Comparison of Cardiac and Non-Cardiac Biomarkers for Risk Stratification in Elderly Patients with Non-Massive Pulmonary Embolism.

Biomarkers unrelated to myocardial necrosis, such as cystatin C, copeptin, and mid-regional pro-adrenomedullin (MR-proADM), showed promise for cardiovascular risk prediction. Knowing whether they are comparable to cardiac biomarkers such as high-sensitive cardiac-troponin T (hs-cTnT) or N-terminal pro-Brain natriuretic peptide (NT-proBNP) in elderly patients with acute non-massive pulmonary embolism (NMPE) remains elusive. This study aims at comparing the prognostic accuracy of cardiac and non-cardiac biomarkers in patients with NMPE aged ≥65 years over time. In the context of the SWITCO65+ cohort, we evaluated 227 elderly patients with an available blood sample taken within one day from diagnosis. The primary study endpoint was defined as PE-related mortality and the secondary endpoint as PE-related complications. The biomarkers' predictive ability at 1, 3, 12 and 24 months was determined using C-statistics and Cox regression. For both study endpoints, C-statistics (95% confidence interval) were stable over time for all biomarkers, with the highest value for hs-cTnT, ranging between 0.84 (0.68-1.00) and 0.80 (0.70-0.90) for the primary endpoint, and between 0.74 (0.63-0.86) and 0.65 (0.57-0.73) for the secondary endpoint. For both study endpoints, cardiac biomarkers were found to be independently associated with risk, NT-proBNP displaying a negative predictive value of 100%. Among non-cardiac biomarkers, only copeptin and MR-proADM were independent predictors of PE-related mortality but they were not independent predictors of PE-related complications, and displayed lower negative predictive values. In elderly NMPE patients, cardiac biomarkers appear to be valuable prognostic to identify very low-risk individuals. ClinicalTrials.gov NCT00973596

Towards a definition of a real-time forecasting network for rainfall induced shallow landslides

PREVIEW is an European Commission FP6 Integrated Project with the aim of developing, at an European level, innovative geo-information services for atmospheric, geophysical and man-made risks. Within this framework, the Landslides Platform Service 2 (forecasting of shallow rapid slope movements) has developed an integrated procedure for the forecasting and warning of distributed shallow landsliding to be used for civil protection purposes. The Service consists of an automated end-to-end forecasting chain which uses data from a probabilistic downscaled short-term rainfall forecast, soil saturation estimates and meteorological radar outputs. The above data are entered into a hydro-geological model that makes use of an infinite slope approach to calculate the distributed Factor of Safety over the entire basin. All outputs, and much of the input data, are shown on a WebGIS system so that end-users can interactively access and download data. A distinctive feature of the service is the use of an innovative soil depth model for predicting the distributed thickness of the regolith cover within the basin, which is one of the most important parameters controlling shallow landslide triggering. The service was developed in a pilot test site in NE Italy, the Armea basin. Validation makes use of two rainfall events: one that occurred in 2000 and a smaller, more recent event (2006) that caused fewer landslides. Rainfall data have been used to compute a distributed factor-of-safety map that has been overlaid onto the landslide inventory. Instead of a traditional validation approach based on the number count of correctly identified landslides, we carried out an alternative procedure based on the landslides area that gave outcomes which, for this preliminary stage of the research, can be considered promising

Sol–gel-derived glass-ceramic photorefractive films for photonic structures

Glass photonics are widespread, from everyday objects around us to high-tech specialized devices. Among different technologies, sol–gel synthesis allows for nanoscale materials engineering by exploiting its unique structures, such as transparent glass-ceramics, to tailor optical and electromagnetic properties and to boost photon-management yield. Here, we briefly discuss the state of the technology and show that the choice of the sol–gel as a synthesis method brings the advantage of process versatility regarding materials composition and ease of implementation. In this context, we present tin-dioxide–silica (SnO2–SiO2) glass-ceramic waveguides activated by europium ions (Eu3+). The focus is on the photorefractive properties of this system because its photoluminescence properties have already been discussed in the papers presented in the bibliography. The main findings include the high photosensitivity of sol–gel 25SnO2:75SiO2 glass-ceramic waveguides; the ultraviolet (UV)-induced refractive index change (∆n ~ −1.6 × 10−3), the easy fabrication process, and the low propagation losses (0.5 ± 0.2 dB/cm), that make this glass-ceramic an interesting photonic material for smart optical applications

CXCL-8/IL8 Produced by Diffuse Large B-cell Lymphomas Recruits Neutrophils Expressing a Proliferation-Inducing Ligand APRIL.

Tumor-infiltrating neutrophils have been implicated in malignant development and progression, but mechanisms are ill defined. Neutrophils produce a proliferation-inducing ligand APRIL/TNFSF13, a factor that promotes development of tumors from diverse origins, including diffuse large B-cell lymphoma (DLBCL). High APRIL expression in DLBCL correlates with reduced patient survival, but the pathway(s) dictating APRIL expression are not known. Here, we show that all blood neutrophils constitutively secrete APRIL, and inflammation-associated stimuli, such as TNF, further upregulate APRIL. In a significant fraction of DLBCL patients, tumor cells constitutively produced the ELC-CXC chemokine CXCL-8 (IL8), enabling them to recruit APRIL-producing blood neutrophils. CXCL-8 production in DLBCL was unrelated to the cell of origin, as APRIL-producing neutrophils infiltrated CXCL-8(+) DLBCL from both germinal center (GC) and non-GC subtypes. Rather, CXCL-8 production implied events affecting DNA methylation and acetylation. Overall, our results showed that chemokine-mediated recruitment of neutrophils secreting the tumor-promoting factor APRIL mediates DLBCL progression. Cancer Res; 77(5); 1097-107. ©2016 AACR

Imaging of SNR IC443 and W44 with the Sardinia Radio Telescope at 1.5 GHz and 7 GHz

Observations of supernova remnants (SNRs) are a powerful tool for investigating the later stages of stellar evolution, the properties of the ambient interstellar medium, and the physics of particle acceleration and shocks. For a fraction of SNRs, multi-wavelength coverage from radio to ultra high-energies has been provided, constraining their contributions to the production of Galactic cosmic rays. Although radio emission is the most common identifier of SNRs and a prime probe for refining models, high-resolution images at frequencies above 5 GHz are surprisingly lacking, even for bright and well-known SNRs such as IC443 and W44. In the frameworks of the Astronomical Validation and Early Science Program with the 64-m single-dish Sardinia Radio Telescope, we provided, for the first time, single-dish deep imaging at 7 GHz of the IC443 and W44 complexes coupled with spatially-resolved spectra in the 1.5-7 GHz frequency range. Our images were obtained through on-the-fly mapping techniques, providing antenna beam oversampling and resulting in accurate continuum flux density measurements. The integrated flux densities associated with IC443 are S_1.5GHz = 134 +/- 4 Jy and S_7GHz = 67 +/- 3 Jy. For W44, we measured total flux densities of S_1.5GHz = 214 +/- 6 Jy and S_7GHz = 94 +/- 4 Jy. Spectral index maps provide evidence of a wide physical parameter scatter among different SNR regions: a flat spectrum is observed from the brightest SNR regions at the shock, while steeper spectral indices (up to 0.7) are observed in fainter cooling regions, disentangling in this way different populations and spectra of radio/gamma-ray-emitting electrons in these SNRs.Comment: 13 pages, 9 figures, accepted for publication to MNRAS on 18 May 201

Enoxaparin for primary thromboprophylaxis in ambulatory patients with coronavirus disease-2019 (the OVID study): a structured summary of a study protocol for a randomized controlled trial.

The OVID study will demonstrate whether prophylactic-dose enoxaparin improves survival and reduces hospitalizations in symptomatic ambulatory patients aged 50 or older diagnosed with COVID-19, a novel viral disease characterized by severe systemic, pulmonary, and vessel inflammation and coagulation activation. The OVID study is conducted as a multicentre open-label superiority randomised controlled trial. Inclusion Criteria 1. Signed patient informed consent after being fully informed about the study's background. 2. Patients aged 50 years or older with a positive test for SARS-CoV2 in the past 5 days and eligible for ambulatory treatment. 3. Presence of respiratory symptoms (i.e. cough, sore throat, or shortness of breath) or body temperature >37.5° C. 4. Ability of the patient to travel to the study centre by private transportation, performed either by an accompanying person from the same household or by the patient themselves 5. Ability to comply with standard hygiene requirements at the time of in-hospital visit, including a face mask and hand disinfectant. 6. Ability to walk from car to study centre or reach it by wheelchair transport with the help of an accompanying person from the same household also complying with standard hygiene requirements. 7. Ability to self-administer prefilled enoxaparin injections after instructions received at the study centre or availability of a person living with the patient to administer enoxaparin. Exclusion Criteria 1. Any acute or chronic condition posing an indication for anticoagulant treatment, e.g. atrial fibrillation, prior venous thromboembolism (VTE), acute confirmed symptomatic VTE, acute coronary syndrome. 2. Anticoagulant thromboprophylaxis deemed necessary in view of the patient's history, comorbidity or predisposing strong risk factors for thrombosis: a. Any of the following events occurring in the prior 30 days: fracture of lower limb, hospitalization for heart failure, hip/knee replacement, major trauma, spinal cord injury, stroke, b. previous VTE, c. histologically confirmed malignancy, which was diagnosed or treated (surgery, chemotherapy, radiotherapy) in the past 6 months, or recurrent, or metastatic, or inoperable. 3. Any clinically relevant bleeding (defined as bleeding requiring hospitalization, transfusion, surgical intervention, invasive procedures, occurring in a critical anatomical site, or causing disability) within 30 days prior to randomization or sign of acute bleeding. 4. Intracerebral bleeding at any time in the past or signs/symptoms consistent with acute intracranial haemorrhage. 5. Haemoglobin <8 g/dL and platelet count <50 x 10 <sup>9</sup> cells/L confirmed by recent laboratory test (<90 days). 6. Subjects with any known coagulopathy or bleeding diathesis, including known significant liver disease associated with coagulopathy. 7. Severe renal insufficiency (baseline creatinine clearance <30 mL/min calculated using the Cockcroft-Gault formula) confirmed by recent laboratory test (<90 days). 8. Contraindications to enoxaparin therapy, including prior heparin-induced thrombocytopenia and known hypersensitivity. 9. Current use of dual antiplatelet therapy. 10. Participation in other interventional studies over the past 30 days. 11. Non-compliance or inability to adhere to treatment or lack of a family environment or support system for home treatment. 12. Cognitive impairment and/or inability to understand information provided in the study information. Patient enrolment will take place at seven Swiss centres, including five university hospitals and two large cantonal hospitals. Patients randomized to the intervention group will receive subcutaneous enoxaparin at the recommended dose of 4,000 IU anti-Xa activity (40 mg/0.4 ml) once daily for 14 days. Patients randomized to the comparator group will receive no anticoagulation. Primary outcome: a composite of any hospitalization or all-cause death occurring within 30 days of randomization. (i) a composite of cardiovascular events, including deep vein thrombosis (including catheter-associated), pulmonary embolism, myocardial infarction/myocarditis, arterial ischemia including mesenteric and extremities, acute splanchnic vein thrombosis, or ischemic stroke within 14 days, 30 days, and 90 days of randomization; (ii) each component of the primary efficacy outcome, within 14 days, 30 days, and 90 days of randomization; (iii) net clinical benefit (accounting for the primary efficacy outcome, composite cardiovascular events, and major bleeding), within 14 days, 30 days, and 90 days of enrolment; (iv) primary efficacy outcome, within 14 days, and 90 days of enrolment; (v) disseminated intravascular coagulation (ISTH criteria, in-hospital diagnosis) within 14 days, 30 days, and 90 days of enrolment. Patients will undergo block stratified randomization (by age: 50-70 vs. >70 years; and by study centre) with a randomization ratio of 1:1 with block sizes varying between 4 and 8. Randomization will be performed after the signature of the informed consent for participation and the verification of the eligibility criteria using the electronic data capture software (REDCAP, Vanderbilt University, v9.1.24). In this open-label study, no blinding procedures will be used. The sample size calculation is based on the parameters α = 0.05 (2-sided), power: 1-β = 0.8, event rate in experimental group, pexp = 0.09 and event rate in control group, pcon = 0.15. The resulting total sample size is 920. To account for potential dropouts, the total sample size was fixed to 1000 with 500 patients in the intervention group and 500 in the control group. Protocol version 1.0, 14 April 2020. Protocol version 3.0, 18 May 2020 Recruiting start date: June 2020. Last Patient Last Visit: March 2021. ClinicalTrials.gov Identifier: NCT04400799 First Posted: May 26, 2020 Last Update Posted: July 16, 2020 FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol

Proyecto IRESUD: interconexión de sistemas fotovoltaicos a la red eléctrica en ambientes urbanos. estado de avance a julio de 2014 y primeras mediciones en sistemas piloto

En el marco de una convocatoria del Ministerio de Ciencia, Tecnología e Innovación Productiva, se conformó, en el año 2011, el consorcio público-privado IRESUD entre la Comisión Nacional de Energía Atómica (CNEA), la Universidad Nacional de San Martín (UNSAM) y 5 empresas privadas, para la ejecución del proyecto “Interconexión de Sistemas Fotovoltaicos a la Red Eléctrica en Ambientes Urbanos”. El principal objetivo del mismo es introducir en el país tecnologías asociadas con la interconexión a la red eléctrica, en áreas urbanas, de sistemas fotovoltaicos (FV), contemplando para ello cuestiones técnicas, económicas y regulatorias. En este trabajo, se presenta el grado de avance del proyecto en lo referente a las cuestiones regulatorias y a las instalaciones piloto realizadas o en ejecución en diferentes partes del país. Asimismo, se muestran las primeras mediciones de algunas de las instalaciones actualmente en operación y se analiza el comportamiento de un inversor FV de conexión a red.Fil: Durán, J. C.. Comisión Nacional de Energía Atómica; Argentina. Universidad Nacional de San Martín; ArgentinaFil: Socolovsky, Hernan Pablo. Comisión Nacional de Energía Atómica; Argentina. Universidad Nacional de San Martín; ArgentinaFil: Raggio, D.. Comisión Nacional de Energía Atómica; ArgentinaFil: Godfrin, Elena María. Comisión Nacional de Energía Atómica; ArgentinaFil: Jakimczyk, J.. Universidad Tecnológica Nacional; ArgentinaFil: Martinez Bogado, Mónica Gladys. Universidad Nacional de San Martín; Argentina. Comisión Nacional de Energía Atómica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Diaz, F. J.. Universidad Nacional de La Plata. Facultad de Informática; ArgentinaFil: Castro, N. E.. Universidad Nacional de La Plata. Facultad de Informática; ArgentinaFil: Pedro, G.. Provincia del Neuquen. Ministerio de Hacienda Obras y Servivcios Publicos. Ente Provincial de Energia del Neuquen; ArgentinaFil: Sepúlveda, O.. Provincia del Neuquen. Ministerio de Hacienda Obras y Servivcios Publicos. Ente Provincial de Energia del Neuquen; ArgentinaFil: Argañaraz, C.. Provincia del Neuquen. Ministerio de Hacienda Obras y Servivcios Publicos. Ente Provincial de Energia del Neuquen; ArgentinaFil: Benítez, E.. Universidad Nacional de Luján; ArgentinaFil: Roldán, A.. Universidad Nacional de Luján; ArgentinaFil: Righini, R.. Universidad Nacional de Luján; Argentin

The Anticoagulation of Calf Thrombosis (ACT) project: study protocol for a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Half of all lower limb deep vein thrombi (DVT) in symptomatic ambulatory patients are located in the distal (calf) veins. While proximal disease warrants therapeutic anticoagulation to reduce the associated risks, distal DVT often goes untreated. However, a proportion of untreated distal disease will undoubtedly propagate or embolize. Concern also exists that untreated disease could lead to long-term post thrombotic changes. Currently, it is not possible to predict which distal thrombi will develop such complications. Whether these potential risks outweigh those associated with unrestricted anticoagulation remains unclear. The Anticoagulation of Calf Thrombosis (ACT) trial aims to compare therapeutic anticoagulation against conservative management for patients with acute symptomatic distal deep vein thrombosis.</p> <p>Methods</p> <p>ACT is a pragmatic, open-label, randomized controlled trial. Adult patients diagnosed with acute distal DVT will be allocated to either therapeutic anticoagulation or conservative management. All patients will undergo 3 months of clinical and assessor blinded sonographic follow-up, followed by 2-year final review. The project will commence initially as an external pilot study, recruiting over a 16-month period at a single center to assess feasibility measures and clinical event rates. Primary outcome measures will assess feasibility endpoints. Secondary clinical outcomes will be collected to gather accurate data for the design of a definitive clinical trial and will include: (1) a composite endpoint combining thrombus propagation to the popliteal vein or above, development of symptomatic pulmonary embolism or sudden death attributable to venous thromboembolic disease; (2) the incidence of major and minor bleeding episodes; (3) the incidence of post-thrombotic leg syndrome at 2 years using a validated screening tool; and (4) the incidence of venous thromboembolism (VTE) recurrence at 2 years.</p> <p>Discussion</p> <p>The ACT trial will explore the feasibility of comparing therapeutic anticoagulation to conservative management in acute distal DVT, within a modern cohort. We also aim to provide contemporary data on clot propagation, bleeding rates and long-term outcomes within both groups. These results will inform the conduct of a definitive study if feasibility is established.</p> <p>Trial registration</p> <p>Current Controlled Trials <a href="http://www.controlled-trials.com/ISRCTN75175695">ISRCTN75175695</a></p

Landslide mapping and monitoring by using radar and optical remote sensing: examples from the EC-FP7 project SAFER

This paper focuses on the Landslide Thematic services of the EU-funded FP7-SPACE project SAFER (Services and Applications For Emergency Response) for inventory mapping, monitoring and rapid mapping by using Earth Observation (EO). We exploited satellite Interferometric Synthetic Aperture Radar (InSAR) and Object-Based Image Analysis (OBIA), and discuss example applications in South Tyrol and Abruzzo (Italy), Lower Austria (Austria), Lubietova (Slovakia) and the Kaohsiung County (Taiwan). These case studies showcase the significance of radar and optical EO data, InSAR and OBIA methods for landslide mapping and monitoring in different geological environments and during all phases of emergency management: mitigation, preparedness, crisis and recovery