In pursuit of visual attention: SSVEP frequency-tagging moving targets.

Previous research has shown that visual attention does not always exactly follow gaze direction, leading to the concepts of overt and covert attention. However, it is not yet clear how such covert shifts of visual attention to peripheral regions impact the processing of the targets we directly foveate as they move in our visual field. The current study utilised the co-registration of eye-position and EEG recordings while participants tracked moving targets that were embedded with a 30 Hz frequency tag in a Steady State Visually Evoked Potentials (SSVEP) paradigm. When the task required attention to be divided between the moving target (overt attention) and a peripheral region where a second target might appear (covert attention), the SSVEPs elicited by the tracked target at the 30 Hz frequency band were significantly, but transiently, lower than when participants did not have to covertly monitor for a second target. Our findings suggest that neural responses of overt attention are only briefly reduced when attention is divided between covert and overt areas. This neural evidence is in line with theoretical accounts describing attention as a pool of finite resources, such as the perceptual load theory. Altogether, these results have practical implications for many real-world situations where covert shifts of attention may discretely reduce visual processing of objects even when they are directly being tracked with the eyes

Managing Carbon Aspirations: The Influence of Corporate Climate Change Targets on Environmental Performance

Addressing climate change is among the most challenging ethical issues facing contemporary business and society. Unsustainable business activities are causing significant distributional and procedural injustices in areas such as public health and vulnerability to extreme weather events, primarily because of a distinction between primary emitters and those already experiencing the impacts of climate change. Business, as a significant contributor to climate change and beneficiary of externalizing environmental costs, has an obligation to address its environmental impacts. In this paper, we explore the role of firms’ climate change targets in shaping their emissions trends in the context of a large multi-country sample of companies. We contrast two intentions for setting emissions reductions targets: symbolic attempts to manage external stakeholder perceptions via “greenwashing” and substantive commitments to reducing environmental impacts. We argue that the attributes of firms’ climate change targets (their extent, form, and time horizon) are diagnostic of firms’ underlying intentions. Consistent with our hypotheses, while we find no overall effect of setting climate change targets on emissions, we show that targets characterized by a commitment to more ambitious emissions reductions, a longer target time frame, and absolute reductions in emissions are associated with significant reductions in firms’ emissions. Our evidence suggests the need for vigilance among policy-makers and environmental campaigners regarding the underlying intentions that accompany environmental management practices and shows that these can to some extent be diagnosed analytically

ITALIAN CANCER FIGURES - REPORT 2015: The burden of rare cancers in Italy = I TUMORI IN ITALIA - RAPPORTO 2015: I tumori rari in Italia

OBJECTIVES: This collaborative study, based on data collected by the network of Italian Cancer Registries (AIRTUM), describes the burden of rare cancers in Italy. Estimated number of new rare cancer cases yearly diagnosed (incidence), proportion of patients alive after diagnosis (survival), and estimated number of people still alive after a new cancer diagnosis (prevalence) are provided for about 200 different cancer entities. MATERIALS AND METHODS: Data herein presented were provided by AIRTUM population- based cancer registries (CRs), covering nowadays 52% of the Italian population. This monograph uses the AIRTUM database (January 2015), which includes all malignant cancer cases diagnosed between 1976 and 2010. All cases are coded according to the International Classification of Diseases for Oncology (ICD-O-3). Data underwent standard quality checks (described in the AIRTUM data management protocol) and were checked against rare-cancer specific quality indicators proposed and published by RARECARE and HAEMACARE (www.rarecarenet.eu; www.haemacare.eu). The definition and list of rare cancers proposed by the RARECAREnet "Information Network on Rare Cancers" project were adopted: rare cancers are entities (defined as a combination of topographical and morphological codes of the ICD-O-3) having an incidence rate of less than 6 per 100,000 per year in the European population. This monograph presents 198 rare cancers grouped in 14 major groups. Crude incidence rates were estimated as the number of all new cancers occurring in 2000-2010 divided by the overall population at risk, for males and females (also for gender-specific tumours).The proportion of rare cancers out of the total cancers (rare and common) by site was also calculated. Incidence rates by sex and age are reported. The expected number of new cases in 2015 in Italy was estimated assuming the incidence in Italy to be the same as in the AIRTUM area. One- and 5-year relative survival estimates of cases aged 0-99 years diagnosed between 2000 and 2008 in the AIRTUM database, and followed up to 31 December 2009, were calculated using complete cohort survival analysis. To estimate the observed prevalence in Italy, incidence and follow-up data from 11 CRs for the period 1992-2006 were used, with a prevalence index date of 1 January 2007. Observed prevalence in the general population was disentangled by time prior to the reference date (≤2 years, 2-5 years, ≤15 years). To calculate the complete prevalence proportion at 1 January 2007 in Italy, the 15-year observed prevalence was corrected by the completeness index, in order to account for those cancer survivors diagnosed before the cancer registry activity started. The completeness index by cancer and age was obtained by means of statistical regression models, using incidence and survival data available in the European RARECAREnet data. RESULTS: In total, 339,403 tumours were included in the incidence analysis. The annual incidence rate (IR) of all 198 rare cancers in the period 2000-2010 was 147 per 100,000 per year, corresponding to about 89,000 new diagnoses in Italy each year, accounting for 25% of all cancer. Five cancers, rare at European level, were not rare in Italy because their IR was higher than 6 per 100,000; these tumours were: diffuse large B-cell lymphoma and squamous cell carcinoma of larynx (whose IRs in Italy were 7 per 100,000), multiple myeloma (IR: 8 per 100,000), hepatocellular carcinoma (IR: 9 per 100,000) and carcinoma of thyroid gland (IR: 14 per 100,000). Among the remaining 193 rare cancers, more than two thirds (No. 139) had an annual IR <0.5 per 100,000, accounting for about 7,100 new cancers cases; for 25 cancer types, the IR ranged between 0.5 and 1 per 100,000, accounting for about 10,000 new diagnoses; while for 29 cancer types the IR was between 1 and 6 per 100,000, accounting for about 41,000 new cancer cases. Among all rare cancers diagnosed in Italy, 7% were rare haematological diseases (IR: 41 per 100,000), 18% were solid rare cancers. Among the latter, the rare epithelial tumours of the digestive system were the most common (23%, IR: 26 per 100,000), followed by epithelial tumours of head and neck (17%, IR: 19) and rare cancers of the female genital system (17%, IR: 17), endocrine tumours (13% including thyroid carcinomas and less than 1% with an IR of 0.4 excluding thyroid carcinomas), sarcomas (8%, IR: 9 per 100,000), central nervous system tumours and rare epithelial tumours of the thoracic cavity (5%with an IR equal to 6 and 5 per 100,000, respectively). The remaining (rare male genital tumours, IR: 4 per 100,000; tumours of eye, IR: 0.7 per 100,000; neuroendocrine tumours, IR: 4 per 100,000; embryonal tumours, IR: 0.4 per 100,000; rare skin tumours and malignant melanoma of mucosae, IR: 0.8 per 100,000) each constituted <4% of all solid rare cancers. Patients with rare cancers were on average younger than those with common cancers. Essentially, all childhood cancers were rare, while after age 40 years, the common cancers (breast, prostate, colon, rectum, and lung) became increasingly more frequent. For 254,821 rare cancers diagnosed in 2000-2008, 5-year RS was on average 55%, lower than the corresponding figures for patients with common cancers (68%). RS was lower for rare cancers than for common cancers at 1 year and continued to diverge up to 3 years, while the gap remained constant from 3 to 5 years after diagnosis. For rare and common cancers, survival decreased with increasing age. Five-year RS was similar and high for both rare and common cancers up to 54 years; it decreased with age, especially after 54 years, with the elderly (75+ years) having a 37% and 20% lower survival than those aged 55-64 years for rare and common cancers, respectively. We estimated that about 900,000 people were alive in Italy with a previous diagnosis of a rare cancer in 2010 (prevalence). The highest prevalence was observed for rare haematological diseases (278 per 100,000) and rare tumours of the female genital system (265 per 100,000). Very low prevalence (<10 prt 100,000) was observed for rare epithelial skin cancers, for rare epithelial tumours of the digestive system and rare epithelial tumours of the thoracic cavity. COMMENTS: One in four cancers cases diagnosed in Italy is a rare cancer, in agreement with estimates of 24% calculated in Europe overall. In Italy, the group of all rare cancers combined, include 5 cancer types with an IR>6 per 100,000 in Italy, in particular thyroid cancer (IR: 14 per 100,000).The exclusion of thyroid carcinoma from rare cancers reduces the proportion of them in Italy in 2010 to 22%. Differences in incidence across population can be due to the different distribution of risk factors (whether environmental, lifestyle, occupational, or genetic), heterogeneous diagnostic intensity activity, as well as different diagnostic capacity; moreover heterogeneity in accuracy of registration may determine some minor differences in the account of rare cancers. Rare cancers had worse prognosis than common cancers at 1, 3, and 5 years from diagnosis. Differences between rare and common cancers were small 1 year after diagnosis, but survival for rare cancers declined more markedly thereafter, consistent with the idea that treatments for rare cancers are less effective than those for common cancers. However, differences in stage at diagnosis could not be excluded, as 1- and 3-year RS for rare cancers was lower than the corresponding figures for common cancers. Moreover, rare cancers include many cancer entities with a bad prognosis (5-year RS <50%): cancer of head and neck, oesophagus, small intestine, ovary, brain, biliary tract, liver, pleura, multiple myeloma, acute myeloid and lymphatic leukaemia; in contrast, most common cancer cases are breast, prostate, and colorectal cancers, which have a good prognosis. The high prevalence observed for rare haematological diseases and rare tumours of the female genital system is due to their high incidence (the majority of haematological diseases are rare and gynaecological cancers added up to fairly high incidence rates) and relatively good prognosis. The low prevalence of rare epithelial tumours of the digestive system was due to the low survival rates of the majority of tumours included in this group (oesophagus, stomach, small intestine, pancreas, and liver), regardless of the high incidence rate of rare epithelial cancers of these sites. This AIRTUM study confirms that rare cancers are a major public health problem in Italy and provides quantitative estimations, for the first time in Italy, to a problem long known to exist. This monograph provides detailed epidemiologic indicators for almost 200 rare cancers, the majority of which (72%) are very rare (IR<0.5 per 100,000). These data are of major interest for different stakeholders. Health care planners can find useful information herein to properly plan and think of how to reorganise health care services. Researchers now have numbers to design clinical trials considering alternative study designs and statistical approaches. Population-based cancer registries with good quality data are the best source of information to describe the rare cancer burden in a population

A falling of the veils: turning points and momentous turning points in leadership and the creation of CSR

This article uses the life stories approach to leadership and leadership development. Using exploratory, qualitative data from a Forbes Global 2000 and FTSE 100 company, we discuss the role of the turning point (TP) as an important antecedent of leadership in corporate social responsibility. We argue that TPs are causally efficacious, linking them to the development of life narratives concerned with an evolving sense of personal identity. Using both a multi-disciplinary perspective and a multi-level focus on CSR leadership, we identify four narrative cases. We propose that they helped to re-define individuals’ sense of self and in some extreme cases completely transformed their self-identity as leaders of CSR. Hence we also distinguish the momentous turning point (MTP) that created a seismic shift in personality, through re-evaluation of the individuals’ personal values. We argue that whilst TPs are developmental experiences that can produce responsible leadership, the MTP changes the individuals’ personal priorities in life to produce responsible leadership that perhaps did not exist previously. Thus we appropriate Maslow’s (1976, p. 77) metaphorical phrase ‘A falling of the veils’ from his discussion of peak and desolation experiences that produce personal growth. Using a multi-disciplinary literature from social theory (Archer, 2012) moral psychology (Narvaez, 2009) and social psychology (Schwartz, 2010), we present a theoretical model that illustrates the psychological process of the (M)TP, thus contributing to the growing literature on the microfoundations of CSR

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Teachers’ feedback and children’s sociometrical status in primary school classes

Gli atteggiamenti e i comportamenti degli insegnanti sembrano influire sulla reputazione sociale dei bambini tra i compagni di classe. Questo studio ha l’obiettivo di verificare la relazione tra azioni compiute dall’insegnante e status sociometrico dei bambini, utilizzando il metodo osservativo. Hanno partecipato allo studio 54 bambini (40 maschi), con età media di 8 anni e 3 mesi e le loro insegnanti. Ai bambini sono state somministrate le nomine dei pari, al fine di categorizzarli nei gruppi di popolari, rifiutati e medi. Mediante una griglia osservativa i feedback forniti dalle insegnanti sono stati classificati in positivi, negativi, correttivi e neutri. I risultati mostrano che complessivamente le insegnanti utilizzano più feedback positivi rispetto a quelli delle altre categorie. Inoltre i feedback negativi sono rivolti ai bambini rifiutati più che ai popolari. Lo studio conferma dunque che esiste una relazione tra reputazione sociale tra i compagni di classe e comportamenti degli insegnanti nei confronti dei bambini

Glioblastoma in irradiated elderly patients: two case reports.

We report our experience with two elderly patients with histologically proven diagnosis of glioblastoma multiforme who were treated 25 and 18 years earlier for tinea capitis and scalp cutaneous hemangioma respectively in the same areas where the glioblastoma multiforme had grown. These pathologies were benign, and nowadays can be treated with alternative approaches rather than radiotherapy. Radiotherapeutic treatment should be carefully considered before using it in young patients with benign pathologies who have a long life expectancy and subsequently a higher risk of developing radio-induced malignant lesions. Radio-induced gliomas are typical of patients younger than the ones with "spontaneous" glioblastomas; however, the subjects of our study were elderly (78 and 72 years)

A rare case of Meckel's cave primary lymphoma: a case report and elaboration of the diagnostic algorithm

Management of lesions involving Meckel's cave can represent a challenge for neurosurgeons, because of the deep-seated location and the surrounding complex neurovascular structures. Very small lesions arising from MC are generally asymptomatic and radiological follow-up with head MRI and PET-CT is sufficient to control these lesions. In rare cases, the rapid increase in the size of lesions and the alteration of the neurologic status make early histological characterization mandatory in the plethora of lesions arising from Meckel's cave; a very small percentage is represented by central nervous system lymphomas. Primary diffuse large B-cell lymphoma is the most commonly found. Aggressive surgery, in case of suspicious Meckel's cave lesions, is strongly discouraged, because this procedure may increase the risk of postoperative deficit and provides no survival benefit compared with biopsy alone. The aim of the present paper is to report a very rare case of primary Meckel's cave diffuse large B-cell lymphoma (only seven cases were described in literature) and standardize an operative algorithm to avoid the risks of an incorrect surgical conduct

THE OCCIPITAL TRANS-TENTORIAL APPROACH TO PINEAL REGION TUMORS

BACKGROUND The Occipital Trans-Tentorial approach (OTT) to pineal region was popularized by Poppen in 1966. The 'so-called' Poppen's approach offers some unquestionable advantages in the treatment of those pineal tumors extending superioriorly above the tentorial edge, inferioriorly into the cerebellomesencephalic fissure and/or laterally beyond the medial borders of the tentorium. The authors report a step-by-step description of the OTT approach also highlighting the tips and the triks of this approach and the advantages related to a supratentorial surgical perspective to pineal area and posterior fossa. MATERIALS AND METHODS A stepwise description of the OTT approach has been reported. Some surgical cases from a personal series of 20 pineal tumors treated in a range period of 10 years (2004-2014) have been furthermore reviewed and discussed. RESULTS OTT approach involves a midline or L-shaped skin incision extending more above than below the inion to skeletonize the occipital squama and the external occipital protuberance. The inion serves as an important landmark to identify the torcular. A burr hole has to be placed on the external occipital protuberance and along the superior sagittal and ipsilateral transverse sinuses to perform a paramedian supratentorial occipital craniotomy. Extremely care should be taken to avoid injuries to the sinuses. Opening of the dura above the tranverse sinus and immediately lateral to the superior sagital sinus allows for a posterior inter emispheric exposure of the ipsilateral tentorium. The trans-tentorial access to the pineal region and the posterior third ventricle involves the caoagulation, cutting and reflection of the tentorium. This allows for a sub-occipital trans-tentorial perspective of the pineal region. In the personal series the OTT approach has been employed alone or in a combination with the infratentorial supracerebellar approach (ITSC) to treat different kind of lesions involving the pineal region. Compared with the ITSC, OTT approach has resulted more suitable and advantageous exspecially in those lesions with a para median or more cephalad extension. CONCLUSIONS The OTT approach is very useful to treat those pineal tumors caraharacterized by a para-mediam extension and/or involving the posterior third ventricle. The reflection of the tentorium provides an excellent and wide view of the pineal region both from above and from below. A detailed knowledge of the anatomy of this region, as well as the different steps of the approach are both of utmost importance to execute safely the approach

THE INFRA-TENTORIAL SUPRACEREBELLAR APPROACH

BACKGROUND The Infra-tentorial Supracerebellar approach (ITSC) to pineal region was described by Krause in 1911 and refined and popularized by Stein in 1982.Basically, ITSC offers an optimal exposure of the area between the vein of Galen complex and the cerebellomesencephalic fissure, so it is very useful for small to medium sized tumors confined to the micline and/or having a minimal para-median infratentorial extension. The authors critically review the personal series of pineal tumors removed via ITSC approach, also focusing on the selection criteria in the choice of the most suitable approach to pineal tumors. MATERIALS AND METHODS A wide review of pineal tumors treated in a range of 10 years (2004-2014) has been performed, with special emphasis to those cases treated via an ITSC route. This review regarded the type of lesion, indications to ITSC approach, choice of patient surgical position, complications and outcome. RESULTS In a range period of 10 years, 36 pineal region tumors have been treated. Among these, 15 were men and 21 female. The mean age was 43.1 years. The size of lesions were <3 cm in 30 cases and ≥3 cm in 6 cases. All lesions (14 meningiomas, 7 low grade gliomas, 2 high grade gliomas, 3 hemangioblastomas, 2 cavernomas, 2 pinealomas, 2 metastases, 2 dysgerminomas, 1 schwannoma, 1 medulloblastoma) were completely resected. In 16 cases an ITSC approach was performed, whereas an occipital trans-tentorial approach was employed in 20 cases. All tumors were completely removed surgically without any injury to the venous complex. There was no incidence of mortality or morbidity in our group of patients, and all functional outcomes were good to excellent postoperatively. CONCLUSIONS Pineal region is among the most complex intracranial areas to be reached mainly due to its deep location and the obstacle posed by the vascular structures in the midline. It derives that tumours involving this region are some of the most difficult lesions to expose and remove. Our review suggests that ITSC approach is an useful and safe approach, with a very low morbidity and zero mortality, for removing those pineal tumors with a midline infratentorial extension