593 research outputs found

    Weathering of evaporites: natural versus anthropogenic signature on the composition of river waters

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    Weathering of evaporites strongly influences the chemistry of continental runoff, making surface waters poorly exploitable for civil uses. In south-central Sicily, this phenomenon is worsened by the occurrence of abandoned landfills of old sulphur and salt mines. The industrial evolution of the Bosco-S. Cataldo mining site leaved two landfills from the early exploitation of a sulphur mine followed by that of a kainite deposit. In particular, the weathering of these landfills leads the dissolved salt (TDS) values up to about 200 g l−1 in the Stincone–Salito Stream waters. This process induces the V, Cr and Fe desorption from sediments and particulates in the aqueous phase under reducing conditions. At the same time, the weathering of salt minerals releases Rb and Cs, originally contained in halite. The overall processes lead to the V, Cr, Fe, Rb and Cs enrichment of waters from the Stincone–Salito Stream system accompanied by a sharp growth of As content, up to about 13 µg l−1, caused by As release from Fe-bearing solids due to the high salinity. Therefore, the scenario of the weathering of Bosco-S. Cataldo mine landfills depicts an environment strongly influenced by effects of the growing salinity and euxinic water conditions where the attained TDS, Eh and pH conditions reduce the natural scavenging capability of the interested river system, favouring a growth of residence time of toxic elements in river waters

    Visualizing climate change impact with ubiquitous spatial technologies

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    Permanent Pancreatic Duct Occlusion With Neoprene-based Glue Injection After Pancreatoduodenectomy at High Risk of Pancreatic Fistula : A Prospective Clinical Study

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    OBJECTIVE: The aim of this study was to assess safety and efficacy of pancreatic duct occlusion (PDO) with neoprene-based glue in selected patients undergoing pancreatoduodenectomy (PD) at high risk of postoperative pancreatic fistula (POPF). BACKGROUND DATA: PD is the reference standard approach for tumors of the pancreaticoduodenal region. POPF is the most relevant complication after PD. PDO has been proposed as an alternative to anastomosis to manage the pancreatic stump. METHODS: A single-center, prospective, nonrandomized trial enrolled 100 consecutive PD for cancer. Patients at high risk for POPF according to Fistula Risk Score (FRS) >15% ( 656 points) were treated with PDO using neoprene glue (study cohort); patients with FRS 6415% ( 645 points) received pancreaticojejunal anastomosis (PJA: control cohort). Primary endpoint was complication rate grade 653 according to Dindo-Clavien Classification (DCC). Other postoperative outcomes were monitored (ClinicalTrials.gov NCT03738787). RESULTS: Fifty-one patients underwent PDO and 49 PJA. DCC 653, postoperative mortality, and POPF grade B-C were 25.5% versus 24.5% (P = 0.91), 5.9% versus 2% (P = 0.62), and 11.8% versus 16.3% (P = 0.51) in the study versus control cohort, respectively. At 1 and 3 years, new-onset diabetes was diagnosed in 13.7% and 36.7% of the study cohort versu 4.2% and 12.2% in controls (P = 0.007). CONCLUSIONS: PDO with neoprene-based glue is a safe technique that equalizes early outcome of selected patients at high risk of POPF to those at low risk undergoing PJA. Neoprene-based PDO, however, triples the risk of diabetes at 1 and 3 years

    Crossmodal representation of a functional robotic hand arises after extensive training in healthy participants

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    a b s t r a c t The way in which humans represent their own bodies is critical in guiding their interactions with the environment. To achieve successful body-space interactions, the body representation is strictly connected with that of the space immediately surrounding it through efficient visuo-tactile crossmodal integration. Such a body-space integrated representation is not fixed, but can be dynamically modulated by the use of external tools. Our study aims to explore the effect of using a complex tool, namely a functional prosthesis, on crossmodal visuo-tactile spatial interactions in healthy participants. By using the crossmodal visuo-tactile congruency paradigm, we found that prolonged training with a mechanical hand capable of distal hand movements and providing sensory feedback induces a pattern of interference, which is not observed after a brief training, between visual stimuli close to the prosthesis and touches on the body. These results suggest that after extensive, but not short, training the functional prosthesis acquires a visuo-tactile crossmodal representation akin to real limbs. This finding adds to previous evidence for the embodiment of functional prostheses in amputees, and shows that their use may also improve the crossmodal combination of somatosensory feedback delivered by the prosthesis with visual stimuli in the space around it, thus effectively augmenting the patients' visuomotor abilities

    Crossmodal representation of a functional robotic hand arises after extensive training in healthy participants

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    The way in which humans represent their own bodies is critical in guiding their interactions with the environment. To achieve successful body-space interactions, the body representation is strictly connected with that of the space immediately surrounding it through efficient visuo-tactile crossmodal integration. Such a body-space integrated representation is not fixed, but can be dynamically modulated by the use of external tools. Our study aims to explore the effect of using a complex tool, namely a functional prosthesis, on crossmodal visuo-tactile spatial interactions in healthy participants. By using the crossmodal visuo-tactile congruency paradigm, we found that prolonged training with a mechanical hand capable of distal hand movements and providing sensory feedback induces a pattern of interference, which is not observed after a brief training, between visual stimuli close to the prosthesis and touches on the body. These results suggest that after extensive, but not short, training the functional prosthesis acquires a visuo-tactile crossmodal representation akin to real limbs. This finding adds to previous evidence for the embodiment of functional prostheses in amputees, and shows that their use may also improve the crossmodal combination of somatosensory feedback delivered by the prosthesis with visual stimuli in the space around it, thus effectively augmenting the patients' visuomotor abilities

    Competing risk analysis on outcome after hepatic resection of hepatocellular carcinoma in cirrhotic patients

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    To investigate death for liver failure and for tumor recurrence as competing events after hepatectomy of hepatocellular carcinoma. METHODS Data from 864 cirrhotic Child-Pugh class A consecutive patients, submitted to curative hepatectomy (1997-2013) at two tertiary referral hospitals, were used for competing-risk analysis through the Fine and Gray method, aimed at assessing in which circumstances the oncological benefit from tumour removal is greater than the risk of dying from hepatic decompensation. To accomplish this task, the average risk of these two competing events, over 5 years of follow-up, was calculated through the integral of each cumulative incidence function, and represented the main comparison parameter. RESULTS Within a median follow-up of 5.6 years, death was attributable to tumor recurrence in 63.5%, and to liver failure in 21.2% of cases. In the first 16 mo, the risk of dying due to liver failure exceeded that of dying due to tumor relapse. Tumor stage only affects death from recurrence; whereas hepatitis C infection, Model for End-stage Liver Disease score, extent of hepatectomy and portal hypertension influence death from liver failure (P < 0.05 in all cases). The combination of these clinical and tumoral features identifies those patients in whom the risk of dying from liver failure did not exceed the tumour-related mortality, representing optimal surgical candidates. It also identifies those clinical circumstances where the oncological benefit would be borderline or even where the surgery would be harmful. CONCLUSION Having knowledge of these competing events can be used to weigh the risks and benefits of hepatic resection in each clinical circumstance, separating optimal from non-optimal surgical candidates

    A Comparison of Computerized Chemical Models for Equilibrium Calculations in Aqueous Systems

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    A survey of computer programs which are currently being used to calculate the distribution of species in aqueous solutions, especially natural waters, has been made in order to 1) provide an inventory of available programs with a short description of their uses, 2) compare the consistency of their output for two given test solutions and 3) identify major weaknesses or problems encountered from their use. More than a dozen active programs which can be used for distribution of species and activity calculations for homogeneos equilibria among the major anions and cations of natural waters have been inventoried. Half of these programs can also accept several trace elements including Fe, Al, Mn, Cu, Ni, Zn, Cd, Pb, Ag, Hg, As, Ba, Sr, and B. Consistency between programs was evaluated by comparing the log of the molal concentrations of free ions and complexes for two test solutions: a hypothetical seawater analysis and a hypothetical river water analysis. Comparison of the free major ion concentrations in the river water test case shows excellent agreement for the major species. In the seawater test case there is less agreement and for both test cases the minor species commonly show orders of magnitude differences in concentrations. These differences primarily reflect differences in the thermodynamic data base of each chemical model although other factors such as activity coefficient calculations, redox assumptions, temperature corrections, alkalinity corrections and the number of complexes used all have an affect on the output

    Systemic Treatment of Patients With Gastrointestinal Cancers During the COVID-19 Outbreak: COVID-19-adapted Recommendations of the National Cancer Institute of Milan

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    The current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak poses a major challenge in the treatment decision-making of patients with cancer, who may be at higher risk of developing a severe and deadly SARS-CoV-2 infection compared with the general population. The health care emergency is forcing the reshaping of the daily assessment between risks and benefits expected from the administration of immune-suppressive and potentially toxic treatments. To guide our clinical decisions at the National Cancer Institute of Milan (Lombardy region, the epicenter of the outbreak in Italy), we formulated Coronavirus-adapted institutional recommendations for the systemic treatment of patients with gastrointestinal cancers. Here, we describe how our daily clinical practice has changed due to the pandemic outbreak, with the aim of providing useful suggestions for physicians that are facing the same challenges worldwide

    Systemic Treatment of Patients With Gastrointestinal Cancers During the COVID-19 Outbreak : COVID-19-adapted Recommendations of the National Cancer Institute of Milan

    Get PDF
    The current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak poses a major challenge in the treatment decision-making of patients with cancer, who may be at higher risk of developing a severe and deadly SARS-CoV-2 infection compared with the general population. The health care emergency is forcing the reshaping of the daily assessment between risks and benefits expected from the administration of immune-suppressive and potentially toxic treatments. To guide our clinical decisions at the National Cancer Institute of Milan (Lombardy region, the epicenter of the outbreak in Italy), we formulated Coronavirus-adapted institutional recommendations for the systemic treatment of patients with gastrointestinal cancers. Here, we describe how our daily clinical practice has changed due to the pandemic outbreak, with the aim of providing useful suggestions for physicians that are facing the same challenges worldwide
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