Use and Implications of Echocardiography in the Hemodynamic Assessment of Cardiogenic Shock.

Cardiogenic shock (CS) is a complex multisystem syndrome due to pump failure, associated with high mortality and morbidity. Its hemodynamic characterization is key to the diagnostic algorithm and management. Pulmonary artery catheterization is the gold standard for the left and right hemodynamic evaluation, but some concerns exist for invasivity and untoward mechanical and infective complications. Transthoracic echocardiography is a robust noninvasive diagnostic tool for hemodynamic multiparametric assessment that well applies to the management of CS. Its applications expand from etiology definition to the choice of therapeutic intervention and their monitoring. The present review aims at detailing the role of ultrasounds in CS emphasizing the clinical implications of combining cardiac and non-cardiac ultrasounds examinations that may correlate with prognosis.

Observation of Rayleigh-Lamb waves generated by the 2022 Hunga-Tonga volcanic eruption with the POLA detectors at Ny-Ålesund.

The eruption of the Hunga-Tonga volcano in the South Pacific Ocean on January 15, 2022, at about 4:15 UTC, generated a violent explosion, which created atmospheric pressure disturbances in the form of Rayleigh-Lamb waves detected all over the globe. Here we discuss the observation of the Hunga-Tonga shock-wave performed at the Ny-Ålesund Research Station on the Spitsbergen island, by the detectors of the PolarquEEEst experiment and their ancillary sensors. Online pressure data as well as the results of dedicated offline analysis are presented and discussed in details. Results include wave arrival times, wave amplitude measurements and wave velocity calculation. We observed five passages of the shock wave with a significance larger than 3 [Formula: see text] and an amplitude up to 1 hPa. The average propagation velocity resulted to be (308 ± 0.6) m/s. Possible effects of the atmospheric pressure variation associated with the shock-wave multiple passages on the cosmic-ray rate at ground level are also investigated. We did not find any significant evidence of this effect.

Development of a reference material for analysing naturally occurring radioactive material from the steel industry.

Accurate measurement of naturally occurring radionuclides in blast furnace slag, a by-product of the steel industry, is required for compliance with building regulations where it is often used as an ingredient in cement. A matrix reference blast furnace slag material has been developed to support traceability in these measurements. Raw material provided by a commercial producer underwent stability and homogeneity testing, as well as characterisation of matrix constituents, to provide a final candidate reference material. The radionuclide content was then determined during a comparison exercise that included 23 laboratories from 14 countries. Participants determined the activity per unit mass for 226Ra, 232Th and 40K using a range of techniques. The consensus values obtained from the power-moderated mean of the reported participant results were used as indicative activity per unit mass values for the three radionuclides: A0(226Ra) = 106.3 (34) Bq·kg-1, A0(232Th) = 130.0 (48) Bq·kg-1 and A0(40K) = 161 (11) Bq·kg-1 (where the number in parentheses is the numerical value of the combined standard uncertainty referred to the corresponding last digits of the quoted result). This exercise helps to address the current shortage of NORM industry reference materials, putting in place infrastructure for production of further reference materials.

Cutting efficiency of conventional and heat-treated nickel-titanium rotary or reciprocating glide path instruments.

AIM: To compare the cutting efficiency of several glide path files: HyFlex EDM Glidepath File (HEGF), One G (OG), R-Pilot (RP) and WaveOne Gold Glider (WOGG) at different cutting inclinations. METHODOLOGY: Cutting efficiency of 120 new HEGF, OG, RP and WOGG was tested at 90°, 70° and 45° inclination in relation to the sample. Depending on manufacturer instructions, instruments were tested in continuous rotation or reciprocating motion against standardized gypsum samples for 120 s using a customized apparatus. Cutting efficiency was determined by measuring the weight loss and the length of the sample cut. Data were analysed using two-way analysis of variance and Tukey t-test (P < 0.05). RESULTS: RP and WOGG had greater cutting ability than HEGF and OG in all tested angles. RP tested at 45° had significantly greater cutting efficiency than when tested at 90° and 70° (P < 0.05). OG was not significantly different in terms of cutting ability at 90°, 70° and 45° (P > 0.05). HEGF and WOGG had significantly greater cutting efficiency at 45° and 70° compared to 90° (P < 0.05), with no significant difference between 45° and 70° (P > 0.05). RP had the greatest cutting ability at all tested angles. CONCLUSIONS: Reciprocating glide path instruments had greater cutting efficiency compared to those in continuous rotation. An inclined insertion (45° or 70°) increased the cutting ability of glide path files except for One G conventional NiTi files.

Colorimetric study about the stratification's effect on colour perception of resin composites.

To evaluate the influence of a different order of dentin and enamel layers on stratification appearance of different resin composites. 144 Dentin (D) and Enamel (E) composite samples (Clearfil Majesty ES-2 Premium, Brilliant EverGlow, Estelite Asteria), 1 mm thick, were divided into 12 configurations for each composite, with Enamel-Dentin-Dentin-Enamel (EDDE) assumed as target. The colour specification was conducted using a spectrophotometer, elaborating the results with the CIE L*a*b* colour coordinates and calculating the colour difference in terms of [Formula: see text] quantity. A value of this last major of 3.3 was considered not clinically acceptable. Moreover, data were analyzed using two-way analysis of variance and Tukey post hoc test (P < 0.05). For Clearfil Majesty ES-2 Premium and Brilliant EverGlow, six configurations showed [Formula: see text] > 3.3 compared to gold standard EDDE. [Formula: see text] was influenced especially by b* and L* coordinates (P < 0.05). EDED showed no visual difference (0 < [Formula: see text] < 1.1) for both composites. For Estelite Asteria, two configurations reported [Formula: see text] > 3.3 compared to EDDE. In particular, the L* coordinate influenced [Formula: see text] results (P < 0.05). EDDD was the best configuration (0 < [Formula: see text] < 1.1). Within the limits of a vitro study, Brilliant EG showed more dependence from order and thickness of stratification (resulting more similar to Clearfil Majesty ES-2 Premium); therefore, it could be indicated for more complex aesthetic restorations. Estelite Asteria seems to be able to balance small differences in thickness of dentin and enamel layers, and consequently, it is more indicated to different clinical situations.

Microbiological survey of raw and ready-to-eat leafy green vegetables marketed in Italy.

The presence of foodborne pathogens (Salmonella spp., Listeria monocytogenes, Escherichia coli O157:H7, thermotolerant Campylobacter, Yersinia enterocolitica and norovirus) in fresh leafy (FL) and ready-to-eat (RTE) vegetable products, sampled at random on the Italian market, was investigated to evaluate the level of risk to consumers. Nine regional laboratories, representing 18 of the 20 regions of Italy and in which 97.7% of the country's population resides, were involved in this study. All laboratories used the same sampling procedures and analytical methods. The vegetable samples were screened using validated real-time PCR (RT-PCR) methods and standardized reference ISO culturing methods. The results show that 3.7% of 1372 fresh leafy vegetable products and 1.8% of 1160 "fresh-cut" or "ready-to-eat" (RTE) vegetable retailed in supermarkets or farm markets, were contaminated with one or more foodborne pathogens harmful to human health.

The evaluation of the microbial safety of fresh ready-to-eat vegetables produced by different technologies in Italy.

AIMS: The study was performed to evaluate the safety of whole and RTE vegetables and to investigate the effectiveness of different preventive strategies for the quality assurance of RTE vegetables collected from three Italian production systems. Producer 1, applied a strict system in compliance with GAP- GMP - HACCP, Producer 2 used chlorine disinfection at a second washing step, and Producer 3 using a physical microbial stabilization. METHODS: During the period 2005-2007, a total of 964 samples including whole vegetables and RTE salads, collected from three different producers in central Italy, were analysed to quantify the aerobic mesophilic count (AMC) and Escherichia coli, and for the presence of Salmonella spp, Listeria monocytogenes, E. coli O157:H7, hepatitis A virus and Norovirus (NoV). RESULTS: None of the whole vegetable samples were positive for L. monocytogenes, E. coli O157:H7, HAV and NoV; however, a low prevalence of Salmonella was found. No pathogens were detected with cultural methods in any of the RTE vegetables analysed, only two RTE samples were positive for L. monocytogenes with PCR, but were not confirmed by the cultural method. The median values of AMC in RTE vegetables measured 24 h after packaging were statistically different among the 3 producers (5·4 × 10(6), 1·5 × 10(7) and 3·7 × 10(7) CFU g(-1), respectively; P=0·011). The lowest level was detected in Producer 1. CONCLUSION: The products that were processed applying rigorously GAP, GMP and HACCP showed a better microbiological quality than those processed with chemical or physical stabilization. STUDY SIGNIFICANCE AND IMPACT: The results of the study evidenced the efficacy of GAP, GMP and HACCP in improving microbiological quality of whole and RTE vegetables.

Comparison of different concentration methods for the detection of hepatitis A virus and calicivirus from bottled natural mineral waters.

Viral contamination of drinking water is frequently reported as the primary source of gastroenteritis or hepatitis outbreaks. The presence of viruses at low concentration levels in most environmental water poses major analytical problems when determining their concentration. To evaluate the efficiency of different recovery methods of viral RNA from bottled water, a comparison was made of 2 positively and 2 negatively charged membranes that were used for absorbing and releasing HAV virus particles during the filtration of viral spiked bottled water. All the 4 membranes, regardless of charge and pore size, had low level viral recovery. The results show that a considerable number of the virus particles passed through the pores of the membranes instead of being trapped by the electrostatic charges. Two different procedures were then compared using 1.5L polyethylene bottles spiked with 10-fold serial dilutions of HAV and FCV. The first procedure included an ultrafiltration-based method followed by MiniMag RNA extraction, and the second an ultracentrifugation-based method followed by RNA extraction using QIAamp viral RNA mini kit. The ultracentrifugation-based method resulted in a better recovery of HAV and FCV when compared to the ultrafiltration-based method.

Inclusive K(S);(0)K(S);(0) resonance production in ep collisions at HERA.

Inclusive K_{S};{0}K_{S};{0} production in ep collisions at the DESY ep collider HERA was studied with the ZEUS detector using an integrated luminosity of 0.5 fb;{-1}. Enhancements in the mass spectrum were observed and are attributed to the production of f_{2}(1270)/a_{2};{0}(1320), f_{2};{'}(1525) and f_{0}(1710). Masses and widths were obtained using a fit which takes into account theoretical predictions based on SU(3) symmetry arguments, and are consistent with the Particle Data Group values. The f_{0}(1710) state, which has a mass consistent with a glueball candidate, was observed with a statistical significance of 5 standard deviations. However, if this state is the same as that seen in gammagamma-->K_{S};{0}K_{S};{0}, it is unlikely to be a pure glueball state.

Epidemiological and virological characterization of a large community-wide outbreak of hepatitis A in southern Italy.

A large outbreak of hepatitis A virus (HAV) infection occurred in 2004 in Campania, a region of southern Italy, with 882 cases reported between 1 January and 1 August. The local public health authorities and the Italian National Institute of Health carried out investigations in order to characterize the agent, identify the source of infection and the route of transmission, and implement appropriate control measures. A web-based reporting system enhanced the flow of information between public health authorities, providing real-time epidemic curves and frequency distributions. The same 1B HAV genotype was found in 90% of sera from a subset of patients with acute disease, suggesting a local common source. A case-control study in the municipality with the highest attack rate showed that raw seafood consumption, in particular if illegally sold in water, was strongly associated with HAV illness. Samples of seafood systematically collected from retailers were found contaminated by HAV.

Use of zeolitized pumice waste as a water softening agent.

Important pumice quarries are located on the island of Lipari (Italy) where an intense activity of extraction, transformation and trade of pumice takes place. Nevertheless, the finest fraction amounting to about 60% of mined pumice is discarded and disposed off in open-sky pits. This implies economic losses for mining industries and environmental problems for neighbouring villages. In order to find a sustainable use of this waste, we resumed and improved an old extractive process with aqueous sodium alkali, where a sodium silicate concentrated solution was produced together with an unextracted residue partially converted into zeolite P in Na+ form and now we are searching for suitable applications of this residue. In this paper, we relate about its use as a low cost water softening agent on the basis of results obtained from several tests both in batch systems and column. They show that, at room temperature, the residue works well with calcium and badly with magnesium, whereas, at 60 degrees C, also the affinity toward Mg ions increases to acceptable levels. Repeated regenerations of the residue with concentrated NaCl solutions do not appreciably compromise the performance. The limits for the possible use as water softening agent are defined.

Detection of hepatitis A virus in mussels from different sources marketed in Puglia region (South Italy).

Hepatitis A virus (HAV) infection is endemic in Puglia (South Italy). Epidemiological studies indicate that shellfish consumption, particularly mussels, is a major risk factor for HAV infection, since these products are eaten raw or slightly cooked. Nested reverse transcriptase-polymerase chain reaction (RT-PCR) has been shown to be a sensitive technique for the detection of HAV in mussels. The aim of the present study was to detect the presence of HAV in a large sample of mussels by nested RT-PCR and to confirm the presence of infectious viral particles in positive samples by cell culture infection and RT-PCR confirmation. Two hundred and ninety samples of mussels from different sources were collected between December 1999 and January 2000. One hundred samples were collected before being subjected to depuration, 90 after depuration, and 100 were sampled in different seafood markets. HAV-RNA was detected in 20 (20.0%) of non-depurated mussels, in 10 (11.1%) of depurated samples, and in 23 (23.0%) of samples collected in the shellfish markets, without any significant difference in the prevalence of positive samples by collection sources (chi2 = 4.79, p = 0.09). Of the 53 samples found positive by nested RT-PCR, 18 (34.0%) resulted positive by cell culture assay. No relationship between viral contamination and bacterial contamination was found (p = 0.41). This study confirms the usefulness of molecular techniques in detecting HAV in shellfish and, thus, for the screening of a large sample of naturally contaminated mussels. Improved shellfish depuration methods are needed to obtain virus-safe shellfish and reduce the risk for public human health.

Behavior of aeromonas hydrophila in bottled mineral waters.

The growth and survival of Aeromonas hydrophila in three types of natural mineral waters were investigated. Mineral waters with different levels of mineral content (low, medium, and high) were experimentally contaminated with A. hydrophila, stored at different temperatures (10 degrees C and 20 degrees C), and analyzed at intervals over a 60-day period. Water samples that were not experimentally contaminated were investigated for indigenous A. hydrophila. The results confirmed that A. hydrophila may occur naturally in mineral waters and showed that the level of mineral content, temperature, length of storage, and, in some cases, the type of container used may favor the growth of A. hydrophila. The greatest proliferation was observed in water with a low mineral content stored in PET bottles at 10 degrees C, in which A. hydrophila peaked at day 28 (4.47 +/- 0.01 log CFU/100 ml). At 20 degrees C, the same load was observed at day 60. The presence of high densities of A. hydrophila in bottled mineral water can constitute a risk for some groups of consumers, such as elderly and immunocompromised persons.

Detecting the presence of infectious hepatitis A virus in molluscs positive to RT-nested-PCR.

AIMS: The objective of this study was to determine the presence of infectious hepatitis A virus (HAV) in molluscs naturally contaminated with viral HAV-RNA. METHODS AND RESULTS: One hundred and forty-two mollusc samples were analysed for the presence of viral HAV-RNA using RT-nested-PCR; positive samples were then analysed with an integrated method, cell-culture RT-PCR, to detect infectious virus. Viral HAV-RNA was detected in 34.5% of the samples while 12.7% of the total samples were positive for the presence of infectious virus. CONCLUSIONS: The results demonstrate the validity of the screening method (RT-nested-PCR) and the necessity of applying a method that is capable of detecting the presence of infectious HAV. SIGNIFICANCE AND IMPACT OF THE STUDY: The study demonstrates that in any case, to determine the safety for human consumption, the results of RT-nested-PCR must be confirmed with an integrated cell-culture PCR method.

Closed-circuit system for the depuration of mussels experimentally contaminated with hepatitis A virus.

In Italy, the consumption of raw or slightly cooked mussels represents the most important risk factor for the transmission of hepatitis A virus (HAV). Although there exist effective methods for the bacterial depuration of contaminated mussels, these methods are poorly effective on enteric viruses. The objective of the present study was to evaluate the effectiveness of a closed-circuit depuration system that uses both ozone and UV light for disinfecting water and that allows salinity and temperature, important parameters for the metabolism of mussels (Mytilus galloprovincialis), to be maintained at constant levels. The results showed that this depuration method decreased the viral load (from 1.72 log 50% tissue culture infective dose [TCID50] ml(-1) to <1 log TCID50 ml(-1) within 24 h and from 3.82 log TCID50 ml(-1) to <1 log TCID50 ml(-1) within 48 h). However, in both cases, after 120 h of depuration, a residual amount of virus capable of replicating in cells was detected. These results show that depuration, even if performed with advanced systems, may not guarantee the absence of virus.

Presence of chitinase in adult Varroa destructor, an ectoparasitic mite of Apis mellifera.

The enzyme spectrum of an ectoparasitic mite of the honeybee. Varroa destructor (Anderson and Trueman) was studied using a semi-quantitative method, especially designed for complex samples which have not been purified. Exopeptidases and phosphatases are shown present. A chitinase and enzymes able to transform beta carbohydrates are also present with a large range in the intensity of the reaction. The role of the chitinase can be related to the supply of nutritional needs or/and the piercing and sucking behaviour of the adult parasite. Chitinase activity could be one factor influencing the balance between the parasite and its host.

Prolonged effectiveness of Norplant(R) capsule implants: a 7-year study.

Soft tubing Norplant(R) contraceptive implants were studied in 1210 women for 7 years to measure the duration of effectiveness and the magnitude of the pregnancy rates over that time. Mean age at enrollment was 27.4 years. Of the enrollees, 42% were US residents. One-sixth (16.1%) weighed >/=70 kg at the time of implant placement. At the end of 5 years, the cumulative pregnancy rate was 1.1/100; at the end of 7 years, it was 1.9/100. No pregnancies occurred to any of the 400 women who enrolled in the study at age >/=30 years and who weighed <100 kg. Among women aged 18-33 years, the 7-year Norplant pregnancy rates are comparable to the median pregnancy rates of tubal sterilization methods for women of the same age and duration of use. For women aged >/=34 years, without regard to weight at admission, the 7-year effectiveness of soft tubing Norplant equals or surpasses that of tubal sterilization. For continuing implant users, annual pregnancy rates <1.0/100 in years 6 and 7, together with low cumulative pregnancy rates, testify that Norplant capsule implants remain highly effective for 7 years.