Climate-driven shifts in decapod larvae assemblages in a temperate estuary.

The study examines the complex impact of climatic patterns, driven by the North Atlantic Oscillation (NAO), on regional climate, hydrology, and sea surface temperatures. Focused on the period from 2003 to 2012, the research specifically investigates the influence of thermal variability on decapod larval communities. Monthly zooplanktonic sampling conducted at the Mondego Estuary, Portugal, entrance over a decade revealed the prevalence of Carcinus maenas, Diogenes pugilator, and Pachigrapsus marmoratus larvae. These assemblages displayed notable interannual and seasonal fluctuations, often corresponding with changes in sea surface temperatures. Significant system shifts around 2007, instigated by the large-scale NAO, led to subsequent modifications in sea surface temperature and decapod larvae communities' dynamics. Post-2007, there was an upward trajectory in both species' abundance and richness. Phenologically during the former period, the community exhibited two abundance peaks, with the earlier peak occurring sooner, attributed to heightened temperatures instead of the unique peak exhibited before 2007. The research further elucidated the occurrences of Marine Heatwaves (MHW) in the region, delving into their temporal progression influenced by the NAO. Although water temperature emerged as a crucial factor influencing decapod larvae communities annually and seasonally, the study did not observe discernible impacts of MHW events on these communities. These communities represent essential trophic links and are crucial for the survival success of adult decapods. Given the rapid pace of climate change and increasing temperatures, it is imperative to assess whether these environmental shifts, particularly in thermal conditions, affect these meroplanktonic communities.

Association of conduit dimensions with perioperative outcomes and long-term quality of life after esophagectomy for malignancy.

Objective: The impact of conduit dimensions and location of esophagogastric anastomosis on long-term quality of life after esophagectomy remains unexplored. We investigated the association of these parameters with surgical outcomes and patient-reported quality of life at least 18 months after esophagectomy. Methods: We identified all patients who underwent esophagectomy for cancer from 2018 to 2020 in our institution. We reviewed each patient's initial postoperative computed tomography scan measuring the gastric conduit's greatest width (centimeters), linear staple line length (centimeters), and relative location of esophagogastric anastomosis (vertebra). Quality of life was ascertained using patient-reported outcome measures. Perioperative complications, length of stay, and mortality were collected. Multivariate regressions were performed. Results: Our study revealed that a more proximal anastomosis was linked to an increased risk of pulmonary complications, a lower recurrence rate, and greater long-term insomnia. Increased maximum intrathoracic conduit width was significantly associated with trouble enjoying meals and reflux long term after esophagectomy. A longer conduit stapled line correlated with fewer issues related to insomnia, improved appetite, less dysphagia, and significantly enhanced "social," "role," and "physical'" aspects of the patient's long-term quality of life. Conclusions: The dimensions of the gastric conduit and the height of the anastomosis may be independently associated with outcomes and long-term quality of life after esophagectomy for cancer.

Late Subacute Cerebral Hematoma Mimicking a Metastasis on PSMA PET/CT.

ABSTRACT: A 64-year-old man with history of prostate cancer was found to have rising prostate-specific antigen after radical prostatectomy. 18 F-DCFPyL PET/CT demonstrated a prostate-specific membrane antigen-avid brain lesion in the left frontal lobe and no other findings to account for rising prostate-specific antigen. Brain MRI demonstrated a small intraparenchymal hematoma with late subacute features in this location. The patient reported a seizure 3 weeks before but was otherwise asymptomatic, and neurologic examination was normal. Follow-up MRI demonstrated gradual decrease in size of the hematoma without treatment.

COVID-19: Findings in nuclear medicine from head to toe.

COVID-19 is a multisystemic disease, and hence its potential manifestations on nuclear medicine imaging can extend beyond the lung. Therefore, it is important for the nuclear medicine physician to recognize these manifestations in the clinic. While FDG-PET/CT is not indicated routinely in COVID-19 evaluation, its unique capability to provide a functional and anatomical assessment of the entire body means that it can be a powerful tool to monitor acute, subacute, and long-term effects of COVID-19. Single-photon scintigraphy is routinely used to assess conditions such as pulmonary embolism, cardiac ischemia, and thyroiditis, and COVID-19 may present in these studies. The most common nuclear imaging finding of COVID-19 vaccination to date is hypermetabolic axillary lymphadenopathy. This may pose important diagnostic and management dilemmas in oncologic patients, particularly those with malignancies where the axilla constitutes a lymphatic drainage area. This article aims to summarize the relevant literature published since the beginning of the pandemic on the intersection between COVID-19 and nuclear medicine.

Modelling coastal upwelling off NW Iberian Peninsula: New insights on the fate of phytoplankton blooms.

The northwestern coast of the Iberian Peninsula is a region characterized by pronounced hydrologic and biogeochemical activity, resulting in important fish and shellfish resources whose exploitation has a strong local socioeconomic impact. This high biological diversity is strongly dependent on coastal upwelling induced by favourable winds, which presents seasonal variability. This motivates the present study, which aims to understand the relation between local circulation, hydrography and Chl-a concentration under summer upwelling events of different intensities and clarify their effects in the region. To achieve this purpose, a coupled physical-biological model was developed and validated for the northwestern coast of the Iberian Peninsula, based on the use of MOHID modelling system and the application of a nested domains methodology. Comparison of predictions with observations demonstrated the model's accuracy in reproducing the physical and biogeochemical properties of the study region, both at the surface and along the water column. The study of different summer upwelling events shows that the local phytoplankton patterns are dependent on the characteristics of the event. Results show that under high upwelling favourable winds, a surface southwestward flow and an equatorward flow through the water column develop near the coast, inducing offshore advection of nutrient and phytoplankton-rich waters. Otherwise, under light upwelling favourable winds, surface currents are weak, a poleward flow develops, and phytoplankton is retained near the coast.

SDHx mutations and temozolomide in malignant pheochromocytoma and paraganglioma.

Malignant pheochromocytomas (PHEOs)/paragangliomas (PGLs) are rare tumors for which clinical outcomes remain poorly defined and therapeutic options are limited. Approximately 27% carry pathogenic germline succinate dehydrogenase (SDHx) mutations; the presence of such mutations has been correlated with response to temozolomide (TMZ). We aimed to investigate the association between germline mutations in SDHx and response to TMZ. We retrospectively identified patients with metastatic malignant PHEO/PGLs treated with TMZ- based chemotherapy at Dana-Farber Cancer Institute between 2003 and 2020. The correlation between response by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and PET Response Criteria in Solid Tumors (PERCIST) and the presence of SDHx mutations in the germline and tumor was evaluated. Nineteen patients received TMZ. Seventeen underwent germline assessment: 9 (53%) carried a pathogenic SDHx germline mutation. Fifteen patients were evaluable for response by RECIST 1.1: 6 (40%) partial response, 4 (27%) stable disease, and 5 (33%) progressive disease. Overall median progression-free survival was 2.2 years. Three-year overall survival (OS) was 58%. Median PFS was 1.3 years and 5.5 years for carriers and non-carriers, respectively and OS was 1.5 years and not estimable for carriers and non-carriers, respectively. The response by PERCIST criteria in nine patients correlated with the RECIST 1.1 assessment. Our series represents one of the largest analyses of patients with malignant PHEOs/PGLs treated with TMZ who have available germline data. The incidence of pathogenic germline SDHx mutations was similar to what has been previously published, though our analysis suggests that there may be a limited association between response to TMZ and pathogenic germline SDHx mutations.

Diminished Efficacy of Programmed Death-(Ligand)1 Inhibition in STK11- and KEAP1-Mutant Lung Adenocarcinoma Is Affected by KRAS Mutation Status.

INTRODUCTION: STK11 and KEAP1 mutations (STK11 mutant [STK11MUT] and KEAP1MUT) are among the most often mutated genes in lung adenocarcinoma (LUAD). Although STK11MUT has been associated with resistance to programmed death-(ligand)1 (PD-[L]1) inhibition in KRASMUT LUAD, its impact on immunotherapy efficacy in KRAS wild-type (KRASWT) LUAD is currently unknown. Whether KEAP1MUT differentially affects outcomes to PD-(L)1 inhibition in KRASMUT and KRASWT LUAD is also unknown. METHODS: Clinicopathologic and genomic data were collected from September 2013 to September 2020 from patients with advanced LUAD at the Dana-Farber Cancer Institute/Massachusetts General Hospital cohort and the Memorial Sloan Kettering Cancer Center/MD Anderson Cancer Center cohort. Clinical outcomes to PD-(L)1 inhibition were analyzed according to KRAS, STK11, and KEAP1 mutation status in two independent cohorts. The Cancer Genome Atlas transcriptomic data were interrogated to identify differences in tumor gene expression and tumor immune cell subsets, respectively, according to KRAS/STK11 and KRAS/KEAP1 comutation status. RESULTS: In the combined cohort (Dana-Farber Cancer Institute/Massachusetts General Hospital + Memorial Sloan Kettering Cancer Center/MD Anderson Cancer Center) of 1261 patients (median age = 61 y [range: 22-92], 708 women [56.1%], 1065 smokers [84.4%]), KRAS mutations were detected in 536 cases (42.5%), and deleterious STK11 and KEAP1 mutations were found in 20.6% (260 of 1261) and 19.2% (231 of 1202) of assessable cases, respectively. In each independent cohort and in the combined cohort, STK11 and KEAP1 mutations were associated with significantly worse progression-free (STK11 hazard ratio [HR] = 2.04, p < 0.0001; KEAP1 HR = 2.05, p < 0.0001) and overall (STK11 HR = 2.09, p < 0.0001; KEAP1 HR = 2.24, p < 0.0001) survival to immunotherapy uniquely among KRASMUT but not KRASWT LUADs. Gene expression ontology and immune cell enrichment analyses revealed that the presence of STK11 or KEAP1 mutations results in distinct immunophenotypes in KRASMUT, but not in KRASWT, lung cancers. CONCLUSIONS: STK11 and KEAP1 mutations confer worse outcomes to immunotherapy among patients with KRASMUT but not among KRASWT LUAD. Tumors harboring concurrent KRAS/STK11 and KRAS/KEAP1 mutations display distinct immune profiles in terms of gene expression and immune cell infiltration.

A modeling study of light extinction due to cohesive sediments in a shallow coastal lagoon under well mixed conditions.

Cohesive sediments play an important ecological role in coastal systems, affecting light penetration in the water column and consequently the local biogeochemical processes. The main aim of this work is to study the water-column light extinction coefficient (k) dependence on cohesive sediment dynamics within Ria de Aveiro lagoon under sea level rise and extreme freshwater discharges events. A coupled estuarine hydrodynamic and transport model is explored, following previous modeling frameworks developed for the Ria de Aveiro. Three scenarios were simulated: a reference scenario (SC1), wherein present hydrodynamic, mean sea level and present freshwater discharges were used to simulate present hydrodynamic and cohesive sediments; a scenario considering local projections of sea level rise of 0.42 m (SC2); and a third one corresponding to maximum freshwater inflow for the lagoon's tributaries (SC3). Results show higher concentrations of cohesive sediments near the rivers mouths, gradually decreasing toward the lagoon's inlet. From SC2 scenario was found that the effect of sea level rise in sediment dynamics and in water-column light extinction coefficient is not significant. However, the tidal prism increase in this case induces a dilution of the sediments concentration from fluvial origin and consequently a slightly k decrease. Contrarily, in SC3 scenario, the extreme freshwater inflow enhances the cohesive sediment concentration in the entire lagoon, limiting the light penetration in the water column. In summary, extreme river discharge events have a highest impact on water-column light penetration in Ria the Aveiro than predicted sea level rise.

Subtidal variability of the Tagus river plume in winter 2013.

The subtidal variability of surface plume response to local wind and river runoff is studied off central Portugal using a hindcast model for the Tagus Estuary (TE) plume. In addition to the model, the main patterns of variability of the TE plume were extracted in an automated mode using Self Organizing Maps (SOM). Three characteristic spatial patterns are extracted in a 3 × 2 SOM array: in synoptic time scales, northward and southward propagation of the plume and transitional periods. Results suggest that river runoff and wind induce strong variability in the coastal ocean, and that the TE plume has a rapid response to their changes. Under high river runoff there is a southern propagation of the plume, even during downwelling favorable winds, revealing bi-directional patterns due to the combined effect of estuarine outflow, wind direction and coastline in establishment the plume direction. The same is found during transitional periods, revealing that the TE plume has significant influence both north and south of the estuary mouth. SOM was applied for the first time to extract spatial and temporal features of the TE plume and prove to be a reliable tool to study large quantities of data in addition to the model results analysis.

Thoracic wall trauma-misdiagnosed lesions on radiographs and usefulness of ultrasound, multidetector computed tomography and magnetic resonance imaging.

Blunt injuries to the chest wall are an important chapter on emergency room (ER) departments, being the third most common injuries in trauma patients which ominous complications could appear. This article describes different types of traumatic events affecting the chest wall, which maybe misdiagnosed with conventional X-ray. Special emphasis has been done in computed tomography (CT) and multidetector CT (MDCT) imaging. This technique is considered the "gold-standard" for those traumatic patients, due to its fast acquisition covering the whole area of interest in axial plane, reconstructing multiplanar (2D, 3D) volume-rendered images with a superb quality and angiographic CT capabilities for evaluating vascular damage. Complementary techniques such as ultrasonography (US) and magnetic resonance imaging (MRI) may improve the diagnostic accuracy due to its great capacity in visualising soft-tissue trauma (muscle-tendinous tears) and subtle fractures. All these imaging methods have an important role in quantifying the severity of chest wall trauma. The findings of this study have been exposed with cases of our archives in a didactic way.

Variz venosa pulmonar: una entidad rara que imita una malformación arteriovenosa / Pulmonary venous varix: A rare entity imitating arteriovenous malformation

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Unusual circulation patterns of the Rias Baixas induced by Minho freshwater intrusion (NW of the Iberian Peninsula).

The Minho River, situated 30 km south of the Rias Baixas, is the most important freshwater source flowing into the Western Galician coast (NW of the Iberian Peninsula). The buoyancy generated by the Minho estuarine plume can reverse the normal circulation pattern inside the Rias Baixas affecting the exchange between the Rias and the ocean, changing the input of nutrients. Nevertheless, this inversion of the circulation patterns is not a well-monitored phenomenon. The only published results based on in situ data related to the presence of the Minho River plume inside the Rias de Vigo and Pontevedra correspond to an event measured on spring 1998. In this case unexpectedly higher inflow surface current velocities were found at the Ria de Pontevedra, located further away from Minho River. Thus, the main aim of this study is to research the main factors inducing this unusual pattern on the circulation of the Rias de Vigo and Pontevedra. A numerical model implementation of MOHID previously developed, calibrated, and validated for this coastal area was used. Several scenarios were performed in order to explain the individual effect of the Minho River, rivers discharging into each Rias, and estuarine morphology changes. According to the model results, the Minho River discharge is a key factor in the establishment of the negative circulation, while small rivers inside the Rias slightly attenuate this circulation. The negative circulation was stronger in Ria de Pontevedra independently of the distance of this coastal system from the Minho River mouth, showing that morphologic estuarine features are the main factor justifying the different local circulation patterns.

An investigation on body displacement after two drowning accidents.

The finding of human remains in aquatic environments is usually attributed to causes such as work-related or recreational accidents, suicides, discarded homicide victims, and natural disasters. When the point and date of entry in the water is unknown, these findings pose serious challenges to forensic analysis given the difficulty to estimate the drift of the body. In this context, the information retrieved from cases where the point of entry and body recovery sites are known, as well as the timing, is significant. Two drowning accidents in marine coastal waters were analyzed. In both cases the post-mortem submersion interval (PMSI) is known, as well as the accident (point of entry) and body recovery sites. Accumulated degree days (ADD) was estimated in both cases using satellite sea surface temperature data. In both cases the bodies were recovered in the vicinity of the accident site (~2 km in case 1 and less than 1 km in case 2). Results were interpreted in terms of oceanographic conditions, physical settings and ADD. The results provide some relevant clues on the fate of human cadavers in coastal marine environments that can be used by officials and agencies involved in the recovery of bodies, as well as by forensic investigators when dealing with these findings.