Progettazione in movimento: strumenti, tecniche, linguaggi per potenziare il pensiero progettuale

Il tema del design di immagini animate nell’attuale scenario della comunicazione e la ricerca di nuove aree applicative di questo linguaggio sono stati in questi anni al centro di una serie di iniziative del laboratorio AnimazioneDesign della Facoltà di Architettura di Alghero. La problematica è di attualità crescente: grazie alla rivoluzione digitale l’animazione ha visto crescere in pochi anni il suo spazio di riferimento, uscendo dai suoi più tradizionali territori – l’intrattenimento, la sperimentazione artistica – per abbracciare un nuovo universo di applicazioni: la comunicazione di progetto, il web, l’e-learning, la manualistica, la simulazione e la divulgazione scientifica. Il confronto con questa tematica, del tutto nuova nello scenario della didattica universitaria italiana, e – nelle esperienze portate avanti nel nostro laboratorio in questi anni – la sua sistematica applicazione in settori a spiccata componente progettuale come il design e l’architettura, hanno fatto emergere alcuni interessanti spunti. L’animazione si è infatti rivelata da un lato uno straordinario fluidificatore dei flussi di comunicazione e dall’altro uno strumento di riflessione concettuale e un punto di osservazione privilegiato per la rilettura e la reinterpretazione dell’attività progettuale. Obiettivo di questo volume è raccogliere alcune recenti esperienze e i risultati della ricerca Progettazione in movimento. Strumenti, tecniche, linguaggi per potenziare il pensiero progettuale, resa possibile da un contributo della Regione Autonoma della Sardegna (L.R. 20 15 del 2006) per “progetti di ricerca e sperimentazione sui nuovi linguaggi e sulle tecnologie audiovisive”

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

H3K27me3 Immunohistochemical Loss Predicts Lower Response to Neo-Adjuvant Chemo-Radiotherapy in Rectal Carcinoma

A watch-and-wait approach was suggested to avoid the possible complications related to surgery in patients with rectal carcinoma showing clinical complete response after neoadjuvant chemo-radiotherapy (CRT). Since clinical response may not correlate with pathological response, markers with higher accuracy are needed to identify patients who are likely responders and could be spared surgery. This study aims to assess whether H3K27me3 immunohistochemical expression in pre-treatment rectal carcinoma predicts response to neoadjuvant CRT or shows prognostic relevance. We assessed H3K27me3 immunostaining in 46 endoscopic biopsies of rectal carcinomas treated with neoadjuvant CRT and surgery. H3K27me3 immunostaining was lost in 20, retained in 19, and inconclusive (absent in neoplastic and non-neoplastic cells) in 7 cases. Retained H3K27me3 immuno-expression was significantly associated with ypTNM stage 0 (p = 0.0111) and high tumor regression, measured using either five-tiered (p = 0.0042) or two-tiered Dworak tumor regression grade (p = 0.0009). Poor differentiation, determined counting the number of poorly differentiated clusters (PDC grade) or tumor budding (TB) foci (TB grade), in the pre-treatment biopsy, was significantly associated with a shorter time to progression after surgery (p = 0.008; p = 0.0093). However, only PDC grade (p = 0.0023), together with radial margin involvement (p = 0.0001), retained prognostic significance in the multivariate analysis. The assessment of H3K27me3 immunostaining in pre-treatment endoscopic biopsy of rectal carcinoma could be useful to predict response to neo-adjuvant CRT and to identify patients who could safely undergo watch-and-wait approach. PDC and TB grade in the pre-treatment biopsy could provide additional prognostic information in patients with rectal carcinoma treated with neoadjuvant CRT and surgery

Fully Biobased Polyesters Based on an Isosorbide Monomer for Coil Coating Applications

In this work, novel fully biobased polyester resins are presented for use as binders in the field of coil coating technology. These new materials are based on the copolymerization of isosorbide (ISo) with different industrially available aliphatic biobased building blocks. In order to assess the effect of chemical composition on the chemical-physical properties of such biobased polyester resins, the amount of ISo was systematically varied (18-36 wt %), and the molecular weight and thermal response of the resulting materials were evaluated by means of gel permeation chromatography, differential scanning calorimetry, and thermogravimetric analysis. It was found that by tuning the ISo content in the resins, their glass transition temperature (T g ) could be controlled (-22 to 28 °C) without considerably affecting their molecular weight (in the range of 4000-5000 g/mol). The resulting cross-linked coatings (both clear and pigmented) were found to exhibit excellent mechanical properties as well as chemical and photochemical durability, as evidenced by comparative microindentation, hydrolysis, and accelerated weathering tests conducted on the new biobased systems and on commercial oil-based benchmarks. The results of this study demonstrate a versatile approach to tune the chemical-physical response of fully biobased polyester coatings and provide evidence of the potential of ISo-based polyester binders as sustainable high-performance materials for coil coating applications

Strategies for acrylamide mitigation in biscuits

Food safety deals with handling, preparation (processing), and storage of food to prevent food-borne illness. During all these phases, food might be subject to microbial, physical, and chemical contamination. Acrylamide is a process contaminant that is formed during heat treatment of food rich in proteins and sugars, while it is absent in raw foodstuffs. Most acrylamide is formed primarily through the Maillard reaction, which specifically involves the amino group of asparagine, the carbonyl group of reducing sugars, and intermediate molecules of the Maillard reaction. Acrylamide in biscuits represents a major concern. To date, there are no technological strategies to completely prevent acrylamide formation, although there are some ways to mitigate its concentration in food. This research work was aimed at modifying the current formulation of biscuits to reduce the acrylamide content while maintaining the chemical, physical, and sensory characteristics of the original product. A strategy based on the FoodDrinkEurope Acrylamide Toolbox was adopted. The content of the leavening agent ammonium bicarbonate, the baking temperature program, and the time duration of steam released during the baking process were the three factors evaluated through a factorial design of experiment. The partial replacement of ammonium bicarbonate (from 9.0 g to 1.5 g per 500 g of flour) with sodium bicarbonate (from 4.5 g to 12.48 g), lowering of the temperature in the central phase of the baking process (from 170 °C to 150 °C), and the release of steam for 3 min resulted in an 87.2% reduction in acrylamide concentration compared with control biscuits. Different analyses were performed on the sample set, CIELab color indices and aw were the parameters that showed the most significant correlation with acrylamide concentration in biscuits and could, therefore, become markers to predict the acrylamide content along production lines for an instant evaluation

From the Core of the Empire. New Archaeological Discoveries of the University of Udine in Ancient Assyria / Dall'centro dell'Impero. Nuove scoperte Archeologiche dell’Universita di Udine nell’Antica Assiria

Il volume, pubblicato in occasione dei trent’anni di attività dell’Università di Udine nel Vicino Oriente, ripercorre attraverso i vari saggi di cui è composto, sia le tappe della scoperta dell’Assiria dalle prime esplorazioni dell’Ottocento alle scoperte più recenti, che la storia della costruzione dell’impero Assiro e delle sue capitali da parte dei grandi re, Sagon e Assurbanipal in particolare

Hepatic and Extrahepatic Colorectal Metastases Have Discordant Responses to Systemic Therapy. Pathology Data from Patients Undergoing Simultaneous Resection of Multiple Tumor Sites

Background: Systemic therapy is the standard treatment for patients with hepatic and extrahepatic colorectal metastases. It is assumed to have the same effectiveness on all disease foci, independent of the involved organ. The present study aims to compare the response rates of hepatic and extrahepatic metastases to systemic therapy. Methods: All consecutive patients undergoing simultaneous resection of hepatic and extrahepatic metastases from colorectal cancer after oxaliplatin- and/or irinotecan-based preoperative chemotherapy were analyzed. All specimens were reviewed. Pathological response to chemotherapy was classified according to tumor regression grade (TRG). Results: We analyzed 45 patients undergoing resection of 134 hepatic and 72 extrahepatic metastases. Lung and lymph node metastases had lower response rates to chemotherapy than liver metastases (TRG 4–5 95% and 100% vs. 67%, p = 0.008, and p = 0.006). Peritoneal metastases had a higher pathological response rate than liver metastases (TRG 1–3 66% vs. 33%, p < 0.001) and non-hepatic non-peritoneal metastases (3%, p < 0.001). Metastases site was an independent predictor of pathological response to systemic therapy. Conclusions: Response to chemotherapy of distant metastases from colorectal cancer varies in different organs. Systemic treatment is highly effective for peritoneal metastases, more so than liver metastases, while it has a very poor impact on lung and lymph node metastases

The COVID - AGICT study: COVID-19 and advanced gastro-intestinal cancer surgical treatment. A multicentric Italian study on the SARS-CoV-2 pandemic impact on gastro-intestinal cancers surgical treatment during the 2020. Analysis of perioperative and short-term oncological outcomes

Background: This Italian multicentric retrospective study aimed to investigate the possible changes in outcomes of patients undergoing surgery for gastrointestinal cancers during the COVID-19 pandemic. Method: Our primary endpoint was to determine whether the pandemic scenario increased the rate of patients with colorectal, gastroesophageal, and pancreatic cancers resected at an advanced stage in 2020 compared to 2019. Considering different cancer staging systems, we divided tumors into early stages and advanced stages, using pathological outcomes. Furthermore, to assess the impact of the COVID-19 pandemic on surgical outcomes, perioperative data of both 2020 and 2019 were also examined. Results: Overall, a total of 8250 patients, 4370 (53%) and 3880 (47%) were surgically treated during 2019 and 2020 respectively, in 62 Italian surgical Units. In 2020, the rate of patients treated with an advanced pathological stage was not different compared to 2019 (P = 0.25). Nevertheless, the analysis of quarters revealed that in the second half of 2020 the rate of advanced cancer resected, tented to be higher compared with the same months of 2019 (P = 0.05). During the pandemic year 'Charlson Comorbidity Index score of cancer patients (5.38 +/- 2.08 vs 5.28 +/- 2.22, P = 0.036), neoadjuvant treatments (23.9% vs. 19.5%, P < 0.001), rate of urgent diagnosis (24.2% vs 20.3%, P < 0.001), colorectal cancer urgent resection (9.4% vs. 7.37, P < 0.001), and the rate of positive nodes on the total nodes resected per surgery increased significantly (7 vs 9% -2.02 +/- 4.21 vs 2.39 +/- 5.23, P < 0.001). Conclusions: Although the SARS-CoV-2 pandemic did not influence the pathological stage of colorectal, gastro-esophageal, and pancreatic cancers at the time of surgery, our study revealed that the pandemic scenario negatively impacted on several perioperative and post-operative outcomes

The COVID - AGICT study: COVID–19 and advanced gastro-intestinal cancer surgical treatment. A multicentric Italian study on the SARS-CoV-2 pandemic impact on gastro-intestinal cancers surgical treatment during the 2020. Analysis of perioperative and short-term oncological outcomes

Background This Italian multicentric retrospective study aimed to investigate the possible changes in outcomes of patients undergoing surgery for gastrointestinal cancers during the COVID-19 pandemic. Method Our primary endpoint was to determine whether the pandemic scenario increased the rate of patients with colorectal, gastroesophageal, and pancreatic cancers resected at an advanced stage in 2020 compared to 2019. Considering different cancer staging systems, we divided tumors into early stages and advanced stages, using pathological outcomes. Furthermore, to assess the impact of the COVID-19 pandemic on surgical outcomes, perioperative data of both 2020 and 2019 were also examined. Results Overall, a total of 8250 patients, 4370 (53%) and 3880 (47%) were surgically treated during 2019 and 2020 respectively, in 62 Italian surgical Units. In 2020, the rate of patients treated with an advanced pathological stage was not different compared to 2019 (P = 0.25). Nevertheless, the analysis of quarters revealed that in the second half of 2020 the rate of advanced cancer resected, tented to be higher compared with the same months of 2019 (P = 0.05). During the pandemic year ‘Charlson Comorbidity Index score of cancer patients (5.38 ± 2.08 vs 5.28 ± 2.22, P = 0.036), neoadjuvant treatments (23.9% vs. 19.5%, P < 0.001), rate of urgent diagnosis (24.2% vs 20.3%, P < 0.001), colorectal cancer urgent resection (9.4% vs. 7.37, P < 0.001), and the rate of positive nodes on the total nodes resected per surgery increased significantly (7 vs 9% - 2.02 ± 4.21 vs 2.39 ± 5.23, P < 0.001). Conclusions Although the SARS-CoV-2 pandemic did not influence the pathological stage of colorectal, gastroesophageal, and pancreatic cancers at the time of surgery, our study revealed that the pandemic scenario negatively impacted on several perioperative and post-operative outcomes

Clinical nutrition in surgical oncology: Young AIOM-AIRO-SICO multidisciplinary national survey on behalf of NutriOnc research group

Malnutrition is a common condition in cancer patients which is usually associated with functional limitations, as well as increased morbidity and mortality. Based on the support of the young sections of Italian Association of Medical Oncology (AIOM), Italian Association of Radiotherapy and Clinical Oncology (AIRO) and Italian Society of Surgical Oncology (SICO) merged into the NutriOnc Research Group, we performed a multidisciplinary national survey with the aim to define the awareness of nutritional issues among healthcare professionals delivering anticancer care. The questionnaire was organized in four sections, as follows: Knowledge and practices regarding Nutritional Management of cancer patients; Timing of screening and assessment of Nutritional Status; Nutritional Treatment and prescription criteria; Immunonutrition and educational topics. The modules focused on esophagogastric, hepato-bilio-pancreatic and colorectal malignancies. Overall, 215 physicians completed the survey. As regards the management of Nutritional Status of cancer patients, many responders adopted the ERAS program (49.3%), while a consistent number of professionals did not follow a specific validated nutritional care protocol (41.8%), mainly due to lack of educational courses (14.5%) and financial support (15.3%). Nearly all the included institutions had a multidisciplinary team (92%) to finalize the treatment decision-making. Cancer patients routinely underwent nutritional screening according to 57.2% of interviewed physicians. The timing of nutritional assessment was at diagnosis (37.8%), before surgery (25.9%), after surgery (16.7%), before radiochemotherapy (13.5%) and after radiochemotherapy (7%). Most of the responders reported that nutritional status was assessed throughout the duration of cancer treatments (55.6%). An important gap between current delivery and need of nutritional assessment persists. The development of specific and defined care protocols and the adherence to these tools may be the key to improving nutritional support management in clinical practice