A case of cryptogenic organizing pneumonia occurring in Crohn's disease.

A 29 year-old-man with Crohn's disease, who developed diffuse pulmonary infiltrates and hypoxemia two months following oral administration of mesalazine, was examined. Clinical findings and computed tomography were suggestive of, and lung histology was diagnostic of, bronchiolitis obliterans organizing pneumonia, also known as cryptogenic organizing pneumonia. Although the data did not allow for definitive conclusions, they did suggest that the pulmonary disease was an extraintestinal manifestation of Crohn's disease, rather than an adverse reaction to mesalazine. In fact, the patient showed clinical, radiological and functional improvements, despite the treatment with mesalazine and the withdrawal of steroid therapy

Operational resilience of reservoirs to climate change, agricultural demand, and tourism: A case study from Sardinia

Copyright © 2015 Elsevier. NOTICE: this is the author’s version of a work that was accepted for publication in Science of the Total Environment. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Science of the Total Environment (2015), DOI: 10.1016/j.scitotenv.2015.04.066Many (semi-) arid locations globally, and particularly islands, rely heavily on reservoirs for water supply. Some reservoirs are particularly vulnerable to climate and development changes (e.g. population change, tourist growth, hydropower demands). Irregularities and uncertainties in the fluvial regime associated with climate change and the continuous increase in water demand by different sectors will add new challenges to the management and to the resilience of these reservoirs. The resilience of vulnerable reservoirs must be studied in detail to prepare for and mitigate potential impacts of these changes. In this paper, a reservoir balance model is developed and presented for the Pedra e' Othoni reservoir in Sardinia, Italy, to assess resilience to climate and development changes. The model was first calibrated and validated, then forced with extensive ensemble climate data for representative concentration pathways (RCPs) 4.5 and 8.5, agricultural data, and with four socio-economic development scenarios. Future projections show a reduction in annual reservoir inflow and an increase in demand, mainly in the agricultural sector. Under no scenario is reservoir resilience significantly affected, the reservoir always achieves refill. However, this occurs at the partial expenses of hydropower production with implications for the production of renewable energy. There is also the possibility of conflict between the agricultural sector and hydropower sector for diminishing water supply. Pedra e' Othoni reservoir shows good resilience to future change mostly because of the disproportionately large basin feeding it. However this is not the case of other Sardinian reservoirs and hence a detailed resilience assessment of all reservoirs is needed, where development plans should carefully account for the trade-offs and potential conflicts among sectors. For Sardinia, the option of physical connection between reservoirs is available, as are alternative water supply measures. Those reservoirs at risk to future change should be identified, and mitigating measures investigated.European Commission Seventh Framework Project ‘WASSERMed’ (Water Availability and Security in Southern EuRope and the Mediterranean

Pulmonary sclerosing pneumocytoma: A pre and intraoperative diagnostic challenge. report of two cases and review of the literature

Pulmonary sclerosing pneumocytoma is a rare benign pulmonary tumor of primitive epithelial origin. Because of the unspecific radiological features mimicking malignancies and its histological heterogeneity, the differential diagnosis with adenocarcinoma and carcinoid tumors is still challenging. We report our experience of two cases of sclerosing pneumocytoma, as well as a review of the literature. Immunohistochemical findings showed intense staining of the cuboidal epithelial cells for cytokeratin-pool and TTF-1, with focal positivity for progesterone receptors. Round and spindle cells expressed positivity for vimentin, TTF-1 and focally for the progesterone receptor. Cytologic diagnosis of pulmonary pneumocytoma requires the identification of its dual cell population, made up of abundant stromal cells and fewer surface cells. Since the pre-and intraoperative diagnosis should guide surgical decision making, obtaining a sufficient specimen size to find representative material in the cell block is of paramount importance

Multi-stakeholder development of a serious game to explore the water-energy-food-land-climate nexus: The SIM4NEXUS approach

This is the final version of the article. Available from the publisher via the DOI in this record.Water, energy, food, land and climate form a tightly-connected nexus in which actions on one sector impact other sectors, creating feedbacks and unanticipated consequences. This is especially because at present, much scientific research and many policies are constrained to single discipline/sector silos that are often not interacting (e.g., water-related research/policy). However, experimenting with the interaction and determining how a change in one sector could impact another may require unreasonable time frames, be very difficult in practice and may be potentially dangerous, triggering any one of a number of unanticipated side-effects. Current modelling often neglects knowledge from practice. Therefore, a safe environment is required to test the potential cross-sectoral implications of policy decisions in one sector on other sectors. Serious games offer such an environment by creating realistic 'simulations', where long-term impacts of policies may be tested and rated. This paper describes how the ongoing (2016-2020) Horizon2020 project SIM4NEXUS will develop serious games investigating potential plausible cross-nexus implications and synergies due to policy interventions for 12 multi-scale case studies ranging from regional to global. What sets these games apart is that stakeholders and partners are involved in all aspects of the modelling definition and process, from case study conceptualisation, quantitative model development including the implementation and validation of each serious game. Learning from playing a serious game is justified by adopting a proof-of-concept for a specific regional case study in Sardinia (Italy). The value of multi-stakeholder involvement is demonstrated, and critical lessons learned for serious game development in general are presented.The work described in this paper has been conducted within the project SIM4NEXUS. This project has received funding from the European Union’s Horizon 2020 research and innovation programme under Grant Agreement No. 689150 SIM4NEXUS

erasmus syndrome in a marble worker

Erasmus syndrome is defined as the association of silica exposure and subsequent development of systemic sclerosis. The limited number of cases reported in the literature mainly involves miners and only sporadically other professionals. We describe a case of Erasmus syndrome in a marble worker. A 68 year old man came to our observation complaining pelvic and scapular girdle pain, evening fever, intense weakness and emaciation for about 1 month. He also reported to have had Raynaud's phenomenon in his hands for the last 13 years. Also, his occupational history revealed a chronic exposure to silica dust. The patient presented pain in his shoulders and hips, moderate skin thickening and sclerosis in his hands and fingers extending proximally to his wrists. The diagnosis of systemic sclerosis was determined according to his clinical and medical history, the positivity of anti-Scl 70 antibodies, the nailfold capillaroscopy suggestive of an active scleroderma pattern and the detection of a mild restrictive pulmonary syndrome. The evaluation of the organbased complications excluded a gastroenterological and cardiovascular involvement, while the chest computed tomography (CT) detected multiple small nodules with a mantle distribution and enlarged lymph nodes with no signs of interstitial lung disease and fibrosis. Additional tests (positron emission tomography-CT, flexible bronchoscopy and broncho-alveolar lavage) excluded infectious diseases and cancer. However, given the pulmonary involvement, we performed a histological examination of the parenchyma and lymph nodes, which revealed a picture of pneumoconiosis. In the end, the occupational history and the findings from the diagnostic procedures led to the diagnosis of pulmonary silicosis. The precise definition of the pulmonary involvement was essential to the therapeutic approach to this patient

PILOT APPLICATION OF 3D UNDERWATER IMAGING TECHNIQUES FOR MAPPING <i>POSIDONIA OCEANICA</i> (L.) DELILE MEADOWS

Seagrass communities are considered one of the most productive and complex marine ecosystems. Seagrasses belong to a small group of 66 species that can form extensive meadows in all coastal areas of our planet. Posidonia oceanica beds are the most characteristic ecosystem of the Mediterranean Sea, and should be constantly monitored, preserved and maintained, as specified by EU Habitats Directive for priority habitats. Underwater 3D imaging by means of still or video cameras can allow a detailed analysis of the temporal evolution of these meadows, but also of the seafloor morphology and integrity. Video-photographic devices and open source software for acquiring and managing 3D optical data rapidly became more and more effective and economically viable, making underwater 3D mapping an easier task to carry out. 3D reconstruction of the underwater scene can be obtained with photogrammetric techniques that require just one or more digital cameras, also in stereo configuration. In this work we present the preliminary results of a pilot 3D mapping project applied to the P. oceanica meadow in the Marine Protected Area of Capo Rizzuto (KR, Calabria Region &ndash; Italy)