Appendiceal Neuroendocrine Tumors and Anorectal Melanoma

Tumor growth and spread are a complicated matter and are the result of many interconnected factors. The analysis of patterns emerging from highly numerous populations might help shed some light on such an intricate mechanism. In this respect, our studies are mostly based on the SEER database, a nation representative dataset collecting data regarding the US population, over a very long time span. This approach is revealed to be particularly useful for rare tumors, as prospective studies are not feasible. Here, we present the results and the clinical implications of our inquires: we show the impact on overall survival of several morphological and demographic characteristics of various malignancies including anorectal melanoma and neuroendocrine tumors of the appendix. The impact of surgical treatment is discussed as well. Finally, we endorse the need to find more reliable markers of tumor biology, such as genetic patterns, to tailor an effective multidisciplinary treatment

Olfactory Dysfunction, Headache, and Mental Clouding in Adults with Long-COVID-19: What Is the Link between Cognition and Olfaction? A Cross-Sectional Study

Smell alteration and cognitive impairment are common features of the Long-COVID Syndrome. Mental clouding, often described as brain fog, might affect smell by altering recollection of odors or through a share mechanism of neuroinflammation. We investigated mental clouding, headache, and cognitive function in adult patients with persistent COVID-19 olfactory dysfunction. This multi-center cross-sectional study enrolled 152 adults with self-reported olfactory dysfunction from 3 tertiary centers specialized in COVID-19 olfactory disorders. Inclusion criteria were smell alterations after COVID-19 persisting over 6 months from infection, age >18 and < 65. Exclusion criteria included smell alterations, headache, or memory problems prior to COVID-19 infection. The patients were evaluated by olfactometry, nasal endoscopy, headache scale, cognitive assessment, Mini Mental State Examination (MMSE), and self-reported measures. Smell dysfunction was stratified and classified based on olfactory deficit severity and presence of olfactory distortion (parosmia, cacosmia). Data on smell disorder, mental clouding, MMSE, and headache were analyzed to assess correlations. Among the 152 patients studied, 50 (32.8%) presented with anosmia, 25 (16.4%) with hyposmia, 10 (6.6%) with parosmia/cacosmia, and 58 patients (38.2%) with a combination of hyposmia and parosmia; seven (4.6%) patients suffered from headache exclusively, and two (1.4%) had headache and mental clouding as their primary symptom. Headache was reported by 76 (50%) patients, and mental clouding by 71 (46.7%). The patients reporting headache, mental clouding, or both, had significantly increased risk of suffering from anosmia and/or hyposmia when compared with their counterparts without these neurological symptoms. No patients had reduced MMSE scores. In our cohort of adult patients with post-COVID-19, smell alterations persisting over 6 months, cognitive impairment and headache were associated with more severe olfactory loss, consistent with neuroinflammatory mechanisms mediating a variety of Long-COVID symptoms

Learning-by-Doing Methodology towards Urban Decarbonisation: An Application in Valletta (Malta)

Since approximately 75% of Europeans currently live in cities, and this number will rise, urban areas are the most important testbeds for energy transition, climate change adaptation measures, and decarbonisation models, on which studies and efforts for concrete change must focus. The teaching of mitigation and adaptation measures to climate change and decarbonisation models has gradually taken up space within university courses. However, the complexity of the decarbonisation issue is raising awareness on the urgency of an interdisciplinary approach that can be conveyed by spatial planning. Currently, this approach is not widespread in Higher Education Institutions in Europe but is nonetheless necessary to let new professional profiles emerge who are able to coordinate different stakeholders, data, and information sources. The Erasmus+ project CITY MINDED (2020–2022) has worked in this direction, by developing and testing a methodology for the design of a structured ordinary practice for teaching urban decarbonisation to students in Higher Education. This practice (at the same time, interdisciplinary, collaborative, experiential, and place-based) aims to offer students a combination of different approaches and working methods to investigate and improve urban neighbourhoods and districts, resulting in the definition of an operative roadmap for decarbonisation in the medium-to-long-term. The aim of this article is to highlight the learning-by-doing experience developed by the project consortium, with reference to the testing of the methodology conducted within an Intensive Course in the City of Valletta (Malta). In particular, the paper illustrates how this experience succeeded in stimulating students with different academic backgrounds to establish connections across disciplines, in raising their awareness about the complexity of city decarbonisation processes. Overcoming the strict time and budget constraints of an EU-funded project, such an approach can be further developed, replicated on theoretical grounds, and implemented within different degree programmes dealing with urban sustainability

Internet and social media use among patients with colorectal diseases (ISMAEL): a nationwide survey

Aim: Social media are used daily by both healthcare workers and patients. Online platforms have the potential to provide patients with useful information, increase their engagement and potentially revolutionize the patient-physician relationship. This survey aimed to evaluate the impact of the Internet and social media (I&SM) on patients affected by colorectal and proctological diseases to define a pathway to develop an evidence-based communications strategy. Method: A 31-item anonymous electronic questionnaire was designed. It consisted of different sections concerning demographics and education, reason for the visit, knowledge of the diseases, frequency of I&SM use and patients' opinions about physicians' websites. Results: Over a 5-month period, 37 centres and 105 surgeons took part in the survey, and a total of 5800 patients enrolled. Approximately half of them reported using the Internet daily, and 74.6% of the study population used it at least once per week. There was a correlation (P < 0.001) between those who used the Internet for work and those who had knowledge of both symptoms and the likely diagnosis before consultation. Patients who used the Internet daily were more likely to request a consultation within 6 months of symptom onset (P < 0.0001). Patients with anorectal diseases were more likely to know about their disease and symptoms before the visit (P < 0.001). Conclusion: Colorectal patients use I&SM to look for health-related information mainly after their medical visit. Surgeons and hospital networks should plan a tailored strategy to increase patient engagement, delivering appropriate information on social medi