Mechanisms of oxygenation responses to proning and recruitment in COVID-19 pneumonia

Purpose This study aimed at investigating the mechanisms underlying the oxygenation response to proning and recruitment maneuvers in coronavirus disease 2019 (COVID-19) pneumonia. Methods Twenty-five patients with COVID-19 pneumonia, at variable times since admission (from 1 to 3 weeks), underwent computed tomography (CT) lung scans, gas-exchange and lung-mechanics measurement in supine and prone positions at 5 cmH(2)O and during recruiting maneuver (supine, 35 cmH(2)O). Within the non-aerated tissue, we differentiated the atelectatic and consolidated tissue (recruitable and non-recruitable at 35 cmH(2)O of airway pressure). Positive/negative response to proning/recruitment was defined as increase/decrease of PaO2/FiO(2). Apparent perfusion ratio was computed as venous admixture/non aerated tissue fraction. Results The average values of venous admixture and PaO2/FiO(2) ratio were similar in supine-5 and prone-5. However, the PaO2/FiO(2) changes (increasing in 65% of the patients and decreasing in 35%, from supine to prone) correlated with the balance between resolution of dorsal atelectasis and formation of ventral atelectasis (p = 0.002). Dorsal consolidated tissue determined this balance, being inversely related with dorsal recruitment (p = 0.012). From supine-5 to supine-35, the apparent perfusion ratio increased from 1.38 +/- 0.71 to 2.15 +/- 1.15 (p = 0.004) while PaO2/FiO(2) ratio increased in 52% and decreased in 48% of patients. Non-responders had consolidated tissue fraction of 0.27 +/- 0.1 vs. 0.18 +/- 0.1 in the responding cohort (p = 0.04). Consolidated tissue, PaCO2 and respiratory system elastance were higher in patients assessed late (all p < 0.05), suggesting, all together, "fibrotic-like" changes of the lung over time. Conclusion The amount of consolidated tissue was higher in patients assessed during the third week and determined the oxygenation responses following pronation and recruitment maneuvers

Disease-specific and general health-related quality of life in newly diagnosed prostate cancer patients: The Pros-IT CNR study

Background: The National Research Council (CNR) prostate cancer monitoring project in Italy (Pros-IT CNR) is an observational, prospective, ongoing, multicentre study aiming to monitor a sample of Italian males diagnosed as new cases of prostate cancer. The present study aims to present data on the quality of life at time prostate cancer is diagnosed. Methods: One thousand seven hundred five patients were enrolled. Quality of life is evaluated at the time cancer was diagnosed and at subsequent assessments via the Italian version of the University of California Los Angeles-Prostate Cancer Index (UCLA-PCI) and the Short Form Health Survey (SF-12). Results: At diagnosis, lower scores on the physical component of the SF-12 were associated to older ages, obesity and the presence of 3+ moderate/severe comorbidities. Lower scores on the mental component were associated to younger ages, the presence of 3+ moderate/severe comorbidities and a T-score higher than one. Urinary and bowel functions according to UCLA-PCI were generally good. Almost 5% of the sample reported using at least one safety pad daily to control urinary loss; less than 3% reported moderate/severe problems attributable to bowel functions, and sexual function was a moderate/severe problem for 26.7%. Diabetes, 3+ moderate/severe comorbidities, T2 or T3-T4 categories and a Gleason score of eight or more were significantly associated with lower sexual function scores at diagnosis. Conclusions: Data collected by the Pros-IT CNR study have clarified the baseline status of newly diagnosed prostate cancer patients. A comprehensive assessment of quality of life will allow to objectively evaluate outcomes of different profile of care

Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

Background: Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage 653 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage 653 CKD in a large cohort of patients affected by T1DM. Methods: A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage 653 CKD (eGFR &lt; 60 mL/min/1.73 m2) or eGFR reduction &gt; 30% from baseline was evaluated. Results: The mean estimated GFR was 98 \ub1 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR &lt; 90 ml/min/m2 were independent risk factors for stage 653 CKD and renal function worsening. When compared to patients with eGFR &gt; 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions: Albuminuria and eGFR reduction represent independent risk factors for incident stage 653 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening

Combined Effect of Dipping in Oxalic or in Citric Acid and Low O2 Modified Atmosphere, to Preserve the Quality of Fresh-Cut Lettuce during Storage

Leaf edge browning is the main factor affecting fresh-cut lettuce marketability. Dipping in organic acids as well as the low O2 modified atmosphere packaging (MAP), can be used as anti-browning technologies. In the present research paper, the proper oxalic acid (OA) concentration, able to reduce respiration rate of fresh-cut iceberg lettuce, and the suitable packaging materials aimed to maintaining a low O2 during storage, were selected. Moreover, the combined effect of dipping (in OA or in citric acid) and packaging in low O2 was investigated during the storage of fresh-cut iceberg lettuce for 14 days. Results showed a significant effect of 5 mM OA on respiration rate delay. In addition, polypropylene/polyamide (PP/PA) was select as the most suitable packaging material to be used in low O2 MAP. Combining OA dipping with low O2 MAP using PP/PA as material, resulted able to reduce leaf edge browning, respiration rate, weight loss and electrolyte leakage, preserving the visual quality of fresh-cut lettuce until 8 days at 8 &deg;C

Non-destructive and contactless estimation of chlorophyll and ammonia contents in packaged fresh-cut rocket leaves by a Computer Vision System

Computer Vision Systems (CVS) offer a non-destructive and contactless tool to assign visual quality level to fruit and vegetables and to estimate some of their internal characteristics. The innovative CVS described in this paper exploits the combination of image processing techniques and machine learning models (Random Forests) to assess the visual quality and predict the internal traits on unpackaged and packaged rocket leaves. Its performance did not depend on the cultivation system (traditional soil or soilless). The same CVS, exploiting its machine learning components, was able to build effective models for either the classification problem (visual quality level assignment) and the regression problems (estimation of senescence indicators such as chlorophyll and ammonia contents) just by changing the training data. The experiments showed a negligible performance loss on packaged products (Pearson's linear correlation coefficient of 0.84 for chlorophyll and 0.91 for ammonia) with respect to unpackaged ones (0.86 for chlorophyll and 0.92 for ammonia). Thus, the non-destructive and contactless CVS represents a valid alternative to destructive, expensive and time-consuming analyses in the lab and can be effectively and extensively used along the whole supply chain, even on packaged products that cannot be analyzed using traditional tools

Non-destructive and contactless estimation of chlorophyll and ammonia contents in packaged fresh-cut rocket leaves by a Computer Vision System

Computer Vision Systems (CVS) offer a non-destructive and contactless tool to assign visual quality level to fruit and vegetables and to estimate some of their internal characteristics. The innovative CVS described in this paper exploits the combination of image processing techniques and machine learning models (Random Forests) to assess the visual quality and predict the internal traits on unpackaged and packaged rocket leaves. Its performance did not depend on the cultivation system (traditional soil or soilless). The same CVS, exploiting its machine learning components, was able to build effective models for either the classification problem (visual quality level assignment) and the regression problems (estimation of senescence indicators such as chlorophyll and ammonia contents) just by changing the training data. The experiments showed a negligible performance loss on packaged products (Pearson's linear correlation coefficient of 0.84 for chlorophyll and 0.91 for ammonia) with respect to unpackaged ones (0.86 for chlorophyll and 0.92 for ammonia). Thus, the non-destructive and con tactless CVS represents a valid alternative to destructive, expensive and time-consuming analyses in the lab and can be effectively and extensively used along the whole supply chain, even on packaged products that cannot be analyzed using traditional tools

Reduced Fertilization to Improve Sustainable Use of Resources and Preserve Postharvest Quality of Fresh-Cut Wild Rocket (<i>Diplotaxis tenuifolia</i> L.) in Soil-Bound and Soilless Cultivation

Reducing fertilizer input is a goal for helping greenhouse farming to achieve higher sustainability in the production process while preserving overall crop performance and quality. Wild rocket plants were cultivated in a plastic greenhouse divided into two independent sectors, one for soil-bound (SbS) cultivation and another equipped for soilless (ScS) cultivation systems. In both SbS and ScS, the crop was subjected to treatments consisting of a high- and a low-input fertilization program (HF and LF treatment, respectively). Water use efficiency (WUE) and partial factor productivity (PFP) for nutrients (N, P, K, Ca, and Mg for ScS, and N for SbS) were measured. Rocket leaves, separated for the cultivation system and fertilization program and collected at different cuts during the growing cycle, were cold stored at 10 °C until 16 d. On each sampling day (at harvest and during storage), the sensory parameters, respiration rate, dry matter, color, electrolyte leakage, antioxidant activity, total phenols, total chlorophyll and ammonia content were evaluated. In ScS, the PFP for all nutrients supplied as fertilizers showed a significant increase with the LF treatment, with values higher than 30% recorded for N, K, and Ca. As for the postharvest performance, rocket leaves cultivated in ScS showed better qualitative traits than those cultivated in SbS, as suggested by the lower values of ammonia content and electrolyte leakage recorded at the end of storage period in samples grown in ScS. Moreover, in ScS, the data showed lower membrane damage in LF than HF rocket leaves. Finally, regarding total chlorophyll content, even if no effect of each treatment was recorded in SbS, rocket cultivated in ScS showed a better retention of this parameter by applying LF rather than HF treatment. In addition to this, a PLS model (R2 = 0.7) able to predict the cultivation system, using as a variable non-destructively measured total chlorophyll content, was implemented. Low fertilization input, both in SbS and in ScS, allowed satisfying production levels and more sustainable management of nutrients. LF treatment applied to ScS also had in positive effects on the postharvest quality of fresh-cut rocket leaves