Awake Da Vinci robotic partial nephrectomy: First case report ever in a situation of need

We report a unique case of a robotic partial nephrectomy performed under continuous spinal anesthesia (CSA). A 63-year-old woman, active smoker with mild obesity and previous right pneumonectomy, was diagnosed with a growing 5.5-cm renal right cystic tumor. Being at high risk for general anesthesia, a loco-regional approach was indicated. Therefore, after multidisciplinary discussion, a robotic-assisted partial nephrectomy under CSA was considered mandatory. After T4-T5 sensory and motor block, retroperitoneoscopic robot-assisted surgery was successfully performed. Postoperative period was uneventful, with optimal pain control. This unique case demonstrates the feasibility of robotic surgery under CSA, for imperative indications

Assessment of post-failure evolution of a large earthflow through field monitoring and numerical modelling

AbstractThe analysis of the residual hazard existing after the emergency phases generated by the activation or reactivation of landslides is rarely taken into account in a proper manner. However, the assessment of landslide post-failure evolution should represent a key factor to control potential landslide reactivations and prevent new landslide-induced damages. This paper presents the results of a long-term field monitoring activity performed in the years after the emergency phase of the Montaguto (Italy) earthflow reactivation occurred in 2010 as well as the results of 2-D and 3-D numerical analyses aimed at interpreting the post-emergency landslide behaviour. The results of the numerical simulations, which agree well with the in situ monitoring data, allow to define a conceptual model of the earthflow behaviour that is related to the pore water pressure variations resulting from the drained or undrained processes occurring in the landslide body. The study proposed confirms a general reduction of the landslide activity, as well as allows to detect the factors that control the residual activity existing in a specific area of the landslide and to infer possible critical scenarios for landslide reactivations

1054 Noninvasive Qp/Qs ratio measurement with phase-contrast cine MRI in patients with atrial septal defect: comparison with heart catheterization

The correlation analysis showed a good overlap between measurements (Qp: r = 0.65, p = 0.0004; Qs: r = 0.64, p = 0.0005; Qp/Qs ratio: r = 0.68, p = 0.0002), also confirmed by regression analysis (R2 = 0.42, p < 0.001 for Qp; R2 = 0.41, p = 0.001 for QS; R2 = 0.46, p < 0.001 for Qp/Qs ratio), and by the Bland-Altman statistical analysis for method comparison (see Figure 1). The interobserver variability was low

Pyrgi. Analysis of possible climatic effects on a coastal archaeological site

This work refers to an interdisciplinary study on the archaeological site of Pyrgi, an Etruscan harbour still under excavation, located on the Lazio’s coast in Santa Severa, in the province of Rome. The site in question is subject to frequent flooding which compromises its accessibility and delays the archaeological excavation operations. The study is based on the combined use of geomatic technologies, meteorological and climatic models, and hydrogeological knowledge of the examined site, to have a global view of the hazard to which it is exposed. Different geomatic techniques at different scales are used in the analysis. Large scale surveys are carried out to define the water networks and to monitor the site using satellite images. On a small scale, drone photogrammetry techniques are used to assess the morphology of the territory and eventual protection from natural hazards present in the site. Using these images, a detailed digital surface model (DSM) has been generated. The objective of the research is to assess the main cause of the floods and the time the water stays in the site and to determine if the floods are periodic phenomena over time or random events. The study was conducted using images captured by Sentinel 2 satellites processed at level 2-A. These images enabled the identification of the flooding periods of the site for the years of monitoring. The study was conducted by comparing the captured images with rainfall data, paying attention to extreme weather phenomena that occurred from 2012 to date. The rainfall data are provided by the National Department of Civil Protection to CNR-ISAC by an agreement between the two institutions. The same images have been compared with the wind data recorded by the anemometer located in the Civitavecchia harbour and the wave height data available from ERA5 reanalysis. Knowledge of the main cause of the floods and a possible periodicity will allow to plan correct conservation of the site through specific protection measures designed according to the hazards to which it is exposed

Chapter Pyrgi: analysis of possible climatic effects on a coastal archaeological site

This work refers to an interdisciplinary study on the archaeological site of Pyrgi, an Etruscan harbour still under excavation, located on the Lazio’s coast in Santa Severa, in the province of Rome. The objective of the research is to assess the main cause of the floods and the time the water stays in the site to determine if the floods are periodic phenomena over time or random events for guarantee a correct conservation of the site . The study is based on the combined use of geomatic technologies, meteorological and climatic models, and hydrogeological knowledge

Early diagnosis of bladder cancer through the detection of urinary tyrosine-phosphorylated proteins

BACKGROUND: A noninvasive, highly sensitive and specific urine test is needed for bladder cancer (BC) diagnosis and surveillance in addition to the invasive cystoscopy. We previously described the diagnostic effectiveness of urinary tyrosine-phosphorylated proteins (UPY) and a new assay (UPY-A) for their measurement in a pilot study. The aim of this work was to evaluate the performances of the UPY-A using an independent cohort of 262 subjects. METHODS: Urinary tyrosine-phosphorylated proteins were measured by UPY-A test. The area under ROC curve, cutoff, sensitivity, specificity and predictive values of UPY-A were determined. The association of UPY levels with tumour staging, grading, recurrence and progression risk was analysed by Kruskal–Wallis and Wilcoxon's test. To test the probability to be a case if positive at the UPY-A, a logistic test adjusted for possible confounding factor was used. RESULTS: Results showed a significant difference of UPY levels between patients with BC vs healthy controls. For the best cutoff value, 261.26 Standard Units (SU), the sensitivity of the assay was 80.43% and the specificity was 78.82%. A statistically significant difference was found in the levels of UPY at different BC stages and grades between Ta and T1 and with different risk of recurrence and progression. A statistically significant increased risk for BC at UPY-A ⩾261.26 SU was observed. CONCLUSIONS: The present study supplies important information on the diagnostic characteristics of UPY-A revealing remarkable performances for early stages and allowing its potential use for different applications encompassing the screening of high-risk subjects, primary diagnosis and posttreatment surveillance