Autologous Hematopoietic Stem Cell Transplantation (AHSCT): Standard of Care for Relapsing–Remitting Multiple Sclerosis Patients

Abstract Autologous hematopoietic stem cell transplantation (AHSCT) has been used in the treatment of highly active multiple sclerosis (MS) for over two decades. It has been demonstrated to be highly efficacious in relapsing–remitting (RR) MS patients failing to respond to disease-modifying drugs (DMDs). AHSCT guarantees higher rates of no evidence of disease activity (NEDA) than those achieved with any other DMDs, but it is also associated with greater short-term risks which have limited its use. In the 2019 updated EBMT and ASBMT guidelines, which review the clinical evidence of AHSCT in MS, AHSCT indication for highly active RRMS has changed from “clinical option” to “standard of care”. On this basis, AHSCT must be proposed on equal footing with second-line DMDs to patients with highly active RRMS, instead of being considered as a last resort after failure of all available treatments. The decision-making process requires a close collaboration between transplant hematologists and neurologists and a full discussion of risk–benefit of AHSCT and alternative treatments. In this context, we propose a standardized protocol for decision-making and informed consent process

Nitrogen fertilization and arbuscular mycorrhizal fungi do not mitigate the adverse effects of soil contamination with polypropylene microfibers on maize growth

Soil contamination with microplastics may adversely affect soil properties and functions and consequently crop productivity. In this study, we wanted to verify whether the adverse effects of microplastics in the soil on maize plants (Zea mays L.) are due to a reduction in nitrogen (N) availability and a reduced capacity to establish symbiotic relationships with arbuscular mycorrhizal (AM) fungi. To do this, we performed a pot experiment in which a clayey soil was exposed to two environmentally relevant concentrations of polypropylene (PP; one of the most used plastic materials) microfibers (0.4% and 0.8% w/w) with or without the addition of N fertilizer and with or without inoculation with AM fungi. The experiment began after the soil had been incubated at 23 °C for 5 months. Soil contamination with PP considerably reduced maize root and shoot biomass, leaf area, N uptake, and N content in tissue. The adverse effects increased with the concentration of PP in the soil. Adding N to the soil did not alleviate the detrimental effects of PP on plant growth, which suggests that other factors besides N availability played a major role. Similarly, although the presence of PP did not inhibit root colonization by AM fungi (no differences were observed for this trait between the uncontaminated and PP-contaminated soils), the addition of the fungal inoculum to the soil failed to mitigate the negative impact of PP on maize growth. Quite the opposite: mycorrhization further reduced maize root biomass accumulation. Undoubtedly, much research remains to be done to shed light on the mechanisms involved in determining plant behavior in microplastic-contaminated soils, which are most likely complex. This research is a priority given the magnitude of this contamination and its potential implications for human and environmental health

Insect oviposition in herbaceous plants attracts egg parasitoids despite fungal phytopathogen infection

Egg parasitoids are important natural enemies of several insect pests. The ability to kill the pest before it can inflict damage to the plant makes egg parasitoids ideal candidates for biological control. Several studies have shown that egg parasitoids exploit oviposition-induced plant volatiles (OIPVs) to locate host eggs laid on plant organs. Yet such studies have often overlooked that, in nature, plants frequently suffer concurrent attack by insect herbivores and phytopathogens. These dual attacks can modify the emission of induced plant volatiles, which may potentially interfere with the host location abilities of egg parasitoids. We investigated this research question using the following study organisms: the broad bean Vicia faba, the plant pathogen Stemphylium sp., the southern green stink bug Nezara viridula and its associated egg parasitoid Trissolcus basalis. We showed that T. basalis is able to exploit OPIVs in order to locate N. viridula egg masses even when V. faba plants were previously infected by Stemphylium sp. Chemical analyses indicate that the egg parasitoid ability to exploit OIPVs persists despite significant alterations of the volatile blends emitted by plants suffering multiple biotic stresses. This study highlights the importance of incorporating the complexity of multiple biotic stresses when studying parasitoid foraging behavior, in order to comprehend how to enhance the effectiveness of natural enemies in crop protection

Acute kidney injury and acute kidney disease in high-dose cisplatin-treated head and neck cancer

Background: In locally advanced head and neck squamous cell carcinoma (LA-SCCHN) at least 200mg/m2 (standard dose 300 mg/m2) of cisplatin concomitant with radiotherapy represents the standard of care, both in postoperative and conservative settings. Nevertheless, high dose administration every 3 weeks is often replaced with low dose weekly cisplatin to avoid toxicities like kidney injury, though often failing to reach the therapeutic dose. Our aim was to investigate the incidence of renal impairment in the real-life setting, integrating high dose cisplatin with adequate supportive therapy, and to explore both Acute Kidney Injury (AKI) and Acute Kidney Disease (AKD), a recently described clinical renal syndrome that encompasses functional alterations of the kidney lasting fewer than 3 months. Methods: One hundred and nine consecutive patients affected by LA-SCCHN and treated with at least a cumulative dosage of 200 mg/m2 of cisplatin concomitant with radiotherapy were enrolled in this prospective observational study. Results: AKI was reported in 12.8% of patients, 50% of whom were stage 1 (KDIGO criteria), while 25.7% of the cohort developed AKD. Patients with baseline estimated Glomerular Filtration Rate (eGFR) < 90 ml/min showed a higher incidence of AKD (36.2% vs 17.7%). Hypertension, baseline eGFR, and therapy with Renin-angiotensin-aldosterone system inhibitors proved to be significant factors associated with both AKI and AKD. Conclusion: AKI and AKD are not rare complications of high-dose cisplatin, but an appropriate prevention strategy and accurate monitoring of patients during treatment could lead to a reduction of the burden of these conditions

Does the virial mass drive the intra-cluster light? The relationship between the ICL and Mvir_{vir} from VEGAS

In this Letter we revisit the relationship between the fraction of the intra-cluster light (ICL) and both the virial mass and the fraction of Early Type Galaxies in the host halo. This is based on a statistically significant and homogeneous sample of 22 groups and clusters of galaxies in the local Universe ($z \leq 0.05$), obtained with the VST Early-type GAlaxy Survey (VEGAS). Taking advantage of the long integration time and large area of the VEGAS images, we are able to map the galaxy outskirts and ICL down to $\mu_g$ $\geq$ 29-30 mag/arcsec$^2$ and out to hundreds of kpc. With this data-set, we have expanded the sample of ICL measurements, doubling the previous measures available from the literature for z $\leq$ 0.05. The main result of this work is the lack of any significant trend between the fraction of ICL and the virial mass of the host environment, covering a wide range of virial masses ( $\sim$ $10^{12.5} \leq M_{vir} \leq 10^{15.5} M_{\odot}$), in agreement with some theoretical studies. Since the new data points are all derived with the same methodology and from the same observational setup, and all have comparable depth, the large observed scatter indicates an intrinsic variation in the ICL fraction.On the other hand, there is a weak relation between the fraction of ICL and the fraction of Early Type Galaxies in the host halo, where a larger fraction of ICL is found in groups and clusters of galaxies dominated by earlier morphological types, indicating a connection between the ICL and the dynamical state of the host system.Comment: Letter to the editor, accepted for publication in A&A. 8 pages, 3 figure

Lung ultrasonography for long-term follow-up of COVID-19 survivors compared to chest CT scan

Background: While lung ultrasonography (LUS) has utility for the evaluation of the acute phase of COVID-19 related lung disease, its role in long-term follow-up of this condition has not been well described. The objective of this study is to compare LUS and chest computed tomography (CT) results in COVID-19 survivors with the intent of defining the utility of LUS for long-term follow-up of COVID-19 respiratory disease. Methods: Prospective observational study that enrolled consecutive survivors of COVID-19 with acute hypoxemic respiratory failure (HARF) admitted to the Respiratory Intensive Care Unit. Three months following hospital discharge, patients underwent LUS, chest CT, body plethysmography and laboratory testing, the comparison of which forms the basis of this report. Results: 38 patients were enrolled, with a total of 190 lobes analysed: men 27/38 (71.1%), mean age 60.6 y (SD 10.4). LUS findings and pulmonary function tests outcomes were compared between patients with and without ILD, showing a statistically significant difference in terms of LUS score (p: 0.0002), FEV1 (p: 0.0039) and FVC (p: 0.012). ROC curve both in lobe by lobe and in patient's overall analysis revealed an outstanding ILD discrimination ability of LUS (AUC: 0.94 and 0.95 respectively) with a substantial Cohen's coefficient (K: 0.74 and 0.69). Conclusions: LUS has an outstanding discrimination ability compared to CT in identifying an ILD of at least mild grade in the post COVID-19 follow-up. LUS should be considered as the first-line tool in follow-up programs, while chest CT could be performed based on LUS findings

Somatostatin receptor PET/CT imaging for the detection and staging of pancreatic NET. A systematic review and meta-analysis

We investigated the diagnostic performance of Somatostatin Receptor Positron Emission Tomography/Computed Tomography (SSR-PET/CT) for the detection of primary lesion and initial staging of pancreatic neuroendocrine tumors (pNETs). A comprehensive literature search up to January 2020 was performed selecting studies in presence of: sample size ≥10 patients; index test (i.e., 68Ga-DOTATOC or 68Ga-DOTANOC or 68Ga-DOTATATE PET/CT); and outcomes (i.e., detection rate (DR), true positive, true negative, false positive, and false-negative). The methodological quality was evaluated with QUADAS-2. Pooled DR and pooled sensitivity and specificity for the identification of the primary tumor were assessed by a patient-based and a lesion-based analysis. Thirty-eight studies were selected for the qualitative analysis, while 18 papers were included in the meta-analysis. The number of pNET patients ranged from 10 to 142, for a total of 1143 subjects. At patient-based analysis, the pooled sensitivity and specificity for the assessment of primary pNET were 79.6% (95% confidence interval (95%CI): 71–87%) and 95% (95%CI: 75–100%) with a heterogeneity of 59.6% and 51.5%, respectively. Pooled DR for the primary lesion was 81% (95%CI: 65–90%) and 92% (95%CI: 80–97%), respectively, at patient-based and lesion-based analysis. In conclusion, SSR-PET/CT has high DR and diagnostic performances for primary lesion and initial staging of pNETs

NSHT: New Smart Hybrid Transducer for Structural and Geotechnical Applications

This work describes the application of a new transducer prototype for continuous monitoring in both the structural and geotechnical fields. The transducer is synthetically constituted by a wire of optical fiber embedded between two fiber tapes (fiberglass or carbon fiber) and glued by a matrix of polyester resin. The fiber optical wire ends have been connected to a control unit whose detection system is based on Brillouin optical time-domain frequency analysis. Three laboratory tests were carried out to evaluate the sensor's reliability and accuracy. In each experiment, the transducer was applied to a sample of inclinometer casing sets in different configurations and with different constraint conditions. The experimental collected data were compared with theoretical models and with data obtained from the use of different measuring instruments to perform validation and calibration of the transducer at the same time. Several diagrams can compare the transducer and highlight its suitability for the monitoring and maintenance of structures. The characteristic of the transducer suggests its use as a mixed system for reinforcing and monitoring, especially in the lifetime maintenance of critical infrastructures such as transportation and service networks, and historical heritag

Predictors of Patient-Reported Dysphagia Following IMRT Plus Chemotherapy in Oropharyngeal Cancer

The aim of this cross-sectional study is to evaluate the factors associated with patient-reported dysphagia in patients affected by locally advanced oropharyngeal cancer (OPC) treated with definitive intensity-modulated radiation therapy (IMRT) and concurrent chemotherapy (CHT), with or without induction CHT. We evaluated 148 OPC patients treated with IMRT and concurrent CHT, without evidence of disease and who had completed their treatment since at least 6 months. At their planned follow-up visit, patients underwent clinical evaluation and completed the M.D. Anderson dysphagia inventory (MDADI) questionnaire. The association between questionnaire composite score (MDADI-CS) and different patients\u2019 and tumor\u2019s characteristics and treatments (covariates) was investigated by univariable and multivariable analyses, the latter including only covariates significant at univariable analysis. With a median time from treatment end of 30 months [range 6\u201374 months, interquartile range (IQR) 16\u201350 months], the median (IQR) MDADI-CS was 72 (63\u201384). The majority of patients (82.4%) had a MDADI-CS 65 60. At multivariable analysis, female gender, human papilloma virus (HPV)-negative status, and moderate and severe clinician-rated xerostomia were significantly associated with lower MDADI-CS. Patient-perceived dysphagia was satisfactory or acceptable in the majority of patients. HPV status and xerostomia were confirmed as important predictive factors for swallowing dysfunction after radiochemotherapy. Data regarding female gender are new and deserve further investigation