Constraining the origin of UHECRs and astrophysical neutrinos

We explore the possibility of a common origin of ultrahigh energy cosmic rays (UHECRs) and astrophysical neutrinos and further constrain sources which are consistent with this possibility. We show that the common origin hypothesis can be satisfied for the Sibyll2.3c hadronic interaction model but is difficult to accommodate for EPOS-LHC, showing that multimessenger analyses have the power to also constrain hadronic physics beyond LHC energies. We constrain properties of UHECR source environments (and potentially astrophysical neutrino sources), including their photon temperature, gas density, size, magnetic field strength and coherence length, using UHECR and neutrino spectra and composition. Our analysis represents a new type of information on UHECR sources, independent of the mechanism responsible for the UHECR acceleration

Infodemiological patterns in searching medication errors: Relationship with risk management and shift work

INTRODUCTION: Western world health care systems have been trying to improve their efficiency and effectiveness in order to respond properly to population aging and non-communicable diseases epidemic. Treatment of the elderly population is becoming complex due to the high number of prescribed drugs because of multimorbidity. Errors in drugs administration in different health care related settings are an actual important issue due to different causes. Aim of this observational study is to measure the online interest in seeking medication errors information related to risk management and shift work. MATERIALS AND METHODS: We investigated Google Trends® for popular search relating to medication errors, risk management and shift work. Relative search volumes (RSVs) were evaluated from 2008 to 2018. A comparison between RSV curves related to medication errors, risk management and shift work was carried out. Then, we compared the world to Italian search. RESULTS: RSVs were persistently higher for risk management than for medication errors (mean RSVs 069 vs. 48%) and RSVs were stably higher for medication errors than shift work (mean RSVs 48 vs. 22%). In Italy, RSVs were much lower compared to the rest of the world, and RSVs for medication errors during the study period were negligible. Mean RSVs for risk management and shift work were 3 and 25%, respectively. RSVs related to medication errors and clinical risk management were correlated (r=0.520, p<0.0001). CONCLUSIONS: Google Trends® search query volumes related to medication errors, risk management and shift work are different. RSVs for risk management are higher, and they are correlated with medication errors. Also, shift work search appears to be lower. These results should be interpreted in order to correctly evaluate how to decrease the number of medication errors in different health care related setting

Measuring knowledge, attitudes and behavior of nurses in medication management. Cross-cultural comparisons in Italy and Malta

Medication errors are one of the most common causes of negative events affecting patient safety all over the world.  Scientific literature divides the factors that contribute to the occurrence of harmful events into factors related to the characteristics of the healthcare workers and factors related to the organization of the drug management process. The aim of the study was to examine the knowledge, attitudes and behaviours related to medication errors among Italian and Maltese nurses

A rapid review of time management strategies among nurse managers

Background: Time management practice is the act of influencing one's behavioural dimensions to complete as many tasks as possible within a specified amount of time. These behavioural dimensions include work organization and the continued application of time management techniques. Good time management, such as setting goals and priorities, as well as planning and delegating tasks, can facilitate productivity and success, contributing to work effectiveness, maintaining balance and job satisfaction. Conversely, poor time management has been associated with poor quality of work, low productivity, negative influence on the career path, and high levels of stress. Aim: The study aims to identify the strategies used by middle nurse managers in time management. Methods: A rapid review of biomedical databases was undertaken during the month of June 2021. The included studies were published in English and in Italian. Results: Findings reveal that the most used and effective time management strategies for nurse managers are setting goals, and priorities and delegating tasks. Other useful strategies also found to be fundamental are discussed in detail. Conclusion: A manager should prioritize the concept of planning, which can be counted as an efficient time management technique and educate himself on delegating. Time management has an impact not only on productivity and organizational success, but also on the balance between private and working life of managers

Peripheral giant cell granuloma: immunohistochemical analysis of different markers. Study of three cases

El granuloma periférico de células gigantes (GPCG) es una lesión de tejido blando no neoplásica ocasionada por una reacción hiperplásica a consecuencia de un traumatismo o inflamación. Es una lesión reactiva del tejido blando que se desarrolla exclusivamente en la cavidad oral y con una ligera predilección en el sexo femenino. La localización habitual de GPCG es en la región de los premolares y la mucosa de la cresta alveolar edéntula. Se presentan tres casos con GPCG (dos hombres y una mujer) con una edad comprendida entre los 25 y 35 años. Todos los pacientes se trataron con resección quirúrgica y ninguno sufrió recidivas. Con el propósito de determinar el posible origen de las células estromales mononucleares y de las células gigantes multinucleares, las muestras de cada caso se estudiaron mediante inmunohistoquímica (marcadores CD-68, CD-34 y α-1 antitripsina) con el fin de evaluar la expresión del linaje endotelial y del linaje monocito/macrófago. Los resultados inmunohistoquímicos mostraron una marcada positividad difusa de CD-68 en las células estromales mononucleares y en las células gigantes multinucleadas. Estas últimas resultaron ser inmunonegativas para CD-34 y sólo puntualmente positivas para α-1 antitripsina. Estos resultados sugieren que las cιlulas gigantes multinucleares poseen un fenotipo osteoclαstico, proviniendo del linaje monocito/macrσfago, y que no derivan del linaje de las células endoteliales de los capilares. Se establece la importancia de un exhaustivo diagnóstico y de una exéresis quirúrgica completa de la lesión (curetaje óseo) con el propósito de evitar la reabsorción del diente y hueso adyacente

Fibrolipoma gigante de la mejilla: a propósito de un caso

El fibrolipoma es una neoplasia de origen mesenquimal, rara en la cavidad oral, representando el 1% de todos los tumores benignos orales. Es una variante histológica del lipoma simple, que normalmente se manifiesta a nivel de la mucosa oral, suelo de la boca, lengua y labios. La etiología suele ser traumática cuando afecta localizaciones extraorales, mientras se considera idiopática al manifestarse a nivel bucal. En este artículo se presenta un raro caso de fibrolipoma de mejilla, y se discuten los aspectos diagnósticos, histo-patológicos y de tratamiento de acuerdo a la literatura. Lipomas are common soft tissue mesenchymal neoplasms, rare in the oral cavity, representing 1% of all benign oral tumors. Fibrolipoma is a histological variant of the classic lipoma which normally affects buccal mucosa, floor of the mouth, tongue and lips. In this article is presented a rare case of fibrolipoma of the cheek and are discussed all the aspects of diagnosis, histology and surgical treatment, according to literature data

Oral dysplastic complications after HSCT: Single case series of multidisciplinary evaluation of 80 patients

Oral squamous cell carcinoma (OSCC) is the most common secondary solid malignancy after hematopoietic stem‐cell transplantation (HSCT). OSCC following HSCT is frequently preceded by chronic graft‐versus‐host disease (cGVHD). The aim of this study was to describe a cohort of post‐HSCT patients and to evaluate the onset of oral epithelial dysplasia and/or OSCC over time. In this retrospective cohort study, we present a cohort of hematological patients that underwent HSCT. Demographic variables, clinical hematological data, data regarding acute graft‐versus‐host disease (aGVHD) and cGVHD, and oral clinical features were analyzed. We focused on clinicopathological features of a subgroup of 22 patients with oral cGVHD and OSCC after HSCT. Among 80 included patients, 46 patients (57,5%) developed aGVHD and 39 patients (48,7%) developed cGVHD. Oral mucosa was involved in 17 patients with aGVHD (36,9%) and in 22 patients (56,4%) with cGVHD. Out of a total of 22 oral biopsies, roughly 40% revealed mild to moderate dysplasia, and 32 % were OSCC. In the absence of international agreement on the best timing of oral follow‐up after HSCT, it is mandatory to establish a close multidisciplinary evaluation in order to prevent the onset of HSCT-related OSCC and to reduce post‐transplant mortality due to secondary tumors

Electrical structure of the lithosphere from Rio de la Plata craton to Paraná basin: amalgamation of cratonic and refertilized lithospheres in SW Gondwanaland

We conducted a magnetotelluric (MT) study from Paleoproterozoic Rio de la Plata Craton, in Uruguay, toward Paleozoic-Mesozoic Paraná Basin, in Brazil. The 850-km-long MT transect comprises 35 evenly spaced broadband electromagnetic soundings sites. In the Paraná Basin, 11 additional long-period measurements were acquired to extend the maximum depth of investigation. All data were inverted using two- and three-dimensional approaches obtaining the electrical resistivity structure from the surface down to 200 km. The Rio de la Plata Craton is>200-km thick and resistive (~2,000Ωm). Its northern limit is electrically defined by a lithosphere scale lateral transition and lower crust conductive anomalies (1–10Ωm) interpreted as a Paleoproterozoic suture at the southern edge of Rivera-Taquarembó Block. The latter is characterized by an approximately 100-km thick and moderate resistive (>500Ωm) upper mantle. The Ibaré shear zone is another suture where an ocean-ocean subduction generated the 120-km thick and resistive (>1,000Ωm) São Gabriel juvenile arc. Proceeding northward, a 70- to 80-km thick, 150-km wide, and inclined resistive zone is imaged. This zone could be remnant of an oceanic lithosphere or island arcs accreted at the southern border of Paraná Basin. The MT transect terminates within the southern Paraná Basin where a 150- to 200-km-thick less resistive lithosphere (<1,000Ωm) may indicate refertilization processes during plate subduction and ocean closure in Neoproterozoic-Cambrian time. Our MT data support a tectonic model of NNE– SSW convergence for this segment of SW Gondwanaland

A Troubling Diagnosis of Verrucous Squamous Cell Carcinoma (“the Bad Kind” of Keratosis) and the Need of Clinical and Pathological Correlations: A Review of the Literature with a Case Report

Verrucous carcinoma (also known as Ackerman tumor) is an uncommon exophytic low-grade well-differentiated variant of squamous cell carcinoma. This neoplasm typically involves the oral cavity, larynx, genitalia, skin, and esophagus. It is well known for its locally aggressiveness and for its clinically slow-growing behaviour with minimal metastatic potential. Verrucous carcinoma of oral cavity is so closely aligned with the use of snuff and chewing tobacco that it has been called the “snuff dipper's cancer”. Recent studies have proved the role of HPV. The typical clinical presentation of oral verrucous carcinoma has long been known, as its remarkably innocuous appearance and biological behaviour. In this work, we report a review of the scientific literature and describe a troublesome case of oral verrucous cancer