Cadmium and hypertension in exposed workers: A meta-analysis

Abstrac

The orientation and kinematics of inner tidal tails around dwarf galaxies orbiting the Milky Way

Using high-resolution collisionless N-body simulations we study the properties of tidal tails formed in the immediate vicinity of a two-component dwarf galaxy evolving in a static potential of the Milky Way (MW). The stellar component of the dwarf is initially in the form of a disk and the galaxy is placed on an eccentric orbit motivated by CDM-based cosmological simulations. We measure the orientation, density and velocity distribution of the stars in the tails. Due to the geometry of the orbit, in the vicinity of the dwarf, where the tails are densest and therefore most likely to be detectable, they are typically oriented towards the MW and not along the orbit. We report on an interesting phenomenon of `tidal tail flipping': on the way from the pericentre to the apocentre the old tails following the orbit are dissolved and new ones pointing towards the MW are formed over a short timescale. We also find a tight linear relation between the velocity of stars in the tidal tails and their distance from the dwarf. Using mock data sets we demonstrate that if dwarf spheroidal (dSph) galaxies in the vicinity of the MW are tidally affected their kinematic samples are very likely contaminated by tidally stripped stars which tend to artificially inflate the measured velocity dispersion. The effect is stronger for dwarfs on their way from the peri- to the apocentre due to the formation of new tidal tails after pericentre. Realistic mass estimates of dSph galaxies thus require removal of these stars from kinematic samples.Comment: 8 pages, 7 figures, accepted for publication in MNRA

NEMO-SN1 Abyssal Cabled Observatory in the Western Ionian Sea

The NEutrinoMediterranean Observatory—Submarine Network 1 (NEMO-SN1) seafloor observatory is located in the central Mediterranean Sea, Western Ionian Sea, off Eastern Sicily (Southern Italy) at 2100-m water depth, 25 km from the harbor of the city of Catania. It is a prototype of a cabled deep-sea multiparameter observatory and the first one operating with real-time data transmission in Europe since 2005. NEMO-SN1 is also the first-established node of the European Multidisciplinary Seafloor Observatory (EMSO), one of the incoming European large-scale research infrastructures included in the Roadmap of the European Strategy Forum on Research Infrastructures (ESFRI) since 2006. EMSO will specifically address long-term monitoring of environmental processes related to marine ecosystems, marine mammals, climate change, and geohazards

Abdominal drainage after elective colorectal surgery: propensity score-matched retrospective analysis of an Italian cohort

background: In italy, surgeons continue to drain the abdominal cavity in more than 50 per cent of patients after colorectal resection. the aim of this study was to evaluate the impact of abdominal drain placement on early adverse events in patients undergoing elective colorectal surgery. methods: a database was retrospectively analysed through a 1:1 propensity score-matching model including 21 covariates. the primary endpoint was the postoperative duration of stay, and the secondary endpoints were surgical site infections, infectious morbidity rate defined as surgical site infections plus pulmonary infections plus urinary infections, anastomotic leakage, overall morbidity rate, major morbidity rate, reoperation and mortality rates. the results of multiple logistic regression analyses were presented as odds ratios (OR) and 95 per cent c.i. results: a total of 6157 patients were analysed to produce two well-balanced groups of 1802 patients: group (A), no abdominal drain(s) and group (B), abdominal drain(s). group a versus group B showed a significantly lower risk of postoperative duration of stay >6 days (OR 0.60; 95 per cent c.i. 0.51-0.70; P < 0.001). a mean postoperative duration of stay difference of 0.86 days was detected between groups. no difference was recorded between the two groups for all the other endpoints. conclusion: this study confirms that placement of abdominal drain(s) after elective colorectal surgery is associated with a non-clinically significant longer (0.86 days) postoperative duration of stay but has no impact on any other secondary outcomes, confirming that abdominal drains should not be used routinely in colorectal surgery

Bowel preparation for elective colorectal resection: multi-treatment machine learning analysis on 6241 cases from a prospective Italian cohort

background current evidence concerning bowel preparation before elective colorectal surgery is still controversial. this study aimed to compare the incidence of anastomotic leakage (AL), surgical site infections (SSIs), and overall morbidity (any adverse event, OM) after elective colorectal surgery using four different types of bowel preparation. methods a prospective database gathered among 78 Italian surgical centers in two prospective studies, including 6241 patients who underwent elective colorectal resection with anastomosis for malignant or benign disease, was re-analyzed through a multi-treatment machine-learning model considering no bowel preparation (NBP; No. = 3742; 60.0%) as the reference treatment arm, compared to oral antibiotics alone (oA; No. = 406; 6.5%), mechanical bowel preparation alone (MBP; No. = 1486; 23.8%), or in combination with oAB (MoABP; No. = 607; 9.7%). twenty covariates related to biometric data, surgical procedures, perioperative management, and hospital/center data potentially affecting outcomes were included and balanced into the model. the primary endpoints were AL, SSIs, and OM. all the results were reported as odds ratio (OR) with 95% confidence intervals (95% CI). results compared to NBP, MBP showed significantly higher AL risk (OR 1.82; 95% CI 1.23-2.71; p = .003) and OM risk (OR 1.38; 95% CI 1.10-1.72; p = .005), no significant differences for all the endpoints were recorded in the oA group, whereas MoABP showed a significantly reduced SSI risk (OR 0.45; 95% CI 0.25-0.79; p = .008). conclusions MoABP significantly reduced the SSI risk after elective colorectal surgery, therefore representing a valid alternative to NBP

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

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

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

FUNCTIONAL AND TECHNOLOGICAL RETROFITTING OF MODERN BUILDINGS. THE FORMER POST OFFICE BUILDING IN SABAUDIA

Il tema del contributo è l’adeguamento funzionale e tecnologico del patrimonio architettonico esistente e, in particolare, di quello dell’inizio del Novecento ed è il risultato di esperienze personali di ricerca svolte dagli autori. La rifunzionalizzazione dell’architettura moderna costituisce un tema di crescente e vivo interesse con forti ricadute ambientali, dovute al ridotto consumo di superficie rispetto alla nuova edificazione, ed economiche, per la rendita di posizione. Un adeguamento funzionale e tecnologico rappresenta, o almeno dovrebbe rappresentare, un importante strategia per garantire la gestione e la manutenzione dell’edificio che, riportato a nuova vita, viene valorizzato con l’inserimento di funzioni e soluzioni in grado di soddisfare le peculiari esigenze del contesto sociale e culturale in cui è localizzato. L’individuazione della nuova funzione oltre che delle soluzioni tecnologiche necessarie a consentire il suo svolgimento, rappresenta quindi non il fine ultimo dell’intervento ma il primo passo per continuare a consentirne la fruizione. Ovviamente tali interventi presentano delle implicazioni di carattere critico-operativo che coinvolgono i rapporti tra le varie scale del costruito, dall’inserimento urbano al dettaglio costruttivo. Visto l’insieme dei vincoli di carattere culturale, sociale ed economico-produttivo, è evidente come non esista un unico approccio all’analisi e alla progettazione di un intervento di adeguamento. Il contributo individuerà i più frequenti ostacoli che un progettista deve affrontare quando interviene su un edificio esistente con l’obiettivo di prolungarne la vita utile magari modificandone la destinazione d’uso. È necessario superare l’attuale carenza di un adeguato approccio conoscitivo e progettuale negli interventi sul costruito, perlopiù contrassegnata da una sostanziale indifferenza nei confronti degli assetti tipologici e del processo evolutivo: tutto ciò invece è fondamentale per ogni scelta progettuale perché ogni intervento, anche quello più accorto, può compromettere l’atmosfera e l’omeostasi costruttiva di un fabbricato. A tale scopo, a titolo esemplificativo, verrà presentato il progetto di adeguamento funzionale e tecnologico che ha trasformato l’ex Palazzo delle Poste e Telegrafi a Sabaudia, progettato da Angiolo Mazzoni nel 1932 e completato nel 1934, in un Centro di documentazione, studio e conservazione della memoria.This paper addressed the functional and technological retrofitting of the existing architectural heritage, above all early 20th century buildings, and is the result of the authors’ personal research. The functional retrofitting of modern architecture is an issue that is attracting more and more keen interest, with powerful environmental impacts from the reduced consumption of surface compared to new builds, as well as economical impacts as a result of location-induced income. Functional and technological retrofitting is, or at least should be, an important strategy to safely manage and maintain a building, which, once revamped, is enhanced by the addition of functions and solutions that fulfil the specific requirements of the social and cultural milieu it is located in. Therefore, finding such new functions as well as the technological solutions needed to perform them is not the ultimate purpose of a work, it is the first step to keep it used. Of course, such works have critical-operational implications on the relations between the different dimensions of an existing building, from the way it fits in with the surroundings to its constructive details. Because of all such cultural, social and economic-productive restrictions, it is clear there can be no single approach to investigating and designing a retrofitting project. This paper will try to find the most frequent obstacles a designer has to face when working on an existing building to extend its service life, maybe by changing its use. The current lack of a proper cognitive and design approach to working on existing buildings, often marred by disrespect for their typological set-up or evolutionary process, must be overcome: all this is essential, instead, to choosing the right design, because any project, even the smartest one, may impair the atmosphere and constructive homeostasis of a building. To achieve this purpose, the recent project in which the former Post Office building in Sabaudia, designed by Angiolo Mazzoni in 1932 and completed in 1934, was converted into a Centre for documentation, study and preservation of memory, will be described therein

La condivisione come generatrice di trasformazioni

Il tema della condivisione rappresenta certamente uno dei più attuali ambiti di investigazione e progettazione. È quanto emerge dalla ricerca condotta con approccio multidisciplinare nel Dipartimento di Architettura dell’Università degli Studi Roma Tre: la ricerca avanza delle riflessioni teoriche e progettuali che concentrano l’attenzione sul senso collettivo dell’abitare con particolare attenzione al tema del cohousing attraverso una traduzione più ampia del termine. Dopo aver definito alcuni elementi delle diverse modalità di condivisione nelle nuove pratiche urbane, viene posto l’accento sul tema della condivisione quale elemento centrale nella rigenerazione; nelle sue attuali forme, il co-housing valica la dimensione domestica e diventa urbano (co-neighborhood), con un complesso di relazioni che stimola la creazione di un sistema di condivisioni generatore di trasformazioni. Infine, lo studio delle esperienze recenti più avanzate evidenzia come un intervento di co-housing possa contribuire a formulare nuovi assiomi attraverso modelli di mutuo soccorso, processi di coesione sociale, strumenti di tutela dell’ambiente e sostenibilità economica, anche attraverso strategie di rigenerazione e di valorizzazione del patrimonio immobiliare esistente.The issue of “sharing” is undoubtedly one of the most current and challenging fields of study and planning. This is what emerges from an ongoing research, conducted with the involvement of various disciplines’ researchers of the Department of Architecture of Roma Tre University: the research proposes theoretical and design reflections, which focus on the collective sense of living, with particular emphasis on broader contexts and different meanings of cohousing. After defining some elements of the different ways of sharing in the new urban practices, the emphasis is on "sharing" as a central element in the regeneration. In its current practice the co-housing crosses the domestic dimension and becomes urban (co-neighbourhood) with a complex of relationships that stimulates the growth of a sharing system, which in turn, generates transformations: a metamorphosis that can only affect the existing buildings, with the aim of regenerating the old city. Finally the study, based on the most recent and innovative experiences, highlights how a cohousing project can contribute to formulate new axioms by mutual-aid models, social cohesion processes, tools of environmental protection and economic sustainability, even through the reorganization and the enhancement of the existing building heritage