Spatial data and GIS for the assessment of the environmental impact at Mount Etna

One of the fundamental tasks for environmental impact assessment and natural risk management is the accurate and updated cataloging of road infrastructures and buildings. This is particularly important in volcanic areas, in order to predict the range of damage and disruption, and therefore losses and reconstruction costs that could result from an eruption. GIS allows immediate access to spatial data with the ability to overlay location-based information for easy interpretation, providing a critical tool for assessing and mitigating risk from natural phenomena. In this work, we present an innovative GIS‑based system for the identification of the values exposed to volcanic eruptions at Mount Etna, which can be used in both the readiness and response phases to a volcanic emergency. We carried out a precision mapping of buildings and road infrastructures on the flanks of the Etna volcano, giving particular attention to the exposed sensitive buildings (such as schools, barracks, hospitals, etc.) and to the construction and roofing characteristics. The result is an informative and dynamic platform that offers new opportunities and challenges to decision makers for the definition of both long‑term strategies, such as territorial planning, and short‑term strategies, for the prediction of the impact of eruptions or for managing evacuations during volcanic emergencies

UN APPROCCIO GEOMATICO PER LA GESTIONE DEL RICOVERO DEL PAZIENTE AFFETTO DA COVID-19

During the COVID-19 pandemic period, it is often necessary to hospitalize a patient positive for the virus and in serious health conditions in suitable hospitals. The difficulty in managing these emergencies arises from the fact that it is often not possible to know which is the nearest hospital with beds available for hospitalization of the COVID-19 patients. In this work, we pre-sent a GIS application based on a relational database that allows to determine an optimal path for the patient transport from a starting point to the nearest hospital with free places for hospitalization. The developed application re-duces the patient's transport time, decreasing the exposure time of the medi-cal staff in the ambulance in contact with the positive patient. The applica-tion was developed in the urban area of Catania where hospitals gather a large pool of users and therefore it is essential to have a system that in real-time provides the available beds and thus optimize the distribution of COVID-19 positive patients who need an admission to a hospital

Methacronous Intercostal and Peritoneal Metastases from Resected Well-differentiated Hepatocellular Carcinoma: Description of a Case and Review of Literature

Introduction: The aim of this report is to prove the possibility of simultaneous difficult cardiac and urologic operation. Important point to make in our report concerns the fact that the oncologic treatment was not delayed despite severe heart disease. There is also an advantage in avoiding second operation and hence anesthesiaCase Presentation: A 72 year old male presented to us with right renal mass lesion with tumour thrombus extending up to right atrium. He had undergone Percutaneous Transluminal Coronary Angioplasty 5 years ago and had two coronary stents in situ. Coronary angiography revealed triple vessel coronary re obstruction. After proper planning he underwent right radical nephrectomy with tumour thombectomy along with Coronary Artery Bypass Grafting in the same sitting.Conclusion: One-stage cardiac and uro-oncologic operation can be a safe and beneficial procedure, if performed in selected patients

Thymomectomy versus complete thymectomy in early-stage non-myasthenic thymomas: a multicentric propensity score-matched study

Objectives: Thymomectomy is gaining consensus over complete thymectomy in early-stage thymoma without myasthenia gravis. This is due both to the difficulty of establishing prospective and randomized controlled studies and to the lack of well-defined selection criteria. This bicentric, retrospective propensity score-matched study aims at comparing oncological outcomes, measured in terms of overall survival and thymoma-related survival, in patients undergoing either thymomectomy or complete thymectomy. Methods: We retrospectively analysed medical records of patients with clinical early-stage (I and II) thymoma undergoing thymomectomy or complete thymectomy. Exclusion criteria were the presence of myasthenia gravis, clinical advanced tumours and thymic carcinoma. A propensity score-matching analysis was applied to reduce potential preoperative selection biases such as comorbidity (Charlson score), tumour maximal diameter and surgical approach (open versus minimal). All variables were dichotomized. Results: A total of 255 patients were enrolled from 2 different Hospitals, 126 underwent complete thymectomy and 129 a thymomectomy. Disease-free and thymoma-related survivals showed a 5-year rate of 87.7% and 96.0% and a 10-year rate of 82.2% and 91.9%, respectively. Propensity score-matching analysis selected a total of 176 patients equally divided between the 2 groups. No difference was found for both disease-free (P = 0.11) and thymoma-related (P = 0.37) survival in the 2 groups of resection. Multivariable Cox regression analysis showed that histology (P < 0.001), residual disease (P < 0.001) and adjuvant chemotherapy (P < 0.001) were the only predictors of shorter disease-free survival. Whereas there was no evidence to confirm that disease-free and thymoma-related survivals were influenced by resection extent. Conclusions: Thymomectomy is an adequate surgical resection for non-myasthenic thymoma, achieving disease-free and thymoma-related survivals comparable to those after complete thymectomy

Ammonia Toxicity and Associated Protein Oxidation: A Single-Cell Surface Enhanced Raman Spectroscopy Study

Ammonia (NH3) is a commonly used industrial chemical to which exposure at high concentrations can result in severe skin damage. Moreover, high levels of ammonia in the human body can lead to hyperammonemia conditions and enhanced cancer metabolism. In this work, the toxicity mechanism of NH3 has been studied against human dermal fibroblast (HDF) cells using surface-enhanced Raman spectroscopy (SERS). For this purpose, gold nanoparticles of size 50 nm have been prepared and used as probes for Raman signal enhancement, after being internalized inside HDF cells. Following the exposure to ammonia, HDF cells showed a significant variation in the protein ternary structure's signals, demonstrating their denaturation and oxidation process, together with early signs of apoptosis. Meaningful changes were observed especially in the Raman vibrations of sulfur-containing amino acids (cysteine and methionine) together with aromatic residues. Fluorescence microscopy revealed the formation of reactive oxygen and nitrogen species in cells, which confirmed their stressed condition and to whom the causes of protein degradation can be attributed. These findings can provide new insights into the mechanism of ammonia toxicity and protein oxidation at a single-cell level, demonstrating the high potential of the SERS technique in investigating the cellular response to toxic compounds

How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Forest Fire Spreading Using Free and Open-Source GIS Technologies

Forest fires are one of the most dangerous events, causing serious land and environmental degradation. Indeed, besides the loss of a huge quantity of plant species, the effects of fires can go far beyond: desertification, increased risk of landslides, soil erosion, death of animals, etc. For these reasons, mathematical models able to predict fire spreading are needed in order to organize and optimize the extinguishing interventions during fire emergencies. This work presents a new system to simulate and predict the movement of the fire front based on free and open source Geographic Information System (GIS) technologies and the Rothermel surface fire spread model, with the adjustments made by Albini. We describe the mathematical models used, provide an overview of the GIS design and implementation, and present the results of some simulations at Etna volcano (Sicily, Italy), characterized by high geomorphological heterogeneity, and where the native flora and fauna may be preserved and perpetuated. The results consist of raster maps representing the progress times of the fire front starting from an ignition point and as a function of the topography and wind directions. The reliability of results is strictly affected by the correct positioning of the fire ignition point, by the accuracy of the topography that describes the morphology of the territory, and by the setting of the meteorological conditions at the moment of the ignition and propagation of the fire.</jats:p

Lung Cancer Treatment: From Tradition to Innovation

Lung cancer (LC) is the second most commonly diagnosed cancer and the primary cause of cancer death worldwide in 2020. LC treatment is associated with huge costs for patients and society; consequently, there is an increasing interest in the prevention, early detection with screening, and development of new treatments. Its surgical management accounts for at least 90% of the activity of thoracic surgery departments. Surgery is the treatment of choice for early-stage non-small cell LC. In this article, we discuss the state of the art of thoracic surgery for surgical management of LC. We start by describing the milestones of LC treatment, which are lobectomy and an adequate lymphadenectomy, and then we focus on the traditional and innovative minimally invasive surgical approaches available: video-assisted thoracoscopic surgery (VATS) and robotic-assisted thoracoscopic surgery (RATS). A brief overview of the innovation and future perspective in thoracic surgery will close this mini-review.</jats:p