Pre-Alpine and Alpine deformation at San Pellegrino pass (Dolomites, Italy)

In this work, we present the geological map of the San Pellegrino pass, inserted in the spectacular scenario of the Dolomiti region (Southern Alps, Italy), at a scale of 1:10.000 and accompanied by geological cross-sections. The detailed distinction of lithological thin units allowed to achieve a consistent interpretation of the local structural setting by drawing brittle and ductile Alpine tectonic deformations. The differential deformation and structural styles within the geological map are the result of the different rheological nature of volcanic and sedimentary rocks, as well as of the superimposition of compressional Alpine tectonics over Permo-Mesozoic extensional tectonic phases, and consequent reactivation of inherited structures

Diverticular Disease and Rifaximin: An Evidence-Based Review

There have been considerable advances in the treatment of diverticular disease in recent years. Antibiotics are frequently used to treat symptoms and prevent complications. Rifaximin, a non-absorbable antibiotic, is a common therapeutic choice for symptomatic diverticular disease in various countries, including Italy. Because of its low systemic absorption and high concentration in stools, it is an excellent medicine for targeting the gastrointestinal tract, where it has a beneficial effect in addition to its antibacterial properties. Current evidence shows that cyclical rifaximin usage in conjunction with a high-fiber diet is safe and effective for treating symptomatic uncomplicated diverticular disease, while the cost-effectiveness of long-term treatment is unknown. The use of rifaximin to prevent recurrent diverticulitis is promising, but further studies are needed to confirm its therapeutic benefit. Unfortunately, there is no available evidence on the efficacy of rifaximin treatment for acute uncomplicated diverticulitis

Conhecimento dos estudantes de medicina sobre aleitamento materno

Breastfeeding (BF) is essential for the development of the child and the promotion of a bond between mother and child. Therefore, it is essential that medical students know how to advise on the subject, to stimulate BF, so this study aimed to identify their knowledge in relation to BF knowledge, guidance, orientation, and management. Cross-sectional study with 252 medical students from a private university, carried out in the second semester of 2021 and first semester of 2022. The students answered a questionnaire that investigated seven domains that evaluated the knowledge and experience about BF. The Stata Program, version 16.0, was used in the statistical analyses. Chi-square test was applied to verify differences between students with no prior knowledge about AM (<7th period) and those with prior knowledge (>7th period). It was observed that students with prior knowledge obtained 65% (95%CI 56.2% - 73.0%) of performance in the general knowledge item about AM, while students without knowledge had 13.2% (95%CI 8.3 % - 20.2%). The subject with the best performance in both groups, with no statistically significant difference, was on the effectiveness of BF (96.0%; 95%CI 92.8 - 97.8). The content with the worst performance was the expression of breast milk, where 10.8% (95%CI 6.5 - 17.5) of students with no prior knowledge and 16.3% (95%CI 10.7 - 23.9) with knowledge got a better score. In view of the results obtained, it was concluded that students from the 7th to 12th period have more knowledge about the subject compared to students from the initial periods, even with poor performance in the domain expression of breast milk.O aleitamento materno (AM) é fundamental para o desenvolvimento da criança e da promoção de vínculo entre mãe e filho. Diante disso, é primordial que os estudantes de medicina oriente sobre a temática, a fim de estimular o AM, por isso, tal estudo teve por objetivo identificar o conhecimento em relação ao conhecimento, orientações e manejo do AM. Estudo transversal com 22 estudantes de medicina de uma universidade, no 2º semestre de 20 e 1º semestre de 2022. Os estudantes responderam22. O Programa Stata, versão 16.0, foi avaliado nas estimativas estatísticas. Teste quiquadrado foi aplicado para diferenças entre os estudantes sem conhecimento prévio sobre AM (<7º) e os com conhecimento prévio ( > 7º período).Observou-se que os alunos com conhecimento prévio obtiveram 65% (IC95% 56,2% - 73,0%) de desempenho no quesito conhecimento geral sobre AM, enquanto os alunos sem conheceram 13,2% (IC95% 8,3) % - 20,2%). O desempenho em diferença significativa foi sobre o melhor significado do AM (96% 92,8,8) - IC95% 92,8,8. O conteúdo com melhor desempenho foi a expressão do leite materno, onde 10,8% (IC95% 6,5 - 17,5) dos estudantes sem conhecimento prévio e 16,3% (IC95% 10,7 - 23,9) com conhecimentoram o melhor escore obtido. Resultados maternos, concluídos-se que os alunos do 7º ao 12º período possuem mais conhecimento sobre o tema com os alunos dos períodos iniciais, mesmo apresentando desempenho ruim no domínio

The identifying depression early in adolescence risk stratified cohort (IDEA-RiSCo) : rationale, methods, and baseline characteristics

Background: The characterization of adolescents at high risk for developing depression has traditionally relied on the presence or absence of single risk factors. More recently, the use of composite risk scores combining information from multiple variables has gained attention in prognostic research in the field of mental health. We previously developed a sociodemographic composite score to estimate the individual level probability of depression occurrence in adolescence, the Identifying Depression Early in Adolescence Risk Score (IDEA-RS). Objectives: In this report, we present the rationale, methods, and baseline characteristics of the Identifying Depression Early in Adolescence Risk Stratified Cohort (IDEA-RiSCo), a study designed for in-depth examination of multiple neurobiological, psychological, and environmental measures associated with the risk of developing and with the presence of depression in adolescence, with a focus on immune/inflammatory and neuroimaging markers. Methods: Using the IDEA-RS as a tool for risk stratification, we recruited a new sample of adolescents enriched for low (LR) and high (HR) depression risk, as well as a group of adolescents with a currently untreated major depressive episode (MDD). Methods for phenotypic, peripheral biological samples, and neuroimaging assessments are described, as well as baseline clinical characteristics of the IDEA-RiSCo sample. Results: A total of 7,720 adolescents aged 14-16 years were screened in public state schools in Porto Alegre, Brazil. We were able to identify individuals at low and high risk for developing depression in adolescence: in each group, 50 participants (25 boys, 25 girls) were included and successfully completed the detailed phenotypic assessment with ascertainment of risk/MDD status, blood and saliva collections, and magnetic resonance imaging (MRI) scans. Across a variety of measures of psychopathology and exposure to negative events, there was a clear pattern in which either the MDD group or both the HR and the MDD groups exhibited worse indicators in comparison to the LR group. Conclusion: The use of an empirically-derived composite score to stratify risk for developing depression represents a promising strategy to establish a risk-enriched cohort that will contribute to the understanding of the neurobiological correlates of risk and onset of depression in adolescence

Prospective Follow-up of Adolescents with and at Risk for Depression::Protocol and Methods of the Identifying Depression Early in Adolescence Risk Stratified Cohort (IDEA-RiSCo) Longitudinal Assessments

Objective: To present the protocol and methods for the prospective longitudinal assessments — including clinical and digital phenotyping approaches — of the Identifying Depression Early in Adolescence Risk Stratified Cohort (IDEA-RiSCo) study, which comprises Brazilian adolescents stratified at baseline by risk of developing depression or presence of depression. Method: Of 7,720 screened adolescents aged 14-16, we recruited 150 participants (75 boys, 75 girls) based on a composite risk score: 50 with low risk for developing depression (LR), 50 with high risk for developing depression (HR), and 50 with an active untreated major depressive episode (MDD). Three annual follow-up assessments were conducted, involving clinical measures (parent and adolescent-reported questionnaires and psychiatrist assessments), active and passive data sensing via smartphones, and neurobiological measures (neuroimaging and biological material samples). Retention rates were 96% (Wave 1), 94% (Wave 2), and 88% (Wave 3), with no significant differences by sex or group (p &gt; 0.05). Participants highlighted their familiarity with the research team and assessment process as a motivator for sustained engagement.Discussion: This protocol relied on novel aspects, such as the use of a WhatsApp bot, which is particularly pertinent for low-to-middle-income countries, and the collection of information from diverse sources in a longitudinal design, encompassing clinical data, self-reports, parental reports, GPS data, and ecological momentary assessments. The study engaged adolescents over an extensive period and demonstrated the feasibility of conducting a prospective follow-up study with a risk-enriched cohort of adolescents in a middle-income country, integrating mobile technology with traditional methodologies to enhance longitudinal data collection. <br/

The Identifying Depression Early in Adolescence Risk Stratified Cohort (IDEA-RiSCo): Rationale, Methods, and Baseline Characteristics

Background: The characterization of adolescents at high risk for developing depression has traditionally relied on the presence or absence of single risk factors. More recently, the use of composite risk scores combining information from multiple variables has gained attention in prognostic research in the field of mental health. We previously developed a sociodemographic composite score to estimate the individual level probability of depression occurrence in adolescence, the Identifying Depression Early in Adolescence Risk Score (IDEA-RS).Objectives: In this report, we present the rationale, methods, and baseline characteristics of the Identifying Depression Early in Adolescence Risk Stratified Cohort (IDEA-RiSCo), a study designed for in-depth examination of multiple neurobiological, psychological, and environmental measures associated with the risk of developing and with the presence of depression in adolescence, with a focus on immune/inflammatory and neuroimaging markers.Methods: Using the IDEA-RS as a tool for risk stratification, we recruited a new sample of adolescents enriched for low (LR) and high (HR) depression risk, as well as a group of adolescents with a currently untreated major depressive episode (MDD). Methods for phenotypic, peripheral biological samples, and neuroimaging assessments are described, as well as baseline clinical characteristics of the IDEA-RiSCo sample.Results: A total of 7,720 adolescents aged 14–16 years were screened in public state schools in Porto Alegre, Brazil. We were able to identify individuals at low and high risk for developing depression in adolescence: in each group, 50 participants (25 boys, 25 girls) were included and successfully completed the detailed phenotypic assessment with ascertainment of risk/MDD status, blood and saliva collections, and magnetic resonance imaging (MRI) scans. Across a variety of measures of psychopathology and exposure to negative events, there was a clear pattern in which either the MDD group or both the HR and the MDD groups exhibited worse indicators in comparison to the LR group.Conclusion: The use of an empirically-derived composite score to stratify risk for developing depression represents a promising strategy to establish a risk-enriched cohort that will contribute to the understanding of the neurobiological correlates of risk and onset of depression in adolescence

How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p &lt; 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p &lt; 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p &lt; 0.0001) or urgent (20.4% vs. 38.5%; p &lt; 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p &lt; 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice

Usefulness of three-dimensional computed tomographic anatomy in endoscopic frontal recess surgery

The endoscopic bidimensional vision offered by the endoscope during endoscopic sinus surgery involves difficulty in visualizing surgical field depth which makes it difficult to learn this surgical technique and makes it necessary for the endoscopic surgeon to mentally create a three-dimensional (3D) picture of the paranasal sinuses anatomy. In particular, frontal recess surgery requires good knowledge of its anatomic position, also since it is necessary to use angled endoscopes, which distort the view, and angular instruments which are difficult to use. Purpose of this project is to offer to the endoscopic surgeon a detailed 3D model of the nose and paranasal sinuses with particular attention to the frontal recess

The Experience of Receiving a Diagnosis of Depression in Adolescence: A Pilot Qualitative Study in Brazil

Receiving a diagnosis of depression can have an important impact on the lives of adolescents. However, there is limited information about how youth tackle, attribute meaning to and understand mental health diagnoses. The aim of this study was to explore adolescents\u27 initial reactions after receiving a clinical diagnosis of Major Depressive Disorder in the context of a neurobiological study of depression in Brazil. Using a qualitative design, eight Brazilian adolescents were interviewed twice: immediately after a psychiatric assessment and neuroimaging study, in which they were given a diagnosis of depression, and in a follow-up visit 2 weeks later. Interviews were designed to explore the subjective experience of receiving the diagnosis and the impacts of depression on adolescents\u27 lives. Framework Analysis was used to analyze the accounts. Diagnosis was perceived as a reification of an abnormal status, highlighting the role of stigma and the process of disclosing the diagnosis to others. Adolescents reported the multiple sensemaking processes that occurred when they received a diagnosis of depression, and most struggled with the idea that negative emotions would equate their experience with a disorder. The results show that future efforts could enhance clinical assessment processes with adolescents by exploring adolescents\u27 reactions to diagnosis, as well as the support networks available to them, resulting in increased help-seeking behaviors, and diminished social and personal stigma

Final Design of ITER In-Vessel Coils and Manufacturing of In-Vessel Coil Conductor

Following a decision made at the ITER Council in November 2013, two types of in-vessel coils (IVCs), namely, edge-localized mode (ELM) coils to mitigate ELMs and vertical stability (VS) coils to provide vertical stabilization of the plasma, have been incorporated in the ITER baseline design. The in-vessel environment is severe, characterized by large transient electromagnetic fields, high radiation flux, and high temperature. To withstand this environment and provide the required functionality, a “mineral insulated conductor” (MIC) technology has been selected for the IVC conductor. It consists of an axially water-cooled copper conductor surrounded by magnesium oxide insulation and a stainless steel jacket. A major advantage of the coil design is the choice of the same conductor material and dimensions for both VS and ELM coils, long conductor length which eliminates the need for any internal joints, and Cu welding for the joints between coils and feeders. In situ winding of the VS coils is asking for the development of a creative solution for the unspooling, straightening, precise winding tools, bending, forming, and metrology processes in a tight and congested environment. Mock-ups for design verification and manufacturing feasibility have been produced, in particular, for the bracket manufacture and to perform thermal and mechanical fatigue testing on an ELM control coil winding pack assembly. Installation trials of a half-size ELM control coil have been performed to verify the feasibility of the assembly procedure. This article will give an overview of the IVC design status and the progress of ITER IVC conductor manufacturing