Pillars and Buttes: A Petrologic Comparison of Modern and Ancient Hydrocarbon Seep Rock

Purpose: Literature on the formation of authigenic rock at cold seeps focuses on the role of microbes in creating geochemically favorable environment for the precipitation of carbonate and barite minerals. Less understood is the pathway that lithified microbial patches of seafloor sediment follow to become rock formations that are identified in strata dating back to the Silurian. In this study I will compare Holocene seep rock from the Gulf of Mexico to Cretaceous carbonates that have been identified as seep rock. Through the study of rock in its early stages of formation to rock that has likely undergone multiple phases of diagenesis I aim to establish a hypothetical sequence of formation of the Cretaceous seep rocks

Pillars and Buttes: A Petrologic Comparison of Modern and Ancient Hydrocarbon Seep Rock

Purpose: Literature on the formation of authigenic rock at cold seeps focuses on the role of microbes in creating geochemically favorable environment for the precipitation of carbonate and barite minerals. Less understood is the pathway that lithified microbial patches of seafloor sediment follow to become rock formations that are identified in strata dating back to the Silurian. In this study I will compare Holocene seep rock from the Gulf of Mexico to Cretaceous carbonates that have been identified as seep rock. Through the study of rock in its early stages of formation to rock that has likely undergone multiple phases of diagenesis I aim to establish a hypothetical sequence of formation of the Cretaceous seep rocks

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

Ongoing barriers to immediate postpartum long-acting reversible contraception: a physician survey

Abstract Background Postpartum women are at risk for unintended pregnancy. Access to immediate long-acting reversible contraception (LARC) may help decrease this risk, but it is unclear how many providers in the United States routinely offer this to their patients and what obstacles they face. Our primary objective was to determine the proportion of United States obstetric providers that offer immediate postpartum LARC to their obstetric patients. Methods We surveyed practicing Fellows and Junior Fellows of the American College of Obstetricians and Gynecologists (ACOG) about their use of immediate postpartum LARC. These members are demographically representative of ACOG members as a whole and represent all of the ACOG districts. Half of these Fellows were also part of the Collaborative Ambulatory Research Network (CARN), a group of ACOG members who voluntarily participate in research. We asked about their experience with and barriers to immediate placement of intrauterine devices and contraceptive implants after delivery. Results There were a total of 108 out of 600 responses (18%). Participants practiced in a total of 36 states and/or US territories and their median age was 52 years. Only 26.9% of providers surveyed offered their patients immediate postpartum LARC, and of these providers, 60.7% work in a university-based practice. There was a statistically significant association between offering immediate postpartum LARC and practice type, with the majority of providers working at a university-based practice (p < 0.001). Multiple obstacles were identified, including cost or reimbursement, device availability, and provider training on device placement in the immediate postpartum period. Conclusion The majority of obstetricians surveyed do not offer immediate postpartum long-acting reversible contraception to patients in the United States. This is secondary to multiple obstacles faced by providers

Trapianto intracerebrale di striato fetale nella malattia di Huntington: un aggiornamento dell'esperienza clinica italiana

Presso la Clinica Neurochirurgica dell’Azienda Ospedaliero-Universitaria Careggi di Firenze è in corso di sperimentazione il trial “Trapianto intracerebrale di tessuto striatale fetale nella Malattia di Huntington”. Dal febbraio 2006, 18 pazienti sono stati sottoposti a trapianto robotico-assistito in sede caudato-putaminale di tessuto ottenuto dall’eminenza ganglionare di feti di 9-12,4 settimane derivati da interruzioni volontarie di gravidanza. I pazienti hanno ricevuto immunosoppressone tripla per almeno un anno. Riferiamo qui i risultati a lungo termine dei primi 10 pazienti, focalizzando su sicurezza, effetti neurologici e implicazioni immunogenetiche. Il follow-up medio è stato di 66,5 mesi. Nessun paziente ha presentato segni neurologici focali aggiuntivi o di ipertensione endocranica. In 4 pazienti si è osservata una crescita del graft tale da superare le dimensioni dello striato nativo. Studi volumetrici in risonanza magnetica hanno dimostrato la stabilità nel tempo del tessuto neogenerato. Il tasso di peggioramento secondo la Unified Huntington’s Disease Rating Scale è risultato essere ridotto di 0,9 unità/anno per il punteggio motorio e di 2,7 unità/anno per il punteggio cognitivo rispetto al periodo pre-trapianto e a quello osservato in un gruppo di 16 controlli. Cinque pazienti hanno sviluppato anticorpi anti-HLA donatore-specifici in un arco temporale di 0-49 mesi dal trapianto. Gli anticorpi prodotti erano spesso rivolti contro specificità antigeniche comuni ai due feti donatori. In conclusione, l’insieme degli elementi clinici ed imaging indica la sostanziale sicurezza a lungo termine delle nostre procedure. E’ necessario prestare attenzione agli aspetti di istocompatibilità ed alle esigenze di immunosoppressione e sono auspicabili approfondimenti prima di poter affermare che la produzione di anticorpi anti-HLA influisca sull’efficacia del trapianto. Sul piano neurologico, l’intervento rallenta il declino motorio e cognitivo di questi pazienti. Se tali risultati saranno replicati, sarà ragionevole proporre il trapianto a pazienti con minore carico di malattia con l’obiettivo di protrarne il soggiorno in stadi meno avanzati

Impact of microcirculatory video quality on the evaluation of sublingual microcirculation in critically ill patients

We aimed to assess the impact of image quality on microcirculatory evaluation with sidestream dark-field (SDF) videomicroscopy in critically ill patients and explore factors associated with low video quality. This was a retrospective analysis of a single-centre prospective observational study. Videos of the sublingual microcirculation were recorded using SDF videomicroscopy in 100 adult patients within 12 h from admittance to the intensive care unit and every 24 h until discharge/death. Parameters of vessel density and perfusion were calculated offline for small vessels. For all videos, a quality score (-12 = unacceptable, 1 = suboptimal, 2 = optimal) was assigned for brightness, focus, content, stability, pressure and duration. Videos with a total score ≤8 were deemed as unacceptable. A total of 2455 videos (853 triplets) was analysed. Quality was acceptable in 56 % of videos. Lower quality was associated with worse microvascular density and perfusion. Unreliable triplets (≥1 unacceptable or missing video, 65 % of total) showed lower vessel density, worse perfusion and higher flow heterogeneity as compared to reliable triplets (p 8, p < 0.001) or requiring mechanical ventilation (18.0 ± 4.5 vs. 17.2 ± 3.8 mm/mm(2) in not mechanically ventilated patients, p = 0.059). We concluded that SDF video quality depends on both the operator's experience and patient's cooperation. Low-quality videos may produce spurious data, leading to an overestimation of microvascular alteration

Abstracts from the 23rd Italian congress of Cystic Fibrosis and the 13th National congress of Cystic Fibrosis Italian Society

Cystic Fibrosis (CF) occurs most frequently in caucasian populations. Although less common, this disorder have been reported in all the ethnicities. Currently, there are more than 2000 described sequence variations in CFTR gene, uniformly distributed and including variants pathogenic and benign (CFTR1:www.genet.sickkids.on.ca/). To date,only a subset have been firmily established as variants annotated as disease-causing (CFTR2: www.cftr2.org). The spectrum and the frequency of individual CFTR variants, however, vary among specific ethnic groups and geographic areas. Genetic screening for CF with standard panels of CFTR mutations is widely used for the diagnosis of CF in newborns and symptomatic patients, and to diagnose CF carrier status. These screening panels have an high diagnostic sensitivity (around 85%) for CFTR mutations in caucasians populations but very low for non caucasians. Developed in the last decade, Next-Generation Sequencing (NGS) has been the last breakthrough technology in genetic studies with a substantial reduction in cost per sequenced base and a considerable enhancement of the sequence generation capabilities. Extended CFTR gene sequencing in NGS includes all the coding regions, the splicing sites and their flankig intronic regions, deep intronic regions where are localized known mutations,the promoter and the 5'-3' UTR regions. NGS allows the analysis of many samples concurrently in a shorter period of time compared to Sanger method . Moreover, NGS platforms are able to identify CFTR copy number variation (CNVs), not detected by Sanger sequencing. This technology has provided new and reliable approaches to molecular diagnosis of CF and CFTR-Related Disorders. It also allows to improve the diagnostic sensitivity of newborn and carrier screeningmolecular tests. In fact, bioinformatics tools suitable for all the NGS platforms can filter data generated from the gene sequencing, and analyze only mutations with well-established disease liability. This approach allows the development of targeted mutations panels with a higher number of frequent CF mutations for the target populationcompared to the standard panels and a consequent enhancement of the diagnostic sensitivity. Moreover, in the emerging challenge of diagnosing CF in non caucasians patients, the possibility of customize a NGS targeted mutations panel should increase the diagnostic sensitivity when the target population has different ethnicities