Postoperative pain surveys in Italy from 2006 and 2012. (POPSI and POPSI-2)

OBJECTIVE: Despite established standards, effective treatments, and evidence-based guidelines, postoperative pain control in Italy and other parts of the world remains suboptimal. Pain control has been recognized as a fundamental human right. Effective treatments exist to control postsurgical pain. Inadequate postoperative analgesia may prolong the length of hospital stays and may adversely impact outcomes. MATERIALS AND METHODS: The same multiple-choice survey administered at the SIAARTI National Congress in Perugia in 2006 (n=588) was given at the SIAARTI National Congress in Naples, Italy in 2012 (n=635). The 2012 survey was analysed and compared to the 2006 results. RESULTS: Postoperative pain control in Italy was less than optimal in 2006 and showed no substantial improvements in 2012. Geographical distinctions were evident with certain parts of Italy offering better postoperative pain control than other. Fewer than half of hospitals represented had an active Acute Pain Service (APS) and only about 10% of postsurgical patients were managed according to evidence-based guidelines. For example, elastomeric pumps for continuous IV infusion are commonly used in Italy, although patient-controlled analgesia systems are recommended in the guidelines. The biggest obstacles to optimal postoperative pain control reported by respondents could be categorized as organizational, cultural, and economic. CONCLUSIONS: There is considerable room for improvement in postoperative pain control in Italy, specifically in the areas of clinical education, evidence-based treatments, better equipment, and implementation of active APS departments in more hospitals. Two surveys taken six years apart in Italy reveal, with striking similarity, that there are many unmet needs in postoperative pain control and that Italy still falls below European standards for postoperative pain control

Efficacy of topical imiquimod 3.75% in the treatment of actinic keratosis of the scalp in immunosuppressed patients: our case series

AbstractBackground: Actinic keratoses (AK) represent common cutaneous lesions, appearing in 'Field cancerization areas' and potentially evolving toward invasive neoplasm. Immunosuppressed patients ..

SASICE: Safety and sustainability in civil engineering

The performance of the built environment and the construction sector are of major importance in Europe’s long term goals of sustainable development in a changing climate. At the same time, the quality of life of all European citizens needs to be improved and the safety of the built environment with respect to man-made and natural hazards, such as flooding and earthquakes, needs to be ensured. Education has a central role to play in the transformation of a construction sector required to meet increasing demands with regard to safety and sustainability. In this work, the SASICE project is presented. The aim of this project is to promote the integration of safety and sustainability in civil engineering education. The project is organised in the context of the Lifelong Learning Programme, funded by the European Community. The coordinator organisation is the University of Bologna. Nine partner universities from different countries are involved in this transnational project. The universities participating to the project constitute a network of high level competences in the civil engineering area, with several opportunities to improve lifelong learning adopting different media: joint curricula, teaching modules and professor and student exchanges. As a response to the challenge regarding new educational methods in sustainable engineering, teaching modules are developed in 4 thematic areas: (1) Safety in construction, (2) Risk induced by Natural Hazards Assessment, (3) Sustainability in construction, and (4) Sustainability at the territorial level. The development of the teaching modules is based on an extensive analysis of the need for highly qualified education on Safety and Sustainability involving all relevant stakeholders (European and national authorities, companies, research institutes, professional organizations, and universities).The main target is enabling students to introduce these advanced topics in their study plans and curricula and reach, at the end of their studies, a specific skill and expertise in safety and sustainability in Civil Engineering. With our natural resources fading away and our infrastructure in dire need of repair, new trends and challenges in civil engineering education in the concept of “Sustainable Development” are needed to be adressed.<br/

Exploring the interplay between metabolic power and equivalent distance in training games and official matches in soccer: a machine learning approach.

Introduction: This study aimed to explore the interplay between metabolic power (MP) and equivalent distance (ED) and their respective roles in training games (TGs) and official soccer matches. Furthermore, the secondary objective was to investigate the connection between external training load (ETL), determined by the interplay of metabolic power and equivalent distance, and internal training load (ITL) assessed through HR-based methods, serving as a measure of criterion validity. Methods: Twenty-one elite professional male soccer players participated in the study. Players were monitored during 11 months of full training and overall official matches. The study used a dataset of 4269 training games and 380 official matches split into training and test sets. In terms of machine learning methods, the study applied several techniques, including K-Nearest Neighbors, Decision Tree, Random Forest, and Support-Vector Machine classifiers. The dataset was divided into two subsets: a training set used for model training and a test set used for evaluation. Results: Based on metabolic power and equivalent distance, the study successfully employed four machine learning methods to accurately distinguish between the two types of soccer activities: TGs and official matches. The area under the curve (AUC) values ranged from 0.90 to 0.96, demonstrating high discriminatory power, with accuracy levels ranging from 0.89 to 0.98. Furthermore, the significant correlations observed between Edwards' training load (TL) and TL calculated from metabolic power metrics confirm the validity of these variables in assessing external training load in soccer. The correlation coefficients (r values) ranged from 0.59 to 0.87, all reaching statistical significance at p &lt; 0.001. Discussion: These results underscore the critical importance of investigating the interaction between metabolic power and equivalent distance in soccer. While the overall intensity may appear similar between TGs and official matches, it is evident that underlying factors contributing to this intensity differ significantly. This highlights the necessity for more comprehensive analyses of the specific elements influencing physical effort during these activities. By addressing this fundamental aspect, this study contributes valuable insights to the field of sports science, aiding in the development of tailored training programs and strategies that can optimize player performance and reduce the risk of injuries in elite soccer

Relationship between aerobic fitness and metabolic power metrics in elite male soccer players

The aim was to assess the relationship between aerobic fitness and metabolic power metrics in elite male soccer players, and the possible differences that playing positions might impose during match play over new metabolic power metrics. Sixty-two elite professional male soccer players (13 central backs, 13 side backs, 22 midfielders, and 14 forwards) took part in the study. Players were monitored during eleven months of full training (including pre-season and in-season) and over all official matches (Serie A matches, Italy Cup matches). Aerobic fitness tests were conducted one week after the start of the preseason, and 8, 24 and 36 weeks after the beginning of the Championship. Players' aerobic fitness and metabolic power metrics were considered as the mean of all seasonal testing and of pooling data of 38 championship matches and 3 or 6 Italy Cup matches for all the calculations respectively. The velocity at 4 mmol·L-1 (VL4) was significantly related to metabolic power metrics match variables with correlation ranging from trivial to very large (r = 0.32 to r = 0.89). Receiver-operating-characteristic (ROC) analysis showed that speed at VL4 was sensitive in detecting high metabolic power distance (HMPD) changes in all but central back players as revealed by area under the curve (central back .78, 95%CI .47 to .95; full back .93, 95%CI .64 to 0.99; midfielder .88, 95%CI .67 to 0.98; forward .90, 95%CI .62 to 0.99). This study's findings provide further evidence for the ecological validity of aerobic fitness in elite male soccer players. Players having a HMPD cut-off equal to or higher than &gt; 1450 m for central backs, &gt; 1990 m for full backs, &gt; 2170 m for midfielders and &gt; 1670 m for forwards may be considered as possessing superior aerobic fitness status. In light of this study's findings, the VL4 test may be considered a valid test to evaluate meaningful information for direct generic aerobic training in soccer players

R705H mutation of MYH9 is associated with MYH9-related disease and not only with non-syndromic deafness DFNA17

MYH9-related disease (MYH9-RD) is a rare autosomal dominant disease caused by mutation of MYH9, the gene encoding for the heavy chain of non-muscle myosin IIA (NMMHC-IIA). MYH9-RD patients have macrothrombocytopenia and granulocyte inclusions (pathognomonic sign of the disease) containing wild-type and mutant NMMHC-IIA. During life they might develop sensorineural hearing loss, cataract, glomerulonephritis, and elevation of liver enzymes. One of the MYH9 mutations, p.R705H, was previously reported to be associated with DFNA17, an autosomal dominant non-syndromic sensorineural hearing loss without any other features associated. We identified the same mutation in two unrelated families, whose four affected individuals had not only hearing impairment but also thrombocytopenia, giant platelets, leukocyte inclusions, as well as mild to moderate elevation of some liver enzymes. Our data suggest that DFNA17 should not be a separate genetic entity but part of the wide phenotypic spectrum of MYH9-RD characterized by congenital hematological manifestations and variable penetrance and expressivity of the extra-hematological features

How to choose a good marker to analyze the olive germplasm (Olea europaea l.) and derived products

The olive tree (Olea europaea L.) is one of the most cultivated crops in the Mediterranean basin. Its economic importance is mainly due to the intense production of table olives and oil. Cultivated varieties are characterized by high morphological and genetic variability and present a large number of synonyms and homonyms. This necessitates the introduction of a rapid and accurate system for varietal identification. In the past, the recognition of olive cultivars was based solely on analysis of the morphological traits, however, these are highly influenced by environmental conditions. Therefore, over the years, several methods based on DNA analysis were developed, allowing a more accurate and reliable varietal identification. This review aims to investigate the evolving history of olive tree characterization approaches, starting from the earlier morphological methods to the latest technologies based on molecular markers, focusing on the main applications of each approach. Furthermore, we discuss the impact of the advent of next generation sequencing and the recent sequencing of the olive genome on the strategies used for the development of new molecular markers

New insight into the identity of italian grapevine varieties: The case study of calabrian germplasm

Calabria is a region located in Southern Italy and it is characterized by a long tradition of viticulture practices and favorable pedoclimatic conditions for grapevine cultivation. Nevertheless, less than 2% of cultivated land is dedicated to grapevine growing in Calabria. The characterization of local grapevine accessions is crucial to valorize the local and peculiar Italian products and boost the Calabrian winemaking sector. With this purpose, we performed a deep characterization of two widespread Calabrian grapevine varieties—Magliocco Dolce and Brettio Nero, of which very little is known. In particular, a genetic and morphological analysis, a berry physico-chemical and polyphenolic compositions assessment, and oenological evaluation of monovarietal wines were carried out. Our results allowed us to demonstrate that Magliocco Dolce and Brettio Nero are unique and distinct varieties with peculiar morphological and chemical characteristics and show the suitability of these two varieties in high-quality wine production. Moreover, the obtained molecular profiles will be useful for authentication and traceability purposes

Automatic Extraction of Dermatological Parameters from Nevi Using an Inexpensive Smartphone Microscope: A Proof of Concept

The evolution of smartphone technology has made their use more common in dermatological applications. Here we studied the feasibility of using an inexpensive smartphone microscope for the extraction of dermatological parameters and compared the results obtained with a portable dermoscope, commonly used in clinical practice. Forty-two skin lesions were imaged with both devices and visually analyzed by an expert dermatologist. The presence of a reticular pattern was observed in 22 dermoscopic images, but only in 10 smartphone images. The proposed paradigm segments the image and extracts texture features which are used to train and validate a neural network to classify the presence of a reticular pattern. Using 5-fold cross-validation, an accuracy of 100% and 95% was obtained with the dermoscopic and smartphone images, respectively. This approach can be useful for general practitioners and as a triage tool for skin lesion analysis