EVALUATION OF THE AEROSOL TYPE EFFECT ON THE SURFACE REFLECTANCE RETRIEVAL USING CHRIS/PROBA IMAGES OVER LAND

Surface reflectance has a central role in the analysis of land surface for a broad variety of agricultural, geological and urban studies. An accurate atmospheric correction, obtained by an appropriate selection of aerosol type and loading, is the first requirement for a reliable surface reflectance estimation. The aerosol type is defined by its micro-physical properties, while the aerosol loading is described by optical thickness at 550 nm. The aim of this work is to evaluate the radiative impact of the aerosol model on the surface reflectance obtained from CHRIS (Compact High Resolution Imaging Spectrometer) hyperspectral data over land by using the specifically developed algorithm CHRIS@CRI (CHRIS Atmospherically Corrected Reflectance Imagery) based on the 6SV radiative transfer model. Five different aerosol models have been used: one provided by the AERONET inversion products (used as reference), three standard aerosol models in 6SV, and one obtained from the output of the GEOS-Chem global chemistry-transport model (CTM). As test case the urban site of Bruxelles and the suburban area of Rome Tor Vergata have been considered. The results obtained encourages the use of CTM in operational retrieval and provides an evaluation of the role of the aerosol model in the atmospheric correction process, considering the different microphysical properties impact

Stretching stenoses of the external auditory canal: a report of four cases and brief review of the literature

Acquired stenosis of the external auditory canal may be caused by a variety of insults, all sharing a common pathogenesis, namely a cascade of inflammatory changes leading to medial canal fibrosis. Previous surgery (canaloplasty or meatoplasty) and radiotherapy, especially if associated with a history of parotid surgery extended to the external auditory canal, have been implicated as possible causes. The literature offers advice on the management of stenosis consequent to otosurgery for congenital and acquired defects, but nothing on forms secondary to radiotherapy to the head and neck region. The proposed solutions are often cumbersome and difficult to fabricate, and therefore expensive. The aim of this paper, in which the cases of four patients are reported, is to present a new technique initially used for the most severe form - i.e. external auditory canal stenosis after surgery and radiotherapy - and then extended to forms due to different causes. This new technique involves the use of a series of surgical steel tubes of increasing dimension commonly used for tissue expansion in a body piercing practice called stretching and known as ear stretching tunnels or ear stretchers. This innovative approach proved effective in solving external auditory canal stenosis in our patients, with the least discomfort for the patient and the lowest cost. We consider this new solution to be feasible and practical and are convinced that it provides a new approach to an old problem. Further studies are needed to increase the number of clinical cases to verify how long the ear stretcher should be kept in place for the stenosis to stabilise, and to establish whether surgery is always necessary after ear stretcher application and, if so, the best timing for surgery

Case Report: All That Glisters Is Not* Cancer

Properly performed staging in non-small-cell lung cancer (NSCLC) is necessary to avoid wrong therapeutic decisions. Here we present a case which manifested as advanced NSCLC but ultimately was composed of two different and rare pathologies. The first is a TTF-1 positive axillary lymph node that could be defined either as an unusual isolated differentiated cancer of unknown primary or as an even rarer case of ectopic lung epithelium which underwent malignant transformation. The second is sarcoidosis, a sarcoid-like alteration, in remission after oral steroids. The main implication of a correct diagnosis regards patient outcome and the avoidance of toxic inappropriate systemic chemotherapy

Functionalized Enzyme-Responsive Biomaterials to Model Tissue Stiffening in vitro

The mechanical properties of the cellular microenvironment play a crucial role in modulating cell function, and many pathophysiological processes are accompanied by variations in extracellular matrix (ECM) stiffness. Lysyl oxidase (LOx) is one of the enzymes involved in several ECM-stiffening processes. Here, we engineered poly(ethylene glycol) (PEG)-based hydrogels with controlled mechanical properties in the range typical of soft tissues. These hydrogels were functionalized featuring free primary amines, which allows an additional chemical LOx-responsive behavior with increase in crosslinks and hydrogel elastic modulus, mimicking biological ECM-stiffening mechanisms. Hydrogels with elastic moduli in the range of 0.5–4 kPa were obtained after a first photopolymerization step. The increase in elastic modulus of the functionalized and enzyme-responsive hydrogels was also characterized after the second-step enzymatic reaction, recording an increase in hydrogel stiffness up to 0.5 kPa after incubation with LOx. Finally, hydrogel precursors containing HepG2 (bioinks) were used to form three-dimensional (3D) in vitro models to mimic hepatic tissue and test PEG-based hydrogel biocompatibility. Hepatic functional markers were measured up to 7 days of culture, suggesting further use of such 3D models to study cell mechanobiology and response to dynamic variation of hydrogels stiffness. The results show that the functionalized hydrogels presented in this work match the mechanical properties of soft tissues, allow dynamic variations of hydrogel stiffness, and can be used to mimic changes in the microenvironment properties of soft tissues typical of inflammation and pathological changes at early stages (e.g., fibrosis, cancer)

Saccades and smooth pursuit eye movements in central vertigo

In order to analyze the diagnostic efficiency of saccadic and pursuit eye movements compared to findings from brain magnetic resonance imaging in patients with central vertigo, 108 patients were selected from 580 dizzy patients as cases of suspected central origin; the saccadic and pursuit eye movements were evaluated by electronystagmography and findings were compared to information from magnetic resonance imaging. The study of oculomotor movements in patients suspected of having a central lesion revealed a 83.3% sensitivity and 21.2% specificity. Restricting consideration to severe alterations in eye movements as indicative of a central origin, this test gives a 71.4% sensitivity and 50.0% specificity. In conclusion, the study of alterations in oculomotor movements, in patients with suspected central lesions, proved to be a test with good sensitivity also compared with results of magnetic resonance imaging

Systemic sclerosis sine scleroderma in children

Objective: Juvenile systemic sclerosis (JSSc) is a rare condition in childhood and its variety with no skin involvement, sine scleroderma (ssJSSc), is anecdotal. We report the first case series of patients with ssJSSc. Methods: Demographic, clinical and laboratory data of patients with JSSc followed at our centre were retrospectively collected. Patients with no skin involvement but with all of the features RP, positive ANA, intestinal dysmotility and/or interstitial lung disease (ILD) or pulmonary arterial hypertension (PAH) and/or cardiac or renal involvement typical of scleroderma were defined as having ssJSSc and compared with those with classic JSSc (cJSSc). Results: Among 52 JSSc patients seen in 20 years, five (9.6%) presented with ssJSSc. Their clinical features and those of the only two patients reported in the literature so far were compared with classic JSSc with available complete data. Six patients had cardiac involvement as presenting feature, three primary cardiomyopathy, three secondary to PAH. Two patients died after a brief disease course and one rapidly underwent heart transplantation. In comparison with cJSSc, ssJSSc showed a significantly longer diagnostic delay (20.1 vs 8.3 months, P = 0.017), higher frequency of cardiac involvement (85.7 vs 15.6%, P = 0.001) and worse outcome, intended as mortality or end-stage organ failure rates (42.9% vs 6.2%, P < 0.001). Conclusion: Cardiac involvement represents the most important characteristic of ssJSSc and carries a high morbidity and mortality rate. The longer delay in diagnosis underlines the need for a comprehensive rheumatological work-up in patients with isolated cardiomyopathy or PAH/ILD

Surgical resection of oral cancer: en-bloc versus discontinuous approach

Objectives: In the past literature agreed on treating oral carcinomas, using an \u201cen-bloc\u201d resection (EBR) but recently minimally invasive transoral surgery has spread as the preferable treatment for selected cases. This latter technique, which is performed with a discontinuous resection (DR), allows for a satisfactory postoperative quality of life (QoL) maintaining good survival rates. Materials and methods: In this study, we analyzed data about 147 surgically treated patients with oral cancer involving tongue and floor of the mouth. The sample was divided according to the surgical approach: EBR and DR group which were compared in terms of recurrence, overall survival, disease-free survival, and QoL. Results: In the DR group, survival analysis showed better results in term of survival, locoregional control, and postoperative anxiety, while the other QoL scores were similar in the two groups. Conclusion: The more invasive approach does not correlate to a better outcome. In selected cases, DR is an oncologically safe technique; EBR is still a valid option to treat advanced oral cancers

pT3 N0 Laryngeal Squamous Cell Carcinoma: Oncologic Outcomes and Prognostic Factors of Surgically Treated Patients

Objectives/Hypothesis: To assess the disease control, survival rates, and prognostic factors of exclusive surgical treatment for patients with pT3 N0 laryngeal squamous cell carcinoma (LSCC). Study Design: Multicentric retrospective cohort study. Methods: Multicentric retrospective case series of previously untreated patients with pT3 R0N0 LSCC, who received exclusive surgery between 2011 and 2019. Tumor location; subsite involvement; grading; and lymphatic, vascular, and perineural invasion were reported. Overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS) were measured. Results: Fifty-four patients (mean age 67.1; male sex 83.3%; mean follow-up period 37 months) underwent total laryngectomy (48.1%) or partial laryngectomy (51.9%). Ipsilateral or bilateral neck dissection was performed in 46 (85.2%) cases. Perineural invasion was more frequent in case of supraglottic involvement than glottic involvement (85.7% vs. 14.3%, P&nbsp;=.03). Five (9.3%) patients experienced recurrence (3 local recurrences, 1 nodal recurrence, 1 distant recurrence). Rate of recurrence differed between glottic (0%), supraglottic (80%), and transglottic (20%) tumors (P&nbsp;=.01), with a lower risk yielded by glottic involvement (odds ratio [OR], 0.05, 95% confidence interval [95% CI], 0.01–0.56, P&nbsp;=.01). A higher risk was recorded in case of perineural invasion (OR, 66.0, 95% CI, 1.41–3085.3, P&nbsp;=.03). The OS, DSS, and DFS were 79.6%, 96.3%, and 90.7%, without differences regarding the type of surgery. The DFS was lower in case of supraglottic involvement when compared to purely glottic LSCC (83.9% vs. 100%, P&nbsp;=&nbsp;0.02). Conclusions: Exclusive surgery is a safe option for patients with pT3 R0N0 LSCC. Adjuvant treatments or closer follow-up monitoring might be considered in case of supraglottic involvement or perineural invasion. Level of Evidence: 4 Laryngoscope, 131:2262–2268, 2021

Case report: Exploring under the tip of the iceberg: A case series of “self-limiting” multisystem inflammatory syndrome in children

Multisystem inflammatory syndrome in children (MIS-C) is a serious condition triggered by SARS-COV-2 infection, characterized by persistent fever, multiorgan dysfunction, and increased inflammatory markers. It requires hospitalization and prompt treatment, with nearly 60% of the cases needing intensive care and 2% fatality rate. A wide spectrum of clinical characteristics and therapeutic approaches has been reported in MIS-C. We describe a series of four patients with MIS-C, defined according to the current case definitions, with a self-limiting course and no need for immunomodulatory treatment (“self-limiting MIS-C”). Few data about self-limiting MIS-C are available to date and no information on medium- and long-term outcome of this subset of patients has been reported. Although limited in size, our experience provides new insights into the MIS-C syndrome, highlighting an underestimated aspect of the disease that may have significant therapeutic implications

Prognostic role of euthyroid sick syndrome in MIS-C: results from a single-center observational study

Background: Euthyroid sick syndrome (ESS) is characterized by low serum levels of free triiodothyronine (fT3) with normal or low levels of thyroid stimulating hormone (TSH) and free thyroxine (fT4) and is reported in different acute clinical situations, such as sepsis, diabetic ketoacidosis and after cardiac surgery. Our aim was to evaluate the predicting role of ESS for disease severity in patients with Multisystem Inflammatory Syndrome in children (MIS-C). Methods: A single-centre observational study on consecutive patients with MIS-C. Before treatment clinical, and laboratory data were collected and, in a subset of patients, thyroid function tests were repeated 4 weeks later. Variables distribution was analyzed by Mann-Whitney U-test and correlations between different parameters were calculated by Spearman's Rho coefficient. Results: Forty-two patients were included and 36 (85.7%) presented ESS. fT3 values were significantly lower in patients requiring intensive care, a strong direct correlation was shown between fT3 and Hb, platelet count and ejection fraction values. A significant inverse correlation was retrieved between fT3 levels and C-reactive protein, brain natriuretic peptide, IL-2 soluble receptor and S-100 protein. Subjects with severe myocardial depression (EF < 45%) had lower fT3 values than subjects with higher EF. The thyroid function tests spontaneously normalized in all subjects who repeated measurement 4 weeks after admission. Conclusion: ESS is a frequent and transient condition in acute phase of MIS-C. A severe reduction of fT3 must be considered as important prognostic factor for severe disease course, with subsequent relevant clinical impact in the management of these patients