A novel stepwise micro-TESE approach in non obstructive azoospermia

Background: The purpose of the study was to investigate whether micro-TESE can improve sperm retrieval rate (SRR) compared to conventional single TESE biopsy on the same testicle or to contralateral multiple TESE, by employing a novel stepwise micro-TESE approach in a population of poor prognosis patients with non-obstructive azoospermia (NOA). Methods: Sixty-four poor prognosis NOA men undergoing surgical testicular sperm retrieval for ICSI, from March 2007 to April 2013, were included in this study. Patients inclusion criteria were a) previous unsuccessful TESE, b) unfavorable histology (SCOS, MA, sclerahyalinosis), c) Klinefelter syndrome. We employed a stepwise micro-TESE consisting three-steps: 1) single conventional TESE biopsy; 2) micro-TESE on the same testis; 3) contralateral multiple TESE. Results: SRR was 28.1 % (18/64). Sperm was obtained in both the initial single conventional TESE and in the following micro-TESE. The positive or negative sperm retrieval was further confirmed by a contralateral multiple TESE, when performed. No significant pre-operative predictors of sperm retrieval, including patients’ age, previous negative TESE or serological markers (LH, FSH, inhibin B), were observed at univariate or multivariate analysis. Micro-TESE (step 2) did not improve sperm retrieval as compared to single TESE biopsy on the same testicle (step 1) or multiple contralateral TESE (step 3). Conclusions: Stepwise micro-TESE could represent an optimal approach for sperm retrieval in NOA men. In our view, it should be offered to NOA patients in order to gradually increase surgical invasiveness, when necessary. Stepwise micro-TESE might also reduce the costs, time and efforts involved in surgery

Patterns of CT lung injury and toxicity after stereotactic radiotherapy delivered with helical tomotherapy in early stage medically inoperable NSCLC

To evaluate toxicity and patterns of radiologic lung injury on CT images after hypofractionated image-guided stereotactic body radiotherapy (SBRT) delivered with helical tomotherapy (HT) in medically early stage inoperable non-small-cell lung cancer (NSCLC)

Sustainability of global feeding.Coopetitive interaction among vegan and non-vegan food firms

In this paper, we face the problem of global feeding sustainability and related environmental issues, with a strong attention to possible public heath improvements. Specifically, we shall consider food producers and sellers of vegan (or vegetarian) and non-vegan (or non-vegetarian) food. We propose possible quantitative agreements among different food producers, in order to develop a sustainable healthier diet for future generations, by using a mathematical co-opetitive approach and game theory. The co-opetitive approach used by the authors provides a game theory model, which could help producers of vegan food an easier entry in global market and obtain a considerable free publicity. Meanwhile, the model could allow big producers/sellers of non-vegetarian food a smooth rapid transaction to more sustainable and healthier vegan or vegetarian production/supply. In particular, we propose an exemplary complex agreement setting among McDonald's and Muscle of Wheat, a small but strongly innovative Italian food producer. We think that, on one hand, Muscle of Wheat cannot enter a global market without the help of a large globalized food producer already present in the market, on the other hand, we think equally difficult that a large static and poorly innovative producer cannot follow credibly and rapidly enough the increasing and challenging issues of global food sustainability. We remark that our game model represents an asymmetric R&D alliance between McDonald's and Muscle of Wheat. The aim of our contribution is twofold. Firstly, we explain the advantages of a vegan diet for the human health, environmental issues, food sustainability, population sustainability; in fact, the model explain how global food producers could improve environmental, social and health conditions of world population. Secondly, we show how game theory normal-form and extensive-form games can be used in coopetition studies in order to increase health conditions of people, address climate change, address hunger in the world, improve welfare in a particular market. The results of the mathematical study prove that we can find win-win solutions for both firms, which are also good for world environment, human healthy, human population sustainability and climate change

An environmentally sustainable global economy. A coopetitive model

This paper proposes a model representing a global economy which aims to become environmentally sustainable. The model looks both at the production side and the consumption side of the economy. Regarding the production side, the suggested model considers investment and innovation in climate technologies, whereas on the side of the consumption it takes into account economic and policy instruments to change the patterns of consumption of the households. The model follows a game theory approach and applies a theoretical framework à la Cournot. The results of the paper are the following: the model provides win-win solutions, namely strategic situations in which each country takes advantages by cooperating and competing at the same time within the global economy, and where each country gets a positive return. In fact, the model shows the convenience for each country to cooperate and suggests the implementation of policies in order to satisfy the basic requirements of 2030 Agenda for Sustainable Development, in terms of production, consumption and climate change

Sustainability of global feeding.Coopetitive interaction among vegan and non-vegan food firms

In this paper, we face the problem of global feeding sustainability and related environmental issues, with a strong attention to possible public heath improvements. Specifically, we shall consider food producers and sellers of vegan (or vegetarian) and non-vegan (or non-vegetarian) food. We propose possible quantitative agreements among different food producers, in order to develop a sustainable healthier diet for future generations, by using a mathematical co-opetitive approach and game theory. The co-opetitive approach used by the authors provides a game theory model, which could help producers of vegan food an easier entry in global market and obtain a considerable free publicity. Meanwhile, the model could allow big producers/sellers of non-vegetarian food a smooth rapid transaction to more sustainable and healthier vegan or vegetarian production/supply. In particular, we propose an exemplary complex agreement setting among McDonald's and Muscle of Wheat, a small but strongly innovative Italian food producer. We think that, on one hand, Muscle of Wheat cannot enter a global market without the help of a large globalized food producer already present in the market, on the other hand, we think equally difficult that a large static and poorly innovative producer cannot follow credibly and rapidly enough the increasing and challenging issues of global food sustainability. We remark that our game model represents an asymmetric R&D alliance between McDonald's and Muscle of Wheat. The aim of our contribution is twofold. Firstly, we explain the advantages of a vegan diet for the human health, environmental issues, food sustainability, population sustainability; in fact, the model explain how global food producers could improve environmental, social and health conditions of world population. Secondly, we show how game theory normal-form and extensive-form games can be used in coopetition studies in order to increase health conditions of people, address climate change, address hunger in the world, improve welfare in a particular market. The results of the mathematical study prove that we can find win-win solutions for both firms, which are also good for world environment, human healthy, human population sustainability and climate change

Articuler les temps et les présences de la nature urbaine : une méthode contemporaine

Le terme « nature urbaine » a constitue pendant longtemps un oxymore dont !'opposition s'est au fur et a mesure attenuee. La nature urbaine est desormais pen;ue comme l'entremelement d'objets aussi bien biolo-giques, chimiques, geologiques, sociaux que technologiques, liant tout a la fois humains et non-humains, espaces urbains et non-urbains. Au sein de ce systeme, un vaste champ d'experimentations s'est developpe et devoile le plus souvent a travers des imaginaires verts : la nature est par exemple souvent utilisee comme une strategie esthetique, donnant !'impression que la ville l'integre (et s'y integre) garantissant ainsi les meilleures conditions de vie, ou encore.comme une solution technique qui diminue l'effet des « ilots de chaleur ». Au-dela de ces premiers objectifs, la nature urbaine a egalement ete utilisee pour masquer une urbanisation capitaliste entrainant des inegalites sociales dues a une « gentrification verte » ou encore, elle a servi a propulser des entreprises technocratiques dans le cas des villes dites intelligentes. Dans ces imaginaires verts -favorisant les discours generaux a propos de l'urbanisme vert developpe aujourd'hui-la nature demeure toujours au-dehors, dans un etat idealise, prete a etre consommee. Et ces imaginaires eclipsent d'autres instances possibles, d'autres dynamiques et d'autres formes de participation publique. La nature est utilisee pour paci-fier, pour « mettre d'accord », car elle represente une valeur consensuelle, meme si en realite ce contexte urbain regorge de natures contestees qui appellent a la participation et a !'engagement du public

Pulmonary congenital cystic adenomatoid malformation, type I, presenting as a single cyst of the middle lobe in an adult: case report

<p>Abstract</p> <p>Background</p> <p>Congenital cystic adenomatoid malformation (CCAM) of the lung is an uncommon fetal development anomaly of the terminal respiratory structures. The large cyst type usually occurs in stillborn infants or newborn infants with respiratory distress. Cases of CCAM have been previously described in adulthood, more often type I with multiloculated cystic lesions.</p> <p>Case presentation</p> <p>We report a case of type I CCAM presenting as a single, expansive cystic mass in the middle pulmonary lobe in a 38-year-old man, revealed by persistent cough and haemoptysis. Computed tomographic scan showed a single cyst with air fluid level, occupying the lateral segment of the lobe. When the type I CCAM is a single cyst, other cystic pulmonary lesions must be excluded. The intrapulmonary localization and the absence of cartilage in the cyst wall are conclusive findings of CCAM. The pathogenesis, management and differential diagnosis with other lung malformations are discussed along with a review of the literature.</p> <p>Conclusion</p> <p>The literature data confirm that surgical resection is the treatment of choice in all cases of CCAM and in the cases of cystic pulmonary lesions with uncertain radiological findings, in order to perform a histological examination of the lesion and to prevent infection and the potential neoplastic transformation.</p

Symptoms of mental health problems among Italian adolescents in 2017–2018 school year: a multicenter cross-sectional study

Background Identifying individual and contextual factors that influence adolescent well-being is a research priority. This study aimed to assess the prevalence of symptoms of mental health problems and some related factors in Italian adolescents in 2017–2018. Methods The present study was a cross-sectional survey among 3002 students aged 15–16 years who resided in two Italian provinces, in North and South Italy. Symptoms of mental health problems were assessed using the SDQ and CES-DC, and students’ risk-taking behaviors and school climate perception were assessed. All information was collected anonymously. Logistic regression models were used to assess the associations of tobacco and alcohol use, screen time, bullying, and school climate with symptoms of mental health problems. Results One student out of five reported symptoms of mental health problems, with a more than double proportion among girls than boys (28.7% vs 10.4% with depressive symptoms, respectively). Thirty percent and 40% of students smoked tobacco or drank alcoholic beverages at least once in the past month, and more than 40% reported being victims or authors of bullying in the past 6 months. Smoking behavior, alcohol consumption, screen time, bullying, and negative school climate had 1.2- to 3.3-fold increased odds of symptoms of mental health problems without substantial differences between sexes and geographical areas. Conclusions Tobacco and alcohol use, screen time, bullying, and school climate were independently associated with symptoms of mental health problems in a large sample of 15–16-year-old Italian adolescents without substantial gender and geographical differences