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

Platelets and Hepatocellular Cancer: Bridging the Bench to the Clinics

Growing interest is recently being focused on the role played by the platelets in favoring hepatocellular cancer (HCC) growth and dissemination. The present review reports in detail both the experimental and clinical evidence published on this topic. Several growth factors and angiogenic molecules specifically secreted by platelets are directly connected with tumor progression and neo-angiogenesis. Among them, we can list the platelet-derived growth factor, the vascular endothelial growth factor, the endothelial growth factor, and serotonin. Platelets are also involved in tumor spread, favoring endothelium permeabilization and tumor cells' extravasation and survival in the bloodstream. From the bench to the clinics, all of these aspects were also investigated in clinical series, showing an evident correlation between platelet count and size of HCC, tumor biological behavior, metastatic spread, and overall survival rates. Moreover, a better understanding of the mechanisms involved in the platelet-tumor axis represents a paramount aspect for optimizing both current tumor treatment and development of new therapeutic strategies against HCC

The impact of renewable energy systems on local sustainability

The purpose of the paper is to discuss and assess the impact of renewable energy, RE, generation on sustainable communities, with a specific focus on employment impact. In recent years, local authorities have been involved in the energy planning process due to the site-specific nature of renewable production and thanks to their nearer connection to citizens. Four small and medium-size sustainable communities belonging to Marche region, in central Italy, have been analysed. The work forecasts the employment generated by the RE capacity defined by two different energy scenarios: 1) the 'business as usual' scenario with a 20% CO2 emission reduction target by 2020, where all the energy policies suggested by Sustainable Energy Action Plans have been considered; 2) the 'potential' scenario with a 50% CO2 emission reduction target by 2050. Results show that the spreading of renewable energy, as expected, can increase local jobs, although the high investments required and problems connected to the impact on the grid have to be considered in the analysis of the global economic effect

Helminth parasites of the dwarf sperm whale Kogia sima (Cetacea: Kogiidae) from the Mediterranean Sea, with implications on host ecology

Limited data exist on the occurrence of the dwarf sperm whale Kogia sima in the Mediterranean Sea and its parasite fauna. Here, the occurrence of the anisakid species Anisakis physeteris and A. pegreffii in the stomach chambers of an adult female dwarf sperm whale, stranded in southern Italy, is reported. In addition, the occurrence of Phyllobothrium delphini larvae infecting the blubber of the caudal peduncle region was recorded. A. physeteris and A. pegreffii represent the 2 parasite species of the genus, mostly distributed in the Mediterranean Sea in fish and squids. The finding of A. pegreffii and A. physeteris in the dwarf sperm whale represents a new record in this host species for the Mediterranean Sea. The study of gastrointestinal content also revealed a massive presence of cephalopod beaks identified as belonging to pelagic squids including the umbrella squid Histioteuthis bonnellii, the reverse jewel squid H. reversa, the long-armed squid Chiroteuthis veranii, and the comb-finned squid Ctenopteryx sicula. The feeding habits of the dwarf sperm whale, as well as the occurrence of these squid residuals in the cetacean host, suggest that these squid species play a major role in maintaining the life cycle of anisakid parasite species and P. delphini

Prevalence of Functional Gastrointestinal Disorders in Children and Adolescents in the Mediterranean Region of Europe

Little is known about the prevalence of functional gastrointestinal disorders (FGIDs) in children from the Mediterranean area of Europe. We aimed to assess the prevalence of FGIDs in children and adolescents in this region

The Iso2k database: A global compilation of paleo-δ18O and δ2H records to aid understanding of Common Era climate

Reconstructions of global hydroclimate during the Common Era (CE; the past-2000 years) are important for providing context for current and future global environmental change. Stable isotope ratios in water are quantitative indicators of hydroclimate on regional to global scales, and these signals are encoded in a wide range of natural geologic archives. Here we present the Iso2k database, a global compilation of previously published datasets from a variety of natural archives that record the stable oxygen (18O) or hydrogen (2H) isotopic compositions of environmental waters, which reflect hydroclimate changes over the CE. The Iso2k database contains 759 isotope records from the terrestrial and marine realms, including glacier and ground ice (210); speleothems (68); corals, sclerosponges, and mollusks (143); wood (81); lake sediments and other terrestrial sediments (e.g., loess) (158); and marine sediments (99). Individual datasets have temporal resolutions ranging from sub-annual to centennial and include chronological data where available. A fundamental feature of the database is its comprehensive metadata, which will assist both experts and nonexperts in the interpretation of each record and in data synthesis. Key metadata fields have standardized vocabularies to facilitate comparisons across diverse archives and with climate-model-simulated fields. This is the first global-scale collection of water isotope proxy records from multiple types of geological and biological archives. It is suitable for evaluating hydroclimate processes through time and space using large-scale synthesis, model-data intercomparison and (paleo)data assimilation. The Iso2k database is available for download at https://doi.org/10.25921/57j8-vs18 (Konecky and McKay, 2020) and is also accessible via the NOAA/WDS Paleo Data landing page: Https://www.ncdc.noaa.gov/paleo/study/2959