Hydrodynamic Feedbacks of Salt-Marsh Loss in the Shallow Microtidal Back-Barrier Lagoon of Venice (Italy)

Extensive loss of salt marshes in back-barrier tidal embayments is ongoing worldwide as a consequence of land-use changes, wave-driven lateral marsh erosion, and relative sea-level rise compounded by mineral sediment starvation. However, how salt-marsh loss affects the hydrodynamics of back-barrier systems and feeds back into their morphodynamic evolution is still poorly understood. Here we use a depth-averaged numerical hydrodynamic model to investigate the feedback between salt-marsh erosion and hydrodynamic changes in the Venice Lagoon, a large microtidal back-barrier system in northeastern Italy. Numerical simulations are carried out for past morphological configurations of the lagoon dating back up to 1887, as well as for hypothetical scenarios involving additional marsh erosion relative to the present-day conditions. The progressive loss of salt marshes significantly impacted the lagoon hydrodynamics, both directly and indirectly, by amplifying high-tide water levels, reducing wind-wave energy dissipation, and critically affecting tidal asymmetries across the lagoon. Restoration projects and manmade protection of marsh margins, which have been implemented over the past few decades, limited the detrimental effects of marsh loss on the lagoon hydrodynamics, while not substantially changing the risk of flooding in urban lagoon settlements. Compared to previous studies, our analyses suggest that the hydrodynamic response of back-barrier systems to salt-marsh erosion is extremely site-specific, depending closely on the morphological characteristics of the embayment as well as on the external tidal and wind forcings

Experimental Setup and Measuring System to Study SolitaryWave Interaction with Rigid Emergent Vegetation

The aim of this study is to present a peculiar experimental setup, designed to investigate the interaction between solitary waves and rigid emergent vegetation. Flow rate changes due to the opening and closing of a software-controlled electro-valve generate a solitary wave. The complexity of the problem required the combined use of different measurement systems of water level and velocity. Preliminary results of the experimental investigation, which allow us to point out the effect of the vegetation on the propagation of a solitary wave and the effectiveness of the measuring system, are also presented. In particular, water level and velocity field changes due to the interaction of the wave with rigid vegetation are investigated in detail

Reduced parahippocampal cortical thickness in subjects at ultra-high risk for psychosis

Background Grey matter volume and cortical thickness represent two complementary aspects of brain structure. Several studies have described reductions in grey matter volume in people at ultra-high risk (UHR) of psychosis; however, little is known about cortical thickness in this group. The aim of the present study was to investigate cortical thickness alterations in UHR subjects and compare individuals who subsequently did and did not develop psychosis. Method We examined magnetic resonance imaging data collected at four different scanning sites. The UHR subjects were followed up for at least 2 years. Subsequent to scanning, 50 UHR subjects developed psychosis and 117 did not. Cortical thickness was examined in regions previously identified as sites of neuroanatomical alterations in UHR subjects, using voxel-based cortical thickness. Results At baseline UHR subjects, compared with controls, showed reduced cortical thickness in the right parahippocampal gyrus (p<0.05, familywise error corrected). There were no significant differences in cortical thickness between the UHR subjects who later developed psychosis and those who did not. Conclusions These data suggest that UHR symptomatology is characterized by alterations in the thickness of the medial temporal cortex. We did not find evidence that the later progression to psychosis was linked to additional alterations in cortical thickness, although we cannot exclude the possibility that the study lacked sufficient power to detect such difference

Reduced parahippocampal cortical thickness in subjects at ultra-high risk for psychosis

Background: Grey matter volume and cortical thickness represent two complementary aspects of brain structure. Several studies have described reductions in grey matter volume in people at ultra-high risk (UHR) of psychosis; however, little is known about cortical thickness in this group. The aim of the present study was to investigate cortical thickness alterations in UHR subjects and compare individuals who subsequently did and did not develop psychosis. Method: We examined magnetic resonance imaging data collected at four different scanning sites. The UHR subjects were followed up for at least 2 years. Subsequent to scanning, 50 UHR subjects developed psychosis and 117 did not. Cortical thickness was examined in regions previously identified as sites of neuroanatomical alterations in UHR subjects, using voxel-based cortical thickness. Results: At baseline UHR subjects, compared with controls, showed reduced cortical thickness in the right parahippocampal gyrus (p<0.05, familywise error corrected). There were no significant differences in cortical thickness between the UHR subjects who later developed psychosis and those who did not. Conclusions: These data suggest that UHR symptomatology is characterized by alterations in the thickness of the medial temporal cortex. We did not find evidence that the later progression to psychosis was linked to additional alterations in cortical thickness, although we cannot exclude the possibility that the study lacked sufficient power to detect such differences

Adherence to antibiotic treatment guidelines and outcomes in the hospitalized elderly with different types of pneumonia

Background: Few studies evaluated the clinical outcomes of Community Acquired Pneumonia (CAP), Hospital-Acquired Pneumonia (HAP) and Health Care-Associated Pneumonia (HCAP) in relation to the adherence of antibiotic treatment to the guidelines of the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS) in hospitalized elderly people (65 years or older). Methods: Data were obtained from REPOSI, a prospective registry held in 87 Italian internal medicine and geriatric wards. Patients with a diagnosis of pneumonia (ICD-9 480-487) or prescribed with an antibiotic for pneumonia as indication were selected. The empirical antibiotic regimen was defined to be adherent to guidelines if concordant with the treatment regimens recommended by IDSA/ATS for CAP, HAP, and HCAP. Outcomes were assessed by logistic regression models. Results: A diagnosis of pneumonia was made in 317 patients. Only 38.8% of them received an empirical antibiotic regimen that was adherent to guidelines. However, no significant association was found between adherence to guidelines and outcomes. Having HAP, older age, and higher CIRS severity index were the main factors associated with in-hospital mortality. Conclusions: The adherence to antibiotic treatment guidelines was poor, particularly for HAP and HCAP, suggesting the need for more adherence to the optimal management of antibiotics in the elderly with pneumonia

Pain and Frailty in Hospitalized Older Adults

Introduction: Pain and frailty are prevalent conditions in the older population. Many chronic diseases are likely involved in their origin, and both have a negative impact on quality of life. However, few studies have analysed their association. Methods: In light of this knowledge gap, 3577 acutely hospitalized patients 65&nbsp;years or older enrolled in the REPOSI register, an Italian network of internal medicine and geriatric hospital wards, were assessed to calculate the frailty index (FI). The impact of pain and some of its characteristics on the degree of frailty was evaluated using an ordinal logistic regression model after adjusting for age and gender. Results: The prevalence of pain was 24.7%, and among patients with pain, 42.9% was regarded as chronic pain. Chronic pain was associated with severe frailty (OR = 1.69, 95% CI 1.38–2.07). Somatic pain (OR = 1.59, 95% CI 1.23–2.07) and widespread pain (OR = 1.60, 95% CI 0.93–2.78) were associated with frailty. Osteoarthritis was the most common cause of chronic pain, diagnosed in 157 patients (33.5%). Polymyalgia, rheumatoid arthritis and other musculoskeletal diseases causing chronic pain were associated with a lower degree of frailty than osteoarthritis (OR = 0.49, 95%CI 0.28–0.85). Conclusions: Chronic and somatic pain negatively affect the degree of frailty. The duration and type of pain, as well as the underlying diseases associated with chronic pain, should be evaluated to improve the hospital management of frail older people

The multifaceted spectrum of liver cirrhosis in older hospitalised patients: Analysis of the REPOSI registry

Background: Knowledge on the main clinical and prognostic characteristics of older multimorbid subjects with liver cirrhosis (LC) admitted to acute medical wards is scarce. Objectives: To estimate the prevalence of LC among older patients admitted to acute medical wards and to assess the main clinical characteristics of LC along with its association with major clinical outcomes and to explore the possibility that well-distinguished phenotypic profiles of LC have classificatory and prognostic properties. Methods: A cohort of 6,193 older subjects hospitalised between 2010 and 2018 and included in the REPOSI registry was analysed. Results: LC was diagnosed in 315 patients (5%). LC was associated with rehospitalisation (age-sex adjusted hazard ratio, [aHR] 1.44; 95% CI, 1.10-1.88) and with mortality after discharge, independently of all confounders (multiple aHR, 2.1; 95% CI, 1.37-3.22), but not with in-hospital mortality and incident disability. Three main clinical phenotypes of LC patients were recognised: relatively fit subjects (FIT, N = 150), subjects characterised by poor social support (PSS, N = 89) and, finally, subjects with disability and multimorbidity (D&amp;M, N = 76). PSS subjects had an increased incident disability (35% vs 13%, P &lt; 0.05) compared to FIT. D&amp;M patients had a higher mortality (in-hospital: 12% vs 3%/1%, P &lt; 0.01; post-discharge: 41% vs 12%/15%, P &lt; 0.01) and less rehospitalisation (10% vs 32%/34%, P &lt; 0.01) compared to PSS and FIT. Conclusions: LC has a relatively low prevalence in older hospitalised subjects but, when present, accounts for worse post-discharge outcomes. Phenotypic analysis unravelled the heterogeneity of LC older population and the association of selected phenotypes with different clinical and prognostic features

Neuroanatomical abnormalities that predate the onset of psychosis : a multicenter study

People experiencing possible prodromal symptoms of psychosis have a very high risk of developing the disorder, but it is not possible to predict, on the basis of their presenting clinical features, which individuals will subsequently become psychotic. Recent neuroimaging studies suggest that there are volumetric differences between individuals at ultra-high risk (UHR) for psychosis who later develop psychotic disorder and those who do not. However, the samples examined to date have been small, and the findings have been inconsistent