Initial Surgical Strategy for the Treatment of Type A Acute Aortic Dissection: Does Proximal or Distal Extension of the Aortic Resection Influence the Outcomes?

(1) Background: We sought to analyze and compare the outcomes in terms of early and late mortality and freedom from a redo operation in patients undergoing surgical treatment for a type A acute aortic dissection in relation to the initial surgical treatment strategy, i.e., proximal or distal extension of the aortic segment resection, compared with isolated resection of the supracoronary ascending aorta. (2) Methods: This is a retrospective study in which we included 269 patients who underwent operations for a type A acute aortic dissection in the Department of Cardiac Surgery of Tor Vergata University from May 2006 to May 2016. The patients were grouped according to the extent of the performed surgical treatment: isolated replacement of the supracoronary ascending aorta (NE, no extension), replacement of the aortic root (PE, proximal extension), replacement of the aortic arch (DE, distal extension), and both (BE, bilateral extension). The analyzed variables were in-hospital mortality, postoperative complications (incidence of neurological damage, renal failure and need for prolonged intubation), late mortality and need for a redo operation. (3) Results: Unilateral cerebral perfusion was performed in 49.3% of the patients, and bilateral perfusion-in 50.6%. The overall in-hospital mortality was 31.97%. In the multivariate analysis, advanced age, cardiopulmonary bypass time and preoperative orotracheal intubation were independent predictors of in-hospital mortality. In the population of patients who survived the surgery, the probability of survival at 92 months was 70 +/- 5%, the probability of freedom from a redo operation was 71.5 +/- 5%, the probability of freedom from the combined end-point death and a redo operation was 50 +/- 5%. The re-intervention rate in the general population was 16.9%. The overall probability of freedom from re-intervention was higher in patients undergoing aortic root replacement, although not reaching a level of statistical significance. Patients who underwent aortic arch treatment showed reduced survival. (4) Conclusions: In the treatment of type A acute aortic dissection, all the surgical strategies adopted were associated with satisfactory long-term survival. In the group of patients in which the aortic root had not been replaced, we observed reduced event-free survival

Ecophysiological Responses to Rainfall Variability in Grassland and Forests Along a Latitudinal Gradient in Italy

In the Mediterranean region, ecosystems are severely affected by climate variability. The Italian Peninsula is a hot spot for biodiversity thanks to its heterogeneous landscape and the Mediterranean, Continental, and Alpine climates hosting a broad range of plant functional types along a limited latitudinal range from 40\u2032 to 46\u2032 N. In this study we applied a comparative approach integrating descriptive statistics, time series analysis, and multivariate techniques to answer the following questions: (i) do the climatic variables affect Gross Primary Productivity (GPP), Reco, Water Use Efficiency (WUE), and ET to a similar extent among different sites? (ii) Does a common response pattern exist among ecosystems along a latitudinal gradient in Italy? And, finally (iii) do these ecosystems respond synchronically to meteorological conditions or does a delayed response exist? Six sites along a latitudinal, altitudinal, and vegetational gradient from semi-arid (southern Italy), to a mountainous Mediterranean site (central Italy), and sub-humid wet Alpine sites (northern Italy) were considered. For each site, carbon and water fluxes, and meteorological data collected during two hydrologically-contrasting years (i.e., a dry and a wet year) were analyzed. Principal Component Analysis (PCA) was adopted to identify temporal and spatial variations in GPP, Ecosystem Respiration (Reco), WUE, and Evapotranspiration (ET). The model outlined differences among Mediterranean semi-arid, Mediterranean mountainous, and Alpine sites in response to contrasting precipitation regimes. GPP, Reco, WUE, and ET increased up to 16, 19, 25, and 28%, respectively in semi-arid Mediterranean sites and up to 15, 32, 15, and 11%, respectively in Alpine sites in the wet year compared to the dry year. Air temperature was revealed to be one of the most important variables affecting GPP, Reco, WUE, and ET in all the study sites. While relative air humidity was more important in southern Mediterranean sites, global radiation was more significant in northern Italy. Our work suggests that a realistic prediction of the main responses of Italian forests under climate change should also take in account delayed responses due to acclimation to abiotic stress or changing environmental conditions

Ecophysiological Responses to Rainfall Variability in Grassland and Forests Along a Latitudinal Gradient in Italy

In the Mediterranean region, ecosystems are severely affected by climate variability. The Italian Peninsula is a hot spot for biodiversity thanks to its heterogeneous landscape and the Mediterranean, Continental, and Alpine climates hosting a broad range of plant functional types along a limited latitudinal range from 40′ to 46′ N. In this study we applied a comparative approach integrating descriptive statistics, time series analysis, and multivariate techniques to answer the following questions: (i) do the climatic variables affect Gross Primary Productivity (GPP), Reco, Water Use Efficiency (WUE), and ET to a similar extent among different sites? (ii) Does a common response pattern exist among ecosystems along a latitudinal gradient in Italy? And, finally (iii) do these ecosystems respond synchronically to meteorological conditions or does a delayed response exist? Six sites along a latitudinal, altitudinal, and vegetational gradient from semi-arid (southern Italy), to a mountainous Mediterranean site (central Italy), and sub-humid wet Alpine sites (northern Italy) were considered. For each site, carbon and water fluxes, and meteorological data collected during two hydrologically-contrasting years (i.e., a dry and a wet year) were analyzed. Principal Component Analysis (PCA) was adopted to identify temporal and spatial variations in GPP, Ecosystem Respiration (Reco), WUE, and Evapotranspiration (ET). The model outlined differences among Mediterranean semi-arid, Mediterranean mountainous, and Alpine sites in response to contrasting precipitation regimes. GPP, Reco, WUE, and ET increased up to 16, 19, 25, and 28%, respectively in semi-arid Mediterranean sites and up to 15, 32, 15, and 11%, respectively in Alpine sites in the wet year compared to the dry year. Air temperature was revealed to be one of the most important variables affecting GPP, Reco, WUE, and ET in all the study sites. While relative air humidity was more important in southern Mediterranean sites, global radiation was more significant in northern Italy. Our work suggests that a realistic prediction of the main responses of Italian forests under climate change should also take in account delayed responses due to acclimation to abiotic stress or changing environmental conditions

Soil science challenges in a new era: A transdisciplinary overview of relevant topics

Concise ReviewTransdisciplinary approaches that provide holistic views are essential to properly understand soil processes and the importance of soil to society and will be crucial in the future to integrate distinct disciplines into soil studies. A myriad of challenges faces soil science at the beginning of the 2020s. The main aim of this overview is to assess past achievements and current challenges regarding soil threats such as erosion and soil contamination related to different United Nations sustainable development goals (SDGs) including (1) sustainable food production, (2) ensure healthy lives and reduce environmental risks (SDG3), (3) ensure water availability (SDG6), and (4) enhanced soil carbon sequestration because of climate change (SDG13). Twenty experts from different disciplines related to soil sciences offer perspectives on important research directions. Special attention must be paid to some concerns such as (1) effective soil conservation strategies; (2) new computational technologies, models, and in situ measurements that will bring new insights to in-soil process at spatiotemporal scales, their relationships, dynamics, and thresholds; (3) impacts of human activities, wildfires, and climate change on soil microorganisms and thereby on biogeochemical cycles and water relationships; (4) microplastics as a new potential pollutant; (5) the development of green technologies for soil rehabilitation; and (6) the reduction of greenhouse gas emissions by simultaneous soil carbon sequestration and reduction in nitrous oxide emission. Manuscripts on topics such as these are particularly welcomed in Air, Soil and Water Researchinfo:eu-repo/semantics/publishedVersio

A new bioavailable fenretinide formulation with antiproliferative, antimetabolic, and cytotoxic effects on solid tumors.

Fenretinide is a synthetic retinoid characterized by anticancer activity in preclinical models and favorable toxicological profile, but also by a low bioavailability that hindered its clinical efficacy in former clinical trials. We developed a new formulation of fenretinide complexed with 2-hydroxypropyl-beta-cyclodextrin (nanofenretinide) characterized by an increased bioavailability and therapeutic efficacy. Nanofenretinide was active in cell lines derived from multiple solid tumors, in primary spheroid cultures and in xenografts of lung and colorectal cancer, where it inhibited tumor growth independently from the mutational status of tumor cells. A global profiling of pathways activated by nanofenretinide was performed by reverse-phase proteomic arrays and lipid analysis, revealing widespread repression of the mTOR pathway, activation of apoptotic, autophagic and DNA damage signals and massive production of dihydroceramide, a bioactive lipid with pleiotropic effects on several biological processes. In cells that survived nanofenretinide treatment there was a decrease of factors involved in cell cycle progression and an increase in the levels of p16 and phosphorylated p38 MAPK with consequent block in G0 and early G1. The capacity of nanofenretinide to induce cancer cell death and quiescence, together with its elevated bioavailability and broad antitumor activity indicate its potential use in cancer treatment and chemoprevention

XIPE: the X-ray Imaging Polarimetry Explorer

X-ray polarimetry, sometimes alone, and sometimes coupled to spectral and temporal variability measurements and to imaging, allows a wealth of physical phenomena in astrophysics to be studied. X-ray polarimetry investigates the acceleration process, for example, including those typical of magnetic reconnection in solar flares, but also emission in the strong magnetic fields of neutron stars and white dwarfs. It detects scattering in asymmetric structures such as accretion disks and columns, and in the so-called molecular torus and ionization cones. In addition, it allows fundamental physics in regimes of gravity and of magnetic field intensity not accessible to experiments on the Earth to be probed. Finally, models that describe fundamental interactions (e.g. quantum gravity and the extension of the Standard Model) can be tested. We describe in this paper the X-ray Imaging Polarimetry Explorer (XIPE), proposed in June 2012 to the first ESA call for a small mission with a launch in 2017 but not selected. XIPE is composed of two out of the three existing JET-X telescopes with two Gas Pixel Detectors (GPD) filled with a He-DME mixture at their focus and two additional GPDs filled with pressurized Ar-DME facing the sun. The Minimum Detectable Polarization is 14 % at 1 mCrab in 10E5 s (2-10 keV) and 0.6 % for an X10 class flare. The Half Energy Width, measured at PANTER X-ray test facility (MPE, Germany) with JET-X optics is 24 arcsec. XIPE takes advantage of a low-earth equatorial orbit with Malindi as down-link station and of a Mission Operation Center (MOC) at INPE (Brazil).Comment: 49 pages, 14 figures, 6 tables. Paper published in Experimental Astronomy http://link.springer.com/journal/1068

Differential cross section measurements for the production of a W boson in association with jets in proton–proton collisions at √s = 7 TeV

Measurements are reported of differential cross sections for the production of a W boson, which decays into a muon and a neutrino, in association with jets, as a function of several variables, including the transverse momenta (pT) and pseudorapidities of the four leading jets, the scalar sum of jet transverse momenta (HT), and the difference in azimuthal angle between the directions of each jet and the muon. The data sample of pp collisions at a centre-of-mass energy of 7 TeV was collected with the CMS detector at the LHC and corresponds to an integrated luminosity of 5.0 fb[superscript −1]. The measured cross sections are compared to predictions from Monte Carlo generators, MadGraph + pythia and sherpa, and to next-to-leading-order calculations from BlackHat + sherpa. The differential cross sections are found to be in agreement with the predictions, apart from the pT distributions of the leading jets at high pT values, the distributions of the HT at high-HT and low jet multiplicity, and the distribution of the difference in azimuthal angle between the leading jet and the muon at low values.United States. Dept. of EnergyNational Science Foundation (U.S.)Alfred P. Sloan Foundatio

Juxtaposing BTE and ATE – on the role of the European insurance industry in funding civil litigation

One of the ways in which legal services are financed, and indeed shaped, is through private insurance arrangement. Two contrasting types of legal expenses insurance contracts (LEI) seem to dominate in Europe: before the event (BTE) and after the event (ATE) legal expenses insurance. Notwithstanding institutional differences between different legal systems, BTE and ATE insurance arrangements may be instrumental if government policy is geared towards strengthening a market-oriented system of financing access to justice for individuals and business. At the same time, emphasizing the role of a private industry as a keeper of the gates to justice raises issues of accountability and transparency, not readily reconcilable with demands of competition. Moreover, multiple actors (clients, lawyers, courts, insurers) are involved, causing behavioural dynamics which are not easily predicted or influenced. Against this background, this paper looks into BTE and ATE arrangements by analysing the particularities of BTE and ATE arrangements currently available in some European jurisdictions and by painting a picture of their respective markets and legal contexts. This allows for some reflection on the performance of BTE and ATE providers as both financiers and keepers. Two issues emerge from the analysis that are worthy of some further reflection. Firstly, there is the problematic long-term sustainability of some ATE products. Secondly, the challenges faced by policymakers that would like to nudge consumers into voluntarily taking out BTE LEI