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Crop lodging – the bending of crop stems from the vertical – is a major yield-reducing factor in cereal crops and causes deterioration in grain quality. Accurate assessment of crop lodging is important for improving estimates of crop yield losses, informing insurance loss adjusters and influencing management decisions for subsequent seasons. The role of remote sensing data, particularly synthetic aperture radar (SAR) data has been emphasized in the recent literature for crop lodging assessment. However, the effect of lodging on SAR scattering mechanisms is still unknown. Therefore, this research aims to understand the possible change in scattering mechanisms due to lodging by investigating SAR image pairs before and after lodging. We conducted the study in 26 wheat fields in the Bonifiche Ferraresi farm, located in Jolanda di Savoia, Ferrara, Italy. We measured temporal crop biophysical (e.g. crop angle) parameters and acquired multi-incidence angle RADARSAT-2 (R-2 FQ8-27° and R-2 FQ21-41°) and Sentinel-1 (S-1 40°) images corresponding to the time of field observations. We extracted metrics of SAR scattering mechanisms from RADARSAT-2 and Sentinel-1 image pairs in different zones using the unsupervised H/α decomposition algorithm and Wishart classifier. Contrasting results were obtained at different incidence angles. Bragg surface scattering increased in the case of S-1 (6.8%), R-2 FQ8 (1.8%) while at R-2 FQ21, it decreased (8%) after lodging. The change in double bounce scattering was more prominent at low incidence angle. These observations can guide future use of SAR-based information for operational crop lodging assessment in particular, and sustainable agriculture in general.

Image-based 3D models generation typically involves three stages, namely: 2D image acquisition, data processing, and 3D surface generation and editing. The availability of different easy-to-use and low-cost image acquisition solutions, combined with open-source or commercial processing tools, has democratized the 3D reconstruction and digital twin generation. But high geometric and texture fidelity on small- to medium-scale objects as well as integrated commercial system for mass 3D digitization are not available. The paper presents our effort to build such a system, i.e. a market-ready multi-camera solution and a customized reconstruction process for mass 3D digitization of small to medium objects. The system is realized as a joint work between industrial and academic partners, in order to employ the latest technologies for the needs of the market. The proposed versatile image acquisition and processing system pushes to the limits the 3D digitization pipeline combining a rigid capturing system with photogrammetric reconstruction methods.

The European Union and the European Space Agency (EU/ESA) have promoted since 1998 (Baveno Manifesto*) the GMES Programme (Global Monitoring for Environment and Security), nowadays called Copernicus (www.copernicus.eu). In the agriculture domain, the use of Copernicus Sentinel imagery and its services are providing several new opportunities. The knowledge of fundamentals of Earth Observation/Geographic Information EO/GI, namely Geomatics, for the development of innovative strategies for professional skills adequacy and capacity building, supporting Copernicus user uptake, becomes mandatory (Gomarasca, 2009). The target is to help bridging gaps between supply and demand of education and training for geospatial sector (www.eo4geo.eu). The innovative and strategical novelties are the complete free access to Sentinel time series imagery and digital image processing software “Sentinel toolboxes” such as SNAP (Sentinel Application Platform) for different environments (Windows, Mac, Unix). The paper introduce topics as crop mapping and monitoring, biophysical parameters, phenology and yield estimations, through several concluded or ongoing international projects such as: ERMES -FP7 (http://www.ermes-fp7space.eu/it/homepage/, Busetto et al. 2017) and SATURNO (https://www.progettosaturno.it/, Nutini et al., 2018) devoted to the regional agricultural monitoring. As conclusion, SNAP software for image processing of Sentinel data was demonstrated and tested together with Earth Engine software for specific vertical agriculture applications. The topics reported in this paper have been part of the Summer School ‘Sentinel for Applications in Agriculture’ supported by the Copernicus programme, several scientific associations (AIT, ASITA, EARSeL - European Association of Remote Sensing Laboratories), the European Erasmus+ project EO4GEO, University Departments and Geo-Information Companies.

Lodging is a major yield-reducing factors in wheat, causing reductions up to 80%. Timely detection of lodging can reduce its impacts and support proper decisions regarding expected yield, crop price or its insurance. Since the incidence of lodging is heterogeneous within a field, very high-resolution remote sensing data can be viable for accurate and prompt spatio-temporal assessment of lodging severity. As such unmanned aerial vehicles (UAVs) provide a versatile and cost-effective solution to monitor crops on a small scale with sub-centimetre spatial resolution. In this study, we analysed the spectral variability between different grades of lodging severity (non-lodged (NL), moderate (ML), severe (SL) and very severe (VSL)) and classified them using high-resolution UAV data. Multispectral orthomosaic UAV images with 5cm resolution and nine bands (covering the VIS-NIR spectrum with Sentinel-2 filters) were acquired in May 2018 for two wheat fields in Bonifiche Ferraresi farm, Jolanda di Savoia, Italy. Concurrent to the time of image acquisition, a field campaign was carried out in which crop characteristics and lodging related parameters were collected. The results showed that reflectance magnitude increased with lodging severity and demonstrated that the red-edge and NIR bands can be used to clearly discriminate between NL and lodged (all grades) wheat and to some extent between different lodging classes (ML, SL and VSL). The nearest neighbourhood classification performed using an object-based segmentation yielded optimal results with an overall accuracy of 90%, thus demonstrating the use of multispectral UAV data as a promising tool for wheat lodging assessment.

In this study we exploit UAV data for estimating Fractional Vegetation Cover (FVC) of maize crop at the early stages of the growing season. UAV survey with a MicaSense RedEdge multispectral sensor was carried out on July 13th, 2017 over a maize field in Italy; simultaneous RGB in situ pictures were collected to build a reference dataset of FVC over 15 ESU (Elementary Sampling Units) distributed over the field under investigation. The approach proposed for classification of UAV data is based on local contrast enhancement techniques applied to a vegetation index (NDVI-Normalized Difference Vegetation Index) to capture signal from small plants at the early development stage. The output fc map is obtained over grid cells over 70 × 70 cm size. The approach proposed here, based on contextual analysis, reduced artefacts due to illumination conditions by better enhancing signal from vegetation compared to, for example, simple band combination such as vegetation index alone (e.g. NDVI). Validation accomplished by a point comparison between estimated (from UAV) and in situ measured FVC values provided R2 = 0.73 and RMSE = 6%.

During recent years hyperspectral remote sensing data were successfully used to characterise the state and properties of vegetation. The information on vegetation cover and status is useful for a range of environmental modelling studies. Recent works devoted to the understanding of the fate of Persistent Organic Pollutants (POPs) in the environment showed that forests and vegetation in general act as a «sponge» for chemicals present in air and the intensity of this «capture» effect depends on some vegetation parameters such as surface area, leaf composition, turnover etc. In the framework of the DARFEM experiment conducted in late June 2001, different airborne hyperspectral images were acquired and analysed to derive some vegetation parameters of relevance for multimedia models, such as the spatial distribution of plant species and their relative foliage biomass. The study area, south west of Milan, encompasses a range of land cover types typical of Northern Italy, including intensive poplar plantations and natural broad-leaf forest. An intensive field campaign was accomplished during the aerial survey to collect vegetation parameters and radiometric measurements. Results obtained from the analysis of hyperspectral images, map of vegetation species, Leaf Area Index (LAI) and foliage biomass are presented and discussed.

Background: The challenge of addressing obesity persists in healthcare, necessitating nuanced approaches and personalized strategies. This study aims to evaluate the effects of diverse therapeutic interventions on anthropometric and biochemical parameters in individuals with overweight and obesity within a real-world clinical context., Methods: A retrospective analysis was conducted on 192 patients (141 females, 51 males) aged 18 to 75, with a BMI ranging from 25 to 30 (14.1%) and BMI ≥ 30 (85.9%), observed over a 12-month period at our Endocrinology Unit. Treatment cohorts comprised individuals following different regimens: Mediterranean Diet (MD), with an approximate daily intake of 1500 kcal for women and 1800 kcal for men (71% patients); Ketogenic Diet (KD), utilizing the VLCKD protocol characterized by a highly hypocaloric dietary regimen < 800 kcal/day (14% patients); metformin, administered using the oral formulation (5% patients); pharmacological intervention with GLP1-RA administered via subcutaneous injection with incremental dosage (10% patients). Supply constraints limited the efficacy of Liraglutide, whereas Semaglutide was excluded from comparisons due to its unavailability for obesity without diabetes. Blood tests were conducted to assess lipid profile, glycemic profile, and anthropometric parameters, including BMI, waist circumference, and waist-to-height ratio., Results: Significant BMI changes were observed from baseline to 6 months across MD, KD, and Liraglutide groups (p < 0.05). KD exhibited notable reductions in waist circumference and waist-to-height ratio within the initial quarter (p < 0.05), with a significant triglyceride decrease after 6 months (p < 0.05), indicating its efficacy over MD. Liraglutide demonstrated a substantial reduction in HbA1 c levels in the first quarter (p < 0.05). During the first three months, the ANOVA test on fasting blood glucose showed a statistically significant impact of the time variable (p < 0.05) rather than the specific treatments themselves (Liraglutide and KD), suggesting that adherence during the early stages of therapy may be more critical than treatment choice., Conclusions: Positive outcomes from targeted interventions, whether pharmacological or dietary should encourage the exploration of innovative, long-term strategies that include personalized treatment alternation. The absence of standardized protocols underscores the importance of careful and tailored planning in managing obesity as a chronic condition., (© 2024. The Author(s).)

The ancient Roman god Ianus was a mysterious divinity with two opposite faces, one looking at the past and the other looking to the future. Likewise, metformin is an "old" drug, with one side looking at the metabolic role and the other looking at the anti-proliferative mechanism; therefore, it represents a typical and ideal bridge between diabetes and cancer. Metformin (1,1-dimethylbiguanidine hydrochloride) is a drug that has long been in use for the treatment of type 2 diabetes mellitus, but recently evidence is growing about its potential use in other metabolic conditions and in proliferative-associated diseases. The aim of this paper is to retrace, from a historical perspective, the knowledge of this molecule, shedding light on the subcellular mechanisms of action involved in metabolism as well as cellular and tissue growth. The intra-tumoral pharmacodynamic effects of metformin and its possible role in the management of different neoplasms are evaluated and debated. The etymology of the name Ianus is probably from the Latin term ianua , which means door . How many new doors will this old drug be able to open?, Competing Interests: The authors declare no conflicts of interest.

Pancreatic fluid collections (PFCs) are well-known complications of acute pancreatitis. The overinfection of these collections leads to a worsening of the prognosis with an increase in the morbidity and mortality rate. The primary strategy for managing infected pancreatic necrosis (IPN) or symptomatic PFCs is a minimally invasive step-up approach, with endosonography-guided (EUS-guided) transmural drainage and debridement as the preferred and less invasive method. Different stents are available to drain PFCs: self-expandable metal stents (SEMSs), double pigtail stents (DPPSs), or lumen-apposing metal stents (LAMSs). In particular, LAMSs are useful when direct endoscopic necrosectomy is needed, as they allow easy access to the necrotic cavity; however, the rate of adverse events is not negligible, and to date, the superiority over DPPSs is still debated. Moreover, the timing for necrosectomy, the drainage technique, and the concurrent medical management are still debated. In this review, we focus attention on indications, timing, techniques, complications, and particularly on aspects that remain under debate concerning the EUS-guided drainage of PFCs.

Background: Syndrome of inappropriate antidiuresis (SIAD) is one of the most frequent causes of euvolemic hyponatremia (serum sodium levels < 135 mEq/L) and it represents more than 35% of hyponatremia cases in hospitalized patients. It is characterized by an inappropriate vasopressin (AVP)/antidiuretic hormone (ADH) secretion, which occurs independently from effective serum osmolality or circulating volume, leading to water retention via its action on type 2 vasopressin receptor in the distal renal tubules. Corpus callosum agenesis (CCA) is one of the most common congenital brain defects, which can be associated to alterations in serum sodium levels. This report presents a rare case of chronic hyponatremia associated with SIAD in a woman with CCA, whose correction of serum sodium levels only occurred following twice-daily tolvaptan administration., Case Presentation: A 30-year-old female was admitted to our hospital for non-acute hyponatremia with dizziness, headache, distal tremors, and concentration deficits. She had profound hyponatremia (Na 121 mmol/L) with measured plasma hypo-osmolality (259 mOsm/Kg) and urinary osmolality greater than 100 mOsm/Kg (517 mOsm/Kg). She presented clinically as normovolemic. After the exclusion of other causes of normovolemic hyponatremia, such as hypothyroidism and adrenal insufficiency, a diagnosis of SIAD was established. We have ruled out paraneoplastic, inflammatory, and infectious causes, as well as ischemic events. Her medical history showed a CCA and frontal teratoma. We administered tolvaptan initially at a low dosage (15 mg once a day) with persistence of hyponatremia. Therefore, the dosage was first doubled (30 mg once a day) and then increased to 45 mg once a day with an initial improvement in serum sodium levels, although not long-lasting. We therefore tried dividing the 45 mg tolvaptan administration into two doses of 30 mg and 15 mg respectively, using an off-label treatment schedule, thus achieving long-lasting serum sodium levels in the low-normal range associated with a general clinical improvement., Conclusions: This report underlines the importance of the correct diagnosis, management and treatment of SIAD, as well as the need for further studies about the pharmacokinetics and pharmacodynamics of vasopressin receptor antagonists., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Arecco, Demontis, Della Sala, Musso, Gay, Boschetti, Ferone and Gatto.)

Background: The role of vitamin D (25(OH)D) in the pathogenesis and outcome of several conditions, including autoimmune diseases, diabetes and cancers is largely described in the literature. The aims of this study were to evaluate the prevalence of 25(OH)D deficit in a cohort of patients with neuroendocrine neoplasms (NENs) in comparison to a matched healthy control group and to analyze the possible role of 25(OH)D as a prognostic factor for NENs in terms of biological aggressiveness, tumor progression and survival. Methods: From 2009 to 2023, 172 patients with NENs (99 females; median age, 63 years) were included in the study. Serum 25(OH)D levels were defined as deficient if ≤20 ng/mL. The possible associations between 25(OH)D levels and disease grading, staging, ki67%, overall survival (OS), and progression-free survival (PFS) were considered. Results: NEN patients had significantly lower 25(OH)D levels compared to controls ( p < 0.001) regardless of the primary origin. Patients with 25(OH)D < 20 ng/mL had a significantly higher ki67 index ( p = 0.02) compared to the ones with 25(OH)D levels above 20 ng/mL. Patients with disease progression were found to have a significantly lower 25(OH)D at baseline ( p = 0.02), whereas PFS and OS were not significantly influenced by 25(OH)D. Conclusions: Vitamin D deficiency is highly prevalent among NENs and is associated with higher ki67 and disease progression. Our study highlights the importance of monitoring 25(OH)D levels in patients with NENs, as its deficiency appeared to be linked to the worst biological tumor aggressiveness.

Background: We present an intriguing case of primary adrenal lymphoma, with associated primary adrenal insufficiency (PAI), in a patient presenting a transitory partial 21-hydroxylase deficiency during the active phase of the adrenal disease., Case Presentation: An 85-years old woman was referred because of worsening asthenia, lumbar pain, generalized myalgia and arthralgia. During investigations a computed tomography (CT) scan evidenced two large bilateral adrenal masses, highly suspicious for primary adrenal tumor. The hormonal assessment revealed very low levels of morning plasma cortisol and 24-h urinary cortisol, elevated ACTH levels with low plasma concentration of aldosterone, pointing to the diagnosis of PAI. After diagnosis of PAI our patient started glucocorticoid and mineralcorticoid replacement therapy with clinical benefit. In order to further characterize the adrenal lesions, adrenal biopsy, was performed. The histology revealed a high grade non-Hodgkin lymphoma with an immunophenotype consistent with intermediate aspects between diffuse large B-cell and Burkitt lymphoma, with a high proliferation index (KI-67 > 90%). The patient received chemotherapy with epirubicin, vincristine, cyclophosphamide, and rituximab, associated with methylprednisolone that resulted in a complete clinical and radiological remission within one year. After 2 years from the diagnosis and a total of 6 cycles of rituximab, the patient was in good clinical condition and was taking only the replacement therapy for PAI. The patient initially presented also a slight increase of 17-hydroxyprogesterone (17-OHP) for age that normalize after resolution of lymphoproliferative disease., Conclusions: In the presence of bilateral adrenal disease and/or in the presence of signs and symptoms of PAI clinicians must exclude the presence of PAL. The evidence of elevated ACTH-stimulated 17-OHP levels also in patients with other adrenal masses, together with the detection of elevated basal 17-OHP levels in our patient make it more plausible, in our view, an effect of the lesion on the "healthy" adrenal tissue residue than a direct secretory activity by the adrenal tumor., (© 2023. The Author(s).)

Over the past few years, several applications have been extensively exploiting the advantages of deep learning, in particular when using convolutional neural networks (CNNs). The intrinsic flexibility of such models makes them widely adopted in a variety of practical applications, from medical to industrial. In this latter scenario, however, using consumer Personal Computer (PC) hardware is not always suitable for the potential harsh conditions of the working environment and the strict timing that industrial applications typically have. Therefore, the design of custom FPGA (Field Programmable Gate Array) solutions for network inference is gaining massive attention from researchers and companies as well. In this paper, we propose a family of network architectures composed of three kinds of custom layers working with integer arithmetic with a customizable precision (down to just two bits). Such layers are designed to be effectively trained on classical GPUs (Graphics Processing Units) and then synthesized to FPGA hardware for real-time inference. The idea is to provide a trainable quantization layer, called Requantizer , acting both as a non-linear activation for neurons and a value rescaler to match the desired bit precision. This way, the training is not only quantization-aware , but also capable of estimating the optimal scaling coefficients to accommodate both the non-linear nature of the activations and the constraints imposed by the limited precision. In the experimental section, we test the performance of this kind of model while working both on classical PC hardware and a case-study implementation of a signal peak detection device running on a real FPGA. We employ TensorFlow Lite for training and comparison, and use Xilinx FPGAs and Vivado for synthesis and implementation. The results show an accuracy of the quantized networks close to the floating point version, without the need for representative data for calibration as in other approaches, and performance that is better than dedicated peak detection algorithms. The FPGA implementation is able to run in real time at a rate of four gigapixels per second with moderate hardware resources, while achieving a sustained efficiency of 0.5 TOPS/W (tera operations per second per watt), in line with custom integrated hardware accelerators.

Background: The vanishing testis syndrome (VTS), is a 46, XY disorder of sex development (46, XY DSD) and is characterized by the absence of testis in a 46, XY subject with male genitalia, gonadal dysgenesis and consequent hypergonadotropic hypogonadism., Case Presentation: A young man affected by VTS has been followed up for more than 15-year in our center. The patient received different testosterone formulations, which modulated his IGF-1 levels and height velocity, depending on different stimulatory effects, mimicking pubertal spurt until achieving a final height in line with his genetic target. Exogenous testosterone, activating GH/IGF-1 system, can directly influence growth pattern. With this particular case report we demonstrate that an accurate monitoring of patients with VTS, as well as a perfect reproduction of testosterone secretion during pubertal spurt, can guarantee a normal growth and development and, consequently, a high level of quality of life in adulthood., Conclusion: Testosterone levels act an important role during pubertal spurt in modulating the GH/IGF-1 axis, besides its well-known impact in sexual development. Very little amount of exogenous testosterone can stimulate IGF-1 secretion and provide to growth velocity the drive that characterizes the initial phases of the growth spurt., (© 2023. The Author(s).)

Although GH and IGF-1 excess has a controversial impact on bone mineral density (BMD), acromegalic patients display variable degrees of bone structure impairment. In this study, we aim to investigate the usefulness of trabecular bone score (TBS), compared to BMD, in identifying acromegalic patients with impaired lumbar spine trabecular microarchitecture. Forty-four acromegalic patients were investigated for disease control, metabolic and gonadal status, bone metabolism parameters, and the presence of vertebral fractures (VFs). Patients and matched healthy controls underwent BMD and TBS examination. Mean TBS values were lower in patients than in controls (p < 0.001), without significant differences in mean lumbar and femoral BMD. TBS values were significantly higher in controlled patients compared to the uncontrolled ones (p = 0.012). No significant differences were found in bone markers with respect to disease control. Mean TBS or lumbar BMD did not significantly differ in patients with or without VFs (prevalence 11.4%). TBS and BMD levels were lower in hypogonadal patients compared to the eugonadal ones (p = 0.030 and p < 0.001, respectively). In conclusion, TBS values are significantly lower in patients than in controls, confirming the presence of impaired lumbar spine trabecular bone in acromegaly. Both uncontrolled disease and hypogonadism contribute to TBS deterioration in acromegaly.

The spaceborne imaging spectroscopy mission PRecursore IperSpettrale della Missione Applicativa (PRISMA), launched on 22 March 2019 by the Italian Space Agency, opens new opportunities in many scientific domains, including precision farming and sustainable agriculture. This new Earth Observation (EO) data stream requires new-generation approaches for the estimation of important biophysical crop variables (BVs). In this framework, this study evaluated a hybrid approach, combining the radiative transfer model PROSAIL-PRO and several machine learning (ML) regression algorithms, for the retrieval of canopy chlorophyll content (CCC) and canopy nitrogen content (CNC) from synthetic PRISMA data. PRISMA-like data were simulated from two images acquired by the airborne sensor HyPlant, during a campaign performed in Grosseto (Italy) in 2018. CCC and CNC estimations, assessed from the best performing ML algorithms, were used to define two relations with plant nitrogen uptake (PNU). CNC proved to be slightly more correlated to PNU than CCC ( R 2 = 0.82 and R 2 = 0.80, respectively). The CNC-PNU model was then applied to actual PRISMA images acquired in 2020. The results showed that the estimated PNU values are within the expected ranges, and the temporal trends are compatible with plant phenology stages., Competing Interests: Disclosure statement No potential conflict of interest was reported by the authors.

Background: To investigate the effects of the COVID-19 lockdowns on the vasculopathic population. Methods: The Divisions of Vascular Surgery of the southern Italian peninsula joined this multicenter retrospective study. Each received a 13-point questionnaire investigating the hospitalization rate of vascular patients in the first 11 months of the COVID-19 pandemic and in the preceding 11 months. Results: 27 out of 29 Centers were enrolled. April-December 2020 (7092 patients) vs. 2019 (9161 patients): post-EVAR surveillance, hospitalization for Rutherford category 3 peripheral arterial disease, and asymptomatic carotid stenosis revascularization significantly decreased (1484 (16.2%) vs. 1014 (14.3%), p = 0.0009; 1401 (15.29%) vs. 959 (13.52%), p = 0.0006; and 1558 (17.01%) vs. 934 (13.17%), p < 0.0001, respectively), while admissions for revascularization or major amputations for chronic limb-threatening ischemia and urgent revascularization for symptomatic carotid stenosis significantly increased (1204 (16.98%) vs. 1245 (13.59%), p < 0.0001; 355 (5.01%) vs. 358 (3.91%), p = 0.0007; and 153 (2.16%) vs. 140 (1.53%), p = 0.0009, respectively). Conclusions: The suspension of elective procedures during the COVID-19 pandemic caused a significant reduction in post-EVAR surveillance, and in the hospitalization of asymptomatic carotid stenosis revascularization and Rutherford 3 peripheral arterial disease. Consequentially, we observed a significant increase in admissions for urgent revascularization for symptomatic carotid stenosis, as well as for revascularization or major amputations for chronic limb-threatening ischemia.

In the next few years, the new Copernicus Hyperspectral Imaging Mission (CHIME) is foreseen to be launched by the European Space Agency (ESA). This missions will provide an unprecedented amount of hyperspectral data, enabling new research possibilities within several fields of natural resources, including the "agriculture and food security" domain. In order to efficiently exploit this upcoming hyperspectral data stream, new processing methods and techniques need to be studied and implemented. In this work, the hybrid approach (HYB) and its variant, featuring sampling dimensionality reduction through active learning heuristics (HAL), were applied to CHIME-like data to evaluate the retrieval of crop traits, such as chlorophyll and nitrogen content at both leaf (LCC and LNC) and canopy level (CCC and CNC). The results showed that HYB was able to provide reliable estimations at canopy level (R 2 = 0.79, RMSE = 0.38 g m -2 for CCC and R 2 = 0.84, RMSE = 1.10 g m -2 for CNC) but failed at leaf level. The HAL approach improved retrieval accuracy at canopy level (best metric: R 2 = 0.88 and RMSE = 0.21 g m -2 for CCC; R 2 = 0.93 and RMSE = 0.71 g m -2 for CNC), providing good results also at leaf level (best metrics: R 2 = 0.72 and RMSE = 3.31 μg cm -2 for LCC; R 2 = 0.56 and RMSE = 0.02 mg cm -2 for LNC). The promising results obtained through the hybrid approach support the feasibility of an operational retrieval of chlorophyll and nitrogen content, e.g., in the framework of the future CHIME mission. However, further efforts are required to investigate the approach across different years, sites and crop types in order to improve its transferability to other contexts., Competing Interests: Conflicts of Interest: The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Growth hormone (GH), once the age of linear growth is completed, continues to play a fundamental role for the human body. In adulthood, GH contributes to regulate muscle, cardiovascular and bone metabolism. The same happens in old age, although there is less data on the effect of GH in the elderly. Regardless the age of onset, a reduced quality of life (QoL), an increased cardiovascular risk and an accelerated age-related decline in physical strength have been demonstrated in the elderly with GH deficiency (EGHD). In adults with GH deficiency (AGHD), recent studies suggest a role of GH replacement therapy (GHrt) in improving lean/fat mass ratio, blood pressure, lipid profile, bone metabolism and QoL. Despite these recent studies, there is still a lack of randomized controlled trials proving these positive effects in EGHD. Moreover, the lack of a long-term positive outcome on mortality, and the cost of GHrt could often impact on treatment decision-making and lead to postpone or avoid the prescription. The aim of this mini-review is to summarize the available data on GHrt in EGHD, in order to highlight its weaknesses and strengths and to provide directions to clinicians that will help in the management of this specific set of patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Ricci Bitti, Franco, Albertelli, Gatto, Vera, Ferone and Boschetti.)

Acromegaly is a rare and severe disease caused by an increased and autonomous secretion of growth hormone (GH), thus resulting in high circulating levels of insulin-like growth factor 1 (IGF-1). Comorbidities and mortality rate are closely related to the disease duration. However, in most cases achieving biochemical control means reducing or even normalizing mortality and restoring normal life expectancy. Current treatment for acromegaly includes neurosurgery, radiotherapy and medical therapy. Transsphenoidal surgery often represents the recommended first-line treatment. First-generation somatostatin receptor ligands (SRLs) are the drug of choice in patients with persistent disease after surgery and are suggested as first-line treatment for those ineligible for surgery. However, only about half of patients treated with octreotide (or lanreotide) achieve biochemical control. Other available drugs approved for clinical use are the second-generation SRL pasireotide, the dopamine agonist cabergoline, and the GH-receptor antagonist pegvisomant. In the present paper, we revised the current literature about the management of acromegaly, aiming to highlight the most relevant and recent therapeutic strategies proposed for patients resistant to first-line medical therapy. Furthermore, we discussed the potential molecular mechanisms involved in the variable response to first-generation SRLs. Due to the availability of different medical therapies, the choice for the most appropriate drug can be currently based also on the peculiar clinical characteristics of each patient., Competing Interests: DF has been a speaker for, participated on advisory boards and received research grants from Novartis, Pfizer and Ipsen. FG has been a speaker for Novartis, participated on advisory boards and/or received personal fees from Novartis, AMCo Ltd and IONIS Pharmaceuticals. The other authors report no conflicts of interest in this work., (© 2020 Corica et al.)

Accurate nitrogen (N) management is crucial for the economic and environmental sustainability of cropping systems. Different methods have been developed to increase the efficiency of N fertilizations. However, their costs and/or low usability have often prevented their adoption in operational contexts. We developed a diagnostic system to support topdressing N fertilization based on the use of smart apps to derive a N nutritional index (NNI; actual/critical plant N content). The system was tested on paddy rice via dedicated field experiments, where the smart apps PocketLAI and PocketN were used to estimate, respectively, critical (from leaf area index) and actual plant N content. Results highlighted the system's capability to correctly detect the conditions of N stress (NNI < 1) and N surplus (NNI > 1), thereby effectively supporting topdressing fertilizations. A resource-efficient methodology to derive PocketN calibration curves for different varieties-needed to extend the system to new contexts-was also developed and successfully evaluated on 43 widely grown European varieties. The widespread availability of smartphones and the possibility to integrate NNI and remote sensing technologies to derive variable rate fertilization maps generate new opportunities for supporting N management under real farming conditions.

The triangle method has been applied to derive a weekly indicator of evaporative fraction on vegetated areas in a temperate region in Northern Italy. Daily MODIS Aqua Land Surface Temperature (MYD11A1) data has been combined with air temperature maps and 8-day composite MODIS NDVI (MOD13Q1/MYD13Q1) data to estimate the Evaporative Fraction ( EF ) at 1 km resolution, on a daily basis. Measurements at two eddy covariance towers located within the study area have been exploited to assess the reliability of satellite based EF estimations as well as the robustness of input data. Weekly syntheses of the daily EF indicator ( EF w ) were then derived at regional scale for the years 2010, 2011 and 2012 as a proxy of overall surface moisture condition. EF w showed a temporal behavior consistent with growing cycles and agro-practices of the main crops cultivated in the study area (rice, forages and corn). Comparison with official regional corn yield data showed that variations in EF w cumulated over summer are related with crop production shortages induced by water scarcity. These results suggest that weekly-averaged EF estimated from MODIS data is sensible to water stress conditions and can be used as an indicator of crops' moisture conditions at agronomical district level. Advantages and disadvantages of the proposed approach to provide information useful to issue operational near real time bulletins on crop conditions at regional scale are discussed., Competing Interests: The authors declare no conflict of interest.

Knowing where, when, and how much rice is planted and harvested is crucial information for understanding the effects of policy, trade, and global and technological change on food security. We developed RiceAtlas, a spatial database on the seasonal distribution of the world's rice production. It consists of data on rice planting and harvesting dates by growing season and estimates of monthly production for all rice-producing countries. Sources used for planting and harvesting dates include global and regional databases, national publications, online reports, and expert knowledge. Monthly production data were estimated based on annual or seasonal production statistics, and planting and harvesting dates. RiceAtlas has 2,725 spatial units. Compared with available global crop calendars, RiceAtlas is nearly ten times more spatially detailed and has nearly seven times more spatial units, with at least two seasons of calendar data, making RiceAtlas the most comprehensive and detailed spatial database on rice calendar and production.

Context: Ectopic Cushing's Syndrome (ECS) can be a diagnostic challenge with the hormonal source difficult to find. This study analyzes the accuracy of imaging studies in ECS localization., Evidence Acquisition: Systematic review of medical literature for ECS case series providing individual patient data on at least one conventional imaging technique (computed tomography [CT]/magnetic resonance imaging) and one of the following: 111In-pentetreotide (OCT), 131I/123I-metaiodobenzylguanidine, 18Ffluoro-2-deoxyglucose-positron emission tomography (FDG-PET), 18F-fluorodopa-PET (F-DOPA-PET), 68Ga- DOTATATE-PET/CT or 68Ga-DOTATOC-PET/CT scan (68Gallium-SSTR-PET/CT)., Evidence Summary: The analysis comprised 231 patients (females, 50.2%; age, 42.617 y). Overall, 52.4%(121/231) had "overt" ECS,18.6% had "occult" ECS, and 29% had "covert" ECS. Tumors were located in the lung (55.3%), mediastinum-thymus (7.9%), pancreas (8.5%), adrenal glands (6.4%), gastrointestinal tract (5.4%), thyroid (3.7%), and other sites (12.8%), and primary tumors were mostly bronchial neuroendocrine tumors (NETs) (54.8%), pancreatic NETs (8%), mediastinum-thymus NETs (6.9%), gastrointestinal NETs (5.3%), pheochromocytoma (6.4%), neuroblastoma (3.2%), and medullary thyroid carcinoma (3.2%). Tumors were localized byCTin66.2%(137/207), magnetic resonance imaging in 51.5% (53/103), OCT in 48.9% (84/172), FDG-PET in 51.7% (46/89), F-DOPAPET in 57.1% (12/21), 131/123I-metaiodobenzylguanidine in 30.8% (4/13), and 68Gallium-SSTRPET/CT in 81.8% (18/22) of cases. Molecular imaging discovered 79.1% (53/67) of tumors unidentified by conventional radiology, with OCT the most commonly used, revealing the tumor in 64%, followed by FDG-PET in 59.4%. F-DOPA-PET was used in only seven covert cases (sensitivity, 85.7%). Notably, 68Gallium-SSTR-PET/CT had 100% sensitivity among covert cases., Conclusions: Nuclear medicine improves the sensitivity of conventional radiology when tumor site identification is problematic. OCT offers a good availability/reliability ratio, and FDG-PET was proven useful. 68Gallium-SSTR-PET/CT use was infrequent, despite offering the highest sensitivity.

Objective: This prospective study aimed to evaluate the impact of growth hormone deficiency (GHD) on cardiac autonomic tone and on cardiovascular risk and the changes after 12 months of GH replacement therapy (GHRT). GHD is associated with increased cardiovascular morbidity and mortality. This has been attributed to increased markers of cardiovascular risk and to abnormalities of both the cardiac and peripheral autonomic nervous systems. The autonomic cardiac nervous system (ACNS) can be indirectly evaluated by analysis of heart rate variability (HRV) in clinostatism and orthostatism., Design: We compared 14 GHD patients at baseline and after 12 months of GHRT and 17 healthy controls. We analyzed a number of cardiovascular risk factors and we used analysis of HRV during the Tilt Test that identified high frequency (HF) and low frequency (LF), representing parasympathetic and sympathetic activity, respectively., Results: Compared with the control group, in either clinostatism or in orthostatism our patients showed a significantly lower value of LF (P=0.047; P=0.004, respectively), whereas HF was significantly reduced in orthostatism (P=0.037), and indicatively in clinostatism (P=0.065). These values remained unchanged after 12 months of GHRT. No statistically significant differences were found between the LF/HF ratio in untreated and treated patients. In GHD patients, there was a significant reduction of cardiovascular risk in 12 months of replacement therapy (P=0.002)., Conclusions: Our study highlights the absence of sympathovagal imbalance in GHD patients; GHRT does not change ACNS during the first year of GH treatment but it reduces the absolute cardiovascular risk in these patients.

Low birth weight and length for gestational age are associated with a high risk of short stature and metabolic syndrome in adulthood. The mechanisms that link prenatal growth to adult stature and metabolic syndrome have not yet been entirely clarified. The aim of our study was to evaluate the relationship between standardized anthropometric measures at birth and insulin-like growth factor (IGF)-I, IGF-II, insulin, adiponectin, and non-esterified fatty acid (NEFA) cord blood levels in the general population. One hundred fifty-eight random newborn subjects (77F, 81M) from Genoa, Italy, were analyzed. Anthropometric parameters were measured and standardized according to standard Italian tables. Insulin values were treated as categorical, since in several cases the results fell below detection cut-off. Mean birth weight was 3,214.23&#x2213;488.99 gr and mean length was 49.82&#x2213;2.17 cm. Females had higher mean IGF-I (p=0.04), and were more likely to have insulin values either <2 &#956;U/ml or >4.5&#956;U/ml (p= 0.04) compared to males. Weight and length SD scores (SDS) were higher in subjects with elevated insulin levels (p=0.002). A moderate correlation was found between weight and IGF-II (r=0.354). Multivariable analysis demonstrated that standardized birth weight was associated with IGFII and insulin values. Our data highlight the importance of IGF-II in fetal growth and suggest that gender differences should be taken into consideration when evaluating prenatal growth.

Identifying managed flooding in paddy fields is commonly used in remote sensing to detect rice. Such flooding, followed by rapid vegetation growth, is a reliable indicator to discriminate rice. Spectral indices (SIs) are often used to perform this task. However, little work has been done on determining which spectral combination in the form of Normalised Difference Spectral Indices (NDSIs) is most appropriate for surface water detection or which thresholds are most robust to separate water from other surfaces in operational contexts. To address this, we conducted analyses on satellite and field spectral data from an agronomic experiment as well as on real farming situations with different soil and plant conditions. Firstly, we review and select NDSIs proposed in the literature, including a new combination of visible and shortwave infrared bands. Secondly, we analyse spectroradiometric field data and satellite data to evaluate mixed pixel effects. Thirdly, we analyse MODIS data and Landsat data at four sites in Europe and Asia to assess NDSI performance in real-world conditions. Finally, we test the performance of the NDSIs on MODIS temporal profiles in the four sites. We also compared the NDSIs against a combined index previously used for agronomic flood detection. Analyses suggest that NDSIs using MODIS bands 4 and 7, 1 and 7, 4 and 6 or 1 and 6 perform best. A common threshold for each NDSI across all sites was more appropriate than locally adaptive thresholds. In general, NDSIs that use band 7 have a negligible increase in Commission Error over those that use band 6 but are more sensitive to water presence in mixed land cover conditions typical of moderate spatial resolution analyses. The best performing NDSI is comparable to the combined index but with less variability in performance across sites, suggesting a more succinct and robust flood detection method.

Aim: To show our experience in the surgical treatment of superficial vein insufficiency of the lower limbs., Subjects and Methods: Since 2002 we have performed 659 procedures of endovascular laser therapy (EVLT) (group A) in the treatment of chronic venous insufficiency of the great saphenous vein using a 980 nm diode laser. A closely matched group of 100 patients (50 Group A, 50 Group B) with homogeneous clinical findings (CEAP classification) was controlled with a mean follow-up of 18 months in our more recent experience (3 years). Most patients operated on in this period were lost to follow-up., Results: The Final results showed that EVLT can be used only in a specific selected group of cases based on anatomy and hemodynamics and while 980 nm EVLT could not be selected as the best treatment for this pathology, it could be placed side by side with conventional therapy., Conclusions: In our one year's more recent experience, we observed an increased number of patients treated with conventional therapy. The development of new laser tools (new wavelengths and continuous radial laser) and the improvement of clinical follow up may lead us to a more correct application of EVLT in the absence of randomized trials because of widespread clinical findings and poor pathological follow-up of this approach to superficial venous insufficiency.

The role of somatostatin and dopamine receptors as molecular targets for the treatment of patients with pituitary adenomas is well established. Indeed, dopamine and somatostatin receptor agonists are considered milestones for the medical therapy of these tumours. However, in recent years, the knowledge of the expression of subtypes of somatostatin and dopamine receptors in pituitary adenomas, as well as of the coexpression of both types of receptors in tumour cells, has increased considerably. Moreover, recent insights suggest a functional interface of dopamine and somatostatin receptors, when coexpressed in the same cells. This interaction has been suggested to occur via dimerisation of these G-protein-coupled receptors. In addition, there was renewed interest around the concept of cell specificity in response to ligand-induced receptor activation. New experimental drugs, including novel somatostatin analogues, binding to multiple somatostatin receptor subtypes, as well as hybrid somatostatin-dopamine compounds have been generated, and recently a completely novel class of molecules has been developed. These advances have opened new perspectives for the medical treatment of patients with pituitary tumours poorly responsive to the present clinically available drugs, and perhaps also for the treatment of other categories of neuroendocrine tumours. The aim of the present review is to summarise the novel insights in somatostatin and dopamine receptor pathophysiology, and to bring these new insights into perspective for the future strategies in the medical treatment of patients with pituitary adenomas.

The HIV-1 Rev transactivator is phosphorylated in vitro by protein kinase CK2 at two residues, Ser-5 and Ser-8; these sites are also phosphorylated in vivo. Here we show that the mechanism by which CK2 phosphorylates Rev is unique in several respects, notably: (i) it is fully dependent on the regulatory, beta-subunit of CK2; (ii) it relies on the integrity of an acidic stretch of CK2 beta which down-regulates the phosphorylation of other substrates; (iii) it is inhibited in a dose-dependent manner by polyamines and other polycationic effectors that normally stimulate CK2 activity. In contrast, a peptide corresponding to the amino-terminal 26 amino acids of Rev, including the phosphoacceptor site, is readily phosphorylated by the catalytic subunit of CK2 even in the absence of the beta-subunit. These data, in conjunction with the observation that two functionally inactive derivatives of Rev with mutations in its helix-loop-helix motif are refractory to phosphorylation, indicate the phosphorylation of Rev by CK2 relies on conformational features of distinct regions that are also required for the transactivator's biological activity.