A systematic review of microsurgical reconstruction of the jaws using vascularized fibula flap technique in patients with bisphosphonate-related osteonecrosis

OBJECTIVE: The aim of this systematic review was to assess the role of microsurgical reconstruction of the jaws in patients with bisphosphonate-related osteonecrosis, and biological complications after an observation period of at least 12 months. Material and methods: An electronic MEDLINE search supplemented by manual searching was conducted to identify studies reporting data of at least 12 months observation on the microsurgical reconstruction of the jaws in patients with bisphosphonate-related osteonecrosis. RESULTS: Four studies resulted eligible for the analysis yielded. Three out of five studies were free of complications, with a success rate of 100% as no recurrence of osteonecrosis was registered. CONCLUSIONS: Microsurgical reconstruction of the jaws represents a valid treatment modality in patients with bisphosphonate-related osteonecrosis at 3rd stage of the disease

A Frame Element Model for the Nonlinear Analysis of FRP-Strengthened Masonry Panels Subjected to In-Plane Loads

A frame element model for evaluating the nonlinear response of unstrengthened and FRP-strengthened masonry panels subjected to in-plane vertical and lateral loads is presented. The proposed model, based on some assumptions concerning the constitutive behaviour of masonry and FRP material, considers the panel discretized in frame elements with geometrical and mechanical properties derived on the basis of the different states characterizing the sectional behaviour. The reliability of the proposed model is assessed by considering some experimental cases deduced from the literature

Primera liberación de juveniles de mero Epinephelus marginatus (Lowe, 1834) (Serranidae: Teleostei) cultivados en criadero en arrecifes artificiales en el mar Mediterráneo: resultados de un estudio experimental

A pilot experiment of stock enhancement based on the release of hatchery-reared juveniles of dusky grouper, Epinephelus marginatus, was carried out at two artificial reefs located 0.9 km offshore the south-western Sicilian coast (Central Mediterranean). The fish assemblages inhabiting the reefs were characterized using underwater visual census (UVC) surveys. Despite some differences in fish species richness, diversity and abundance, both artificial reefs provide suitable feeding resources and shelter opportunities for the settlement of dusky grouper juveniles. A total of 95 dusky grouper juveniles, which were 3 and 4 years old, were released. No stress-related effects on fish swimming or behaviour were observed during the step by step transportation to the sea-bottom at 20 m depth. After release, several groupers showed very low reactivity; freezing and schooling were the most common behaviours. The sighting rate after one month of UVC surveys was 15.7% and 20% at the two artificial reefs. No effect of fish size at release on grouper survival was observed. Some groupers were not recorded on the pyramid of release but elsewhere in the same artificial reef, which demonstrated their ability to move around the reef. The extent of dispersal of the released juveniles largely exceeded the area encompassed by the reefs, which was shown by recaptures of tagged groupers by local fishermen up to 13 km from the release site. This result provides a first insight into the potential of stock enhancement of hatchery reared dusky grouper juveniles for marine ranching and conservation purposes.Un experimento de repoblación, basado en la liberación de juveniles de mero Epinephelus marginatus cultivados en criadero, fue realizado en dos arrecifes artificiales situados 0.9 kilómetros fuera de las costas sicilianas sur-occidentales (Mediterráneo Central). La ictiofauna de los arrecifes fue caracterizada a través de inmersiones submarinas, utilizando la técnica de censo visual (UVC). A pesar de algunas diferencias en número de especies, diversidad y abundancia, ambos arrecifes artificiales proporcionaron recursos alimenticios y refugio adecuados para el establecimiento de juveniles de mero. En total se liberaron 95 meros juveniles de 3 y 4 años de edad. Ningún efecto relacionado al estrés fue observado en el comportamiento de natación de los peces durante el gradual transporte hasta 20 m de profundidad. Después de la liberación, varios meros mostraron una reactividad muy baja, siendo el comportamiento más común quedarse inmóviles y agregados. Después de un mes de censos visuales, las tasas de avistamientos obtenidas en los arrecifes artificiales fueron de 15.7% y 20%. No se observó relación entre el tamaño en el momento de la liberación y la supervivencia. Algunos peces no fueron observados cerca del punto de liberación sino en otra parte del mismo arrecife artificial, demostrando así su capacidad de moverse por los alrededores. Según lo indicado por los pescadores locales que recobraron meros marcados hasta 13 kilómetros del punto de liberación, el grado de la dispersión de los juveniles liberados superó ampliamente el área abarcada por los arrecifes. Este resultado proporcionan la primera evaluación del potencial de los juveniles de E. marginatus cultivados en criadero para actividades de cría en mar y conservación

The Lucca Comics and Games Festival as a platform for transformational cultural tourism: Evidence from the perceptions of residents

There is ample literature on residents' perceptions of the costs and benefits of tourism activities. Much less attention has been provided to residents' perceptions of transformational cultural events redefining local identity and tourism demand. We examine one such case study, the Lucca Comics and Games (LCAG), whose interest also derives from the fact that Lucca is an established Italian heritage city, with relevant attraction capacity for traditional heritage tourism. We have administered a questionnaire to a sample of the local population (411 interviews), with high educational and cultural access levels. We find that LCAG-related tourism is perceived to have differential impact with respect to tourism in general on several dimensions of interest, both in terms of perceived costs and benefits, also as an effect of cognitive biases. Our results provide interesting implications in terms of the role of transformational cultural events such as LCAG in driving change in heritage cities

Curing is caring? Liability reforms, defensive medicine and malpractice litigation in a post-pandemic world

We analyze different scenarios of defensive medicine in a unique game theoretic framework, representing a healing relationship between a physician and a patient. The physician should choose between providing the optimal treatment or an inferior one, which can amount to practicing defensive medicine. The patient should choose whether to litigate or not, if an adverse event occurs. When both agents have no dominant strategy, we obtain four scenarios representing the positive and negative forms of defensive medicine, with or without physician's moral hazard. We find that certain legal parameters can have opposite effects on the probabilities that physicians practice defensive medicine and that patients litigate, depending respectively on the form of defensive medicine and on the presence of moral hazard. This result can explain the ambiguous results, reported in empirical literature, of legal reforms aimed at discouraging defensive medicine and medical malpractice litigation

From 3-Port to New Laparoendoscopic Single-Site (LESS) Cholecystectomy : A Critical Analysis of Available Evidence.

In recent years, laparoendoscopic single-site surgery (LESS) has gained greater interest and diffusion for the treatment of gallstones. This critical review aims to evaluate the feasibility and safety of LESS cholecystectomy versus the 3-port technique (TPT) through a comparative analysis of 5 parameters: mean operative time, intraoperative and postoperative complications, conversion to open, conversion to the 4-trocar technique and postoperative hospital stay. The authors performed a systematic search of the medical literature through a search of PubMed and Ovid EMBASE. Inclusion criteria were as follows: publication date between January 1, 2005, and December 31, 2010; English or Italian language; human participants and series of 20 operations or more. There were 5 manuscripts meeting the inclusion criteria for TPT and 23 for LESS. Only one prospective randomized controlled trial comparing TPT and LESS was identified. Operative time is significantly longer in the single-incision group. Complications and conversion rates to the 4-port technique are higher in LESS. Postoperative hospital stay is similar in the 2 groups. Rate of conversion to open is higher in TPT. Despite the number of publications on LESS cholecystectomy, the vast majority of data available in the literature are from small case series without any comparative data. Although LESS cholecystectomy is a fashionable technique there are few data available for an evidence-based determination as to the real benefits of this technique. Well-designed comparative studies are suggested to validate the clinical benefits and ensure that there are no new complications or added costs associated with the new technique

Imagination vs. routines: festive time, weekly time, and the predictive brain

This paper examines the relationship between societal structures shaped by traditions, norms, laws, and customs, and creative expressions in arts and media through the lens of the predictive coding framework in cognitive science. The article proposes that both dimensions of culture can be viewed as adaptations designed to enhance and train the brain’s predictive abilities in the social domain. Traditions, norms, laws, and customs foster shared predictions and expectations among individuals, thereby reducing uncertainty in social environments. On the other hand, arts and media expose us to simulated experiences that explore alternative social realities, allowing the predictive machinery of the brain to hone its skills through exposure to a wider array of potentially relevant social circumstances and scenarios. We first review key principles of predictive coding and active inference, and then explore the rationale of cultural traditions and artistic culture in this perspective. Finally, we draw parallels between institutionalized normative habits that stabilize social worlds and creative and imaginative acts that temporarily subvert established conventions to inject variability