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The current study integrates remote sensing, machine learning, and physicochemical parameters to detect hydrodynamic conditions and groundwater quality deterioration in non-rechargeable aquifer systems. Fifty-two water samples were collected from all water resources in Siwa Oasis and analyzed for physical (pH, T°C, EC, and TDS) chemical (SO42−, HCO3−, NO3−, Cl−, CO32−, SiO2, Mg2+, Na+, Ca2+, and K+), and trace metals (AL, Fe, Sr, Ba, B, and Mn). A digital elevation model supported by machine learning was used to predict the change in the land cover (surface lake area, soil salinity, and water logging) and its effect on water quality deterioration. The groundwater circulation and interaction between the deep aquifer (NSSA) and shallow aquifer (TCA) were detected from the pressure-depth profile of 27 production wells penetrating NSSA. The chemical facies evolution in the aquifer systems were (Ca–Mg–HCO3) in the first stage (freshwater of NSSA) and changed to (Na–Cl) type in the last stage (brackish water of TCA and springs). Support vector machine successfully predicted the rapid increase of the hypersaline lake area from 22.6 km2 to 60.6 km2 within 30 years, which deteriorated a large part of the cultivated land, reflecting the environmental risk of over-extraction of water for irrigation of agricultural land by flooding technique and lack of suitable drainage network. The waterlogging in the study was due to a reduction in the infiltration rate (low permeability) of the soil and quaternary aquifer. The cause of this issue could be a complete saturation of agricultural water with chrysotile, calcite, talc, dolomite, gibbsite, chlorite, Ca-montmorillonite, illite, hematite, kaolinite and K-mica (saturation index >1), giving the chance of these minerals to precipitate in the pore spaces of the soil and decrease the infiltration rate. The NSSA is appropriate for irrigation, whereas TCA is inappropriate due to potential salinity and magnesium risks. The best way to manage water resources in Siwa Oasis could be to use underground drip irrigation and combine water with TCA and NSSA.

Summary: The role of immune checkpoints in the setting of tissue injury remains unknown. Using an experimental model of isoproterenol (ISO)-induced stress cardiomyopathy, we show that ISO-induced myocardial injury provokes tissue-autonomous up-regulation of the programmed death-1 (PD-1):programmed death ligand (PD-L) axis in cardiac resident innate immune cells and T cells. PD-1 signaling was responsible for modulating the acute inflammatory response, as well as normalization of impaired left ventricular structure and function after ISO injection. Necrotic cardiac extracts were sufficient to increase the expression of PD-1 in macrophages and T cells in vitro. Viewed together these studies suggest that the PD-1:PD-L signaling axis regulates immune responses to cardiac tissue injury and is important for restoring myocardial homeostasis.

The last decade has seen important developments in the treatment of metastatic colorectal cancer (mCRC). In this scenario, interventional locoregional treatments could play an expanding role offering safe and effective integrated options in the continuum-of-care offering curative as well as palliative approaches.Based on ESMO guidelines, the toolbox of ablative treatments also includes intra-arterial palliative options, like chemoembolization, that can be offered as an alternative option in patients failing the available chemotherapeutic regimens.However, to date, there is still a limited use of chemoembolization in clinical practice.Based on this background, a comprehensive review of the methodologic and technical considerations as well as clinical indications and future perspectives seems to be useful with the aim to demonstrate the field’s value of the procedure, highlight their advantages, and ensure an increased role in treatment management of patients with colorectal liver metastases.

Objective: Exploitation of protective metabolic pathways within injured myocardium still remains an unclarified therapeutic target in heart disease. Moreover, while the roles of altered fatty acid and glucose metabolism in the failing heart have been explored, the influence of highly dynamic and nutritionally modifiable ketone body metabolism in the regulation of myocardial substrate utilization, mitochondrial bioenergetics, reactive oxygen species (ROS) generation, and hemodynamic response to injury remains undefined. Methods: Here we use mice that lack the enzyme required for terminal oxidation of ketone bodies, succinyl-CoA:3-oxoacid CoA transferase (SCOT) to determine the role of ketone body oxidation in the myocardial injury response. Tracer delivery in ex vivo perfused hearts coupled to NMR spectroscopy, in vivo high-resolution echocardiographic quantification of cardiac hemodynamics in nutritionally and surgically modified mice, and cellular and molecular measurements of energetic and oxidative stress responses are performed. Results: While germline SCOT-knockout (KO) mice die in the early postnatal period, adult mice with cardiomyocyte-specific loss of SCOT (SCOT-Heart-KO) remarkably exhibit no overt metabolic abnormalities, and no differences in left ventricular mass or impairments of systolic function during periods of ketosis, including fasting and adherence to a ketogenic diet. Myocardial fatty acid oxidation is increased when ketones are delivered but cannot be oxidized. To determine the role of ketone body oxidation in the remodeling ventricle, we induced pressure overload injury by performing transverse aortic constriction (TAC) surgery in SCOT-Heart-KO and αMHC-Cre control mice. While TAC increased left ventricular mass equally in both groups, at four weeks post-TAC, myocardial ROS abundance was increased in myocardium of SCOT-Heart-KO mice, and mitochondria and myofilaments were ultrastructurally disordered. Eight weeks post-TAC, left ventricular volume was markedly increased and ejection fraction was decreased in SCOT-Heart-KO mice, while these parameters remained normal in hearts of control animals. Conclusions: These studies demonstrate the ability of myocardial ketone metabolism to coordinate the myocardial response to pressure overload, and suggest that the oxidation of ketone bodies may be an important contributor to free radical homeostasis and hemodynamic preservation in the injured heart.

Study region: Siwa Oasis is located very far (800 km) from the main water resources (Nile River) of Egypt and the people in the study area mainly rely on groundwater for all purposes Study focus: The deterioration of drinking water quality and the accumulation of potentially toxic elements (PTEs) in water at high levels in arid regions such as Siwa Oasis in Egypt can pose significant risks to humans and living organisms. The methodology of study involved performing geochemical modeling, contamination source detection, and optimizing a new model using machine learning model for prediction of integrated weight water quality index (IWQI), Health risk indices (HI and HQ) regarding oral and dermal exposure to potentially toxic elements (PTEs). New hydrological insights for the region: The key findings of this research showed that the Nubian sandstone aquifer (NSSA) is characterized mainly by mixed Ca-Mg-Cl/SO4 fresh water type and influenced by silicate weathering. The nitrates sources fell between atmospheric inputs in the case of NSSA, soil nitrogen in Tertiary carbonate aquifer (TCA), springs, and drains, while sewage water strongly affects the lakes. The IWQI values demonstrated that water resources in the deep aquifer (NSSA) is appropriate for drinking with ranking of quality range from medium to excellent quality (IWQI < 150). The shallow aquifer (TCA) is suitable for drinking in the south east of the Oasis only with intermediate quality ranking (100 < IWQI < 150), while the poor water quality needs further treatment in the western side of Siwa Oasis. The non-carcinogenic risks evaluation revealed the vulnerability of child and adult to oral exposure of PTEs in the west and center of the investigated area. The feed forward back propagation neural network (FFBP-NN) model was a powerful tool for predicting IWQI and HI, where the relationship between the actual and predicted value had R2 greater than 0.95 and mean square error (MSE) range from 5.4E-05–0.66, root mean square error (RMSE) between 0.006 and 0.81, and relative square error (RSE) between 0.001 and 2.4 E-05.

ABSTRACT: Background: There are few meta-analyses examining the prognostic value of right ventricular ejection fraction (RVEF) for a specific type of cardiovascular disease (CVD). The aim of this study was to compare the association of cardiac magnetic resonance (CMR)-derived RVEF with adverse outcomes for several specific types of CVD, using a robust Bayesian model-averaged meta-analysis. Methods: Three databases were searched for CMR articles reporting hazard ratios (HRs) of RVEF restricted to a specific type of CVD. For each specific type of CVD, Bayesian model-averaged meta-analyses with and without publication bias adjustments were conducted to evaluate the strength of evidence for RVEF according to the Bayes factor (BF). Results: Among 108 articles (21,166 patients) analyzing 11 CVD types, pooled HR for 5% reduction in RVEF assessed by publication bias-unadjusted, Bayesian model-averaged meta-analysis offered moderate or strong evidence of an association with outcomes for all types of CVD (HR: 1.07–1.37, BF10: 4.3–9.6 * 107). In contrast, a robust Bayesian model-averaged meta-analysis, adjusted for publication bias, found moderate or strong evidence in favor of an association of RVEF with outcomes only in hypertrophic cardiomyopathy (HR: 1.19, 95% credible interval (CrI): 0.98–1.42, BF10: 5.0), dilated cardiomyopathy (HR: 1.16, 95% CrI: 1–1.22, BF10: 23.3), pulmonary hypertension (HR: 1.05, 95% CrI: 1–1.12, BF10: 3.0), and aortic stenosis (HR: 1.15, 95% CrI: 0.97–1.34, BF10: 4.2). There was weak evidence for an association of RVEF with adverse outcomes in seven other CVDs. Conclusion: In a Bayesian meta-analysis adjusted for publication bias, there was moderate or strong evidence for an association of RVEF with outcomes for only four CVDs. Additional data may strengthen evidence regarding other CVDs.

Highlights of right ventricular characteristics of left ventricular noncompaction using 3D echocardiography.The aspects of right ventricular volumes and function investigated with 3D echocardiography in a large cohort of left ventricular noncompaction morphology (LVNC) population remains unclear.The objective of our research was to study the left (LV) and right (RV) ventricular parameters using 3D echocardiography and analyze the clinical features of a LVNC population with preserved LV ejection fraction (EF > 50 %) in comparison with healthy controls (HC).We selected 41 LVNC subjects with preserved LV function (EF: 52.91 ± 3 %, male n = 26) and without any comorbidities and compared them with an age and sex-matched HC. Three dimensional endocardial contours were evaluated to determine the following LV and RV parameters: end-diastolic (EDV) and end-systolic (ESV) volumes, stroke volume, EF, LV global longitudinal and circumferential strain and RV septal and free wall longitudinal strain.Regarding the clinical characteristics, the family involvement had a notable proportion, accounting for 51%. The EF and strain values of the LVNC population were significantly decreased in both RV and LV compared to HC. Although the LV volumes of the LVNC group were significantly elevated, the RV volumetric parameters did not differ significantly compared to controls. We found significant correlations between LV and RV volumetric and functional parameters and linear regression models showed that LV EDV and LV ESV determined the RV volumetric values.While the alteration and relationship of the RV parameters may represent the potential of biventricular involvement, clinical characteristics of the LVNC group underlines the necessity of monitoring this population, even with preserved EF.

Accurate echocardiographic evaluation of the systemic right ventricle is challenging because of its specific morphology and contraction patterns. We present a detailed multimodality assessment of the systemic right ventricle, analyze the relative contribution of the longitudinal, radial, and anteroposterior components of systolic function, and identify reasons for a potential discrepancy among imaging modalities. (Level of Difficulty: Intermediate.)

Study region: Three karst regions in Hungary and Slovakia. Study focus: Time series of environmental tracers both in the groundwater recharge and discharge provide important insights into how a karst water system works. The aim of the present work was to study the response of discharging karst waters to recharge using time series of environmental tracers, such as tritium, stable water isotopes, noble gases and SF6. New hydrological insights for the region: Our results show that sampling frequency plays a significant role in detecting short residence times (months): the seasonality of 18O isotope composition of a selected karst spring indicates a 10 % contribution of recent water with a residence time of half a year. The contribution of an older component can be proven by the decrease of the tritium content of the waters, which compares to the decreasing trend of the tritium time series of the precipitation. However, the tritium concentrations are just slightly lower than those of the precipitation and the recharge water, hence the residence times of these shallow springs are supposed to be short. 3H/3He and SF6 apparent ages confirm this to be between 0 and 10 years, with a median of 1.4 years. Our study demonstrates that long-term time series are preferable to provide better estimation to the age distribution than individual, short-term investigations.

In the context of climate change, Nature-Based Solutions (NBSs), a recently developed concept, are increasingly considered as part of the adaptation strategies of the cities. Studies using expert models and methods (EMM) receive a great deal of scientific attention. Considering EMM increasing use, this study aims to perform an analysis of the reported evaluation results, reflecting the capability of the EMM to accurately tackle urban challenges identified within the EU Nature4Cities project. Then, we propose a set of indicators and recommendations about sixteen EMM to be used by funders, researchers and practitioners when evaluating the performance of NBSs. The coupling of the different components (climate, water and soil) is not a simple matter. The analysis relies on the definition of the range of the reported metrics and on the investigation of the relationship between the various indices, applied for the EMM evaluation. Secondly, the study assesses the existing EMM, indicating the potential of NBSs: (i) to reduce urban heat island, (ii) to limit surface warming, (iii) to increase the thermal comfort of people, (iv) to limit the overheating and runoff of surfaces due to impervious areas, (v) to increase water retention during stormy episodes, (vi) to improve storm water quality at the outlet of the sustainable urban drainage systems, (vii) to promote the filtration and epuration of storm water runoff in soil and (viii) to be a support for vegetation. The analysis reveals that EMM can be considered as helpful tools for urban microclimate, urban soil and water management analysis, provided their limitations and characteristics are taken into account by the user when choosing tools and interpreting results (e.g. application scale). With regard to the performance of NBSs, the most commonly used indicators clearly depend on the scale of the project.