Progetto di strutturazione di una procedura aziendale sul processo assistenziale nei pazienti affetti da tumore esofageo

La chirurgia, a tutt’oggi, rimane un punto fermo nel trattamento del cancro dell’esofago e nei pazienti con neoplasia esofagea in stadio precoce, cioè in assenza di secondarismi linfonodali e/o a distanza, la chirurgia resettiva è l’unico trattamento che può offrire reali prospettive di cura e/o di guarigione, purché la resezione chirurgica sia completa. Al contrario, nei pazienti con una neoplasia localmente avanzata, storicamente, la sola chirurgia otteneva una sopravvivenza a cinque anni del 10-20%. Prospettive incoraggianti sembrano aprirsi grazie ad un approccio multimodale alle neoplasie in fase avanzata.La costituzione quindi di un gruppo multidisciplinare appare fondamentale per la corretta pianificazione dei differenti trattamenti disponibili nel singolo paziente. La decisione terapeutica è frutto di una stretta collaborazione con oncologi e radioterapisti nell'ambito del Gruppo Oncologico Multidisciplinare (GOM).E’ inoltre necessario, per prevenire il rischio di errori, utilizzare un modello comune per la redazione delle procedure, in modo tale che qualunque operatore possa immediatamente comprenderne il senso e le modalità di attuazione, anche se di UO o di struttura diversa da quella che ha curato la redazione

Variations in epilithic microbial biofilm composition and recruitment of a canopy-forming alga between pristine and urban rocky shores

Brown algae of the genus Ericaria are habitat formers on Mediterranean rocky shores supporting marine biodiversity and ecosystem functioning. Their population decline has prompted attempts for restoration of threatened populations. Although epilithic microbial biofilms (EMBs) are determinant for macroalgal settlement, their role in regulating the recovery of populations through the recruitment of new thalli is yet to be explored. In this study, we assessed variations in microbial biofilms composition on the settlement of Ericaria amentacea at sites exposed to different human pressures. Artificial fouling surfaces were deployed in two areas at each of three study sites in the Ligurian Sea (Capraia Island, Secche della Meloria and the mainland coast of Livorno), to allow bacterial biofilm colonization. In the laboratory, zygotes of E. amentacea were released on these surfaces to evaluate the survival of germlings. The EMB’s composition was assessed through DNA metabarcoding analysis, which revealed a difference between the EMB of Capraia Island and that of Livorno. Fouling surfaces from Capraia Island had higher rates of zygote settlement than the other two sites. This suggests that different environmental conditions can influence the EMB composition on substrata, possibly influencing algal settlement rate. Assessing the suitability of rocky substrata for E. amentacea settlement is crucial for successful restoration

Gait Alterations in Adults after Ankle Fracture: A Systematic Review

none6(1) Background: Ankle fracture results in pain, swelling, stiffness and strength reduction, leading to an altered biomechanical behavior of the joint during the gait cycle. Nevertheless, a common pattern of kinematic alterations has still not been defined. To this end, we analyzed the literature on instrumental gait assessment after ankle fracture, and its correlation with evaluator based and patient-reported outcome measures. (2) Methods: We conducted a systematic search, according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, of articles published from January 2000 to June 2021 in PubMed, Embase and PEDro on instrumental gait assessment after ankle fracture. (3) Results: Several changes in gait occur after ankle fracture, including a reduction in step length, swing time, single support time, stride length, cadence, speed and an earlier foot-off time in the affected side. Additionally, trunk movement symmetry (especially vertical) is significantly reduced after ankle fracture. The instrumental assessments correlate with different clinical outcome measures. (4) Conclusions: Instrumental gait assessment can provide an objective characterization of the gait alterations after ankle fracture. Such assessment is important not only in clinical practice to assess patients’ performance but also in clinical research as a reference point to evaluate existing or new rehabilitative interventions.noneMarta Mirando, Corrado Conti, Federica Zeni, Fabio Pedicini, Antonio Nardone, Chiara PaveseMirando, Marta; Conti, Corrado; Zeni, Federica; Pedicini, Fabio; Nardone, Antonio; Pavese, Chiar

Effects of the Chemical Treatment on the Physical-Chemical and Electrochemical Properties of the Commercial Nafion™ NR212 Membrane

Polymer Electrolyte Fuel Cells (PEFCs) are one of the most promising power generation systems. The main component of a PEFC is the proton exchange membrane (PEM), object of intense research to improve the efficiency of the cell. The most commonly and commercially successful used PEMs are Nafion™ perfluorosulfonic acid (PFSA) membranes, taken as a reference for the development of innovative and alternative membranes. Usually, these membranes undergo different pre-treatments to enhance their characteristics. With the aim of understanding the utility and the effects of such pre-treatments, in this study, a commercial Nafion™ NR212 membrane was subjected to two different chemical pre-treatments, before usage. HNO3 or H2O2 were selected as chemical agents because the most widely used ones in the procedure protocols in order to prepare the membrane in a well-defined reference state. The pre-treated membranes properties were compared to an untreated membrane, used as-received. The investigation has showed that the pre-treatments enhance the hydrophilicity and increase the water molecules coordinated to the sulphonic groups in the membrane structure, on the other hand the swelling of the membranes also increases. As a consequence, the untreated membrane shows a better mechanical resistance, a good electrochemical performance and durability in fuel cell operations, orienting toward the use of the NR212 membrane without any chemical pre-treatment

First observations on marine subaqueous soils in "Torre del Cerrano" marine protected area, Adriatic sea (Italy)

Subaqueous soils have to be studied with proper methodologies, according to a pedological approach and considering the key role of animal bioturbation. Morphological and chemical characteristics of submerged soils found in the MPA of "Torre del Cerrano", Adriatic sea (Italy), have been studied in this way, and we conclude that submarine soils of the MPA are important examples of pedogenesis promoted by animals. Soils from the highly protected marine area hosted a major biodiversity than those from the sub- and non-protected areas, while no striking differences in terms of soil physical and chemical characteristics among protected, sub-protected and non-protected areas occurred

A multi-scale approach to the recent activity of the Stradella thrust in the seismotectonic context of the Emilia Arc (northwestern Italy)

The frontal thrusts and folds of the northern Apennines - Italy - are mainly covered under the alluvial deposits of the Po Plain. Some of these structures show geological evidence of Late Quaternary activity, thus posing the need for an accurate seismic hazard assessment due to widespread housing settlements, industries, lifeline infrastructures, and large towns. We present new morphostructural, geophysical, and seismological data to discuss the recent activity of the Broni-Sarmato fault, an 18 km-long outcropping section of the north-verging Stradella thrust, located 50 km south of Milan, along the Pede-Apennine thrust front (PTF) in the rear of the Emilia Arc thrust system. The new geoelectrical surveys across the fault scarp show deformation of the shallow deposits. The outcropping deformations, with a fault scarp ranging up to 25.8 m, are investigated within the seismotectonic framework of the PTF and the Emilia Arc. The analysis of the associated seismicity and new focal mechanisms highlight two seismogenic contractional volumes dipping at low-angle southwest-ward, at upper (<12 km) and lower crustal depths (~20–30 km). The shallow seismicity partially illuminates the Stradella thrust and its along-strike southeastward prosecution along the extent of the Stradella-Salsomaggiore Arc. Subordinately, it also illuminates some of the Emilia Arc thrust planes. The deeper seismogenic volume shows large patches of the basal thrust of the Emilia Arc fault system. We interpret the above multi-scale data as evidence of ongoing tectonic activity of the outer fronts of the Emilia Arc under a regional NNE-oriented compressional stress field, with some evidence of thrust involvement along the Pede-Apennine front. In our 3D fault-model reconstruction, all the analyzed thrust structures appear as expressions of a thick-skinned deformation that controls earthquake release at different structural levels

The THYCOVIT (Thyroid Surgery during COVID-19 pandemic in Italy) study: results from a nationwide, multicentric, case-controlled study

none29: The outbreak of the COVID-19 pandemic has led to a disruption of surgical care. The aim of this multi-centric, retrospective study was to evaluate the impact of the pandemic on surgical activity for thyroid disease among the Italian Units of Endocrine Surgery. Three phases of the pandemic were identified based on the epidemiological situation and the public measures adopted from the Italian Government (1st phase: from 9th March to 3rd May 2020; 2nd phase: from 4th May to 14th June; 3rd phase: from 15th June to 31st). The patients operated upon during these phases were compared to those who underwent surgery during the same period of the previous year. Overall, 3892 patients from 28 Italian endocrine surgical units were included in the study, 1478 (38%) operated upon during COVID-19 pandemic, and 2414 (62%) during the corresponding period of 2019. The decrease in the number of operations was by 64.8%, 44.7% and 5.1% during the three phases of COVID-19 pandemic, compared to 2019, respectively. During the first and the second phases, the surgical activity was dedicated mainly to oncological patients. No differences in post-operative complications were noted between the two periods. Oncological activity for thyroid cancer was adequately maintained during the COVID-19 pandemic.noneMedas, Fabio; Ansaldo, Gian Luca; Avenia, Nicola; Basili, Giancarlo; Boniardi, Marco; Bononi, Marco; Bove, Aldo; Carcoforo, Paolo; Casaril, Andrea; Cavallaro, Giuseppe; Chiofalo, Maria Grazia; Conzo, Giovanni; De Pasquale, Loredana; Del Rio, Paolo; Dionigi, Gianlorenzo; Dobrinja, Chiara; Docimo, Giovanni; Graceffa, Giuseppa; Iacobone, Maurizio; Innaro, Nadia; Lombardi, Celestino Pio; Palestini, Nicola; Pedicini, Francesco; Perigli, Giuliano; Pezzolla, Angela; Scerrino, Gregorio; Spiezia, Stefano; Testini, Mario; Calò, Pietro GiorgioMedas, Fabio; Ansaldo, Gian Luca; Avenia, Nicola; Basili, Giancarlo; Boniardi, Marco; Bononi, Marco; Bove, Aldo; Carcoforo, Paolo; Casaril, Andrea; Cavallaro, Giuseppe; Chiofalo, Maria Grazia; Conzo, Giovanni; De Pasquale, Loredana; Del Rio, Paolo; Dionigi, Gianlorenzo; Dobrinja, Chiara; Docimo, Giovanni; Graceffa, Giuseppa; Iacobone, Maurizio; Innaro, Nadia; Lombardi, Celestino Pio; Palestini, Nicola; Pedicini, Francesco; Perigli, Giuliano; Pezzolla, Angela; Scerrino, Gregorio; Spiezia, Stefano; Testini, Mario; Calò, Pietro Giorgi