Cyclone-anticyclone asymmetry in rotating thin fluid layers

We report of a series of laboratory experiments and numerical simulations of freely-decaying rotating turbulent flows confined in domains with variable height. We show that the vertical confinement has important effects on the formation of large-scale columnar vortices, the hallmark of rotating turbulence, and in particular delays the development of the cyclone-anticyclone asymmetry. We compare the experimental and numerical results face-to-face, showing the robustness of the results.Comment: 12 pages, 10 figure

Italian survey on benign paroxysmal positional vertigo

Benign paroxysmal positional vertigo (BPPV) is the most common type of peripheral vertigo. BPPV often relapses after the first episode, with a recurrence rate between 15% and 50%. To date both the aetiopathogenetic processes that lead to otoconia detachment and the factors that make BPPV a relapsing disease are still unclear, but recent epidemiological studies have shown a possible association with cardiovascular risk factors. The aim of the present study (Sesto Senso Survey) was to evaluate in the Italian population through an observational survey, the main demographic and clinical characteristics of patients with BPPV (first episode or recurrent) with particular focus on the potential cardiovascular risk factors. The survey was conducted in 158 vestibology centres across Italy on 2,682 patients (mean age 59.3 ± 15.0 years; 39.1% males and 60.9% females) suffering from BPPV, from January 2013 to December 2014. The results showed a high prevalence of cardiovascular risk factors such as high blood pressure (55.8%), hypercholesterolaemia (38.6%) and diabetes (17.7%), as well as a family history of cardiovascular disease (49.4%). A high percentage of patients also had hearing loss (42.9%), tinnitus (41.2%), or both (26.8%). The presence of hypertension, dyslipidaemia and pre-existing cardiovascular comorbidities were significantly related to recurrent BPPV episodes (OR range between 1.84 and 2.31). In addition, the association with diabetes and thyroid/autoimmune disease (OR range between 1.73 and 1.89) was relevant. The survey results confirm the significant association between cardiovascular comorbidities and recurrent BPPV and identify them as a potential important risk factor for recurrence of BPPV in the Italian population, paving the way for the evaluation of new therapeutic strategies in the treatment of this disease

Usability assessment of an intraoperative planning software

Usability is a crucial aspect of medical device safety. The brand-new European Regulation requires the manufacturer to assess the usability of the new medical devices. In this study, we evaluate the usability of a new medical device intended to assist the intraoperative planning with the visualization of 3d patient-specific organ models. The usability study started from the early stage of the device design and iterated through an early formative, completed with desk-based activities, late formative, completed with a focus group, and summative phase, that comprised a user test, and questionnaire filling. The identified usability issues are mitigated, the safety of the device user interface is confirmed and the training contents are defined and confirmed. Additional information regarding the user experience is collected and analyzed to identify further improvements of the device

Global well-posedness of the Kirchhoff equation and Kirchhoff systems

This article is devoted to review the known results on global well-posedness for the Cauchy problem to the Kirchhoff equation and Kirchhoff systems with small data. Similar results will be obtained for the initial-boundary value problems in exterior domains with compact boundary. Also, the known results on large data problems will be reviewed together with open problems.Comment: arXiv admin note: text overlap with arXiv:1211.300

Aberrant BLM cytoplasmic expressionassociates with DNA damage stress and hypersensitivity to DNA-damaging agents in colorectal cancer

Background Bloom syndrome is a rare and recessive disorder characterized by loss-of-function mutations of the BLM gene, which encodes a RecQ 30–50 DNA helicase. Despite its putative tumor suppressor function, the contribution of BLM to human sporadic colorectal cancer (CRC) remains poorly understood. Methods The transcriptional regulation mechanism underlying BLM and related DNA damage response regulation in independent CRC subsets and a panel of derived cell lines was investigated by bioinformatics analysis, the transcriptomic profile, a CpG island promoter methylation assay, Western blot, and an immunolocalization assay. Results In silico analysis of gene expression data sets revealed that BLM is overexpressed in poorly differentiated CRC and exhibits a close connection with shorter relapsefree survival even after adjustment for prognostic factors and pathways that respond to DNA damage response through ataxia telangiectasia mutated (ATM) signaling. Functional characterization demonstrated that CpG island promoter hypomethylation increases BLM expression and associates with cytoplasmic BLM mislocalization and increased DNA damage response both in clinical CRC samples and in derived cancer cell lines. The DNA-damaging agent S-adenosylmethionine suppresses BLM expression, leading to the inhibition of cell growth following accumulation of DNA damage. In tumor specimens, cytoplasmic accumulation of BLM correlates with DNA damage and cH2AX and phosphorylated ATM foci and predicts long-term progression-free survival in metastatic patients treated with irinotecan. Conclusions Taken together, the findings of this study provide the first evidence that cancer-linked DNA hypomethylation and cytosolic BLM mislocalization might reflect compromised levels of DNA-repair activity and enhanced hypersensitivity to DNA-damaging agents in CRC patients

Drug resistance in B and non-B subtypes amongst subjects recently diagnosed as primary/recent or chronic HIV-infected over the period 2013–2016: Impact on susceptibility to first-line strategies including integrase strand-transfer inhibitors

Objectives To characterize the prevalence of transmitted drug resistance mutations (TDRMs) by plasma analysis of 750 patients at the time of HIV diagnosis from January 1, 2013 to November 16, 2016 in the Veneto region (Italy), where all drugs included in the recommended first line therapies were prescribed, included integrase strand transfer inhibitors (InNSTI). Methods TDRMs were defined according to the Stanford HIV database algorithm. Results Subtype B was the most prevalent HIV clade (67.3%). A total of 92 patients (12.3%) were expected to be resistant to one drug at least, most with a single class mutation (60/68–88.2% in subtype B infected subjectsand 23/24–95.8% in non-B subjects) and affecting mainly NNRTIs. No significant differences were observed between the prevalence rates of TDRMs involving one or more drugs, except for the presence of E138A quite only in patients with B subtype and other NNRTI in subjects with non-B infection. The diagnosis of primary/recent infection was made in 73 patients (9.7%): they had almost only TDRMs involving a single class. Resistance to InSTI was studied in 484 subjects (53 with primary-recent infection), one patient had 143C in 2016, a total of thirteen 157Q mutations were detected (only one in primary/recent infection). Conclusions Only one major InSTI-TDRM was identified but monitoring of TDRMs should continue in the light of continuing presence of NNRTI-related mutation amongst newly diagnosed subjects, sometime impacting also to modern NNRTI drugs recommended in first-line therapy

Italian survey on benign paroxysmal positional vertigo

La vertigine parossistica posizionale benigna (VPPB) è il tipo più comune di vertigine periferica. Frequentemente dopo il primo episodio la VPPB presenta recidive, con un tasso di ricorrenza tra il 15% ed il 50%. Ad oggi non vi è chiarezza sui processi eziopatogenetici che portano al distacco degli otoconi né su quali siano i fattori che rendono la VPPB una patologia recidivante, ma recenti studi epidemiologici hanno evidenziato una possibile associazione con fattori di rischio cardiovascolari. Lo scopo del presente studio (Sesto Senso Survey) è stato quello di valutare nella popolazione italiana, attraverso unindagine osservazionale, le principali caratteristiche demografiche e cliniche dei pazienti con VPPB (primo episodio o ricorrente), con particolare attenzione ai potenziali fattori di rischio cardiovascolare. Lindagine è stata condotta in 158 centri di Vestibologia in tutta Italia su 2.682 pazienti (età media 59,3 ± 15,0 anni; 39,1 maschi e 60,9% femmine) affetti da VPPB, da gennaio 2013 a dicembre 2014. I risultati hanno mostrato in questi pazienti lalta prevalenza di fattori di rischio cardiovascolari come ipertensione arteriosa (55,8%), ipercolesterolemia (38,6%) e diabete (17,7%), oltre ad una elevata familiarità per malattie cardiovascolari (49,4%). In unelevata percentuale di pazienti si è inoltre registrata la presenza di ipoacusia (42,9%), acufeni (41,2%) o entrambi (26,8%). Significativamente correlata agli episodi di recidiva di VPPB è risultata la presenza di ipertensione arteriosa, dislipidemia e comorbidità cardiovascolare accertata (range OR tra 1,84 e 2,31). Rilevanti anche le associazioni con diabete e patologie tiroidee e autoimmuni (range OR tra 1,73 e 1,89). I risultati dellindagine confermano la significativa associazione tra comorbidità cardiovascolari e VPPB recidivanti e le identificano come importante potenziale fattore di rischio per le recidive di VPPB nella popolazione italiana, aprendo la strada alla valutazione di nuove strategie terapeutiche nel trattamento di questa patologia

O treinamento da musculatura inspiratória é ineficiente em pacientes graves submetidos à ventilação mecânica

PURPOSE: Invasive mechanical ventilation is associated with complications, and its abbreviation is desirable. The imbalance between increased workload, decreased inspiratory muscle strength and endurance is an important determinant of ventilator dependence. Low endurance may be present due to respiratory muscle atrophy, critical illness, or steroid use. Specific inspiratory muscle training may increase or preserve endurance. The objective of the study was to test the hypothesis that inspiratory muscle training from the beginning of mechanical ventilation would abbreviate the weaning duration and decrease reintubation rate. As a secondary objective, we described the evolution of inspiratory muscle strength with and without inspiratory muscle training. METHODS: Prospective, randomized clinical trial in an adult clinical-surgical intensive care unit. Twelve patients trained the inspiratory muscles twice a day, and 13 patients did not (control). Training was performed adjusting the sensitivity of the ventilator based on the maximal inspiratory pressure. Patients underwent daily surveillance of the maximal inspiratory pressure. RESULTS: The weaning duration (31 ± 22 hr, control and 23 ± 11 hr, training group; P = .24) and reintubation rate (5 control and 3 training group; P = .39) were not statistically different. The maximal inspiratory pressure of the control group showed a trend toward a modest increase. In contrast, the training group showed a small decrease (P = .34). CONCLUSIONS: In acute critically ill patients, inspiratory muscle training from the beginning of mechanical ventilation neither abbreviated the weaning duration, nor decreased the reintubation rate. Inspiratory muscle strength tended to stay constant, along the mechanical ventilation, with or without this specific inspiratory muscle training.OBJETIVO: A ventilação mecânica invasiva é associada a complicações, portanto sua abreviação é desejada. O desbalanço entre o aumento da carga sobre os músculos inspiratórios, a diminuição da força e a resistência muscular é determinante na dependência da ventilação. A baixa resistência muscular pode ser causada por atrofia muscular, pela doença grave ou pelo uso de corticoesteróides. O treinamento da musculatura inspiratória pode aumentar ou preservar a resistência. O objetivo principal do estudo foi testar a hipótese que o treinamento da musculatura inspiratória desde o início da ventilação iria abreviar o desmame da ventilação e diminuir a taxa de reintubação. Como objetivo secundário descrevemos a evolução da pressão inspiratória máxima com e sem treinamento da musculatura inspiratória. MÉTODOS: Estudo prospectivo e aleatorizado em unidade de tratamento intensivo Clínico-Cirúrgica. Doze pacientes treinaram a musculatura inspiratória duas vezes ao dia e treze não treinaram (controle). O treinamento foi realizado ajustando a sensibilidade do ventilador, baseando-se na pressão inspiratória máxima. Os pacientes tiveram sua pressão inspiratória máxima verificada diariamente. RESULTADOS: A duração do desmame (31 ± 22 controle e 23 ± 11 horas grupo treinamento; p=0.24) não foi estatisticamente diferente. A pressão inspiratória máxima do grupo controle teve leve tendência ao aumento, enquanto o grupo treinamento teve leve tendência à diminuição. CONCLUSÃO: Em pacientes graves, o treinamento da musculatura inspiratória desde o início da ventilação mecânica não abreviou o desmame, nem diminuiu a reintubação. A pressão inspiratória máxima tendeu a manter-se constante ao longo da ventilação mecânica, com ou sem o treinamento inspiratório aplicado

Red mark syndrome: Is the aquaculture water microbiome a keystone for understanding the disease aetiology?

Aquaculture significantly contributes to the growing demand for food worldwide. However, diseases associated with intensive aquaculture conditions, especially the skin related syndromes, may have significant implications on fish health and industry. In farmed rainbow trout, red mark syndrome (RMS), which consists of multiple skin lesions, currently lacks recognized aetiological agents, and increased efforts are needed to elucidate the onset of these conditions. Most of the past studies were focused on analyzing skin lesions, but no study focused on water, a medium constantly interacting with fish. Indeed, water tanks are environmental niches colonized by microbial communities, which may be implicated in the onset of the disease. Here, we present the results of water and sediment microbiome analyses performed in an RMS-affected aquaculture facility, bringing new knowledge about the environmental microbiomes harbored under these conditions. On the whole, no significant differences in the bacterial community structure were reported in RMS-affected tanks compared to the RMS-free ones. However, we highlighted significant differences in microbiome composition when analyzing different samples source (i.e., water and sediments). Looking at the finer scale, we measured significant changes in the relative abundances of specific taxa in RMS-affected tanks, especially when analyzing water samples. Our results provide worthwhile insight into a mostly uncharacterized ecological scenario, aiding future studies on the aquaculture built environment for disease prevention and monitoring