Chapter New coastal protection and sea energy production

The innovative proposal is to substitute traditional nourishment and rockfill breakwaters with total submersion energized reef turbines, so as to favor: cost of the maintenance, re-growth of the marine grasslands, sea depollution and landscape retraining. The rise in the beach level and limitation of coastal erosion, consequent deposition of suspended sand for natural nourishment, represents the principal economic benefit. Soft defense of the coasts, in calm inshore belt, mimics coral reefs and floating spinning helix, in an indifferent equilibrium in the water, turns by minimum currents

NUOVA DIFESA DEL RIPASCIMENTO NATURALE E DELLE PRATERIE MARINE

New defense location is in the seabed transition zone between enormous offshore pulsing vertical waves energy and conversion into inshore horizontal currents energy. Artificial reef, articulated in staggered barriers of the turbines, compose a soft defense of the coasts that mimics the coral reef, especially for its location far from the storms. The barriers reduce the sea currents speed below the sea level with the consequent deposition of the suspended sand for natural nourishment. The patented vertical turbines are made up of helix fixed to a floating spinning top so as to be in indifferent equilibrium in water, for which they turn by the minimum currents. The electric energy is produced even at low number of laps, but long lasting and therefore with hours of production higher than the eolic and photovoltaic. The costs of these barriers are very advantageous compared to the actual coastal defenses, based on the nourishment and on the cliffs, because the direct electrical dispatching covers the cost of amortization, and specially the cost of the maintenance. The new defense, in order to prevent sea level rise due to climate change, also embank the coast flooding through the natural nourishment and re-growth of the marine grasslands, so as recovering hectares of the beaches, with great economic benefits. The reconversion of the usual nourishment and the cliffs by proposed energized reef recoveries the marine ecosystem, the landscape and promotes the sea depollutio

Chapter New coastal protection and sea energy production

The innovative proposal is to substitute traditional nourishment and rockfill breakwaters with total submersion energized reef turbines, so as to favor: cost of the maintenance, re-growth of the marine grasslands, sea depollution and landscape retraining. The rise in the beach level and limitation of coastal erosion, consequent deposition of suspended sand for natural nourishment, represents the principal economic benefit. Soft defense of the coasts, in calm inshore belt, mimics coral reefs and floating spinning helix, in an indifferent equilibrium in the water, turns by minimum currents

Precision Oncology in Gastro-Esophageal Adenocarcinoma

Gastro-esophageal adenocarcinomas (GEA) are a leading cause of cancer mortality, with limited therapeutic strategies available. With the advent of next-generation sequencing (NGS) and novel technologies, our understanding of its pathogenesis and molecular characterization continues to be improved, and new biomarkers have been identified. The onset and progression of gastric cancer has been attributed to multiple factors, including genetic alterations, epigenetic modifications, Helicobacter pylori, and Epstein-Barr Virus (EBV) infection, and dietary habits. These advances permit to integrate clinical, genetic, and epigenetic changes, and apply them to individual GEA patients in the era of precision medicine. Some biomarker-driven strategies are already part of consolidated clinical practice, proving the feasibility of this approach in principle, as is the case with the use of trastuzumab in human epidermal growth factor receptor 2 (HER2)-expressing GEA. Others, namely in the setting of immunotherapy and targeted therapy, are still investigational and require further study. The treatment of GEA is no longer defined by a “one size fits all” approach, and the definition of molecular subgroups amenable to individualized treatment strategies is likely the way forward. However, the lack of standardization and the multiplication of proposed classifications and biomarkers represents a significant obstacle to establishing a new paradigm. While small-scale experiences are undoubtedly of value and essential for hypothesis generation, appropriately powered prospective clinical trials are now urgently needed to translate these hypotheses in evidence-based practice. In this review, we will discuss the current and future potential biomarkers, drugs, and therapeutic approaches available for the management of GEA patients

The Evolving Systemic Treatment for Advanced Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is one of the common and fatal malignancies, which remains a global health challenge, with an estimated incidence of more than 1 million cases by 2025. The current major progress has improved the management of patients with advanced disease. Systemic treatments with multitarget agents, antiangiogenics alone or in combination with an immune checkpoint inhibitor (ICI), have been approved following positive results from phase III clinical studies. Several ongoing trials are currently exploring novel combinations and are expected to further change the HCC treatment landscape. In this review, we present all approved targeted agents for advanced HCC with an emphasis on their clinical efficacy and discuss the exciting results of the combination of targeted therapy and ICI. Finally, we also summarize the advances in clinical research for HCC

Multidisciplinary Approach to a Patient with Acinar Cell Carcinoma, a Rare Pancreatic Malignancy

Acinar cell carcinoma (ACC) of the pancreas is a relatively rare malignant neoplasm that constitutes about 1% of all pancreatic exocrine tumors. The disease is generally managed similarly as pancreatic ductal adenocarcinoma (PDAC), with surgical resection for localized disease and systemic chemotherapy in the metastatic setting. Here, we present a case of a 69-year-old patient with ACC of the pancreatic head treated with a multidisciplinary approach

Research progress on KRAS mutations in colorectal cancer

The RAS gene family, responsible for signal transduction within the mitogen activated protein kinase (MAPK) and phosphatidylinositol 3 kinase (PI3K) pathways, is frequently involved in carcinogenesis, and alterations in its member genes can be detected, with variable frequency, in a wide variety of solid and hematological cancers. These alterations may behave as prognostic-predictive biomarkers and driver mutations, making them an interesting therapeutic target. Since their discovery, many strategies have been pursued to act on their signaling pathways. Indeed, in clinical practice, KRAS, the most prominent member of the RAS gene family, represents an especially elusive target in most malignancies; pathway inhibition is carried out upstream, on the EGFR receptor, or downstream, most frequently on the BRAF/MEK/ERK cascade. Recently, clinically relevant direct RAS inhibition has been successfully achieved with the development of potent and selective covalent inhibitors of KRAS c.34G>T (p.G12C). These latest-generation drugs represent both a new and interesting tool in the therapeutic armamentarium and a symbolic end to the myth of KRAS undruggability. However, their clinical relevance and appropriate place in treatment strategies remain to be determined