Encrinus aculeatus von Meyer, 1849 (Crinoidea, Encrinidae) from the Middle Triassic of Val Brembana (Alpi Orobie, Bergamo, Italy)

The Triassic crinoid Encrinus aculeatus is described from a single bedding plane of uncertain Pelsonian or early Illyrian or (less probable) late Ladinian origin from Val Brembana (Alpi Orobie, Bergamo, Italy) based on 36 more or less complete crowns and columns. The specimens represent an obrutional echinoderm lagerst\ue4tte of the Muschelkalk type. The individuals are semi-adult and juvenile; adult individuals are lacking. Morphological description and comparison with the holotype and additional material from the Lower Muschelkalk and basal Middle Muschelkalk of Upper Silesia (Poland) prove the assignment to Encrinus aculeatus. However, the species concept of genus Encrinus is critical because several characters are inconsistent. E. aculeatus occurs in the Middle Triassic (Bithynian to early Illyrian, ? early Ladinian) of the western Tethys shelf and Peritethys basins (Southern Alps, Balaton Upland, Germanic Basin). Encrinus aculeatus is regarded ancestral to the Upper Muschelkalk (latest Illyrian) E. liliiformis. Until now, E. liliiformis has not yet been proven with certainty from outside the Germanic Basin; references are based on isolated and undiagnostic material

UPPER JURASSIC (TITHONIAN) AMMONITES FROM THE SPITI SHALES IN WESTERN ZANSKAR (NW HIMALAYAS)

A description is given of the ammonites collected during the Italian expedition to the Zanskar region of the NW Himalayas in 1984. The paleontological analysis is made in the context of a depositional and ecological model proposed for Spi ti Shales facies. The genera Uhligites, "Virgatosphinctes ", Aulacosphinctes and Parapallasiceras are identified. An upper to uppermost Lower Tithonian age is assigned for the highest levels of the Spiti Shales Fm. in the sector examined, although it may be possible that the extreme base of the Upper Tithonian is also represented

The Middle Triassic lagerstätt e of Monte San Giorgio reveals the oldest lace bugs (Hemiptera: Tingidae): Archetingis ladinica gen. n. sp. n.

A new genus and species of fossil lace bugs (Hemiptera; Tingidae), Archetingis ladinica gen. n. et sp. n. is described from the lower Kalkschieferzone (Meride Limestone, Upper Ladinian) of the Swiss side of Monte San Giorgio. The new taxon clearly resembles modern Tingidae in its hemelytra and pronotum, with two rows of areole, in the presence of bucculae closed at the anterior end, not extending beyond the apex of the head, and in the presence of a labial groove on the meso-/metathoracic sternum. Distinctive features are the thick femurs of the first and second pair of legs, the exceptional size (total length of ~12 mm) if compared with both fossil and extant species. Archetingis ladinica gen. n. et sp. n. represents by far the oldest known species of this family and brings back the origin of Tingidae of approximately 140 My, well into the Middle Triassic. The discovery of A. ladinica, beside its evolutionary consequences on the origin of extant Tingidae, provides evidences for the presence of terrestrial ecosystems nearby to the depositional environment. According to the living and trophic behavior of extant Tingidae, those emerged lands had to be covered by vegetation

Medicina Interna e Clinical Governance: quali proposte per il prossimo futuro?

Medicina Interna oggi: introduzione M. Campanini Cos’è la Medicina Interna? M. La Regina, P. Gnerre La Medicina Interna deve garantire una buona qualità di assistenza alle persone anziane ospedalizzate G. Iosa Lean organization e learning organization a confronto per la Medicina Interna D. Croce Clinical governance: ultima spiaggia per salvare la sanità pubblica? A. Cartabellotta È ancora possibile una reale alleanza tra clinici e gestori per una Medicina Interna ospedaliera sostenibile? S. De Carli La cultura internistica come visione di un auspicato cambiamento in medicina e nella organizzazione ospedaliera: l’esperienza di due realtà toscane G. Landini, G. Panigada, L. Masotti, I. Chiti Indicatori di qualità nella Medicina Interna ospedaliera: solamente durata di degenza, ricoveri inappropriati, mortalità intraospedaliera e tasso di re-ricovero a 30 giorni? E. Foglia, D. Croce Medicina Interna e rischio clinico: criticità e possibili correttivi G. Chesi, F. Dall’Orto, P. Ragni, R. Nardi Nuovi assetti organizzativi in area medica: aspetti gestionali clinici ed economici I. Stefani, A. Mazzone Troppe procedure M. Bobbio, L. Lusiani, R. Frediani Medicina Interna e wise medicine: le proposte FADOI, le prospettive assistenziali e le ricadute gestionali G. Panigada, I. Chiti, A. Fortini, L. Masotti, N. Napoli Il percorso del tromboembolismo venoso nell’ospedale per intensità di cure: paradigma di wise medicine L. Masotti, I. Chiti, G. Landini, N. Napoli, G. Panigada Governo clinico e Medicina Interna: quali proposte per il prossimo futuro? R. Risicato Potenzialità dell’audit clinico in Medicina Interna: lo studio DDIMA M. Gambacorta, in collaborazione con il DDIMA Group Conclusioni: Medicina Interna domani A. Fontanell

A new species of the genus Perleidus (Actinopterygii: Perleidiformes) from the Middle Triassic of Southern China

Perleidus sinensis n. sp., a new species of "Subholostea " fossil fish of the order Perleidiformes is described herein on the basis of a single, well-preserved specimen collected from the Upper Member of the Guanling Formation (Pelsonian, Middle Anisian, Middle Triassic) outcropping near Luoping (Yunnan Province) in South China. The vertebrate assemblage yielded by these levels is proving to be of importance with regard to the marine Triassic ichthyofaunas, not only due to the variety, richness and quality of preservation of the faunas, but also from a paleobiogeographic point of view. The new taxon here described belongs to the genus Perleidus, so far represented only in the upper Ladinian of Northern Italy and Switzerland; this find reconfirms a very close connection between the Eastern and Western Tethys during the Middle Triassic, when many fish genera may have migrated from the Southern China Block to the Western Tethys area, giving rise to a notable radiation during some intervals of the Triassic. Besides Perleidus, other actinopterygians are common to both margins of the Tethys, such as Sangiorgioichthys, Habroichthys, Placopleurus, Peltopleurus, Peltoperleidus, Marcopoloichthys, Colobodus, Luopingichthys as well as the cosmopolitan genera Saurichthys and Birgeria

Terrestrial origin of viviparity in Mesozoic marine reptiles indicated by early triassic embryonic fossils

Viviparity in Mesozoic marine reptiles has traditionally been considered an aquatic adaptation. We report a new fossil specimen that strongly contradicts this traditional interpretation. The new specimen contains the oldest fossil embryos of Mesozoic marine reptile that are about 10 million years older than previous such records. The fossil belongs to Chaohusaurus (Reptilia, Ichthyopterygia), which is the oldest of Mesozoic marine reptiles (ca. 248 million years ago, Early Triassic). This exceptional specimen captures an articulated embryo in birth position, with its skull just emerged from the maternal pelvis. Its headfirst birth posture, which is unlikely to be a breech condition, strongly indicates a terrestrial origin of viviparity, in contrast to the traditional view. The tail-first birth posture in derived ichthyopterygians, convergent with the conditions in whales and sea cows, therefore is a secondary feature. The unequivocally marine origin of viviparity is so far not known among amniotes, a subset of vertebrate animals comprising mammals and reptiles, including birds. Therefore, obligate marine amniotes appear to have evolved almost exclusively from viviparous land ancestors. Viviparous land reptiles most likely appeared much earlier than currently thought, at least as early as the recovery phase from the end-Permian mass extinction

A New SteatoScore in the Evaluation of Non-Alcoholic Liver Disease in Oncologic Patients

PurposeThe aims of this study were to evaluate the reproducibility of a new multi-parametric steatoscore (new SteatoScore) in oncologic patients with non-alcoholic fatty liver disease (NAFLD) and to compare it with computed tomography (CT). Materials and MethodsFifty-one (31 men, 20 women) oncologic patients, with a mean age and weight of 63.9 years and 78.33 kg, respectively, were retrospectively enrolled in the study. Patients underwent ultrasound (US) and computed tomography (CT) examinations as part of their oncologic follow-up protocol. US examinations were performed by using a 3.5-MHz convex probe. During the US examination, three standardized clips were obtained in each patient. Two operators performed all measurements, one of whom repeated the processing twice in 1 year. Hepatic/renal ratio (HR), attenuation rate (AR), diaphragm visualization (DV), hepatic/portal vein ratio (HPV), and portal vein wall visualization (PVW) were acquired and calculated by using Matlab and inserted in a multi-parametric algorithm called new SteatoScore. On unenhanced CT scan, hepatic attenuation (HA), liver-spleen difference (L-S), and liver/spleen ratio (L/S) were measured by placement of a region of interest (ROI) within liver and spleen parenchyma, avoiding areas with vessels and biliary ducts. ResultsThe intra-observer variability was greater than the inter-observer one, with intraclass correlation coefficient (ICC) values of 0.94 and 0.97, respectively. Correlation between single US and CT parameters provided an agreement in no case exceeding 50%. New SteatoScore showed high reproducibility, and high coefficient of correlation with L-S (R = -0.64; p < 0.0001) and L/S (R = -0.62; p < 0.0001) at CT. ConclusionNew SteatoScore has a high reproducibility and shows a good correlation with unenhanced CT in evaluation of oncologic patients with NAFLD

Percutaneous Application of High Power Microwave Ablation With 150 W for the Treatment of Tumors in Lung, Liver, and Kidney: A Preliminary Experience

Objective: The aim of this study is to evaluate the feasibility, safety, and short-term effectiveness of a high-power (150 W) microwave ablation (MWA) device for tumor ablation in the lung, liver, and kidney. Methods: Between December 2021 and June 2022, patients underwent high-power MWA for liver, lung, and kidney tumors. A retrospective observational study was conducted in accordance with the Declaration of Helsinki. The MWA system utilized a 150-W, 2.45-GHz microwave generator (Emprint™ HP Ablation System, Medtronic). The study assessed technical success, safety, and effectiveness, considering pre- and post-treatment diameter and volume, lesion location, biopsy and/or cone beam computed tomography (CBCT) usage, MWA ablation time, MWA power, and dose-area product (DAP). Results: From December 2021 to June 2022, 16 patients were enrolled for high-power MWA. Treated lesions included hepatocellular carcinoma (10), liver metastasis from colon cancer (1), liver metastasis from pancreatic cancer (1), squamous cell lung carcinoma (2), renal cell carcinoma (1), and renal oncocytoma (1). Technical success rate was 100%. One grade 1 complication (6.25%) was reported according to CIRSE classification. Overall effectiveness was 92.8%. Pre- and post-treatment mean diameters for liver lesions were 19.9 mm and 37.5 mm, respectively; for kidney lesions, 34 mm and 35 mm; for lung lesions, 29.5 mm and 31.5 mm. Pre- and post-treatment mean volumes for liver lesions were 3.4 ml and 24 ml, respectively; for kidney lesions, 8.2 ml and 20.5 ml; for lung lesions, 10.2 ml and 32.7 ml. The mean ablation time was 48 minutes for liver, 42.5 minutes for lung, and 42.5 minutes for renal ablation. The mean DAP for all procedures was 40.83 Gcm2. Conclusion: This preliminary study demonstrates the feasibility, safety, and effectiveness of the new 150 W MWA device. Additionally, it shows reduced ablation times for large lesions

Recalibration of the insect evolutionary time scale using Monte San Giorgio fossils suggests survival of key lineages through the End-Permian Extinction

Insects are a highly diverse group of organisms and constitute more than half of all known animal species. They have evolved an extraordinary range of traits, from flight and complete metamorphosis to complex polyphenisms and advanced eusociality. Although the rich insect fossil record has helped to chart the appearance of many phenotypic innovations, data are scarce for a number of key periods. One such period is that following the End-Permian Extinction, recognized as the most catastrophic of all extinction events. We recently discovered several 240-million-year-old insect fossils in the Mount San Giorgio Lagerstatte (Switzerland-Italy) that are remarkable for their state of preservation (including internal organs and soft tissues), and because they extend the records of their respective taxa by up to 200 million years. By using these fossils as calibrations in a phylogenomic dating analysis, we present a revised time scale for insect evolution. Our date estimates for several major lineages, including the hyperdiverse crown groups of Lepidoptera, Hemiptera: Heteroptera and Diptera, are substantially older than their currently accepted post-Permian origins. We found that major evolutionary innovations, including flight and metamorphosis, appeared considerably earlier than previously thought. These results have numerous implications for understanding the evolution of insects and their resilience in the face of extreme events such as the End-Permian Extinction