Regionalization of ports as a strategic leverage to improve competitiveness. A study on central italy ports and related hinterland

Nowadays, the success of a maritime port does not depend anymore on its traditional intrinsic points of strength, such as the internal capacity, but also on its ability to effectively integrate the development of its hinterland into business relations and supply chains. Mediterranean ports can get competitive, if specific "regionalization" processes are launched and supported. Key point for this strategy is the hinterland involvement: logistics and transports integration, railways, realization and development of dryports, terminals, distribution centres. All these are core elements for this purpose. The overall focus has changed from port performances to performance of the entire supply chain in the port-hinterland relationship. This is what it is going to do the Port of Civitavecchia, the most important port in Lazio Region, would like to become the central point into commercial, industrial and infrastructural development of central Italy. The development of railway terminal and of regional road network for the developing of intermodal logistics chain, of the industrial port activities (shipbuilding sector and oil bunkering), of trade relations with Fiumicino Airport and with the roman agroindustrial sector, of logistics relations with the dryport of Orte and with the intermodal terminal (road-railway) of Pomezia Santa Palomba, are some of the activities planned and undertaken by the port for improving the regionalization of Civitavecchia. Aim of this paper is to show and underline how these regionalization processes can increase the development, and so benefit the entire regional hinterland and the competitiveness and attraction of the entire port system. A model to estimate the regionalization effect has been designed by the authors and implemented to make a comparison analysis between Civitavecchia and competing ports. © 2021 Georg Thieme Verlag. All rights reserved

Conventional Drills Versus Piezoelectric Surgery Preparation for Placement of Four Immediately Loaded Zygomatic Oncology Implants in Edentulous Maxillae: 3 Year Results of a Within Person Randomised Controlled Trial

PURPOSE. A within-person randomised controlled trial to compare the outcome of site preparation for two zygomatic oncology implants per zygoma using conventional preparation with rotary drills or piezoelectric surgery with dedicated inserts. MATERIALS AND METHODS. Twenty edentulous patients with severely atrophic maxillae and insufficient bone volumes for placing dental implants with less than 4 mm of bone height subantrally had their hemi-maxillae randomised according to a within-patient study design into implant site preparation with either conventional rotational drills or piezoelectric surgery. Two zygomatic oncology implants (unthreaded coronal portion) were placed in each hemi-maxilla. Implants that achieved an insertion torque of greater than 40 Ncm were immediately loaded with provisional screw-retained metal-reinforced acrylic prostheses. Outcome measures were: prosthesis and implant failures, any com-plications, time to place the implants, presence of post-operative haematoma, and patient preference, as assessed by blinded assessors when possible. All patients were followed up for 3 years after loading. RESULTS. In two patients, drills had to be used in the piezoelectric surgery arm in order to prepare implant sites properly. One implant from the conventional drill group did not achieve an insertion torque of greater than 40 Ncm since the zygoma fractured. Three patients dropped out. Two distal oncology implants failed in the same patient (one per group), who was not prosthetically rehabilitated. Six patients experienced at least one complication at drilled sites and five at piezoelectric surgery sites (three patients had bilateral complications), the difference not being statistically significant (odds ratio = 1.5; P [McNemar’s test] = 1.0; 95% CI of odds ratio: 0.25 to 8.98). Implant placement with con-vention drills took on average 14.35±1.76 minutes vs. 23.50±2.26 minutes with piezoelectric surgery, the implant placement time being significantly shorter with conventional drilling (difference = 9.15±1.69 minutes; 95%CI: 8.36 to 9.94 minutes; P = 0.000). Post-operative haematomas were larger at drilled sites in 11 patients and similar at both sides in nine patients (chi-square = 20.4; df = 3; P = 0.0001), and 16 patients found both techniques equally acceptable while four preferred piezoelectric surgery (chi-square = 34.4; df = 3; P<0.0001). CONCLUSIONS. Although these results may be system-dependent, and therefore cannot be generalised to other zygomatic systems with confidence, both drilling techniques achieved similar clinical outcomes. However, conventional drilling required 9 minutes less and could be used in all instances, though it was more aggressive

Tear Osmolarity and Dry Eye Symptoms in Women Using Oral Contraception and Contact Lenses

Purpose—To examine the relationship between oral contraceptive pill (OCP) use, contact lens wear, and dry eye signs and symptoms in healthy young females. Methods—Fifty-two women using OCPs and forty-five women not using any form of hormonal contraception were enrolled. Medical, menstrual, and contact lens histories were obtained and dry eye symptoms were assessed using the Ocular Surface Disease Index (OSDI) and Symptom Assessment iN Dry Eye (SANDE) questionnaires. Tear osmolarity testing was performed using the TearLab™ Osmolarity System. Results—Mean age of all subjects was 26.0 ± 3.7 years. There were no significant differences in any of the measurements between the follicular and luteal phases. While SANDE scores were significantly higher in subjects with OCP and recent contact lens use (p\u3c0.01), there were no significant differences in OSDI and tear osmolarity amongst the same subject groups. Subjects who reported both OCP and recent contact lens use had significantly higher OSDI and SANDE scores (p=0.015 and p\u3c0.001, respectively). Conclusions—There were no differences between the phases of the menstrual cycle. Tear osmolarity was not affected by OCP or contact lens use in young females. However, the combination of OCP use and contact lens wear may increase the severity of dry eye symptoms

Status of the Cylindical-GEM project for the KLOE-2 Inner Tracker

The status of the R&D on the Cylindrical-GEM (CGEM) detector foreseen as Inner Tracker for KLOE-2, the upgrade of the KLOE experiment at the DAFNE phi-factory, will be presented. The R&D includes several activities: i) the construction and complete characterization of the full-size CGEM prototype, equipped with 650 microns pitch 1-D longitudinal strips; ii) the study of the 2-D readout with XV patterned strips and operation in magnetic field (up to 1.5T), performed with small planar prototypes in a dedicated test at the H4-SPS beam facility; iii) the characterization of the single-mask GEM technology for the realization of large-area GEM foils.Comment: 4 pages, 10 figures, Presented at Vienna Conference on Instrumentation (Feb 15-20, 2010, Vienna, Austria). Submitted to the Proceeding

Everolimus plus exemestane in postmenopausal patients with HR(+) breast cancer: BOLERO-2 final progression-free survival analysis.

IntroductionEffective treatments for hormone-receptor-positive (HR(+)) breast cancer (BC) following relapse/progression on nonsteroidal aromatase inhibitor (NSAI) therapy are needed. Initial Breast Cancer Trials of OraL EveROlimus-2 (BOLERO-2) trial data demonstrated that everolimus and exemestane significantly prolonged progression-free survival (PFS) versus placebo plus exemestane alone in this patient population.MethodsBOLERO-2 is a phase 3, double-blind, randomized, international trial comparing everolimus (10 mg/day) plus exemestane (25 mg/day) versus placebo plus exemestane in postmenopausal women with HR(+) advanced BC with recurrence/progression during or after NSAIs. The primary endpoint was PFS by local investigator review, and was confirmed by independent central radiology review. Overall survival, response rate, and clinical benefit rate were secondary endpoints.ResultsFinal study results with median 18-month follow-up show that median PFS remained significantly longer with everolimus plus exemestane versus placebo plus exemestane [investigator review: 7.8 versus 3.2 months, respectively; hazard ratio = 0.45 (95% confidence interval 0.38-0.54); log-rank P &lt; 0.0001; central review: 11.0 versus 4.1 months, respectively; hazard ratio = 0.38 (95% confidence interval 0.31-0.48); log-rank P &lt; 0.0001] in the overall population and in all prospectively defined subgroups, including patients with visceral metastases, [corrected] and irrespective of age. The incidence and severity of adverse events were consistent with those reported at the interim analysis and in other everolimus trials.ConclusionThe addition of everolimus to exemestane markedly prolonged PFS in patients with HR(+) advanced BC with disease recurrence/progression following prior NSAIs. These results further support the use of everolimus plus exemestane in this patient population. ClinicalTrials.gov #NCT00863655

A proposed protocol for ordinary and extraordinary hygienic maintenance in different implant prosthetic scenarios

Prevention of peri-implantitis involves the early diagnosis of peri-implant mucositis. This article presents a protocol of hygienic maintenance in different implant prosthetic scenarios: single crown, fixed partial prosthesis, fixed full-arch, and overdentures. Others clinical conditions have to be taken into consideration: patient compliance; history of periodontitis; implants placed in augmented bone; short, zygomatic, pterygoid, and tilted implants; and complex prosthesis with false gingiva. Two levels of implant maintenance are described: ordinary, performed by dental hygienist, and extraordinary, carried out by both dentist and hygienist. Extraordinary maintenance also involves the removal and decontamination of the prosthetic structure. To obtain an effective prevention of peri-implantitis, one must plan ordinary and extraordinary hygiene in relation to the type of rehabilitation and clinical parameters

Pregnant with metastatic neuroendocrine tumour of the ovary: what now?

Neuroendocrine tumours (NET) are a heterogeneous group of neoplasms commonly occurring in the gastrointestinal tract or lungs but can occur in other regions. Primary ovarian NET account for 5% of all NET and 0.1% of all ovarian malignancies. In metastatic disease, the therapeutic goal is to extend survival and to improve quality of life. As these tumours express somatostatin receptors, somatostatin analogues are frequently used to control symptoms. Here we present a case of a pregnant woman with an ovarian NET with liver metastases and carcinoid syndrome who was treated with the somatostatin analogue, Octreotide LAR. We also summarize reported data of the use of somatostatin analogues during pregnancy

Effects of Omega-3 Supplementation on Exploratory Outcomes in the Dry Eye Assessment and Management Study.

We report results from a multicenter, randomized clinical trial (N=535) of the effect of ω-3 supplementation, relative to placebo, on exploratory and minimally invasive outcome measures for moderate to severe dry eye disease

A comparison of lysosomal enzymes expression levels in peripheral blood of mild- and severe-Alzheimer’s disease and MCI patients: implications for regenerative medicine approaches

The association of lysosomal dysfunction and neurodegeneration has been documented in several neurodegenerative diseases, including Alzheimer’s Disease (AD). Herein, we investigate the association of lysosomal enzymes with AD at different stages of progression of the disease (mild and severe) or with mild cognitive impairment (MCI). We conducted a screening of two classes of lysosomal enzymes: glycohydrolases (β-Hexosaminidase, β-Galctosidase, β-Galactosylcerebrosidase, β-Glucuronidase) and proteases (Cathepsins S, D, B, L) in peripheral blood samples (blood plasma and PBMCs) from mild AD, severe AD, MCI and healthy control subjects. We confirmed the lysosomal dysfunction in severe AD patients and added new findings enhancing the association of abnormal levels of specific lysosomal enzymes with the mild AD or severe AD, and highlighting the difference of AD from MCI. Herein, we showed for the first time the specific alteration of β-Galctosidase (Gal), β-Galactosylcerebrosidase (GALC) in MCI patients. It is notable that in above peripheral biological samples the lysosomes are more sensitive to AD cellular metabolic alteration when compared to levels of Aβ-peptide or Tau proteins, similar in both AD groups analyzed. Collectively, our findings support the role of lysosomal enzymes as potential peripheral molecules that vary with the progression of AD, and make them useful for monitoring regenerative medicine approaches for AD