Proposal of resources optimization in the hospital treatment of heart failure by an increased utilization of cardiac rehabilitation

weight on social cost. An improved resources utilization could promote a reduction of the new hospitalization and a of medical costs. Working hypotesis: To analyze a model of increased utilization of our Cardiac Rehabilitation (CR) Unit, aiming at improving the cost/profit ratio through a better use of resources and a better assignment of care. With a reduction of average length of stay in the Operative Units for acute patients, we could promote a demand of post-acute hospitalization of 950.7 days of hospitalization that could be assigned to Cardiologic Rehabilitation Unit. Results: With the transfer of patients the utilization rate of CR would increase to 97%. With a mean period in bed of 15.3 days we could hospitalize 62 additional patients and the total margin of contribution would became positive: 69.817 euro. The break even analysis applied to costs and returns of the Unit shows a further indication to increase the hospitalization number in CR Unit with patients transfered from acute patient units. Under the same costs the recovery of efficiency leads to a reduction of variable costs. In the same time there is an increase of returns due to an increase of mean value for case and an increase of services. Conclusion: The increase in the efficiency in the utilization of CR Unit leads to an increase of the Hospital efficiency. The transfer of patients from acute units to CR Unit would allow an increased hospitalization rate for acute patients without requiring additional resources

A Geological Itinerary Through the Southern Apennine Thrust-Belt (Basilicata—Southern Italy)

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Th17-related cytokines: new players in the control of chronic intestinal inflammation

Crohn's disease (CD) and ulcerative colitis (UC), the main forms of inflammatory bowel diseases (IBD) in man, are thought to be caused by an excessive and poorly controlled immune response that is directed against components of the normal microflora. The exact sequence of events by which this pathological process is triggered and maintained is not fully understood, but studies in experimental models of IBD and data emerging from recent clinical trials indicate that T cell-derived cytokines are crucial mediators of the tissue damage. Although CD and UC have been traditionally considered two typical examples of T helper (Th)1 or Th2-associated disease respectively, it is now known that CD- and UC-related inflammation is also marked by enhanced production of cytokines made by a distinct subset of Th cells, termed Th17 cells. Th17 cytokines can have both tissue-protective and inflammatory effects in the gut and there is evidence that Th17 cells can alter their cytokine program according to the stimuli received and convert into Th1-producing cells. These novel findings have contributed to advancing our understanding of mechanisms of gut tissue damage and open new avenues for development of therapeutic strategies in IBD

GEOCONSERVAZIONE: PRINCIPI DI BASE E RILEVANZA SOCIALE

In questi ultimi anni, la “Geoconservazione” ha assunto tutte le caratteristiche di una vera e propria disciplina scientifica emergente nell’ambito delle Scienze della Terra. Scopo principale della Geoconservazione è la tutela del patrimonio geologico, in altre parole la conservazione delle sue unità di base, cioè di quei siti ed aree significative dal punto di vista geologico, note come geositi. Questo deve avvenire mediante una serie di attività scientifiche, che comprendono la redazione di specifici inventari, l’implementazione di procedure di classificazione e lo studio delle metodologie più appropriate per la loro individuazione, valutazione, tutela, valorizzazione e monitoraggio. I suoi principi di base, metodi ed obiettivi possono essere riconosciuti e definiti nell’ambito di una “Geoconservazione di base” (Basic Geoconservation). Le interrelazioni con altre discipline scientifiche e la produzione di specifiche conoscenze che consentono di stabilire forti legami con la società, come la realizzazione di materiali utili per la divulgazione scientifica e di servizi speciali per il turismo geologico, invece, sono oggetto di studio nell’ambito di altri due livelli di approfondimento, definite come “Applicazioni di tecniche per la Geoconservazione” (Technical Applications of Geoconservation) e “Geoconservazione Applicata” (Applied Geoconservation)

Environmental geology applied to geoconservation in the interaction between geosites and linear infrastructures in south-eastern Italy.

Southern Italy includes a large variety of geological environments represented by sedimentary, metamorphic and volcanic rocks. The understanding of the complex geological historyleading to the present-day setting of Southern Italyhas been achieved through a great number of geological studies performed on key localities which show geological features of elevated scientific interest. Often, these key outcrops orgeosites,fall into highly sensitive and vulnerable areas, especially wherelinear infrastructures occur,represented inmost cases by railways, roads and bridges.The main aim of this paper is to analyze the interaction between some significant geosites and linear infrastructures. Therefore, the study takes into account the guidelines provided by ISPRA (Italian Institute for Environmental Protection and Research)and the experience arising from a series of activities and projects carried out by the SIGEA (Italian Society of Environmental Geology).As a first step, we have linked the principles and applications of the "Environmental Geology"with the concept of "Geoconservation". .Two case-studies have been selected and described. The first case concerns the interaction between the Lagonegro Calabro-Lucanarailway bridge (Basilicata Region, Southern Italy) and a Deep-Seated Gravitational Slope Deformation (DSGSD) affecting the bridge. Thus the landslide activity is recorded by the progressive deformation of the bridge. The second case is represented by the interaction between the Torre di Lesco cave(Apulia Region, Southern Italy) and theRoad n. 96 (Altamura-Bari) where the construction for the widening the road led to the discovery of an impressive, hitherto unknown, karstic cave

Geomorphological evolution of the Vendicari karstic coastal lake system (SE Sicily, Italy)

The Vendicari coastal lake system (SE Sicily) presents several geomorphic characteristics, which suggest it was originated as a part of a 6 km long karst polje during the Late Pleistocene sea level lowstand. Exhumed cryptokarst karren and terraced concentric surfaces point to this working hypothesis. The generation of this depression could have been favoured by the low to moderate neotectonic activity in the zone, which consisted in slight uplifting and subsequent fracturing. Open joints in the Vendicari Pleistocene carbonates show a radial outline with the prevalence of NNW-SSE discontinuities. Once formed, polje evolution would have consisted in a progressive compartmentalisation and splitting into several polje bottoms, some of which form a part of the present Vendicari lake system and are surrounded by stepped corrosion surfaces. The postglacial sea level rise had drowned most part of the original polje, which can be still recognized in the inner continental shelf. Sea level stabilization after the Holocene eustatic maximum favoured the development of a beach barrier, which generated additional coastal lakes of lagoonal type