Fast emitting nanocomposites for high-resolution ToF-PET imaging based on multicomponent scintillators

Time-of-Flight Positron Emission Tomography is a medical imaging technique, based on the detection of two back-to-back {\gamma}-photons generated from radiotracers injected in the body. Its limit is the ability of employed scintillation detectors to discriminate in time the arrival of {\gamma}-pairs, i.e. the coincidence time resolution (CTR). A CTR < 50 ps that would enable fast imaging with ultralow radiotracer dose. Monolithic materials do not have simultaneously the required high light output and fast emission characteristics, thus the concept of scintillating heterostructure is proposed, where the device is made of a dense scintillator coupled to a fast-emitting light material. Here we present a composite polymeric scintillator, whose density has been increased upon addition of hafnium oxide nanoparticles. This enhanced by +300% its scintillation yield, surpassing commercial plastic scintillators. The nanocomposite is coupled to bismuth germanate oxide (BGO) realizing a multilayer scintillator. We observed the energy sharing between its components, which activate the nanocomposite fast emission enabling a net CTR improvement of 25% with respect to monolithic BGO. These results demonstrate that a controlled loading with dense nanomaterials is an excellent strategy to enhance the performance of polymeric scintillators for their use in advanced radiation detection and imaging technologies

Multiple subglacial water bodies below the south pole of Mars unveiled by new MARSIS data

The detection of liquid water by the Mars Advanced Radar for Subsurface and Ionosphere Sounding (MARSIS) at the base of the south polar layered deposits in Ultimi Scopuli has reinvigorated the debate about the origin and stability of liquid water under present-day Martian conditions. To establish the extent of subglacial water in this region, we acquired new data, achieving extended radar coverage over the study area. Here, we present and discuss the results obtained by a new method of analysis of the complete MARSIS dataset, based on signal processing procedures usually applied to terrestrial polar ice sheets. Our results strengthen the claim of the detection of a liquid water body at Ultimi Scopuli and indicate the presence of other wet areas nearby. We suggest that the waters are hypersaline perchlorate brines, known to form at Martian polar regions and thought to survive for an extended period of time on a geological scale at below-eutectic temperatures

Electromagnetic fields counteract IL-1β during chondrogenesis in synovial bovine mesenchymal progenitor cells

Objective. Mesenchymal stem cells (MSCs) isolated from synovium and from synovial fluid, have shown a chondrogenesis potential suggesting that synovium is an excellent source of MSCs for cartilage regeneration. Electromagnetic fields (EMFs) display several effects on cartilage: increase the synthesis of proteoglycans (PGs), prevents the catabolic effect of the pro-inflammatory cytokine interleukin-1β (IL-1β), appear useful for the treatment of osteoarthritis. Our goal was to evaluate if the chondrogenic differentiation of synovial bovine mesenchymal progenitor cells, may be influenced by EMFs. Further, as chondrogenic differentiation of MSCs could be altered in an inflammatory environment and EMFs can counteract IL-1β activity, we also evaluated the role of EMFs during chondrogenic differentiation in the presence of IL-1β. Design. Synovial fluid was aspirated from the metacarpophalangeal joints of bovine. Synovial cells at the 3rd passage were centrifuged to obtain pellet cultures. Pellets were cultured in chondrogenic medium alone (control) or supplemented with 10 ng/ml TGF-β3 and/or 50 ng/ml IL-1β. The pellets were unexposed or exposed to EMF (75 Hz, 1.5 mT) (Igea, Carpi, Italy), during the whole period in culture (34 days). Alcian blue for sulphated glycosaminoglycans and immunostaining for type II collagen, were performed. PG synthesis was measured by radioactive 35S-sulphate incorporation. Results. Pellets cultured in the presence of TGF-β3 exhibited positive staining for type II collagen and Alcian blue, compared to control, indicating chondrogenic differentiation of synovial bovine mesenchymal progenitor cells. In the presence of IL-1β, type II collagen and Alcian blue staining dramatically decreased compared to TGF-β3 treatment alone. When pellets treated with both TGF-β3 and IL-1β were exposed to EMF, the histochemical staining for type II collagen and Alcian blue increased compared to EMF-unexposed pellets, suggesting that EMF might counteract the IL-1β effect. Biochemical analysis on PG synthesis confirmed histochemical data. Conclusions. The presence of inflammatory cytokines, such as IL-1β in human joints, may explain why existing methods of cartilage engineering repair strategies, that rely on the in situ differentiation of MSCs, fail to provide a reliably successful. Results of this study support the hypothesis that EMF treatment may favour chondrogenic differentiation in inflammatory conditions, suggesting a possible strategy for improving the clinical outcome of cartilage repair procedures

The Impact of the COVID-19 Pandemic on the Mental Health of Healthcare Workers in Italy: Analyzing the Role of Individual and Workplace-Level Factors in the Reopening Phase After Lockdown

IntroductionItaly is one of the high-income countries hit hardest by Covid-19. During the first months of the pandemic, Italian healthcare workers were praised by media and the public for their efforts to face the emergency, although with limited knowledge and resources. However, healthcare workers soon had to face new challenges at a time when the national health system was working hard to recover. This study focuses on this difficult period to assess the impact of the COVID-19 pandemic on the mental health of Italian healthcare workers. Materials and MethodsHealthcare workers from all Italian regions [n = 5,502] completed an online questionnaire during the reopening phase after the first wave lockdown. We assessed a set of individual-level factors (e.g., stigma and violence against HCWs) and a set of workplace-level factors (e.g., trust in the workplace capacity to handle COVID-19) that were especially relevant in this context. The primary outcomes assessed were score &gt;= 15 on the Patient Health Questionnaire-9 and score &gt;= 4 on the General Health Questionnaire-12, indicators of clinically significant depressive symptoms and psychological distress, respectively. Logistic regression analyses were performed on depressive symptoms and psychological distress for each individual- and workplace-level factor adjusting for gender, age, and profession. ResultsClinically significant depressive symptoms were observed in 7.5% and psychological distress in 37.9% of HCWs. 30.5% of healthcare workers reported having felt stigmatized or discriminated, while 5.7% reported having experienced violence. Feeling stigmatized or discriminated and experiencing violence due to being a healthcare worker were strongly associated with clinically significant depressive symptoms [OR 2.98, 95%CI 2.36-3.77 and OR 4.72 95%CI 3.41-6.54] and psychological distress [OR 2.30, 95%CI 2.01-2.64 and OR 2.85 95%CI 2.16-3.75]. Numerous workplace-level factors, e.g., trust in the workplace capacity to handle COVID-19 [OR 2.43, 95%CI 1.92-3.07] and close contact with a co-worker who died of COVID-19 [OR 2.05, 95%CI 1.56-2.70] were also associated with clinically significant depressive symptoms. Similar results were found for psychological distress. ConclusionsOur study emphasizes the need to address discrimination and violence against healthcare professionals and improve healthcare work environments to strengthen the national health system's capacity to manage future emergencies

Monitoring the last Apennine glacier: recent in situ campaigns and modelling of Calderone glacial apparatus

The Calderone glacier is at present the most southern glacier in Europe (42° 28' 15’’ N). The little apparatus (about 20.000 m2 in surface area) has been giving an interesting response both to short- and long-term climatic variations which resulted in a considerable reduction in surface area and volume. The glacial apparatus is split into two ice bodies (glacierets) since 2000. The two glacierets are located in a deep northward valley below the top of the Corno Grande (2912 m asl) in the centre of the Gran Sasso d’Italia mountain range (Central Italy). Such glacial apparatus has been subjected to a strong reduction, with a loss of total surface area of about 50% and thickness of about 65%with respect to the hypothetical size (about 105.00 m2 and 55 m at the Little Ice Age). Since early 90s the Calderone glacier has been subjected to several multidisciplinary field campaigns to monitor and evaluate its role as an environmental indicator in the framework of global warming. Starting from historical series related to more than a century of records, the variability of the different glacier properties has been estimated by using classical geomorphologic methods as well as in situ and remote sensing techniques. In particular, the last field campaigns, in 2015, 2016 and 2019, have been carried out using Ground Penetrating Radar equipped with different antenna frequencies, drone-based survey, snow pit measurements and chemical-physical sampling. The measurement campaigns have been complemented by a regional climate analysis, spanning the last fifty years, and snowpack modelling initialized with microphysical snow data (e.g., snow density, crystal shape and size, hardness). The snowpack chemical analyses include the main and trace elements, soluble inorganic and organic ions, EC/OC and PAH, with different spatial resolution depending on the analytes. We present here the methodological approach used and some preliminary results

Electromagnetic fields (EMFs) and adenosine receptors modulate prostaglandin E2 and cytokine production in human osteoarthritic synovial fibroblasts

Objective. Synovial fibroblasts (SFs) contribute to the development of osteoarthritis (OA) by the secretion of a wide range of pro-inflammatory mediators, including cytokines and lipid mediators of inflammation (1). Previous studies show that electromagnetic fields (EMFs) may represent a potential therapeutical approach to limit cartilage degradation and to control inflammation associated to OA, and that they may act through the adenosine pathway (2). On this basis the aim of this study was to investigate if EMFs might modulate inflammatory activities of human SFs derived from OA patients (OASFs) and the possible involvement of adenosine receptors (ARs) in mediating EMF effects. Design. SFs obtained from OA patients, undergoing total hip joint replacement surgery, were exposed to EMFs (1.5 mT; 75 Hz) for 24 hours. In control and EMF-exposed cells, ARs were evaluated by western blotting, quantitative real-time RT-PCR and saturation binding experiments and cAMP levels were measured by a specific assay. In the absence and in the presence of interleukin-1β (IL-1β), used as a pro-inflammatory stimulus, prostaglandin E2 (PGE2), cytokine and matrix degrading enzyme production was evaluated in OASFs exposed to EMFs and treated with selective adenosine receptor agonists and antagonists. Results. EMF exposure induced a selective increase in A2A and A3 ARs. These increases were associated to changes in cAMP levels, indicating that ARs were functionally active in EMF-exposed cells. In IL-1β-treated OASFs, functional data obtained in the presence of  A2A and A3 adenosine agonists and antagonists showed that EMFs inhibit the release of (PGE2) and of the proinflammatory cytokines interleukin-6 (IL-6) and interleukin-8 (IL-8), whilst stimulate the release of interleukin-10 (IL-10), an antinflammatory cytokine. Further, results show that these effects appear to be mediated by the EMF-induced upregulation of A2A and A3 ARs. No effects of EMFs or ARs have been observed on matrix degrading enzymes production. Conclusions: EMFs display anti-inflammatory effects in human OASFs and these EMF-induced .ffects are in part mediated by the adenosine pathway, specifically by the A2A and A3 ARs activation. Taken together, these results suggest that SFs could represent potential therapeutic targets cells for EMF treatment and open new clinical perspectives to the control of inflammation associated to joint diseases. 1. Martel-Pelletier J et al. Eklem Hastalik Cerrahisi. 2010; 21(1):2-14. 2. De Mattei M et al. Osteoarthritis Cartilage. 2009; 17(2):252-262

Reply to: Explaining bright radar reflections below the south pole of Mars without liquid water

In their Matter Arising Lalich et al.1 simulate MARSIS echoes at the base of the South Polar Layered Deposits (SPLD) assuming three different layering scenarios (Fig. 1 in ref.1): (a) dusty water ice overlaying bedrock; (b) one CO2 ice layer between dusty water ice and bedrock; and, (c) two basal CO2 ice layers interbedded with one layer of dusty water ice. A surficial layer of CO2 ice ranging from 0 m (no layer) to 2 m in thickness is also considered. The first layer in each simulation is a semi-infinite half space assigned the permittivity of free space, and the bedrock is a semi-infinite half space with pure basaltic rock permittivity. These authors argue that constructive interference generated by some layered configurations produce waveforms (Fig. 2 in ref.1) with local maxima corresponding to the bright basal reflections observed by MARSIS at Ultimi Scopuli 2,3. They conclude that this explanation is more plausible than liquid brines being the source of the bright reflections, as posited instead by Orosei et al.2 and Lauro et al.3. In an earlier paper, however, Orosei et al.4 explored the same model and mathematics covering the entire range of possible parameters for two and three basal CO2 ice layers. Through the quantitative analysis of 3.45 x 108 simulation results, these authors demonstrated that local maxima at one of the MARSIS operating frequencies are not matched by local maxima at the other operating frequencies: that is, a layer stack producing constructive interference at one frequency, does not produce the same effect at the other frequencies, which is inconsistent with MARSIS real data. Thus, constructive interference by basal layers is not a viable mechanism to explain the bright basal reflections at Ultimi Scopuli. Because most of the points in Lalich et al.1 are superseded by Orosei et al.’s4 work, we refer interested readers to that earlier paper for a full discussion of the models and results. Here, we focus on three critical aspects: electromagnetic model; dielectric values used in the simulations; and materials and geology

Localization of anatomical changes in patients during proton therapy with in-beam PET monitoring: a voxel-based morphometry approach exploiting Monte Carlo simulations

Purpose: In-beam positron emission tomography (PET) is one of the modalities that can be used for in vivo noninvasive treatment monitoring in proton therapy. Although PET monitoring has been frequently applied for this purpose, there is still no straightforward method to translate the information obtained from the PET images into easy-to-interpret information for clinical personnel. The purpose of this work is to propose a statistical method for analyzing in-beam PET monitoring images that can be used to locate, quantify, and visualize regions with possible morphological changes occurring over the course of&nbsp;treatment. Methods: We selected a patient treated for squamous cell carcinoma (SCC) with proton therapy, to perform multiple Monte Carlo (MC) simulations of the expected PET signal at the start of treatment, and to study how the PET signal may change along the treatment course due to morphological changes. We performed voxel-wise two-tailed statistical tests of the simulated PET images, resembling the voxel-based morphometry (VBM) method commonly used in neuroimaging data analysis, to locate regions with significant morphological changes and to quantify the&nbsp;change. Results: The VBM resembling method has been successfully applied to the simulated in-beam PET images, despite the fact that such images suffer from image artifacts and limited statistics. Three dimensional probability maps were obtained, that allowed to identify interfractional morphological changes and to visualize them superimposed on the computed tomography (CT) scan. In particular, the characteristic color patterns resulting from the two-tailed statistical tests lend themselves to trigger alarms in case of morphological changes along the course of&nbsp;treatment. Conclusions: The statistical method presented in this work is a promising method to apply to PET monitoring data to reveal interfractional morphological changes in patients, occurring over the course of treatment. Based on simulated in-beam PET treatment monitoring images, we showed that with our method it was possible to correctly identify the regions that changed. Moreover we could quantify the changes, and visualize them superimposed on the CT scan. The proposed method can possibly help clinical personnel in the replanning procedure in adaptive proton therapy treatments

In-vivo range verification analysis with in-beam PET data for patients treated with proton therapy at CNAO

Morphological changes that may arise through a treatment course are probably one of the most significant sources of range uncertainty in proton therapy. Non-invasive in-vivo treatment monitoring is useful to increase treatment quality. The INSIDE in-beam Positron Emission Tomography (PET) scanner performs in-vivo range monitoring in proton and carbon therapy treatments at the National Center of Oncological Hadrontherapy (CNAO). It is currently in a clinical trial (ID: NCT03662373) and has acquired in-beam PET data during the treatment of various patients. In this work we analyze the in-beam PET (IB-PET) data of eight patients treated with proton therapy at CNAO. The goal of the analysis is twofold. First, we assess the level of experimental fluctuations in inter-fractional range differences (sensitivity) of the INSIDE PET system by studying patients without morphological changes. Second, we use the obtained results to see whether we can observe anomalously large range variations in patients where morphological changes have occurred. The sensitivity of the INSIDE IB-PET scanner was quantified as the standard deviation of the range difference distributions observed for six patients that did not show morphological changes. Inter-fractional range variations with respect to a reference distribution were estimated using the Most-Likely-Shift (MLS) method. To establish the efficacy of this method, we made a comparison with the Beam's Eye View (BEV) method. For patients showing no morphological changes in the control CT the average range variation standard deviation was found to be 2.5&nbsp;mm with the MLS method and 2.3&nbsp;mm with the BEV method. On the other hand, for patients where some small anatomical changes occurred, we found larger standard deviation values. In these patients we evaluated where anomalous range differences were found and compared them with the CT. We found that the identified regions were mostly in agreement with the morphological changes seen in the CT scan