The Role of Public Governance in the Pursuit of Sustainable Development of the ILVA Steel Plant: An Interpretative Framework

The aim of this paper was to investigate the role of public institutions in the pursuit of sustainable development in a case study of international relevance: Taranto’s ILVA steel plant, which is one of the biggest steel and iron centres in Europe. The case study was analysed through investigating the dierent aspects of sustainable development in the four phases of development of the steel plant, from public direct management to private management. The analysis, based on a series of unstructured data, was carried out by applying a triple bottom line approach and the total interpretative structuring model (TISM). Evidence shows how—in the absence of stable, coherent, strong and present public institutions, capable of reading the forces of the local and international context and of intervening with regulatory actions inspired by a planned and interiorized economic strategy—the market, left in the hands of the private entrepreneur only, is destined to fail, and the paths of multidimensional sustainable development stray away from the ambitions of modern states

Acute appendicitis in infants

Acute appendicitis is very uncommon in the first year of life and often its presentation is atypical with high risk of complications. Hereby, we present 4 clinical cases of infants, who were diag- nosed with acute appendicitis in our hospital over the last year. The reported clinical cases high- light the several drawbacks clinicians face when managing infants with symptoms suggestive for acute appendicitis. After specific diagnostic work-up, even if not conclusive, patients were intra- operatively diagnosed with acute appendicitis and underwent appendicectomy. Maintaining a high index of suspicion for acute appendicitis in infants presenting with intra-abdominal sepsis of unclear etiology is, in our opinion, the most crucial factor to avoid complications and longer hospitalization

Progetto ImmaginAzione

Questo è il progetto realizzato per l'hackaton 2020+20, svoltosi nell'ambito del Festival della Partecipazione di Bologna. L'obiettivo è immaginare lo scenario di un futuro desiderabile, in linea con le necessità del nostro tempo e con le necessità che crediamo saranno rilevanti nel futuro. Il progetto affronta i temi della relazione città campagna, cittadinanza e comunità, governo, istruzione, mobilità, sanità e ambiente, e prevede: 1. Analisi del contesto attuale 2. Scenario che si desidera realizzare nel 2040 3. Scenario intermedio al 2030 4. Azioni che le istituzioni e la cittadinanza devono porre in essere per passare dall’analisi del contesto attuale allo scenario 2030 5. Azioni che le istituzioni e la cittadinanza devono porre in essere per passare dallo scenario 2030 allo scenario 204

Chemical and physical analysis of phaco handpiece tip surfaces before and after cataract\ua0surgery

PURPOSE: To evaluate the surface chemical composition and roughness of different phaco tips before and after their use during cataract surgery. SETTING: Eye Clinic, University of Trieste, Trieste, Italy. DESIGN: Experimental study. METHODS: Of the 66 tips studied, 33 (15 new, 15 after single use, and 3 after multiple uses) were studied with X-ray photoemission spectroscopy and 33 (15 new, 15 after single use, and 3 after multiple uses) were examined using scanning electron microscopy with energy dispersive X-ray spectroscopy analysis and contact profilometry. All analyses were performed on the far end of the tip. RESULTS: Used phaco tips showed signs of wear at the end of the tip, with the deposition of debris. The cutting edge appeared to be rounded and irregular. After surgery, an increase in the surface roughness was detected. The chemical analyses showed modification of the superficial alloy composition and the biological origin of some debris deposited after surgery. The deterioration and wear observed were more remarkable after multiple surgical procedures. CONCLUSIONS: Used phaco tips showed relevant signs of deterioration and deposition of biological material, mostly involving the cutting edge. Reusable tips might release remnants of previous procedures. The adoption of single-use disposable phaco tips seems to be highly advisable

Prognosis of screen-detected breast cancers: results of a population based study

BACKGROUND: The reduced mortality rate from breast carcinoma among women offered screening mammography is demonstrated after 15–20 years of follow-up. However, the assessment of 5-year overall and event-free survival could represent an earlier measure of the efficacy of mammography screening program (MSP). METHODS: All cases of breast cancer diagnosed in the Province of Modena between years 1996 and 2000 in women aged 50 to 69 years, were identified through the Modena Cancer Registry (MCR). Stage of disease and treatment information were obtained from clinical records. All the events occurring up to June 30, 2003 were retrieved by experienced monitors. Five-year overall and event-free survival were the principal end-points of the study. RESULTS: During a 5-year period, 587 primary breast cancers were detected by the MSP and 471 primary breast cancers were diagnosed out of the MSP. The screen-detected breast cancers were smaller, more likely node negative, with low histological grade, low proliferative activity and positive receptors status. Furthermore, the breast cancer diagnosed through the MSP more frequently received a conservative surgery. The 5-year survival rate was 94% in the screen-detected group, versus 84% in the other group (p = 0.0001). The rate of 5-year event-free survival was 89% and 75% for the MSP participants and not participants, respectively (p = 0.0001). CONCLUSIONS: Our data confirm a favourable outcome of screen-detected breast cancers in terms of five-year overall and event-free survival, which reflect the good quality assurance parameters of the MSP. Finally, a cancer registry should be implemented in every area covered by screening programs

Italian guidelines for the management of irritable bowel syndrome: Joint Consensus from the Italian Societies of: Gastroenterology and Endoscopy (SIGE), Neurogastroenterology and Motility (SINGEM), Hospital Gastroenterologists and Endoscopists (AIGO), Digestive Endoscopy (SIED), General Medicine (SIMG), Gastroenterology, Hepatology and Pediatric Nutrition (SIGENP) and Pediatrics (SIP)

The irritable bowel syndrome (IBS) is a chronic disorder of gut-brain interaction. IBS is still associated with areas of uncertainties, especially regarding the optimal diagnostic work-up and the more appropriate management. Experts from 7 Italian Societies conducted a Delphi consensus with literature summary and voting process on 27 statements. Recommendations and quality of evidence were evaluated using the grading of recommendations, assessment, development, and evaluation (GRADE) criteria. Consensus was defined as >80% agreement and reached for all statements.In terms of diagnosis, the consensus supports a positive diagnostic strategy with a symptom-based approach, including the psychological comorbidities assessment and the exclusion of alarm symptoms, together with the digital rectal examination, full blood count, C- reactive protein, serology for coeliac disease, and fecal calprotectin assessment. Colonoscopy should be recommended in patients with alarm features. Regarding treatment, the consensus strongly supports a dietary approach for patients with IBS, the use of soluble fiber, secretagogues, tricyclic antidepressants, psychologically directed therapies and, only in specific IBS subtypes, rifaximin. A conditional recommendation was achieved for probiotics, polyethylene glycol, antispasmodics, selective serotonin reuptake inhibitors and, only in specific IBS subtypes, 5-HT3 antagonists, 5-HT4 agonists, bile acid sequestrants

Clinical Features, Cardiovascular Risk Profile, and Therapeutic Trajectories of Patients with Type 2 Diabetes Candidate for Oral Semaglutide Therapy in the Italian Specialist Care

Introduction: This study aimed to address therapeutic inertia in the management of type 2 diabetes (T2D) by investigating the potential of early treatment with oral semaglutide. Methods: A cross-sectional survey was conducted between October 2021 and April 2022 among specialists treating individuals with T2D. A scientific committee designed a data collection form covering demographics, cardiovascular risk, glucose control metrics, ongoing therapies, and physician judgments on treatment appropriateness. Participants completed anonymous patient questionnaires reflecting routine clinical encounters. The preferred therapeutic regimen for each patient was also identified. Results: The analysis was conducted on 4449 patients initiating oral semaglutide. The population had a relatively short disease duration (42%  60% of patients, and more often than sitagliptin or empagliflozin. Conclusion: The study supports the potential of early implementation of oral semaglutide as a strategy to overcome therapeutic inertia and enhance T2D management