Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

A first update on mapping the human genetic architecture of COVID-19

peer reviewe

The fuzzy boundaries of the social (pragmatic) communication disorder (SPCD): Why the picture is still so confusing?

Introduction: Since the introduction of Social (Pragmatic) Communication Disorder (SPCD) in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) in 2013, a debate has arisen in the scientific community about its usefulness in differential diagnosis for other clinical categories such as Autism Spectrum Disorder (ASD) and Specific Language Impairment (SLI). Indeed, SPCD criteria share a common deficit in communication and pragmatic skills with these diagnostic entities. Available assessment tools seem scarce and not sensitive enough to clarify diagnostic criteria and clinical boundaries. This study aims to review the existing literature on diagnostic screening for SPCD to highlight confounding variables in the domains examined, overlap with other diagnostic entities, and lack of specificity of available assessment tools in identifying the core deficits of the disorder. Methods: The search strategy was defined by combining the following keywords: “social pragmatic communication disorder,” “DSM-5,” “differential diagnosis,” and “child.” The search was performed in three databases: Medline (PubMed), Scopus, and Web of Science. All studies published between 2013 and April 2023, written in English, and with a major focus on SPCD were included in the review. Results: After the screening for the eligibility, 18 studies were included in the review. Most of these studies aimed to investigate the differential diagnosis between SPCD and other diagnostic categories (e.g., specific language impairment and autism spectrum disorder). Of these researches, only 6 were ad hoc experimental studies, while the others were based on previously collected databases. Conclusions: SPCD seems to have its own peculiarities and characteristics, indicating its clinical relevance, as emphasized by the DSM-5. However, the lack of specific instruments and a number of confounding variables make it difficult to identify and differentiate SPCD from other diagnostic entities. Further research is needed to overcome the lack of specific clinical instruments and lack of empirical studies

Microwave Curing Of Cementitious Materials

High performance mortars were either microwave-treated, at 80°C for 15-780 min, or wet-cured, at 80°C for 24h, and their mechanical properties (flexural and compression strength) and microstructural features (porosity, bound water, texture of crystalline components) investigated. The cement was a type I 52.5 OPC to which microsilica was added as the pore filling component. The aggregate was natural sand. A low water to cement ratio (0.24) and a polymeric acrylic superfluidifier were used to limit the residual porosity and retain good workability. The compressive strength, after 24 h at room temperature, was ~50 MPa which increased to ~100 MPa after hot wet cure (flexural data were ~6 and ~16 MPa, respectively). For the microwave treated mortars the compressive strength varied from ~50 to ~110 MPa, depending on the duration of exposure and sample confinement during the treatment. The strength of mortars was strictly related to the variation of water content. Both the total porosity, evaluated by mercury intrusion porosimetry, and the threshold pore size, regularly decreased on extending the microwave treatment. X-ray diffraction spectra showed that the cement constituents did not react completely due to the limited amount of water and the brevity of the treatment. The cement gel of microwaved mortars appeared to be better structured than that of the wet-cured counterpart

Advancements In Modelling The Development Of Microstructure In Cement Pastes

The time evolution of some microstructural parameters (porosity, composition) and physical properties (electrical conductivity) of young cement pastes have been modelled by means of a numerical code (chemhyd3d) based on the percolation theory. The computational results have been compared with experimental data (for the electrical conductivity) and porosities reckoned by the Powers equation. Very good agreement has been found which indicated that the effects of the foremost parameters on the properties of mortars and concrete can now accurately predicted

Electrical properties of fluidified portland cement mixes in the early stage of hydration

The electrical conductivity and the dielectric constant of cement mixes have been studied in the initial stages of setting to correlate the time evolution of the electrical parameters with the chemical and microstructural modifications. The formulations, based on a mix of Portland cement and microsilica, were fluidified with various amounts of an acrylic polyelectrolite and had a w/c ratio of 0.24. Measurements were carried out at ambient temperature for times of up to 40 h, in the frequency interval 30 Hz–200 kHz. The conductivity showed a marked decrease correlated with the loss of connectivity of the macroscopic porosity (depercolation). The time to the drop of conductivity depended linearly on the concentration of superplasticizer whose retarding effect was clearly evidenced. A dielectric amplification phenomenon was observed which vanished after the porosity depercolated. The temperature profiles of mixtures with different concentrations of the superplasticizer were drawn and a simple model was developed to compute the specific thermal power as a function of time. A substantial coincidence was found, on the time axis, between depercolation and maximum rate of setting. Vicat tests were also carried out

Metodi elettrici nella tecnologia di malte e calcestruzzi

The application of electrical methods to the technology of cementitious materials opens up new possibilities for monitoring setting and hardening processes of fresh, admixtured pastes or for tracking the invasion of aggressive chemicals in hardened structures. The electrical conductivity can be related, by means of percolation models, to the porosity of the material and, therefore, to its strength. Innovative formulations with unusual properties can also be produced by controlling the electrical conductivity of hardened mortars. Further, energy efficient accelerated hardening techniques and contactless breaking techniques for decontamination and decommissioning processes in nuclear power plants are being developed

Accelerated Curing Of Cement Based Materials

Portland cements are slow hardening materials and several techniques are used to expedite the attainment of a satisfactory strength, i.e., chemicals, reduction of particle size, heat. Increasing the temperature is by far the most effective. Dielectric heating is a well established technique in materials technology but the cement industry has so far expressed little interest in this technology, probably because the effects on the final properties of mortars and concrete are not well established yet and for the greater complexity of the process compared, for instance, to steam curing. Fear of radiation leakage from high power applicators not correctly designed and operated has placed a further constraint to the acceptance of this technique. Although early results of microwave heating were unsatisfactory, likely because of overheating effects, the availability of temperature controlled microwave applicators now makes it possible to choose temperature profiles that favourably influences the final properties of the materials. Here we report on the effects of microwave treatments on three types of modified portland cements: one contained microsilica and the others granulated slag or flyash from coal burning. In all cases an acrylic superfluidifier was used to keep water content low. The microwave treatment was given at 80°C for 0 to 16 h. The mechanical properties of the microwave treated samples were compared to those of samples treated in water at 80°C for 24 h. Mercury intrusion porosimetry, thermal analysis and SEM examination were also carried out to investigate the microstructural modifications brought about by the microwave treatment