Clinical and diagnostic findings in COVID-19 patients: an original research from SG Moscati Hospital in Taranto Italy.

The coronavirus disease 2019 (COVID-19) pandemic is a worldwide medical challenge due to the scarcity of proper information and remedial resources. The ability to efficiently avoid a further SARS-CoV-2 pandemic will, therefore, depend on understanding several factors which include host immunity, virus behavior, prevention measures, and new therapies. This is a multi-phase observatory study conducted in the SG Moscati Hospital of Taranto in Italy that was converted into COVID-19 Special Care Unit for SARS-Co-V2 risk management. Patients were admitted to the 118 Emergency Pre-Hospital and Emergency Department based on two diagnostic criteria, the nasopharyngeal swab assessed by reverse-transcriptase-polymerase-chain-reaction (RT-PCR) and CT-scan image characterized by ground glass opacity. Patients were divided into four groups, positive-positive (ER-PP), negative-positive (ER-NP), negative-negative (ER-NN) and a group admitted to the ICU (ER-IC). A further control group was added when the T and B lymphocyte subsets were analyzed. Data included gender, age, vital signs, arterial blood gas analysis (ABG), extensive laboratory results with microbiology and bronchoalveolar lavage fluid (BALF) which were analyzed and compared. Fundamental differences were reported among the groups. Males were significantly higher in PP, ICU, and NP groups, from 2 to 4-fold higher than females, while in the NN group, the number of females was mildly higher than males; the PP patients showed a marked alkalotic, hypoxic, hypocapnia ABG profile with hyperventilation at the time of admission; finally, the laboratory and microbiology results showed lymphopenia, fibrinogen, ESR, CRP, and eGFR were markedly anomalous. The total number of CD4+ and CD8+ T cells was dramatically reduced in COVID-19 patients with levels lower than the normal range delimited by 400/µL and 800/µL, respectively, and were negatively correlated with blood inflammatory responses.

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.

Lower serum magnesium levels are associated with more rapid decline of renal function in patients with diabetes mellitus type 2.

AIMS: Hypomagnesemia has been implicated in adversely affecting diabetic complications. This is a retrospective study designed to determine whether there is any association between serum magnesium concentration [Mg2+] and the rate of renal function deterioration, as determined by the slope of serum creatinine reciprocals versus time (1/SCr-vs-t), in patients with diabetes mellitus type 2 (DM2). MATERIALS AND METHODS: DM2 patients without known kidney disease seen at Olive View-UCLA Medical Center for any reason during January-March 2001 were included. For each patient, all available data from our electronic database for [Mg2+], hemoglobin A(1C) (HbA(1C), serum creatinine (SCr), lipid profiles, routine urinary analysis, as well as history of hypertension and pharmacy profiles were retrieved. The average of all parameters obtained and linear regression analyses for the slope of 1/SCr-vs-t plot were performed for each patient. Patients were stratified by gender and divided into four groups based on increasing [Mg2+]. Correlations between each parameter including the slope of 1/SCr-vs-t and the four magnesium groups were analyzed. RESULTS: 252 males and 298 females with a mean follow-up of 62.6 +/- 22.5 months were included. Patients belonging to lower [Mg2+] groups for both genders had significantly worse slopes of 1/SCr-vs-t plot independent of the presence of hypertension and use of ACEI/ARB, diuretics, HMG-CoA enzyme inhibitors or aspirin. In a multivariate regression analysis controlling for age, HbA(1C) and various components of the lipid profile, [Mg2+] remained an independent predictor for the slope of 1/SCr-vs-t. A trend for worse proteinuria based on routine urinary analysis was observed among patients belonging to the lowest [Mg2+] group. CONCLUSIONS: Lower [Mg2+] is associated with a faster renal function deterioration rate in DM2 patients.

Two-year outcome of first-line antiretroviral therapy among HIV-1 vertically-infected children in Hanoi, Vietnam.

A retrospective analysis of 86 HIV-1 vertically-infected Vietnamese children with a follow-up period >24 months after initiating antiretroviral therapy (ART) was performed from 2008 to 2012, to assess the outcome of first-line ART in resource-limited settings. Of the 86 children, 68 (79.1%) were treated successfully (plasma HIV-1 viral load [VL] <1000 copies/ml), and 63 (73.3%) had full viral suppression (VL <400 copies/ml) after 24 months of ART. No significant difference between successfully treated patients and failure groups was observed in VL, CD4(+) T-cell count or clinical stage at baseline; age at ART start; or ART regimen. All 14 children with VL >5000 copies/ml, one of four children with VL 1000-5000 copies/ml and none with VL <1000 copies/ml developed reverse transcriptase inhibitor (RTI)-resistance mutations by 24 months of ART. Y181C and M184V/I were the most dominant non-nucleoside and nucleoside RTI-resistance mutations, respectively (13/15, 86.7%). These findings suggest that VL testing after 24 months of ART can be used to efficiently differentiate ART failures among HIV-1 vertically-infected children in resource-limited settings.

gamma-secretase cleavage is distinct from endoplasmic reticulum degradation of the transmembrane domain of the amyloid precursor protein.

One of the critical cleavage events that generates Alzheimer's amyloid Abeta peptide occurs within the transmembrane domain (TMD) of the amyloid precursor protein (APP) and is carried out by a poorly understood enzyme activity known as gamma-secretase. To investigate this processing, a probe molecule, H26-57C, was constructed containing the TMD of APP flanked immediately on each side by unique epitope tags. H26-57C-transfected cells secrete a approximately 2.9-kDa fragment, indicating that the lumenal and cytosolic domains of APP are not required for gamma-secretase processing. Pulse-chase experiments indicate that the probe turns over with a half-life of 8 min. No degradation intermediates are detected during the chase period, indicating that TMD turnover is a highly processive mechanism. The protease inhibitors, ALLN and MG132, cause a dramatic (50-fold) increase in the steady-state amount of the probe. All of the inhibitors that prevent degradation of the probe in the rough endoplasmic reticulum increase the amount of the approximately 2.9-kDa fragment that is secreted into the media and also causes a similar increase the secretion of 4 kDa Abeta from APP-transfected cells. These results indicate that the system responsible for the degradation of the probe in the rough endoplasmic reticulum and the intramembrane cleavage by gamma-secretase that produces soluble, secreted Abeta are distinct and opposing processes.

Training effects on the regional blood flow response to exercise in myocardial infarcted rats.

The regional blood flow (BF) response to submaximal exercise was determined for sedentary and trained myocardial infarcted (MI) rats. Training consisted of treadmill running (10% grade, 30 m/min) for 1 h/day, 5 days/wk for 12-14 wk and produced decreases in resting heart rate and increases in maximal O2 uptake and endurance capacity. BF determined at 2 and 6 min of exercise (via radiolabeled microspheres) demonstrated that trained rats maintained greater BF to organs found in the abdominal region when compared with their sedentary counterparts. BF to the total hindlimb musculature at 2 min of exercise was greater in sedentary rats when compared with their trained counterparts and was the consequence of greater BF to 10 of the 27 muscle or muscle parts investigated. At 6 min of exercise, BF to the total hindlimb musculature was similar between trained and sedentary rats, as BF in 9 of 27 muscles or muscle parts investigated decreased from 2 to 6 min of exercise for the sedentary group. In general, the BF patterns within and among the individual muscles of the hindlimb were different between the two groups. Trained rats tended to maintain greater BF to the predominantly red muscles, whereas the sedentary rats maintained greater BF to the predominantly white muscles at 6 min of exercise. In conclusion, the training-induced changes in BF found in this study are similar to those found previously for normal rats, and they demonstrate that endurance training produces changes in the regional distribution of BF during exercise in MI rats.

Molecular analysis of beta-thalassemia in South Vietnam.

The high prevalence of beta-thalassemia in Southeast Asia is a major public health problem. Development of genetic counseling and prenatal diagnosis programs is a priority. To provide the groundwork for such programs in South Vietnam, we determined the spectrum of beta-thalassemia mutations in 35 severely affected patients and their relatives. We identified six different beta-thalassemia alleles (five beta(0) and one beta(+) mutations), in addition to the common mutation at codon 26 (GAG --> AAG) responsible for Hb E. These data provide insights into the distribution of beta-thalassemia alleles in the Vietnamese population.

Arsenic contamination of groundwater and drinking water in Vietnam: a human health threat.

This is the first publication on arsenic contamination of the Red River alluvial tract in the city of Hanoi and in the surrounding rural districts. Due to naturally occurring organic matter in the sediments, the groundwaters are anoxic and rich in iron. With an average arsenic concentration of 159 micrograms/L, the contamination levels varied from 1 to 3050 micrograms/L in rural groundwater samples from private small-scale tubewells. In a highly affected rural area, the groundwater used directly as drinking water had an average concentration of 430 micrograms/L. Analysis of raw groundwater pumped from the lower aquifer for the Hanoi water supply yielded arsenic levels of 240-320 micrograms/L in three of eight treatment plants and 37-82 micrograms/L in another five plants. Aeration and sand filtration that are applied in the treatment plants for iron removal lowered the arsenic concentrations to levels of 25-91 micrograms/L, but 50% remained above the Vietnamese Standard of 50 micrograms/L. Extracts of sediment samples from five bore cores showed a correlation of arsenic and iron contents (r2 = 0.700, n = 64). The arsenic in the sediments may be associated with iron oxyhydroxides and released to the groundwater by reductive dissolution of iron. Oxidation of sulfide phases could also release arsenic to the groundwater, but sulfur concentrations in sediments were below 1 mg/g. The high arsenic concentrations found in the tubewells (48% above 50 micrograms/L and 20% above 150 micrograms/L) indicate that several million people consuming untreated groundwater might be at a considerable risk of chronic arsenic poisoning.