Proposed improvement of coastal habitat resilience: The case study of Pantano forest of Policoro in southern Italy

In the last decades, climate change and the rapid urbanization due to the development of the coastal economy have led to biodiversity loss and the fragmentation of habitat in many coastal zones. The presence of protected areas cannot prevent the progress of land degradation. However, these areas are very important because they provide significant ecosystem services and affect local tourism. With regard to increasing adaptation strategies to human pressures and climate change, the present study proposes a detailed monitoring activity and an ecological restoration plan which could improve the resilience of a protected coastal zone in the Pantano forest of Policoro, located on the Ionian coast (southern Italy). In this area, continuous phenomena of intensive deforestation, hydraulic reclamation actions, and fires have reduced the native species of particular naturalistic value, favouring the advancement of desertification, coastal erosion, and saltwater intrusion. The proposed actions are derived from a preliminary analysis on maps, UAV-images, climate data and from meetings with the local community. The operative process detailed in this article could be applied to other protected areas which are subjected to the same phenomena and problems

Effectiveness of Intraoperative Parathyroid Monitoring (ioPTH) in predicting a multiglandular or malignant parathyroid disease

Aim The main goal of our study was to confirm the usefulness of intra-operative parathyroid hormone (PTH) monitoring (ioPTH) when using minimally invasive techniques for treatment of sporadic Primary hyperparathyroidism (pHTP). Furthermore, we aimed to evaluate if ioPTH monitoring may help to predict the etiology of primary hyperparathyroidism, especially in malignant or multiglandular parathyroid disease. Methods A retrospective review of 125 consecutive patients with pHPT who underwent parathyroidectomy between 2001 and 2016\ua0at the Department of General Surgery was performed. For each patient, the specific preoperative work-up consisted of: high-resolution US of the neck by a skilled sonographer, sestamibi parathyroid scan, laryngoscopy, and serum measurement of PTH, serum calcium levels, and serum 25(OH)D levels. Results The study included 125 consecutive patients who underwent surgery for pHPT. At the histological examination, we registered 113 patients with simple adenomatous pathology (90,4%), 5 atypical adenomas (4%), 3 cases of parathyroid carcinoma (2,4%), and 4 histological exams of different nature (3,2%). Overall, 6 cases (4,8%) of multiglandular disease were found. We reported 10 cases (8%) of recurrent/persistent hyperparathyroidism: 1/10 in a patient affected by atypical adenoma, 9/10 in patients with benign pathology. Regarding these 10 cases, in three (30%) patients, ioPTH wasn't dosed (only frozen section (FS) exam was taken), in 5 cases (50%) ioPTH dropped more than 50% compared to basal value (false negative results), and in 2 (20%) cases, ioPTH did not drop >50% from the first samples taken, the extemporary exam had confirmed the presence of adenoma and the probable second hyperfunctioning adenoma was not found. Conclusions IoPTH determinations ensure operative success of surgical resection in almost all hyperfunctioning tissue; in particular it is very important during minimally invasive parathyroidectomy, as it allows avoiding bilateral neck exploration. The use of ioPTH monitoring offer increased sensitivity in detecting multiglandular disease and can minimize the need and risk associated with recurrent operations, and may facilitate cost-effective minimally invasive surgery. Moreover, intraoperative PTH monitoring could be a reliable marker to predict a malignant disease during parathyroidectomy, showing higher ioPTH baseline value and superior drop compared to benign disease

Sepsis Team Organizational Model to Decrease Mortality for Intra-Abdominal Infections: Is Antibiotic Stewardship Enough?

Introduction. Sepsis is an overwhelming reaction to infection with significant morbidity, requiring urgent interventions in order to improve outcomes. The 2016 Sepsis-3 guidelines modified the previous definitions of sepsis and septic shock, and proposed some specific diagnostic and therapeutic measures to define the use of fluid resuscitation and antibiotics. However, some open issues still exist. Methods. A literature research was performed on PubMed and Cochrane using the terms “sepsis” AND “intra-abdominal infections” AND (“antibiotic therapy” OR “antibiotic treatment”). The inclusion criteria were management of intra-abdominal infection (IAI) and effects of antibiotic stewardships programs (ASP) on the outcome of the patients. Discussion. Sepsis-3 definitions represent an added value in the understanding of sepsis mechanisms and in the management of the disease. However, some questions are still open, such as the need for an early identification of sepsis. Sepsis management in the context of IAI is particularly challenging and a prompt diagnosis is essential in order to perform a quick treatment (source control and antibiotic treatment). Antibiotic empirical therapy should be based on the kind of infection (community or hospital acquired), local resistances, and patient’s characteristic and comorbidities, and should be adjusted or de-escalated as soon as microbiological information is available. Antibiotic Stewardship Programs (ASP) have demonstrated to improve antimicrobial utilization with reduction of infections, emergence of multi-drug resistant bacteria, and costs. Surgeons should not be alone in the management of IAI but ideally inserted in a sepsis team together with anaesthesiologists, medical physicians, pharmacists, and infectious diseases specialists, meeting periodically to reassess the response to the treatment. Conclusion. The cornerstones of sepsis management are accurate diagnosis, early resuscitation, effective source control, and timely initiation of appropriate antimicrobial therapy. Current evidence shows that optimizing antibiotic use across surgical specialities is imperative to improve outcomes. Ideally every hospital and every emergency surgery department should aim to provide a sepsis team in order to manage IAI

Field emission from single and few-layer graphene flakes

We report the observation and characterization of field emission current from individual single- and few-layer graphene flakes laid on a flat SiO2/Si substrate. Measurements were performed in a scanning electron microscope chamber equipped with nanoprobes, used as electrodes to realize local measurements of the field emission current. We achieved field emission currents up to 1 {\mu}A from the flat part of graphene flakes at applied fields of few hundred V/{\mu}m. We found that emission process is stable over a period of several hours and that it is well described by a Fowler-Nordheim model for currents over 5 orders of magnitude

Biomarkers changes after neoadjuvant chemotherapy in breast cancer: A seven-year single institution experience

The adoption of neoadjuvant chemotherapy (NACT) for breast cancer (BC) is increasing. The need to repeat the biomarkers on a residual tumor after NACT is still a matter of debate. We verified estrogen receptors (ER), progesterone receptors (PR), Ki67 and human epidermal growth factor receptor 2 (HER2) status changes impact in a retrospective monocentric series of 265 BCs undergoing NACT. All biomarkers changed with an overall tendency toward a reduced expression. Changes in PR and Ki67 were statistically significant (p = 0.001). Ki67 changed in 114/265 (43.0%) cases, PR in 44/265 (16.6%), ER in 31/265 (11.7%) and HER2 in 26/265 (9.8%). Overall, intrinsic subtype changed in 72/265 (27.2%) cases after NACT, and 10/265 (3.8%) cases switched to a different adjuvant therapy accordingly. Luminal subtypes changed most frequently (66/175; 31.7%) but with less impact on therapy (5/175; 2.8%). Only 3 of 58 triple-negative BCs (5.2%) changed their intrinsic subtype, but all of them switched treatment. No correlation was found between intrinsic subtype changes and clinicopathological features. To conclude, biomarkers changes with prognostic implications occurred in all BC intrinsic subtypes, albeit they impacted therapy mostly in HER2 negative and/or hormone receptors negative BCs. Biomarkers retesting after NACT is important to improve both tailored adjuvant therapies and prognostication of patients

Mortar FEs on Overlapping Meshes : Application to Magnetodynamics

Abstract The finite element (FE) method is frequently used in magnetodynamics as well suited to treat problems with complex geometries while keeping a simplicity in the implementation. However, some modelisations, as in eddy current (EC) non destructive testing (NDT), present the particularity to have moving parts. A global remeshing can be necessary which causes expensive CPU time. Domain decomposition methods allowing to take into account the movement without having to remesh the whole computational domain. The mortar element method (MEM), a variational non-conforming domain decomposition approach [1] offers attractive advantages in terms of flexibility and accuracy. In its original version for non-overlapping subdomains, the information is transferred through the skeleton of the decomposition by means of a suitable L 2 -projection of the field trace from the master to the slave subdomains. A MEM with overlapping subdomains has been proposed to coupled a global scalar potential defined everywhere in the considered domain and a local vector potential defined only in (possibly moving) conductor

Further progress/developments, on surface/bulk treated Constantan wires, for anomalous heat generation by H2/D2 interaction

In the framework of those studies aimed to analyze anomalous effects (thermal and/or nuclear) due to the interaction among some specific materials (pure and/or alloys) and H2 (or D2), we focused, since 2011, on a specific alloy called Constantan (Cu55-Ni44-Mn1). We selected such material using our own considerations and intuitions and because, according to a scientific paper [1], it has the largest energy value for dissociation of H2 to 2H, i.e. about 3eV. Among others B. Ahern suggested that Ni-Cu-H can be used for heat generation. We improved the preparation procedure of such wire from simple thermal treatments (up to May 2012 [2])to more sophisticated ones, with more tight control of the multilayered (400-700) surface structures. Some of the results were presented at ICCF17, Aug. 2012 [3]. After [3], several groups asked to make their own experiments using such kind of wires ([phi]=200[mu]m, l=100cm) to cross-check (and possibly improve) our results. Some of such Researchers (group of M. Fleischmann Memorial Project; U. Mastromatteo) made public their (positive) results since Dec. 14, 2012 at Ministry of Aeronautics in Rome, Italy. In short, using an (home-made) apparatus integrated with an acquisition system (type PXi) by National Instruments, we made, since September 2012, not mentioning qualitative reconfirmation of previous results, further and unexpected progress and discoveries: a) We developed a new kind of procedure of measurement (about anomalous excess heat) under dynamic vacuum, to avoid the effect of different thermal conductivity, inside the gas cell, due to type of gas and pressure variation: the wire didn't lose, macroscopically, H even at T=600[degrees]C. b) We developed a new, very simple, type of surface coating (2 layers) that is nano-diamandoidslike; c) We observed, at least 2 times, the phenomenon of water splitting due to catalytic effect of surface treated Constantan. Such phenomenon is larger in comparison with what expected just by thermal splitting (wires temperature of about 300-500[degrees]C); d) We observed a very large variation (about a factor 100) of Resistive Thermal Coefficient (RTC) of the wire used (400 layers) as the amount of H (related to the macroscopic value of resistive ratio R/Ro, normalize to empty wire Ro) increased. As example, with "treated" virgin wire (w/o H2) the RTC was about 5*10-6 and increased to6*10-4 when the R/Ro reduced to 0.68; temperature range 20-300[degrees]C. The RTC is larger with D in respect to H. Experiments are in progress also at 77K. e) Overall results are affected by previous operating conditions

Non-Equilibrium and Quantum Coherent Phenomena in the Electromechanics of Suspended Nanowires

Strong coupling between electronic and mechanical degrees of freedom is a basic requirement for the operation of any nanoelectromechanical device. In this Review we consider such devices and in particular investigate the properties of small tunnel-junction nanostructures that contain a movable element in the form of a suspended nanowire. In these systems, electrical current and charge can be concentrated to small spatial volumes resulting in strong coupling between the mechanics and the charge transport. As a result, a variety of mesoscopic phenomena appear, which can be used for the transduction of electrical currents into mechanical operation. Here we will in particular consider nanoelectromechanical dynamics far from equilibrium and the effect of quantum coherence in both the electronic and mechanical degrees of freedom in the context of both normal and superconducting nanostructures.Comment: 20 pages, 13 figures, figures update

What do we have to know about PD-L1 expression in prostate cancer? A systematic literature review. Part 3: PD-L1, intracellular signaling pathways and tumor microenvironment

The tumor microenvironment (TME) includes immune (T, B, NK, dendritic), stromal, mesenchymal, endothelial, adipocytic cells, extracellular matrix, and cytokines/chemokines/soluble factors regulating various intracellular signaling pathways (ISP) in tumor cells. TME influences the survival/progression of prostate cancer (PC), enabling tumor cell immune-evasion also through the activation of the PD-1/PD-L1 axis. We have performed a systematic literature review according to the PRISMA guidelines, to investigate how the PD-1/PD-L1 pathway is influenced by TME and ISPs. Tumor immune-escape mechanisms include suppression/exhaustion of tumor infiltrating cytotoxic T lymphocytes, inhibition of tumor suppressive NK cells, increase in immune-suppressive immune cells (regulatory T, M2 macrophagic, myeloid-derived suppressor, dendritic, stromal, and adipocytic cells). IFN-γ (the most investigated factor), TGF-β, TNF-α, IL-6, IL-17, IL-15, IL-27, complement factor C5a, and other soluble molecules secreted by TME components (and sometimes increased in patients’ serum), as well as and hypoxia, influenced the regulation of PD-L1. Experimental studies using human and mouse PC cell lines (derived from either androgen-sensitive or androgen-resistant tumors) revealed that the intracellular ERK/MEK, Akt-mTOR, NF-kB, WNT and JAK/STAT pathways were involved in PD-L1 upregulation in PC. Blocking the PD-1/PD-L1 signaling by using immunotherapy drugs can prevent tumor immune-escape, increasing the anti-tumor activity of immune cells