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Background: The combination of atezolizumab-bevacizumab has been proven to be superior to sorafenib for the treatment of unresectable hepatocellular carcinoma not amenable to locoregional treatments, be-coming the standard of care of systemic therapy.Aim: This study aimed at assessing real-world feasibility of atezolizumab-bevacizumab in patients treated with tyrosine-kinase inhibitors.Methods: Among 1447 patients treated with tyrosine-kinase inhibitors from January 2010 to December 2020, we assessed the percentage of those potentially eligible to atezolizumab-bevacizumab (according to IMbrave-150 trial criteria), and the overall survival of eligible and non-eligible patients.Results: 422 (29%) patients were qualified for atezolizumab-bevacizumab therapy. The main exclusion causes were Child-Pugh class and Performance Status. Adopting the more permissive inclusion criteria of SHARP trial, 535 patients became eligible. The median overall survival of tyrosine-kinase inhibitors patients was 14.9 months, longer in eligible patients than in their counterpart due to better baseline liver function and oncological features.Conclusion: Real-world data indicate that less than one-third of hepatocellular carcinoma patients treated with tyrosine-kinase inhibitors are potentially eligible to atezolizumab-bevacizumab according to the reg-istration trial criteria. These patients have a longer survival than the non-eligible ones. If the selection criteria of atezolizumab-bevacizumab trial are maintained in clinical practice, tyrosine-kinase inhibitors will remain the most used systemic therapy for hepatocellular carcinoma patients.(c) 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Background & Aims The Pre-TACE-Predict model was devised to assess prognosis of patients treated with trans-arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). However, before entering clinical practice, a model should demonstrate that it performs a useful role. Methods We performed an independent external validation of the Pre-TACE model in a cohort that differs in setting and time period from the one that generated the original model. Data from 826 patients treated with TACE for naïve HCC (2008-2018) were used to assess calibration and discrimination of the Pre-TACE-Predict model. Results The four risk-categories identified by the Pre-TACE-Predict model had gradient monotonicity, with median survivals of 52.0, 36.2, 29.9, and 14.1 months respectively. However, predicted survivals systematically underestimated observed survivals (R2: 0.667). A recalibration was adopted maintaining fixed the prognostic index and modifying the baseline survival function. This resulted in an almost perfect calibration (R2: 0.995) in all the four risk categories. Cox regressions showed that aetiology and macrovascular invasion, included in the Pre-TACE-Predict model, had no prognostic impact in the present study population, and that coefficients for tumour size and multiplicity were overestimated. The c-index was similar to that of the m-HAP-III, but higher than those of HAP, m-HAP-II and the six-and-twelve models. Conclusions The recalibration of Pre-TACE-Predict model improved the estimation of survival probabilities of HCC patients treated with TACE. The highest discriminatory ability of the Pre-TACE-model in comparison to other available models, together with risk stratification and recalibration, makes it the best prognostic tool currently available for these patients.

The prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing globally. This study aimed to determine the prevalence of NAFLD and the probability of liver fibrosis in Italian primary care services.We carried out a population-based and nested case-control study including all individuals aged 18 years and above registered at Italian primary care services. Data were collected from the general practitioners' network from 2010 to 2017. NAFLD cases were identified via the ICD-9-CM and Hepatic Steatosis Index score 36 and were matched each up to 10 controls. Other causes of liver diseases were excluded. The risk of fibrosis was assessed using the FIB-4 and NAFLD fibrosis scores (NFS).NAFLD was present in 9% of the primary care population with high regional variability. Among NAFLD subjects: 25% had diabetes, 10% had chronic kidney disease, 11% had cardiovascular disease and 28% were obese. Furthermore, 30% had at least two comorbidities and 13% had cirrhosis. Once cirrhosis was excluded, the risk of any degree of fibrosis was 13.8% with NFS and 20.5% with FIB-4 in subjects65 years.Even if there is an identification gap in primary care, recorded cases with NAFLD have a high frequency of associated comorbidities. Despite regional variability, a close relation between cirrhosis and NAFLD exists (OR: 3.48, 95% CI: 3.23-3.76). Therefore, the use of non-invasive tests should be promoted in primary care as a useful tool for the early identification of fibrosis risk, independently of evidence of steatosis.

Background and aims: In patients with hepatocellular carcinoma (HCC), macrovascular invasion (MaVI) limits treatment options and decreases survival. Detailed data on the relationship between MaVI extension and patients' characteristics, and its impact on patients' outcome are limited. We evaluated the prevalence and extension of MaVI in a large cohort of consecutive HCC patients, analysing its association with liver disease and tumour characteristics, as well as with treatments performed and patients' survival. Methods: We analysed data of 4774 patients diagnosed with HCC recorded in the Italian Liver Cancer (ITA.LI.CA) database (2008-2018). Recursive partition analysis (RPA) was performed to evaluate interactions between MaVI, clinical variables and treatment, exploring the inter-relationship determining overall survival. Results: MaVI prevalence was 11.1%, and median survival of these patients was 6.0months (95% CI, 5.1-7.1). MaVI was associated with younger age at diagnosis, presence of symptoms, worse Performance Status (PS) and liver function, high alphafetoprotein levels and large HCCs. MaVI extension was associated with worse PS, ascites and greater impairment in liver function. RPA identified patients' categories with different treatment indications and survival, ranging from 2.4months in those with PS>1 and ascites, regardless of MaVI extension (receiving best supportive care in 90.3% of cases), to 14.1months in patients with PS 0-1, no ascites and Vp1-Vp2 MaVI (treated with surgery in 19.1% of cases). Conclusions: MaVI presence and extension, together with PS and ascites, significantly affect patients' survival and treatment selection. The decision tree based on these parameters may help assess patients' prognosis and inform therapeutic decisions.

BACKGROUND AND AIMS Several epidemiological studies have observed an increased risk for nephrolithiasis in patients affected by non-alcoholic fatty liver disease (NAFLD). However, the urinary lithogenic risk profile for patients with NAFLD is currently unknown. METHOD We systematically analysed the urinary metabolic profile of patients affected by NAFLD and liver cirrhosis (LC), followed at the hepatology outpatient clinic of our institution, compared to healthy individuals. A complete metabolic work-up for kidney stone disease was performed in all subjects. Multivariable linear regression models adjusted for age, sex, body mass index, eGFR and diabetes, were applied to assess differences in urinary lithogenic risk factors between healthy individuals and patients affected by NAFLD and LC. RESULTS A total of 42 patients and 12 healthy individuals were included in the analysis. No differences in age, sex and BMI were found among patients affected by NAFLD and LC, whereas the latter were more diabetic (71.4% versus 14.3%). After adjusting for multiple confounders, patients with NAFLD and LC had lower urinary magnesium (−55 mg/24 h; 95% CI −104, −6; P = 0.03 and −63 mg/24 h; 95% CI −121, −6; P = 0.03, respectively) and borderline oxalate (−1.21 mg/24 h; 95% CI −2.42, −0.01; P = 0.05 and −1.42 mg/24 h; 95% CI −2.79, −0.04; P = 0.04, respectively) excretions, compared with healthy controls. Compared with LC patients, NAFLD patients showed higher urinary ammonia (539 mEq/24 h; 95% CI 245, 833; P CONCLUSION Altered urinary ammonia and magnesium excretions seems to be involved in the higher risk for stone formation found in patients with NAFLD. More studies are needed to investigate stone phenotypes and renal handling of ammonia in this setting.

Abdominal pain represents a frequent symptom for referral to emergency departments and/or internal medicine outpatient setting. Similarly, fever, fatigue and weight loss are non-specific manifestations of disease. The present case describes the diagnostic process in a patient with abdominal pain and a palpable abdominal mass. Abdominal ultrasonography confirmed the presence of a mass in the mesogastrium. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) scans oriented toward calcific lymphadenopathies with increased metabolism in the positron emission tomography–computed tomography (PET-CT) scan. Laboratory examinations were inconclusive, although serology for Brucella and the Quantiferon test were positive. After multidisciplinary discussion, the patient underwent surgical excision of the abdominal mass. Histological examination excluded malignancies and oriented toward brucellosis in a patient with latent tuberculosis. The patient was treated with rifampin 600 mg qd and doxycycline 100 mg bid for 6 weeks with resolution of the symptoms. In addition, rifampin was continued for a total of 6 months in order to treat latent tuberculosis. This case underlines the need for a multidisciplinary approach in the diagnostic approach to abdominal lymphadenopathies.

The soil moisture active/passive (SMAP) satellite microwave radiometer has been providing global measurements of L-band thermal emission from Earth since April 2015. Although the radiometer operates in the protected 1400–1427 MHz portion of the radio spectrum, its measurements are still corrupted by either radio frequency interference (RFI) from out-of-band emissions via legal sources or by sources operating in-band illegally. The SMAP radiometer includes a digital backend that enables implementation of multiple ground-based RFI detection and filtering algorithms. This data is used to collect statistics and trends of Earth's RFI environment. This article examines properties of the global RFI environment as observed by SMAP, including information on RFI source properties (obtained from analysis of SMAP multiple detector outputs) and the evolution of the RFI environment in time. Residual RFI contributions after the application of SMAP RFI processing are also examined as preliminary information for the development of future methods to address their effect.

CN006 is the name given by the European Space Agency (ESA) in their reports on radio frequency interference (RFI) to an instance of RFI in the L-band spectral window at 1.413 GHz protected for passive use only. The source of the interference is located east of the Chinese city of Hangzhou in an area with radar installations. Its effect was initially indistinguishable from that of many such RFI sources observed by the ESA's SMOS and NASA's Soil Moisture Active Passive (SMAP) radiometers over China. However, in July 2020, the level of radiation increased dramatically reaching levels exceeding 1700000 K as reported by Soil Moisture and Ocean Salinity (SMOS) becoming the strongest source observed by SMOS. This article describes an analysis of this very strong source (a radar). It provides information to provide insight into an example of a well-defined source of RFI and illustrates the powerful capability of the SMAP radiometer receiver and RFI processing incorporated in it for identifying and understanding interference.

Barrett’s esophagus (BE) and esophagitis share potentially modifiable risk factors such as obesity, smoking, and alcohol. The role of diet on BE and esophagitis is still debated. The objective of this study was to examine the association between some dietary habits and the risk of BE and esophagitis in Italy. A multicenter case–control study involving 1285 individuals was carried out in 12 areas. Patients with a new diagnosis of BE (320) or esophagitis (359) and a group of endoscopic controls (606) were included. Information on personal history and dietary habits was collected using a structured questionnaire. No clear monotonic significant dose–response relationship was found for most of the considered food items. Nevertheless, the most extreme consumption category of red meat, cold cuts, dairy products, and fried foods showed esophagitis risk excesses varying from 19 to 49%. A higher fat rich diet seemed to increase risk by 49% for BE and 94% for esophagitis. A downward tendency in esophagitis (− 27%) and BE risk (− 20%) was found associated with higher frequency of fresh fruit intake. In addition, a statistically significant twofold increased risk for both BE and esophagitis was found for subjects eating late evening snacks more than once every three days in comparison with the lowest intake category (no consumption). BE and esophagitis patients appeared to be more likely than controls to follow a diet rich in fats and poor in fruit and vegetables. Late evening snacks were found to be associated with both disorders.

Sandy beaches are ecosystems often subjected to a variety of pollution sources, including heavy metals and polycyclic aromatic hydrocarbons, largely due to improper human activities. The sandhopper Talitrus saltator s. l. (Montagu, 1808) typically lives on supralittoral shores where it plays an important ecological role. The purpose of this study was to investigate DNA damage levels on hemocytes of T. saltator by means of the Comet assay. Firstly, we tested the sensitivity and reproducibility of the Comet assay on hemocytes of T. saltator after in vitro exposure (1 h) to the genotoxicant methyl methanesulfonate (MMS). The data demonstrated a DNA damage (defined as % DNA tail) related to MMS exposure in a concentration-dependent manner. Next, we carried out the assay on hemocytes of T. saltator that were exposed in vivo (24 h and 7 days) to (a) lead (Pb), (b) benzo(a)pyrene (B(a)P), (c) mixtures of them. Our data on exposure to Pb or B(a)P showed DNA damage on the hemocytes of T. saltator in a concentration-dependent manner, but apparently with a non-synergistic effect of exposure to their mixtures. Our results provide a background for further studies in order to verify the applicability of Comet assay on T. saltator for assessing genotoxicity levels in sandy beaches subjected to pollution.

The catastrophic antiphospholipid syndrome (CAPS) is a lifethreatening disorder characterized by the rapid development of multiple organs/systems thrombosis, in patients with persistently detectable antiphospholipid antibodies. The vascular occlusions predominantly affect small vessels, leading to a disseminated thrombotic microangiopathic syndrome. Most CAPS episodes are related to the presence of a precipitating factor, such as infections and malignant diseases, usually ending up in multiple organ failure. Clinical manifestations may vary according to the extent of the thrombosis, predominantly affecting kidneys, lungs, brain, heart, and skin. Treatment is based on the administration of anticoagulants, corticosteroids, plasma exchange and/or intravenous immunoglobulins. Cyclophosphamide is recommended in CAPS associated with systemic lupus erythematosus. Additionally, rituximab and eculizumab have been used in refractory cases. Overall mortality is still 36.9%, despite recent progress in the therapeutic approach.

Scores in upper GI bleeding (UGIB) are used to stratify death risk and need for hospitalization at admission, but a tool that incorporates dynamic changes during the hospital stay is lacking. We aimed to develop a death risk score that considers changes in clinical status during hospitalization and compare its performance with existing ones.A multicenter cohort study enrolling patients with UGIB in 50 Italian hospitals from January 2014 to December 2015 was conducted. Data were collected and used to develop a risk score using logistic regression analyses. Performance curves (area under the receiver-operating characteristic [AUROC] curves), sensitivities, specificities, positive and negative predictive values, and outcomes classified as low, intermediate, and high death risk were calculated. The score's performance was externally validated and then compared with other scores.We included 1852 patients with nonvariceal UGIB in the development cohort and 912 in the validation cohorts. The new score, which we named the Re.Co.De (rebleeding-comorbidities-deteriorating) score, included 10 variables depicting the changes in clinical conditions while in the hospital. The mortality AUROC curves were .93 (95% confidence interval, .91-.96) in the derivation cohort and .94 (95% confidence interval, .91-.98) in validation cohort. In a comparison of AUROC curves with other scores, the new score showed a significant performance compared with pre- and postendoscopy scores. Patients with low and high scores had 30-day mortality rates of .001% and 48.2%, respectively.The Re.Co.De score has a higher performance for predicting mortality in patients with UGIB compared with other scores, correctly identifying patients at low and high death risk while in the hospital through a dynamic re-evaluation of clinical status.

This paper presents an analysis of Radio Frequency Interference (RFI) in the 1.400-1.427 GHz frequency band. The study considers the sudden and strong increase of interference from a particular emitter in China that has been observed in July 2020 by radiometers from both ESA's SMOS (Soil Moisture Ocean Salinity) and NASA's SMAP (Soil Moisture Active Passive) missions. It provides an example of the characterization of a source of RFI and illustrates the capabilities of the SMAP radiometer receiver and RFI processing incorporated in it to identify and understand interference.

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide and its prevalence is even higher in patients with risk factors such as type 2 diabetes and obesity. Liver biopsy is the gold standard for diagnosis of non-alcoholic steatohepatitis (NASH), particularly for the assessment of fibrosis stage that is a key prognostic factor. Noninvasive methods for assessment of liver fibrosis are a huge need in contemporary hepatology in order to stratify patient's risk of advanced and progressive liver disease. In this perspective different imaging techniques have been developed in last decades and showed high performance in liver fibrosis evaluation. Strengths and weaknesses of all imaging methods are summarized in this review.

The Soil Moisture Active/Passive (SMAP) satellite mission measures Earth’s radiation in the protected portion of the spectrum at 1.413 GHz (L-band) to retrieve geophysical quantities of the surface, such as soil moisture and the frozen/thawed state of the soil. The presence of radio-frequency interference (RFI) in this band is significant and impacts the quality of SMAP measurements. Knowing the location of the sources of RFI is important, because it can help to identify the source itself and also be used to develop strategies to mitigate its impact of the RFI on the data. This paper presents an algorithm that takes advantage of the viewing geometry of SMAP to locate sources of RFI. The results are validated using known locations of RFI sources and by comparison with the measurements of Soil Moisture and Ocean Salinity (SMOS) and Aquarius, two other satellite missions with L-band microwave radiometers operating in the protected band. Comparison with RFI of known location suggests that the algorithm is accurate to 1–2 km. The median distance between the locations reported by SMOS and this algorithm is 2.27 km. A study of the relationship between the localization error and the number of observations of RFI sources shows that the median localization error is about 2 km with 12 observations and about 1 km with 30 observations.

Hepatocellular carcinoma (HCC) is a primary liver tumor derived from metabolic or viral chronic hepatitis, with few treatment options in advanced cases. New biomarkers that allow improving diagnosis and staging are widely desired. Here, we aim to evaluate the performance of Protein Induced by Vitamin K Absence or Antagonist-II (PIVKA-II) in combination with α-fetoprotein (AFP), in the diagnosis of HCC in patients with metabolic or viral hepatitis.We enrolled 60 HCC patients (20 metabolic and 40 viral) and 20 healthy subjects (HS) as negative controls. PIVKA-II, AFP, Matrix metalloproteinase-9 (MMP-9) and Fibroblast growth factor (FGF) serum levels were assessed by immunoassays.AFP and PIVKA-II levels were obviously higher in patients than in HS. AFP displayed a better diagnostic performance than PIVKA-II for viral HCC while PIVKA-II was better for metabolic HCC. The combination of the two biomarkers did not improve the discriminating ability.PIVKA-II may be considered an independent predictor of macrovascular invasion from HCC cells and it can be used to better stratify HCC patients and should be evaluated in prospective studies for early detection of advanced HCC in metabolic subjects.

The important task of deciding and revising frequency allocations at international level falls under the responsibility of the World Radiocommunication Conference (WRC) which is organized by a specialized agency of the United Nations, the Radiocommunications Sector of the International Telecommunications Union (ITU-R). A WRC is held every approximately four years for the purpose of updating the international Radio Regulations (RR). The most recent of these conferences, WRC-19, held at the end of 2019, also defined the Agenda Items for the next WRC that is scheduled to occur in 2023. Here, we review and discuss the WRC-23 Agenda Items that are likely to have the most impact on future remote sensing operations.

Barrett's esophagus (BE) and esophagitis share potentially modifiable risk factors such as obesity, smoking, and alcohol. The role of diet on BE and esophagitis is still debated.The objective of this study was to examine the association between some dietary habits and the risk of BE and esophagitis in Italy.A multicenter case-control study involving 1285 individuals was carried out in 12 areas. Patients with a new diagnosis of BE (320) or esophagitis (359) and a group of endoscopic controls (606) were included. Information on personal history and dietary habits was collected using a structured questionnaire.No clear monotonic significant dose-response relationship was found for most of the considered food items. Nevertheless, the most extreme consumption category of red meat, cold cuts, dairy products, and fried foods showed esophagitis risk excesses varying from 19 to 49%. A higher fat rich diet seemed to increase risk by 49% for BE and 94% for esophagitis. A downward tendency in esophagitis (- 27%) and BE risk (- 20%) was found associated with higher frequency of fresh fruit intake. In addition, a statistically significant twofold increased risk for both BE and esophagitis was found for subjects eating late evening snacks more than once every three days in comparison with the lowest intake category (no consumption).BE and esophagitis patients appeared to be more likely than controls to follow a diet rich in fats and poor in fruit and vegetables. Late evening snacks were found to be associated with both disorders.

Non-alcoholic fatty liver disease (NAFLD) is a common cause of chronic liver disease and represent a common finding in highly prevalent metabolic disorders (i.e. type 2 diabetes, metabolic syndrome, obesity). Non-alcoholic steatohepatitis (NASH) requires liver biopsy for grading and staging the liver damage by the assessment of steatosis, inflammation and fibrosis. In parallel with the development of numerous 'liquid' biomarkers and algorithms that combine anthropometric and laboratory parameters, innovative hepatic imaging techniques have increasingly been developed to attempt to overcome the need for biopsy, both in diagnosis and staging of NAFLD, and in possible use in the follow-up of the disease. In this review, we focused on the different imaging techniques trying to highlight the strengths and disadvantages of different approaches, particularly for ultrasound techniques, in stratifying liver injury and fibrosis in patients with NAFLD / NASH.

Background Pathogenesis of acute diverticulitis and diverticular bleeding remains poorly defined, and few data compare directly risk factors for these complications. Aims to assess differences in clinical features, lifestyles factors and concurrent drug use in patients with acute diverticulitis and those with diverticular bleeding. Methods Data were obtained from the REMAD Registry, an ongoing 5-year prospective, observational, multicenter, cohort study conducted on 1,217 patients. Patient- and clinical- related factors were compared among patients with uncomplicated diverticular disease, patients with previous acute diverticulitis, and patients with previous diverticular bleeding. Results Age was significantly lower (OR 0.48, 95% CI: 0.34–0.67) and family history of diverticular disease was significantly higher (OR 1.60, 95% CI: 1.11–2.31) in patients with previous diverticulitis than in patients with uncomplicated diverticular disease, respectively. Chronic obstructive pulmonary disease was significantly higher in patients with previous diverticular bleeding as compared with both uncomplicated diverticular disease (OR 8.37, 95% CI: 2.60–27.0) and diverticulitis (OR 4.23, 95% CI: 1.11–16.1). Conclusion This ancillary study from a nationwide Registry showed that some distinctive features identify patients with acute diverticulitis and diverticular bleeding. These information might improve the assessment of risk factors for diverticular complications.

Fair and efficient management of the radio-frequency (RF) spectrum as used by different scientific and commercial services is becoming more and more challenging, and this can have a considerable impact on microwave remote sensing. Here, we provide an overview of those spectrum management aspects relevant to the remote-sensing community, along with an introduction to the actors and processes involved in spectrum regulation, including the World Radiocommunication Conference (WRC).

Ocean salinity and soil moisture are key parameters for understanding the global water cycle, weather, and climate. These parameters are being measured with spaceborne radiometers operating in the L-band window at 1400–1427 MHz. Although man-made activity in this band is prohibited, radio frequency interference (RFI) is still a problem over significant portions of the earth. This paper reports a comparison of the RFI environment in this window as observed by two L-band radiometer systems, Aquarius and Soil Moisture and Ocean Salinity. The observed RFI environment depends on the sources and also on the characteristics of the instrument. Comparing the observations provides insight into the extent of the problem (actual sources), the influence of the instrument on the observation of RFI, and on potential ways of mitigating the effects. As this report shows, the global distribution of RFI is largely consistent between the two instruments, but the details, especially at low levels of RFI, depend on the characteristics of the instrument.

Only a few papers have treated of the relationship between Barrett's esophagus (BE) or erosive esophagitis (E) and coffee or tea intake. We evaluated the role of these beverages in BE and E occurrence.Patients with BE (339), E (462) and controls (619) were recruited. Data on coffee and tea and other individual characteristics were collected using a structured questionnaire.BE risk was higher in former coffee drinkers, irrespective of levels of exposure (cup per day; ⩽1: OR=3.76, 95% CI 1.33-10.6;1: OR=3.79, 95% CI 1.31-11.0; test for linear trend (TLT) P=0.006) and was higher with duration (30 years: OR=4.18, 95% CI 1.43-12.3; TLT P=0.004) and for late quitters, respectively (⩽3 years from cessation: OR=5.95, 95% CI 2.19-16.2; TLT P0.001). The risk of BE was also higher in subjects who started drinking coffee later (age18 years: OR=6.10, 95% CI 2.15-17.3). No association was found in current drinkers, but for an increased risk of E in light drinkers (1 cup per day OR =1.85, 95% CI 1.00-3.43).A discernible risk reduction of E (about 20%, not significant) and BE (about 30%, P0.05) was observed in tea drinkers.Our data were suggestive of a reduced risk of BE and E with tea intake. An adverse effect of coffee was found among BE patients who had stopped drinking coffee. Coffee or tea intakes could be indicative of other lifestyle habits with protective or adverse impact on esophageal mucosa.

Seven types of atmospheric dusts (road dust, soil dust, brake dust, desert dust, pellet ash and coke and certified material NIST1648a – urban dust) have been tested for their genotoxicity on specimens of Echinogammarus veneris , a small aquatic amphipod. Experiments were carried out in vivo , by exposing the animals for 24 h to water containing 25 mg/L of dust. Each dust has been chemically analyzed for ions, elemental carbon, organic carbon and for the soluble and insoluble fractions of elements. Non-specific damages to DNA have been evaluated by the comet test, while oxidative damages have been estimated by coupling the comet test with formamido pyrimidine DNA glycosylase reaction. The animal tissues have been acid digested and analyzed for their elemental content to evaluate the bioaccumulation. All the considered dusts have caused a significant non-specific DNA damage, while the oxidative stress was shown only by dust types containing high concentration of elements. Furthermore, the oxidative damage has shown a positive correlation with the total bio-accumulated elemental concentration. For all the dust samples, the correlation with bio-accumulation in the tissues was more satisfactory for the insoluble fraction than for the soluble fraction of elements. Elements contained in solid particles seem then to be the main responsible bioaccumulation and for the oxidative stress.

Arsenic (As) contamination of freshwater is largely due to geogenic processes, but As is also released into the environment because of improper anthropic activities. The European regulatory limits in drinking water are of 10 μg L−1 As. However, knowledge of the genotoxic effects induced by low doses of As in freshwater environments is still scanty. This study was designed to investigate arsenate (As(V)) and arsenite (As(III)) toxicity and low-dose genotoxicity in Gammarus elvirae, which has proved to be a useful organism for genotoxicity assays in freshwater. As(V) and As(III) toxicity was assessed on the basis of the median lethal concentration, LC(50), while estimates of DNA damage were based on the Comet assay. The G. elvirae LC (50–240 h) value we calculated was 1.55 mg L−1 for As(V) and 1.72 mg L−1 for As(III). Arsenic exposure (240 h) at 5, 10, and 50 µg L−1 of As in assays with either arsenate or arsenite-induced DNA damage in hemocytes of G. elvirae in a concentration-dependent manner. Our study provides a basis for future genotoxic research on exposure to freshwater that contains low levels of arsenic.

Radio Frequency Interference (RFI) is a well-documented problem for passive remote sensing of the Earth at L-band even though the measurements are made in the protected band centered at 1.413 GHz. Consequently, filtering for RFI is an important early step in the processing of measurements made by the SMAP (Soil Moisture Active/Passive) radiometer. However, the filtered data still include regions with suspiciously high antenna temperatures. One possible cause of these “hot spots” is interference not fully detected during RFI filtering. This paper presents some evidence supporting this hypothesis and describes an algorithm to identify these “hot spots” so that they can be removed from the measurements. The impact of removing these “hot spots” is generally small, but evidence is presented that the brightness temperature and soil moisture improve when the hot spots are removed.

The 18.6–18.8 GHz band is utilized extensively for scientific uses. Passive microwave measurements in this frequency range are critical for weather forecasting and studies of climate and environmental impacts. This band, however, is shared with commercial communication systems that operate under the Fixed Satellite Service (FSS). FSS communication is used mostly for satellite TV broadcasting, and by a small number of Very Small Aperture Terminal (VSAT) systems. The Radio Regulations of the International Telecommunication Union (ITU) limit the level of FSS transmitted powers in order to avoid interference to passive sensors that operate under the Earth Exploration Satellite Service (EESS). However, Radio Frequency Interference (RFI) affecting spaceborne microwave radiometers such as WindSat, AMSR2 and GPM-GMI at 18 GHZ has been observed and documented for several years since 2010. Calculations considering sea surface reflection show that the observed RFI is consistent with or higher than what could be expected even from the limited level of transmitted power from the FSS. The IEEE Geoscience and Remote Sensing Society (GRSS) has brought this problem to the attention of the ITU Radiocommunication Sector (ITU-R) Study Groups, in view of impending decisions that could potentially dramatically increase the use of this band by commercial operators. The contributions by IEEE GRSS to ITU-R will be presented and various issues involved will be discussed.

We present a physics-based algorithm for retrieving sea surface salinity from L-band radiometric observations from the NASA SMAP instrument. The model is used to assess the radiometer calibration and its long-term stability and produce salinity products that are evaluated against in situ measurements from the Argo network of drifting floats.

Microwave remote sensing relies on the utilisation of the electromagnetic spectrum, which is becoming a precious commodity due to increasing demand by commercial telecommunication and other radio services. The access to this resource is regulated by the International Telecommunication Union, which periodically holds a World Radiocommunication Conference (WRC) where representatives from different countries meet to define international rules for its use.The next WRC will take place in November 2019, and the Frequency Allocations in Remote Sensing (FARS) Technical Committee of the IEEE Geoscience and Remote Sensing Society (GRSS) has prepared a report discussing the Agenda Items of the conference that are most relevant to remote sensing. This contribution will explain the issues at stake for remote sensing at WRC-19, illustrate the document conclusions and provide suggestions on what remote sensing scientists and engineers can do to become more involved in tackling these issues.

Radio Frequency Interference (RFI) at 18.7 GHz in and around the continental United States observed by passive microwave radiometers such as the Global Precipitation Measurement (GPM) Microwave Imager (GMI) has been noted in multiple publications. A large part of this RFI arises from reflected geosynchronous direct broadcast satellite transmissions. The interference yields surprisingly high artificial brightness temperature values, ranging from a few Kelvin up to over 1000 Kelvin. Some of the highest levels and most direct reflections occur over land from specular reflections from smooth surfaces such as lakes and rivers. Over the ocean surrounding the United States, the reflections are generally less directional, occurring at higher glint angles and often with lower peak levels than over land. The interference corrupts the GMI measurements about 13% of the time over the ocean around the US, and over 5% of the time over the affected land areas.

Background: The diagnosis of Coronavirus disease 2019 (COVID-19) relies on the positivity of nasopharyngeal swab. However, a significant percentage of symptomatic patients may test negative. We evaluated the reliability of COVID-19 diagnosis made by radiologists and clinicians and its accuracy versus serology in a sample of patients hospitalized for suspected COVID-19 with multiple negative swabs. Methods: Admission chest CT-scans and clinical records of swab-negative patients, treated according to the COVID-19 protocol or deceased during hospitalization, were retrospectively evaluated by two radiologists and two clinicians, respectively. Results: Of 254 patients, 169 swab-confirmed cases and one patient without chest CT-scan were excluded. A total of 84 patients were eligible for the reliability study. Of these, 21 patients died during hospitalization; the remaining 63 underwent serological testing and were eligible for the accuracy evaluation. Of the 63, 26 patients showed anti-Sars-Cov-2 antibodies, while 37 did not. The inter-rater agreement was “substantial” (kappa 0.683) between radiologists, “moderate” (kappa 0.454) between clinicians, and only “fair” (kappa 0.341) between radiologists and clinicians. Both radiologic and clinical evaluations showed good accuracy compared to serology. Conclusions: The radiologic and clinical diagnosis of COVID-19 for swab-negative patients proved to be sufficiently reliable and accurate to allow a diagnosis of COVID-19, which needs to be confirmed by serology and follow-up.

Background HCV can lead to both chronic liver disease and B-cell lymphoproliferative disorders. A strong association exists between HCV and mixed cryoglobulinaemia (MC). Methods Anti-nuclear antibodies (ANA), rheumatoid factor Ig-G (RF-IgG), free light chain κ and λ (FLC-κ, FLC-λ) levels and κ/λ ratio were evaluated in 50/420 subjects unexpectedly resulted anti-HCV positive after routine screenings for non-hepathological procedures. Results Three/fifty patients had HCV-RNA undetectable in the serum and were excluded from the analysis. Thirty-nine/fifty patients had laboratory evidence of circulating cryoglobulins without liver disease and MC-related symptoms. Among them, 17 resulted ANA-positive. The mean cryocrit was higher in ANA-positive patients, while no other demographic/clinical differences were observed between the groups. Significantly higher levels of RF-IgG were observed in ANA-positive vs ANA-negative patients. κ and λ FLC were higher in ANA-positive patients. A ROC analysis, based on ANA-positivity vs ANA-negativity, confirmed a high sensitivity and specificity of RF-IgG test. Conclusions Published data concerning MC come mostly from symptomatic vasculitis. We analyzed HCV-patients without MC symptoms, founding cryoglobulins in the majority of them. The increased levels of FR-IgG and FLC in CGs-ANA-positive patients, suggest these test could be used to identify a state of silent autoimmune and/or lymphoproliferative condition before the transition to a frank disease in naive HCV-patients without symptoms of extrahepatic manifestations.

The aim of this study was to investigate the relevance and the robustness of active and passive approaches used in freshwater biomonitoring with the ecologically relevant gammarid amphipod Echinogammarus veneris. To assess the contaminant bioavailability in two rivers of Latium (Central Italy), we measured the genotoxic potential in haemocytes by comet assay and metal bioaccumulation in tissues by analytical methods. We adopted an active strategy of exposure in situ and a passive method of sampling in situ. In the first case, the gammarids were exposed in cages in several sampling sites selected along two rivers, while in the sampling in situ, individuals were collected directly in the same sampling sites and then analyzed. The results indicate that the comet assay carried out on haemocytes from caged individuals proved to be a sensitive tool for freshwater genotoxicity monitoring. However, the sampling in situ is more appropriate for a realistic understanding of the presence of trace metal in E. ...

SummaryWithout thromboprophylaxis, knee arthroscopy (KA) carries a low to moderate risk of venous thromboembolism. Over 5 million arthroscopies are performed worldwide yearly. It was our study objective to assess the efficacy and safety of rivaroxaban for thromboprophylaxis after therapeutic KA. Patients undergoing KA in nine Italian teaching or community hospitals were allocated to once-daily rivaroxaban (10 mg) or placebo for seven days in a phase II, multicentre, double-blind, placebo-controlled randomised trial. The primary efficacy outcome was a composite of all-cause death, symptomatic thromboembolism and asymptomatic proximal DVT at three months; major bleeding represented the primary safety outcome. All patients underwent whole-leg ultrasonography at day 7(+1), or earlier if symptomatic. A total of 241 patients were randomised (122 rivaroxaban, 119 placebo), and 234 completed the study. The primary efficacy outcome occurred in 1/120 of the rivaroxaban group and in 7/114 of the placebo group (0.8% vs 6.1%, respectively, p=0.03; absolute risk difference, −5.3%, 95% CI, −11.4 to −0.8; crude relative risk 0.14, 95% CI, 0.02 to 0.83; number-needed-to-treat=19). No major bleedings were observed. We found no association between different arthroscopic procedures and thrombotic events. Small sample size, high exclusion rate, and low number of anterior cruciate ligament reconstruction procedures are the main limitations of our study. In conclusion, a seven-day course of 10-mg rivaroxaban may be safely employed for thromboprophylaxis after KA. Whether prophylaxis after KA should be given to all patients, or to selected “high-risk” subjects, remains to be determined. A larger trial to verify our preliminary results is warranted.

The aim of the present work is to evaluate the genotoxic impact of contaminants along the whole course of Ninfa-Sisto and Amaseno (Latium, Italy) rivers. The authors performed the alkaline Comet assay to assess DNA damage in the freshwater amphipod Gammarus elvirae, exposed ex situ for 24 hours and 7 days to water collected at different sites. The assay, applied on haemocytes, provides a sensitive tool to reveal effects even at low concentrations of pollutants. The results indicate significant increase of DNA damage along the course of the two rivers, compared to the unpolluted upstream sites, even if the analytes do not exceed the permissible limits. Moreover, the results show that there is not a linear correlation between the concentration of analytes and DNA damage. Based on this study's results, it would be desirable to use Comet assay, on proposed test species, as an early warning method to detect genotoxic potential of waters.

The Soil Moisture Active/Passive satellite microwave radiometer has been providing measurements of L-band thermal emission from Earth for more than 2 years. SMAP retrieves surface soil moisture from its brightness temperature measurements, and continues to provide science products to the user community. Even though the SMAP radiometer operates in a protected band, its measurements are still corrupted by Radio Frequency Interference (RFI) caused by illegal in-band transmissions or out-of-band emissions. The SMAP radiometer was designed to include special hardware to enable RFI detection and filtering using multiple detection algorithms. Given the good overall performance of SMAP algorithms to detect RFI sources, an automatic tool to report source properties automatically was developed and is now operational. This paper provides a preliminary analysis of the outputs of this reporting tool with a particular focus on the evolution of the RFI environment observed by SMAP during its period of operations.