“I want to shake your hand before …”: The role of clients, knowledge exchange and market dynamics in southern Italian software firms

This study aims to assess the importance of clients in multi-scalar networks leading to learning competence and knowledge exchange. Furthermore, the difficulties encountered by firms located in a peripheral and marginally innovative area in signing commercial agreements with partners located in distant regions are tackled. Our findings, based on qualitative interviews, reveal that clients are considered to be the most important partners by the founders, owners and professionals of software firms located in the marginally innovative province of Lecce (southeastern Italy). Furthermore, being located in a peripheral area is not seen as a limitation from the technical–infrastructural viewpoint thanks to the opportunity offered by new technologies (e.g. the Internet) and computer-mediated communications. Conversely, the contracting of business agreements with partners located in distant markets is negatively influenced by the geographical distance from potential clients due to the need for previous acquaintance or face-to-face contact engendering trust.publishedVersio

Caribbean Plate margin evolution: constraints and current problems

Oceanic crust was generated at multiple spreading centres during the Jurassic and Early Cretaceous, forming a “proto-Caribbean” oceanic domain. During the Cretaceous, part of that crustal domain thickened into an oceanic plateau, of petrologic Mid-Ocean Ridge (MOR) to Ocean Island Basalt (OIB) affinity. Simultaneously, the South and North American continental plates developed rifting and tholeiitic magmatism in the Middle America region (Venezuela and Cuba). The rifting created space for the proto-Caribbean oceanic domain. Petrological and regional correlations suggest that, beginning in the Cretaceous, the proto-Caribbean domain was involved into two main stages of subduction, referred to as first and second “eo-Caribbean” phases. Each phase is characterized by oblique convergence. The older (mid-Cretaceous) stage, involved in subduction (probably eastward dipping) of thin proto-Caribbean lithosphere, with generation of Island Arc Tholeiitic (IAT) and Calc-Alkaline (CA) magmatism, accompanied by high pressure - low temperature (HP - LT) metamorphic effects, and formation of arc units and ophiolitic melanges (Guatemala, Cuba, Hispaniola and Puerto Rico, in the northern margin; Venezuela in the southern). The Late Cretaceous second stage consisted of westward dipping intra-oceanic subduction; it is recorded by tonalitic arc magmatism related to the onset of the Aves - Lesser Antilles arc system. Since the Late Cretaceous, the inner undeformed portions of the Caribbean oceanic plateau (i.e. the Colombian and Venezuelan Basins) were trapped east of the Pacific subduction of the Chortis, Chorotega and Choco blocks, ultimately building the Central American Isthmus. From Tertiary to Present, continuous eastward movement of the Caribbean Plate with respect to the Americas, gave rise to transpression along both the northern and southern margins, marked by scattered and dismembered ophiolitic terranes

Source and dynamics of a volcanic caldera unrest : Campi Flegrei, 1983–84

Acknowledgements We thank Tiziana Vanorio, Antonella Amoruso, Luca Crescentini, Nicholas Rawlinson, Yasuko Takei, and David Cornwell for the valuable suggestions regarding the methodology and interpretation. Reviews from Tim Greenfield and two anonymous reviewers helped improving both clarity of the manuscript and interpretation. The Royal Society of Edinburgh - Accademia dei Lincei Bilateral Agreement, the Santander Mobility Award of the College of Physical Sciences, University of Aberdeen, and the TIDES EU COST action granted L.D.S. travel grants for the realisation of this study. E.D.P. has been supported by the EPHESTO and KNOWAVES projects, funded by the Spanish Ministry of Education and Science.Peer reviewedPublisher PD

Neoadjuvant treatment in pancreatic cance. Evidence-based medicine? A systematic review and meta-analysis

Neoadjuvant treatment in non-metastatic pancreatic cancer (PaC) has the theoretical advantages of downstaging the tumor, sterilizing any present systemic undetectable disease, selecting patients for surgery and administering therapy to each patient. The aim of this systematic review is to analyze the state of the art on neoadjuvant protocols for non-metastatic PaC. A literature search over the last 10 years was conducted, and papers had to be focused on resectable, borderline resectable (BLR) or locally advanced (LA) histo- or cytologically proven PaC; to be prospective studies or prospectively collected databases; to report percentage of protocol achievement and survival data at least in an intention-to-treat (ITT) analysis. Twelve studies were eligible for systematic review. Studies included a total of 624 patients: 248 resectable, 268 BLR, 71 LA and 37 non-specified. All studies were included for meta-analysis. ITT overall survival (OS) was 16.7 months (95% CI 15.16-18.26 months); for resected patients OS was 22.78 months (95% CI 20.42-25.16), and for eventually non-resected patients it was 9.89 months (95% CI 8.84-10.96). Neoadjuvant approaches for resectable, BLR and LA PaC are spreading. Outcomes tend to be better outside an RCT context, but strong evidences are lacking. Actually such treatments should be performed only in a randomized clinical trial setting

Preoperative anxiety during COVID-19 pandemic: A single-center observational study and comparison with a historical cohort

Background: Preoperative anxiety is a common sensation experienced by patients undergoing surgical interventions. It can influence intraoperative and postoperative management through the activation of the neuroendocrine system, leading to tachycardia, hypertension, pulmonary complications, higher consumption of anesthetic drugs, and increased postoperative pain. Our aim was to investigate the level of preoperative anxiety during the COVID-19 pandemic; we also compared it to the preoperative anxiety of a historical cohort before the outbreak. Methods: This is a single-center observational study. We enrolled 314 patients during the pandemic from May 2021 to November 2021, and our historical cohort consisted of 122 patients enrolled from July 2015 to May 2016 in the university hospital "Federico II" of Naples. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) and the State-Trait Anxiety Inventory (STAI) were used to evaluate preoperative anxiety. In particular, APAIS measures preoperative anxiety and the need for information, and STAI assesses state and trait anxiety through STAI-Y1 and STAI-Y2, respectively. We analyzed APAIS and STAI scores in our population stratified on the basis of age, gender, marital status, previous surgical experiences, and type of surgery, and we compared them to our historical cohort. Statistical analysis was performed through a t-test and ANOVA for parametric data, and the Mann-Whitney and Kruskal-Wallis tests for non-parametric data. Linear regression was used to investigate the correlation between demographic data and the scores of STAI and APAIS in both groups. Results: Our results showed that state and preoperative anxiety remained stable, whereas trait anxiety increased in all the subgroups analyzed. Discussion: Even if state anxiety is considered a variable characteristic of the emotional sphere and trait anxiety a stable element, our findings suggested that COVID-19 deeply influenced trait anxiety, thus altering the patients' psychological foundations

Impact of sarcopenia on outcomes after pancreatectomy for malignancy

Background: Sarcopenia, which is a subclinical loss of skeletal muscle mass as measured by cross-sectional imaging, is commonly observed in patients with malignancy. Few studies have examined the association between the presence of sarcopenia and outcome following surgery. The aim of this study is to evaluate the prevalence of sarcopenia and to investigate its impact on short- and long-term outcomes in patients who underwent pancreatectomy for malignancy. Materials and Methods: A retrospective review of a pancreatectomy database was performed. Skeletal muscle index (SMI) was measured on preoperative cross-sectional imaging in 144 patients undergoing pancreatectomy for cancer between 2007 and 2014. Sarcopenia was defined, according to the international consensus, as an SMI <52.4 cm2 /m2 and <38.9 cm2 /m2 for men and women respectively. The prevalence and impact of sarcopenia on morbidity, mortality, disease-free and overall survivals was assessed relative to other clinicopathological factors. Results: Mean age was 67.15 years and 51% was female. Pancreatic adenocarcinoma represents 66.7% of all cases. Pancreaticoduodenectomy was performed in 114 cases (79.2%). Margin status was R0 in 76.9%. Mean BMI was 24.85 Kg/m2 and mean SMI was 35,43 cm2 /m2 . One hundred and eight (74.5%) were sarcopenic, 37 (43.5%) were overweight/ obese and 43 (29.7%) were both (p = 0.041). Sarcopenia was significantly related to histology, sex, BMI and albumin. Overall morbidity and 90-days mortality were 50.7% and 9.1% respectively. The median follow up was 21 months. Overall and disease-free survival rate were 25,44 months and 11,84 months respectively. Sarcopenia was associated to a not statistically significant increased risk of overall morbidity, mortality and shorter disease- free and overall survivals after pancreatic surgery for cancer. Conclusions: Sarcopenia was found in 74.5% of cancer patients underwent pancreatectomy. It is an occult condition in overweight/obese patients but can be identified using CT scans. This condition, as defined by international consensus, is not associated with worse short-term and long-term outcomes after surgery

translational challenges from the 2014 gastrointestinal cancers symposium toward a true tailored therapy through effective research

Gastrointestinal Cancers Symposium 2014, San Francisco, CA, USA, 16–18 January 2014 The Gastrointestinal Cancers Symposium represents an indisputable occasion for sharing results and research opportunities for investigators around the globe. Across the years along with clinical trials presentations the meeting increasingly acquired a distinct role as a scientific arena for translational research. Also, this year the need for predictive markers for first-generation targeted agents and research about novel biologically driven therapeutic options characterized most of the studies presented. We focus here on reports from the 2014 American Society of Clinical Oncology (ASCO) Gastrointestinal Cancers Symposium indicating an opportunity for biological selection of either the pharmacological target or the patient population in order to enhance clinical outcome

Prognostic significance of KRAS mutation rate in metastatic colorectal cancer patients.

No abstract availabl

Attitudes of university students towards mandatory COVID-19 vaccination policies. A cross-sectional survey in Rome, Italy

Mandatory vaccination (MV) against COVID-19 is a contentious topic. In this study, we used logistic regression models to identify attitudes among Sapienza University students towards MV for COVID-19. We considered three different scenarios: mandatory COVID-19 vaccination (MCV) for healthcare workers (HCWs) (Model 1), for all people aged ≥ 12 years (Model 2), and for admission to schools and universities (Model 3). We collected 5287 questionnaires over a six-month period and divided these into three groups (September-October 2021, November-December 2021, and January-February 2022). MCV for HCWs was the most strongly supported policy (69.8% in favour), followed by MCV for admission to schools and universities (58.3%), and MCV for the general population (54.6%). In a multivariable analysis, the models showed both similarities and differences. There was no association of socio-demographic characteristics with the outcomes, apart from being enrolled in non-healthcare courses, which negatively affected Models 2 and 3. A greater COVID-19 risk perception was generally associated with a more positive attitude towards MCV, although heterogeneously across models. Vaccination status was a predictor of being in favour of MCV for HCWs, whereas being surveyed in November-February 2022 favoured MCV for admission to schools and universities. Attitudes towards MCV were variable across policies; thus, to avoid unintended consequences, these aspects should be carefully considered by policymakers