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

An Integrated Management of Vegetable Agro-Biodiversity: A Case Study in the Puglia Region (Italy) on the Artichoke Landrace ‘Carciofo di Lucera’

The agro-biodiversity of vegetables is threatened, posing major concerns for the future of landraces, which are of fundamental importance both for food safety and for assuring an income to small-scale farmers. To counteract such a trend, the Puglia region (southern Italy) set up a plan to recover, characterize and preserve the resources at risk of genetic erosion. In our paper, we present a case study regarding an artichoke landrace, the ‘Carciofo di Lucera’ variety, that encompasses all activities foreseen in the Puglia region’s plan which is the result of the multi-actor project “BiodiverSO”. Such a project allowed us to recover and characterize crop genetic resources and to pave the way for further actions to preserve and valorize the agro-biodiversity of local vegetables that are still present in the Puglia region. Furthermore, we collected some evidence that allowed us to backdate the origin of artichoke cultivation in the Puglia region by about two centuries and, most important of all, to recover some populations of ‘Carciofo di Lucera’. These preliminary phases were followed by the characterization of this local variety, both from the morphological and the molecular point of view, so that we can discriminate this landrace from other artichoke varieties more accurately. Eventually, we collected all the information in electronic databases and data sheets, thus providing a tool for the public administration which will be useful in the in situ conservation phase

An Integrated Management of Vegetable Agro-Biodiversity: A Case Study in the Puglia Region (Italy) on the Artichoke Landrace ‘Carciofo di Lucera’

The agro-biodiversity of vegetables is threatened, posing major concerns for the future of landraces, which are of fundamental importance both for food safety and for assuring an income to small-scale farmers. To counteract such a trend, the Puglia region (southern Italy) set up a plan to recover, characterize and preserve the resources at risk of genetic erosion. In our paper, we present a case study regarding an artichoke landrace, the ‘Carciofo di Lucera’ variety, that encompasses all activities foreseen in the Puglia region’s plan which is the result of the multi-actor project “BiodiverSO”. Such a project allowed us to recover and characterize crop genetic resources and to pave the way for further actions to preserve and valorize the agro-biodiversity of local vegetables that are still present in the Puglia region. Furthermore, we collected some evidence that allowed us to backdate the origin of artichoke cultivation in the Puglia region by about two centuries and, most important of all, to recover some populations of ‘Carciofo di Lucera’. These preliminary phases were followed by the characterization of this local variety, both from the morphological and the molecular point of view, so that we can discriminate this landrace from other artichoke varieties more accurately. Eventually, we collected all the information in electronic databases and data sheets, thus providing a tool for the public administration which will be useful in the in situ conservation phase

Neutrophil to Lymphocyte Ratio and the Extent of Coronary Artery Disease: Results from a Large Cohort Study

The neutrophil to lymphocyte ratio (NLR), an inflammatory biomarker, may be of predictive and prognostic value for cardiovascular (CV) events. We evaluated the relationship of NLR with the prevalence and extent of coronary artery disease (CAD) in consecutive patients undergoing elective or urgent coronary angiography. Our population (n = 3738 patients) was divided into NLR quartiles. Higher NLR was associated with aging and established CV risk factors, previous percutaneous coronary revascularization, acute presentation, and more complex pharmacological therapy. The NLR was related to platelet count, white blood cell count, creatinine, glycemia, uric acid, and C-reactive protein (all P = .001) levels but inversely related to hemoglobin ( P &lt; .001), total cholesterol ( P = .005), and triglycerides ( P &lt; .001) levels. The NLR was associated with multivessel disease ( P &lt; .001), anterior descending, right coronary arteries ( P &lt; .001) or circumflex branch lesions ( P = .01), percentage of stenosis ( P &lt; .001), coronary calcification ( P &lt; .001), and intracoronary thrombus ( P &lt; .001) but inversely with in-stent restenosis ( P &lt; .001) and thrombolysis in myocardial infarction flow ( P = .04). The NLR was directly related to the prevalence of CAD ( P = .001) and severe CAD ( P &lt; .001). In patients undergoing coronary angiography, the NLR is independently associated with the prevalence and severity of CAD. </jats:p

Colloidal precipitates related to Acid Mine Drainage: bacterial diversity and microfungi heavy metal interactions

The aims of this work were to a) characterize the mycobiota present in these colloidal minerals evaluating the presence of alive fungal propagules and to extracting bacteria DNA; b) verify the strains fungal tolerance and bioaccumulation capability on greenish-blue and ZnSO4 enriched media; c) evaluate potential impact of bacteria in the geochemistry of the system. The preliminary results show an interesting and selected mycobiota able to survive under unfavourable environmental conditions. A significant number of fungal strains were isolated in pure culture. Among them, species belonging to Penicillium and Trichoderma genera were tested on both greenish-blue and ZnSO4 enriched media. The results shown a significant tolerance and bioaccumulation capability to some PTEs. The same colloidal precipitates have been processed to extract bacteria DNA, using a specific procedure developed for DNA extraction from sediments. The results gave a good yield of nucleic acids and the positive PCR amplification of 16S rDNA accomplished the first step for future metagenomic analyses

An anomalous case of acute coronary syndrome: the unexpected autoimmune duo

Acute coronary syndrome represents one of the most common causes of admittance to emergency rooms in Western countries. Despite being in the majority of cases the mirror of coronary atherosclerosis, more rare causes could be hidden beyond this presentation, whose identification is often crucial for patients' outcome. We hereby present the case of a 44-year-old woman, with a history of relapsing-remitting multiple sclerosis in treatment with natalizumab, who was admitted to our division for an acute coronary syndrome. At arrival, anaemia and severe thrombocytopenia were observed; thus, no antiplatelet agent was administered. Within a few hours, aphasia occurred. Clinical presentation and the identification of schistocytes at blood smear led to the suspicion of thrombotic thrombocytopenic purpura, which was then confirmed by laboratory analysis. Immediate high-dose steroids and plasma exchange allowed discharging of the patient within a few days without neurological or cardiac sequelae

Effect of diabetes mellitus on periprocedural myocardial infarction in patients undergoing coronary stent implantation.

BACKGROUND: Diabetic patients undergoing coronary percutaneous interventions (PCI) are still regarded as a very high risk category, due to an increased platelet reactivity and risk of complications especially in patients with inadequate glycemic control. However, while its prognostic impact on long-term outcome is well defined, still unclear is the impact of diabetes on the risk of periprocedural myocardial infarction (PMI) in patients undergoing PCI, that was therefore the aim of our study. METHODS: Myonecrosis biomarkers were dosed at intervals from 6 to 48 hours after non-emergent PCI. PMI was defined as Creatine Kinase-MB increase by 3 times the Upper Limit Normal or by 50% of an elevated baseline value, whereas periprocedural myonecrosis as Troponin I increase by 3 x ULN or 50% of baseline. RESULTS: Of 1311 patients, diabetes mellitus was found in 458 patients (34.9%) and associated with age (p\u2009=\u20090.03), hypertension (p\u2009<\u20090.001), renal failure (p\u2009=\u20090.01), previous MI (p\u2009=\u20090.03), previous coronary revascularization (p\u2009<\u20090.001), higher fasting glycemia and lower haemoglobin (p\u2009<\u20090.001), more severe coronary disease (p\u2009<\u20090.001), multivessel PCI (p\u2009=\u20090.03), coronary calcification (p\u2009=\u20090.003) and instent restenosis (p\u2009<\u20090.001), but lower presence of thrombus (p\u2009=\u20090.03). Diabetics were receiving significantly more frequent specific pharmacological treatment at admission. Diabetic status did not influence the risk of PMI or periprocedural myonecrosis (adjusted OR [95%CI]\u2009=\u20090.90[0.64-1.27], p\u2009=\u20090.57 and adjusted OR[95%CI]\u2009=\u20090.92 [0.70-1.21], p\u2009=\u20090.55). Among diabetic patients, we did not observe any impact of chronic glycaemic control on PMI. CONCLUSIONS: Diabetic status, independently from chronic glycaemic control, is not associated with increased risk of periprocedural MI and myonecrosis in patients undergoing PCI

Quantitative assessment of atrial conduit function: a new index of diastolic dysfunction

Heart failure (HF) epidemic has increased need for accurate diastolic dysfunction (DD) quantitation. Cardiac MRI can elucidate left atrial (LA) phasic function, and accurately quantify its conduit contribution to left ventricular (LV) filling, but has limited availability. We hypothesized that the percentage of LV stroke volume due to atrial conduit volume (LACV), as assessed using 3D-echocardiography, can differentiate among progressive degrees of DD in HF patients