A PLS PATH MODEL TO INVESTIGATE THE RELATIONS BETWEEN INSTITUTIONS AND HUMAN DEVELOPMENT

The paper studies the relations between types of institutions on different components of human development. A role of aggregate demand in determining the material components of human development is assumed. We thus divide institutions into those that create demand and those that are determined by the whole process of development. Similarly we divide human development in its three traditional components (economic development, health, knowledge). Both human development and institutions are assumed as multidimensional constructs; all the main components of these constructs are defined as latent variables, and the relations between them as structural relations. A Partial Least Squares (PLS) path model is developed: it is the aggregation (and simultaneous estimation) of an outer model relating observed or manifest variables to their own latent variable and of a structural model (inner model) relating some endogenous latent variable to other latent variables. From the goodness of fit point of view, our results seem to validate our theoretical assumptions.Structural Equations Models, Institutions, Human Development

Learning from the COVID-19 pandemic in Italy to advance multi-hazard disaster risk management

COVID-19 challenged all national emergency management systems worldwide overlapping with other natural hazards. We framed a ‘parallel phases’ Disaster Risk Management (DRM) model to overcome the limitations of the existing models when dealing with complex multi-hazard risk conditions. We supported the limitations analysing Italian Red Cross data on past and ongoing emergencies including COVID-19 and we outlined three guidelines for advancing multi-hazard DRM: (i) exploiting the low emergency intensity of slow-onset hazards for preparedness actions; (ii) increasing the internal resources and making them available for international support; (iii) implementing multi-hazard seasonal impact-based forecasts to foster the planning of anticipatory actions

F18-FDG-PET/CT in a patient affected by Lynch syndrome

Lynch syndrome (LS) is the most common hereditary syndrome that predisposes patients to colorectal cancer, and it accounts for 2–5% of the total burden of colorectal cancer. We report a case of a 61-year-old female affected by Lynch syndrome who underwent multiple adenocarcinoma resections, studied by F18-FDG-PET/CT for 5 years. This case report suggests a potential role of F18-FDG-PET/CT in the evaluation of patients affected by Lynch syndrome. Nuclear Med Rev 2010; 13, 2: 87–8

Multi-risk assessment in mountain regions: A review of modelling approaches for climate change adaptation

Climate change has already led to a wide range of impacts on our society, the economy and the environment.According to future scenarios, mountain regions are highly vulnerable to climate impacts, including changes in the water cycle (e.g. rainfall extremes, melting of glaciers, river runoff), loss of biodiversity and ecosystems services, damages to local economy (drinking water supply, hydropower generation, agricultural suitability) and human safety (risks of natural hazards). This is due to their exposure to recent climate warming (e.g. temperature regime changes, thawing of permafrost) and the high degree of specialization of both natural and human systems (e.g. mountain species, valley population density, tourism-based economy). These characteristics call for the application of risk assessment methodologies able to describe the complex interactions among multiple hazards, biophysical and socio-economic systems, towards climate change adaptation.Current approaches used to assess climate change risks often address individual risks separately and do not fulfil a comprehensive representation of cumulative effects associated to different hazards (i.e. compound events). Moreover, pioneering multi-layer single risk assessment (i.e. overlapping of single-risk assessments addressing different hazards) is still widely used, causing misleading evaluations of multi-risk processes. This raises key questions about the distinctive features of multi-risk assessments and the available tools and methods to address them.Here we present a review of five cutting-edge modelling approaches (Bayesian networks, agent-based models, system dynamic models, event and fault trees, and hybrid models), exploring their potential applications for multi-risk assessment and climate change adaptation in mountain regions.The comparative analysis sheds light on advantages and limitations of each approach, providing a roadmap for methodological and technical implementation of multi-risk assessment according to distinguished criteria (e.g. spatial and temporal dynamics, uncertainty management, cross-sectoral assessment, adaptation measures integration, data required and level of complexity). The results show limited applications of the selected methodologies in addressing the climate and risks challenge in mountain environments. In particular, system dynamic and hybrid models demonstrate higher potential for further applications to represent climate change effects on multi-risk processes for an effective implementation of climate adaptation strategies

Spinal surgery complications: an unsolved problem—Is the World Health Organization Safety Surgical Checklist an useful tool to reduce them?

Abstract Purpose To investigate whether the World Health Organization Safety Surgical Checklist (SSC) is an effective tool to reduce complications in spinal surgery. Methods We retrospectively evaluated the clinical and radiological charts prospectively collected from patients who underwent a spinal surgery procedure from January 2010 to December 2012. The aim of this study was to compare the incidence of complications between two periods, from January to December 2010 (without checklist) and from January 2011 and December 2012 (with checklist), in order to assess the checklist's effectiveness. Results The sample size was 917 patients with an average of 30-month follow-up. The mean age was 52.88 years. The majority of procedures were performed for oncological diseases (54.4%) and degenerative diseases (39.8%). In total, 159 complications were detected (17.3%). The overall incidence of complications for trauma, infectious pathology, oncology, and degenerative disease was 22.2%, 19.2%, 18.4%, and 15.3%, respectively. No correlation was observed between the type of pathology and the complication incidence. We observed a reduction in the overall incidence of complications following the introduction of the SSC: In 2010 without checklist, the incidence of complications was 24.2%, while in 2011 and 2012, following the checklist introduction, the incidence of complications was 16.7% and 11.7%, respectively (mean 14.2%). Conclusions The SSC seems to be an effective tool to reduce complications in spinal surgery. We propose to extend the use of checklist system also to the preoperative and postoperative phases in order to further reduce the incidence of complications. Graphic abstract These slides can be retrieved under Electronic Supplementary Material

Carbon Fiber-Reinforced PolyEtherEtherKetone (CFR-PEEK) Instrumentation in Degenerative Disease of Lumbar Spine: A Pilot Study

: CFR-PEEK is gaining popularity in spinal oncological applications due to its reduction of imaging artifacts and radiation scattering compared with titanium, which allows for better oncological follow-up and efficacy of radiotherapy. We evaluated the use of these materials for the treatment of lumbar degenerative diseases (DDs) and considered the biomechanical potential of the carbon fiber in relation to its modulus of elasticity being similar to that of bone. Twenty-eight patients with DDs were treated using CRF-PEEK instrumentation. The clinical and radiographic outcomes were collected at a 12-month FU. Spinal fusion was evaluated in the CT scans using Brantigan scores, while the clinical outcomes were evaluated using VAS, SF-12, and EQ-5D scores. Out of the patients evaluated at the 12-month FU, 89% showed complete or almost certain fusion (Brantigan score D and E) and presented a significant improvement in all clinical parameters; the patients also presented VAS scores ranging from 6.81 ± 2.01 to 0.85 ± 1.32, EQ-5D scores ranging from 53.4 ± 19.3 to 85.0 ± 13.7, SF-12 physical component scores (PCSs) ranging from 29.35 ± 7.04 to 51.36 ± 9.75, and SF-12 mental component scores (MCSs) ranging from 39.89 ± 11.70 to 53.24 ± 9.24. No mechanical complications related to the implant were detected, and the patients reported a better tolerance of the instrumentation compared with titanium. No other series of patients affected by DD that was stabilized using carbon fiber implants have been reported in the literature. The results of this pilot study indicate the efficacy and safety of these implants and support their use also for spinal degenerative diseases

Denosumab in patients with aneurysmal bone systs: A case series with preliminary results

Abstract PURPOSE:: Aneurysmal bone cyst (ABC) is a rare skeletal tumor usually treated with surgery/embolization. We hypothesized that owing to similarities with giant cell tumor of bone (GCTB), denosumab was active also in ABC. METHODS:: In this observational study, a retrospective analysis of ABC patients treated with denosumab was performed. Patients underwent radiologic disease assessment every 3 months. Symptoms and adverse events were noted. RESULTS:: Nine patients were identified (6 male, 3 female), with a median age of 17 years (range 14-42 years). Primary sites were 6 spine-pelvis, 1 ulna, 1 tibia, and 1 humerus. Patients were followed for a median time of 23 months (range 3-55 months). Patients received a median of 8 denosumab administrations (range 3-61). All symptomatic patients had pain relief and 1 had paresthesia improvement. Signs of denosumab activity were observed after 3 to 6 months of administration: bone formation by computed tomography scan was demonstrated in all patients and magnetic resonance imaging gadolinium contrast media decrease was observed in 7/9 patients. Adverse events were negligible. At last follow-up, all patients were progression-free: 5 still on denosumab treatment, 2 off denosumab were disease-free 11 and 17 months after surgery, and the last 2 patients reported no progression 12 and 24 months after denosumab interruption and no surgery. CONCLUSIONS:: Denosumab has substantial activity in ABCs, with favorable toxicity profile. We strongly support the use of surgery and/or embolization for the treatment of ABC, but denosumab could have a role as a therapeutic option in patients with uncontrollable, locally destructive, or recurrent disease