The medieval bronze doors of San Zeno, Verona: combining material analyses and art history

The bronze doors of the Basilica of San Zeno in Verona, Italy, are a special case in art history research. They were made by several workshops during the twelfth century: stylistically, two to three workshops were assumed to pro- duce the metal parts of the door. However, it is still unclear when exactly and if this interpretation can be supported by the chemical composition of the metal. In this research we aimed to verify the art history interpretation by iden- tifying the alloy composition of each individual metal plate. The composition of the supporting wooden structures are discussed. A portable ED-XRF instrument and optical microscopes were used to analyse and document the doors non-invasively. The doors were also photographed to produce high resolution orthophotos and 3D models. We can confirm that the metal parts of the doors were made of leaded tin-bronze as well as leaded brass and mounted on a wooden structure mainly made of spruce and oak wood. Chemically, two/three different groups of alloys have been identified, which can be associated with two or three different workshops, and which largely correspond to the stylistic interpretation

Electrochemical behavior of archaeological arsenical bronzes according to the concentration of arsenic in the alloy|Comportamento elettrochimico di bronzi archeologici arsenicali in funzione della concentrazione dell'arsenico in lega

n questo studio si è voluto comprendere come la concentrazione di arsenico in lega influenzi i fenomeni di corrosione in leghe di rame archeologiche. Sono state condotte analisi elettrochimiche su tre leghe in triplicato (denominate CuAs-1, CuAs-3, CuAs-5 sulla base delle diverse percentuali in peso di As in lega). I risultati elettrochimici, confrontati con quelli di campioni di rame puro, indicano che la presenza di arsenico comporta un sostanziale miglioramento del comportamento a corrosione e la lega migliore è quella con il più alto contenuto di arsenico. Questi dati sono confermati dalle analisi spet- troscopiche che indicano la formazione di uno strato di ossidi protettivi misti di rame e arsenico. La minore resistenza alla corrosione del rame è stata invece collegata alla presenza in superficie di sali solubili

Arthroscopic-guided balloon tibioplasty in schatzker iii tibial plateau fracture

Purpose The study aims to present the results at a mean 28-months follow-up of arthroscopic-guided balloon tibioplasty and to spot some technical tricks and some practice using tools and materials. Methods The study relates to six patients with tibial plateau fractures type Schatzker III with tibial plateau depression more than 4 mm at preoperative computed tomography scan (CT-scan). The follow-up period ranged from 22 to 33 months, with a mean of 28 months. No patients were lost to follow-up. The patients were evaluated clinically using the Rasmussen score system and Lysholm score systems at 6 to 12 and 24 months, postoperatively. Radiographic evaluations (standard X-rays) were done preoperatively at 1, 3, and 12 months postoperatively while a CT-scan with 3D reconstruction was performed preoperatively, at the first day and 6 months, postoperatively. Results The mean Rasmussen clinical score at 6 months postoperatively was 26.3 while at 1-year postoperatively the mean Rasmussen clinical score was 28.33. At 2-year postoperatively the mean Rasmussen clinical score was 28.83. Statistically significant difference was found in 6-months and 2-years results (p < 0.05). CT-scan achieved the first postoperative day showed the recovery of approximately 70% of the area of the interested tibial plateau, restoring of the joint surface without articular bone free fragments. Conclusion The described surgical procedure, if correctly performed with proper indications (Schatzker III), respect the principles mentioned above and the clinical and radiological results confirm our purpose. Level of Evidence This is a therapeutic case series, level IV study

Patients with Musculoskeletal Disorders Presenting to the Emergency Department: The COVID-19 Lesson

Background: Musculoskeletal disorders (MSKDs) are the most common class of complaints among patients presenting for care in the Emergency Department (ED). There is a non-urgent patient population with musculoskeletal complaints attending ED services that creates a burgeoning waiting list and contributes to overcrowding in Emergency Departments (EDs), which is a major concern worldwide. The recent (Coronavirus disease-19) COVID-19 pandemic is an unprecedented challenge that is revealing the structural and situational strengths and weaknesses of healthcare systems. Methods: This study retrospectively and prospectively assessed patients presenting to the Emergency Department before and after the COVID-19 outbreak (from 21 February 2019 to 3 May 2019 and from 21 February 2020 to 3 May 2020) with non-traumatic or low-severity musculoskeletal conditions to test the hypothesis that these patients should have access to care outside the ED and that the COVID-19 outbreak has changed patients’ care and health perception. Results: A total of 613 patients were identified, and 542 of them (87.56%) participated in a personalized survey. From this number, 81.73% of the total accesses took place in 2019, and only 18.27% of the accesses took place during the first outbreak and lockdown. More than 90% of patients admitted to the ED accessed care during the day shift in both periods. A total of 87.30% of patients presenting to the ED with a MSKD followed their general practitioner’s (GP) advice/referral in 2019, and 73.87% did so in 2020. The differences in the means of transport to the ED was statistically significant (p-value 0.002). Conclusions: The outbreak and lockdown period confirmed that there is an inappropriate use of the ED related to patients with MSKD. However, the ED appears to be the only available solution for these patients. New services and pathways are therefore needed to enhance MSKD management and reduce ED crowding. Additional observational studies shall be developed to confirm and compare our findings with those of various EDs. The main limit of the inferential part of the study is probably due to the small sample of patients in 2020

Time to care: why the humanities and the social sciences belong in the science of health

Health is more than the absence of disease. It is also more than a biological phenomenon. It is inherently social, psychological, cultural, and historical. Social and personal resources are both key components and key determinants of health, as it has been recognised by major health actors for decades [1–3]. However, open questions remain as to how to build systems that reflect the complexity of health, healthy lives, disease, and sickness, and in a context that is increasingly technologized. Although we find in the literature an increasing understanding of the complexity of health [4–7], the implementation of this knowledge lags behind. Biological approaches to health and disease, as a matter of fact, dominate the development of curative and preventive interventions. We argue that an urgent change of approach is necessary. Methods and concepts from the humanities and social science must be embedded in the concepts and methods of the health sciences and of public health, if we are to promote sustainable interventions capable of engaging with the recognized complexity of health, healthy lives, disease, and sickness. This resonates with the vision expressed by UK Health Secretary and by many policy documents [8,9] from the last decades. Yet, given the difficulties associated with interdisciplinary research, integrated strategies to understand and to intervene on the complexity of health and that engage with biological, social, psychological and behavioural factors are still needed. Our vision is one of radical interdisciplinarity, integrating aspects of biological, psychological, social, and humanities approaches across areas of urgent health need. These areas include, but is not confined to, chronic conditions such as the obesity epidemic, cancer, mental health. Radical interdisciplinarity entails the practical, methodological, and conceptual integration of approaches to health, as they are developed in the health and social sciences, and in the humanities. It is the combination of cognitive resources from individuals belonging to different disciplines, who accept and respect the division of labour and the resulting epistemic dependence to tackle phenomena that would not be adequately conceptualised within any of the involved discipline alone [10]. In what follows, we describe our current understanding of these three aspects, and describe how radical interdisciplinarity would change them.Not funde

Can Clinical and Surgical Parameters Be Combined to Predict How Long It Will Take a Tibia Fracture to Heal? A Prospective Multicentre Observational Study: The FRACTING Study

Healing of tibia fractures occurs over a wide time range of months, with a number of risk factors contributing to prolonged healing. In this prospective, multicentre, observational study, we investigated the capability of FRACTING (tibia FRACTure prediction healING days) score, calculated soon after tibia fracture treatment, to predict healing time. Methods: The study included 363 patients. Information on patient health, fracture morphology, and surgical treatment adopted were combined to calculate the FRACTING score. Fractures were considered healed when the patient was able to fully weight-bear without pain. Results: 319 fractures (88%) healed within 12 months from treatment. Forty-four fractures healed after 12 months or underwent a second surgery. FRACTING score positively correlated with days to healing: r = 0.63 (p < 0.0001). Average score value was 7.3 ± 2.5; ROC analysis showed strong reliability of the score in separating patients healing before versus after 6 months: AUC = 0.823. Conclusions: This study shows that the FRACTING score can be employed both to predict months needed for fracture healing and to identify immediately after treatment patients at risk of prolonged healing. In patients with high score values, new pharmacological and nonpharmacological treatments to enhance osteogenesis could be tested selectively, which may finally result in reduced disability time and health cost savings

Raccomandazioni per l\u2019esecuzione della Curva Standard da Carico Orale di Glucosio (OGTT) per la diagnosi di Diabete Mellito

The Oral Glucose Tolerance Test (OGTT) is a fractional method which measures the body's ability to metabolize glucose. Despite its large-scale use, the OGTT is still not appropriately performed in most of the Italian laboratories, as proven by our previous recent survey. In particular, we have provided evidence for the variability for execution of the OGTT in Italian laboratories indicating a poor tendency to standardise the procedures and the methodologies. These findings have been a stimulus to promote an effective Nationwide educational campaign, in order to standardise the procedures for the diagnosis of altered glucose metabolism and diabetes. The present document reports therefore the recommendations concerning the OGTT performed for the classification of diabetes. These recommendations do not apply to the execution of the OGTT during pregnancy for diagnosing gestational diabetes mellitus