Insediamenti conventuali nei primi anni del XIV secolo nella Civitas Sanctae Mariae, odierna Lucera

In August 1300, Lucera was subjected to a “depopulation” of the Muslim inhabitants with the concurrent destruction of the buildings symbolising their faith. A new cathedral was built and the churches of four convents of Luceria Saracenorum in the Civitas Sanctae Mariae were transformed. Indeed, the urban layout of these churches seems to correspond to a precise will, that is, they seem to be arranged on the sides of a square circumscribed by the walls, at the centre of which is the cathedral

La costruzione di un progetto di conoscenza storica in ambiente digitale. L’Atlante dei palazzi comunali e dei luoghi del potere collettivo nel Medioevo

Il ripensamento delle scienze umane nel contesto di un mondo digitale implica un dialogo stretto tra i saperi: la qualità della ricerca storica può migliorare solo se gli strumenti tecnici – tanto concettuali quanto operativi – fin dai primi passi del lavoro di indagine sono strutturati in un quadro epistemologico corretto per entrambi i contesti scientifici. In questo contesto nasce l’Atlante digitale dei palazzi comunali e dei luoghi del potere collettivo nel Medioevo, sulla base di un’idea iniziale di storici delle istituzioni, storici dell’architettura, storici dell’arte e archeologi, che nel suo sviluppo si è arricchita grazie ai contributi nell’ingegneria informatica. La piattaforma stessa è diventata uno strumento relazionale di conoscenza e approfondimento, e non un semplice catalogo digitalizzato di contenuti già noti. Il contributo mette in luce gli apporti della storia dell’architettura e dell’ingegneria informatica e si focalizza sulle potenzialità d’uso dell’Atlante. The rethinking of the humanities in the context of a digital world implies a close dialogue between humanistic and technical knowledge. The quality of historical research can improve if the technical tools - both conceptual and operational - from the very first steps of the investigative work within an epistemological framework that is coherent and correct for both scientific contexts. This is the context is conceived a Digital Atlas of municipal palaces and places of collective power in the Middle Ages, launched on the basis of an initial idea by historians of institutions, architectural historians, art historians and archaeologists, enriched in its development thanks to contributions of computer engineers. The platform itself is a new relational tool for research, and not just a simple digitized catalogue of previous knowledge. The contribution highlights the inputs of Architectural History and Computer Science in the construction of the digital platform and focuses on the potential of the Atlas

Characterisation of Neisseria meningitidis C strains causing two clusters in the north of Italy in 2007 and 2008.

Two clusters of invasive meningococcal disease in the north of Italy both due to serogroup C/ST-11 clonal complex are here described. The objective of the investigation was to analyse the phenotype and the genotype of meningococci involved in the two clusters which were of national relevance due to the fatal outcome of the majority of cases (six of the total of 10 cases). All the strains were C:2a:P1.5 ST-11/ET-37 clonal complex. Two pulsed field gel electrophoresis (PFGE) and variable number tandem repeats (VNTR) profiles were identified, one for each cluster. VNTRs were different from those detected in Italy for C/ST-11 strains isolated from sporadic cases in the same period. This laboratory surveillance report highlights the importance and the crucial role of molecular characterisation to confirm the relatedness among meningococci responsible for clusters of cases

Antimicrobial susceptibility profiles and genotyping of Neisseria meningitidis of serogroup C, Italy, 2000–2020

BackgroundIn Italy the introduction of meningococcal C conjugate vaccine in 2005 has led to a significant reduction of invasive meningococcal disease (IMD) caused by Neisseria meningitidis of serogroup C (MenC). However, this serogroup is still responsible of sporadic cases, clusters and local outbreaks. The study aims to investigate the genotype and antimicrobial susceptibility profile of MenC isolates collected in Italy from 2000 to 2020.MethodsBacterial isolates and biological samples (blood or cerebrospinal fluid) from invasive meningococcal cases are collected and characterized at the National Reference Laboratory for IMD of Istituto Superiore di Sanità. Antimicrobial susceptibility was determined by MIC Test Strip Method and interpreted according to the EUCAST breakpoints guideline. Genotypic characteristics, including multi locus sequence typing (MLST), finetype, and antimicrobial resistance target genes were performed and analyzed using the PubMLST database. Genomic comparison of core genome MLST (cgMLST) of MenC genomes was also carried out.ResultsFrom 2000 to 2020, a total of 665 MenC isolates were investigated for antimicrobial susceptibility and 301 for genotyping. Over two decades, almost all MenC isolates resulted susceptible to antimicrobials with few isolates resulting resistant to ciprofloxacin (N = 2), penicillin G (N = 13), and rifampicin (N = 9), respectively. Molecular typing of MenC obtained from isolates or clinical specimens identified mostly the genotype C:P1.5-1,10-8:F3-6:ST-11(cc11). However, phylogenetic analysis, performed on genomes from MenC isolates, identified two sub lineages, 11.1 and 11.2, among cc11, of which the sub lineage 11.2 was the predominant.ConclusionWider application of the genomic analysis and monitoring of antimicrobial susceptibility represent key aspects of IMD surveillance and to monitor the continued evolution of these hyperinvasive strains

How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice

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

Global disparities in surgeons’ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study

: The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity > 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI

L’utilizzo delle semibotti nelle "chiese a cupole in asse" in Puglia tra X e XIII secolo

Il “funzionalismo costruttivo” dell’architettura gotica è da considerarsi il punto di arrivo di una serie di sperimentazioni raggiunte in epoche precedenti. Le chiese a cupole in asse, espressione della contaminatio di modelli di ispirazione orientale e occidentale, compaiono in Puglia tra X- XII secolo. La spazialità di tali edifici, che vede l’utilizzo di cupole sferiche su pennacchi a coprire la navata centrale e semibotti rampanti sulle navate laterali funge da sistema razionale per sostenere le coperture della navata principale. Le spinte della cupola risultano equilibrate dagli archi trasversali e longitudinali che convergono sui pilastri; le semibotti che coprono le navate laterali, divise in corrispondenza dei pilastri da diaframmi, assumono la funzione di contrastare parte delle spinte e trasmetterle sulla muratura perimetrale permettendo una riduzione della sezione dei pilastri. Questa concezione anticipa la capacità di esprimersi in termini di ossature, fondamento della ricerca dei costruttori gotici. L’indagine, intorno all’utilizzo della semibotte, intesa come elemento costruttivo, apre un’interessante prospettiva, in una visione più ampia dell’architettura medievale. Si tratta, infatti, di un dispositivo statico che assicura la stabilità della nave centrale e che prefigura il ruolo assunto dagli archi rampanti negli edifici gotici. La datazione dei primi esempi pugliesi in cui troviamo l’utilizzo della semibotte laterale, ossia il Tempietto di Seppanibale presso Fasano (VIII-IX sec.) e la chiesa di San Pietro di Crepacore presso Mesagne (VII sec.), pone alcune questioni, ancora insolute, relativamente alla comparsa nel panorama architettonico medievale di questi dispositivi strutturali, che anticipano cronologicamente gli esempi francesi e catalani. Infatti, se questa soluzione costruttiva appare anche nelle regioni catalane tra X e XII secolo, con lo scopo di fornire un contributo efficace alla statica della navata centrale, in Francia assume un carattere peculiare nelle chiese di pellegrinaggio a nave cieca, voltata a botte e con gallerie coperte a semibotte