An integrated approach shows different use of water resources from Mediterranean maquis species in a coastal dune ecosystem

An integrated approach has been used to analyse the dependence of three Mediterranean species, A. unedo L., Q. ilex L., and P. latifolia L. co-occurring in a coastal dune ecosystem on two different water resources: groundwater and rainfed upper soil layers. The approach included leaf level gas exchanges, sap flow measurements and structural adaptations between 15 May and 31 July 2007. During this period it was possible to capture different species-specific response patterns to an environment characterized by a sandy soil, with a low water retention capacity, and the presence of a water table. The latter did not completely prevent the development of a drought response and, combined with previous studies in the same area, response differences between species have been partially attributed to different root distributions. Sap flow of A. unedo decreased rapidly with the decline of soil water content, while that of Q. ilex decreased only moderately. Midday leaf water potential of P. latifolia and A. unedo ranged between 122.2 and 122.7MPa throughout the measuring period, while in Q. ilex it decreased down to 123.4MPa at the end of the season. A. unedo was the only species that responded to drought with a decrease of its leaf area to sapwood area ratio from 23.9\ub11.2 (May) to 15.2\ub11.5 (July). While A. unedo also underwent an almost stepwise loss on hydraulic conductivity, such a loss did not occur for Q. ilex, whereas P. latifolia was able to slightly increase its hydraulic conducitivity. These differences show how different plant compartments coordinate differently between species in their responses to drought. The different responses appear to be mediated by different root distributions of the species and their relative resistances to drought are likely to depend on the duration of the periods in which water remains extractable in the upper soil layers

Evaluation of Coronary Atherosclerosis by Multislice Computed Tomography in Patients With Acute Myocardial Infarction and Without Significant Coronary Artery Stenosis

Background— It is known that 9% to 31% of women and 4% to 14% of men with acute myocardial infarction have normal coronary arteries or nonsignificant coronary disease at angiography. These patients represent a diagnostic and therapeutic challenge. Multislice computed tomography (CT) can noninvasively identify the presence of coronary plaques even in the absence of significant coronary artery stenosis. This study evaluated the role of 64-slice CT, in comparison with coronary angiography, in detecting and characterizing coronary atherosclerosis in patients with acute myocardial infarction without significant coronary artery stenosis. Methods and Results— Thirty consecutive patients with acute myocardial infarction but without significant coronary stenosis at coronary angiography underwent 64-slice CT. All coronary segments were quantitatively analyzed by means of coronary angiography (CA-QCA) and 64-slice CT (CT-QCA). Forty-seven (10.4%) of the 450 coronary segments were not evaluable by CT. The mean proximal reference diameters at CT-QCA and CA-QCA were, respectively, 2.88�0.75 mm and 2.65�0.9 mm; the overall correlation between CT-QCA and CA-QCA for quantification of reference diameter was r s =0.77; P <0.001. The mean percent stenosis was 14.4�8.0% at CT-QCA and 4.0�11.0% at CA-QCA and the correlation was r s =0.11; P =0.03. Overall CT-QCA showed the presence of 50 plaques, of which only 11 were detected by CA-QCA. CT-QCA identified 25 plaques in infarct-related coronary arteries. Positive remodeling was present in 38 of the 50 plaques (76%), with a higher prevalence in the coronary plaques not visualized by CA-QCA (82.1% versus 54.5%). Conclusions— CT-QCA correlates well with CA-QCA in terms of coronary reference diameter analysis, but not stenosis quantification. Multislice CT can detect coronary atherosclerotic plaques in segments of nonstenotic coronary arteries that are underestimated by CA and may have an incremental diagnostic value for the diagnosis of acute myocardial infarction in patients without significant coronary stenosis at CA

iDREAM: a multidisciplinary methodology and integrated toolset for flight vehicle engineering

Rapid prototyping of flight vehicle engineering needs the use of two key elements: the data from the different building blocks and the required engineering tools to design vital subsystems of the flight vehicle. Politecnico di Torino in the framework of the I-DREAM, a GSTP contract carried out under the supervision of the European Space Agency (ESA), has developed a unique multidisciplinary methodology and integrated toolset able to support the rapid prototyping of a wide range of aerospace vehicles. iDREAM allows complementing the conceptual design activities with the economic viability and technological sustainability assessments. In detail, the iDREAM methodology consists of four main modules that can be used in a stand-alone mode and in an integrated activity flow, exploiting the implemented automatic connections. The first module consists of a well-structured MySQL database developed to support all the other modules, thanks to a unified connection guaranteed by an ad-hoc developed Database Management Library managing the operations of data input and output from/to the database throughout the tool modules. The second module consists of a vehicle design routine and a mission design routine, supporting the design of a new vehicle and mission concept and assessing the main performance of an already existing configuration. The vehicle design routine is called ASTRID-H, and it is the latest version of an in-house conceptual design tool integrating capabilities ranging from high-speed aircraft to lunar-landers design. The vehicle design routine automatically interfaces with ASTOS, a commercial software environment used for mission analysis optimization. Automatic interactions between the two routines inside the module have been ad-hoc developed and tested to guarantee good accuracy of the results. The third module consists of the economic viability module. Once the design is defined, it is possible to run a subsystem-level cost estimation. Using the subsystems’ masses estimated in the design routine, the parametric cost model provides useful insights on the potential development, manufacturing, and operating costs, as well as the cost and price per flight. Eventually, the developed methodology gives the possibility to generate a technology roadmap (fourth module). Supported by a database connection, the tool estimates each technology readiness and risk assessment, along with an indication of the necessary activities, missions, and future works. This paper describes the methodology and the integrated toolset in flight vehicle engineering of Microlaunchers. Eventually, the Electron mission would be used as a benchmark and validation study to showcase the tool’s results and accuracy for preliminary design studies

Impacts of air pollution on human and ecosystem health, and implications for the National Emission Ceilings Directive. Insights from Italy

Across the 28 EU member states there were nearly half a million premature deaths in 2015 as a result of exposure to PM2.5, O3 and NO2. To set the target for air quality levels and avoid negative impacts for human and ecosystems health, the National Emission Ceilings Directive (NECD, 2016/2284/EU) sets objectives for emission reduction for SO2, NOx, NMVOCs, NH3 and PM2.5 for each Member State as percentages of reduction to be reached in 2020 and 2030 compared to the emission levels into 2005. One of the innovations of NECD is Article 9, that mentions the issue of “monitoring air pollution impacts” on ecosystems. We provide a clear picture of what is available in term of monitoring network for air pollution impacts on Italian ecosystems, summarizing what has been done to control air pollution and its effects on different ecosystems in Italy. We provide an overview of the impacts of air pollution on health of the Italian population and evaluate opportunities and implementation of Article 9 in the Italian context, as a case study beneficial for all Member States. The results showed that SO42− deposition strongly decreased in all monitoring sites in Italy over the period 1999–2017, while NO3− and NH4+ decreased more slightly. As a consequence, most of the acid-sensitive sites which underwent acidification in the 1980s partially recovered. The O3 concentration at forest sites showed a decreasing trend. Consequently, AOT40 (the metric identified to protect vegetation from ozone pollution) showed a decrease, even if values were still above the limit for forest protection (5000 ppb h−1), while PODy (flux-based metric under discussion as new European legislative standard for forest protection) showed an increase. National scale studies pointed out that PM10 and NO2 induced about 58,000 premature deaths (year 2005), due to cardiovascular and respiratory diseases. The network identified for Italy contains a good number of monitoring sites (6 for terrestrial ecosystem monitoring, 4 for water bodies monitoring and 11 for ozone impact monitoring) distributed over the territory and will produce a high number of monitored parameters for the implementation of the NECD

Human lunar lander system design, cost estimation and technology roadmaps

This paper describes the methodology developed at Politecnico di Torino to support the European Space Agency in the Human Lunar Landing System design activity and to complement the traditional conceptual design with a multidisciplinary set of analyses which includes a thorough assessment of the economic and technological viability of the solution. The paper briefly describes the logic laying behind each of these analyses and it shows the results of the validation of the integrated design methodology, called iDREAM, with an already existing case study, the Exploration Systems Architecture Study-Lunar Surface Access Module spacecraft (ESAS-LSAM). The results are satisfactory and reveals errors lower than 10% in average, perfectly in line with the expectations of a conceptual design phase

Improved sapflow methodology reveals considerable night-time ozone uptake by Mediterranean species

Due to the evident tropospheric ozone impact on plant productivity, an accurate ozone risk assessment for the vegetation has become an issue. There is a growing evidence that ozone stomatal uptake may also take place at night and that the night-time uptake may be more damaging than diurnal uptake. Estimation of night-time uptake in the field is complicated because of instrumental difficulties. Eddy covariance technology is not always reliable because of the low turbulence at night. Leaf level porometry is defective at relative humidity above 70% which often takes place at night. Improved sap flow technology allows to estimate also slow flows that usually take place at night and hence may be, at present, the most trustworthy technology to measure night-time transpiration and hence to derive canopy stomatal conductance and ozone uptake at night. Based on micrometeorological data and the sap flow of three Mediterranean woody species, the night-time ozone uptake of these species was evaluated during a summer season as drought increased. Night-time ozone uptake was from 10% to 18% of the total daily uptake when plants were exposed to a weak drought, but increased up to 24% as the drought became more pronounced. The percentage increase is due to a stronger reduction of diurnal stomatal conductance than night-time stomatal conductance

Long-Term Effects of Breast Cancer Therapy and Care: Calm after the Storm?

Breast cancer is still a lethal disease and the leading cause of death in women, undermining patients' survival and quality of life. Modern techniques of surgery and radiotherapy allow for the obtaining of good results in terms of survival, however they cause long-term side effects that persist over time, such as lymphedema and neuropathy. Similarly, the advent of new therapies such as endocrine therapy revolutionized breast cancer outcomes, but side effects are still present even in years of follow-up after cure. Besides the side effects of medical and surgical therapy, breast cancer is a real disruption in patients' lives considering quality of life-related aspects such as the distortion of body image, the psychological consequences of the diagnosis, and the impact on family dynamics. Therefore, the doctor-patient relationship is central to providing the best support both during treatment and afterwards. The aim of this review is to summarize the consequences of medical and surgical treatment on breast cancer patients and to emphasize the importance of early prevention of side effects to improve patients' quality of life

Adalimumab and ABP 501 in the Treatment of a Large Cohort of Patients with Inflammatory Arthritis: A Real Life Retrospective Analysis

The recent introduction of ABP 501, an adalimumab biosimilar, in the treatment of rheumatic diseases was supported by a comprehensive comparability exercise with its originator. On the other hand, observational studies comparing adalimumab and ABP 501 in inflammatory arthritis are still lacking. The main aim of this study is to compare the clinical outcomes of the treatment with adalimumab, both the originator and ABP 501, in a large cohort of patients affected by autoimmune arthritis in a real life setting. We retrospectively analysed the baseline characteristics and the retention rate in a cohort of patients who received at least a course of adalimumab (originator or ABP 501) from January 2003 to December 2020. We stratified the study population according to adalimumab use: naive to original (oADA), naive to ABP 501 (bADA) and switched from original to ABP 501 (sADA). The oADA, bADA and sADA groups included, respectively, 724, 129 and 193 patients. In each group, the majority of patients had a diagnosis of rheumatoid arthritis. The total observation period was 9805.6 patient-months. The 18-month retentions rate in oADA, bADA and sADA was, respectively, 81.5%, 84.0% and 88.0% (p &gt; 0.05). The factors influencing the adalimumab retention rate were an axial spondylarthritis diagnosis (Hazard Ratio (HR) 0.70; p = 0.04), switch from oADA to ABP 501 (HR 0.53; p = 0.02) and year of prescription (HR 1.04; p = 0.04). In this retrospective study, patients naive to the adalimumab originator and its biosimilar ABP 501 showed the same retention rate. Patients switching from the originator to biosimilar had a higher retention rate, even though not statistically significant, when compared to naive

Overall mortality in combined pulmonary fibrosis and emphysema related to systemic sclerosis

OBJECTIVES: This multicentre study aimed to investigate the overall mortality of combined pulmonary fibrosis and emphysema (CPFE) in systemic sclerosis (SSc) and to compare CPFE-SSc characteristics with those of other SSc subtypes (with interstitial lung disease-ILD, emphysema or neither). METHODS: Chest CTs, anamnestic data, immunological profile and pulmonary function tests of patients with SSc were retrospectively collected. Each chest CT underwent a semiquantitative assessment blindly performed by three radiologists. Patients were clustered in four groups: SSc-CPFE, SSc-ILD, SSc-emphysema and other-SSc (without ILD nor emphysema). The overall mortality of these groups was calculated by Kaplan-Meier method and compared with the stratified log-rank test; Kruskal-Wallis test, t-Student test and χ² test assessed the differences between groups. P<0.05 was considered statistically significant. RESULTS: We enrolled 470 patients (1959 patient-year); 15.5 % (73/470) died during the follow-up. Compared with the SSc-ILD and other-SSc, in SSc-CPFE there was a higher prevalence of males, lower anticentromere antibodies prevalence and a more reduced pulmonary function (p<0.05). The Kaplan-Meier survival analysis demonstrates a significantly worse survival in patients with SSc-CPFE (HR vs SSc-ILD, vs SSc-emphysema and vs other-SSc, respectively 1.6 (CI 0.5 to 5.2), 1.6 (CI 0.7 to 3.8) and 2.8 (CI 1.2 to 6.6). CONCLUSIONS: CPFE increases the mortality risk in SSc along with a highly impaired lung function. These findings strengthen the importance to take into account emphysema in patients with SSc with ILD

Predictors of DAPSA Response in Psoriatic Arthritis Patients Treated with Apremilast in a Retrospective Observational Multi-Centric Study (2023-02-07)

Background: To date, only a few real-world-setting studies evaluated apremilast effectiveness in psoriatic arthritis (PsA). The aims of this retrospective observational study are to report long-term Disease Activity Index for Psoriatic Arthritis (DAPSA) response of apremilast in PsA patients and to analyze the predictors of clinical response. Methods: All PsA consecutive patients treated with apremilast in fifteen Italian rheumatological referral centers were enrolled. Anamnestic data, treatment history, and PsA disease activity (DAPSA) at baseline, 6 months, and 12 months were recorded. The Mann–Whitney test and chi-squared tests assessed the differences between independent groups, whereas the Wilcoxon matched pairs signed-rank test assessed the differences between dependent samples. Logistic regressions verified if there were factors associated with achievement of DAPSA low disease activity or remission at 6 and 12 months. Results: DAPSA low disease activity or remission rates at 6 and 12 months were observed, respectively, in 42.7% (n = 125) and 54.9% (n = 161) patients. Baseline DAPSA was inversely associated with the odds of achieving low disease activity or remission at 6 months (odds ratio (OR) 0.841, 95% confidence interval (CI) 0.804–0.879; p &lt; 0.01) and at 12 months (OR 0.911, 95% CI 0.883–0.939; p &lt; 0.01). Conclusions: Almost half of the PsA patients receiving apremilast achieved DAPSA low disease activity or remission at 6 and 12 months. The only factor associated with achievement of low disease activity or remission at both 6 and 12 months was baseline DAPSA