The GIS Architecture Elements for the Coastal Areas Along the Adriatic Sea

The study of the national and cross-border Adriatic coastal areas will be approached by using an interdisciplinary method. A comparative reading will focus on an analysis of the main variations undergone by the area and will try to define all the elements involved in those areas where a conflicting presence exists between high quality environmental factors on the one hand and anthropological aggression on the other. In this paper we present the aim of the GES.S.TER. project, that is the creation of a protocol for territorial analysis – namely the G.I.S.A.E. Adriatic (Geographical Information System for Activities along the Coast). The Project is financed by the Interreg IIIA Programme Adriatic Cross Border from 2004 to 2007 (prof. Donatella Cialdea is the Head of GESS.S.TER.). Moreover the Project will be a case-study analysed by the GISIG - Geographical Information Systems International Group. The areas covered by the project include the national Adriatic coast, in particular the coastal area of Molise, and the cross-border coasts of Albania and Croatia (both partners in the project). In the definition of the characteristics that a territorial information system of aid to the GES.S.TER project should have, the parameters for the collection of data and for the reordering of the information, which was already in our possession, have been established. Another necessary step has been that of revising and coordinating the existing sources, keeping in mind that the final purpose of the system is to define the objective landscape qualities, we find ourselves having to face the problem of combining, and consequently, comparing, information coming from different sources. Five resource systems have been selected: physical-environmental; landscape-visual; historical-cultural; agricultural-productive; Demographic-tourism. A further source of information comes from the analysis carried out during the drawing up of the Vast Area Environmental Landscape Territorial Plans and we have defined the criteria for the selection of the indicators. These indicators will be useful for an evaluation of transformations through time of the territories, in order to prepare the documents for the strategic environmental assessment procedures too.

Revisional Surgery After One Anastomosis/Minigastric Bypass: an Italian Multi-institutional Survey

Background: Efficacy and safety of OAGB/MGB (one anastomosis/mini gastric bypass) have been well documented both as primary and as revisional procedures. However, even after OAGB/MGB, revisional surgery is unavoidable in patients with surgical complications or insufficient weight loss. Methods: A questionnaire asking for the total number and demographics of primary and revisional OAGB/MGBs performed between January 2006 and July 2020 was e-mailed to all S.I.C. OB centres of excellence (annual caseload > 100; 5-year follow-up > 50%). Each bariatric centre was asked to provide gender, age, preoperative body mass index (BMI) and obesity-related comorbidities, previous history of abdominal or bariatric surgery, indication for surgical revision of OAGB/MGB, type of revisional procedure, pre- and post-revisional BMI, peri- and post-operative complications, last follow-up (FU). Results: Twenty-three bariatric centres (54.8%) responded to our survey reporting a total number of 8676 primary OAGB/MGBS and a follow-up of 62.42 ± 52.22 months. A total of 181 (2.08%) patients underwent revisional surgery: 82 (0.94%) were suffering from intractable DGER (duodeno-gastric-esophageal reflux), 42 (0.48%) were reoperated for weight regain, 16 (0.18%) had excessive weight loss and malnutrition, 12 (0.13%) had a marginal ulcer perforation, 10 (0.11%) had a gastro-gastric fistula, 20 (0.23%) had other causes of revision. Roux-en-Y gastric bypass (RYGB) was the most performed revisional procedure (109; 54%), followed by bilio-pancreatic limb elongation (19; 9.4%) and normal anatomy restoration (19; 9.4%). Conclusions: Our findings demonstrate that there is acceptable revisional rate after OAGB/MGB and conversion to RYGB represents the most frequent choice

How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice

Planning and concession management under port co-operation schemes: A multiple case study of Italian port mergers

Recent governance reforms have driven many ports to introduce innovative co-operation schemes, including the merger of Port Authorities (PAs). Port merger is generally characterized by a certain level of complexity due to the challenges that ports must face within the most critical management processes affected by port amalgamation. This paper aims to identify and analyse the main challenges that might emerge within two of these critical processes: port planning and concession management. This study undertakes a multiple case study analysis of two newly merged PAs: Genoa-Savona, as the major multi-site gateway port in Italy, and Naples-Salerno, which was renamed as the PA of the Central Tyrrhenian Sea. The main findings of both case studies emphasize the existence of challenging areas that may result in either opportunities or threats, which can also depend on the managerial skills of PA organizations

Immune-Privileged Sites within Skeletal Muscle: Apoptosis of FasL-Transfected Myoblasts Prevents the Formation of FasL-Expressing Muscle Fibers In Vivo

It has been suggested that over-expression of FasL could provide immune-privileged sites where transfected genes or/and grafted cells could exert their therapeutic action without inducing an immune response. Given the good transfectability of skeletal muscle, such tissue has been considered as a prime candidate for FasL engineerization. However, attempts to create FasL-expressing myoblasts have so far generated conflicting results. In this paper we set out to further investigate such approach, both in vitro and in vivo. We have designed a chimeric expression plasmid in which the addition of a GFP moiety to the C-terminal of FasL coding sequence rendered the final protein incapable of inducing apoptosis. Such construct has then been used for in vitro and in vivo transfection of rat muscle cells and its effects were compared with those obtained with a plasmid expressing normal FasL. The vast majority of primary myoblasts transfected in vitro with the FasL-expressing plasmid underwent apoptosis within the first 48 hours. Conversely, transfections with the FasL-GFP plasmid failed to induce cell death and allowed the formation of FasL-GFP positive myotubes, thereby demonstrating the inability of the chimeric product to activate the FasL-Fas pathway. In vivo, muscles co-injected with LacZ- and FasL-encoding plasmids developed a leukocytes infiltrate and transfected fibers were rapidly cleared out. When muscles were injected with a mixture of FasL-GFP and LacZ plasmids, transfected fibers persisted for at least two weeks. The results presented here demonstrate that Fas-FasL interaction is responsible for both the apoptosis of FasL transfected myoblasts in vitro and disappearance of FasL-engineered muscle fibers in vivo when transfections are carried out in regenerating muscles. However, our findings also suggest that it might be possible to obtain FasL-engineered mature muscle fibers by appropriately regulating the expression of the exogenous DNA during muscle differentiation

Enhancing myoblast proliferation by using myogenic factors: a promising approach for improving fiber regeneration in sport medicine and skeletal muscle diseases

Macrophages drive muscle regeneration and repair by removing necrotic material and producing key signaling molecules. The array of cytokines/growth factors produced by macrophages and myogenic cells stimulates the proliferation, migration and differentiation of satellite cells. Although the details of such processes are only partially understood, it is known that the administration of purified growth factors can improve the final outcome after traumatic muscle injuries. Also, such approach has proved to be beneficial in myoblast transplantation experiments in animal models. The translation of such procedures into therapeutic protocols is, however, hampered by high costs and the somewhat oversimplified biochemical input compared to the physiological signal network. We have previously reported that peritoneal macrophages could secrete factors capable of increasing the myoblast/myotube yield in cultures of primary rat myoblasts. Recently, we observed that a macrophage cell line could be stimulated to produce a conditioned medium that specifically enhances the proliferation of cultured neonatal primary myoblasts from mouse, rat, chicken, and human fetal myoblasts. The factors did not inhibit differentiation and led to a striking increase in the rate of contractile myotube formation. The factors could also enhance muscle regenerative processes in vivo, thereby suggesting a potential role as an economical and effective tool for the treatment of traumatic and disease-related muscle injuries. Further experiments in this direction and the biochemical characterization of the macrophage-produced myogenic factors are presently underway. The possibility to use the macrophage factors to improve the myoblast yield from diseased-muscle biopsies is also under investigation

Learning by demonstration for motion planning of upper-limb exoskeletons

The reference joint position of upper-limb exoskeletons is typically obtained by means of Cartesian motion planners and inverse kinematics algorithms with the inverse Jacobian; this approach allows exploiting the available Degrees of Freedom (i.e. DoFs) of the robot kinematic chain to achieve the desired end-effector pose; however, if used to operate non-redundant exoskeletons, it does not ensure that anthropomorphic criteria are satisfied in the whole human-robot workspace. This paper proposes a motion planning system, based on Learning by Demonstration, for upper-limb exoskeletons that allow successfully assisting patients during Activities of Daily Living (ADLs) in unstructured environment, while ensuring that anthropomorphic criteria are satisfied in the whole human-robot workspace. The motion planning system combines Learning by Demonstration with the computation of Dynamic Motion Primitives and machine learning techniques to construct task- and patient-specific joint trajectories based on the learnt trajectories. System validation was carried out in simulation and in a real setting with a 4-DoF upper-limb exoskeleton, a 5-DoF wrist-hand exoskeleton and four patients with Limb Girdle Muscular Dystrophy. Validation was addressed to (i) compare the performance of the proposed motion planning with traditional methods; (ii) assess the generalization capabilities of the proposed method with respect to the environment variability. Three ADLs were chosen to validate the system: drinking, pouring and lifting a light sphere. The achieved results showed a 100% success rate in the task fulfillment, with a high level of generalization with respect to the environment variability. Moreover, an anthropomorphic configuration of the exoskeleton is always ensured