The show must go on: a snapshot of Italian academic working life during mandatory work from home

During the COVID-19 pandemic, universities worldwide have provided continuity to research and teaching through mandatory work from home. Taking into account the specificities of the Italian academic environment and using the Job Demand-Resource-Recovery model, the present study provides, through an online survey, for the first time a description of the experiences of a large sample of academics (N = 2365) and technical and administrative staff (N = 4086) working in Italian universities. The study analyzes the main differences between genders, roles or work areas, in terms of some job demands, recovery experiences, and outcomes, all important dimensions to achieve goals 3, 4, and 5 of the 2030 Agenda for Sustainable Development. The results support the reflections on gender equality measures in universities and provide a general framework useful for further in-depth analysis and development of measures in order to improve well-being (SDG 3), quality of education (SDG 4), and gender equality (SDG 5)

Anatomical study of the pre-segmental and segmental arteries of the kidney and their impact in the nephronsparing surgery

Clamping of the main renal artery (RA) is still regarded as a commonly used technique to decrease haemorrhage in partial nephrectomy, but it causes warm ischaemic injury. The aim of this study was to describe the pattern of pre-segmental and segmental branches of the RA. To obtain vascular corrosions casts, twenty kidneys were injected with acrylic resins and underwent to computed tomography examination. Analysis of images and of casts showed that the pattern of vascularisation of posterior renal segment was constant (except that in one case), presenting one segmental artery. The vascularisation of the anterior parenchyma (apical, superior, middle and inferior segments) originated directly from an anterior branch of the RA (70%) or thorough pre-segmental arteries (PSA) (30%). In 20% two middle segmental artery originated from two different PSAs. A series of vascular renal patterns have been identified, that the surgeon must know before to conduct the selective clamping, i.e. the selective clamping of segmental artery originating from a PSA could more difficult, because the surgeon can wrongly close the PSA with subsequent ischemia of the more parenchymal segments. Moreover, in case of multiple segmental arteries, originating from two PSA, the surgeon can wrongly clamp only one of them with subsequent intraoperative hemorrhage

An anatomo-radiological study of the renal segments

An increasing number of observations call the general scheme of five renal segments into question, with anatomists, radiologists and surgeons that have reported discrepancies between Graves’s scheme and morphological observations. The aims of the present study was to analyse the arterial vascular anatomy with reference to the renal segments. 15 kidneys were injected with acrylic resins to obtain vascular corrosions casts that were analyzed also with computed tomography. A mean number of 6,1 (range 4-8) avascular fissures were found, determining the presence of a mean number of 7,1 segments (range 5-9). The apical and posterior segments were in all the cases single. In the superior and middle territory there was a single segment in 6 cases (40%) and two segments in 9 cases (60%). In the inferior territory there was a single segment in 1 case (6,7%), two segments in 12 cases (80%), and three segments in 2 cases (13,3%). The renal arterial vasculature cannot be schematized according to the classical Graves classification because the majority of the evaluated cases showed a different number of segments. The presence of the fissures in the virtual vascular casts is a useful tool to identify the boundary between the vascular territories

Daily On-Line Set-Up Correction in 3D-Conformal Radiotherapy: Is It Feasible?

Aims and background The aim of this report was to investigate the feasibility in terms of treatment time prolongation of an on-line no-action level correction protocol, based on daily electronic portal image verification. Methods and study design The occupation of a linear accelerator (LINAC) delivering 3-D conformal treatments was monitored for two weeks (from Monday to Friday, 10 working days). An electronic portal image device I-View (Elekta, UK) was used for setup verification. Single-exposure portal images were acquired daily using the initial 8 monitor units delivered for each treatment field. Translational deviations of isocenter position larger than 5 mm or 7 mm, for radical or palliative treatments, respectively, were immediately corrected. In order to estimate the extra workload involved with the on-line protocol, the time required for isocenter check and table correction was specifically monitored. Results Forty-eight patients were treated. In all, 482 fractions had electronic portal images taken. Two hundred and forty-five setup corrections were made (50.8% of all fractions). The occupation of the LINAC lasted 106 h on the whole. Twelve h and 25 min (11.7% of LINAC occupation time) were spent for portal image verification and setup correction. On the average, 4.3 fractions per hour were carried out. Conclusions When used by trained therapists, ideally, portal imaging may be carried out before each fraction, requiring approximately 10% of LINAC occupation time

Brödel’s line: an anatomo-radiological study of the avascular kidney’s plane

The division in anterior and posterior branches of the renal artery implies the existence of an avascular plane, the so call Brödel’s line (1). This longitudinal zone is described along the convex renal border (2) or just posterior to the lateral aspect of the kidney (3). The aim of this study was to describe the extension of Brödel’s line with reference to the renal segments. 12 kidneys were injected with acrylic resins to obtain vascular corrosions casts that were analyzed also with computed tomography. We observed the presence of a relative avascular plane in all vascular casts, located on the posterior surface, ascribable to the Brodel’s line. In 33% of cases the line extended from the apical to the inferior segments, in the 33% of cases it extended from the superior to the inferior segments, in 33% of cases it is limited to the superior and middle segments. Since the Brödel’s line corresponds with the plane of the anterior surface of the posterior hilar calyces, the knowledge of its extension is relevant from the surgical point of view: this area permits a relatively safe access route to the pelvicalyceal system for nephrostomy insertion and incision within this plane results in significantly less blood loss than outside this plane

An 1H NMR study of the cytarabine degradation in clinical conditions to avoid drug waste, decrease therapy costs and improve patient compliance in acute leukemia

Cytarabine, the 4-amino-1-(β-D-arabinofuranosyl)-2(1H)-pyrimidinone, (ARA-C) is an antimetabolite cytidine analogue used worldwide as key drug in the management of leukaemia. As specified in the manufacturers' instructions, once the components-sterile water and cytarabine powder-are unpackaged and mixed, the solution begins to degrade after 6 hours at room temperature and 12 hours at 4°C. To evaluate how to avoid wasting the drug in short-term, low-dose treatment regimens, the reconstituted samples, stored at 25°C and 4°C, were analyzed every day of the test week by reversed-phase HPLC and high-field NMR spectroscopy. All the samples remained unchanged for the entire week, which corresponds to the time required to administer the entire commercial drug package during low-dose therapeutic regimens. The drug solution was stored in a glass container at 4°C in an ordinary freezer and drawn with sterile plastic syringes; during this period, no bacterial or fungal contamination was observed. Our findings show that an cytarabine solution prepared and stored in the original vials retains its efficacy and safety and can, therefore, be divided into small doses to be administered over more days, thus avoiding unnecessary expensive and harmful waste of the drug preparation. Moreover, patients who require daily administration of the drug could undergo the infusion at home without need to go to hospital. The stability of the aliquots would help decrease hospitalization costs

Long term nucleotide and nucleoside analogs treatment in chronic hepatitis B HBeAg negative genotype D patients and risk for hepatocellular carcinoma

Background and rationale of the study. Effect of Long-term nucleoside/nucleotide (NUC) on hepatocellular carcinoma (HCC) incidence in a population of HBeAg-negative genotype D patients has not been adequately studied in real-life cohorts. Our aim was to evaluate the impact of liver fibrosis and other variables on HCC incidence in this population of patients. Of 745 patients with chronic hepatitis B (CHB), 306 HBeAg-negative genotype D were selected and included in this study. All patients received treatment with NUC for at least 18 months. Patients with CHB or compensated cirrhosis were included. Patients with HCC diagnosed before or during the first 18 months of NUC therapy were excluded. Results. HCC was diagnosed in 2 CHB patients (1.0%) and 23 cirrhosis patients (20%) (OR = 24.41, 95% CI 5.40 < OR < 153.2; p < 0.0001). Multivariate analysis revealed that HCC risk was independently associated with age ≥ 60 years (OR = 6.45, 95% CI 1.22 to 34.0; p = 0.02) and liver cirrhosis (OR = 12.1, 95% CI 1.39 to 106.2; p = 0.02), but not with virological response (VR), and previous resistance to NUC, or rescue therapy. Multivariate analysis in cirrhosis patients revealed that only age ≥ 60 years was an independent risk factor associated with HCC (p = 0.003). Conclusions. Liver cirrhosis and age ≥ 60 years are the stronger risk factors for HCC in genotype D HBeAgnegative patients. Previous resistance to NUC in patients that achieved a VR after rescue therapy was not a predictive factor regarding HCC. VR does not appear to significantly reduce the overall incidence of HCC when a patient has already progressed to liver cirrhosis