Constrictive Pericarditis

Constrictive pericarditis (CP) is a challenging clinical scenario in which the heart muscle is entrapped by thick, fibrous, and frequently calcified pericardial layers. Whereas infectious diseases (mostly bacterial) had been observed as the main etiology in the last decades, nowadays, post-surgical or radiotherapy iatrogenic inflammation is becoming highly prevalent with the exception of developing countries and patients with immunodeficiency in which tuberculosis is still frequently observed. Clinically, progressive dyspnea and peripheral edema are present and frequently considered of unknown origin because of the diagnostic challenge that CP poses. As a matter of fact, a specific knowledge of echocardiography and right heart catheterization is essential to recognize constriction features. Moreover, a valuable support is provided by dedicated imaging modalities (mostly magnetic resonance). Complete surgical removal of the pericardium (pericardiectomy), when feasible and performed early, is associated with excellent symptomatic improvement. Unfortunately, in specific scenarios (radiation therapy) or when surgery is performed after severe constriction development, surgical outcomes are poor, and CP assumes the profile of an end-stage disease. This reinforces the unmet need of early detection of CP and the development of novel therapeutic strategies

Multimodality Imaging in the Diagnostic Work-Up of Endocarditis and Cardiac Implantable Electronic Device (CIED) Infection

Infective endocarditis (IE) is a serious cardiac condition, which includes a wide range of clinical presentations, with varying degrees of severity. The diagnosis is multifactorial and a proper characterization of disease requires the identification of the primary site of infection (usually the cardiac valve) and the search of secondary systemic complications. Early depiction of local complications or distant embolization has a great impact on patient management and prognosis, as it may induce to aggressive antibiotic treatment or, in more advanced cases, cardiac surgery. In this setting, the multimodality imaging has assumed a pivotal role in the clinical decision making and it requires the physician to be aware of the advantages and disadvantages of each imaging technique. Echocardiography is the first imaging test, but it has several limitations. Therefore, the integration with other imaging modalities (computed tomography, magnetic resonance imaging, nuclear imaging) becomes often necessary. Different strategies should be applied depending on whether the infection is suspected or already ascertained, whether located in native or prosthetic valves, in the left or right chambers, or if it involves an implanted cardiac device. In addition, detection of extracardiac IE-related lesions is crucial for a correct management and treatment. The aim of this review is to illustrate strengths and weaknesses of the various methods in the most common clinical scenarios

Demonstration of large area forest volume and primary production estimation approach based on Sentinel-2 imagery and process based ecosystem modelling

Forest biomass and carbon monitoring play a key role in climate change mitigation. Operational large area monitoring approaches are needed to enable forestry stakeholders to meet the increasing monitoring and reporting requirements. Here, we demonstrate the functionality of a cloud-based approach utilizing Sentinel-2 composite imagery and process-based ecosystem model to produce large area forest volume and primary production estimates. We describe the main components of the approach and implementation of the processing pipeline into the Forestry TEP cloud processing platform and produce four large area output maps: (1) Growing stock volume (GSV), (2) Gross primary productivity (GPP), (3) Net primary productivity (NPP) and (4) Stem volume increment (SVI), covering Finland and the Russian boreal forests until the Ural Mountains in 10 m spatial resolution. The accuracy of the forest structural variables evaluated in Finland reach pixel level relative Root Mean Square Error (RMSE) values comparable to earlier studies (basal area 39.4%, growing stock volume 58.5%, diameter 35.5% and height 33.5%), although most of the earlier studies have concentrated on smaller study areas. This can be considered a positive sign for the feasibility of the approach for large area primary production modelling, since forest structural variables are the main input for the process-based ecosystem model used in the study. The full coverage output maps show consistent quality throughout the target area, with major regional variations clearly visible, and with noticeable fine details when zoomed into full resolution. The demonstration conducted in this study lays foundation for further development of an operational large area forest monitoring system that allows annual reporting of forest biomass and carbon balance from forest stand level to regional analyses. The system is seamlessly aligned with process based ecosystem modelling, enabling forecasting and future scenario simulation.Peer reviewe

Identification of homozygous deletion in ACAN and other candidate variants in familial classical Hodgkin lymphoma by exome sequencing

Tutkimuksessamme tarkastelimme Lähi-idästä lähtöisin olevaa perhettä, jossa kolmella viidestä lapsesta on todettu nuorellä iällä klassinen Hodgkinin lymfooma (cHL). Perinnöllinen alttius cHL:lle tunnetaan huonosti, eikä taudille mahdollisesti altistavia geenimuutoksia ole aiemmin raportoitui kuin yksi kappale. Geenimuutosten selvittämiseksi eksomisekvensoimme kolmen sairastuneen lapsen verinäytteestä eristetyn DNA:n ja poimimme joukosta kaikkien kolmen jakamat muutokset. Suodatimme lasten jakamien DNA-muutosten joukosta pois omissa vertailujoukoissamme ja useissa julkisissa tietokannoissa esiintyvät geneettiset muutokset ja arvioimme jäljellejääneiden muutosten haitallisuutta kahdella laskennallisella priorisaatioalgoritmilla. Näin saimme järjestettyä jäljelle jääneet 35 jaettua muutosta laskennalliseen haitallisuusjärjestykseen. Jaetuista muutoksista merkittävimmäksi nousi ACAN-geenissä oleva homotsygoottinen 57 emäksen pituinen deleetio c.2836_2892del, jota ei ole aiemmin liitytty cHL-fenotyyppiin

Development of an optimized protocol for NMR metabolomics studies of human colon cancer cell lines and first insight from testing of the protocol using DNA G-quadruplex ligands as novel anti-cancer drugs

The study of cell lines by nuclear magnetic resonance (NMR) spectroscopy metabolomics represents a powerful tool to understand how the local metabolism and biochemical pathways are influenced by external or internal stimuli. In particular, the use of adherent mammalian cells is emerging in the metabolomics field in order to understand the molecular mechanism of disease progression or, for example, the cellular response to drug treatments. Hereto metabolomics investigations for this kind of cells have generally been limited to mass spectrometry studies. This study proposes an optimized protocol for the analysis of the endo-metabolome of human colon cancer cells (HCT116) by NMR. The protocol includes experimental conditions such as washing, quenching and extraction. In order to test the proposed protocol, it was applied to an exploratory study of cancer cells with and without treatment by anti-cancer drugs, such as DNA G-quadruplex binders and Adriamycin (a traditional anti-cancer drug). The exploratory NMR metabolomics analysis resulted in NMR assignment of all endo-metabolites that could be detected and provided preliminary insights about the biological behavior of the drugs tested

The Mucosae-Associated Epithelial Chemokine (MEC/CCL28) Modulates Immunity in HIV Infection

BACKGROUND. CCL28 (MEC) binds to CCR3 and CCR10 and recruits IgA-secreting plasma cells (IgA-ASC) in the mucosal lamina propria (MLP). Mucosal HIV-specific IgA are detected in HIV-infection and exposure. The CCL28 circuit was analyzed in HIV-infected and-exposed individuals and in HIV-unexposed controls; the effect of CCL28 administration on gastrointestinal MLP IgA-ASC was verified in a mouse model. METHODOLOGY/FINDINGS. CCL28 was augmented in breast milk (BM) plasma and saliva of HIV-infected and –exposed individuals; CCR3+ and CCR10+ B lymphocytes were increased in these same individuals. Additionally: 1) CCL28 concentration in BM was associated with longer survival in HIV vertically-infected children; and 2) gastro-intestinal mucosal IgA-ASC were significantly increased in VSV-immunized mice receiving CCL28. CONCLUSIONS. CCL28 mediates mucosal immunity in HIV exposure and infection. CCL28-including constructs should be considered in mucosal vaccines to prevent HIV infection of the gastro-intestinal MLP via modulation of IgA-ASC.Istituto Superiore di Sanita' "Programma Nazionale di Ricerca sull' AIDS"; DG Right to Health and Solidarity Policy; EMPRO and AVIP EC WP6 Projects; Japan Health Science Foundation; National Institutes of Child Health and Human Development (HD 39611, HD 40777

MIM-Deficient Mice Exhibit Anatomical Changes in Dendritic Spines, Cortex Volume and Brain Ventricles, and Functional Changes in Motor Coordination and Learning

In this study, we performed a comprehensive behavioral and anatomical analysis of the Missing in Metastasis (Mtss1/MIM) knockout (KO) mouse brain. We also analyzed the expression of MIM in different brain regions at different ages. MIM is an I-BAR containing membrane curving protein, shown to be involved in dendritic spine initiation and dendritic branching in Purkinje cells in the cerebellum. Behavioral analysis of MIM KO mice revealed defects in both learning and reverse-learning, alterations in anxiety levels and reduced dominant behavior, and confirmed the previously described deficiency in motor coordination and pre-pulse inhibition. Anatomically, we observed enlarged brain ventricles and decreased cortical volume. Although MIM expression was relatively low in hippocampus after early development, hippocampal pyramidal neurons exhibited reduced density of thin and stubby dendritic spines. Learning deficiencies can be connected to all detected anatomical changes. Both behavioral and anatomical findings are typical for schizophrenia mouse models.Peer reviewe

Mitigation Impact of Different Harvest Scenarios of Finnish Forests That Account for Albedo, Aerosols, and Trade-Offs of Carbon Sequestration and Avoided Emissions

The pressure to increase forest and land carbon stocks simultaneously with increasing forest based biomass harvest for energy and materials emphasizes the need for dedicated analyses of impacts and possible trade-offs between these different mitigation options including also forest related biophysical factors, surface albedo and the formation of biogenic Secondary Organic Aerosols (SOA). We analyzed the change in global radiative forcing (RF) due to changes in these climatic agents as affected by the change in state of Finnish forests under increased or decreased harvest scenarios from a baseline. We also included avoided emissions due to wood material and energy substitution. Increasing harvests from baseline (65% of Current Annual Increment) decreased the total carbon sink (carbon in trees, soil and harvested wood products) at least for 50 years. When we coupled this change in carbon with other biosphere responses, surface albedo and aerosols, decreasing harvests from the baseline produced the largest cooling effect during 50 years. Accounting also for the avoided emissions due to increased wood use, the RF responses of the two lowest harvest scenarios were within uncertainty range. Our results show that the effects of forest management on SOA formation should be included in the analyses trying to deduce the net climate impact of forest use. The inclusion of the rarely considered SOA effects enforces the view that the lower the harvest, the more climatic cooling boreal forests provide. These results should act as a caution mark for policy makers who are emphasizing the increased utilization of forest biomass for short-living products and bioenergy as an efficient measure to mitigate climate change.Peer reviewe

Interplanetary Protons versus Interacting Protons in the 2017 September 10 Solar Eruptive Event

We analyze the relativistic proton emission from the Sun during the eruptive event on 2017 September 10, which caused a ground-level enhancement (GLE 72) registered by the worldwide network of neutron monitors. Using the neutron monitor data and interplanetary transport modeling both along and across interplanetary magnetic field (IMF) lines, we deduce parameters of the proton injection into the interplanetary medium. The inferred injection profile of the interplanetary protons is compared with the profile of the >100 MeV γ-ray emission observed by the Fermi Large Area Telescope, attributed to pion production from the interaction of >300 MeV protons at the Sun. GLE 72 started with a prompt component that arrived along the IMF lines. This was followed by a more prolonged enhancement caused by protons arriving at the Earth across the IMF lines from the southwest. The interplanetary proton event is modeled using two sources—one source at the root of the Earth-connected IMF line and another source situated near the solar western limb. The maximum phase of the second injection of interplanetary protons coincides with the maximum phase of the prolonged >100 MeV γ-ray emission that originated from a small area at the solar western limb, below the current sheet trailing the associated coronal mass ejection (CME). A possible common source of interacting protons and interplanetary protons is discussed in terms of proton acceleration at the CME bow shock versus coronal (re-)acceleration in the wake of the CME

State of the art of 18F-FDG PET/CT application in inflammation and infection: a guide for image acquisition and interpretation

Aim The diagnosis, severity and extent of a sterile inflammation or a septic infection could be challenging since there is not one single test able to achieve an accurate diagnosis. The clinical use of 18F-fluorodeoxyglucose ([F-18]FDG) positron emission tomography/computed tomography (PET/CT) imaging in the assessment of inflammation and infection is increasing worldwide. The purpose of this paper is to achieve an Italian consensus document on [F-18]FDG PET/CT or PET/MRI in inflammatory and infectious diseases, such as osteomyelitis (OM), prosthetic joint infections (PJI), infective endocarditis (IE), prosthetic valve endocarditis (PVE), cardiac implantable electronic device infections (CIEDI), systemic and cardiac sarcoidosis (SS/CS), diabetic foot (DF), fungal infections (FI), tuberculosis (TBC), fever and inflammation of unknown origin (FUO/IUO), pediatric infections (PI), inflammatory bowel diseases (IBD), spine infections (SI), vascular graft infections (VGI), large vessel vasculitis (LVV), retroperitoneal fibrosis (RF) and COVID-19 infections. Methods In September 2020, the inflammatory and infectious diseases focus group (IIFG) of the Italian Association of Nuclear Medicine (AIMN) proposed to realize a procedural paper about the clinical applications of [F-18]FDG PET/CT or PET/MRI in inflammatory and infectious diseases. The project was carried out thanks to the collaboration of 13 Italian nuclear medicine centers, with a consolidate experience in this field. With the endorsement of AIMN, IIFG contacted each center, and the pediatric diseases focus group (PDFC). IIFG provided for each team involved, a draft with essential information regarding the execution of [F-18]FDG PET/CT or PET/MRI scan (i.e., indications, patient preparation, standard or specific acquisition modalities, interpretation criteria, reporting methods, pitfalls and artifacts), by limiting the literature research to the last 20 years. Moreover, some clinical cases were required from each center, to underline the teaching points. Time for the collection of each report was from October to December 2020. Results Overall, we summarized 291 scientific papers and guidelines published between 1998 and 2021. Papers were divided in several sub-topics and summarized in the following paragraphs: clinical indications, image interpretation criteria, future perspectivess and new trends (for each single disease), while patient preparation, image acquisition, possible pitfalls and reporting modalities were described afterwards. Moreover, a specific section was dedicated to pediatric and PET/MRI indications. A collection of images was described for each indication. Conclusions Currently, [F-18]FDG PET/CT in oncology is globally accepted and standardized in main diagnostic algorithms for neoplasms. In recent years, the ever-closer collaboration among different European associations has tried to overcome the absence of a standardization also in the field of inflammation and infections. The collaboration of several nuclear medicine centers with a long experience in this field, as well as among different AIMN focus groups represents a further attempt in this direction. We hope that this document will be the basis for a "common nuclear physicians' language" throughout all the country