Seabed mapping in the Pelagie Islands marine protected area (Sicily Channel, southern Mediterranean) using Remote Sensing Object Based Image Analysis (RSOBIA)

In this paper we present the seabed maps of the shallow-water areas of Lampedusa and Linosa, belonging to the Pelagie Islands Marine Protected Area. Two surveys were carried out (“Lampedusa 2015” and “Linosa 2016”) to collect bathymetric and acoustic backscatter data through the use of a Reson SeaBat 7125 high-resolution multibeam system. Ground-truth data, in the form of grab samples and diver video-observations, were also collected during both surveys. Sediment samples were analyzed for grain size, while video images were analyzed and described revealing the acoustic seabed and other bio-physical characteristics. A map of seabed classification, including sediment types and seagrass distribution, was produced using the tool Remote Sensing Object Based Image Analysis (RSOBIA) by integrating information derived from backscatter data and bathy-morphological features, validated by ground-truth data. This allows to create a first seabed maps (i.e. benthoscape classification), of Lampedusa and Linosa, at scale 1:20 000 and 1:32 000, respectively, that will be checked and implemented through further surveys. The results point out a very rich and largely variable marine ecosystem on the seabed surrounding the two islands, with the occurrence of priority habitats, and will be of support for a more comprehensive maritime spatial planning of the Marine Protected Area

Prolonged pre-firing pancreatic compression with linear staplers in distal pancreatectomy: a valuable technique for post-operative pancreatic fistula prevention

Purpose: Post-operative pancreatic fistula (POPF) remains the main complication after distal pancreatectomy (DP). The aim of this study is to evaluate the potential benefit of different durations of progressive stapler closure on POPF rate and severity after DP. Methods: Patients who underwent DP between 2016 and 2023 were retrospectively enrolled and divided into two groups according to the duration of the stapler closure: those who underwent a progressive compression for < 10 min and those for ≥ 10 min. Results: Among 155 DPs, 83 (53.5%) patients underwent pre-firing compression for < 10 min and 72 (46.5%) for ≥ 10 min. As a whole, 101 (65.1%) developed POPF. A lower incidence rate was found in case of ≥ 10 min compression (34-47.2%) compared to < 10 min compression (67- 80.7%) (p = 0.001). When only clinically relevant (CR) POPFs were considered, a prolonged pre-firing compression led to a lower rate (15-20.8%) than the < 10 min cohort (32-38.6%; p = 0.02). At the multivariate analysis, a compression time of at least 10 min was confirmed as a protective factor for both POPF (OR: 5.47, 95% CI: 2.16-13.87; p = 0.04) and CR-POPF (OR: 2.5, 95% CI: 1.19-5.45; p = 0.04) development. In case of a thick pancreatic gland, a prolonged pancreatic compression for at least 10 min was significantly associated to a lower rate of CR-POPF compared to < 10 min (p = 0.04). Conclusion: A prolonged pre-firing pancreatic compression for at least 10 min seems to significantly reduce the risk of CR-POPF development. Moreover, significant advantages are documented in case of a thick pancreatic gland

Adhesive small bowel obstruction in octogenarians: A 6-year retrospective single-center analysis of clinical management and outcomes

Background: Few evidences are available on adhesive bowel obstruction (ASBO)management and outcomes in geriatric patients. Methods: One-hundred-twenty-eight patients aged 65–79 years were retrospectively compared to 77 patients aged ≥80 years. Aim of this study was to compare ASBO management and in-hospital course between patients aged 65–79 years and those over 80 years. Results: Upfront surgery in octogenarians related with a higher rate of major complications (23.7%vs4.9%; p = 0.009) and longer hospitalization (8.8vs7.3 days; p = 0.01). No difference according to age was noted in terms of clinical outcomes when the non-operative management (NOM) was employed. Patients aged ≥80 years managed conservatively presented shorter hospitalization (7.3vs8.8 days; p = 0.04), lower rate of intensive care unit (ICU) admission (0vs18.4%; p = 0.005) and cumulative major complications (2.6%vs23.7%; p = 0.007) as compared to ≥80 years old patients treated with upfront surgery. In this same group, NOM failure did not lead to worse outcomes in comparison to upfront surgery. Conclusions: NOM in≥80 years patients is associated with better in-hospital course. The acceptable clinical outcomes in case of NOM failure further support NOM as first treatment strategy to employ in this same subset of patients

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

Campagna Oceanografica SAFE_2014

Rapporto tecnico e delle attività della Nave Oceanografica Urania, svolte dal Consiglio Nazionale delle Ricerche dal 22 agosto 2014 al 1^ settembre 2014

Seabed mapping in the Pelagie Islands marine protected area (Sicily Channel, southern Mediterranean) using Remote Sensing Object Based Image Analysis (RSOBIA)

In this paper we present the seabed maps of the shallow-water areas of Lampedusa and Linosa, belonging to the Pelagie Islands Marine Protected Area. Two surveys were carried out (“Lampedusa 2015” and “Linosa 2016”) to collect bathymetric and acoustic backscatter data through the use of a Reson SeaBat 7125 high-resolution multibeam system. Ground-truth data, in the form of grab samples and diver video-observations, were also collected during both surveys. Sediment samples were analyzed for grain size, while video images were analyzed and described revealing the acoustic seabed and other bio-physical characteristics. A map of seabed classification, including sediment types and seagrass distribution, was produced using the tool Remote Sensing Object Based Image Analysis (RSOBIA) by integrating information derived from backscatter data and bathy-morphological features, validated by ground-truth data. This allows to create a first seabed maps (i.e. benthoscape classification), of Lampedusa and Linosa, at scale 1:20 000 and 1:32 000, respectively, that will be checked and implemented through further surveys. The results point out a very rich and largely variable marine ecosystem on the seabed surrounding the two islands, with the occurrence of priority habitats, and will be of support for a more comprehensive maritime spatial planning of the Marine Protected Area

Direct observation of spin-orbit-induced 3d hybridization via resonant inelastic extreme ultraviolet scattering on an edge-sharing cuprate

Using high resolution resonant inelastic x-ray scattering measurements, we have observed that the orbital excitations of the quasi-1D spin chain compound CuGeO3 has nontrivial and noticeable orbital mixing effects from 3d valence spin-orbit coupling. In particular, the SOC leads to a significant correction of d(z2) state, which has a direct interplay with the low energy physics of cuprates. Guided by atomic multiplet based modeling, our results strongly support a 3d spin-orbit mixing scenario and explore in detail the nature of these excitations

Effect of Vitamin D Receptor Activator Therapy on Vitamin D Receptor and Osteocalcin Expression in Circulating Endothelial Progenitor Cells of Hemodialysis Patients

Background: The effects of vitamin D receptor (VDR) and osteocalcin (OC) expression as well as VDR agonist (VDRA) therapy on circulating endothelial progenitor cells (EPCs) has not been elucidated yet. Methods: We therefore analyzed EPCs in 30 healthy controls and 82 patients undergoing dialysis (no VDRA therapy: 28; oral calcitriol: 30, and intravenous paricalcitol, PCTA: 24). The percentage of EPCs (CD34+/CD133-/KDR+/CD45-) expressing VDR or OC, and VDR and OC expression defined by mean fluorescence intensity (MFI) were analyzed using flow cytometry. The in vitro effect of VDRAs was evaluated in EPCs isolated from each patient group. Results: The percentage of VDR+ EPCs correlated positively with VDRA therapy and 25(OH)D, and negatively with diabetes, C-reactive protein, hemoglobin and osteopontin. VDR-MFI correlated positively with VDRA therapy, parathyroid hormone (PTH) and 25(OH)D, and negatively with diabetes and osteopontin. The percentage of OC+ EPCs correlated positively with the calcium score, PTH and phosphate, and negatively with 25(OH)D. OC-MFI correlated positively with calcium score, PTH, phosphate and hemoglobin, and negatively with albumin, 25(OH)D and osteopontin. Cell cultures from patients without VDRA therapy had the highest levels of calcium deposition and OC expression, which both significantly decreased following in vitro VDRA administration: in particular extracellular calcium deposition was only reduced by adding PCTA. Conclusions: Our data suggest that 25(OH)D serum levels and VDRA therapy influence VDR and OC expression on circulating EPCs. Since OC expression may contribute to vascular calcification, we hypothesize a putative protective role of VDRA therapy

The impact of the histological classification of ampullary carcinomas on long-term outcomes after pancreaticoduodenectomy: a single tertiary referral center evaluation

Purpose Ampullary carcinomas (ACs) are classified as pancreatobiliary (Pb-AC), intestinal (Int-AC), or mixed (Mixed-AC). The influencing role of AC subtypes on long-term outcomes is still matter of debate. Aim of this study is to evaluate the prognostic role of the three histological variants on the overall (OS) and disease-free survival (DFS) after pancreaticoduodenectomy(PD). Methods All PDs for AC between 2004 and 2020 were included. Patients were classified according to the histological feature in Pb-AC, Int-AC, and Mixed-AC. Five-year OS and DFS were compared among the subtypes. Additionally, the prognostic role of the histological classification on OS and DFS was evaluated. Results Fifty-six (48.7%) Pb-ACs, 53 (46.1%) Int-ACs, and 6 (5.2%) Mixed-ACs were evaluated. A poorer 5-year OS was evidenced for the Pb-AC group (54.1%) as compared to the Int-AC cohort (80.7%) (p = 0.03), but similar to the Mixed-AC population (33%) (p = 0.45). Pb-AC presented a worse 5-year DFS (42.3%) in comparison to the Int-AC (74.8%) (p = 0.002), while no difference was evidenced in comparison to the Mixed-AC (16.7%) (p = 0.51). At the multivariate analysis, the Pb-/Mixed-AC histotype was recognized as negative prognostic factor for both OS (OR: 2.29, CI: 1.05-4.98; p = 0.04) and DFS (OR: 2.17, CI: 1-4.33; p = 0.02). Conclusion Histological subtypes of AC play a relevant role in long-term outcomes after PD. Pb-ACs and Mixed-ACs show a more aggressive tumor biology and a consequent worse survival as compared to the Int-AC subtype