The effects of flank collapses on volcano plumbing systems

The growth of large volcanoes is commonly interrupted by episodes of flank collapse that may be accompanied by catastrophic debris avalanches, explosive eruptions, and tsunamis. El Hierro, the youngest island of the Canary Archipelago, has been repeatedly affected by such mass-wasting events in the last 1 Ma. Our field observations and petrological data suggest that the largest and most recent of these flank collapses—the El Golfo landslide—likely influenced the magma plumbing system of the island, leading to the eruption of higher proportions of denser and less evolved magmas. The results of our numerical simulations indicate that the El Golfo landslide generated pressure changes exceeding 1 MPa down to upper-mantle depths, with local amplification in the surroundings and within the modeled magma plumbing system. Stress perturbations of that order might drastically alter feeding system processes, such as degassing, transport, differentiation, and mixing of magma batches

Positive effects of Nordic Walking on anthropometric and metabolic variables in women with type 2 diabetes mellitus

Objectives. — Lack of physical activity predisposes people to chronic diseases including diabetes mellitus, obesity, and coronary artery diseases. Identifying forms of physical activity is warranted for prevention of these chronic diseases. Daily exercise has also been considered a significant contributing factor in the management of type 2 diabetes. Nordic Walking is shown to be easy to teach and learn, simple and adaptable to subjects with diabetes and metabolic syndrome. Nordic Walking allows training of about 90% of body muscles in the active propulsion phase, thus increasing energy expenditure by 30 to 50%. Aim of our study was to evaluate the effects of Nordic Walking structured training in a group of female patients with type 2 diabetes, looking at changes in anthropometric, metabolic and bioelectrical variables pre- and post-activities. A follow-up of 6 months after the end of the program was also performed. Equipment and methods. — Twenty women with type 2 diabetes, aged 40—65 years, were enrolled. The participants were randomized in two groups: (1) 10 women in the Nordic Walking active gr

Frequency and evolution of sleep-wake disturbances after ischemic stroke: A 2-year prospective study of 437 patients.

OBJECTIVE In the absence of systematic and longitudinal data, this study prospectively assessed both frequency and evolution of sleep-wake disturbances (SWD) after stroke. METHODS In 437 consecutively recruited patients with ischemic stroke or transient ischemic attack (TIA), stroke characteristics and outcome were assessed within the 1st week and 3.2 ± 0.3 years (M±SD) after the acute event. SWD were assessed by interview and questionnaires at 1 and 3 months as well as 1 and 2 years after the acute event. Sleep disordered breathing (SDB) was assessed by respirography in the acute phase and repeated in one fifth of the participants 3 months and 1 year later. RESULTS Patients (63.8% male, 87% ischemic stroke and mean age 65.1 ± 13.0 years) presented with mean NIHSS-score of 3.5 ± 4.5 at admission. In the acute phase, respiratory event index was >15/h in 34% and >30/h in 15% of patients. Over the entire observation period, the frequencies of excessive daytime sleepiness (EDS), fatigue and insomnia varied between 10-14%, 22-28% and 20-28%, respectively. Mean insomnia and EDS scores decreased from acute to chronic stroke, whereas restless legs syndrome (RLS) percentages (6-9%) and mean fatigue scores remained similar. Mean self-reported sleep duration was enhanced at acute stroke (month 1: 07:54 ± 01:27h) and decreased at chronic stage (year 2: 07:43 ± 01:20h). CONCLUSIONS This study documents a high frequency of SDB, insomnia, fatigue and a prolonged sleep duration after stroke/TIA, which can persist for years. Considering the negative effects of SWD on physical, brain and mental health these data suggest the need for a systematic assessment and management of post-stroke SWD

Impact of social determinants on antiretroviral therapy access and outcomes entering the era of universal treatment for people living with HIV in Italy

Background: Social determinants are known to be a driving force of health inequalities, even in high income countries. Aim of our study was to determine if these factors can limit antiretroviral therapy (ART) access, outcome and retention in care of people living with HIV (PLHIV) in Italy. Methods: All ART naïve HIV+ patients (pts) of Italian nationality enrolled in the ICONA Cohort from 2002 to 2016 were included. The association of socio-demographic characteristics (age, sex, risk factor for HIV infection, educational level, occupational status and residency area) with time to: ART initiation (from the first positive anti-HIV test), ART regimen discontinuation, and first HIV-RNA < 50 cp/mL, were evaluated by Cox regression analysis, Kaplan Meier method and log-rank test. Results: A total of 8023 HIV+ pts (82% males, median age at first pos anti-HIV test 36 years, IQR: 29-44) were included: 6214 (77.5%) started ART during the study period. Women, people who inject drugs (PWID) and residents in Southern Italy presented the lowest levels of education and the highest rate of unemployment compared to other groups. Females, pts aged > 50 yrs., unemployed vs employed, and people with lower educational levels presented the lowest CD4 count at ART initiation compared to other groups. The overall median time to ART initiation was 0.6 years (yrs) (IQR 0.1-3.7), with a significant decrease over time [2002-2006 = 3.3 yrs. (0.2-9.4); 2007-2011 = 1.0 yrs. (0.1-3.9); 2012-2016 = 0.2 yrs. (0.1-2.1), p < 0.001]. By multivariate analysis, females (p < 0.01) and PWID (p < 0.001), presented a longer time to ART initiation, while older people (p < 0.001), people with higher educational levels (p < 0.001), unemployed (p = 0.02) and students (p < 0.001) were more likely to initiate ART. Moreover, PWID, unemployed vs stable employed, and pts. with lower educational levels showed a lower 1-year probability of achieving HIV-RNA suppression, while females, older patients, men who have sex with men (MSM), unemployed had higher 1-year risk of first-line ART discontinuation. Conclusions: Despite median time to ART start decreased from 2002 to 2016, socio-demographic factors still contribute to disparities in ART initiation, outcome and durability

Evaluation of the prognostic value of impaired renal function on clinical progression in a large cohort of HIV-infected people seen for care in Italy

Whilst renal dysfunction, especially mild impairment (60 die;ve (Icona) Foundation Study collected between January 2000 and February 2014 with at least two creatinine values available. eGFR (CKD-epi) and renal dysfunction defined using a priori cut-offs of 60 (severely impaired) and 90 ml/min/1.73m2 (mildly impaired). Characteristics of patients were described after stratification in these groups and compared using chi-square test (categorical variables) or Kruskal Wallis test comparing median values. Follow-up accrued from baseline up to the date of the CCVD or AIDS related events or death or last available visit. Kaplan Meier curves were used to estimate the cumulative probability of occurrence of the events over time. Adjusted analysis was performed using a proportional hazards Cox regression model. We included 7,385 patients, observed for a median follow-up of 43 months (interquartile range [IQR]: 21-93 months). Over this time, 130 cerebro-cardiovascular events (including 11 deaths due to CCVD) and 311 AIDS-related events (including 45 deaths) were observed. The rate of CCVD events among patients with eGFR >90, 60-89, <60 ml/min, was 2.91 (95% CI 2.30-3.67), 4.63 (95% CI 3.51-6.11) and 11.9 (95% CI 6.19-22.85) per 1,000 PYFU respectively, with an unadjusted hazard ratio (HR) of 4.14 (95%CI 2.07-8.29) for patients with eGFR <60 ml/min and 1.58 (95%CI 1.10-2.27) for eGFR 60-89 compared to those with eGFR ≥90. Of note, these estimates are adjusted for traditional cardiovascular risk factors (e.g. smoking, diabetes, hypertension, dyslipidemia). Incidence of AIDS-related events was 9.51 (95%CI 8.35-10.83), 6.04 (95%CI 4.74-7.71) and 25.0 (95% CI 15.96-39.22) per 1,000 PYFU, among patients with eGFR >90, 60-89, <60 ml/min, respectively, with an unadjusted HR of 2.49 (95%CI 1.56-3.97) for patients with eGFR <60 ml/min and 0.68 (95%CI 0.52-0.90) for eGFR 60-89. The risk of AIDS events was significantly lower in mild renal dysfunction group even after adjustment for HIV-related characteristics. Our data confirm that impaired renal function is an important risk marker for CCVD events in the HIV-population; importantly, even those with mild renal impairment (90<60)&gt

Increased risk of virologic failure to the first antiretroviral regimen in HIV-infected migrants compared to natives: Data from the ICONA cohort

Migrant and Italian HIV-infected patients (n = 5773) enrolled in the ICONA cohort in 2004-2014 were compared for disparities in access to an initial antiretroviral regimen and/or risk of virologic failure (VF), and determinants of failure were evaluated. Variables associated with initiating antiretroviral therapy (ART) were analysed. Primary endpoint was time to failure after at least 6 months of ART and was defined as: VF, first of two consecutive virus loads (VL) >200 copies/mL; treatment discontinuation (TD) for any reason; and treatment failure as confirmed VL >200 copies/mL or TD. A Poisson multivariable analysis was performed to control for confounders. Migrants presented significantly lower CD4 counts and more frequent AIDS events at baseline. When adjusting for baseline confounders, migrants presented a lower likelihood to begin ART (odds ratio 0.80, 95% confidence interval (CI) 0.67-0.95, p 0.012). After initiating ART, the incidence VF rate was 6.4 per 100 person-years (95% CI 4.8-8.5) in migrants and 2.7 in natives (95% CI 2.2-3.3). Multivariable analysis confirmed that migrants had a higher risk of VF (incidence rate ratio 1.90, 95% CI 1.25-2.91, p 0.003) and treatment failure (incidence rate ratio 1.16, 95% CI 1.01-1.33, p 0.031), with no differences for TD. Among migrants, variables associated with VF were age, unemployment and use of a boosted protease inhibitor-based regimen versus nonnucleoside reverse transcriptase inhibitors. Despite the use of more potent and safer drugs in the last 10 years, and even in a universal health care setting, migrants living with HIV still present barriers to initiating ART and an increased risk of VF compared to natives

La valutazione ecocolor-Doppler degli assi vascolari mesenterici nell'addome acuto. Studio prospettico su 325 pazienti

La diagnosi di infarto intestinale in un paziente con acuzie addominale è difficile. La sua elevata mortalità è essenzialmente determinata da un ritardo diagnostico e terapeutico. Ciò è dovuto sia ad una scarsa specificità dei dati di laboratorio sia alla scarsità dei segni clinici nelle fasi iniziali della malattia. Obiettivo. Identificare il valore predittivo e negativo della metodica ecocolor-Doppler applicata ai vasi mesenterici nella diagnosi di ischemia acuta intestinale. Pazienti e metodi. 325 pazienti sono stati prospetticamente analizzati con un ecocolor-Dopper Aloka ssd 1700: 120 con addome acuto (gruppo A); 120 soggetti sani senza preparazione intestinale (gruppo B); 85 pazienti sani con preparazione intestinale (gruppo C). Abbiamo valutato la visualizzazione in B mode, l’estensione del vaso, la captazione del segnale colore ed i velocitogrammi. Risultati. In un campione selezionato di 32 pazienti con alto sospetto clinico di infarto mesenterico abbiamo rilevato 21 veri negativi,3 falsi positivi, 5 veri positivi e tre falsi negativi. Il valore predittivo positivo e negativo sono stati rispettivamente di 0,62 e 0,87. Conclusioni. La metodica ecocolor-Doppler si è dimostrata più efficace nell’escludere la presenza di una ischemia intestinale piuttosto che nel confermarla quando presente

Landslide failures detection and mapping using Synthetic Aperture Radar: Past, present and future

Landslides are geomorphological processes that shape the landscapes of all continents, dismantling mountains and contributing sediments to the river networks. Caused by geophysical and meteorological triggers, including intense or prolonged rainfall, seismic shaking, volcanic activity, and rapid snow melting, landslides pose a serious threat to people, property, and the environment in many areas. Given their abundance and relevance, investigators have long experimented with techniques and tools for landslide detection and mapping using primarily aerial and satellite optical imagery interpreted visually, or processed by semi-automatic or automatic procedures or algorithms. Optical (passive) sensors have known limitations due to their inability to capture Earth surface images through the clouds and to work in the absence of daylight. The alternatives are active, “all-weather” and “day-and-night”, microwave radar sensors capable of seeing through the clouds and working in presence and absence of daylight. We review the literature on the use of Synthetic Aperture Radar (SAR) imagery to detect and map landslide failures – i.e., the single most significant movement episodes in the history of a landslide – and of landslide failure events – i.e., populations of landslides in areas ranging from a few to several thousand square kilometres caused by a single trigger. We examine 54 articles published in representative journals presenting 147 case studies in 32 nations, in all continents, except Antarctica. Analysis of the geographical location of 70 study areas shows that SAR imagery was used to detect and map landslides in most morphological, geological, seismic, meteorological, climate, and land cover settings. The time history of the case studies reveals the increasing interest of the investigators in the use of SAR imagery for landslide detection and mapping, with less than one article per year from 1995 to 2011, rising to about 5 articles per year between 2012 and 2020, and an average period of about 4.2 years between the launch of a satellite and the publication of an article using imagery taken by the satellite. To detect and map landslides, investigators use a common framework that exploits the phase and the amplitude of the electromagnetic return signal recorded in the SAR images, to measure terrain surface properties and their changes. To discriminate landslides from the surrounding stable terrain, a classification of the ground properties is executed by expert visual (heuristic) interpretation, or through numerical (statistical) modelling approaches. Despite undisputed progress over the last 26 years, challenges remain to be faced for the effective use of SAR imagery for landslide detection and mapping. In the article, we examine the theoretical, research, and operational frameworks for the exploitation of SAR images for landslide detection and mapping, and we provide a perspective for future applications considering the existing and the planned SAR satellite missions.ISSN:0012-8252ISSN:1872-682