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The scientific literature reports on various approaches to regional frequency analysis (RFA) of rainfall extremes. Traditional regional models usually refer to a single time-aggregation interval. They are developed for medium-to-small and climatically and morphologically homogeneous regions, which leads to higher accuracy, yet limits the models' exportability. We propose a different and innovative approach to RFA of rainfall extremes; it consists of ensembles of unsupervised artificial neural networks (ANNs), predicting the parameters of a Gumbel distribution for dimensionless (i.e. standardized by the local value of the mean annual maximum rainfall depth) annual maximum rainfall depths at any location in the study area and for any time-aggregation interval in the 1-24 hours range. Predictions are based on several morpho-climatic descriptors, used as covariates of precipitation extremes, and the applicability of the models extends to a large and morphologically as well as climatically heterogeneous region (Western and Central Northern Italy). ANNs are trained on over 2300 Annual Maximum Series of rainfall depths collected between 1928 and 2011 and associated with five hourly time-aggregation intervals. Based on a comprehensive analysis of predictions obtained at 100 randomly selected validation points, we discuss the potential and drawbacks of ensembles of unsupervised ANNs for integrated (i.e., across various time-aggregation intervals) and multivariate (i.e., considering numerous morphoclimatic covariates) RFA of sub-daily rainfall extremes., The 28th IUGG General Assembly (IUGG2023) (Berlin 2023)

The Bocca delle Menate archaeological site is located in Comacchio town (FE) and provides important evidence of the Roman presence in the Po Delta (Italy). The excavations realized sixty years ago have confirmed the presence of an extensive Roman villa and some part of it was highlighted. With the aim to identify the villa plan and the old highlighted archaeological remains, an archaeological preliminary survey and a geomagnetic geophysical campaign were carried out in October 2020. Although geophysical methods are now considered the best tools for archaeological detections, our results show that they are also excellent tools for the preservation, protection and monitoring of the excavated archaeological heritage.

Results obtained with a new very compact detector for imaging with a matrix of Leak Microstructures (LM)are reported. Spatial linearity and spatial resolution obtained by scanning as well as the detection of alpha particles with 100% efficiency, when compared with a silicon detector, are stressed. Preliminary results recently obtained in detecting single electrons emitted by heated filament (Ec < 1 eV) at 1-3 mbar of propane are reported., 5 pages, 11 figures

Aim This study aimed at evaluating the cost-effectiveness of different non-invasive imaging-guided strategies for the diagnosis of obstructive coronary artery disease (CAD) in a European population of patients from the Evaluation of Integrated Cardiac Imaging in Ischemic Heart Disease (EVINCI) study. Methods and results Cost-effectiveness analysis was performed in 350 patients (209 males, mean age 59 ± 9 years) with symptoms of suspected stable CAD undergoing computed tomography coronary angiography (CTCA) and at least one cardiac imaging stress-test prior to invasive coronary angiography (ICA) and in whom imaging exams were analysed at dedicated core laboratories. Stand-alone stress-tests or combined non-invasive strategies, when the first exam was uncertain, were compared. The diagnostic end-point was obstructive CAD defined as > 50% stenosis at quantitative ICA in the left main or at least one major coronary vessel. Effectiveness was defined as the percentage of correct diagnosis (cd) and costs were calculated using country-specific reimbursements. Incremental cost-effectiveness ratios (ICERs) were obtained using per-patient data and considering “no-imaging” as reference. The overall prevalence of obstructive CAD was 28%. Strategies combining CTCA followed by stress ECHO, SPECT, PET, or stress CMR followed by CTCA, were all cost-effective. ICERs values indicated cost saving from − 969€/cd for CMR-CTCA to − 1490€/cd for CTCA-PET, − 3092€/cd for CTCA-SPECT and − 3776€/cd for CTCA-ECHO. Similarly when considering early revascularization as effectiveness measure. Conclusion In patients with suspected stable CAD and low prevalence of disease, combined non-invasive strategies with CTCA and stress-imaging are cost-effective as gatekeepers to ICA and to select candidates for early revascularization. Electronic supplementary material The online version of this article (10.1007/s10198-019-01096-5) contains supplementary material, which is available to authorized users.

Cardiovascular disease remains a leading cause of morbidity and mortality globally. Changing natural history of the disease due to improved care of acute conditions and ageing population necessitates new strategies to tackle conditions which have more chronic and indolent course. These include an increased deployment of safe screening methods, life-long surveillance, and monitoring of both disease activity and tailored-treatment, by way of increasingly personalized medical care. Cardiovascular magnetic resonance (CMR) is a non-invasive, ionising radiation-free method, which can support a significant number of clinically relevant measurements and offers new opportunities to advance the state of art of diagnosis, prognosis and treatment. The objective of the SCMR Clinical Trial Taskforce was to summarizes the evidence to emphasize where currently CMR-guided clinical care can indeed translate into meaningful use and efficient deployment of resources results in meaningful and efficient use. The objective of the present initiative was to provide an appraisal of evidence on analytical validation, including the accuracy and precision, and clinical qualification of parameters in disease context, clarifying the strengths and weaknesses of the state of art, as well as the gaps in the current evidence This paper is complementary to the existing position papers on standardized acquisition and post-processing ensuring robustness and transferability for widespread use. Themed imaging-endpoint guidance on trial design to support drug-discovery or change in clinical practice (part II), will be presented in a follow-up paper in due course. As CMR continues to undergo rapid development, regular updates of the present recommendations are foreseen. ispartof: J Cardiovasc Magn Reson vol:20 issue:1 pages:67- ispartof: location:England status: Published online

Realizing Refsdal's original idea from 1964, we present estimates of the Hubble constant that are complementary to and potentially competitive with those of other cosmological probes. We use the observed positions of 89 multiple images, with extensive spectroscopic information, from 28 background sources and the measured time delays between the images S1-S4 and SX of supernova "Refsdal" ($z = 1.489$), which were obtained thanks to Hubble Space Telescope (HST) deep imaging and Multi Unit Spectroscopic Explorer (MUSE) data. We extend the strong lensing modeling of the Hubble Frontier Fields (HFF) galaxy cluster MACS J1149.5$+$2223 ($z = 0.542$), published by Grillo et al. (2016), and explore different $��$CDM models. Taking advantage of the lensing information associated to the presence of very close pairs of multiple images at various redshifts and to the extended surface brightness distribution of the SN Refsdal host, we can reconstruct the total mass density profile of the cluster very precisely. The combined dependence of the multiple image positions and time delays on the cosmological parameters allows us to infer the values of $H_{0}$ and $��_{\rm m}$ with relative (1$��$) statistical errors of, respectively, 6% (7%) and 31% (26%) in flat (general) cosmological models, assuming a conservative 3% uncertainty on the final time delay of image SX and, remarkably, no priors from other cosmological experiments. Our best estimate of $H_{0}$, based on the model described in this work, will be presented when the final time-delay measurement becomes available. Our results show that it is possible to utilize time delays in lens galaxy clusters as an important alternative tool for measuring the expansion rate and the geometry of the Universe., 9 pages, 3 figures, 2 tables; accepted for publication in The Astrophysical Journal

We encode the problem of learning the optimal decision tree of a given depth as an integer optimization problem. We show experimentally that our method (DTIP) can be used to learn good trees up to depth 5 from data sets of size up to 1000. In addition to being efficient, our new formulation allows for a lot of flexibility. Experiments show that we can use the trees learned from any existing decision tree algorithms as starting solutions and improve the trees using DTIP. Moreover, the proposed formulation allows us to easily create decision trees with different optimization objectives instead of accuracy and error, and constraints can be added explicitly during the tree construction phase. We show how this flexibility can be used to learn discrimination-aware classification trees, to improve learning from imbalanced data, and to learn trees that minimise false positive/negative errors.

We present a high resolution dissection of the two-dimensional total mass distribution in the core of the Hubble Frontier Fields galaxy cluster MACS J0416.1-2403, at z ~ 0.396. We exploit HST/WFC3 near-IR (F160W) imaging, VLT/MUSE spectroscopy, and Chandra data to separate the stellar, hot gas, and dark-matter mass components in the inner 300 kpc of the cluster. We combine the recent results of our refined strong lensing analysis, which includes the contribution of the intracluster gas, with the modeling of the surface brightness and stellar mass distributions of 193 cluster members, of which 144 are spectroscopically confirmed. We find that moving from 10 to 300 kpc from the cluster center the stellar to total mass fraction decreases from 12% to 1% and the hot gas to total mass fraction increases from 3% to 9%, resulting in a baryon fraction of approximately 10% at the outermost radius. We measure that the stellar component represents ~ 30%, near the cluster center, and 15%, at larger clustercentric distances, of the total mass in the cluster substructures. We subtract the baryonic mass component from the total mass distribution and conclude that within 30 kpc (~ 3 times the effective radius of the BCG) from the cluster center the surface mass density profile of the total mass and global (cluster plus substructures) dark-matter are steeper and that of the diffuse (cluster) dark-matter is shallower than a NFW profile. Our current analysis does not point to a significant offset between the cluster stellar and dark-matter components. This detailed and robust reconstruction of the inner dark-matter distribution in a larger sample of galaxy clusters will set a new benchmark for different structure formation scenarios., Comment: 11 pages, 4figures Accepted on Apj

Dermoscopy features of pigmented epithelioid melanocytoma have not been described up to now.

Background— The choice of imaging techniques in patients with suspected coronary artery disease (CAD) varies between countries, regions, and hospitals. This prospective, multicenter, comparative effectiveness study was designed to assess the relative accuracy of commonly used imaging techniques for identifying patients with significant CAD. Methods and Results— A total of 475 patients with stable chest pain and intermediate likelihood of CAD underwent coronary computed tomographic angiography and stress myocardial perfusion imaging by single photon emission computed tomography or positron emission tomography, and ventricular wall motion imaging by stress echocardiography or cardiac magnetic resonance. If ≥1 test was abnormal, patients underwent invasive coronary angiography. Significant CAD was defined by invasive coronary angiography as >50% stenosis of the left main stem, >70% stenosis in a major coronary vessel, or 30% to 70% stenosis with fractional flow reserve ≤0.8. Significant CAD was present in 29% of patients. In a patient-based analysis, coronary computed tomographic angiography had the highest diagnostic accuracy, the area under the receiver operating characteristics curve being 0.91 (95% confidence interval, 0.88–0.94), sensitivity being 91%, and specificity being 92%. Myocardial perfusion imaging had good diagnostic accuracy (area under the curve, 0.74; confidence interval, 0.69–0.78), sensitivity 74%, and specificity 73%. Wall motion imaging had similar accuracy (area under the curve, 0.70; confidence interval, 0.65–0.75) but lower sensitivity (49%, P P P Conclusions— In a multicenter European population of patients with stable chest pain and low prevalence of CAD, coronary computed tomographic angiography is more accurate than noninvasive functional testing for detecting significant CAD defined invasively. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT00979199.

Objective The aim of this paper was to assess the efficacy of process-based cognitive training (pb-CT) combined with reminiscence therapy (RT) in patients with mild Alzheimer's disease (mAD) and mild cognitive impairment (MCI) and in healthy elderly (HE) subjects. Methods This multicenter, randomized, controlled trial involved 348 participants with mAD, MCI, and HE from four European countries. Participants were randomly assigned to two arms of a crossover design: those in arm A underwent 3 months of computerized pb-CT for memory and executive functions combined with RT and 3 months of rest; those in arm B underwent the reverse. The primary outcome was the effect of the training on memory and executive functions performance. The secondary outcome was the effect of the training on functional abilities in mAD assessed with the instrumental activities of daily living. Results We found a significant effect of the training for memory in all three groups on delayed recall of the Rey Auditory Verbal Learning Test and for executive functions in HE on the phonological fluency test. MCI and HE participants maintained these effects at follow-up. MCI and mAD participants also showed a significant effect of the training on the Mini-mental state examination scale. Participants with mAD showed more stable instrumental activities of daily living during the training versus the rest period. Conclusions Our results corroborate the positive effect of pb-CT and its maintenance primarily on memory in HE and MCI participants that did not seem to be potentiated by RT. Moreover, our results are very promising for the mAD participants. Copyright © 2015 John Wiley & Sons, Ltd.

International audience; The term ‘athlete's heart’ refers to a clinical picture characterized by a slow heart rate and enlargement of the heart. A multi-modality imaging approach to the athlete's heart aims to differentiate physiological changes due to intensive training in the athlete's heart from serious cardiac diseases with similar morphological features. Imaging assessment of the athlete's heart should begin with a thorough echocardiographic examination. Left ventricular (LV) wall thickness by echocardiography can contribute to the distinction between athlete's LV hypertrophy and hypertrophic cardiomyopathy (HCM). LV end-diastolic diameter becomes larger (\textgreater55 mm) than the normal limits only in end-stage HCM patients when the LV ejection fraction is \textless50%. Patients with HCM also show early impairment of LV diastolic function, whereas athletes have normal diastolic function. When echocardiography cannot provide a clear differential diagnosis, cardiac magnetic resonance (CMR) imaging should be performed. With CMR, accurate morphological and functional assessment can be made. Tissue characterization by late gadolinium enhancement may show a distinctive, non-ischaemic pattern in HCM and a variety of other myocardial conditions such as idiopathic dilated cardiomyopathy or myocarditis. The work-up of athletes with suspected coronary artery disease should start with an exercise ECG. In athletes with inconclusive exercise ECG results, exercise stress echocardiography should be considered. Nuclear cardiology techniques, coronary cardiac tomography (CCT) and/or CMR may be performed in selected cases. Owing to radiation exposure and the young age of most athletes, the use of CCT and nuclear cardiology techniques should be restricted to athletes with unclear stress echocardiography or CMR

*Square Project: V.M. Agate (Palmanova, UD), A.M. Anelli (Pistoia), L. Apicella (Salerno), D. Avino (Vairano Scalo, CE), Y. Battaglia (Ferrara), P.L. Bedani (Ferrara), G. Bellinghieri (Messina), A.M. Bernardi (Rovigo), C. Bonifati (Corato, BA), M. Borzumati (Verbania), P.L. Botti (Mantova), M. Brigante (Campobasso), F. Brighina (San Nicola La Strada, CE), P. Calzavara (Conegliano, TV), C. Caputo (Albenga, SV), F. Cardone (Lavello, PZ), F. Cavatorta (Imperia), N. Confessore (Scafati, SA), M. Cossu (Sassari), E. Costantino (Gavardo, BS), G. Costantino (Messina), L. D’Apice (Caserta), R. D’Arcangelo (Arzano, NA), F. Dagostino (Corato, BA), A. Dal Canton (Pavia), G. Delgado (Teano, CE), R. Di Pietro (Napoli), C. Esposito (Pavia), P. Esposito (Pavia), E. Fasianos (Altamura, BA), F. Fiorini (Rovigo), P. Galeotti (Viterbo), G. Garibotto (Genova), A. Gemelli (Rovigo), M.C. Gregorini (Reggio Emilia), P. Iuliano (Benevento), L. La Peccerella (Benevento), M. Liuzzi (Benevento), M. Merola (Sorrento, NA), C. Montesano (Imperia), L.F. Morrone (Benevento), M. Napoli (Galatina, LE), F. Napolitano (Corato, BA), S. Paglia (Lavello, PZ), M. Parravano (Sora, FR), S. Pasquali (Reggio Emilia), A. Rosa (Benevento), M.L. Sambati (Taranto), P. Schiavone (Brindisi), E. Sozzo (Galatina, LE), A. Storari (Ferrara), R. Tarchini (Mantova), G. Tirino (Montesarchio, BN), L. Turchetta (Sora, FR). School Project: G. Bellinghieri (Messina), G. Beltrame (Torino), M. Bozzi (Bari), E. Casolino (Rionero in Vulture, PZ), E. Centrone (Ruvo di Puglia, BA), M. Ciccarelli (Reggio Calabria), T. Cicchetti (Rossano, CS), C. Colturi (Sondrio), E. Costantino (Gavardo, BS), G. Costantino (Messina), F. Dagostino (Corato, BA), E. Fasianos (Altamura, BA), P. Galeotti (Viterbo), Garibotto (Genova), F. Indraccolo (S. Fermo della Battaglia, CO), M. Lombardi (Borgo S. Lorenzo, FI), C. Minoretti (S. Fermo della Battaglia, CO), F. Napolitano (Corato, BA), R. Parsi (Alcamo, TP), F. Petrarulo (Bari), E. Prati (Desenzano del Garda, BS), F. Quarello (Torino), V. Rondanini (Palmi, RC), D. Russo (Barletta), P. Tira (Manerbio, BS), S. Turina (Manerbio, BS), W.D. Valentini (Rieti) WORLD KIDNEY DAY

Previous studies have highlighted the associations between abdominal, cardiac or total fat accumulation and cardiovascular disease. The aim of this study was to investigate the impact of different ectopic fat depots on measurements of metabolic dysfunction and cardiovascular disease risk.Using magnetic resonance imaging in 113 subjects, we measured abdominal (visceral and subcutaneous) and cardiac (epicardial and extra-pericardial) fat depots and examined their association with overall (BMI) and abdominal obesity (waist circumference), dyslipidaemia (triglycerides, total and HDL cholesterol), glucose tolerance (by an oral glucose tolerance test) and insulin sensitivity, blood pressure and 10-year coronary heart disease risk by Framingham score.Fat accumulation was proportional to the degree of obesity, with body fat ranging from 14 to 33 kg, visceral fat from 0.8 to 1.8 kg and cardiac fat from 134 to 236 g. Most cardiac fat (70% on average) was extra-pericardial, with a wide variability for both cardiac depots (epicardial: 172-2008 mm(2); extra-pericardial: 100-5056 mm(2)). Only visceral and extra-pericardial fat, but not epicardial or subcutaneous fat, could discriminate between subjects with three or more factors of the metabolic syndrome or medium-to-high coronary heart disease risk score. Controlling for gender and BMI by multivariable analysis, the best marker of reduced insulin sensitivity was visceral fat (partial r = -0.35); extra-pericardial fat was the closest associate of increased blood pressure (partial r = 0.26) and both extra-pericardial and visceral fat clustered with hypertriglyceridaemia (partial r = 0.29 and 0.24; both P0.02).Increased epicardial fat per se does not necessarily translate into presence or prediction of disease. In contrast, increased deposition of visceral abdominal and extra-pericardial mediastinal fat are both associated with an enhanced cardiovascular disease risk profile.

ObjectivesThe purpose of this study was to assess the frequency, manifestation, and severity of acute adverse reactions associated with administration of several gadolinium-based contrast agents to patients who underwent cardiac magnetic resonance (CMR) imaging in the EuroCMR (European Cardiovascular Magnetic Resonance) Registry multinational and multicenter setting.BackgroundThe frequency, manifestations, and severity of acute adverse reactions associated with gadolinium-based contrast agents in the specific setting of cardiovascular magnetic resonance have not been systematically evaluated yet.MethodsThis is a multicenter and multinational registry with consecutive enrollment of patients in 45 European centers. During the current observation, 17,767 doses of gadolinium-based contrast agent were administered to 17,767 patients. The mean dose was 25.6 ml (range 5 to 80 ml), which is equivalent to 0.128 mmol/kg (range 0.012 to 0.3 mmol/kg).ResultsThirty acute adverse reactions due to contrast administration occurred (0.17%). All reactions were classified as mild according to the American College of Radiology definition. The most frequent complaints following contrast administration were rashes and hives (9 of 30), followed by nausea (7 of 30), and anxiety (6 of 30). The event rate ranged from 0.06% (linear nonionic agent gadodiamide) to 0.47% (linear ionic agent gadobenate dimeglumine). Interestingly, we also found different event rates between the three main indications for CMR imaging, ranging from 0.1% (risk stratification in suspected coronary artery disease) to 0.42% (viability in known coronary artery disease).ConclusionsThe incidence of acute adverse reactions after administration of gadolinium-based contrast in the “off-label” setting of CMR in our population was not different from the incidence in the U.S. Food and Drug Administration–approved general radiology setting. Thus, the off-label use of gadolinium-based contrast in CMR should be regarded as safe concerning the frequency, manifestation, and severity of acute events.