Extended endoscopic endonasal transsphenoidal approach to the suprasellar area: Anatomic considerations - Part I

INTRODUCTION: Interest in using the extended endonasal transsphenoidal approach for management of suprasellar lesions, with either a microscopic or endoscopic technique, has increased in recent years. The most relevant benefit is that this median approach permits the exposure and removal of suprasellar lesions without the need for brain retraction. MATERIALS AND METHODS: Fifteen human cadaver heads were dissected to evaluate the surgical key steps and the advantages and limitations of the extended endoscopic endonasal transplanum sphenoidale approach. We compared this with the transcranial microsurgical view of the suprasellar area as explored using the bilateral subfrontal microsurgical approach, and with the anatomy of the same region as obtained through the endoscopic endonasal route. RESULTS: Some anatomic conditions can prevent or hinder use of the extended endonasal approach. These include a low level of sphenoid sinus pneumatization, a small sella size with small distance between the internal carotid arteries, a wide intercavernous sinus, and a thick tuberculum sellae. Compared with the subfrontal transcranial approach, the endoscopic endonasal approach offers advantages to visualizing the subchiasmatic, retrosellar, and third ventricle areas. CONCLUSION: The endoscopic endonasal transplanum sphenoidale technique is a straight, median approach to the midline areas around the sella that provides a multiangled, close-up view of all relevant neurovascular structures. Although a lack of adequate instrumentation makes it impossible to manage all structures that are visible with the endoscope, in selected cases, the extended endoscopic endonasal approach can be considered part of the armamentarium for surgical treatment of the suprasellar area

Food related risks during pregnancy: how much do women know about it?

Aim Infection with Toxoplasma gondii and Listeria monocytogenes during pregnancy can lead to severe illness in the foetus but it can be prevented by simple hygienic measures. This study evaluated the knowledge that women have about food related risk and the information sources used. Methods We surveyed pregnant women and new mothers in[Removed for blind peer review], using a questionnaire approved by health direction, processed by an optical reader and analyzed using χ² test and Odds Ratio. Results 149 women responded to the survey, 78.5% of them received information from the gynaecologist, 45% from internet and then books/pamphlets. 67.8% felt well informed about food-related risks connected. 94% of them knows Toxoplasma; 39.5% ignore Listeria instead. From our results it’s evident  that graduated women tend to identify all foods as less secure and had better attitudes on cleaning refrigerator, on respecting temperatures, on avoiding consumption of undercooked foods, on protecting food before consumption. Conclusions Pregnant women have good awareness of food-related risks. However there’s a high confusion, due to the use of internet and other not reliable sources. This study demonstrates that it’s necessary to improve the organization of nutritional education by adequately trained health personnel

In Limine: Forme marginali e discorsi di confine

[Italiano]: La seconda Graduate conference organizzata dai dottorandi del Dottorato in Studi letterari, linguistici e comparati dell’Università degli Studi di Napoli “L’Orientale” (20-21 ottobre 2016) ha proposto all’attenzione dei giovani studiosi e ricercatori che hanno risposto al call for papers un tema di grande suggestione: il limen, inteso come margine, confine, frontiera, soglia testuale e metatestuale. Il tema è stato declinato nei vari ambiti disciplinari che concorrono nel progetto formativo del dottorato, non separatamente ma sempre in un dialogo proficuo e costruttivo. Di più, si inserisce perfettamente nella tradizione di studi e di impegno culturale e politico dell’Orientale. In un mondo in cui sempre di più si alzano muri e barriere tra civiltà e culture, bisogna insistere con forza sul valore positivo del limen come punto di contatto e di attraversamento, laboratorio in cui le lingue e le forme di espressione dell’umano si incontrano per creare sempre qualcosa di nuovo ./[English]: The second Graduate Conference organized by the PhD students in Literary, Linguistics and Comparative Studies at the University of Naples 'L'Orientale' (20-21 October 2016) has brought to the attention of young scholars and researchers a subject of great interest: the limen, understood as a margin, boundary, frontier, textual and metatextual threshold. The topic has been investigated in all the disciplinary horizons of the PhD programme, building a profound and constructive dialogue between different approaches. Moreover, it fits perfectly into the tradition of studies fostered at 'L'Orientale' and its cultural and political commitment: in a world where walls and barriers between civilizations and cultures are increasingly erected all over the world, we must strongly insist on the positive value of the limen as a point of contact and crossing, a laboratory where languages and forms of human expression meet with the purpose of creating something new

IN LIMINE. FORME MARGINALI E DISCORSI DI CONFINE/FRINGE FORMS AND BORDER DISCOURSES.

In organizing the second edition of the Graduate Conference of the PhD programme in Literary, Linguistics and Comparative Studies at the University of Naples "L'Orientale", which took place in the splendid setting of Palazzo Du Mesnil on 20-21 October 2016, the members of the organizing committee – in full accordance with the PhD coordinator, prof. Carlo Vecce, and the Board of Professors – continued the path traced by their predecessors, remaining faithful to the interdisciplinary dialogue that has characterized our PhD training programme for years. The conference debate was devoted to investigating the concept of limen in its various meanings: limen as threshold, textual and meta-textual margin; limen as border, boundary; limen as extreme limit; limen as in-betweenness, the threshold of consciousness and perception. The concept of limen is referable to what defines, separates, combines, allows the crossing and contamination, the identification or differentiation. It can be fixed, variable, incorporated or invented and is understood as an object in its literal meaning or as a metaphorical concept. The richness of ambivalent meanings linked to this concept has allowed a wide discussion panorama, in which marginal forms and boundary discourses have been analyzed in a multicentric and multidisciplinary perspective. Given the many submissions (almost three times more than the tight constraints), the committee had the delicate and unenviable task of selecting them; the choices were based on the pre-established themes – marginality in literature, linguistics and in the arts – without favouring any kind of approach and remaining open to innovative proposals that could demonstrate the arbitrariness of superficial and hasty 'labels' present in today's cultural landscape. While aware of the inadequacy of any subdivision for an event such as this one, characterized by a constant strive for interdisciplinary contact, it was decided to place the essays gathered together in this volume in three sections: even if corresponding to distinct research areas, they all share the same field of inquiry in a broader sense. The first section of the volume focuses on Textual Crossings. In this part, we find papers analyzing the relationship between text and 'paratext', those describing the processes of rewriting (understood as evolution of a text according to the different wills of the author, both as a re-use and as transfer to different cultural, chronological and linguistic contexts) and those focusing on innovative solutions adopted in some Italian literary texts at linguistic and stylistic levels. In the second section, Boundaries between Arts and Culture, there is room for contributions that deal with literary works relegated to the margins of the canon (for a rate of originality that is too high compared to current trends or because they are considered to be ancillary in some ways). There are also essays that deal with the theme of socio-anthropological margins, particular notions of the concept of limen and those on different artistic and cultural expressions in motion. Finally, we find studies that make an in-depth examination of issues related to cultural crosses and the loss of collective and individual identity. The third section, Linguistic Marginality, focuses on the contacts between different linguistic systems, on the varieties that arise from those contacts, on speakers’ perception of those varieties, on the ways in which the concept of 'crossing a border' is expressed in different linguistic codes, and, not least, about variations related to unusual communication situations (such as, for example, telematic events). A more detailed description of the essays is provided in the abstracts preceding each paper. Before dismissing this volume, we would like to thank all those who made its realization possible: the speakers, who participated in the Graduate Conference and decided to commit themselves by sending their proposals for the publication of its proceedings; the session chairs, who enthusiastically accepted our invitation, enriching the debate with precious insights; the scientific committee members, who meticulously reviewed the papers, guaranteeing the achievement of the standards required for such a publication, and finally Professor Carlo Vecce, for the constant and discreet support at all stages of our work

<i>Gaia</i> Data Release 1. Summary of the astrometric, photometric, and survey properties

Context. At about 1000 days after the launch of Gaia we present the first Gaia data release, Gaia DR1, consisting of astrometry and photometry for over 1 billion sources brighter than magnitude 20.7. Aims. A summary of Gaia DR1 is presented along with illustrations of the scientific quality of the data, followed by a discussion of the limitations due to the preliminary nature of this release. Methods. The raw data collected by Gaia during the first 14 months of the mission have been processed by the Gaia Data Processing and Analysis Consortium (DPAC) and turned into an astrometric and photometric catalogue. Results. Gaia DR1 consists of three components: a primary astrometric data set which contains the positions, parallaxes, and mean proper motions for about 2 million of the brightest stars in common with the HIPPARCOS and Tycho-2 catalogues – a realisation of the Tycho-Gaia Astrometric Solution (TGAS) – and a secondary astrometric data set containing the positions for an additional 1.1 billion sources. The second component is the photometric data set, consisting of mean G-band magnitudes for all sources. The G-band light curves and the characteristics of ∼3000 Cepheid and RR-Lyrae stars, observed at high cadence around the south ecliptic pole, form the third component. For the primary astrometric data set the typical uncertainty is about 0.3 mas for the positions and parallaxes, and about 1 mas yr−1 for the proper motions. A systematic component of ∼0.3 mas should be added to the parallax uncertainties. For the subset of ∼94 000 HIPPARCOS stars in the primary data set, the proper motions are much more precise at about 0.06 mas yr−1. For the secondary astrometric data set, the typical uncertainty of the positions is ∼10 mas. The median uncertainties on the mean G-band magnitudes range from the mmag level to ∼0.03 mag over the magnitude range 5 to 20.7. Conclusions. Gaia DR1 is an important milestone ahead of the next Gaia data release, which will feature five-parameter astrometry for all sources. Extensive validation shows that Gaia DR1 represents a major advance in the mapping of the heavens and the availability of basic stellar data that underpin observational astrophysics. Nevertheless, the very preliminary nature of this first Gaia data release does lead to a number of important limitations to the data quality which should be carefully considered before drawing conclusions from the data

Prospective validation of the CLIP score: a new prognostic system for patient with cirrhosis and hepatocellular carcinoma

Prognosis of patients with cirrhosis and hepatocellular carcinoma (HCC) depends on both residual liver function and tumor extension. The CLIP score includes Child-Pugh stage, tumor morphology and extension, serum alfa-fetoprotein (AFP) levels, and portal vein thrombosis. We externally validated the CLIP score and compared its discriminatory ability and predictive power with that of the Okuda staging system in 196 patients with cirrhosis and HCC prospectively enrolled in a randomized trial. No significant associations were found between the CLIP score and the age, sex, and pattern of viral infection. There was a strong correlation between the CLIP score and the Okuda stage, As of June 1999, 150 patients (76.5%) had died. Median survival time was 11 months, overall, and it was 36, 22, 9, 7, and 3 months for CLIP categories 0, 1, 2, 3, and 4 to 6, respectively. In multivariate analysis, the CLIP score had additional explanatory power above that of the Okuda stage. This was true for both patients treated with locoregional therapy or not. A quantitative estimation of 2-year survival predictive power showed that the CLIP score explained 37% of survival variability, compared with 21% explained by Okuda stage. In conclusion, the CLIP score, compared with the Okuda staging system, gives more accurate prognostic information, is statistically more efficient, and has a greater survival predictive power. It could be useful in treatment planning by improving baseline prognostic evaluation of patients with RCC, and could be used in prospective therapeutic trials as a stratification variable, reducing the variability of results owing to patient selection

Gaia Data Release 1: Testing parallaxes with local Cepheids and RR Lyrae stars

Context. Parallaxes for 331 classical Cepheids, 31 Type II Cepheids, and 364 RR Lyrae stars in common between Gaia and the Hipparcos and Tycho-2 catalogues are published in Gaia Data Release 1 (DR1) as part of the Tycho-Gaia Astrometric Solution (TGAS). Aims. In order to test these first parallax measurements of the primary standard candles of the cosmological distance ladder, which involve astrometry collected by Gaia during the initial 14 months of science operation, we compared them with literature estimates and derived new period-luminosity (PL), period-Wesenheit (PW) relations for classical and Type II Cepheids and infrared PL, PL-metallicity (PLZ), and optical luminosity-metallicity (M V -[Fe/H]) relations for the RR Lyrae stars, with zero points based on TGAS. Methods. Classical Cepheids were carefully selected in order to discard known or suspected binary systems. The final sample comprises 102 fundamental mode pulsators with periods ranging from 1.68 to 51.66 days (of which 33 with σ Ω /Ω < 0.5). The Type II Cepheids include a total of 26 W Virginis and BL Herculis stars spanning the period range from 1.16 to 30.00 days (of which only 7 with σ Ω /Ω < 0.5). The RR Lyrae stars include 200 sources with pulsation period ranging from 0.27 to 0.80 days (of which 112 with σ Ω /Ω < 0.5). The new relations were computed using multi-band (V,I,J,K s ) photometry and spectroscopic metal abundances available in the literature, and by applying three alternative approaches: (i) linear least-squares fitting of the absolute magnitudes inferred from direct transformation of the TGAS parallaxes; (ii) adopting astrometry-based luminosities; and (iii) using a Bayesian fitting approach. The last two methods work in parallax space where parallaxes are used directly, thus maintaining symmetrical errors and allowing negative parallaxes to be used. The TGAS-based PL,PW,PLZ, and M V - [Fe/H] relations are discussed by comparing the distance to the Large Magellanic Cloud provided by different types of pulsating stars and alternative fitting methods. Results. Good agreement is found from direct comparison of the parallaxes of RR Lyrae stars for which both TGAS and HST measurements are available. Similarly, very good agreement is found between the TGAS values and the parallaxes inferred from the absolute magnitudes of Cepheids and RR Lyrae stars analysed with the Baade-Wesselink method. TGAS values also compare favourably with the parallaxes inferred by theoretical model fitting of the multi-band light curves for two of the three classical Cepheids and one RR Lyrae star, which were analysed with this technique in our samples. The K-band PL relations show the significant improvement of the TGAS parallaxes for Cepheids and RR Lyrae stars with respect to the Hipparcos measurements. This is particularly true for the RR Lyrae stars for which improvement in quality and statistics is impressive. Conclusions. TGAS parallaxes bring a significant added value to the previous Hipparcos estimates. The relations presented in this paper represent the first Gaia-calibrated relations and form a work-in-progress milestone report in the wait for Gaia-only parallaxes of which a first solution will become available with Gaia Data Release 2 (DR2) in 2018. © ESO, 2017

Gaia Data Release 1: Open cluster astrometry: performance, limitations, and future prospects

Context. The first Gaia Data Release contains the Tycho-Gaia Astrometric Solution (TGAS). This is a subset of about 2 million stars for which, besides the position and photometry, the proper motion and parallax are calculated using Hipparcos and Tycho-2 positions in 1991.25 as prior information.Aims. We investigate the scientific potential and limitations of the TGAS component by means of the astrometric data for open clusters.Methods. Mean cluster parallax and proper motion values are derived taking into account the error correlations within the astrometric solutions for individual stars, an estimate of the internal velocity dispersion in the cluster, and, where relevant, the effects of the depth of the cluster along the line of sight. Internal consistency of the TGAS data is assessed.Results. Values given for standard uncertainties are still inaccurate and may lead to unrealistic unit-weight standard deviations of least squares solutions for cluster parameters. Reconstructed mean cluster parallax and proper motion values are generally in very good agreement with earlier HIPPARCOS-based determination, although the Gaia mean parallax for the Pleiades is a significant exception. We have no current explanation for that discrepancy. Most clusters are observed to extend to nearly 15 pc from the cluster centre, and it will be up to future Gaia releases to establish whether those potential cluster-member stars are still dynamically bound to the clusters.Conclusions. The Gaia DR1 provides the means to examine open clusters far beyond their more easily visible cores, and can provide membership assessments based on proper motions and parallaxes. A combined HR diagram shows the same features as observed before using the HIPPARCOS data, with clearly increased luminosities for older A and F dwarfs