temporal phenomena. For instance, an average value of compensated effect of albedo change (Da = 0.01) is 3 kg CO2eq/m2, which has been introduced no matter the position and climatic condition of the site. In our study, we propose a novel procedure to measure RF continuous time history by means of ground measurements, astronomical equations, and satellite calibration. The procedure is called RF-meter. In this way, a more accurate assessment of compensated CO2 may be achieved. A test facility is also designed and proposed to double check the procedure, and preliminary results are reported in order to show and test the calibration procedure. It is expected that albedo-increased surfaces as well as cool roofs and/or other technical solutions will be eligible to obtain Emission Credits (EC). The proposed procedure will aid in the assignment of EC to High-Albedo Solutions (HAS), as it could represent an objective and accurate method to relate the albedo increase to a corresponding CO2 offset

Role of the exchange and correlation potential into calculating the x-ray absorption spectra of half-metallic alloys: the case of Mn and Cu K-edge XANES in Cu2_2MnM (M = Al, Sn, In) Heusler alloys

This work reports a theoretical study of the x-ray absorption near-edge structure spectra at both the Cu and the Mn K-edge in several Cu$_2$MnM (M= Al, Sn and In) Heusler alloys. Our results show that {\it ab-initio} single-channel multiple-scattering calculations are able of reproducing the experimental spectra. Moreover, an extensive discussion is presented concerning the role of the final state potential needed to reproduce the experimental data of these half-metallic alloys. In particular, the effects of the cluster-size and of the exchange and correlation potential needed in reproducing all the experimental XANES features are discussed.Comment: 15 pages, 5 figure

Abnormal hyperventilation in patients with hepatic cirrhosis: Role of enhanced chemosensitivity to carbon dioxide

BACKGROUND: Patients with hepatic cirrhosis frequently show idiopathic hyperventilation at rest, despite no concomitant cardiopulmonary disease. The aim of the study was to determine whether altered chemosensitivity either to hypoxia or hypercapnia could underlie inappropriate hyperventilation in cirrhotic patients. METHODS: We consecutively recruited 30 biopsy proven cirrhotic patients equally distributed in the three Child's classes A, B and C (age 54±8years, mean±SD). All patients underwent evaluation of chemosensitivity to hypoxia and to hypercapnia and blood sampling for brain natriuretic peptide, norepinephrine and progesterone, besides full clinical characterization. We also recruited 10 age- and gender-matched healthy controls (age 55±7years). RESULTS: Overall, 18 patients (60%) showed an increased chemosensitivity to carbon dioxide (CO(2)), while 8 patients (27%) showed enhanced chemosensitivity to hypoxia. Child's class C patients had lower arterial partial pressure of CO(2) (PaCO(2)), higher rest ventilation, increased chemosensitivity to hypercapnia, plasma level of norepinephrine and serum progesterone levels when compared to class A patients and controls (all p<0.05). Rest ventilation was positively related to pH (R=0.41, p=0.023), chemosensitivity to hypercapnia (R=0.54, p=0.002), and progesterone (R=0.53, p=0.016) and negatively to PaCO(2) (R=0.61, p<0.001), but not to hemoglobin level and chemosensitivity to hypoxia. Chemosensitivity to hypercapnia was positively related to PaCO(2) (R=0.74, p<0.001), serum progesterone (R=0.50, p=0.016), and to plasma norepinephrine (R=0.57, p=0.004). CONCLUSIONS: Enhanced chemosensitivity to hypercapnia was found in more decompensated cirrhotic patients and was associated with sympathetic overactivity and elevated serum progesterone, likely representing a key mechanism underlying the "unexplained" hyperventilation observed in such patients

When Two Coincidences are a Clue: A Retrospective Cohort Study Regarding the Incidence of Ruptured Tubal Pregnancies in a Northern Italy Hospital During the COVID-19 Pandemic

Background: Undiagnosed ectopic pregnancies are among the main gynecological emergencies, and hemorrhage from an ectopic pregnancy is still the leading cause of maternal mortality in the first trimester. During the first lockdown period in Italy (March–April 2020) and in March 2021 restrictive measures were issued by the Italian government, but their impact on the incidence of ruptured tubal pregnancies remains unknown. Methods: The purpose of this study was to evaluate the impact of restrictive measures for the COVID-19 outbreak on the incidence of ruptured tubal pregnancies at our referral center for endoscopic gynecologic surgery. In particular, the primary outcome was the comparison of the incidence of ruptured tubal pregnancies between the lockdown phases and the other months of the pandemic. For this retrospective cohort study we considered all women examined for tubal ectopic pregnancy at our emergency unit from 1 January 2019 to 30 April 2021. We divided patients into three groups according to the period they were referred to our center: 10 March 2019–10 March 2020 (Pre-Covid period); 11 March–4 May 2020 and 6 March–30 April 2021 (Lockdown periods); 5 May 2020–5 March 2021 (COVID-19 pandemic period without restrictive policies). We compared data acquired during the lockdown phases with data collected both before the COVID-19 pandemic and during the restriction-free COVID-19 period. Results: 31 of 85 women were diagnosed with a ruptured tubal pregnancy. The proportion of ruptured ectopic pregnancies was higher during the lockdown period than the other two periods combined (62.5% vs 30.4%, p = 0.016). Mean gestational age and beta-HCG levels showed the same tendency (7.31 ± 1.25 weeks vs 5.99 ± 1.28 weeks, p &lt; 0.0001; 7392.56 ± 4337.50 mUI/mL vs 4188.36 ± 3235.95 mUI/mL, p = 0.001). There were no differences between the proportion of ruptured pregnancies during the whole COVID-19 pandemic and the months preceding it (45.7% vs 25.6%, p = 0.07). Conclusions: Our study demonstrated that restrictive lockdown policies for the containment of the COVID-19 outbreak are associated with an increased rate of ruptured extrauterine tubal pregnancies

Hadronic Regge Trajectories: Problems and Approaches

We scrutinized hadronic Regge trajectories in a framework of two different models --- string and potential. Our results are compared with broad spectrum of existing theoretical quark models and all experimental data from PDG98. It was recognized that Regge trajectories for mesons and baryons are not straight and parallel lines in general in the current resonance region both experimentally and theoretically, but very often have appreciable curvature, which is flavor-dependent. For a set of baryon Regge trajectories this fact is well described in the considered potential model. The standard string models predict linear trajectories at high angular momenta J with some form of nonlinearity at low J.Comment: 15 pages, 9 figures, LaTe

Efficacy and safety of combination therapy with everolimus and sorafenib for recurrence of hepatocellular carcinoma after liver transplantation.

Background Recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT) is still associated with a dismal outcome. Combination therapy with everolimus (EVL) and vascular endothelial growth factor inhibitor sorafenib (SORA) is based on the role of both b-Raf and mammalian target of rapamycin/protein kinase B pathways in the pathogenesis of HCC and is being investigated in clinical practice. Methods This was a single-center retrospective analysis on LT recipients with unresectable HCC recurrence and undergoing combination therapy with EVL and SORA. Patients were included if they were switched to EVL+SORA at any time after surgery. Primary endpoint was overall survival (OS) after both LT and recurrence, and response to treatment based on the modified Response Evaluation Criteria in Solid Tumors (mRECIST) in the intention-to-treat (ITT) population. Secondary analysis was safety of combination therapy with EVL and SORA in the population of patients who received ≥1 dose of the study drug. Results Seven patients (100% male; median age 53 years [interquartile range (IQR) 9 years]) were considered for analysis. HCC recurrence was diagnosed at a median (IQR) interval since LT of 9 (126) months, and patients were administered EVL+SORA at a median interval since LT of 11 (126) months. Baseline immunosuppression was with tacrolimus (TAC) in 2 patients (28.6%), cyclosporine (CsA) in 2 (28.6%), and EVL monotherapy in 3 (42.8%). At a median (IQR) follow-up of 6.5 (14) months, 5 patients (71.4%) were alive, 4 of them (57.1%) with tumor progression according to the mRECIST criteria. Median (IQR) time to progression was 3.5 (12) months. Two patients died at a median (IQR) follow-up of 5 (1) months owing to tumor progression in 1 patient (14.3%) and sepsis in the other (14.3%). EVL monotherapy was achieved in 6 patients (85.7%), whereas 1patient (14.3%) could not withdraw from calcineurin inhibitor owing to acute rejection. Treatment complications were: hand-foot syndrome in 5 patients (71.4%), hypertension in 1 (14.3%), alopecia in 1 (14.3%), hypothyroidism in 1 (14.3%), diarrhea in 2 (28.6%), pruritus in 1 (14.3%), abdominal pain in 1 (14.3%), rash in 1 (14.3%), asthenia in 3 (42.8%), anorexia in 3 (42.8%), and hoarseness in 2 (28.6%). Adverse events led to temporary SORA discontinuation in 2 patients (28.6%) and to SORA dose reduction in 3 (42.8%). Conclusions Treatment of HCC recurrence after LT with a combination regimen of EVL+ SORA is challenging because of SORA-related complications. Longer follow-up periods and larger series are needed to better capture the impact of such combination treatment on tumor progression and patient survival.BACKGROUND: Recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT) is still associated with a dismal outcome. Combination therapy with everolimus (EVL) and vascular endothelial growth factor inhibitor sorafenib (SORA) is based on the role of both b-Raf and mammalian target of rapamycin/protein kinase B pathways in the pathogenesis of HCC and is being investigated in clinical practice. METHODS: This was a single-center retrospective analysis on LT recipients with unresectable HCC recurrence and undergoing combination therapy with EVL and SORA. Patients were included if they were switched to EVL+SORA at any time after surgery. Primary endpoint was overall survival (OS) after both LT and recurrence, and response to treatment based on the modified Response Evaluation Criteria in Solid Tumors (mRECIST) in the intention-to-treat (ITT) population. Secondary analysis was safety of combination therapy with EVL and SORA in the population of patients who received ≥1 dose of the study drug. RESULTS: Seven patients (100% male; median age 53 years [interquartile range (IQR) 9 years]) were considered for analysis. HCC recurrence was diagnosed at a median (IQR) interval since LT of 9 (126) months, and patients were administered EVL+SORA at a median interval since LT of 11 (126) months. Baseline immunosuppression was with tacrolimus (TAC) in 2 patients (28.6%), cyclosporine (CsA) in 2 (28.6%), and EVL monotherapy in 3 (42.8%). At a median (IQR) follow-up of 6.5 (14) months, 5 patients (71.4%) were alive, 4 of them (57.1%) with tumor progression according to the mRECIST criteria. Median (IQR) time to progression was 3.5 (12) months. Two patients died at a median (IQR) follow-up of 5 (1) months owing to tumor progression in 1 patient (14.3%) and sepsis in the other (14.3%). EVL monotherapy was achieved in 6 patients (85.7%), whereas 1patient (14.3%) could not withdraw from calcineurin inhibitor owing to acute rejection. Treatment complications were: hand-foot syndrome in 5 patients (71.4%), hypertension in 1 (14.3%), alopecia in 1 (14.3%), hypothyroidism in 1 (14.3%), diarrhea in 2 (28.6%), pruritus in 1 (14.3%), abdominal pain in 1 (14.3%), rash in 1 (14.3%), asthenia in 3 (42.8%), anorexia in 3 (42.8%), and hoarseness in 2 (28.6%). Adverse events led to temporary SORA discontinuation in 2 patients (28.6%) and to SORA dose reduction in 3 (42.8%). CONCLUSIONS: Treatment of HCC recurrence after LT with a combination regimen of EVL+ SORA is challenging because of SORA-related complications. Longer follow-up periods and larger series are needed to better capture the impact of such combination treatment on tumor progression and patient survival

Properties of Regge Trajectories

Early Chew-Frautschi plots show that meson and baryon Regge trajectoies are approximately linear and non-intersecting. In this paper, we reconstruct all Regge trajectories from the most recent data. Our plots show that meson trajectories are non-linear and intersecting. We also show that all current meson Regge trajectories models are ruled out by data.Comment: 30 pages, latex, 18 figures, to be published in Physical Review

Is preoperative ultrasound tumor size a prognostic factor in endometrial carcinoma patients?

Objective: We aimed to assess the prognostic value of preoperative ultrasound tumor size in EC through a single center, observational, retrospective, cohort study. Methods: Medical records and electronic clinical databases were searched for all consecutive patients with EC, preoperative ultrasound scans available to ad hoc estimate tumor size, and a follow-up of at least 2-year, at our Institution from January 2010 to June 2018. Patients were divided into two groups based on different dimensional cut-offs for the maximum tumor diameter: 2, 3 and 4 cm. Differences in overall survival (OS), disease specific survival (DSS) and progression-free survival (PFS) were assessed among the groups by using the Kaplan–Meier estimator and the log-rank test. Results: 108 patients were included in the study. OS, DSS and PFS did not significantly differ between the groups based on the different tumor diameter cut-offs. No significant differences were found among the groups sub-stratified by age, BMI, FIGO stage, FIGO grade, lymphovascular space invasion status, myometrial invasion, lymph nodal involvement, histotype, and adjuvant treatment. Conclusions: Preoperative ultrasound tumor size does not appear as a prognostic factor in EC women