Practice parameters for the treatment of colonic diverticular disease: Italian Society of Colon and Rectal Surgery (SICCR) guidelines

The mission of the Italian Society of Colorectal Surgery (SICCR) is to optimize patient care. Providing evidence-based practice guidelines is therefore of key importance. About the present report it concernes the SICCR practice guidelines for the diagnosis and treatment of diverticular disease of the colon. The guidelines are not intended to define the sole standard of care but to provide evidence-based recommendations regarding the available therapeutic options

Neurotensin localization in adenomatoid cystic malformation versus normal lung: Preliminary report of six consecutive cases

Neuropeptides are considered a new class of neurotransmitters, several of which interact with the immune system as well as the macrophagic activity. Among these, neurotensin (NT) enhances the phagocitic response of macrophages and is the only neuropeptide that can enhance the cytolytic effects of activated macrophages. In this way, it may play a role as an inflammatory mediator. In order to investigate the possible relationship between NT and the defence mechanisms of the lung, we started to localize the presence of NT in pulmonary adenomatoid cystic malformation (CCAM). This series consists of 6 children affected by CCAM. In every case, at operation, we obtained specimens of both normal and pathological lung. Tissue sections from the pathological lung showed a significant increase of NT-like immunoreactivity in respect to sections of normal lung. NT influences and activates the macrophages, thus suggesting that it could represent a defence mechanism in children's lung activated in some malformative conditions. Finally, the increasing evidence of NT immunoreactivity in CCAM could explicate an in utero infectious pathogenesis of this malformation

Effect of two gaps on the flux lattice internal field distribution: evidence of two length scales from muSR in Mg1-xAlxB2

We have measured the transverse field muon spin precession in the flux lattice (FL) state of the two gap superconductor MgB2 and of the electron doped compounds Mg1-xAlxB2 in magnetic fields up to 2.8T. We show the effect of the two gaps on the internal field distribution in the FL, from which we determine two coherence length parameters and the doping dependence of the London penetration depth. This is an independent determination of the complex vortex structure already suggested by the STM observation of large vortices in a MgB2 single crystal. Our data agrees quantitatively with STM and we thus validate a new phenomenological model for the internal fields.Comment: now in press Phys. Rev. Lett., small modifications required by the edito

VNIR spectral characteristics of terrestrial igneous effusive rocks: Mineralogical composition and the influence of texture

The authors would like to thank L. Peruzzo for a useful introduction to the use of the SEM at the GeoScience Department of the University of Padua. Financial support was perovided by Agenzia Spaziale Italiana, SIMBIO-SYS project. The authors would also like to thank two anonymous reviewers, and P. K. Byrne and T. Platz, for their helpful suggestions that improved this manuscript.Visible and Near-Infrared (VNIR) reflectance spectroscopy is an important technique with which to map mineralogy and mineralogical variations across planetary surfaces using remotely sensed data. Absorption bands in this spectral range are due to electronic or molecular processes directly related to mineral families or specific compositions. Effusive igneous rocks are widely recognized materials distributed on the surfaces of terrestrial planets, and are formed by primary minerals that can be discriminated by electronic absorptions (e.g. crystal field absorption). In this paper, we review the current knowledge of effusive rock compositions obtained by crystal field absorption in VNIR reflectance spectroscopy, and consider how different petrographical characteristics influence the mineralogical interpretation of such rock compositions. We show that: (1) the dominant mineralogy can be clearly recognized for crystalline material, especially with relatively large crystal dimension groundmass or high porphyritic index; (2) both grain and crystal size are important factors that influence the spectra of effusive rocks where groundmass is generally characterized by microscopic crystals; and (3) glassy dark components in the groundmass reduce or hide the crystal field absorption of mafic minerals or plagioclase otherwise expected to be present

Deconvolution of mixtures with high plagioclase content for the remote interpretation of lunar plagioclase-rich regions

Spectroscopic measurements were carried out at Inaf-IAPS Istituto Nazionale di Astrofisica, Roma. EMPA analyses have been performed at Dipartimento di Geoscienze, Padova. E4 end-member has been kindly provided by Dr. Sabrina Ferrari, Department of Geosciences, University of Padova. Financial support by Agenzia Spaziale Italiana, SIMBIO-SYS project. The authors are also grateful to Leah Cheek and to an anonymous reviewer for the stimulating comments and useful suggestions.Anorthositic rocks are widespread on the lunar surface and have probably been formed by flotation of PL over a magma ocean. A large portion of pristine rocks are characterized by a low Mg/(Mg+Fe) ratio, and have been classified as ferroan anorthosite, and recently, after observation from SELENE Spectral Profiler,pure anorthosites regions with more than 98% PL have been recognized. In this paper, we analyze a set of mixtures with PL content similar to the ferroan anorthosites and to the pure anorthosite regions, using the Origin Software and the Modified Gaussian Model. We consider three plagioclases with varying FeOwt% contents (PL1, PL2 and PL3)andthree mafic end-members (1) 100% orthopyroxene, (2) 56% orthopyroxene and 44% clinopyroxene, and (3) 100% olivine (OL). The spectral parameters considered here are: band depth, band center, band width, c0 (the continuum intercept) and c1 (the continuum offset). Here we have shown that in pyroxene (PX)-bearing mixtures, the PX is distinguishable even in mixtures with only 1% PX and that PX band at ca. 900 nm is always deeper than PL1 band while PL2 and PL3 are deeperthan OPX 900 nm band from 95, 96% PL. In OL-bearing mixtures, OL detection limit is 2% when mixed with PL1, and 3% and 4% if mixed with PL2 and PL3. We also demonstrated how spectral parameters vary with PL%, and, generally, increasing the PL content: (1) 1250 nm band depth decreases when mixed with OL, while it deepens in mixtures with PX; (2) 1250 nm band centers generally move towards longer wavelength for PL1-bearing mixtures, while do not show significant variations considering PL2/PL3-mixtures; (3) 1250 nm band width of PL1 in E1 and E5-mixtures substantially widens while in other mixtures it only slightly varies. Here we also proposed an application to a real case, from Proclus crater, revealing how studying terrestrial analogues is fundamental to infer hypothesis on the mineralogical composition of a planetary surface, but also how the spectral convergence of spectra characterized by different compositions can led to misleading interpretations

Management of perforated diverticulitis with generalized peritonitis. a multidisciplinary review and position paper

La diverticolite perforata è una condizione clinica emergente e la sua gestione è impegnativa e ancora dibattuta. Lo scopo di questo documento di posizione era di rivedere criticamente le prove disponibili sulla gestione della diverticolite perforata e della peritonite generalizzata al fine di fornire suggerimenti basati sull'evidenza per una strategia di gestione. Quattro società scientifiche italiane (SICCR, SICUT, SIRM, AIGO), esperti selezionati che hanno identificato 5 temi clinicamente rilevanti nella gestione della diverticolite perforata con peritonite generalizzata che trarrebbero beneficio da una revisione multidisciplinare. Sono state affrontate le seguenti 5 problematiche: 1) Criteri per decidere tra trattamento conservativo e chirurgico in caso di diverticolite perforata con peritonite; 2) Criteri o sistema di punteggio per scegliere l'opzione chirurgica più appropriata quando è confermata la peritonite diffusa 3); La procedura chirurgica appropriata in pazienti emodinamicamente stabili o stabilizzati con peritonite diffusa; 4) La procedura chirurgica appropriata per i pazienti con peritonite generalizzata e shock settico e 5) Terapia medica ottimale in pazienti con peritonite generalizzata da perforazione diverticolare prima e dopo l'intervento chirurgico. Nella diverticolite perforata la chirurgia è indicata in caso di peritonite diffusa o fallimento della gestione conservativa e la decisione di operare non è basata sulla presenza di aria extraluminale. Se la peritonite diffusa è confermata, la scelta della tecnica chirurgica si basa sui risultati intraoperatori e sulla presenza o il rischio di shock settico grave. Ulteriori fattori prognostici da considerare sono lo squilibrio fisiologico, l'età, le comorbidità e lo stato immunitario. Nei pazienti emodinamicamente stabili, la laparoscopia di emergenza presenta vantaggi rispetto alla chirurgia a cielo aperto. Le opzioni includono resezione e anastomosi, procedura di Hartmann o lavaggio laparoscopico. Nella peritonite generalizzata con shock settico, è preferibile un approccio chirurgico aperto. La resezione non restaurativa e / o la chirurgia per il controllo del danno sembrano essere le uniche opzioni praticabili, a seconda della gravità dell'instabilità emodinamica. La gestione medica multidisciplinare dovrebbe essere applicata con gli obiettivi principali di controllare l'infezione, alleviare il dolore postoperatorio e prevenire e / o trattare ileo postoperatorio. In conclusione, la complessità e la diversità dei pazienti con perforazione diverticolare e peritonite diffusa richiede una strategia personalizzata, che preveda un'accurata classificazione dello squilibrio fisiologico, la stadiazione dell'infezione intra-addominale e la scelta della procedura chirurgica più appropriata.Perforated diverticulitis is an emergent clinical condition and its management is challenging and still debated. The aim of this position paper was to critically review the available evidence on the management of perforated diverticulitis and generalized peritonitis in order to provide evidence-based suggestions for a management strategy. Four Italian scientific societies (SICCR, SICUT, SIRM, AIGO), selected experts who identified 5 clinically relevant topics in the management of perforated diverticulitis with generalized peritonitis that would benefit from a multidisciplinary review. The following 5 issues were tackled: 1) Criteria to decide between conservative and surgical treatment in case of perforated diverticulitis with peritonitis; 2) Criteria or scoring system to choose the most appropriate surgical option when diffuse peritonitis is confirmed 3); The appropriate surgical procedure in hemodynamically stable or stabilized patients with diffuse peritonitis; 4) The appropriate surgical procedure for patients with generalized peritonitis and septic shock and 5) Optimal medical therapy in patients with generalized peritonitis from diverticular perforation before and after surgery. In perforated diverticulitis surgery is indicated in case of diffuse peritonitis or failure of conservative management and the decision to operate is not based on the presence of extraluminal air. If diffuse peritonitis is confirmed the choice of surgical technique is based on intraoperative findings and the presence or risk of severe septic shock. Further prognostic factors to consider are physiological derangement, age, comorbidities, and immune status. In hemodynamically stable patients, emergency laparoscopy has benefits over open surgery. Options include resection and anastomosis, Hartmann’s procedure or laparoscopic lavage. In generalized peritonitis with septic shock, an open surgical approach is preferred. Non-restorative resection and/or damage control surgery appear to be the only viable options, depending on the severity of hemodynamic instability. Multidisciplinary medical management should be applied with the main aims of controlling infection, relieving postoperative pain and preventing and/or treating postoperative ileus. In conclusion, the complexity and diversity of patients with diverticular perforation and diffuse peritonitis requires a personalized strategy, involving a thorough classification of physiological derangement, staging of intra-abdominal infection and choice of the most appropriate surgical procedure

VNIR spectroscopy of rock forming minerals mixtures: a tool to interpret planetary igneous compositions

Visible and Near Infrared (VNIR) spectroscopy is a powerful technique to investigate and map the mineralogical composition of a Solar System body. Laboratory activities, measuring and analyzing minerals and their mixtures, rock powders and slabs, varying the particle and grain sizes, permit to improve the confidence on the spectra.s interpretation. Here we summarized a set of activity on spectral mixtures between plagioclases and mafic materials at 63-125 and 125-250 µm: illustrating the spectral variations due to the different intensity of the plagioclase absorption varying it Fe2+ content once mixed with orthopyroxene - clinopyroxene, orthopyroxene - olivine poor and - olivine rich materials (Serventi et al., 2013); an IMSA (Hapke, 1993) application to retrieve the endmember.s optical constants and to model the relative mineral abundances in intimate mixtures (Ciarniello et al., 2011) highlighting the influence of the mineral distributions (Carli et al., 2014); a spectra deconvolution with Modified Gaussians (MGM, Sunshine et al., 1990) to define spectral parameters (Band Center, Depth and Width) trends respect to the mineralogical composition of endmembers (mineral chemistry) and mixtures (mineral abundances). Also discussing the influence of the sizes (Serventi et al., 2015)

Nonequilibrium superconducting thin films with sub-gap and pair-breaking photon illumination

We calculate nonequilibrium quasiparticle and phonon distributions for a number of widely-used low transition temperature thin-film superconductors under constant, uniform illumination by sub-gap probe and pair-breaking signal photons simultaneously. From these distributions we calculate material-characteristic parameters that allow rapid evaluation of an effective quasiparticle temperature using a simple analytical expression, for all materials studied (Mo, Al, Ta, Nb, and NbN) for all photon energies. We also explore the temperature and energy-dependence of the low-energy quasiparticle generation efficiency $\eta$ by pair-breaking signal photons finding $\eta \approx 0.6$ in the limit of thick films at low bath temperatures that is material-independent. Taking the energy distribution of excess quasiparticles into account, we find $\eta \to 1$ as the bath temperature approaches the transition temperature in agreement with the assumption of the two-temperature model of the nonequilibrium response that is appropriate in that regime. The behaviour of $\eta$ with signal frequency scaled by the superconducting energy gap is also shown to be material-independent, and is in qualitative agreement with recent experimental results. An enhancement of $\eta$ in the presence of sub-gap (probe) photons is shown to be most significant at signal frequencies near the superconducting gap frequency and arises due to multiple photon absorption events that increase the average energy of excess quasiparticles above that in the absence of the probe.This is the author accepted manuscript. The final version is available via IOP Science at http://iopscience.iop.org/0953-2048/28/5/054002/

11^{11}B NMR study of pure and lightly carbon doped MgB2_2 superconductors

We report a $^{11}$B NMR line shape and spin-lattice relaxation rate ($1/(T_1T)$) study of pure and lightly carbon doped MgB$_{2-x}$C$_{x}$ for $x=0$, 0.02, and 0.04, in the vortex state and in magnetic field of 23.5 kOe. We show that while pure MgB$_2$ exhibits the magnetic field distribution from superposition of the normal and the Abrikosov state, slight replacement of boron with carbon unveils the magnetic field distribution of the pure Abrikosov state. This indicates a considerable increase of $H_{c2}^c$ with carbon doping with respect to pure MgB$_2$. The spin-lattice relaxation rate $1/(T_1T)$ demonstrates clearly the presence of a coherence peak right below $T_c$ in pure MgB$_2$, followed by a typical BCS decrease on cooling. However, at temperatures lower than $\approx 10$K strong deviation from the BCS behavior is observed, probably from residual contribution of the vortex dynamics. In the carbon doped systems both the coherence peak and the BCS temperature dependence of $1/(T_1T)$ weaken, an effect attributed to the gradual shrinking of the $\sigma$ hole cylinders of the Fermi surface with electron doping.Comment: 8 pages, 6 figures, submitted to Phys. Rev.