On the relationships between tectonics and volcanism in the offshore Capo Vaticano, SE Tyrrhenian Sea, during the Plio-Pleistocene

High-resolution bathymetry and a grid of single-channel reflection seismic profiles (Sparker and Chirp) were recently recorded in a sector of the upper slope of Capo Vaticano (CV) promontory (Tyrrhenian coast, W Calabria) where forward and inverse modeling of previously acquired aeromagnetic data highlight the presence of a WNW©\ESE elongated, 20 km long and 3¨C5 km wide, magnetized body extending from sea floor to about 3 km below sea level. Magnetic properties of this body are consistent with those of the medium to highly evolved volcanic rocks of the Aeolian Arc (De Ritis et al., 2010). Forthwith offshore promontory, the bathymetry highlights a complex-shape seamount that develops along a WNW direction, orthogonally interrupted by NE-trending ridges (Loreto et al., 2013), the largest of which shows major- and minor-axes of ca. 11 and 2 km, respectively. Summit elevation is ca. 70 m. Several vented fluids points were imaged on top of the seamount by chirp profiles. The largest of which rises from seafloor up to 6/7 m within water column, assuming the acoustic water velocity of 1500 m/s. Two faults systems associated with extensional faults are mainly observed on seismic profiles. High-angle NW-trending normal faults, SW-dipping, formed along the continental slope connecting the south-west continental shelf of the CV promontory to the Gioia Tauro basin (Pepe et al., 2013). These faults generally have small displacements, up to 40 m, and are sealed by Pleistocene deposits. A NE-trending normal fault, SE-dipping, is also observed on both chirp and sparker profiles. Its length is estimate to be more than 30 km, partially borders the NE-trending ridge intersecting the NW-trending fault. Landward, another NE-trending normal fault affects Pliocene and lower Pleistocene, and is sealed by upper Pleistocene. The described new geophysical data lead to a re-examination of the magnetic anomaly field interpretation. In fact, the revealed NE-trending ridge encounters the CV NW-SE ridge just where the peak value of the Reduced-to-the-Pole magnetic anomaly lies. Therefore, the inherent source body is emplaced where the maximum fracturing occurs. This suggests highly magnetized material crystallized in a vertical conduit that fed a volcanic system, likely fault-controlled, surrounded by the almost not magnetized rocks of the Gioia and the Paola sedimentary basins and of the Arco Calabro Peloritano units

Undertaking rapid evaluations during the COVID-19 pandemic: Lessons from evaluating COVID-19 remote home monitoring services in England

Introduction: Rapid evaluations can offer evidence on innovations in health and social care that can be used to inform fast-moving policy and practise, and support their scale-up according to previous research. However, there are few comprehensive accounts of how to plan and conduct large-scale rapid evaluations, ensure scientific rigour, and achieve stakeholder engagement within compressed timeframes. / Methods: Using a case study of a national mixed-methods rapid evaluation of COVID-19 remote home monitoring services in England, conducted during the COVID-19 pandemic, this manuscript examines the process of conducting a large-scale rapid evaluation from design to dissemination and impact, and reflects on the key lessons for conducting future large-scale rapid evaluations. In this manuscript, we describe each stage of the rapid evaluation: convening the team (study team and external collaborators), design and planning (scoping, designing protocols, study set up), data collection and analysis, and dissemination. / Results: We reflect on why certain decisions were made and highlight facilitators and challenges. The manuscript concludes with 12 key lessons for conducting large-scale mixed-methods rapid evaluations of healthcare services. We propose that rapid study teams need to: (1) find ways of quickly building trust with external stakeholders, including evidence-users; (2) consider the needs of the rapid evaluation and resources needed; (3) use scoping to ensure the study is highly focused; (4) carefully consider what cannot be completed within a designated timeframe; (5) use structured processes to ensure consistency and rigour; (6) be flexible and responsive to changing needs and circumstances; (7) consider the risks associated with new data collection approaches of quantitative data (and their usability); (8) consider whether it is possible to use aggregated quantitative data, and what that would mean when presenting results, (9) consider using structured processes & layered analysis approaches to rapidly synthesise qualitative findings, (10) consider the balance between speed and the size and skills of the team, (11) ensure all team members know roles and responsibilities and can communicate quickly and clearly; and (12) consider how best to share findings, in discussion with evidence-users, for rapid understanding and use. / Conclusion: These 12 lessons can be used to inform the development and conduct of future rapid evaluations in a range of contexts and settings

In Search of New Imaging For Historical Earthquakes: A New Geophysical Survey Offshore Western Calabria (Southern Tyrrhenian Sea, Italy)

During the summer of 2010 we carried out a survey to acquire a multidisciplinary dataset within the Gulf of Sant'Eufemia (SE Tyrrhenian sea, Italy), with the aim of studying the active tectonics affecting the region, including that potentially responsible for key, elusive earthquakes such as the to-date unexplained 8 September 1905 (Mw 7 - 7.5) earthquake. The data here analysed highlight the presence of several tectonic and morphologic features characterizing the investigated area. We have recognized the Angitola Channel, a deep and wide canyon showing a straight trend in its coastward segment, and a meandering trend in the seaward segment. Based on morpho-structural elements, we maintain that the Angitola Channel could be tectonically controlled. Moreover, several gravitational instabilities as slumps and collapses affect the flanks of the morpho-structural high, detected offshore Capo Vaticano. Very high resolution seismic data have unveiled the presence of numerous fluid escape features and several mud volcanoes straddling the sector from the coastline to seaward.INOGS (RIMA Department) supported the acquisition of the entire dataset.Published385-4013.2. Tettonica attivaJCR Journalrestricte

Magnetic resonance enterography compared with ultrasonography in newly diagnosed and relapsing Crohn's disease patients: the METRIC diagnostic accuracy study

Magnetic resonance enterography and enteric ultrasonography are used to image Crohn's disease patients. Their diagnostic accuracy for presence, extent and activity of enteric Crohn's disease was compared. To compare diagnostic accuracy, observer variability, acceptability, diagnostic impact and cost-effectiveness of magnetic resonance enterography and ultrasonography in newly diagnosed or relapsing Crohn's disease. Prospective multicentre cohort study. Eight NHS hospitals. Consecutive participants aged ≥ 16 years, newly diagnosed with Crohn's disease or with established Crohn's disease and suspected relapse. Magnetic resonance enterography and ultrasonography. The primary outcome was per-participant sensitivity difference between magnetic resonance enterography and ultrasonography for small bowel Crohn's disease extent. Secondary outcomes included sensitivity and specificity for small bowel Crohn's disease and colonic Crohn's disease extent, and sensitivity and specificity for small bowel Crohn's disease and colonic Crohn's disease presence; identification of active disease; interobserver variation; participant acceptability; diagnostic impact; and cost-effectiveness. Out of the 518 participants assessed, 335 entered the trial, with 51 excluded, giving a final cohort of 284 (133 and 151 in new diagnosis and suspected relapse cohorts, respectively). Across the whole cohort, for small bowel Crohn's disease extent, magnetic resonance enterography sensitivity [80%, 95% confidence interval (CI) 72% to 86%] was significantly greater than ultrasonography sensitivity (70%, 95% CI 62% to 78%), with a 10% difference (95% CI 1% to 18%;  = 0.027). For small bowel Crohn's disease extent, magnetic resonance enterography specificity (95%, 95% CI 85% to 98%) was significantly greater than ultrasonography specificity (81%, 95% CI 64% to 91%), with a 14% difference (95% CI 1% to 27%). For small bowel Crohn's disease presence, magnetic resonance enterography sensitivity (97%, 95% CI 91% to 99%) was significantly greater than ultrasonography sensitivity (92%, 95% CI 84% to 96%), with a 5% difference (95% CI 1% to 9%). For small bowel Crohn's disease presence, magnetic resonance enterography specificity was 96% (95% CI 86% to 99%) and ultrasonography specificity was 84% (95% CI 65% to 94%), with a 12% difference (95% CI 0% to 25%). Test sensitivities for small bowel Crohn's disease presence and extent were similar in the two cohorts. For colonic Crohn's disease presence in newly diagnosed participants, ultrasonography sensitivity (67%, 95% CI 49% to 81%) was significantly greater than magnetic resonance enterography sensitivity (47%, 95% CI 31% to 64%), with a 20% difference (95% CI 1% to 39%). For active small bowel Crohn's disease, magnetic resonance enterography sensitivity (96%, 95% CI 92% to 99%) was significantly greater than ultrasonography sensitivity (90%, 95% CI 82% to 95%), with a 6% difference (95% CI 2% to 11%). There was some disagreement between readers for both tests. A total of 88% of participants rated magnetic resonance enterography as very or fairly acceptable, which is significantly lower than the percentage (99%) of participants who did so for ultrasonography. Therapeutic decisions based on magnetic resonance enterography alone and ultrasonography alone agreed with the final decision in 122 out of 158 (77%) cases and 124 out of 158 (78%) cases, respectively. There were no differences in costs or quality-adjusted life-years between tests. Magnetic resonance enterography and ultrasonography scans were interpreted by practitioners blinded to clinical data (but not participant cohort), which does not reflect use in clinical practice. Magnetic resonance enterography has higher accuracy for detecting the presence, extent and activity of small bowel Crohn's disease than ultrasonography does. Both tests have variable interobserver agreement and are broadly acceptable to participants, although ultrasonography produces less participant burden. Diagnostic impact and cost-effectiveness are similar. Recommendations for future work include investigation of the comparative utility of magnetic resonance enterography and ultrasonography for treatment response assessment and investigation of non-specific abdominal symptoms to confirm or refute Crohn's disease. Current Controlled Trials ISRCTN03982913. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in ; Vol. 23, No. 42. See the NIHR Journals Library website for further project information

A review of economic evaluation models for cardiac resynchronization therapy with implantable cardioverter defibrillators in patients with heart failure

Objectives Cardiac resynchronization therapy with a biventricular pacemaker (CRT-P) is an effective treatment for dyssynchronous heart failure (DHF). Adding an implantable cardioverter defibrillator (CRT-D) may further reduce the risk of sudden cardiac death (SCD). However, if the majority of patients do not require shock therapy, the cost-effectiveness ratio of CRT-D compared to CRT-P may be high. The objective of this study was to systematically review decision models evaluating the cost-effectiveness of CRT-D for patients with DHF, compare the structure and inputs of these models and identify the main factors influencing the ICERs for CRT-D. Methods A comprehensive search strategy of Medline (Ovid), Embase (Ovid) and EconLit identified eight cost-effectiveness models evaluating CRT-D against optimal pharmacological therapy (OPT) and/or CRT-P. Results The selected economic studies differed in terms of model structure, treatment path, time horizons, and sources of efficacy data. CRT-D was found cost-effective when compared to OPT but its cost-effectiveness became questionable when compared to CRT-P. Conclusions Cost-effectiveness of CRT-D may increase depending on improvement of all-cause mortality rates and HF mortality rates in patients who receive CRT-D, costs of the device, and battery life. In particular, future studies need to investigate longer-term mortality rates and identify CRT-P patients that will gain the most, in terms of life expectancy, from being treated with a CRT-D.This work was supported by the Center for Translational Molecular Medicine and The Netherlands Heart Foundation under the ‘Biomarkers to predict cardiac failure, arrhythmias and success of treatment’ (COHFAR) projec

Geophysical investigation of Pleistocene volcanism and tectonics offshore Capo Vaticano (Calabria, southeastern Tyrrhenian Sea)

Magma upwelling forming volcanic plumbing systems in back arc settings is typically controlled by extensional tectonic structures of the upper crust. Here we investigate this process in the area between the volcanic arc of the Aeolian Islands and the Calabrian arc (SE Tyrrhenian Sea) by integrating morpho-bathymetry and reflection seismic data with the outcomes of \u201cInverse 3D magnetic modeling\u201d of previously gathered aeromagnetic data. Morpho-bathymetric data highlight the presence of a seamount ~10 km offshore Capo Vaticano Promontory (eastern Calabria). This feature, named Capo Vaticano seamount is composed of a series of NE-trending ridges, the greatest of which (R1) is ~12 km long, and 2.4 km wide, displays asymmetric flanks with a landward steep slope, oblique morphological steps and elongated NE-trending rims. The position of the R1 ridge summit fits the Reduced-To-the-Pole peak of a high-intensity magnetic anomaly straddling Capo Vaticano Promontory and its offshore prolongation. Seismic and bathymetric data highlight two extensional fault systems affecting the offshore of Capo Vaticano Promontory during the Plio-Pleistocene: a) a Pliocene NW-trending, SW-dipping normal fault system, and b) a Pleistocene NE-trending, SE-dipping normal fault system. The younger system is composed of a series of en-echelon branching normal faults bounding the eastern side of the R1 ridge. Aeromagnetic data modeling imaged a complex 3D-magnetized body below the R1 ridge exhibiting a sub-vertical conduit-like structure in the shallow part, and a NE-striking, sheet-like shape inclined by 45\ub0 in depth. The location of the sub-vertical conduit coincides with the summit of the R1 ridge. The magma uprising at the root of the volcano was controlled by the Pliocene NW-trending faults whereas its further upwards migration was ostensibly controlled by the Pleistocene NE-trending faults. Both fault systems are responsible for the high level of fracturing that likely favored the up-ward migration of magma. The younger extensional systems also controls the present-day, mantle derived, fluid escapes observed at the summit of the R1 ridge. Relying on seismic stratigraphic evidence as well as the polarity of the magnetic anomaly, the R1 ridge probably started to form during the Olduvai chron (early Pleistocene, 1.81 - 1.96 Ma). Accordingly, the Capo Vaticano volcano may represent the result of magmatic activity that predates the Aeolian volcanic arc

Thickness of marine Holocene sediment in the Gulf of Trieste (northern Adriatic Sea)

We use various geophysical datasets (multibeam and singlebeam echosounder data, sub-bottom profiling Chirp and sonar data and very high-resolution boomer seismic data) along with published sedimentological data and depth data from nautical charts in order to create models of the depth of the seafloor and the base of Holocene marine sediment in the Gulf of Trieste. The two models are later used in order to calculate the thickness of marine Holocene sediment which has been depositing on the Late Pleistocene alluvial plain since the Holocene transgression in the Italian and Slovenian parts of the gulf. Thicker Holocene marine sedimentary sequences averaging at around 5 m are characteristic for the southeastern part of the gulf. In other parts of the gulf the Holocene marine sedimentary cover is very thin or even absent, except in close proximity to the shoreline and fluvial sediment sources, in the area of the Trezza Grande paleodelta and above topographic depressions of the Late Pleistocene base. The presented datasets available from the OGS SNAP data repository (http://doi.org/cpz2) represent a valuable reference for a wide variety of research disciplines dealing with the dynamic Earth system in the Gulf of Trieste and could be used as a valuable tool for designing sampling and geophysical campaigns in the studied area.</p

Rapid fetal fibronectin testing to predict preterm birth in women with symptoms of premature labour: a systematic review and cost analysis

__Background__: Premature birth is defined as birth of before 37 completed weeks' gestation. Not all pregnant women showing symptoms of preterm labour will go on to deliver before 37weeks' gestation. Hence, addition of fetal fibronectin (fFN) testing to the diagnostic workup of women with suspected preterm labour may help to identify those women who do not require active management, and thus avoid unnecessary interven

Thickness of marine Holocene sediment in the Gulf of Trieste (northern Adriatic Sea)

We use various geophysical datasets (multibeam and singlebeam echosounder data, sub-bottom profiling Chirp and sonar data and very high-resolution boomer seismic data) along with published sedimentological data and depth data from nautical charts in order to create models of the depth of the seafloor and the base of Holocene marine sediment in the Gulf of Trieste. The two models are later used in order to calculate the thickness of marine Holocene sediment which has been depositing on the Late Pleistocene alluvial plain since the Holocene transgression in the Italian and Slovenian parts of the gulf. Thicker Holocene marine sedimentary sequences averaging at around 5 m are characteristic for the southeastern part of the gulf. In other parts of the gulf the Holocene marine sedimentary cover is very thin or even absent, except in close proximity to the shoreline and fluvial sediment sources, in the area of the Trezza Grande paleodelta and above topographic depressions of the Late Pleistocene base. The presented datasets available from the OGS SNAP data repository (http://doi.org/cpz2) represent a valuable reference for a wide variety of research disciplines dealing with the dynamic Earth system in the Gulf of Trieste and could be used as a valuable tool for designing sampling and geophysical campaigns in the studied area.</p