A potential beach monitoring based on integrated methods

This study focuses on the analysis of sandy beaches by integrating sedimentological, geomorphological, and geophysical investigations. The beach represents an extremely variable environment where different natural processes act simultaneously with human activities, leading to the gathering of different methodologies of the Earth Sciences to study its evolution in space and time. The aim of this research is to propose a potential procedure for monitoring the morpho-sedimentary processes of sandy beaches by analyzing the textural and compositional characteristics of the sands and quantifying the volumes involved in the coastal dynamics. The study area includes two Apulian sandy beaches (Torre Guaceto and Le Dune beach) that are representative of the coastal dynamics of a large sector of the central/northern Mediterranean Sea involving the southern Adriatic Sea and the northern Ionian Sea. Sedimentological and ecological investigations allowed to describe the textural and compositional characteristics of the beach sands by interpreting their sand provenance and the physical/biological interactions within the beach. The topographic surveys carried out with a Terrestrial Laser Scanner and an Optical Total Station, aimed to quantify the variations of sediment volume over time, whereas the Delft3d software was applied to analyze the effects of the dominant wave motion on the sedimentary dynamics. Lastly, the geophysical techniques which included Sub Bottom Profiler procedures, Ground Penetrating Radar investigation, and resistivity models enabled us to calculate the sand sediment thickness above the bedrock

The Modern Age of Monoclonal Antibodies: The Revolution of Daratumumab

CD38 is a transmembrane glycoprotein expressed on the surface of different cell lines with several functions (receptor, adhesion molecule, ectoenzyme). Based on its high expression in multiple myeloma cells, CD38 is one of the main molecules used in the target therapy age. Daratumumab is the first fully human monoclonal antibody tested in clinical trials, showing efficacy in relapsed/refractory multiple myeloma patients, especially in combination with immunomodulants and/or proteasome inhibitors. The synergic effect concerns multiple myeloma cells as well as the microenvironment (NK cells, macrophage, regulatory B/T cells and CD8+ effector cells). Therefore, the anti-multiple myeloma activity of Daratumumab greatly depends on the immune system: this is the reason why several ongoing clinical trial are testing its efficacy in the naïve patients, with a more effective immune system

Venous thromboembolism prophylaxis in patients with multiple myeloma: where are we and where are we going?

Venous thromboembolism is a common complication of patients with hematologic malignancies, due both to release of procoagulant factors by tumor cells and to external factors, such us drugs. In multiple myeloma patients, the risk is increased by use of immunomodulants, especially when associated to multidrug therapy, during the induction phase. Prevention of venous thromboembolism in myeloma patients is highly recommended but specific guidelines are still lacking. The most common approach is to stratify the thrombotic risk according to individual, myeloma-related and therapy-related risk factors and to use aspirin for all patients, except those with two or more thrombotic risk factors who should be treated with traditional oral or parenteral anticoagulant. A more controversial approach indicates for prophylaxis either anticoagulant or aspirin, regardless of risk stratification. Recent trials investigate prophylaxis in myeloma patients with direct oral anticoagulants, based on studies showing efficacy and safety of this new class of drugs in the treatment and prophylaxis of thrombosis in patients with any malignancy. The results of these trials are encouraging but they need to be confirmed by larger studies. An international consensus about best prophylaxis to prevent venous thromboembolism in patients with multiple myeloma on treatment is still missing. Therefore, thrombosis in multiple myeloma remains an ongoing issue

Monoclonal antibodies in multiple myeloma.

Treatment of multiple myeloma (MM) patients has radically changed over the last years following the introduction of next generation proteasome inhibitors (PI) and immunomodulatory derivative (IMiDs). In the last years, one further therapeutic option for MM patients is represented by monoclonal antibodies (MoAbs), that seem to change the paradigm of MM treatment, particularly for heavily pretreated or double refractory to a PI and IMiDs patients. Antibodies have an immune-based mechanism, induce durable responses with limited toxicity and combine well with existing therapies. The therapeutic effects are prevalently obtained by means of antibody-dependent cellular cytotoxicity (ADCC), antibody-dependent cell-mediated phagocytosis (ADCP), complement-dependent cytotoxicity (CDC) and concurrently by the induction of signals on cell effectors. Immunotherapeutic strategies offer a new and exciting approach to target key molecular pathways that continue to be implicated in the survival of malignant plasma cells. These targets include cell surface proteins (CD38, CD138 [SDC1], B cell maturation antigen [BCMA, TNFRSF17]), cytokines that play a role in plasma cell survival and proliferation (interleukin 6 [IL6] and B cell activating factor), signal regulators of bone metabolism (RANKL [TNFSF11], DKK1) and regulators of the immune system (PD-1[PDCD1], PD-L1[CD274]). This article focuses on new MoAbs and related innovative immunotherapeutic modalities currently under investigation in the treatment landscape of MM

A multidisciplinary study of sandy beaches along the Apulian coast (Southern Italy).

The Apulian coasts are leader in the seaside tourism sector, by offering a great variability of coastal landscapes with a widely acclaimed concentration of tourism on sandy beaches. The Apulia Region contains about 900 km of coastal sectors, which corresponds to 12% of the Italian littorals. During the last fifty years, a significant economic development of many maritime localities is seriously threaten by pervasive coastline retreats, which are one of the most current issues of the region. This study focuses on the processes influencing the mechanisms of erosion, transport and sedimentation in coastal areas characterized by sandy beaches in order to analyse the sedimentary dynamic with a multidisciplinary approach. To achieve this objective, two beaches have been chosen as representative examples of Ionian (Porto Cesareo, Lecce) and Adriatic (Torre Guaceto, Brindisi) sandy coastal sectors of the Apulia region. Both areas are part of Protected Marine Reserves with stunning emerged and submerged landscapes. In terms of sand compositional features, these beaches represent also end-members of the Apulian beaches: Porto Cesareo sands are mainly bioclastic, while Torre Guaceto sands have a predominant siliciclastic (lithoclastic) content. The application of a multidisciplinary approach consists of gathering and testing different techniques. Firstly, the use of the Terrestrial Laser Scanner (LST) will allow analysing the emerged beach environment in superficial and geomorphological terms by constructing three-dimensional terrain models and evaluating beach slopes. The thickness of the emerged beach will be quantified with georadar investigations, whereas a Multibeam procedure will determine different relief forms and the bathymetry of the sea floor. Lastly, the Sub Bottom Profiler technique will be applied to measure the thickness and the sediment volumes that are involved in the coastal dynamic. By a sedimentological point of view, the beaches have been monitored by measuring all possible physical data, using classical and modern techniques. Seasonal sedimentological sampling procedures were carried out through diving techniques from foreshore to lower shoreface environments (local wave base is about 6 m). The grain-size analysis allowed us to calculate the statistical parameters of sands with unimodal distribution. The variation of these parameters along the emerged and submerged subenvironments have been analysed across the entire beach profile. In addition, the relationship between the main statistical parameters (mean versus kurtosis, kurtosis versus sorting, kurtosis versus skewness and mean versus skewness) will be used to investigate the erosive or stable-prograding tendency of the beaches. The most frequent size class of the statistical distribution was investigated with a binocular optical microscope to evaluate the sands composition in quantitative terms. Therefore, the classification of sands included quarts, feldspar, carbonate grains and other components (pyroxene, amphibole and opaque minerals). Within the carbonates class, the percentage of bioclasts was also evaluated. In the end, the sedimentological study of current beach sands with those relicts of platform will allow their reliable use in sandy coast nourishments for future technical interventions

Posterior reversible encephalopathy syndrome (PRES) as complication in a patient with relapsed/refractory multiple myeloma

Background: Multiple myeloma (MM) is a common hematologic malignancy. Immunomodulants, inhibitors of proteasome and monoclonal antibodies represent the standard of care regimens. Neurologic complications could occur in MM patients, both related to the disease or to the therapy. Posterior reversible encephalopathy syndrome (PRES) is a rare disease occurring with a several neurologic symptoms (seizures, headaches, visual loss and confusions) and characterized by typical imaging. It has been described in patients affected by malignancies but only few cases have been reported in MM patients on treatment. Case Report: We herein report the case of a 71 year-old woman with relapsed-refractory micro-molecular MM on treatment with immunomodulants who developed a clonic-tonic seizure during hospitalization for acute kidney failure. The brain computed-tomography (CT) scan and the magnetic resonance imaging (MRI), performed after the event, showed pathologic variations of cortical and subcortical signal of posterior cerebral regions. These findings were considered to be consistent with PRES. The cerebral lesions gradually disappeared, due to supportive therapy. The patient died to hematologic disease progression few months later. Conclusion: The pathophysiology of PRES is still unclear. Further studies are warranted to better understand its relation with multiple myeloma on treatment

Analisi e monitoraggio della dinamica morfo-sedimentaria della spiaggia Le Dune – Porto Cesareo (LE).

Il presente studio riguarda i meccanismi di erosione, trasporto e sedimentazione nei settori costieri della Puglia. Lo scopo della ricerca è testare delle procedure di analisi, monitoraggio e salvaguardia di un tratto di litorale sabbioso, investigando i processi di modificazione morfo-sedimentaria della spiaggia, analizzando i caratteri tessiturali e composizionali delle sabbie e quantificando i volumi coinvolti nella dinamica costiera. L’applicazione di un approccio multidisciplinare permetterà, in un triennio, di analizzare e monitorare la spiaggia Le Dune, una pocket beach situata tra l’Isola della Malva e la cittadina di Porto Cesareo (LE). Il campionamento sedimentologico e le indagini ecologiche permetteranno di interpretare le interazioni fisico / biologiche della spiaggia. Indagini LST e georadar saranno adottate per lo studio del settore emerso. L’attuazione di profili batimetrici e del Sub Bottom Profiler consentiranno l’investigazione della spiaggia sommersa