Morpho-bathymetric acoustic surveys as a tool for mapping traces of anthropogenic activities on the seafloor: The case study of the Taranto area, southern Italy.

In this study, an investigation procedure for mapping the traces of anthropogenic activities on the seafloor is proposed. Analyses are based on the interpretation of acoustic data (Multibeam Echosounder and Side Scan Sonar) acquired in the Taranto coastal area. Specific GIS tools supported the acoustic data analysis, interpretation, and mapping. These analyses highlighted that the seafloor of both coastal basins included in the investigated area is affected by a high distribution of traces related to different anthropogenic activities such as dredging, shipping, and mussel farming activities. Such kind of traces resulted efficiently detectable from morpho-bathymetric acoustic data. In particular, groove traces resulted highly distributed in both basins, while sunken mussel farm facilities are widely distributed in the Mar Grande basin. The results highlight as acoustic surveys represent a useful tool for orienting effective coastal management actions. This study points out how geophysical surveys support the geo-environmental characterization of highly urbanized coastal sectors.

Direct evidence that late Neanderthal occupation precedes a technological shift in southwestern Italy.

OBJECTIVES: During the middle-to-upper Paleolithic transition (50,000 and 40,000 years ago), interaction between Neanderthals and Homo sapiens varied across Europe. In southern Italy, the association between Homo sapiens fossils and non-Mousterian material culture, as well as the mode and tempo of Neanderthal demise, are still vividly debated. In this research, we focus on the study of two human teeth by using 3D geometric morphometric approaches for a reliable taxonomical attribution as well as obtaining new radiometric dates on the archeological sequence. MATERIAL AND METHODS: This work presents two lower deciduous molars uncovered at Roccia San Sebastiano (Mondragone-Caserta, Italy), stratigraphically associated with Mousterian (RSS1) and Uluzzian (RSS2) artifacts. To obtain a probabilistic attribution of the two RSS teeth to each reference taxa group composed of Neanderthals and Homo sapiens, we performed and compared the performance of three supervised learning algorithms (flexible discriminant analysis, multiadaptive regression splines, and random forest) on both crown and cervical outlines obtained by virtual morphometric methods. RESULTS: We show that RSS1, whose Mousterian context appears more recent than 44,800-44,230 cal BP, can be attributed to a Neanderthal, while RSS2, found in an Uluzzian context that we dated to 42,640-42,380 cal BP, is attributed to Homo sapiens. DISCUSSION: This site yields the most recent direct evidence for a Neanderthal presence in southern Italy and confirms a later shift to upper Paleolithic technology in southwestern Italy compared to the earliest Uluzzian evidence at Grotta del Cavallo (Puglia, Italy).

A novel approach to the classification of terrestrial drainage networks based on deep learning and preliminary results on solar system bodies.

Several approaches were proposed to describe the geomorphology of drainage networks and the abiotic/biotic factors determining their morphology. There is an intrinsic complexity of the explicit qualification of the morphological variations in response to various types of control factors and the difficulty of expressing the cause-effect links. Traditional methods of drainage network classification are based on the manual extraction of key characteristics, then applied as pattern recognition schemes. These approaches, however, have low predictive and uniform ability. We present a different approach, based on the data-driven supervised learning by images, extended also to extraterrestrial cases. With deep learning models, the extraction and classification phase is integrated within a more objective, analytical, and automatic framework. Despite the initial difficulties, due to the small number of training images available, and the similarity between the different shapes of the drainage samples, we obtained successful results, concluding that deep learning is a valid way for data exploration in geomorphology and related fields.

Sediment contamination by heavy metals and ecological risk assessment: The case of Gulf of Pozzuoli, Naples, Italy.

Heavy metal concentrations in sediments of the Gulf of Pozzuoli, GoP, and northwest of the Gulf beyond Monte di Procida, MdP, were determined. The enrichment factor, EF, revealed in GoP strong pollution with peaks for Cr and Cu of 61.1 and 96.9. High EF Cr, Cu, and Ni values were observed for MDP. Geoaccumulation index, Igeo, rates GoP extremely polluted by Cr and Cu, Igeo > 5, and MdP heavily polluted by Cr, moderately to heavily polluted by Cu, and heavily to extremely polluted by Ni. Contamination factor, Cf, was high in GoP and varied: Cu > Cr > Ni > Cd > Hg > Zn > Pb > As, and those of Cr, Cu and Ni largely surpassed the thresholds in MdP. The ecological and comprehensive ecological risk placed Cr, Cu, Hg and Ni at high or serious risk level in the Gulf, with a peak of 465 for Cu and at a moderate level in MdP except for a very high risk for Ni.

Contaminants bioaccumulation and pathological assessment in Mytilus galloprovincialis in coastal waters facing the brownfield site of Bagnoli, Italy.

We studied the bioaccumulation of metals and PAHs, the pathological conditions, regressive phenomena and pathogens in wild Mytilus galloprovincialis taken along the North Pier facing the former second Italian largest steelworks of Bagnoli. There was no Cd and Pb bioaccumulation with respect to the EU role 221/2002. Metal shell index decreased as follows: Pb > Ni > Zn > Cu and correlates with the pollution state. The level of BaP was up to thirtysixfold higher the EU rule 835/2011. The sum of 4 hydrocarbons, PAH4, were up to seventeen-fold the rule. PAH levels increased toward the coast. Prevalence values of tissue necrosis and inflammatory lesions were between 50 and 100%. In May animals showed lesion like granulocytomas and inflammatory capsules. Signs of atresia, necrotic oocytes and diffused cases of hermaphroditism were detected. An appropriate localization of farming to avoid contamination from sediment turbulence and risks for consumer health is needed.

Levels of pollution of rare earth elements in the surface sediments from the Gulf of Pozzuoli (Campania, Italy).

The Gulf of Pozzuoli includes the former second largest Italian steelworks of Bagnoli. The REE, Y, Th and Sc pollution in sediments of the Gulf of Pozzuoli was determined. Ce, La, Nd and Pr had the highest percentage distribution of rare earth elements normalized respect to chondrite with 31.19, 28.35, 19.51 and 8.41% individually. It was observed a marked enrichment of these elements, from west to the east from 26.39 to 111.04 mg/kg and from onshore to offshore from 31.67 to 217.74 mg/kg. The output of the principal component analysis revealed that the REE were mainly of anthropic origin being clearly linked to that of PAHs, metals and organic matter. This, together with their distribution patterns, highlighted the role of the former Bagnoli metallurgical plant in the pollution of the gulf.

Estimation of Urinary Creatinine Excretion and Prediction of Renal Function in Morbidly Obese Patients: New Tools from Body Composition Analysis.

BACKGROUND/AIMS: In obese subjects the accuracy of prediction of renal function is quite low. The aim of this study was to obtain a more accurate estimate of urinary creatinine excretion (UCr), creatinine clearance (CCr), and GFR from body cell mass (BCM). METHODS: Seventy-three adult morbidly obese patients (BMI 35.2-64.5 kg/m2) were examined. BCM was calculated from body impedance analysis. CCr was measured (mCCr) and was predicted from BCM and antropometric data (MR-BCMCCr), with Cockcroft and Gault (C&GCCr) and Salazar and Corcoran (S&CCCr) formulas. GFR was predicted from BCM (BCM GFR) and with MDRD and CKD-EPI formulas. RESULTS: Multiple regression (MR) indicated a strict linear correlation between UCr, BCM and anthropometric data. UCr predicted from MR equation (MR-BCMUCr) was very similar to measured UCr. MR-BCMCCr (168±46 mL/min) and mCCr (167±51 mL/min) were also similar, while significant differences were found between mCCr, C&GCCr and S&CCCr. The correlation and the agreement between MR-BCMCCr and mCCr were closer and prediction error was lower than the other formulas. BCM GFR (125±32 mL/min) had close correlations and agreements with MDRD GFR and CKD EPI formulas. CONCLUSIONS: In morbidly obese patients the measurement of BCM meliorates the prediction of UCr and CCr, and allows the prediction of GFR.

Acute Localized Exanthematous Pustulosis (ALEP): Review of Literature with Report of Case Caused by Amoxicillin-Clavulanic Acid.

Acute localized exanthematous pustulosis (ALEP) is a localized form of acute generalized exanthematous pustulosis, characterized by acute onset of multiple nonfollicular, pinhead-sized, sterile pustules following drug administration. Antibiotics, especially ß-lactams and macrolides, have been implicated in the majority of cases, although eruption after nonsteroidal antiinflammatory drugs and many other medications has also been reported. Skin reaction arises quickly within a few hours, resolving rapidly within a few days without treatment, and it is usually accompanied by fever and neutrophilic leukocytosis. We report herein all cases of ALEP described in literature, adding the case of a 35-year-old woman admitted to our hospital with outbreak of erythematous pustules on her face, neck, and chest after amoxicillin-clavulanic acid treatment.

Distribution and enrichment of trace metals in surface marine sediments in the Gulf of Pozzuoli and off the coast of the brownfield metallurgical site of Ilva of Bagnoli (Campania, Italy).

The distribution of metals in surface sediments of Gulf of Pozzuoli (GoP), embedding the former second Italian largest integrated steelworks of Bagnoli, was studied based on sediment dispersal, quality guidelines (SQGs) and quantitative pollution indices of the respective metals. As, Cd, Hg, Pb, Zn largely exceeded the limits. Hg had a mean of 5.8mg/kg, twentyfold higher the rule, accumulating primarily near Bagnoli site. The mean effective range quotient, m-ERM-Q, revealed a high potential for negative biological effects especially in the area nearby the Bagnoli site. The enrichment factor (EF) values were outstandingly high, >1.5 with values which were often ≥100. The geoaccumulation index, Igeo, was very critical for Cr, Cu, Hg and Ni, showing an Igeo in the range of strongly polluted (45). The principal component analysis (PCA) and Pearson's correlation matrix (CM), excluded significant contribution from weathering products.

Characterization and source apportionment of polycyclic aromatic hydrocarbons (pahs) in the sediments of gulf of Pozzuoli (Campania, Italy).

Most of the literature reports on the impact of the former Bagnoli brownfield on the pollution of Bagnoli Bay, embedded in the Gulf of Pozzuoli (GoP). Thus, we studied concentrations, types and sources of sixteen PAHs (EPA) in sediments at 22 sites along 5 transects covering the entire area of GoP. Outstanding levels of PAHs were found, varying from 7.1µgg-1 to 2.5 E+3µgg-1. Sediments collected at sites far away from Bagnoli were found to be polluted to a similar extent than those facing the brownfield site, with values>100µgg-1. Total PAHs levels in the sediments of GoP were higher by thirty-eleven thousand fold than those reported by other studies from various marine sites in the world. Transit axes of fine and very fine sands and diagnostic indexes revealed a common pyrolytic PAHs pollution spreading from the Bagnoli plant to all GoP.

High-Flux Dialysis: Clinical, Biochemical, and Proteomic Comparison with Low-Flux Dialysis and On-Line Hemodiafiltration.

Hemodiafiltration on-line (on-line HDF) is a more efficient treatment than low-flux hemodialysis (HD). Unfortunately, it cannot be proposed to all patients. The aim of this study was to evaluate the safety, efficiency, and mechanisms of removal of toxins with high-flux HD vs. low-flux HD and on-line HDF. Randomized cross-over study designed to evaluate efficiency and tolerability of high-flux HD vs. low-flux HD in aged patients; to compare by means of biochemical and proteomic analyses the efficiency and mechanisms of removal of toxins with high-flux HD vs. on-line HDF. The removal of small toxins was similar with high-flux and low-flux HD. ß2-microglobulin was removed only with high-flux HD, which had an excellent tolerability. The efficiency of high-flux HD was similar to on-line HDF. Proteomic analysis demonstrated that only high-flux membranes remove and adsorb small proteins. High-flux HD may be an efficient alternative to on-line HDF.

Body Composition Analysis Allows the Prediction of Urinary Creatinine Excretion and of Renal Function in Chronic Kidney Disease Patients.

The aim of this study was to predict urinary creatinine excretion (UCr), creatinine clearance (CCr) and the glomerular filtration rate (GFR) from body composition analysis. Body cell mass (BCM) is the compartment which contains muscle mass, which is where creatinine is generated. BCM was measured with body impedance analysis in 165 chronic kidney disease (CKD) adult patients (72 women) with serum creatinine (SCr) 0.6-14.4 mg/dL. The GFR was measured (99mTc-DTPA) and was predicted using the Modification of Diet in Renal Disease (MDRD) formula. The other examined parameters were SCr, 24-h UCr and measured 24-h CCr (mCCr). A strict linear correlation was found between 24-h UCr and BCM (r = 0.772). Multiple linear regression (MR) indicated that UCr was positively correlated with BCM, body weight and male gender, and negatively correlated with age and SCr. UCr predicted using the MR equation (MR-UCr) was quite similar to 24-h UCr. CCr predicted from MR-UCr and SCr (MR-BCM-CCr) was very similar to mCCr with a high correlation (r = 0.950), concordance and a low prediction error (8.9 mL/min/1.73 m²). From the relationship between the GFR and the BCM/SCr ratio, we predicted the GFR (BCM GFR). The BCM GFR was very similar to the GFR with a high correlation (r = 0.906), concordance and a low prediction error (12.4 mL/min/1.73 m²). In CKD patients, UCr, CCr and the GFR can be predicted from body composition analysis.

ß-trace protein is highly removed during haemodialysis with high-flux and super high-flux membranes.

BACKGROUND: Serum ß-trace protein (ßTP, MW 23-29 kDa) is a marker of GFR impairment in renal patients. Recent papers propose to predict residual renal function (RRF) in maintenance haemodialysis (MHD) patients from serum concentrations of ßTP and other small proteins, avoiding the collection of urine. Few data are available on the removal of ßTP in patients treated with dialysis membranes with different flux characteristics. The aim of this study was to evaluate the effects of haemodialysis with low-flux, high-flux and super high-flux membranes on serum concentrations of ßTP in MHD patients with null RRF. METHODS: Serum ßTP concentrations were measured before and after the first dialysis of the week in 51 MDH patients treated by low-flux (n = 24), high-flux (n = 17), or super high-flux (n = 10) membranes. The removal of ß2-microglobulin (ß2M, MW 11.8), cystatin C (Cys, MW 13.3), urea and creatinine was also analyzed. RESULTS: Low-flux membranes did not remove ßTP, ß2M and Cys whose concentration increased at the end of dialysis. High-flux membrane removed more efficiently ß2M and Cys than ßTP. Super high-flux membrane had the highest efficiency to remove ßTP: mean reduction ratio (RR) 53.4%, similar to ß2M (59.5%), and Cys (62.0%). CONCLUSIONS: In conclusion, the plasma clearance of small proteins and particularly of ßTP is dependent from the permeability of the dialysis membranes Therefore, the reliability of the formulas proposed to predict RRF from serum ßTP and other LMWP may be affected by the different permeability of the dialysis membranes.

Urinary ß-trace protein: A unique biomarker to screen early glomerular filtration rate impairment.

The screening for chronic kidney disease (CKD) patients needs the measurement of serum markers like creatinine. Our previous results indicated that urinary excretion of ß-trace protein (BTP), a low-molecular-weight protein (23-29 kDa), is increased in CKD patients from stage 2. The aim of this study was to assess the major determinants of urinary excretion of BTP and to evaluate its feasibility as noninvasive marker of glomerular filtration rate (GFR) impairment.We studied 355 CKD patients (198 males), aged 15 to 83 years, in stable clinical conditions, classified in the different stages of CKD on the basis of GFR (renal clearance of Tc-diethylenetriamine penta-acetic acid). At the same time, we measured serum and urinary creatinine and BTP, and urinary albumin. Urinary excretion of BTP and albumin was expressed as mg/g urinary creatinine. Fractional clearance of BTP was calculated as the ratio of BTP clearance to creatinine clearance (%).Urinary excretion of BTP is mainly determined by its serum concentration and by the level of GFR, and to a lower extent by urinary albumin excretion. In fact, urinary BTP (U-BTP) and fractional clearance of BTP progressively and significantly increased along with the reduction of GFR and the concurrent rise in serum BTP (S-BTP). The relationship of U-BTP with GFR was very similar to that of S-BTP with GFR: U-BTP mirrors S-BTP. The accuracy of U-BTP to screen patients with GFR <90 mL/min/1.73 m was good (area under the curve 0.833), its sensitivity was 76.9%, specificity 80%, and positive predictive value 84.9%. Sensitivity of U-BTP was quite similar to that of S-BTP and serum creatinine.The major determinants of urinary excretion of BTP are S-BTP and GFR. U-BTP may be a suitable noninvasive marker to screen the general population for detection of GFR <90 mL/min/1.73 m.

Effects of anthropogenic activities in a Mediterranean coastland: the case study of the Falerno-Domitio littoral in Campania, Tyrrhenian Sea (southern Italy).

The environmental status of the Falerno-Domitio littoral, a sector of the Italian south coast (Campania region) locally affected by an extensive anthropic pressure and pollution, was assessed by a multi-disciplinary approach, consisting of geological vs. biological studies. Geochemical abundance of potentially hazardous trace metals in beach sands is mainly constrained by the nature of the source rocks. Geochemical data of marine sediment quality with regards to possible heavy metal pollution and the enrichment factors of selected potentially toxic metals show that Cr and V values are higher in marine samples than in natural sources, suggesting that they are, at least in part, of anthropic derivation. A relationship between meiobenthos and heavy metals (Cr, Co, and V) has been also observed, providing a valuable biological marker to human-deriving chemical pollution. Ecotoxicological analyses confirm a relationship between enrichment in selected metals and moderate toxicity of some sea-bottom sediments closer to the coastline.

A multidisciplinary approach for the characterization of the coastal marine ecosystems of Monte Di Procida (Campania, Italy).

A multidisciplinary survey was carried out on the quality of water and sediments of a coastal protected marine area, embedded between the inputs from Bagnoli steel plant to the south and a sewage plant, Volturno River and Regi Lagni channel to the north. The study integrated chemical-sedimentological data with biological and ecotoxicological analyses to assess anthropogenic pressures and natural variability. Data reveal marked differences in anthropogenic pollution between southeastern and northwestern zone, with the north affected by both inorganic and organic flows and the south influenced by levels of As, Pb and Zn in the sediments above law limits, deriving from inputs of the Bagnoli brownfield site. Meiobenthic data revealed at south higher relative abundance of sensitive species to pollution and environmental stress to the south, i.e. Lobatula lobatula and Rosalina bradyi, whereas to the north relative abundance of stress tolerant Quinqueloculina lata, Quinqueloculina pygmaea and Cribroelphidium cuvilleri were determined.

Outcomes of Vascular Access Care and Surgery Managed by Interventional Nephrologists: A Twelve-Year Experience.

BACKGROUND: Optimizing vascular access outcomes is still a challenge, since 30-60% of arteriovenous fistulas fail or do not mature and catheters are widely used in contemporary patients. METHODS: This study reports on strategies and outcomes in a single center in which access planning, surgery and maintenance are managed by a team of nephrologists. We retrospectively analyzed 305 fistulas and 61 grafts created in 270 consecutive patients between 2002 and 2013. RESULTS: The percentage of patients receiving a fistula or graft who initiated hemodialysis with a mature access was 68.6%. Among prevalent patients, 71.7% used a fistula, 15.7% a graft and 12.6% a catheter. Rates of primary failure and revision before cannulation were 14.4 and 1.6% for fistulas vs. 4.9 and 3.3% for grafts. After maturation, complications (1.040 vs. 0.188 per patient-year (py)) and interventions (0.743 vs. 0.066 per py) were greater for grafts than for fistulas (p < 0.001). Secondary patency did not significantly differ between grafts and fistulas (median survival 34.8 vs. 57.3 months, p = 0.36), unless primary failures were excluded from Kaplan-Meier analysis (median survival 34.9 vs. 70.9 months, p = 0.03). CONCLUSIONS: High fistula prevalence, low access-related morbidity and catheter dependence were achieved using individualized strategies, including mid-forearm or perforating vein fistula creation and selective graft placement in high risk patients. Direct involvement of nephrologists throughout all steps of access care can improve access outcomes, by promoting a patient-centered approach.

Reflectance confocal microscopy for scarring and non-scarring alopecia real-time assessment.

Clinical management of alopecia represents one of the major issues in dermatology. Scalp biopsies are not easily accepted because of the high bleeding and sensitive anatomical area. Trichoscopy is routinely used for diagnosis of alopecia, but in several cases lack to provide sufficient information on the status of the disease. Recently, reflectance confocal microscopy demonstrated its usefulness for the evaluation of several inflammatory skin condition and preliminary reports about alopecia have been proposed in the literature. The aim was to identify the confocal features characterizing scarring and non-scarring alopecia. Reflectance confocal microscopy from 86 patients affected by scarring (28 lichen planopilaris and 9 lupus erythematosus) and non-scarring alopecia (30 androgenic alopecia and 19 alopecia areata), were retrospectively, blinded evaluated. Good concordance between different readers on the confocal criteria has been assessed. Statistical significant features, specific for scarring alopecia and non-scarring alopecia have been identified. In this study, data on reflectance confocal microscopy features useful for the differential diagnosis between scarring and non-scarring alopecia have been identified. Further studies focusing on the use of this non-invasive technique in the therapeutic follow-up and distinction of sub-entities of alopecia are still required.

Impact of hyperhydration on the mortality risk in critically ill patients admitted in intensive care units: comparison between bioelectrical impedance vector analysis and cumulative fluid balance recording.

BACKGROUND: Studies have demonstrated a positive correlation between fluid overload (FO) and adverse outcomes in critically ill patients. The present study aims at defining the impact of hyperhydration on the Intensive Care Unit (ICU) mortality risk, comparing Bioelectrical Impedance Vector Analysis (BIVA) assessment with cumulative fluid balance (CFB) recording. METHODS: We performed a prospective, dual-centre, clinician-blinded, observational study of consecutive patients admitted to ICU with an expected length of ICU stay of at least 72 hours. During observational period (72-120 hours), CFB was recorded and cumulative FO was calculated. At the admission and daily during the observational period, BIVA was performed. We considered FO between 5% and 9.99% as moderate and a FO ≥ 10% as severe. According to BIVA hydration scale of lean body mass, patients were classified as normohydrated (>72.7%-74.3%), mild (>71%-72.7%), moderate (>69%-71%) and severe (≤ 69%) dehydrated and mild (>74.3%-81%), moderate (>81%-87%) and severe (>87%) hyperhydrated. Two multivariate logistic regression models were performed: the ICU mortality was the response variable, while the predictor variables were hyperhydration, measured by BIVA (BIVA model), and FO (FO model). A p-value <0.05 was considered to indicate statistical significance. RESULTS: One hundred and twenty-five patients were enrolled (mean age 64.8 ± 16.0 years, 65.6% male). Five hundred and fifteen BIVA measurements were performed. The mean CFB recorded at the end of the observational period was 2.7 ± 4.1 L, while the maximum hydration of lean body mass estimated by BIVA was 83.67 ± 6.39%. Severe hyperhydration measured by BIVA was the only variable found to be significantly associated with ICU mortality (OR 22.91; 95% CI 2.38-220.07; p < 0.01). CONCLUSIONS: The hydration status measured by BIVA seems to predict mortality risk in ICU patients better than the conventional method of fluid balance recording. Moreover, it appears to be safe, easy to use and adequate for bedside evaluation. Randomized clinical trials with an adequate sample size are needed to validate the diagnostic properties of BIVA in the goal-directed fluid management of critically ill patients in ICU.