The importance of a diagnostic pathway in the diagnosis of haemoptysis

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spatiotemporal variability of alkalinity in the mediterranean sea

Abstract. The paper provides a basin-scale assessment of the spatiotemporal distribution of alkalinity in the Mediterranean Sea. The assessment is made by integrating the available observations into a 3-D transport–biogeochemical model. The results indicate the presence of complex spatial patterns: a marked west-to-east surface gradient of alkalinity is coupled to secondary negative gradients: (1) from marginal seas (Adriatic and Aegean Sea) to the eastern Mediterranean Sea and (2) from north to south in the western region. The west–east gradient is related to the mixing of Atlantic water entering from the Strait of Gibraltar with the high-alkaline water of the eastern sub-basins, which is correlated to the positive surface flux of evaporation minus precipitation. The north-to-south gradients are related to the terrestrial input and to the input of the Black Sea water through the Dardanelles. In the surface layers, alkalinity has a relevant seasonal cycle (up to 40 μmol kg−1) that is driven by physical processes (seasonal cycle of evaporation and vertical mixing) and, to a minor extent, by biological processes. A comparison of alkalinity vs. salinity indicates that different regions present different relationships: in regions of freshwater influence, the two quantities are negatively correlated due to riverine alkalinity input, whereas they are positively correlated in open sea areas of the Mediterranean Sea

Stochastic 0-dimensional Biogeochemical Flux Model: Effect of temperature fluctuations on the dynamics of the biogeochemical properties in a marine ecosystem

We present a new stochastic model, based on a 0-dimensional version of the well known biogeochemical flux model (BFM), which allows to take into account the temperature random fluctuations present in natural systems and therefore to describe more realistically the dynamics of real marine ecosystems. The study presents a detailed analysis of the effects of randomly varying temperature on the lower trophic levels of the food web and ocean biogeochemical processes. More in detail, the temperature is described as a stochastic process driven by an additive self-correlated Gaussian noise. Varying both correlation time and intensity of the noise source, the predominance of different plankton populations is observed, with regimes shifted towards the coexistence or the exclusion of some populations. Finally a Fourier analysis carried out on the time series of the plankton populations shows how the ecosystem responds to the seasonal driving for different values of the noise intensit

Progressive fibrosing interstitial lung diseases: A current perspective

Interstitial lung diseases (ILDs) are a large and diverse group of rare and chronic respiratory disorders, with idiopathic pulmonary fibrosis (IPF) being the most common and best-studied member. Increasing interest in fibrosis as a therapeutic target and the appreciation that fibrotic mechanisms may be a treatable target of IPF prompted the development and subsequent approval of the antifibrotics, pirfenidone and nintedanib. The management of ILDs has changed considerably following an understanding that IPF and some ILDs share similar disease behavior of progressive fibrosis, termed “progressive fibrosing phenotype”. Indeed, antifibrotic treatment has shown to be beneficial in ILDs characterized by the progressive fibrosing phenotype. This narrative review summarizes current knowledge in the field of progressive fibrosing ILDs. Here, we discuss the clinical characteristics and pathogenesis of lung fibrosis and highlight relevant literature concerning the mechanisms underlying progressive fibrosing ILDs. We also summarize current diagnostic approaches and the available treatments of progressive fibrosing ILDs and address the optimization of treating progressive fibrosing ILDs with antifibrotics in clinical practice