karst springs of apennines typified by upwelling flux

The hydraulic phenomenon of upwelling, affecting several karst springs of Apennines, has been investigated through piezometric data at different depth and chemical-physical data of springs water. Three different springs in Campania region were analyzed (Serino, Grassano and Caposele springs), characterized by three different groundwater schemes, but with the same upwelling phenomena at the springs. Some data (spring discharge and piezometric levels) have been acquired from the municipal waterwork,. Other data (physical-chemical parameters and Radon values (222Rn)) have been collected ad hoc in spring waters, included the spring discharges of Grassano springs. All the data pointed out that karst springs considered are fed by groundwater flux that locally is vertical. This features, common to others springs of Apennines, can be relevant in the realization of the tapping work, in their maintenance and for the definition of the protection area of the springs

Hydrogeology of the Karst Area of the Grassano and Telese Springs

This work deals with the hydraulic phenomenon of the ascendant groundwater flow affecting the karst area of the Grassano and Telese springs (Campania, Southern Italy). It has been investigated through piezometric measurements, discharge and chemical-physical monitoring of springs and measurements of the radon 222Rn activity. The presence of ascendant flows is supported by numerous and different types of evidences in the area: location and topographical position of the springs; amazing density of sinkholes connected to geomorphic processes that develop below the topographic surface and involve the rising of CO2 and H2S rich waters; constancy of the temperature and the electrical conductivity of the spring waters over the time; fluctuation of the radon activity during the hydrological year; increasing of the hydraulic head with depth; presence of artesian conditions in the alluvial plain. Numerical simulations of the groundwater flow also support the general phenomenon of the ascendant flow in the discharge area and represent a useful background to interpret hydrological phenomena in the study area. The results of the simulations are suitable with all the hydrogeological processes observed in the area of the Grassano and Telese springs; this last is thought to belong to the regional groundwater flow system of the Matese massif and represents its discharge zone

Italian recommendations on enzymatic debridement in burn surgery.

Abstract Introduction Nexobrid®, a bromelain-based type of enzymatic debridement, has become more prevalent in recent years. We present the recommendations on enzymatic debridement (Nexobrid®)'s role based on the practice knowledge of expert Italian users. Methods The Italian recommendations, endorsed by SIUST (Italian Society of Burn Surgery), on using enzymatic debridement to remove eschars for burn treatment were defined. The definition followed a process to evaluate the level of agreement (a measure of consensus) among selected experts, representing Italian burn centers, concerning defined clinical aspects of enzymatic debridement. The consensus involved a multi-phase process based on the Delphi method. Results The consensus panel included experts from Italy with a combined experience of 1068 burn patients treated with enzymatic debridement. At the end of round 3 of the Delphi method, the panel reached 100% consensus on 26 out of 27 statements. The panel achieved full, strong consensus (all respondents strongly agreed on the statement) on 24 out of 27 statements. Discussion The statements provided by the Italian consensus panel represent a "ready to use" set of recommendations for enzymatic debridement in burn surgery that both draw from and complete the existing scientific literature on the topic. These recommendations are specific to the Italian experience and are neither static nor definitive. As such, they will be updated periodically as further quality evidence becomes available

Information Acquisition and Financial Advice

This paper studies the interplay between the investor’s incentives to delegate her asset allocation choice to a biased financial advisor, and the advisor’s decision to acquire information about multiple characteristics of the risky asset. We show that, to prevent unprofitable investments, the investor may delegate to the advisor imposing a cap on the amount of wealth that the advisor can invest. This cap (i) is decreasing in the magnitude of the conflict of interests between the investor and the advisor and (ii) may be lower when the advisor possesses more information. Interestingly, although the investor always prefers a more-informed advisor, the advisor may choose not to acquire full information, and reducing the conflict of interests with the investor may actually induce the advisor to acquire less information

The Upwelling Water Flux Feeding Springs: Hydrogeological and Hydraulic Features

The upwelling groundwater flux has been investigated by deep piezometers in a spring area characterized by alluvial deposits covering a karst substratum in Southern Italy. The piezometers are of varying depth located in a flat area. They have been monitored for a long period (about 40 years), and when measured, a good relationship between spring discharge and hydraulic head was observed. The local upwelling groundwater flux has been deducted by the increasing of the hydraulic head in depth, which allows the estimation of ascendant hydraulic gradient and groundwater velocity during the dry and wet seasons. A specific analytical solution has been used to estimate the zone involved by the ascendant flow, and could also be used in other spring areas. Some physical and chemical characteristics of spring water have been collected, including the radon (222Rn) activity, to support the phenomenon of the ascendant flux. The man geological and hydrogeological features leading to ascendant flux in karst environments is also discussed for some areas of Southern Italy, where many springs are affected

The Upwelling Groundwater Flow in the Karst Area of Grassano-Telese Springs (Southern Italy)

The hydraulic phenomenon of upwelling groundwater flow affecting the karst area of the Grassano-Telese springs (southern Italy) has been investigated through piezometric measurements, discharge, and chemical−physical monitoring of springs, radon activity included. Locally, both large karst springs and sulfurous thermal springs are closely located, and raise several questions on their origin. In this study, the phenomenon of the upwelling flow is supported by different types of evidences: Amazing density of sinkholes connected to hypogenic speleogenesis processes, constancy of temperature, and hydraulic conductivity of spring water, change of radon activity during the hydrological year, increasing of the hydraulic head with depth. Numerical code provides an estimation of the upwelling phenomenon in an unconfined aquifer feeding the karst springs, using MODFLOW tools. Based on the results reached, the phenomenon of the upwelling flow is able to explain the hydrological processes observed in the Telese karst area

Humoral and cardiac effects of TIPS in cirrhotic patients with different "effective" blood volume

The aim of this study was to evaluate the cardiac effects of transjugular intrahepatic portosystemic shunts (TIPS) in cirrhotic patients with different effective blood volume. Two-dimensional echocardiography was performed before and 7 and 28 days after TIPS insertion in 7 cirrhotic patients with PRA 4 ng/mL/h (group B, reduced effective blood volume). Before TIPS, most cirrhotic patients showed diastolic dysfunction as indicated by reduced early maximal ventricular filling velocity (E)/late filling velocity (A) ratio. Patients of group B differed from patients of group A because of smaller left ventricular volumes and stroke volume, indicating central underfilling. After TIPS insertion, portal decompression was associated with a significant increase of cardiac output (CO) and a decrease of peripheral resistances. The most important changes were recorded in patients of group B, who showed a significant increase of both the end-diastolic left ventricular volumes and the E/A ratio and a significant decrease of PRA. In conclusion, these results show that the hemodynamic effects of TIPS differ according to the pre-TIPS effective blood volume. Furthermore, TIPS improves the diastolic cardiac function of cirrhotic patients with effective hypovolemia. This result is likely due to a TIPS-related improvement of the fullness of central blood volume

Diastolic dysfunction is associated with poor survival in patients with cirrhosis with transjugular intrahepatic portosystemic shunt

Background: Transjugular intrahepatic portosystemic shunt (TIPS) is a treatment for portal hypertension-related complications. Accurate prediction of the outcome of patients treated with TIPS is important, because some patients have very short survival. Diastolic dysfunction is frequently observed in patients with cirrhosis. Aim: To investigate whether or not diastolic dysfunction can predict the outcome after TIPS. Methods: Echocardiography with Doppler exploration was performed before and 28 days after TIPS insertion in 32 patients with cirrhosis. Several echocardiographic measures, including the early maximal ventricular filling velocity/late filling velocity (E/A) ratio as indicative of diastolic function, as well as laboratory, clinical and demographic variables were evaluated as predictors of survival. Results: Univariate analysis revealed that the presence of diastolic dysfunction observed 28 days after TIPS (E/A ratio 641) and baseline model of end-stage liver disease score were related to survival. Multivariate analysis identified diastolic dysfunction as an independent predictor of death (RR 8.9, 95% CI 1.9 to 41.5, p = 0.005). During the first year of follow-up, six out of 10 patients with an E/A ratio 641 died, whereas all 22 patients with E/A ratio >1 survived. Conclusions: Diastolic dysfunction estimated using E/A ratio is a promising predictor of death in patients with cirrhosis who are treated with TIPS

Comparability of differential proteomics data generated from paired archival fresh-frozen and formalin-fixed samples by GeLC–MS/MS and spectral counting

In this study, a Veterinary Department repository composed by paired formalin-fixed paraffinembedded (FFPE) and fresh-frozen (FrFr) sets of the same tissues, routinely archived in the typical conditions of a clinical setting, was exploited to perform a comparative evaluation of the results generated by GeLC–MS/MS (1-DE followed by in-gel digestion and LC–MS/MS) and spectral counting with the two types of archival samples. Therefore, two parallel differential proteomic studies were performed using 3 canine mammary carcinomas and 3 normal controls in a paired fashion (6 FrFr and 6 FFPE in total). As a result, the FrFr and FFPE differential proteomic datasets exhibited fair consistency in differential expression trends, according to protein molecular function, cellular localization, networks, and pathways. However, FFPE samples were globally slightly less informative, especially concerning the high-MW subproteome. As a further investigation, new insights into the molecular aspects of protein fixation and retrieval were obtained. In conclusion, archival FFPE samples can be reliably used for differential proteomics studies employing a spectral counting GeLC–MS/MS approach, although some typical biases need to be taken into account, and FrFr specimens (when available) should still be considered as the gold standard for clinical proteomics

Impact of fixation time on GeLC–MS/MS proteomic profiling of formalin-fixed, paraffin-embedded tissues

Formalin-fixed, paraffin-embedded (FFPE) tissue banks represent an invaluable resource for biomarker discovery. Recently, the combination of full-length protein extraction, GeLC–MS/MS analysis, and spectral counting quantification has been successfully applied to mine proteomic information from these tissues. However, several sources of variability affect these samples; among these, the duration of the fixation process is one of the most important and most easily controllable ones. To assess its influence on quality of GeLC–MS/MS data, the impact of fixation time on efficiency of full-length protein extraction efficiency and on quality of label-free quantitative data was evaluated. As a result, although proteins were successfully extracted from FFPE liver samples fixed for up to eight days, fixation time appeared to negatively influence both protein extraction yield and GeLC–MS/MS quantitative proteomic data. Particularly, MS identification efficiency decreased with increasing fixation times. Moreover, amino acid modifications putatively induced by formaldehyde were detected and characterized. These results demonstrate that proteomic information can be achieved also from tissue samples fixed for relatively long times, but suggest that variations in fixation time need to be carefully taken into account when performing proteomic biomarker discovery studies on fixed tissue archives