Characterisation of the different hands in the composition of a 14th century breviary by means of portable XRF analysis and complementary techniques

A 14th century breviary known as Breviario di San Michele della Chiusa, produced at the disposal of the monks of Sacra di San Michele abbey (near Turin, Italy) has been analysed in order to identify the different authors who contributed in its making. The study aimed at revealing how many scribes composed the text and the musical notations and how many artists worked for miniatures and for the decorations of initials. All inks and decorative features have been analysed by means of portable XRF spectrometry for determining elemental distribution and by means of UV-Visible diffuse reflectance spectrophotometry with optic fibres (FORS) and spectrofluorimetry for identifying colourants. The results on non-invasive measurements highlighted that at least 11 persons (6 scribes for the text, 2 scribes for the musical notations, 2 artists for initials and filigrees, 1 artist for the full-page miniature at f. 208v) were at work at the Breviario. Moreover, the black inks used for text and notes have an anomalous composition, being irongall inks with a larger than usual amount of zinc, possibly as a consequence of the use of vitriols made from goslarite; this suggests that the scribes could come from Northern Europe. The presence of traces of bismuth in blue paints also suggested the provenance of azurite from Central or Northern Europe

Caring for cancer survivors: perspectives of oncologists, general practitioners and patients in Italy.

Aim: The present survey investigates the views of medical oncologists, general practitioners (GPs) and patients about the various surveillance strategies. Methods: An online survey was conducted in Italy on a population of 329 medical oncologists, 380 GPs and 350 patients. Results: Most of GPs (n = 291; 76%) claim that follow-up should be provided by the collaboration between GPs and medical oncologists. Most medical oncologists report to have a poor relationship with GPs (n = 151; 46%) or no relationships at all (n = 14; 4%). Most patients believe there is no real collaboration between medical oncologists and GPs (n = 138; 54%). Conclusion: GPs, medical oncologists and patients share the idea that the collaboration between oncologists and GPs for surveillance of cancer survivors is poor and should be improved

Burden on family carers and care-related financial strain at the end of life : a cross-national population-based study

Background: The rising number of deaths from cancer and other life-limiting illnesses is accompanied by a growing number of family carers who provide long-lasting care, including end-of-life care. This population-based epidemiological study aimed to describe and compare in four European countries the prevalence of and factors associated with physical or emotional overburden and difficulties in covering care-related costs among family carers of people at the end of life. Methods: A cross-national retrospective study was conducted via nationwide representative sentinel networks of general practitioners (GPs). Using a standardized form, GPs in Belgium, The Netherlands, Italy and Spain recorded information on the last 3 months of life of every deceased adult practice patient (1 January 2009-31 December 2010). Sudden deaths were excluded. Results: We studied 4466 deaths. GPs judged family carers of 28% (Belgium), 30% (The Netherlands), 35% (Spain) and 71% (Italy) of patients as physically/emotionally overburdened (P < 0.001). For 8% (Spain), 14% (Belgium), 36% (The Netherlands) and 43% (Italy) patients, GPs reported difficulties in covering care-related costs (P < 0.001). Patients < 85 years of age (Belgium, Italy) had higher odds of having physically/emotionally overburdened family carers and financial burden. Death from non-malignant illness (vs. cancer) (Belgium and Italy) and dying at home compared with other locations (The Netherlands and Italy) were associated with higher odds of difficulties in covering care-related costs. Conclusion: In all countries studied, and particularly in Italy, GPs observed a considerable extent of physical/emotional overburden as well as difficulties in covering care-related costs among family carers of people at the end of life. Implications for health-and social care policies are discussed

Therapeutic Value and Innovation of a Drug and Criteria for Evaluation: A Multidisciplinary Experience in the Veneto Region

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Characterisation of the different hands in the composition of a 14th century breviary by means of XRF analysis

A 14th century breviary known as Breviario di San Michele della Chiusa, produced at the disposal of the monks of Sacra di San Michele abbey (near Turin, Italy) has been analysed in order to identify the different authors who contributed in its making. The study aimed at revealing how many scribes composed the text and the musical notations and how many artists worked for miniatures and for the decorations of initials. All inks and decorative features have been analysed by means of portable XRF spectrometry for determining elemental distribution and by means of UV-Visible diffuse reflectance spectrophotometry with optic fibres (FORS) and spectrofluorimetry for identifying colourants. The results on non-invasive measurements highlighted that at least 11 persons (6 scribes for the text, 2 scribes for the musical notations, 2 artists for initials and filigrees, 1 artist for the full-page miniature at f. 208v) were at work at the Breviario. Moreover, the black inks used for text and notes have an anomalous composition, being irongall inks with a larger than usual amount of zinc, possibly as a consequence of the use of vitriols made from goslarite; this suggests that the scribes could come from Northern Europe. The presence of traces of bismuth in blue paints also suggested the provenance of azurite from Central or Northern Europe

Follow-up of breast cancer: why is it necessary to start a Consensus in 2024?

In Italy, breast cancer is the most frequently diagnosed cancer in women, with 55,900 new cases in 2023 (over 90% in the early stages). Due to the screening, early diagnosis and adjuvant treatment, these patients have a 5-years survival rate of 87% after the diagnosis. There are 834,154 women in Italy with a previous diagnosis of breast cancer: most of these women require a follow-up. The AIOM, ESMO and ASCO Guidelines recommend for early breast cancer (EBC) a clinical follow-up with only physical examination (and eliciting of symptoms) and an annual X-ray mammography, on the basis of the results of two randomized trials published in 1994 that showed no benefit in overall survival with intensive follow-up. However, an Italian survey reported the application by 80% of oncologists of an intensive follow-up based on the individual patient’s risk of recurrence. In fact, the oncologists believe that an early diagnosis of locoregional or distant recurrence may allow an early start of very effective therapies. In this lack of up-to-date scientific data, many questions about follow-up remain unanswered and the few ongoing studies will provide results in several years. Non-compliance with guideline recommendations leads to increased costs for the healthcare system. Furthermore, management varies widely from centre to centre with regard to guideline recommendations, resulting in inequalities between patients. For these reasons, the follow-up of breast cancer should be reconsidered. In the absence of recent scientific evidence, a multidisciplinary group of breast cancer experts has initiated a Consensus on the follow-up of EBC according to the mini-Delphi methodology. The project will be completed by the end of 2024

Performance assessment across different care settings of a heart failure hospitalisation risk-score for type 2 diabetes using administrative claims

Predicting the risk of cardiovascular complications, in particular heart failure hospitalisation (HHF), can improve the management of type 2 diabetes (T2D). Most predictive models proposed so far rely on clinical data not available at the higher Institutional level. Therefore, it is of interest to assess the risk of HHF in people with T2D using administrative claims data only, which are more easily obtainable and could allow public health systems to identify high-risk individuals. In this paper, the administrative claims of &gt; 175,000 patients with T2D were used to develop a new risk score for HHF based on Cox regression. Internal validation on the administrative data cohort yielded satisfactory results in terms of discrimination (max AUROC = 0.792, C-index = 0.786) and calibration (Hosmer-Lemeshow test p value &lt; 0.05). The risk score was then tested on data gathered from two independent centers (one diabetes outpatient clinic and one primary care network) to demonstrate its applicability to different care settings in the medium-long term. Thanks to the large size and broad demographics of the administrative dataset used for training, the proposed model was able to predict HHF without significant performance loss concerning bespoke models developed within each setting using more informative, but harder-to-acquire clinical variables

Characteristics of responding oncologists and institutions.

<p>Characteristics of responding oncologists and institutions.</p