Le autostrade del mare in Italia- Analisi delle criticità e prospettive per il futuro

La presente ricerca si propone di analizzare il sistema delle autostrade del mare in Italia con particolare attenzione alle criticità presenti nei nodi marittimi italiani. Le autostrade del mare rappresentano uno strumento introdotto in sede europea per cercare di ridurre il traffico su strada, attraverso incentivi che rendano più conveniente una modalità, quale quella marittima, caratterizzata da un minor impatto ambientale e in grado di generare minori costi generalizzati del trasporto. La necessità stessa di introdurre questo nuovo tipo di “infrastruttura” deriva dalla congestione di alcune grandi arterie del trasporto stradale che hanno aumentato le esternalità del trasporto su gomma, sia merci che passeggeri, mettendo in evidenza la necessità di un riequilibrio modale. Attraverso l’analisi delle rotte attualmente presenti a livello nazionale, degli operatori, dei terminali marittimi e delle criticità ad essi legate, lo studio verifica il raggiungimento degli obbiettivi alla base di questa politica e suggerisce possibili interventi, a livello infrastrutturale e normativo, al fine di promuoverne ulteriormente lo sviluppo.:Motorways of the Sea, Short Sea Shipping, Italian shipping industry, Logistic

A comprehensive cardiopulmonary simulation model for the analysis of hypercapnic respiratory failure

We developed a new comprehensive cardiopulmonary model that takes into account the mutual interactions between the cardiovascular and the respiratory systems along with their short-term regulatory mechanisms. The model includes the heart, systemic and pulmonary circulations, lung mechanics, gas exchange and transport equations, and cardio-ventilatory control. Results show good agreement with published patient data in case of normoxic and hyperoxic hypercapnia simulations. In particular, simulations predict a moderate increase in mean systemic arterial pressure and heart rate, with almost no change in cardiac output, paralleled by a relevant increase in minute ventilation, tidal volume and respiratory rate. The model can represent a valid tool for clinical practice and medical research, providing an alternative way to experience-based clinical decisions

Lithium disilicate posterior overlays: clinical and biomechanical features

The aim of this study was to evaluate the survival rate of lithium disilicate overlays in increasing occlusal vertical dimension (OVD) in the setting of minimally invasive techniques and the restoration thicknesses at different tooth sites. This is an observational study evaluating 43 lithium disilicate overlays (Lithium IPS e.max Press, Ivoclar Vivadent) on 8 patients, prepared with minimally invasive criteria over a follow-up period between 19 to 45 months (mean follow-up of 32 months). Occlusal vertical dimension's increase was planned using occlusal treatment plan and diagnostic wax-up. Prior to adhesive cementation, restoration thicknesses were measured with a caliber. The survival rate was calculated by Kaplan-Meier analysis. Restoration survival rates at 32 months were 97.7%. One infiltration was observed, no cases of fracture occurred. The greatest thickness in monolithic restorations was detected in the cusp sides of teeth, whereas the thinnest was highlighted in the central fossa. The average amount of dental tissue removed during preparation was 0.98 mm in non-functional cusps, 0.88 mm in functional cusps, and 0.57 mm in the central fossa. Lithium disilicate posterior overlays show an excellent complication-free survival rate, and the material allows for conservative restorations with minimum thickness. Monolithic lithium disilicate overlays feature a satisfying 32-month survival rate. The technique allows to perform restorations with a minimal removal of dental tissue, while limiting fractures over time. Its esthetical performance is excellent

Fracture strength and ribbond fibers : in vitro analysis of mod restorations

Ribbond fibers are supposed to be a reinforcing material in restoration of compromised teeth. This study aims to compare MOD restorations with and without Ribbond Fiber in terms of fracture strength under axial loading; to identify the minimum depth of M

Response to a Comment on “Malignant transformation evidences of Oral Lichen Planus: When the time is of the essence”

Dear Editor, We want to thank Desai et al. [1] for the comment and discussion on our article “Malignant transformation evidences of Oral Lichen Planus: When the time is of the essence” [2]. Firstly, we are pleased to inform you that our extended work about Oral Lichen Planus (OLP) and malignant transformation was recently published, which allows us to better understand unclear issues [3]. However, regarding the letter by Desai RS et al., some clarifications deserve to be provided. We are in agreement with Guan et al. [4] who highlighted that OLP malignant transformation occurred also in not smokers patients. Our findings, indeed, showed a significant malignant transformation rate associated with localization of OLP lesions (especially on tongue margins, OR = 3.55 and P = 0.04) and with features of them (particularly erosive and ulcerative lesions, OR = 2.48 and P = 0.1). Regarding habits, smoking was found to be significantly associated with cancer transformation with an Odds Ratio (OR) of 3.29 (IC 0.58–18.37) and P = 0.18; on the other side, it was difficult to estimate the role of alcoholic consumption, due to uncertain answers of patients interviewed. Nevertheless, in our opinion, the important focus to evaluate is the observation period of patients when OLP is diagnosed and lesions. Our work showed the great importance of extending follow-up to early diagnose malignant transformation; indeed some of them occurred later than 4 years of observation, meaning that the cancer transformation rate of OLP lesions is a significant risk during the life as Guan et al. suggested in their research. Considering our results, we can conclude that clinical features of OLP lesions must be carefully evaluated for the correct timing of the follow-up, which must be as long as possible for them. We sincerely thank Desai RS et al. for the discussion about our work

Clinical and Esthetical Evaluation of 79 Lithium Disilicate Multilayered Anterior Veneers with a Medium Follow-Up of 3 Years

Objectives Primary aim of this study was to evaluate survival rate of lithium disilicate veneers in upper and lower anterior teeth. Secondary aims were to evaluate changing in proportions of teeth before and after restorations and to assess mean thickness of the veneers. Materials and Methods Seventy-nine upper and lower lithium disilicate veneers were made in 13 patients with worn teeth. Mean follow-up was 3 years. To perform anterior definitive rehabilitations, malocclusions and loss of vertical dimension were treated by full mouth rehabilitations to obtain proper occlusal conditions. Veneers were made of lithium disilicate core and fluorapatite-based ceramic stratification. Survival rate was calculated by Kaplan-Meier analysis. Changing in teeth proportion before and after restorations was analyzed by a paired t -test. Descriptive statistics of thickness values were also performed. Results One case of detachment was observed with a 98.7% survival rate. Teeth's proportions were preserved although the first upper right incisor and canine changed in dimension. Conclusions Lithium disilicate veneers in esthetical rehabilitations of worn teeth proved to be an effective way of treatment in a medium follow-up of 3 years. Proportions seemed to be maintained with a minimum dental removal

Microleakage of Direct Restorations. Comparisonbetween Bulk-Fill and Traditional Composite Resins:Systematic Review and Meta-Analysis

Since the bulk-fill composites were produced, there was a progressive diffusion of their use for direct conservative treatment in posterior teeth. Their chemical structure increases the depth of cure and decreases the polymerization contraction; in this man- ner, bulk-fill composites can be placed in 4 mm single layers and the treatment times are considerably reduced. However, aesthetic and mechanical properties and impact on microleakage of bulk-fill resins are still unclear. This systematic review and meta-analysis aimed to assess the risk of microleakage of direct posterior restorations made of bulk-fill versus conventional composite resins. Researches were performed on PubMed and Scopus databases. Eligible in vivo studies, published since 2006, were reviewed. Outcomes of marginal discoloration, marginal adaptation, and recurrent caries were considered to conduct the systematic review and meta-analysis. Secondary data were examined to implement additional analysis and assess the risk of bias. Eight randomized clinical trials were analyzed, involving 778 direct restorations. The summary of RCTs led to significant but inconsistent results; the marginal discolor- ation and recurrent caries were found to be improved respectively by 5.1 and 1.4%, whereas the marginal adaptation was reduced of 6.5%. Secondary analyses revealed that follow-up periods, the adhesive system used and the class of carious lesions eval- uated are confounding factors, and they result in a risk of bias across studies. Bulk-fill composites are innovative materials for conservative dentistry and they can be used to reduce treatment steps and duration of operative times. There are insufficient data to explore the relationship between bulk-fill composites and microleakage and further investigations are needed

Implementing post-orthodontic compliance among adolescents wearing removable retainers through Whatsapp: a pilot study

Purpose: To determine whether the use of social media is useful in improving compliance and follow-up attendance among patients wearing retainers after orthodontic treatment. Patients and methods: Sixty post-orthodontic patients (aged 16-19 years), randomized in two groups: follow-up supported by participation in WhatsApp chat group (SG), and Control Group (CG). All patients were scheduled for quarterly check-ups for monitoring of orthodontic stability by measurement of intercanine width at the beginning of the study (t(0)) and every 4 months t(1), t(2), t(3)) for 1 year of observation. Patients in the SG additionally participated in a WhatsApp chat group, where they would send, on a weekly basis, snapshots showing his/her occlusion. Every month, the orthodontist acting as the moderator awarded the best five snapshots by publishing a ranking in the chat. Results: Participants in the SG featured smaller changes from the intercanine widths at baseline (at debonding) compared to the CG patients at all times during 1 year of follow-up. Follow-up attendance was regular in both groups in the first 8 months of follow-up. After that, patient compliance decreased in the CG, with eight patients missing check-up appointments. Conclusion: Engaging adolescent patients directly through WhatsApp activity seems to increase regularity in wearing removable retainers, attendance to follow-up schedule, and yield better long-term outcome in terms of orthodontic stability and compliance

Apps for oral hygiene in children 4 to 7 years : fun and effectiveness

Nowadays apps in preschool age are largely used in learning improvement. The aim of this work was to test effectiveness of apps in improving oral hygiene in children patients aged from 4 to 7 years and evaluating correlation between parents educational attainment and children oral hygiene. 100 patients aged from 4 to 7 years were randomly assigned by an external office in the study group (SG: 32 females, 18 males) and in the control group (CG: 28 females and 22 males). Plaque index (PI) and carious lesions localisation were detected. At baseline all patients and one of the parents were instructed at chair-side about the proper oral hygiene techniques. SG patients were also given app as an aid in oral hygiene practice. Follow-up was 12 months. Measurements were made every three months at chair-side visits. Information about children compliance in oral hygiene and educational level of parents were obtained by questionnaires at t0 and after 12 months. SG patients showed stronger oral hygiene and PI lower than those in CG. Questionnaire showed higher compliance of SG patients and parents educational level seemed to affect children oral hygiene. Apps in children allowed achieving encouraging results with improvement of oral hygiene and health