Bringing radiology to patient's home using mobile equipment : a weapon to fight COVID-19 pandemic

Because of coronavirus disease 2019 (COVID-19) high contagiousness, it is crucial to identify and promptly isolate COVID-19 patients. In this context, chest imaging examinations, in particular chest x-ray (CXR), can play a pivotal role in different settings, to triage in case of unavailability, delay of or first negative result of reverse transcriptase-polymerase chain reaction (RT-PCR), and to stratify disease severity. Considering the need to reduce, as much as possible, hospital admission of patients with suspected or confirmed infection, the use of mobile x-ray equipment could represent a safe approach. We picture a potential sequence of events, involving a team composed by a radiographer and a nurse, going to patient's home to perform CXR, nasopharyngeal swab (and, if needed, also a blood sample), with fast radiologist tele-reporting, and resulting patient management approach (home isolation or emergency room admission, when needed). This approach brings healthcare to patient's home, reducing the risk of infected subjects referring to family doctors' office or emergency departments, and strengthening community medicine while maintaining a strong connection with radiology departments

Lessons from a natural experiment: Allopatric morphological divergence and sympatric diversification in the Midas cichlid species complex are largely influenced by ecology in a deterministic way

Explaining why some lineages diversify while others do not and how are key objectives in evolutionary biology. Young radiations of closely related species derived from the same source population provide an excellent opportunity to disentangle the relative contributions of possible drivers of diversification. In these settings, lineage‐specific effects are shared and can be ruled out. Moreover, the relevant demographic and ecological parameters can be estimated accurately. Midas cichlid fish in Nicaragua have repeatedly colonized several crater lakes, diverged from the same source populations, and, interestingly, diversified in some of them but not others. Here, using the most comprehensive molecular and geometric morphometric data set on Midas cichlids to date (∼20,000 SNPs, 12 landmarks, ∼700 individuals), we aim to understand why and how crater lake populations diverge and why some of them are more prone to diversify in sympatry than others. Taking ancestor‐descendant relationships into account, we find that Midas cichlids diverged in parallel from their source population mostly—but not exclusively—by evolving more slender body shapes in all six investigated crater lakes. Admixture among crater lakes has possibly facilitated this process in one case, but overall, admixture and secondary waves of colonization cannot predict morphological divergence and intralacustrine diversification. Instead, morphological divergence is larger the more dissimilar a crater lake is compared to the source lake and happens rapidly after colonization followed by a slow‐down with time. Our data also provide some evidence that founder effects may positively contribute to divergence. The depth of a crater lake is positively associated with variation in body shapes (and number of species), presumably by providing more ecological opportunities. In conclusion, we find that parallel morphological divergence in allopatry and the propensity for diversification in sympatry across the entire Midas cichlid fish radiation is partly predictable and mostly driven by ecology.publishe

A system for beach video-monitoring: Beachkeeper plus

A suitable knowledge of coastal systems, of their morphodynamic characteristics and their response to storm events and man-made structures is essential for littoral conservation and management. Nowadays webcams represent a useful device to obtain information from beaches. Video-monitoring techniques are generally site specific and softwares working with any image acquisition system are rare. Therefore, this work aims at submitting theory and applications of an experimental video monitoring software: Beachkeeper plus, a freeware non-profit software, can be employed and redistributed without modifications. A license file is provided inside software package and in the user guide. Beachkeeper plus is based on Matlab ® and it can be used for the analysis of images and photos coming from any kind of acquisition system (webcams, digital cameras or images downloaded from internet), without any a-priori information or laboratory study of the acquisition system itself. Therefore, it could become a useful tool for beach planning. Through a simple guided interface, images can be analyzed by performing georeferentiation, rectification, averaging and variance. This software was initially operated in Pietra Ligure (Italy), using images from a tourist webcam, and in Mar del Plata (Argentina) using images from a digital camera. In both cases the reliability in different geomorphologic and morphodynamic conditions was confirmed by the good quality of obtained images after georeferentiation, rectification and averaging. © 2012 Elsevier Ltd.Fil: Brignone, Massimo. University of Genoa; ItaliaFil: Schiaffino, Chiara F.. University of Genoa; ItaliaFil: Isla, Federico Ignacio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones Marinas y Costeras. Universidad Nacional de Mar del Plata. Facultad de Ciencias Exactas y Naturales. Instituto de Investigaciones Marinas y Costeras; ArgentinaFil: Ferrari, Marco. University of Genoa; Itali

Considerations of Efficiency and Distributive Justice in Multidimensional Poverty Measurement

Ab den 1980er Jahren entwickelte Amartya Sen eine neue Wohlfahrtstheorie: den Capability Approach (Sen, 1979; 1985; 1992; 1999; 2009). Dabei ersetzen Capabilities und Functionings, d.h. das, was Personen tatsächlich in der Lage sind zu tun und zu sein, den traditionellen Einkommensansatz. Armut ist im Capability Approach das Unvermögen, ein bestimmtes Minimum an zentralen Capabilities zu erreichen, die benötigt werden, um das Leben nach den eigenen Vorstellungen zu gestalten. Der Capability Approach hat so viele interessante Eigenschaften, besonders in Bezug auf die Armutsmessung, dass er zunehmend Einfluss in der Wohlfahrtsökonomie gewinnt. Diese Entwicklung wird durch empirische Untersuchungen gefördert, die zeigen, dass dieser multidimensionale Ansatz zur Armutsmessung deutlich andere Ergebnisse generiert als der traditionelle Einkommensansatz (vgl. Klasen, 2000, Alkire und Santos, 2010, Figari, 2012). Der derzeitige multidimensionale Ansatz hat jedoch eine methodische Schwäche: Ungleichheit zwischen Armutsdimensionen wird entweder als Korrelationssensitivität definiert – womit Effizienz aber nicht Verteilungsgerechtigkeit berücksichtigt wird – oder als die Verteilung multipler Mangelerscheinungen in einer Gesellschaft – womit Verteilungsgerechtigkeit aber nicht Effizienz berücksichtigt wird. Die ersten beiden Kapitel dieser Dissertation widmen sich der Behebung dieser methodischen Schwäche. Dazu wird Ungleichheit zwischen Dimensionen zunächst als „korrelationssensitive Verteilung multipler Mangelerscheinungen in einer Gesellschaft“ definiert. Die ersten beiden Kapitel operationalisieren diese erweiterte Definition für den Fall ordinaler und kardinaler Armutsindices. Im Einzelnen wird ein neues Axiom für den ordinalen sowie den kardinalen Fall eingeführt, das das Ausmaß, mit dem ein Ungleichheitsfördernder Tausch Armut sinken (oder steigen) lässt, von der Beziehung zwischen den Armutsdimensionen abhängig macht. Diese Neuerung wird benutzt um eine neue Klasse ordinaler bzw. kardinaler Armutsindices herzuleiten. Diese zwei Klassen sind die ersten additiven Armutsindices die in der Lage sind, sowohl Ungleichheit als auch Korrelationssensitivität zu erfassen. Das dritte Kapitel nutzt das deutsche sozio-ökonomische Panel um zwei ordinale Armutsindices für Deutschland vorzuschlagen, die auf der zuvor entwickelten Methode basieren: den „Deutschen Korrelationssensitiven Armutsindex“ und den „Subjektiven Korrelationssensitiven Armutsindex“. Die beiden Indices werden mit dem offiziellen deutschen Armutsmaß, der Armutsgefährdungsquote, über Dimensionen, Regionen und über die Zeit hinweg verglichen. Die Resultate zeigen vor allem eines: die signifikanten Unterschiede in der Beurteilung von Armut und Armutstrends die durch die verschiedenen Indices versursacht werden und den hohen Mehrwert den die Operationalisierung des Capability Approachs darstellt

Reproducibility of Ablated Volume Measurement Is Higher with Contrast-Enhanced Ultrasound than with B-Mode Ultrasound after Benign Thyroid Nodule Radiofrequency Ablation—A Preliminary Study

The reproducibility of contrast-enhanced ultrasound (CEUS) and standard B-mode ultrasound in the assessment of radiofrequency-ablated volume of benign thyroid nodules was compared. A preliminary study was conducted on consecutive patients who underwent radiofrequency ablation (RFA) of benign thyroid nodules between 2014 and 2016, with available CEUS and B-mode post-ablation checks. CEUS and B-mode images were retrospectively evaluated by two radiologists to assess inter- and intra-observer agreement in the assessment of ablated volume (Bland-Altman test). For CEUS, the mean inter-observer difference (95% limits of agreement) was 0.219 mL (-0.372-0.809 mL); for B-mode, the mean difference was 0.880 mL (-1.655-3.414 mL). Reproducibility was significantly higher for CEUS (85%) than for B-mode (27%). Mean intra-observer differences (95% limits of agreement) were 0.013 mL (0.803-4.097 mL) for Reader 1 and 0.031 mL (0.763-3.931 mL) for Reader 2 using CEUS, while they were 0.567 mL (-2.180-4.317 mL, Reader 1) and 0.759 mL (-2.584-4.290 mL, Reader 2) for B-mode. Intra-observer reproducibility was significantly higher for CEUS (96% and 95%, for the two readers) than for B-mode (21% and 23%). In conclusion, CEUS had higher reproducibility and inter- and intra-observer agreement compared to conventional B-mode in the assessment of radiofrequency-ablated volume of benign thyroid nodules

CT-derived pulmonary vascular metrics and clinical outcome in COVID-19 patients

To assess pulmonary vascular metrics on chest CT of COVID-19 patients, and their correlation with pneumonia extent (PnE) and outcome, we analyzed COVID-19 patients with an available previous chest CT, excluding those performed for cardiovascular disease. From February 21 to March 21, 2020, of 672 suspected COVID-19 patients from two centers who underwent CT, 45 RT-PCR-positives (28 males, median age 75, IQR 66-81 years) with previous CTs performed a median 36 months before (IQR 12-72 months) were included. We assessed PnE, pulmonary artery (PA) diameter, ascending aorta (Ao) diameter, and PA/Ao ratio. Most common presentations were fever and dyspnea (15/45) and fever alone (13/45). Outcome was available for 41/45 patients, 15/41 dead and 26/41 discharged. Ground-glass opacities (GGOs) alone were found in 29/45 patients, GGOs with consolidations in 15/45, consolidations alone in 1/45. All but one patient had bilateral pneumonia, 9/45 minimal, 22/45 mild, 9/45 moderate, and 5/45 severe PnE. PA diameter (median 31 mm, IQR 28-33 mm) was larger than before (26 mm, IQR 25-29 mm) (P<0.001), PA/Ao ratio (median 0.83, IQR 0.76-0.92) was higher than before (0.76, IQR 0.72-0.82) (P<0.001). Patients with adverse outcome (death) had higher PA diameter (P=0.001), compared to discharged ones. Only weak correlations were found between Delta PA or Delta PA/Ao and PnE (rho <= 0.453, P <= 0.032), with 4/45 cases with moderate-severe PnE and minimal increase in PA metrics. In conclusion, enlarged PA diameter was associated to death in COVID-19 patients, a finding deserving further investigation as a potential driver of therapy decision-making

The anti-apoptotic effect of ASC-exosomes in an in vitro ALS model and their proteomic analysis

Stem cell therapy represents a promising approach in the treatment of several neurodegenerative disorders, including amyotrophic lateral sclerosis (ALS). The beneficial effect of stem cells is exerted by paracrine mediators, as exosomes, suggesting a possible potential use of these extracellular vesicles as non-cell based therapy. We demonstrated that exosomes isolated from adipose stem cells (ASC) display a neuroprotective role in an in vitro model of ALS. Moreover, the internalization of ASC-exosomes by the cells was shown and the molecules and the mechanisms by which exosomes could exert their beneficial effect were addressed. We performed for the first time a comprehensive proteomic analysis of exosomes derived from murine ASC. We identified a total of 189 proteins and the shotgun proteomics analysis revealed that the exosomal proteins are mainly involved in cell adhesion and negative regulation of the apoptotic process. We correlated the protein content to the anti-apoptotic effect of exosomes observing a downregulation of pro-apoptotic proteins Bax and cleaved caspase-3 and upregulation of anti-apoptotic protein Bcl-2 \u3b1, in an in vitro model of ALS after cell treatment with exosomes. Overall, this study shows the neuroprotective effect of ASC-exosomes after their internalization and their global protein profile, that could be useful to understand how exosomes act, demonstrating that they can be employed as therapy in neurodegenerative diseases

Eight previously unidentified mutations found in the OA1 ocular albinism gene

BACKGROUND: Ocular albinism type 1 (OA1) is an X-linked ocular disorder characterized by a severe reduction in visual acuity, nystagmus, hypopigmentation of the retinal pigmented epithelium, foveal hypoplasia, macromelanosomes in pigmented skin and eye cells, and misrouting of the optical tracts. This disease is primarily caused by mutations in the OA1 gene. METHODS: The ophthalmologic phenotype of the patients and their family members was characterized. We screened for mutations in the OA1 gene by direct sequencing of the nine PCR-amplified exons, and for genomic deletions by PCR-amplification of large DNA fragments. RESULTS: We sequenced the nine exons of the OA1 gene in 72 individuals and found ten different mutations in seven unrelated families and three sporadic cases. The ten mutations include an amino acid substitution and a premature stop codon previously reported by our team, and eight previously unidentified mutations: three amino acid substitutions, a duplication, a deletion, an insertion and two splice-site mutations. The use of a novel Taq polymerase enabled us to amplify large genomic fragments covering the OA1 gene. and to detect very likely six distinct large deletions. Furthermore, we were able to confirm that there was no deletion in twenty one patients where no mutation had been found. CONCLUSION: The identified mutations affect highly conserved amino acids, cause frameshifts or alternative splicing, thus affecting folding of the OA1 G protein coupled receptor, interactions of OA1 with its G protein and/or binding with its ligand

Contrasting signatures of genomic divergence during sympatric speciation

Population genomic analyses of Midas cichlid fishes in young Nicaraguan crater lakes suggest that sympatric speciation is promoted by polygenic architectures. The transition from 'well-marked varieties' of a single species into 'well-defined species'-especially in the absence of geographic barriers to gene flow (sympatric speciation)-has puzzled evolutionary biologists ever since Darwin(1,2). Gene flow counteracts the buildup of genome-wide differentiation, which is a hallmark of speciation and increases the likelihood of the evolution of irreversible reproductive barriers (incompatibilities) that complete the speciation process(3). Theory predicts that the genetic architecture of divergently selected traits can influence whether sympatric speciation occurs(4), but empirical tests of this theory are scant because comprehensive data are difficult to collect and synthesize across species, owing to their unique biologies and evolutionary histories(5). Here, within a young species complex of neotropical cichlid fishes (Amphilophus spp.), we analysed genomic divergence among populations and species. By generating a new genome assembly and re-sequencing 453 genomes, we uncovered the genetic architecture of traits that have been suggested to be important for divergence. Species that differ in monogenic or oligogenic traits that affect ecological performance and/or mate choice show remarkably localized genomic differentiation. By contrast, differentiation among species that have diverged in polygenic traits is genomically widespread and much higher overall, consistent with the evolution of effective and stable genome-wide barriers to gene flow. Thus, we conclude that simple trait architectures are not always as conducive to speciation with gene flow as previously suggested, whereas polygenic architectures can promote rapid and stable speciation in sympatry.Peer reviewe