Combining remote sensing analysis with machine learning to evaluate short-term coastal evolution trend in the shoreline of Venice.

With increasing storminess and incessant sea-level rise, coastal erosion is becoming a primary issue along many littorals in the world. To cope with present and future climate change scenarios, it is important to map the shoreline position over years and assess the coastal erosion trends to select the best risk management solutions and guarantee a sustainable management of communities, structures, and ecosystems. However, this objective is particularly challenging on gentle-sloping sandy coasts, where also small sea-level changes trigger significant morphological evolutions. This study presents a multidisciplinary study combining satellite images with Machine Learning and GIS-based spatial tools to analyze short-term shoreline evolution trends and detect erosion hot-spots on the Venice coast over the period 2015-2019. Firstly, advanced image preprocessing, which is not frequently adopted in coastal erosion studies, was performed on satellite images downloaded within the same tidal range. Secondly, different Machine Learning classification methods were tested to accurately define shoreline position by recognizing the land-sea interface in each image. Finally, the application of the Digital Shoreline Analysis System tool was performed to evaluate and visualize coastal changes over the years. Overall, the case study littoral reveals to be stable or mainly subjected to accretion. This is probably due to the high presence of coastal protection structures that stabilize the beaches, enhancing deposition processes. In detail, with respect to the total length of the considered shoreline (about 83 km), 5 % of the coast is eroding, 36 % is stable, 52 % is accreting and 7 % is not evaluable. Despite a significant coastal erosion risk was not recognized within this region, well-delimited erosion hot-spots were mapped in correspondence of Caorle, Jesolo and Cavallino-Treporti municipalities. These areas deserve higher attention for territorial planning and prioritization of adaptation measures, facing climate change scenarios and sea-level rise emergencies in the context of Integrated Coastal Zone Management.

Hepatopulmonary fusion in a newborn. An uncommon intraoperatory finding during right congenital diaphragmatic hernia surgery: case description and review of literature.

Hepatic pulmonary fusion is a rare malformation associated with right congenital diaphragmatic hernia (CDH), often only discovered during surgical repair of the defect. Fourteen previous cases have been reported in the literature. We describe a case of a full term male newborn with prenatal ultrasound diagnosis of right CDH who underwent a thoracoscopy converted to a thoracotomy, due to this rare aforementioned intraoperative incidental finding. We reviewed the previous reported literature, especially focusing on the chosen surgical approach, concluding that an early and appropriate preoperative imaging investigation may be crucial for the best management of these kinds of patients.

The application of multiparameter reference intervals for pre-donation capillary blood counts: the experience of a single institution.

OBJECTIVES: To evaluate a set of reference counts applied to multiparameter pre-counts in blood donors. AIM: Analyse the impact of pre-donation counts and specific reference intervals on donors' management. BACKGROUND: Multiparameter blood counts allow an improved enrollment process of blood donors due to a prompt identification of abnormalities involving haemoglobin (Hb), white blood cells (WBC) and platelets (PLT). METHODS/MATERIALS: Multiple pre-donation capillary counts were applied in the enrollment process of 13,347 consecutive donors. The rate of specific alterations of permanent exclusion and donor readmittance to donations for temporary exclusion had been evaluated, applying a set of multiparameter reference intervals. RESULTS: Alterations involved Hb in 72.55% of cases, mean corpuscular volume (MCV) in 20.99%, total WBC in 9.39%, lymphocytes in 7.55% and PLT in 6.07%. Among donors with initial alterations (543; 4.06%), 12.70% were readmitted to donations within 15 days, 14.36% had permanent exclusion, 36.83% underwent prompt supplementation treatment and 36.09% were lost at follow-up or refused treatments. DISCUSSION: The systematic use of blood count reference intervals and pre-donation multiparameter blood counts allowed prompt identification of WBC, PLT and MCV alterations, readmittance within 15 days of 12.70% of initially excluded donors and contributed to prompt management of supplement deficiency.

Evaluation of the analytical performances of a portable, 18-parameter hemometric system using capillary blood samples for blood donor enrolment.

BACKGROUND AND OBJECTIVES: Blood donor enrolment process is frequently based on the sole capillary haemoglobin (Hb) evaluation while platelet donors by apheresis also requires platelet (Plt) count. The 'sole Hb' approach prevents a complete donor evaluation and does not allow Plt donor enrolment. To extend blood counts before donations, we evaluated the performances of a multiparametric counter using capillary blood. MATERIALS AND METHODS: The ABX Micros 60 (Micros 60) blood analyzer was employed on capillary blood and compared with venous counts by a reference counter (Coulter AcT 5diff) in a first series of 416 donors and in a second series of 136, after a 3-month period of routine use of this study counter. An average of 50 microl of capillary blood was collected whose 10 microl had been aspirated by Micros 60. RESULTS: High correlations were found between capillary counts using Micros 60 and venous counts using the reference counter. Mean Plt counts differed of 37 x 10(9)/l less for capillary approach in the first series of comparisons, but decreased to 10 x 10(9)/l less in the second series due to a greater expertise of operators in capillary sampling. All other parameters were accurate and never reached clinical relevance albeit they showed statistically significant differences. CONCLUSION: Data on Micros 60 demonstrated that capillary predonation counts may represent a feasible and effective approach to realize an accurate enrolment process of blood and Plt donors.

Kidney length and scarring in children with urinary tract infection: importance of ultrasound scans.

BACKGROUND: Many studies have demonstrated that dimercaptosuccinic acid (DMSA) scintigraphy is the most sensitive diagnostic method in the identification of irreversible renal lesions (scars) in children with previous episodes of acute pyelonephritis (APN). This study assessed the reliability of ultrasound in identifying reflux nephropathy in children with acute pyelonephritis with or without vesicoureteric reflux (VUR). METHODS: Eighty children (45 female and 35 male, age range 5 months to 10 years, average age 2 years 1 month) with a positive history for at least one episode of APN participated in this study. All children underwent voiding cystourethrography, DMSA scintigraphy 4 to 8 months after the most recent episode of APN, and an ultrasound test evaluation less than 2 months after DMSA scintigraphy. RESULTS: Voiding cystourethrograms showed VUR in 52 children (68%); 13 of these were bilateral, for a total of 65 refluxing kidney units of the 154 (42%) evaluated; DMSA scintigram was normal for 108 of 154 kidneys (70%). Of the 65 kidneys with VUR, DMSA scintigram displayed normal findings in 29 cases (45%) and pathologic findings in 36 (55%). In the 79 nonrefluxing kidneys, DMSA scintigram was normal in 69 cases (87%). The relative risk of scarring in VUR kidneys is 2.6. The ultrasound study recorded a maximum longitudinal diameter between the 5th and 95th percentiles in 80 of 89 (81%) kidneys without VUR and in 21 of 65 (32%) with VUR. A significant correlation was found between maximum longitudinal diameters and DMSA scintigraphic findings in kidneys with VUR and those without VUR, respectively. CONCLUSION: This study establishes that ultrasound scans, by means of a simple and reproducible measurement technique, maximum longitudinal diameter, have a predictive value with regard to the presence of scars, with few exceptions. This finding, in our opinion, could lead to a decrease in the number of invasive procedures, in particular DMSA scan, in patients with APN.

[Spigelio's hernia. Anatomo-clinical considerations and description of 5 clinical cases]. / Le ernie di Spigelio. Considerazioni anatomo-cliniche e descrizione di 5 casi clinici.

Spigelian hernia, or ventro-lateral hernia is a rare clinical condition, it represents about 1.5% of hernial formation cases of the abdominal wall. It is localised laterally to the rectus muscle and emerges from the semilunar arch. The line, which joins the IX rib to the pubic tubercle, defines the limit between muscular and aponeurotic portion of trasversus abdominis muscle. Diagnosis often results misunderstood. As a matter of fact, this hernia has typically an intraparietal localization and the clinical picture seldom presents characteristic signs. The hernial sac and its content can be appreciated subcutaneously in only 2% of cases. It is estimated that about 50% of patients affected by this condition have a certain diagnosis before surgery. The early clinical signs are generally aspecific and deceitful, represented by oppressive grief and rarely by an abdominal wall tumor; it occurs that it starts with a complication: intestinal occlusion (23%), subocclusion (8%), strangulation (20%, but some authors report percentage up to 50%). We report 5 cases who came to our observation during the last 7 years; all patients underwent elective surgery, and specifically 3 patients in day surgery. Starting from the discussion of these cases, we review anatomy, etiology, clinical nature, instrumental investigation and surgical technique of this rare kind of hernia, comparing our experience to literature reported case histories.

Melanoma antigen genes 1 and 2 are differentially expressed in human gastric and cardial carcinomas.

BACKGROUND: MAGE genes encode for tumor-rejection antigens and are expressed in tumors of different histologic types but not in normal tissues, with the exception of testis and placenta. The aim of this study was to evaluate the frequency of MAGE-1 and -2 expression in gastric and in cardial carcinomas; these conditions have been described as two distinct diseases, having different etiologies, epidemiologic patterns, and gene mutations. METHODS: Two groups of patients were studied: patients with distal gastric carcinoma and patients with carcinoma of the cardia. A group of patients with intestinal metaplasia in the gastric mucosa and controls were also included. All of them underwent upper GI endoscopy. Paired biopsy specimens were taken for routine histology and for RNA extraction, to study the expression of MAGE-1 and -2 genes. RESULTS: None of the intestinal metaplastic samples or controls expressed MAGE-1 and -2 at detectable levels. Whereas 40% of the gastric cancer patients expressed either MAGE-1 or -2, 26.6% transcribed both. In the cardial cancer group, 20% of the cases expressed at least one MAGE, and only 6.6% expressed both genes. These results might reinforce the concept that cancer of the cardia is a distinct neoplastic disease with regard to esophageal and gastric (distal) carcinomas. CONCLUSIONS: Here we show that MAGE gene expression occurs in advanced stages of gastric and cardial cancer and therefore appears to be a late event. This might point to a reconsideration of their potential role in cancer immunotherapy.

Expression of the epidermal growth factor receptor gene in human intestinal metaplasia: a preliminary report.

BACKGROUND: The role of growth factors/receptors in the etiopathology and/or development of gastric cancer has recently come under scrutiny, since overexpression or amplification of the EGF system has been found in many intestinal type gastric cancers and related to a more aggressive behavior. Since these gastric carcinomas appear to develop from intestinal metaplasia, a study was planned to investigate whether overexpression of the EGF-receptor gene also occurred in intestinal metaplastic mucosa. METHODS: Patients underwent upper GL endoscopy. Gastric biopsies for routine histology, Helicobacter pylori detection, quantification of intestinal metaplasia and EGF-R expression analysis were performed. A 30mer EGF-R specific oligonucleotide was end-labeled and used to probe a dot blot filter containing the RNA from the bioptic samples. RESULTS: Though all the gastric samples transcribed the EGF-R gene to a detectable level, overexpression of the EGF-R gene was found in the metaplastic mucosa in a minority of patients. CONCLUSIONS: These preliminary findings suggest that overexpression of the EGF-R gene is infrequent in the metaplastic gastric mucosa.