CONTRIBUIÇÕES TEÓRICAS SOBRE GEOGRAFIA CULTURAL: A EVOLUÇÃO DO CONCEITO DE CULTURA

A ciência geográfica, ao reconhecer a cultura como uma de suas temáticas centrais, encontrou respostas para os questionamentos vinculados à organização socioespacial. A Geografia Cultural, uma tendência renovada a partir da década de 1970, estuda os fenômenos geográficos com um olhar crítico, influenciada, também, pela evolução do conceito de cultura promovida por antropólogos, sociólogos e outros cientistas desse período, entre eles, Herbert Hoggart, Raymond Williams, Edward Thompson e Stuart Hall. Desse modo, enfatiza-se, ainda, a contribuição de Friedrich Ratzel, Paul Vidal de La Blache e Carl Sauer para a introdução da temática cultural nos estudos geográficos. Nessa perspectiva, o presente estudo visa destacar as reformulações do conceito de cultura e a evolução da Geografia Cultural como tendência científica atrelada à análise das questões sociais contemporânea

Archeologia delle alte quote sulla montagna veneta: la campagna di ricognizione di superficie 2019 a Recoaro Terme (Vicenza)

In this paper we present the preliminary results of the 2019 field survey conducted in the framework of the project \u201cBeyond the border. Study and enhancement of the highlands between Veneto and Trentino\u201d. The aim of this overarching project, which applies a multidisciplinary approach, is threefold: to detect in this mountain landscape the main activity areas and reconstruct possible connections between them; to analyse the long-term relationships between Trentino and Prealpine Veneto from prehistory to the present day; and to study the evolving function of this frontier area during periods of conflict/interaction. Several methods were employed to shed light on the above-mentioned research aims: field-walking survey, analysis of aerial photos, ethnographic and archival research, GIS-based landscape analysis and predictive modelling, and LiDAR data for feature detection in wooded areas. The combined use of all these approaches allowed us to identify long-term exploitation activities, which are documented also by both the ethnographic and archaeological data. The major periods of conflict in these areas are also highlighted in the archaeological record. The 2019-survey campaign opens up new research directions such as the future excavation of Bronze Age occupation zones; network and connectivity analysis between Prealpine Veneto and Trentino; hillforts and their interaction with the highlands

Unresectable stage III non-small cell lung cancer: could durvalumab be safe and effective in real-life clinical scenarios? Results of a single-center experience

IntroductionThe standard of care for patients with unresectable stage III non-small cell lung cancer (NSCLC) is chemoradiotherapy (CRT) followed by consolidation durvalumab as shown in the PACIFIC trial. The purpose of this study is to evaluate clinical outcomes and toxicities regarding the use of durvalumab in a real clinical scenario. MethodsA single-center retrospective study was conducted on patients with a diagnosis of unresectable stage III NSCLC who underwent radical CRT followed or not by durvalumab. Tumor response after CRT, pattern of relapse, overall survival (OS) and progression-free survival (PFS), and toxicity profile were investigated. ResultsEighty-five patients met the inclusion criteria. The median age was 67 years (range 45-82 years). Fifty-two patients (61.2%) started sequential therapy with durvalumab. The main reason for excluding patients from the durvalumab treatment was the expression of PD-L1 < 1%. Only two patients presented a grade 4 or 5 pneumonitis. A median follow-up (FU) of 20 months has been reached. Forty-five patients (52.9%) had disease progression, and 21 (24.7%) had a distant progression. The addition of maintenance immunotherapy confirmed a clinical benefit in terms of OS and PFS. Two-year OS and PFS were respectively 69.4% and 54.4% in the durvalumab group and 47.9% and 24.2% in the no-durvalumab group (p = 0.015, p = 0.007). ConclusionIn this real-world study, patients treated with CRT plus durvalumab showed clinical outcomes and toxicities similar to the PACIFIC results. Maintenance immunotherapy after CRT has been shown to be safe and has increased the survival of patients in clinical practice

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Ethnoarchaeology of Pastoralism in Valcamonica high pastures

The high pastures of Vione, in the northern Valcamonica, have been exploited since many centuries by shepherds and people carring out many other activities. A systematic field survey, made by one of the authors in the summer 2017, has found out many structures, most of them probably linked to the pastoral activities. Fourty-seven buildings have been documented, put on a map thanks to the GIS technology and classified in different categories according to their dimensions, shapes and constructive techniques. Thanks to a multidisciplinary approach, data coming from different fields and sources (such as remote sensing, historical cartography, written sources, historical cadastres and place-names) has been combined - and processed with GIS spatial analysis - in order to understand the interaction between structures and territory; understand pastoral strategy and their changes through time; reconstruct the absolute or relative chronology of the structures; understand the relationship between pastoral structures and rock art. The paper will compare the northern Valcamonica situation emerging from this study with those of the two areas used as model for this research: Val di Sole (Trento) and Lessinia (Verona). Some remarks will be made also about the possible relationship between the analysed structures and Valcamonica graffiti

Reflexões na geografia cultural: a materialidade e a imaterialidade da cultura / Reflections on cultural geography: the materiality and immateriality of the culture

O presente artigo visa contribuir teoricamente com o estudo da Geografia Cultural, uma vez que esta é uma tendência da ciência geográfica centrada no conceito de cultura, alicerçada por conceitos basilares, entre eles, o de paisagem cultural e código cultural. Desse modo, pretende-se relacionar os referidos conceitos, compreendendo que a paisagem cultural é o resultado do sistema simbólico de um grupo cultural formado por códigos culturais materiais e imateriais representativos

Diagnostic accuracy of 3T magnetic resonance imaging in the preoperative localisation of parathyroid adenomas: comparison with ultrasound and 99mTc-sestamibi scans

Objectives: To evaluate the diagnostic performance of 3TMRI in comparison with ultrasound (US) and 99mTc-sestamibi scan for presurgical localisation of parathyroid adenomas (PTAs) in patients with primary hyperparathyroidism (PHPT). Methods: Fifty-seven patients affected by PHPT were prospectively enrolled and underwent US, 99mTc-sestamibi and 3TMRI. T2-weighted and post-contrast T1-weighted Iterative decomposition of water and fat with Echo Asymmetry and Least squares estimation (IDEAL) sequences were acquired. Diagnostic performance of US, 99mTc-sestamibi and MRI in localising PTAs to correct quadrant were compared according to surgical and pathological findings. Results: According to surgical findings, US correctly localised 41/46 PTAs (sensitivity of 89.1%; specificity 97.5%; PPV 93.1% and NPV 95.6%); 99mTc-sestamibi correctly localised 38/46 PTAs (sensitivity 83.6%, specificity 98.3%, PPV 95% and NPV 93.7%). US and 99mTc-sestamibi combined had a sensitivity of 93.4% (43/46 PTAs), specificity of 98.3%, PPV 95% and NPV 98.3%. MRI correctly localised 45/46 PTAs (sensitivity 97.8%; specificity 97.5%; PPV 93.7% and NPV 99.2%). MRI was able to detect six adenomas missed by 99mTc-sestamibi and two adenomas missed by US. MRI and US were able to detect all enlarged parathyroid glands in patients with multiglandular disease. MRI identified six of seven ectopic adenomas. Conclusions: Our study demonstrated high diagnostic performance of 3T MRI in the preoperative PTAs quadrant localisation, as well as in patients with multiglandular disease and ectopic PTAs. MRI may be preferred to adequately select patient candidates for minimally invasive parathyroidectomy (MIP). Key Points: • PTA(s) quadrant localisation by 3TMRI was more accurate than US+99mTc-sestamibi.• MRI identified all enlarged glands in multiglandular disease similarly to US.• MRI identified 6/7 ectopic PTAs similarly to 99mTc-sestamibi.• Presurgical PTA(s) localisation by 3TMRI select the optimal candidates for MIP