Importance of Surface Sediments for Reliable 210Pb Dating

Lead-210, 137Cs and 241Am dating techniques have been extensively used in the dating of recent sediments. However, collection of an intact core is the first essential step towards having reliable 210Pb chronologies for the sediments. We collected short gravity cores from Loch Morar, a deep (310 m max. depth), steep-sided lake in Scotland. Lead-210 chronologies for one of the cores did not match with the 137Cs and 241Am records, and the radionuclide data indicate that surface sediments in this core were likely missing. Therefore, sediment chronologies and accumulation rates calculated from unsupported 210Pb activities in the core were deemed unreliable, as confirmed by another core from the same lake. Dating of the cores suggests that sediment dating not only depends on accurate counting of radionuclide activities, but also on the integrity of the cores, in turn determined by sampling location. Importantly, however 210Pb, 137Cs and 241Am data can be carefully assessed to determine the integrity of sediment cores

Multimodality Treatment with Conventional Transcatheter Arterial Chemoembolization and Radiofrequency Ablation for Unresectable Hepatocellular Carcinoma

Background/Aims: To evaluate the efficacy of multimodality treatment consisting of conventional transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (RFA) in patients with non-resectable and non-ablatable hepatocellular carcinoma (HCC). Methods: In this retrospective study, 85 consecutive patients with HCC (59 solitary, 29 multifocal HCC) received TACE followed by RFA between 2001 and 2010. The mean number of tumors per patient was 1.6 +/- 0.7 with a mean size of 3.0 +/- 0.9 cm. Both local efficacy and patient survival were evaluated. Results: Of 120 treated HCCs, 99 (82.5%) showed a complete response (CR), while in 21 HCCs (17.5%) a partial response was depicted. Patients with solitary HCC revealed CR in 91% (51/56); in patients with multifocal HCC (n = 29) CR was achieved in 75% (48 of 64 HCCs). The median survival for all patients was 25.5 months. The 1-, 2-, 3- and 5-year survival rates were 84.6, 58.7, 37.6 and 14.6%, respectively. Statistical analysis revealed a significant difference in survival between Barcelona Clinic Liver Cancer (BCLC) A (73.4 months) and B (50.3 months) patients, while analyses failed to show a difference for Child-Pugh score, Cancer of Liver Italian Program (CLIP) score and tumor distribution pattern. Conclusion: TACE combined with RFA provides an effective treatment approach with high local tumor control rates and promising survival data, especially for BCLC A patients. Randomized trials are needed to compare this multimodality approach with a single modality approach for early-stage HCC. Copyright (C) 2011 S. Karger AG, Base

Diversity and distribution of chironomids (Diptera, Chironomidae) in pristine Alpine and pre-Alpine springs (Northern Italy)

The diversity and distribution of chironomids (Diptera, Chironomidae) were studied in relation to environmental factors in 81 springs under pristine conditions in the Italian Prealps and Alps (Trentino and Veneto, NE-Italy, 46\ub0N, 10-11\ub0E). Each spring was surveyed once, between May and November, in 2005 or in 2007-2008, within 50 m of the spring\u2019s source (eucrenal). A total of 173 macroinvertebrate samples were collected, in which 26,871 chironomids (including larvae, pupae, pupal exuviae and adults) were counted. Five subfamilies (Tanypodinae, Diamesinae, Prodiamesinae, Orthocladiinae and Chironominae), 54 genera and 104 species/groups of species were identified. As expected, Orthocladiinae accounted for a large part of specimens (82%), followed by Diamesinae (10%), Chironominae Tanytarsini (6%) and Tanypodinae (2%). Together the Chironominae Chironomini and Prodiamesinae contributed less than 0.05% of the fauna. Larvae represented 97.5% of specimens, mostly juveniles (62.6%). Maximum richness and diversity occurred at intermediate altitudes (ca 900-2100 m a.s.l.). Most taxa were found in a small proportion of sites, and frequencies declined gradually for more widely distributed species. A high number (67%) of rare (= present in less than 10% of sites) taxa were found. Three to 27 taxa were identified per spring. The rheocrene/rheo-helocrene springs were richest in taxa (generally >15 taxa), the mineral spring was poorest, with only three taxa. Most taxa were crenophilous, including lentic, rheobiontic and bryophilous taxa. A Principal Component Analysis (PCA) was performed including 98 taxa. Axes were interpreted calculating the correlation coefficients between site scores and 24 environmental factors. The species with the highest scores were Pseudokiefferiella parva, Corynoneura sp. A, Metriocnemus eurynotus gr., Paratrichocladius skirwithensis and Tvetenia calvescens. Five clusters of sites were identified with K-means analysis on the basis of the first and second PCA axes and a Discriminant Analysis was used to detect environmental factors discriminating the clusters: altitude, canopy cover, hydrological regime, pH, and granulometry as percentage of cobbles and stones. The highly individual nature of springs was highlighted; within the same river basin, between springs and within a single spring. These results suggest that prudent and conservative land management should assume that all springs sheltering such unique faunal assemblages need protectio

Chironomids from Southern Alpine running waters : ecology, biogeography

The chironomid fauna living in running waters in the Southern Alps was investigated from an ecological and biogeographical point of view: 202 species were identified (not including terrestrial species). It must be emphasised that species identification is tentative within some genera, especially those awaiting revision (e.g., Boreoheptagyia, Chaetocladius). Although much taxonomic work was done in the past on the chironomid Alpine fauna, there are still many unsolved problems. Most of the species found are widespread in the Palearctic Region, with no evidence of bio-geographical barriers separating different Alpine sectors. Really a relatively high number of species reported from the northern and western side (France, Switzerland, Austria) of the Alps was not captured on the southern side (Italy), whereas most species found on the southern side are also present on the northern one. Very few species are reported from southern side only. Lack of sampling, imperfect taxonomic knowledge and different environmental conditions between the northern and southern sides may be responsible of this result. A comparison of the fauna of the southern Alps with the fauna of the Apennines suggests that the differences are probably more related to ecological conditions (lack of glaciers in the Apennines) than to biogeographical barriers. Different chironomid assemblages colonise manifold habitat types: strict cold-stenothermal species tolerating high current velocity (e.g., Diamesa latitarsis - steinboecki group) are almost the sole inhabitants of kryal biotopes, while other cold-stenothermal species are restricted to cold springs (Diamesa dampfi, D. incallida, Tokunagaia rectangularis, T. tonollii), there are also species characteristic of hygropetric habitats (Syndiamesa edwardsi, S. nigra) or restricted to lacustrine habitats (Corynoneura lacustris, Paratanytarsus austriacus). It must be emphasised that different responses to environmental factors can be observed between species belonging to the same genus (e.g., Diamesa, Eukiefferiella, Orthocladius, Paratrichocladius), so species identification is really needed for a good ecological work. Water temperature, current velocity, substrate type are the most critical factors, sometime chironomid species appear to be rather opportunistic and their presence or absence cannot be clearly related to a well defined range of values of environmental variables: be it a lack of knowledge or a real datum will be the task of future studies. The waters of the Alps are still relatively unpolluted, but hydraulic stress due to river damming and canalization is a serious problem for macrofauna conservation, and as the glaciers retreat, the species confined to the glacial snouts are at risk of extinction, some of them possibly even before their existence be discovered

Benthic macroinvertebrates as indicators in lakes

Benthic macroinvertebrates are considered to be good indicators of the trophic status of lakes but in the Mediterranean area gaps in knowledge on taxonomical and autoecological traits of species hinder their potential as indicators. Seventy-eight Italian lakes were sampled, belonging to 10 types according to morphometrical, geographical and geological parameters. An unsupervised neural network (SOM analysis) was carried out using 65 Chironomid and Oligochaete species collected in 1865 samples. he accordance between lake types and species assemblages was tested. Indicator weight of species was calculated considering their optima for trophic variables (dissolved oxygen, TP, transparency). A Benthic Quality Index (BQI) and a weighted diversity index were then calculated to test their potential as indicators of trophic status of lakes. Alpine, volcanic and large profundal lakes were separated into diferent clusters, characterized by diferent communities, chemical and morphometrical parameters. On the contrary, other lake types with similar trophic status were grouped together, showing similar taxa assemblages. BQI values were in agreement with the trophic condition of lakes, while the weighted diversity index showed low values for alpine lakes due to low species numbers

The effect of music-induced emotion on visual-spatial learning in people with Parkinson's disease: A pilot study

Introduction: Emotional states have been shown to influence cognitive processes including visual-spatial learning. Parkinson's Disease (PD), besides manifesting with the cardinal motor symptoms, presents cognitive and affective disturbances. Here we aimed at investigating whether manipulation of the emotional state by means of music was able to influence the performance of a visual-spatial learning task in a group of PD participants. Methods: Ten PD patients and 11 healthy elderly (ELD) were asked to perform a visual-spatial learning task while listening two musical pieces evoking a neutral emotion or fear. Targets were presented on a screen in a preset order over four blocks and subjects were asked to learn the sequence order by attending to the display. At the end of each block, participants were asked to verbally recall the sequence and a score was assigned (Verbal Score, VS). Results: Analysis of variance-type statistic test on the VS disclosed a significant effect of Music and sequence Blocks (p = 0.01 and p < 0.001, respectively) and a significant interaction between Group and sequence Blocks. Sequence learning occurred across the training period in both groups, but PD patients were slower than ELD and at the end of the training period learning performance was worse in PD with respect to ELD. In PD patients, like in ELD, fear-inducing music has a detrimental effect on visual-spatial learning performances, which are slower and decreased. Conclusion: These findings confirm an impairment in visual-spatial learning in PD and indicates that the emotional state influences this learning ability similarly to healthy controls

A randomized controlled trial on the effects induced by robot-assisted and usual-care rehabilitation on upper limb muscle synergies in post-stroke subjects

Muscle synergies are hypothesized to reflect connections among motoneurons in the spinal cord activated by central commands and sensory feedback. Robotic rehabilitation of upper limb in post-stroke subjects has shown promising results in terms of improvement of arm function and motor control achieved by reassembling muscle synergies into a set more similar to that of healthy people. However, in stroke survivors the potentially neurophysiological changes induced by robot-mediated learning versus usual care have not yet been investigated. We quantified upper limb motor deficits and the changes induced by rehabilitation in 32 post-stroke subjects through the movement analysis of two virtual untrained tasks of object placing and pronation. The sample analyzed in this study is part of a larger bi-center study and included all subjects who underwent kinematic analysis and were randomized into robot and usual care groups. Post-stroke subjects who followed robotic rehabilitation showed larger improvements in axial-to-proximal muscle synergies with respect to those who underwent usual care. This was associated to a significant improvement of the proximal kinematics. Both treatments had negative effects in muscle synergies controlling the distal district. This study supports the definition of new rehabilitative treatments for improving the neurophysiological recovery after stroke

A New SteatoScore in the Evaluation of Non-Alcoholic Liver Disease in Oncologic Patients

PurposeThe aims of this study were to evaluate the reproducibility of a new multi-parametric steatoscore (new SteatoScore) in oncologic patients with non-alcoholic fatty liver disease (NAFLD) and to compare it with computed tomography (CT). Materials and MethodsFifty-one (31 men, 20 women) oncologic patients, with a mean age and weight of 63.9 years and 78.33 kg, respectively, were retrospectively enrolled in the study. Patients underwent ultrasound (US) and computed tomography (CT) examinations as part of their oncologic follow-up protocol. US examinations were performed by using a 3.5-MHz convex probe. During the US examination, three standardized clips were obtained in each patient. Two operators performed all measurements, one of whom repeated the processing twice in 1 year. Hepatic/renal ratio (HR), attenuation rate (AR), diaphragm visualization (DV), hepatic/portal vein ratio (HPV), and portal vein wall visualization (PVW) were acquired and calculated by using Matlab and inserted in a multi-parametric algorithm called new SteatoScore. On unenhanced CT scan, hepatic attenuation (HA), liver-spleen difference (L-S), and liver/spleen ratio (L/S) were measured by placement of a region of interest (ROI) within liver and spleen parenchyma, avoiding areas with vessels and biliary ducts. ResultsThe intra-observer variability was greater than the inter-observer one, with intraclass correlation coefficient (ICC) values of 0.94 and 0.97, respectively. Correlation between single US and CT parameters provided an agreement in no case exceeding 50%. New SteatoScore showed high reproducibility, and high coefficient of correlation with L-S (R = -0.64; p < 0.0001) and L/S (R = -0.62; p < 0.0001) at CT. ConclusionNew SteatoScore has a high reproducibility and shows a good correlation with unenhanced CT in evaluation of oncologic patients with NAFLD

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

p 159analysis of early tumor shrinkage and depth of response in metastatic pancreatic cancer patients treated with first line modified folfirinox or gemcitabine nab paclitaxel

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