A numerical study of the benthic–pelagic coupling in a shallow shelf sea (Gulf of Trieste)

A coupled physical–biogeochemical 1D model (BFM–POM 1D) with an intermediate complexity benthic formulation was used to carry out sensitivity tests on the coupling parameters (sedimentation and diffusion at the sediment–water interface). Moreover, a mechanistic experiment was designed to investigate the role of filter feeders in regulating the biogeochemical state of the system in a coastal sea. Best reference parameters of sedimentation and diffusion were chosen from the sensitivity experiments carried out based on available observations. The mechanistic experiment revealed the importance of filter feeders' role in trapping pelagic organic matter and regulating benthic–pelagic nutrient fluxes, as well as controlling pelagic primary production. The model demonstrated to be able to qualitatively reproduce the biogeochemical characteristics of the system and adapt to different trophic configurations. The results shown are encouraging and foresee its possible use as a tool to study causal relationships and help in finding solutions for management issues

Linking 1D coastal ocean modelling to environmental management: an ensemble approach

The use of a one-dimensional interdisciplinary numerical model of the coastal ocean as a tool contributing to the formulation of ecosystem-based management (EBM) is explored. The focus is on the definition of an experimental design based on ensemble simulations, integrating variability linked to scenarios (characterised by changes in the system forcing) and to the concurrent variation of selected, and poorly constrained, model parameters. The modelling system used was previously specifically designed for the use in "data-rich" areas, so that horizontal dynamics can be resolved by a diagnostic approach and external inputs can be parameterised by nudging schemes properly calibrated. Ensembles determined by changes in the simulated environmental (physical and biogeochemical) dynamics, under joint forcing and parameterisation variations, highlight the uncertainties associated to the application of specific scenarios that are relevant to EBM, providing an assessment of the reliability of the predicted changes. The work has been carried out by implementing the coupled modelling system BFM-POM1D in an area of Gulf of Trieste (northern Adriatic Sea), considered homogeneous from the point of view of hydrological properties, and forcing it by changing climatic (warming) and anthropogenic (reduction of the land-based nutrient input) pressure. Model parameters affected by considerable uncertainties (due to the lack of relevant observations) were varied jointly with the scenarios of change. The resulting large set of ensemble simulations provided a general estimation of the model uncertainties related to the joint variation of pressures and model parameters. The information of the model result variability aimed at conveying efficiently and comprehensibly the information on the uncertainties/reliability of the model results to non-technical EBM planners and stakeholders, in order to have the model-based information effectively contributing to EBM

A management oriented 1-D ecosystem model: Implementation in the Gulf of Trieste (Adriatic Sea).

In this paper a coupled physical-biogeochemical one-dimensional numerical model (BFM-POM 1D) was implemented in the Gulf of Trieste, (northern Adriatic Sea) and its structure was tested in order to evaluate its usability as a tool to support coastal management and planning. The evaluation concerned the ability of the model to reproduce the main trophic pathways, as well as their temporal variability, in terms of seasonal variations. The ecosystem structure comprised three phytoplankton groups, four zooplankton groups, one bacterial group, and a simple benthic return in order to parametrise benthic processes. The dynamics and interactions between groups were studied, as well as the model's sensitivity to different trophic web configurations. Results showed that the model was capable of replicating the behaviour of seasonal vertical profiles of the major biogeochemical elements, and the prevalence of the microbial food web shaping the trophic chain in the Gulf of Trieste. The model also responded to strong forcings at the surface and different trophic arrangements, thus providing initial evidence of its potential as a scientific tool aimed at marine coastal management

Antifungal susceptibility of invasive yeast isolates in Italy: the GISIA3 study in critically ill patients

<p>Abstract</p> <p>Background</p> <p>Yeasts are a common cause of invasive fungal infections in critically ill patients. Antifungal susceptibility testing results of clinically significant fungal strains are of interest to physicians, enabling them to adopt appropriate strategies for empiric and prophylactic therapies. We investigated the antifungal susceptibility of yeasts isolated over a 2-year period from hospitalised patients with invasive yeast infections.</p> <p>Methods</p> <p>638 yeasts were isolated from the blood, central venous catheters and sterile fluids of 578 patients on general and surgical intensive care units and surgical wards. Etest strips and Sensititre panels were used to test the susceptibility of the isolates to amphotericin B, anidulafungin, caspofungin, fluconazole, itraconazole, posaconazole and voriconazole in 13 laboratories centres (LC) and two co-ordinating centres (CC). The Clinical and Laboratory Standards Institute (CLSI) reference broth microdilution method was used at the CCs for comparison.</p> <p>Results</p> <p>Etest and Sensititre (LC/CC) MIC₉₀values were, respectively: amphotericin B 0.5/0.38, 1/1 mg/L; anidulafungin 2/1.5 and 1/1 mg/L; caspofungin 1/0.75 and 0.5/0.5 mg/L; fluconazole 12/8 and 16/16 mg/L; itraconazole 1/1.5, 0.5/0.5 mg/L; posaconazole 0.5 mg/L and voriconazole 0.25 mg/L for all. The overall MIC₉₀values were influenced by the reduced susceptibility of <it>Candida parapsilosis </it>isolates to echinocandins and a reduced or lack of susceptibility of <it>Candida glabrata </it>and <it>Candida krusei </it>to azoles, in particular fluconazole and itraconazole. Comparison of the LC and CC results showed good Essential Agreement (90.3% for Etest and 92.9% for Sensititre), and even higher Categorical Agreement (93.9% for Etest and 96% for Sensititre); differences were observed according to the species, method, and antifungal drug. No cross-resistance between echinocandins and triazoles was detected.</p> <p>Conclusions</p> <p>Our data confirm the different antifungal susceptibility patterns among species, and highlight the need to perform antifungal susceptibility testing of clinically relevant yeasts. With the exception of a few species (e.g. <it>C. glabrata </it>for azoles and <it>C. parapsilosis </it>for echinocandins), the findings of our study suggest that two of the most widely used commercial methods (Etest and Sensititre) provide valid and reproducible results.</p

Serial Troponin for Early Detection of Nivolumab Cardiotoxicity in Advanced Non-Small Cell Lung Cancer Patients

Background: Rare cases of severe myocarditis are reported during treatment with nivolumab. Troponin, a biomarker of cardiac damage, is a key component of the diagnostic workup of many cardiac disorders, including myocarditis. This study investigates the role of troponin to assess cardiac involvement during nivolumab therapy for non-small cell lung cancer (NSCLC). Materials and Methods: We evaluated 59 NSCLC patients, analyzing serum samples collected within a translational research study. Troponin above the upper normal limit (0.046 ng/mL) was defined as Tn+, whereas normal but detectable troponin (0.015\u20130.045) was defined as Tndet. Troponin alterations were interpreted on the grounds of the following elements: peak values and time curve, cardiac comorbidities, signs and symptoms coincident to troponin elevation, ECG, echocardiography, and disease progression. Results: No patient had cardiovascular events. Among 362 available blood samples, Tn+ (max 0.317 ng/mL) was found in 13 determinations belonging to 6 patients. Seven other patients had isolated Tndet. In five patients, Tn+ was attributed to cardiac comorbidities, disease progression, or worsening clinical status. One patient without cardiac history and in good clinical condition had a sustained troponin increase\u2014soon after the start of therapy\u2014and after careful evaluation of all relevant elements, it was interpreted as a marker of nivolumab-related subclinical myocarditis. Conclusion: Tn+ may occur in NSCLC patients treated with nivolumab, but in most cases it does not indicate nivolumab cardiotoxicity. In some cases, however, a careful interpretation of troponin alteration, especially at the beginning of therapy, enables identification of subclinical myocarditis, thus allowing early cardiac treatment. Implications for Practice: Myocarditis is a rare but serious adverse event of immune checkpoint blockade with nivolumab, which needs to be recognized as soon as possible. This article suggests that troponin, a user-friendly biomarker of myocardial cytotoxicity, might be useful for early detection of immune-mediated myocarditis. However, because troponin abnormalities might also be related to a number of conditions capable of causing myocardial oxygen demand-supply mismatch, a careful cardiac assessment should be performed in non-small cell lung cancer patients in order to properly interpret any troponin increase. According to the available evidence, monitoring troponin during the first weeks of treatment can be considered reasonable

Unraveling the Microbiome of Necrotizing Enterocolitis: Insights in Novel Microbial and Metabolomic Biomarkers

International audienceNecrotizing enterocolitis (NEC) is among the most relevant gastrointestinal diseases affecting mostly prematurely born infants with low birth weight. While intestinal dysbiosis has been proposed as one of the possible factors involved in NEC pathogenesis, the role of the gut microbiota remains poorly understood. In this study, the gut microbiota of preterm infants was explored to highlight differences in the composition between infants affected by NEC and infants prior to NEC development. A large-scale gut microbiome analysis was performed, including 47 shotgun sequencing data sets generated in the framework of this study, along with 124 retrieved from publicly available repositories. Meta-analysis led to the identification of preterm community state types (PT- CSTs), which recur in healthy controls and NEC infants. Such analyses revealed an overgrowth of a range of opportunistic microbial species accompanying the loss of gut microbial biodiversity in NEC subjects. Moreover, longitudinal insights into preterm infants prior to NEC development indicated Clostridium neonatale and Clostridium perfringens species as potential biomarkers for predictive early diagnosis of this disease. Furthermore, functional investigation of the enzymatic reaction profiles associated with pre-NEC condition suggested DL-lactate as a putative metabolic biomarker for early detection of NEC onset.IMPORTANCE Necrotizing enterocolitis (NEC) is a severe gastrointestinal disease occurring predominantly in premature infants whose etiology is still not fully understood. In this study, the analysis of infant fecal samples through shotgun metagenomics approaches revealed a marked reduction of the intestinal (bio)diversity and an overgrowth of (opportunistic) pathogens associated with the NEC development. In particular, dissection of the infant's gut microbiome before NEC diagnosis high-lighted the potential involvement of Clostridium genus members in the progression of NEC. Remarkably, our analyses highlighted a gastrointestinal DL-lactate accumulation among NEC patients that might represent a novel potential functional biomarker for the early diagnosis of NEC

Linking 1D coastal ocean modelling to environmental management: an ensemble approach

The use of a one-dimensional interdisciplinary numerical model of the coastal ocean as a tool contributing to the formulation of ecosystem-based management (EBM) is explored. The focus is on the definition of an experimental design based on ensemble simulations, integrating variability linked to scenarios (characterised by changes in the system forcing) and to the concurrent variation of selected, and poorly constrained, model parameters. The modelling system used was previously specifically designed for the use in "data-rich" areas, so that horizontal dynamics can be resolved by a diagnostic approach and external inputs can be parameterised by nudging schemes properly calibrated. Ensembles determined by changes in the simulated environmental (physical and biogeochemical) dynamics, under joint forcing and parameterisation variations, highlight the uncertainties associated to the application of specific scenarios that are relevant to EBM, providing an assessment of the reliability of the predicted changes. The work has been carried out by implementing the coupled modelling system BFM-POM1D in an area of Gulf of Trieste (northern Adriatic Sea), considered homogeneous from the point of view of hydrological properties, and forcing it by changing climatic (warming) and anthropogenic (reduction of the land-based nutrient input) pressure. Model parameters affected by considerable uncertainties (due to the lack of relevant observations) were varied jointly with the scenarios of change. The resulting large set of ensemble simulations provided a general estimation of the model uncertainties related to the joint variation of pressures and model parameters. The information of the model result variability aimed at conveying efficiently and comprehensibly the information on the uncertainties/reliability of the model results to non-technical EBM planners and stakeholders, in order to have the model-based information effectively contributing to EBM