Neural indicators of fatigue in chronic diseases : A systematic review of MRI studies

The authors would like to thank the Sir Jules Thorn Charitable Trust for their financial support.Peer reviewedPublisher PD

Patient and Renal Outcomes of Posttransplant Lymphoproliferative Disorder Following Solid Organ Transplantations - A Single Center Experience

Introduction: Post-transplant Proliferative Disorder (PTLD) is a significant complication after solid organ transplantation (SOT). Major risk factors that contribute to the development of PTLD include Epstein-Barr Virus (EBV) infection and degree of immunosuppression. Despite novel therapies, the 5-year survival rate of PTLD only improved from 40% to 50% over the years. The reported 5-year survival rate of PTLD also remains significantly lower compared to around 90% in other malignancies such as breast and colon cancer. In our center, we hypothesize better transplant outcomes compared to those reported in preceding literatures. Methods: We retrospectively reviewed the electronic medical records of all patients who had a SOT followed by the diagnosis of PTLD from the last 10 years. We collected donor and recipient characteristics, time interval between SOT and PTLD diagnosis, disease characteristics based on the WHO 2017 classification, response to treatment, and outcomes. We calculated the mortality rate and graft failure rate to evaluate patient survival and allograft survival outcomes. Results: In our center, there were 32 patients that underwent a SOT and were later diagnosed with PTLD. Of them, 12 were female, and 8 were non-Hispanic blacks. PTLD was diagnosed in 18 kidney transplants, 11 liver transplants, 2 simultaneous kidney-pancreas transplants, and one simultaneous liver-kidney transplant. Mean time from SOT to PTLD diagnosis was 63 months, with 13 patients diagnosed in the 1st year post transplant. The main PTLD subtype was monomorphic B-cell lymphoma (20/32 patients) and 16 of them were diffuse large B cell lymphomas (DLBCL). Three patients had graft involvement by PTLD. Mean serum creatinine was 2.29 mg/dL, with mean follow up time of 57.7 months. There were 11 deaths in the cohort (33%), and 5 graft failures (15%) at the five year follow up mark. Discussion: Patient survival and allograft survival in PTLD patients are better in our center than reported in the literature. In our cohort, PTLD was not a significant cause of graft failure after 5 years of follow up. Further studies are needed to look at the disease characteristics that will help determine more specific prognostic factors

Millennial-scale climatic variability between 340000 and 270000 years ago in SW Europe : evidence from a NW Iberian margin pollen sequence

© 2009 The Authors. This article is distributed under the terms of the Creative Commons Attribution 3.0 License. The definitive version was published in Climate of the Past 5 (2009): 53-72, doi:10.5194/cp-5-53-2009We present a new high-resolution marine pollen record from NW Iberian margin sediments (core MD03-2697) covering the interval between 340 000 and 270 000 years ago, a time period centred on Marine Isotope Stage (MIS) 9 and characterized by particular baseline climate states. This study enables the documentation of vegetation changes in the north-western Iberian Peninsula and therefore the terrestrial climatic variability at orbital and in particular at millennial scales during MIS 9, directly on a marine stratigraphy. Suborbital vegetation changes in NW Iberia in response to cool/cold events are detected throughout the studied interval even during MIS 9e ice volume minimum. However, they appear more frequent and of higher amplitude during the 30 000 years following the MIS 9e interglacial period and during the MIS 9a-8 transition, which correspond to intervals of an intermediate to high ice volume and mainly periods of ice growth. Each suborbital cold event detected in NW Iberia has a counterpart in the Southern Iberian margin SST record. High to moderate amplitude cold episodes detected on land and in the ocean appear to be related to changes in deep water circulation and probably to iceberg discharges at least during MIS 9d, the mid-MIS 9c cold event and MIS 9b. This work provides therefore additional evidence of pervasive millennial-scale climatic variability in the North Atlantic borderlands throughout past climatic cycles of the Late Pleistocene, regardless of glacial state. However, ice volume might have an indirect influence on the amplitude of the millennial climatic changes in Southern Europe.This research was supported by IPEV (Institut Paul Emile Victor), PNEDC (Programme National d’Etude de la Dynamique du Climat), the Gary Comer Science and Education Foundation and the US National Science Foundation (OCE grants 8-4911100 and 8-256500)

Indian monsoon variations during three contrasting climatic periods : the Holocene, Heinrich Stadial 2 and the last interglacial-glacial transition

Author Posting. © The Author(s), 2015. This is the author's version of the work. It is posted here by permission of Elsevier for personal use, not for redistribution. The definitive version was published in Quaternary Science Reviews 125 (2015): 50-60, doi:10.1016/j.quascirev.2015.06.009.In contrast to the East Asian and African monsoons the Indian monsoon is still poorly documented throughout the last climatic cycle (last 135,000 years). Pollen analysis from two marine sediment cores (NGHP-01-16A and NGHP-01-19B) collected from the offshore Godavari and Mahanadi basins, both located in the Core Monsoon Zone (CMZ) reveals changes in Indian summer monsoon variability and intensity during three contrasting climatic periods: the Holocene, the Heinrich Stadial (HS) 2 and the Marine Isotopic Stage (MIS) 5/4 during the ice sheet growth transition. During the first part of the Holocene between 11,300 and 4,200 cal years BP, characterized by high insolation (minimum precession, maximum obliquity), the maximum extension of the coastal forest and mangrove reflects high monsoon rainfall. This climatic regime contrasts with that of the second phase of the Holocene, from 4,200 cal years BP to the present, marked by the development of drier vegetation in a context of low insolation (maximum precession, minimum obliquity). The historical period in India is characterized by an alternation of strong and weak monsoon centennial phases that may reflect the Medieval Climate Anomaly and the Little Ice Age, respectively. During the HS 2, a period of low insolation and extensive iceberg discharge in the North Atlantic Ocean, vegetation was dominated by grassland and dry flora indicating pronounced aridity as the result of a weak Indian summer monsoon. The MIS 5/4 glaciation, also associated with low insolation but moderate freshwater fluxes, was characterized by a weaker reduction of the Indian summer monsoon and a decrease of seasonal contrast as recorded by the expansion of dry vegetation and the development of Artemisia, respectively. Our results support model predictions suggesting that insolation changes control the long term trend of the Indian monsoon precipitation, but its millennial scale variability and intensity are instead modulated by atmospheric teleconnections to remote phenomena in the North Atlantic, Eurasia or the Indian Ocean.The work of C.Z. was supported by the ANR MONOPOL

L'Ingegneria della Grande Guerra 1915-1918. Incontro di studio e mostra bibliografica sugli aspetti tecnologici del primo conflitto mondiale

Il volume raccoglie gli atti e i materiali di un seminario di studi e di una mostra bibliografica tenutisi in occasione del primo centenario della Grande guerra presso la Scuola di Ingegneria e Architettura dell’Università di Bologna. Gli interventi indagano l’applicazione e lo sviluppo, in ambito bellico, di tecnologie ingegneristiche che da un lato espressero un tragico potenziale distruttivo, dall’altro ebbero nel conflitto un’occasione di sviluppo. Vi si tratta dell’importanza strategica del petrolio come carburante per navi, carrarmati e aerei e come fonte di energia per le fabbriche, dello sviluppo delle tecniche di mappatura del territorio, la fotogrammetria aerea, delle nuove drammatiche modalità di combattimento e costruzione di ordigni bellici, senza trascurare il più generale contesto dello sviluppo industriale italiano legato alla produzione di armamenti. In appendice si pubblica il catalogo dell’esposizione, tenutasi nell’atrio della Scuola di Ingegneria e Architettura, progettata negli anni ’30 dall’architetto Giuseppe Vaccaro. Questa parte del volume indaga l’interesse tecnico-scientifico dei professori e degli studenti della Scuola d’applicazione per gli ingegneri di Bologna verso il conflitto mondiale; vi sono descritti alcuni documenti bibliografici conservati nelle raccolte storiche della Biblioteca Interdipartimentale di Ingegneria e Architettura. Inoltre lo spoglio della documentazione amministrativa conservata presso l’Archivio Storico dell’Università di Bologna ha fatto riemergere il coinvolgimento umano e l’interesse più generale della comunità, che alla Scuola faceva riferimento: l’entusiasmo degli studenti desiderosi di partecipare al conflitto, lo strazio dei molti lutti e la celebrazione della memoria dei caduti

The ACER pollen and charcoal database: a global resource to document vegetation and fire response to abrupt climate changes during the last glacial period

Quaternary records provide an opportunity to examine the nature of the vegetation and fire responses to rapid past climate changes comparable in velocity and magnitude to those expected in the 21st-century. The best documented examples of rapid climate change in the past are the warming events associated with the Dansgaard–Oeschger (D–O) cycles during the last glacial period, which were sufficiently large to have had a potential feedback through changes in albedo and greenhouse gas emissions on climate. Previous reconstructions of vegetation and fire changes during the D–O cycles used independently constructed age models, making it difficult to compare the changes between different sites and regions. Here, we present the ACER (Abrupt Climate Changes and Environmental Responses) global database, which includes 93 pollen records from the last glacial period (73–15 ka) with a temporal resolution better than 1000 years, 32 of which also provide charcoal records. A harmonized and consistent chronology based on radiometric dating (14C, 234U∕230Th, optically stimulated luminescence (OSL), 40Ar∕39Ar-dated tephra layers) has been constructed for 86 of these records, although in some cases additional information was derived using common control points based on event stratigraphy. The ACER database compiles metadata including geospatial and dating information, pollen and charcoal counts, and pollen percentages of the characteristic biomes and is archived in Microsoft AccessTM at https://doi.org/10.1594/PANGAEA.870867

Proactive and systematic multidimensional needs assessment in patients with advanced cancer approaching palliative care: a study protocol

Introduction: The benefits of palliative care rely on how healthcare professionals assess patients' needs in the initial encounter/s; crucial to the design of a personalised therapeutic plan. However, there is currently no evidence-based guideline to perform this needs assessment. We aim to design and evaluate a proactive and systematic method for the needs assessment using quality guidelines for developing complex interventions. This will involve patients, their relatives and healthcare professionals in all phases of the study and its communication to offer clinical practice a reliable approach to address the palliative needs of patients. Methods and analysis: To design and assess the feasibility of an evidence-based, proactive and systematic Multidimensional needs Assessment in Palliative care (MAP) as a semistructured clinical interview guide for initial palliative care encounter/s in patients with advanced cancer. This is a two-phase multisite project conducted over 36 months between May 2019 and May 2022. Phase I includes a systematic review, discussions with stakeholders and Delphi consensus. The evidence gathered from phase I will be the basis for the initial versions of the MAP, then submitted to Delphi consensus to develop a preliminary guide of the MAP for the training of clinicians in the feasibility phase. Phase II is a mixed-methods multicenter feasibility study that will assess the MAP's acceptability, participation, practicality, adaptation and implementation. A nested qualitative study will purposively sample a subset of participants to add preliminary clues about the benefits and barriers of the MAP. The evidence gathered from phase II will build a MAP user guide and educational programme for use in clinical practice. Ethics and dissemination: Ethical approval for this study has been granted by the university research ethics committee where the study will be carried out (approval reference MED-2018-10). Dissemination will be informed by the results obtained and communication will occur throughout

Macrophage and adipocyte interaction as a source of inflammation in kidney disease

In obesity, adipose tissue derived inflammation is associated with unfavorable metabolic consequences. Uremic inflammation is prevalent and contributes to detrimental outcomes. However, the contribution of adipose tissue inflammation in uremia has not been characterized. We studied the contribution of adipose tissue to uremic inflammation in-vitro, in-vivo and in human samples. Exposure to uremic serum resulted in activation of inflammatory pathways including NFκB and HIF1, upregulation of inflammatory cytokines/chemokines and catabolism with lipolysis, and lactate production. Also, co-culture of adipocytes with macrophages primed by uremic serum resulted in higher inflammatory cytokine expression than adipocytes exposed only to uremic serum. Adipose tissue of end stage renal disease subjects revealed increased macrophage infiltration compared to controls after BMI stratification. Similarly, mice with kidney disease recapitulated the inflammatory state observed in uremic patients and additionally demonstrated increased peripheral monocytes and inflammatory polarization of adipose tissue macrophages (ATMS). In contrast, adipose tissue in uremic IL-6 knock out mice showed reduced ATMS density compared to uremic wild-type controls. Differences in ATMS density highlight the necessary role of IL-6 in macrophage infiltration in uremia. Uremia promotes changes in adipocytes and macrophages enhancing production of inflammatory cytokines. We demonstrate an interaction between uremic activated macrophages and adipose tissue that augments inflammation in uremia

Onset of Mediterranean outflow into the North Atlantic

Sediments cored along the southwestern Iberian margin during Integrated Ocean Drilling Program Expedition 339 provide constraints on Mediterranean Outflow Water (MOW) circulation patterns from the Pliocene epoch to the present day. After the Strait of Gibraltar opened (5.33 million years ago), a limited volume of MOW entered the Atlantic. Depositional hiatuses indicate erosion by bottom currents related to higher volumes of MOW circulating into the North Atlantic, beginning in the late Pliocene. The hiatuses coincide with regional tectonic events and changes in global thermohaline circulation (THC). This suggests that MOW influenced Atlantic Meridional Overturning Circulation (AMOC), THC, and climatic shifts by contributing a component of warm, saline water to northern latitudes while in turn being influenced by plate tectonics

Representing the function and sensitivity of coastal interfaces in earth system models

© The Author(s), 2020. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Ward, N. D., Megonigal, J. P., Bond-Lamberty, B., Bailey, V. L., Butman, D., Canuel, E. A., Diefenderfer, H., Ganju, N. K., Goni, M. A., Graham, E. B., Hopkinson, C. S., Khangaonkar, T., Langley, J. A., McDowell, N. G., Myers-Pigg, A. N., Neumann, R. B., Osburn, C. L., Price, R. M., Rowland, J., Sengupta, A., Simard, M., Thornton, P. E., Tzortziou, M., Vargas, R., Weisenhorn, P. B., & Windham-Myers, L. Representing the function and sensitivity of coastal interfaces in earth system models. Nature Communications, 11(1), (2020): 2458, doi:10.1038/s41467-020-16236-2.Between the land and ocean, diverse coastal ecosystems transform, store, and transport material. Across these interfaces, the dynamic exchange of energy and matter is driven by hydrological and hydrodynamic processes such as river and groundwater discharge, tides, waves, and storms. These dynamics regulate ecosystem functions and Earth’s climate, yet global models lack representation of coastal processes and related feedbacks, impeding their predictions of coastal and global responses to change. Here, we assess existing coastal monitoring networks and regional models, existing challenges in these efforts, and recommend a path towards development of global models that more robustly reflect the coastal interface.Funding for this work was provided by Pacific Northwest National Laboratory (PNNL) Laboratory Directed Research & Development (LDRD) as part of the Predicting Ecosystem Resilience through Multiscale Integrative Science (PREMIS) Initiative. PNNL is operated by Battelle for the U.S. Department of Energy under Contract DE-AC05-76RL01830. Additional support to J.P.M. was provided by the NSF-LTREB program (DEB-0950080, DEB-1457100, DEB-1557009), DOE-TES Program (DE-SC0008339), and the Smithsonian Institution. This manuscript was motivated by discussions held by co-authors during a three-day workshop at PNNL in Richland, WA: The System for Terrestrial Aquatic Research (STAR) Workshop: Terrestrial-Aquatic Research in Coastal Systems. The authors thank PNNL artist Nathan Johnson for preparing the figures in this manuscript and Terry Clark, Dr. Charlette Geffen, and Dr. Nancy Hess for their aid in organizing the STAR workshop. The authors thank all workshop participants not listed as authors for their valuable insight: Lihini Aluwihare (contributed to biogeochemistry discussions and development of concept for Fig. 3), Gautam Bisht (contributed to modeling discussion), Emmett Duffy (contributed to observational network discussions), Yilin Fang (contributed to modeling discussion), Jeremy Jones (contributed to biogeochemistry discussions), Roser Matamala (contributed to biogeochemistry discussions), James Morris (contributed to biogeochemistry discussions), Robert Twilley (contributed to biogeochemistry discussions), and Jesse Vance (contributed to observational network discussions). A full report on the workshop discussions can be found at https://www.pnnl.gov/publications/star-workshop-terrestrial-aquatic-research-coastal-systems