I soffi carotidei asintomatici scoperti in corso di bilancio preoperatorio. Condotta diagnostica e terapeutica.

no abstrac

Characteristics and outcome of patients with newly diagnosed advanced or metastatic lung cancer admitted to intensive care units (ICUs)

BACKGROUND: Although patients with advanced or metastatic lung cancer have poor prognosis, admission to the ICU for management of life-threatening complications has increased over the years. Patients with newly diagnosed lung cancer appear as good candidates for ICU admission, but more robust information to assist decisions is lacking. The aim of our study was to evaluate the prognosis of newly diagnosed unresectable lung cancer patients. METHODS: A retrospective multicentric study analyzed the outcome of patients admitted to the ICU with a newly diagnosed lung cancer (diagnosis within the month) between 2010 and 2013. RESULTS: Out of the 100 patients, 30 had small cell lung cancer (SCLC) and 70 had non-small cell lung cancer. (Thirty patients had already been treated with oncologic treatments.) Mechanical ventilation (MV) was performed for 81 patients. Seventeen patients received emergency chemotherapy during their ICU stay. ICU, hospital, 3- and 6-month mortality were, respectively, 47, 60, 67 and 71%. Hospital mortality was 60% when invasive MV was used alone, 71% when MV and vasopressors were needed and 83% when MV, vasopressors and hemodialysis were required. In multivariate analysis, hospital mortality was associated with metastatic disease (OR 4.22 [1.4-12.4]; p = 0.008), need for invasive MV (OR 4.20 [1.11-16.2]; p = 0.030), while chemotherapy in ICU was associated with survival (OR 0.23, [0.07-0.81]; p = 0.020). CONCLUSION: This study shows that ICU management can be appropriate for selected newly diagnosed patients with advanced lung cancer, and chemotherapy might improve outcome for patients with SCLC admitted for cancer-related complications. Nevertheless, tumors' characteristics, numbers and types of organ dysfunction should be taken into account in the decisional process before admitting these patients in ICU.Peer reviewe

Spectral and intensity variations of Galactic 26^Al emission

Gamma-ray line emission from the radioactive decay of 26Al reflects nucleosynthesis in massive stars and supernovae. We use INTEGRAL 26Al measurements to characterize the distribution and characteristics of 26Al source regions throughout the Galaxy. We detect the 26Al line from the inner Galaxy at 28\sigma significance. The line appears narrow, and we constrain broadening in the source regions to <1.3 keV (2\sigma). Different sky distribution models do not significantly affect those large-scale results. The 26Al intensity for the inner Galaxy is derived as (2.9\pm 0.2)\times 10^{-4}ph\ cm^{-2} s^{-1} rad^{-1}, consistent with earlier results from COMPTEL and SPI data. This can be translated to an 26Al mass of 2.7\pm 0.7 solar mass in the Galaxy as a whole. The 26Al intensity is also confirmed to be somewhat brighter in the 4th than in the 1st quadrant (ratio 1.3\pm 0.2). 26Al spectra separately derived for regions along the Galactic plane show clear line centroid shifts, attributed largely to the Galaxy's large-scale rotation. The 26Al line toward the direction of the Aquila region (20deg < l < 40deg) appears somewhat broadened. Latitudinal variations of 26Al emission towards the inner Galaxy are studied, finding a latitudinal scale height of 130^{+120}_{-70} pc (1\sigma) for 26Al in the inner Galaxy and a hint of peculiar 26Al emission towards the region l5deg.Comment: 13 pages, 12 figures, accepted for the publication in A&

Astrophysical and Cosmological Implications of Large Volume String Compactifications

We study the spectrum, couplings and cosmological and astrophysical implications of the moduli fields for the class of Calabi-Yau IIB string compactifications for which moduli stabilisation leads to an exponentially large volume V ~ 10^{15} l_s^6 and an intermediate string scale m_s ~ 10^{11}GeV, with TeV-scale observable supersymmetry breaking. All K\"ahler moduli except for the overall volume are heavier than the susy breaking scale, with m ~ ln(M_P/m_{3/2}) m_{3/2} ~ (\ln(M_P/m_{3/2}))^2 m_{susy} ~ 500 TeV and, contrary to standard expectations, have matter couplings suppressed only by the string scale rather than the Planck scale. These decay to matter early in the history of the universe, with a reheat temperature T ~ 10^7 GeV, and are free from the cosmological moduli problem (CMP). The heavy moduli have a branching ratio to gravitino pairs of 10^{-30} and do not suffer from the gravitino overproduction problem. The overall volume modulus is a distinctive feature of these models and is an M_{planck}-coupled scalar of mass m ~ 1 MeV and subject to the CMP. A period of thermal inflation can help relax this problem. This field has a lifetime ~ 10^{24}s and can contribute to dark matter. It may be detected through its decays to 2\gamma or e^+e^-. If accessible the e^+e^- decay mode dominates, with Br(\chi \to 2 \gamma) suppressed by a factor (ln(M_P/m_{3/2}))^2. We consider the potential for detection of this field through different astrophysical sources and find that the observed gamma-ray background constrains \Omega_{\chi} <~ 10^{-4}. The decays of this field may generate the 511 keV emission line from the galactic centre observed by INTEGRAL/SPI.Comment: 31 pages, 2 figures; v2. refs adde

Wind power in China - Dream or reality?

After tremendous growth of wind power generation capacity in recent years, China now has 44.7 GW of wind-derived power. Despite the recent growth rates and promises of a bright future, two important issues - the capability of the grid infrastructure and the availability of backup systems - must be critically discussed and tackled in the medium term. The study shows that only a relatively small share of investment goes towards improving and extending the electricity infrastructure which is a precondition for transmitting clean wind energy to the end users. In addition, the backup systems are either geographically too remote from the potential wind power sites or currently financially infeasible. Finally, the introduction of wind power to the coal-dominated energy production system is not problem-free. Frequent ramp ups and downs of coal-fired plants lead to lower energy efficiency and higher emissions, which are likely to negate some of the emission savings from wind power. The current power system is heavily reliant on independently acting but state-owned energy companies optimizing their part of the system, and this is partly incompatible with building a robust system supporting renewable energy technologies. Hence, strategic, top-down co-ordination and incentives to improve the overall electricity infrastructure is recommended

Statistical and visual differentiation of subcellular imaging

<p>Abstract</p> <p>Background</p> <p>Automated microscopy technologies have led to a rapid growth in imaging data on a scale comparable to that of the genomic revolution. High throughput screens are now being performed to determine the localisation of all of proteins in a proteome. Closer to the bench, large image sets of proteins in treated and untreated cells are being captured on a daily basis to determine function and interactions. Hence there is a need for new methodologies and protocols to test for difference in subcellular imaging both to remove bias and enable throughput. Here we introduce a novel method of statistical testing, and supporting software, to give a rigorous test for difference in imaging. We also outline the key questions and steps in establishing an analysis pipeline.</p> <p>Results</p> <p>The methodology is tested on a high throughput set of images of 10 subcellular localisations, and it is shown that the localisations may be distinguished to a statistically significant degree with as few as 12 images of each. Further, subtle changes in a protein's distribution between nocodazole treated and control experiments are shown to be detectable. The effect of outlier images is also examined and it is shown that while the significance of the test may be reduced by outliers this may be compensated for by utilising more images. Finally, the test is compared to previous work and shown to be more sensitive in detecting difference. The methodology has been implemented within the iCluster system for visualising and clustering bio-image sets.</p> <p>Conclusion</p> <p>The aim here is to establish a methodology and protocol for testing for difference in subcellular imaging, and to provide tools to do so. While iCluster is applicable to moderate (<1000) size image sets, the statistical test is simple to implement and will readily be adapted to high throughput pipelines to provide more sensitive discrimination of difference.</p

Fast automated cell phenotype image classification

BACKGROUND: The genomic revolution has led to rapid growth in sequencing of genes and proteins, and attention is now turning to the function of the encoded proteins. In this respect, microscope imaging of a protein's sub-cellular localisation is proving invaluable, and recent advances in automated fluorescent microscopy allow protein localisations to be imaged in high throughput. Hence there is a need for large scale automated computational techniques to efficiently quantify, distinguish and classify sub-cellular images. While image statistics have proved highly successful in distinguishing localisation, commonly used measures suffer from being relatively slow to compute, and often require cells to be individually selected from experimental images, thus limiting both throughput and the range of potential applications. Here we introduce threshold adjacency statistics, the essence which is to threshold the image and to count the number of above threshold pixels with a given number of above threshold pixels adjacent. These novel measures are shown to distinguish and classify images of distinct sub-cellular localization with high speed and accuracy without image cropping. RESULTS: Threshold adjacency statistics are applied to classification of protein sub-cellular localization images. They are tested on two image sets (available for download), one for which fluorescently tagged proteins are endogenously expressed in 10 sub-cellular locations, and another for which proteins are transfected into 11 locations. For each image set, a support vector machine was trained and tested. Classification accuracies of 94.4% and 86.6% are obtained on the endogenous and transfected sets, respectively. Threshold adjacency statistics are found to provide comparable or higher accuracy than other commonly used statistics while being an order of magnitude faster to calculate. Further, threshold adjacency statistics in combination with Haralick measures give accuracies of 98.2% and 93.2% on the endogenous and transfected sets, respectively. CONCLUSION: Threshold adjacency statistics have the potential to greatly extend the scale and range of applications of image statistics in computational image analysis. They remove the need for cropping of individual cells from images, and are an order of magnitude faster to calculate than other commonly used statistics while providing comparable or better classification accuracy, both essential requirements for application to large-scale approaches

Insulin utilizes the PI 3-kinase pathway to inhibit SP-A gene expression in lung epithelial cells

BACKGROUND: It has been proposed that high insulin levels may cause delayed lung development in the fetuses of diabetic mothers. A key event in lung development is the production of adequate amounts of pulmonary surfactant. Insulin inhibits the expression of surfactant protein A (SP-A), the major surfactant-associated protein, in lung epithelial cells. In the present study, we investigated the signal transduction pathways involved in insulin inhibition of SP-A gene expression. METHODS: H441 cells, a human lung adenocarcinoma cell line, or human fetal lung explants were incubated with or without insulin. Transcription run-on assays were used to determine SP-A gene transcription rates. Northern blot analysis was used to examine the effect of various signal transduction inhibitors on SP-A gene expression. Immunoblot analysis was used to evaluate the levels and phosphorylation states of signal transduction protein kinases. RESULTS: Insulin decreased SP-A gene transcription in human lung epithelial cells within 1 hour. Insulin did not affect p44/42 mitogen-activated protein kinase (MAPK) phosphorylation and the insulin inhibition of SP-A mRNA levels was not affected by PD98059, an inhibitor of the p44/42 MAPK pathway. In contrast, insulin increased p70 S6 kinase Thr389 phosphorylation within 15 minutes. Wortmannin or LY294002, both inhibitors of phosphatidylinositol 3-kinase (PI 3-kinase), or rapamycin, an inhibitor of the activation of p70 S6 kinase, a downstream effector in the PI 3-kinase pathway, abolished or attenuated the insulin-induced inhibition of SP-A mRNA levels. CONCLUSION: Insulin inhibition of SP-A gene expression in lung epithelial cells probably occurs via the rapamycin-sensitive PI 3-kinase signaling pathway

A Search for sub-km KBOs with the Method of Serendipitous Stellar Occultations

The results of a search for sub-km Kuiper Belt Objects (KBOs) with the method of serendipitous stellar occultations are reported. Photometric time series were obtained on the 1.8m telescope at the Dominion Astrophysical Observatory (DAO) in Victoria, BC, and were analyzed for the presence of occultation events. Observations were performed at 40 Hz and included a total of 5.0 star-hours for target stars in the ecliptic open cluster M35 (beta=0.9deg), and 2.1 star-hours for control stars in the off-ecliptic open cluster M34 (beta=25.7deg). To evaluate the recovery fraction of the analysis method, and thereby determine the limiting detectable size, artificial occultation events were added to simulated time series (1/f scintillation-like power-spectra), and to the real data. No viable candidate occultation events were detected. This limits the cumulative surface density of KBOs to 3.5e10 deg^{-2} (95% confidence) for KBOs brighter than m_R=35.3 (larger than ~860m in diameter, assuming a geometric albedo of 0.04 and a distance of 40 AU). An evaluation of TNO occultations reported in the literature suggests that they are unlikely to be genuine, and an overall 95%-confidence upper limit on the surface density of 2.8e9 deg^{-2} is obtained for KBOs brighter than m_R=35 (larger than ~1 km in diameter, assuming a geometric albedo of 0.04 and a distance of 40 AU) when all existing surveys are combined.Comment: Accepted for publication in A