The Effects of Non-Indigenous Macrophytes on Native Biodiversity: Case Studies from Sicily

Biological invasions are widely recognized as a major threat to native biodiversity, ecosys tem functioning and services. Non-indigenous species (NIS) may in time become invasive (invasive alien species (IAS)), determining significant environmental, socioeconomic and human health impacts such as biodiversity loss and ecosystem service degradation. The Mediterranean islands, particu larly Sicily and the circum-Sicilian islands (northwestern Mediterranean Sea), which are important hotspots of biodiversity, are notably vulnerable to anthropogenic pressures such as biological in vasions. Therefore, monitoring NIS distribution as well as understanding their effects on native biodiversity is critical in these areas for planning effective conservation strategies. Here, we report four different case studies from Sicily that highlight how NIS may affect native biodiversity and habitats. The first three case studies were carried out within Marine Protected Areas (MPAs) and highlight (1) the ability of Caulerpa cylindracea to promote the establishment of other NIS, including biofouling worms belonging to the genus Branchiomma; (2) how the shift in habitat from the native Ericaria brachycarpa to the invasive Asparagopsis taxiformis may drastically erode the primary producer biomass and associated biodiversity; and (2) that the presence of Lophocladia lallemandii can affect the molluscan assemblage inhabiting the canopy-forming Gongolaria montagnei. The fourth case study, performed along the northwestern coast of Sicily, shows how Halophila stipulacea can affect the growth of the co-occurring native seagrass Cymodocea nodosa. Overall, these case studies demonstrate various ways in which NIS can interact with native biodiversity and habitats. Furthermore, they emphasize that MPAs are ineffective at preventing the introduction and spread of NIS

Understanding the purchasing behavior of consumers in response to sustainable marketing practices: An empirical analysis in the food domain

Sustainability has become an important driver in defining business strategies, affecting most critical corporate functions and changing the way in which value is created, communicated, and distributed. This is increasingly impacting marketing practices, in particular, through promoting the development of sustainable marketing in the food sector. In line with this, our study aimed to investigate if and how sustainable marketing practices affect consumer loyalty to a specific brand. To answer our research questions, we relied on the results of a survey submitted to a sample of 907 Italian consumers of biscuits. Results showed that the consumers’ attention to sustainable issues (in the absence of adequate information that can guide them in choosing a brand) did not result in brand loyalty. The same outcome was found when consumers were overloaded by marketing campaigns, which had the effect of confusing users and making them unfaithful. Ultimately, when consumers showed both engagement with sustainable concerns and sensitivity to marketing initiatives (i.e., they are sensitive to sustainable marketing practices), a positive effect on brand loyalty was observed. Our results contribute to the emerging stream of literature discussing the relevance and potential impact of sustainable marketing

Conserving Marine Forests: Assessing the Effectiveness of a Marine Protected Area for Cystoseira sensu lato Populations in the Central Mediterranean Sea

Marine Protected Areas (MPAs) are vital for biodiversity conservation, yet their effectiveness in preserving foundation seaweeds remains understudied. This study investigates the diversity and distribution of Cystoseira sensu lato (including Cystoseira, Ericaria and Gongolaria, hereafter referred to as Cystoseira s.l.) populations in an MPA located in the central Mediterranean Sea, comparing them with those in two unprotected sites. We hypothesized MPA Cystoseira s.l. populations would display higher diversity and structure compared to outside unprotected sites. Results revealed a total of 19 Cystoseira s.l. species at depths of 0-20 m, with the MPA exhibiting a higher diversity than unprotected sites. Thus, MPAs can play a crucial role in fostering the diversity of Cystoseira s.l. populations. However, no significant differences were observed among the MPA's protection zones, raising questions about the zoning effectiveness. Additionally, our survey uncovered a substantial presence of non-indigenous seaweeds within the MPA. In conclusions, while MPAs improved Cystoseira s.l. diversity compared to unprotected sites, the varying efficacy of protection within MPA zones suggested a necessity for site-specific conservation strategies. The presence of non-indigenous seaweeds emphasizes ongoing challenges. This study provides a baseline for understanding Cystoseira s.l. population dynamics, crucial for future monitoring and conservation efforts in the face of global change

Neoadjuvant therapy for breast cancer

Objective: To evaluate the frequency of neoadjuvant therapy (NT) in women with stage I–III breast cancer in Italy and whether it is influenced by biological characteristics, screening history, and geographic area. Methods: Data from the High Resolution Study conducted in 7 Italian cancer registries were used; they are a representative sample of incident cancers in the study period (2009–2013). Included were 3546 women aged <85 years (groups <50, 50–69, 70–64, and 75+) with stage I–III breast cancer at diagnosis who underwent surgery. Women were classified as receiving NT if they received chemotherapy, target therapy, and/or hormone therapy before the first surgical treatment. Logistic models were built to test the association with biological and contextual variables. Results: Only 8.2% of women (290 cases) underwent NT; the treatment decreases with increasing age (14.5% in age <50 and 2.2% in age 75+), is more frequent in women with negative receptors (14.8%), HER2-positive (15.7%), and triple-negative (15.6%). The multivariable analysis showed the probability of receiving NT is higher in stage III (odds ratio [OR] 3.83; 95% confidence interval [CI] 2.83–5.18), luminal B (OR 1.87; 95% CI 1.27–2.76), triple-negatives (OR 1.88; 95% CI 1.15–3.08), and in symptomatic cancers (OR 1.98; 95% CI 1.13–3.48). Use of NT varied among geographic areas: Reggio Emilia had the highest rates (OR 2.29; 95% CI 1.37–3.82) while Palermo had the lowest (OR 0.41; 95% CI 0.24–0.68). Conclusions: The use of NT in Italy is limited and variable. There are no signs of greater use in hospitals with more advanced care

Optimizing critical illness outcomes through the family experience-A theoretical review

An estimated six to eight million patients are admitted to the intensive care unit (ICU) in the United States every year [1, 2]. It is possible that new and innovative medical therapies have provided patients with treatment options that enhance survival of a critical illness and allow them go home with more medical support than previously available in earlier years. This may explain why there are now millions of ICU survivors are a result of declining mortality rates (8-19%) even though there are increased ICU admissions [3, 4]. This also indicates a change in direction of the attitudes and beliefs of the family unit today and their desire for the family member to return home after critical illness instead of moving to a tertiary facility for care

Capsular closure after hip arthroscopy: our experience

BACKGROUND AND AIM OF THE WORK: In the last decade, arthroscopic treatment of hip diseases has significantly spread and evolved and currently it represents the gold standard for the treatment of femoral- acetabular impingement. In the recent years, the function of the joint capsule (and therefore the results of an arthroscopic capsulotomy) has been hugely developed, opening a heated debate. The Literature is still torn about the need for a capsular suture, but more recent studies are more oriented in its execution at the end of the surgical procedure. According to these recent studies, the joint capsule performs an essential function of primary stability, and its closure is therefore necessary to restore the native anatomy and physiology. Nevertheless, capsular management remains a controversial topic. This is a retrospective study with the aim of assessing the influence of capsular suture on the patient's functional outcome in a cohort of patients with femoral-acetabular impingement arthroscopically treated. HYPOTHESIS: Our hypothesis is that an adequate capsular suture positively influences the patient's functional outcome. METHODS AND RESULTS: 50 patients treated with hip arthroscopy for femoral-acetabular impingement have been retrospectively enrolled at the Orthopaedic Clinic of Academic Hospital of Udine during a period of two-years (2017-2018); collected data have been analysed and compared with a retrospective model. Patients have been divided into two equivalent groups, 25 treated with capsular suture, 25 without performing the suture. Patient's post-operative functional outcome has been analysed using the modified Harris Hip Score (mHHS), the Non-Arthritic Hip Score (NAHS) and the Hip Outcome Score-Sport Scale (HOS-SS). The functional outcome in patients where capsular sutures were performed was better than in non-sutured patients, in all three analysed scales. CONCLUSIONS: Capsular suture with a single side-to-side stitch at the end of the procedure can positively influence the patient's functional outcome

Histological analysis of ACL reconstruction failures due to synthetic-ACL (LARS) ruptures

INTRODUCTION: Anterior Cruciate Ligament (ACL) reconstruction is an established surgical procedure. Synthetic ligaments represent an option for ACL reconstruction. Their popularity declined for the raising concerns due to re-ruptures, knee synovitis and early arthritis related to I and II generation artificial ligaments. The introduction of a III generation synthetic ligament (Ligament Advanced Reinforcement System-LARS) permitted renewed interest in the adoption of this kind of graft. Main purpose of our study was to describe the histological findings on samples obtained from a consecutive series of ACL revision surgeries due to LARS ACL reconstruction failures. Secondary aim was to determine the reason for LARS rupture. METHODS: In a period between 2016 and 2018 eleven patients underwent ACL revision surgery due to LARS ACL reconstruction failure. At the time of the arthroscopic procedure, samples of synovial membrane and remnants of the torn LARS were sent to the Pathological-Anatomy Institute of our Hospital for a histological analysis. RESULTS: Histological analysis of the synovial tissues confirmed the arthroscopic evidence of synovitis mainly characterized by chronic inflammation with predominance of multinucleated giant cells. The adoption of polarized light microscopy revealed the presence of brightly bi-refractive material (LARS wear particles) in the synovial tissue; at higher magnification wear debris were detected inside the cytoplasma of multi nucleated cells. The histological analysis of the removed LARS revealed a surrounding typical foreign body reaction with poor signs of fibrovascular ingrowth of the synthetic ligament. CONCLUSIONS: Our findings could not clearly advocate a unique mechanism of LARS-ACL reconstruction failure: biologic issues (poor tissue ingrowth) and mechanical issues (fibers properties and tunnel position) probably concur in a multi factorial manner. ACL reconstruction using artificial ligaments can not be considered a simple surgery. Artificial augments require some expertise and could therefore achieve better results if used by skilled sport surgeons other than trainees or low volume surgeons. The Authors believe that ACL reconstruction with synthetic devices still have restricted indications for selected patients (e.g. elderly patients who require a fast recovery, professional athlete, autologous tendons not available and/or refusing donor tendons). Our study arises additional suspicion on the unresponsiveness of synthetic fibers and claim some concern in the implantation of synthetic devices

Effects of prism adaptation on reference systems for extrapersonal space in neglect patients

Up to now, rehabilitation of unilateral spatial neglect has focused on egocentric forms of neglect, whereas less is known about the possibility to improve allocentric deficits. The present study aimed to examine the efficacy of prism adaptation (PA) training on patients with different forms of neglect: egocentric, allocentric, or mixed. Twenty-eight patients were assessed with specific neglect tests before (T0) and after (T1) 10 sessions of PA training. Performance in the Apples Cancellation test was used to identify patients with egocentric (n = 6), allocentric (n = 5), or mixed (n = 17) forms of neglect. In the overall group of patients, PA training produced significant improvements in performance across different neglect tests. In terms of the egocentric–allocentric distinction, the training was effective in reducing omissions in the left part of space in the Apples Cancellation test both for patients with egocentric neglect and mixed neglect. By contrast, errors of commissions (marking the inability to detect the left part of the target stimulus, i.e., allocentric neglect) remained unchanged after PA in patients with allocentric neglect and actually increased marginally in patients with mixed neglect. The PA training is effective in improving egocentric neglect, while it is ineffective on the allocentric form of the disturbance. Notably, the allocentric component of neglect is frequently impaired, although this is most often in conjunction with the egocentric impairment, yielding the mixed form of neglect. This stresses the importance of developing exercises tuned to improving allocentric neglect

Total knee revision arthroplasty: comparison between tibial tubercle osteotomy and quadriceps snip approach. Complication rate

BACKGROUND AND AIM OF THE WORK: The total knee arthroplasty (TKA) revision is not a second time of primary implant surgery but is a very complex issue for orthopedic surgeon. When local conditions make necessary a greater visualization, medial para-patellar access with quadriceps snip (QS) or the osteotomy of the tibial tuberosity (TTO) can be the solutions. This work aims to compare the quadriceps snip and the detachment of the tibial tubercle, focusing on possible complications. MATERIALS AND METHODS: At our institution, between January 2017 and February 2019 52 TKA revision for periprosthetic joint infection (PJI) or aseptic mobilization were performed. In 43 cases an extensive surgical approach was required: for patients with range of movement (ROM) 60\ub0 a QS was performed. Clinical and radiological follow-up was available for all the 43 cases. RESULTS: The data about clinical outcome in our study show that both groups have a positive trend in KSS score over time with similar ROM results. Two partial avulsions of patellar tendon during revision surgery were reported. Clinical outcome in both groups has shown good results at the end of follow-up with no post-operative incidence of complications. CONCLUSION: We can assert that both QS and TTO are good approach for TKA revision. Future studies will be needed to understand if preparatory ROM is a good way to decide which surgical approach to use.(www.actabiomedica.it)