64 research outputs found

    Lo stock di capitale fisso nelle regioni italiane. 1970 - 1994

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    The aim of this paper is to estimate the series of capital stock at the regional level for Italy. Using the permanent inventory approach we obtain series for 20 regions and 17 sectors of economic activity covering the period 1970 - 1994. The first descriptive analysis presented in this paper confirms the dualistic structure of the Italian economy. Southern regions represent only 30% of total capital stock and their accumulation rate is declining. Moreover we show how the sectoral composition and change of the capital stock presents huge differences across regions

    Safety and Feasibility of Steerable Radiofrequency Ablation in Combination with Cementoplasty for the Treatment of Large Extraspinal Bone Metastases

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    Background: Radiofrequency ablation (RFA) and cementoplasty, individually and in concert, has been adopted as palliative interventional strategies to reduce pain caused by bone metastases and prevent skeletal related events. We aim to evaluate the feasibility and safety of a steerable RFA device with an articulating bipolar extensible electrode for the treatment of extraspinal bone metastases. Methods: All data were retrospectively reviewed. All the ablation procedures were performed using a steerable RFA device (STAR, Merit Medical Systems, Inc., South Jordan, UT, USA). The pain was assessed with a VAS score before treatment and at 1-week and 3-, 6-, and 12-month follow-up. The Functional Mobility Scale (FMS) was recorded preoperatively and 1 month after the treatment through a four-point scale (4, bedridden; 3, use of wheelchair; 2, limited painful ambulation; 1, normal ambulation). Technical success was defined as successful intraoperative ablation and cementoplasty without major complications. Results: A statistically significant reduction of the median VAS score before treatment and 1 week after RFA and cementoplasty was observed (p < 0.001). A total of 6/7 patients who used a wheelchair reported normal ambulation 1 month after treatment. All patients with limited painful ambulation reported normal ambulation after the RFA and cementoplasty (p = 0.003). Technical success was achieved in all the combined procedures. Two cement leakages were reported. No local recurrences were observed after 1 year. Conclusions: The combined treatment of RFA with a steerable device and cementoplasty is a safe, feasible, and promising clinical option for the management of painful bone metastases, challenging for morphology and location, resulting in an improvement of the quality of life of patients

    Prognostic features of gastro-entero-pancreatic neuroendocrine neoplasms in primary and metastatic sites: Grade, mesenteric tumour deposits and emerging novelties

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    Updates in classification of gastro-entero-pancreatic neuroendocrine neoplasms better reflect the biological characteristics of these tumours. In the present study, we analysed the characteristics of neuroendocrine tumours that could aid in a more precise stratification of risk groups. In addition, we have highlighted the importance of grade (re)assessment based on investigation of secondary tumour lesions. Two hundred and sixty-four cases of neuroendocrine tumours of gastro-entero-pancreatic origin from three centres were included in the study. Tumour morphology, mitotic count and Ki67 labelling index were evaluated in specimens of primary tumours, lymph node metastases and distant metastases. These variables were correlated with overall survival (OS) and relapse-free survival (RFS). Tumour stage, number of affected lymph nodes, presence of tumour deposits and synchronous/metachronous metastases were tested as possible prognostic features. Mitotic count, Ki-67 labelling index, primary tumour site, tumour stage, presence of tumour deposits and two or more affected lymph nodes were significant predictors of OS and RFS. At the same time, mitotic count and Ki-67 labelling index can be addressed as continuous variables determining prognosis. We observed a very high correlation between the measures of proliferative activity in primary and secondary tumour foci. The presence of isolated tumour deposits was identified as an important determinant of both RFS and OS for pancreatic (hazard ratio [HR] = 7.61, 95% confidence interval [CI] = 3.96-14.6, P < 0.0001 for RFS; HR = 3.28, 95% CI = 1.56-6.87, P = 0.0017 for OS) and ileal/jejunal neuroendocrine tumours (HR = 1.98, 95% CI = 1.25-3.13, P = 0.0036 for RFS and HR 2.59, 95% CI = 1.27-5.26, P = 0.009 for OS). The present study identifies the presence of mesenterial tumour deposits as an important prognostic factor for gastro-entero-pancreatic neuroendocrine tumours, provides evidence that proliferative parameters need to be treated as continuous variables and further supports the importance of grade determination in all available tumour foci

    Sunitinib in patients with pre-treated pancreatic neuroendocrine tumors: A real-world study

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    Introduction: Besides data reported in a Phase-III trial, data on sunitinib in pancreatic Neuroendocrine Tumors (panNETs) are scanty. Aim: To evaluate sunitinib efficacy and tolerability in panNETs patients treated in a real-world setting. Patients and methods: Retrospective analysis of progressive panNETs treated with sunitinib. Efficacy was assessed by evaluating progression-free survival, overall survival, and disease control (DC) rate (stable disease (SD) + partial response + complete response). Data are reported as median (25th\ue2\u80\u9375th IQR). Results: Eighty patients were included. Overall, 71.1% had NET G2, 26.3% had NET G1, and 2.6% had NET G3 neoplasms. A total of 53 patients (66.3%) had received three or more therapeutic regimens before sunitinib, with 24 patients (30%) having been treated with four previous treatments. Median PFS was 10 months. Similar risk of progression was observed between NET G1 and NET G2 tumors (median PFS 11 months and 8 months, respectively), and between patients who had received \ue2\u89\ua5 3 vs \ue2\u89\ua4 2 therapeutic approaches before sunitinib (median PFS 9 months and 10 months, respectively). DC rate was 71.3% and SD was the most frequent observed response, occurring in 43 pts (53.8%). Overall, 59 pts (73.8%) experienced AEs, which were grade 1\ue2\u80\u932 in 43 of them (72.9%), grade 3 in 15 pts (25.4%), and grade 4 in one patient (1.7%). Six pts (7.5%) stopped treatment due to toxicity. Conclusions: The present real-world experience shows that sunitinib is a safe and effective treatment for panNETs, even in the clinical setting of heavily pre-treated, progressive diseases

    Geomorphology and sedimentology of Porto Pino, SW Sardinia, Western Mediterranean

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    This paper presents a detailed (1:4000) geomorphological, sedimentological and ecological map of a Mediterranean microtidal wave-dominated beach system and adjacent inner shelf. This map is an innovative cartographic product that integrates a range of processes of present and past timeframes. It is part of a larger cartography on the coastal geomorphology of Sardinia (Italy) aiming to facilitate coastal management practices and future scientific research. The study area is located in SW Sardinia (Italy), and focuses on Porto Pino beach, an important tourist destination of semi-pristine nature, facing environmental pressures common to many coastal Mediterranean settings. In this context, the main human impact on coastal dune habitats is described and a full environmental characterization of the beach system is presented

    Epidemiology of gastroenteropancreatic neuroendocrine neoplasms: a review and protocol presentation for bridging tumor registry data with the Italian association for neuroendocrine tumors (Itanet) national database

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    : Neuroendocrine neoplasms (NENs) are rare tumors with diverse clinical behaviors. Large databases like the Surveillance, Epidemiology, and End Results (SEER) program and national NEN registries have provided significant epidemiological knowledge, but they have limitations given the recent advancements in NEN diagnostics and treatments. For instance, newer imaging techniques and therapies have revolutionized NEN management, rendering older data less representative. Additionally, crucial parameters, like the Ki67 index, are missing from many databases. Acknowledging these gaps, the Italian Association for Neuroendocrine Tumors (Itanet) initiated a national multicenter prospective database in 2019, aiming to gather data on newly-diagnosed gastroenteropancreatic neuroendocrine (GEP) NENs. This observational study, coordinated by Itanet, includes patients from 37 Italian centers. The database, which is rigorously maintained and updated, focuses on diverse parameters including age, diagnostic techniques, tumor stage, treatments, and survival metrics. As of October 2023, data from 1,600 patients have been recorded, with an anticipation of reaching 3600 by the end of 2025. This study aims at understanding the epidemiology, clinical attributes, and treatment strategies for GEP-NENs in Italy, and to introduce the Itanet database project. Once comprehensive follow-up data will be acquired, the goal will be to discern predictors of treatment outcomes and disease prognosis. The Itanet database will offer an unparalleled, updated perspective on GEP-NENs, addressing the limitations of older databases and aiding in optimizing patient care. STUDY REGISTRATION: This protocol was registered in clinicaltriasl.gov (NCT04282083)

    Assessment of origin and fate of contaminants along mining-affected Rio Montevecchio (SW Sardinia, Italy): A hydrologic-tracer and environmental mineralogy study

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    Hydrologic tracer techniques were applied to Rio Montevecchio (SW Sardinia, Italy), a stream affected by mine drainage, allowing the calculation of discharge and contaminant loads. Discharge along the stream showed a constant increase throughout the 2.7 km-long study reach, up to 13.6 l/s at the last synoptic point. Calculated loads of mine-related constituents were large, reaching values of 1780 kg/day for, 340 kg/day for Zn, 47 kg/day for Fe, and 50 kg/day for Mn. The difference of the cumulative instream metal loads between the first and the last synoptic sampling points indicated gains of 421 kg/day for Zn, 2080 kg/day for, 56 kg/day for Mn, and 50 kg/day for Fe. The source areas critical for contaminants loading were almost all concentrated in the first 800 meters of the stream, with the exception of Pb, whose loading occurs evenly along the whole study reach. Precipitation of secondary minerals along the streambed was responsible for a very high attenuation of Al and Fe loads (66% and 77%) and affected also and Zn loads, though less effectively. Rio Montevecchio has the second highest metal load among the rivers investigated with tracer techniques in SW Sardinia. In comparison with Rio Irvi, which has one order of magnitude higher metal loads, natural attenuation processes limit the loads in Rio Montevecchio. Results are useful to clarify the hydrogeochemical paths involved in the release and attenuation of pollutants, improving our understanding of stream responses to contamination and aiding development of site-specific remediation actions

    Caratterizzazione sedimentologica della piattaforma interna dell’Arcipelago di La Maddalena: studio e modellizzazione di tre spiagge campione

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    Le coste e i fondali marini dell’Arcipelago di La Maddalena sin dagli anni ’70 sono stati oggetto di studi sia nazionali che internazionali finanziati dal CNR (Campagne: Placers 1979, 1981 e Bonifacio’91). Nuovo impulso alla ricerca è stato dato con le campagne PALEOCLI.GE (1999, 2000, 2001) e più di recente dal Progetto Europeo Interreg IIIA GERER “Gestione ambientale integrata in aree ad elevato rischio di erosione”. La ricerca qui presentata vuole contribuire all’approfondimento delle conoscenze sedimentologiche sui fondali marini dell’area compresa tra Porto Pozzo e l’Isola delle Bisce. Inoltre si vuole dare un contributo alla comprensione dei meccanismi attuali di apporto, ridistribuzione e sedimentazione della piattaforma interna, e all’interazione tra moto ondoso e correnti costiere indotte. Il primo obiettivo è stato raggiunto e i dati sono sintetizzati sulla carta dei sedimenti superficiali dell’area in scala 1:25.000. Il secondo obiettivo è quello di studiare le dinamiche sedimentarie di tre siti campione attraverso: la misurazione delle variazioni stagionali di pendenza e della posizione della linea di riva; gli spostamenti dei volumi sedimentari; la creazione di modelli idrodinamici delle unità fisiografiche studiate. La ricerca è partita dall’analisi di dati acustici (Side Scan Sonar e Single Beam) e sismici (Sub Bottom Profiler e Sparker). Come basi cartografiche sono state usate le Carte Tecniche Regionali in scala 1:10.000 (C.T.R - Regione Autonoma della Sardegna, 1998), integrate con le ortofoto in scala 1:10.000 del 2006 (Regione Autonoma della Sardegna, 2006) e comparate con le ortofoto di annate precedenti (1998, 2003). Nell’area marina sono stati utilizzati i dati batimetrici desunti dalle carte nautiche (I.I.M.I) integrati con i dati acquisiti durante i rilievi di monitoraggio. Sono stati prelevati e studiati 66 campioni con benna Van Veen (5 litri) e 161 campioni di battigia. Inoltre sono stati analizzati 102 campioni provenienti dalle campagne precedenti svolte nell’area, per un totale di 329 campioni studiati. Ogni campione è stato analizzato (tessitura e composizione) e classificato (secondo le classificazioni di Nota e di Folk), inoltre il riconoscimento delle associazioni di facies è stato effettuato tramite analisi al microscopio binoculare. Tutti i dati (cartografici, acustici, sismici e sedimentari) raccolti sono stati analizzati, elaborati, georefernziati e digitalizzati. Le isobate, i campioni e tutti gli altri punti quotati raccolti sono stati utilizzati per creare un modello digitale tridimensionale. Infine i dati sono stati fatti confluire in un unico file GIS sul quale è stata elaborata la “CARTA SEDIMENTOLOGICA E DI FACIES DEL CANALE COMPRESO TRA LA SARDEGNA E LE ISOLE DI LA MADDALENA E CAPRERA” in scala 1:25.000 dove sono state rappresentate le associazioni di facies dei fondali. Le spiagge di Cala di Trana, La Sciumara e Venalonga sono state studiate con l’utilizzo di tecniche di misura di alta precisione con cadenza stagionale, secondo gli standard metodologici individuati all’interno del Progetto Europeo “Interreg IIIA GERER”. I rilievi sono stati effettuati con l’imbarcazione da ricerca dell’Osservatorio Coste E Ambiente Naturale Sottomarino (O.C.E.A.N.S.), equipaggiata con ecografo digitale e posizionamento GPS differenziale (DGPS). Queste misure hanno permesso di visualizzare: i cambiamenti stagionali di assetto, le variazioni della linea di riva, la pendenza della spiaggia emersa e sommersa, la capacità di trasporto sedimentario long-shore e off-shore/in-shore e la capacità di risposta dinamica della surf-zone alle sollecitazioni del moto ondoso in condizioni estreme. Sono stati elaborati i modelli digitali stagionali di spiaggia emersa e sommersa delle tre spiagge. Il modelli digitali di terreno (DTM) terra/mare (spiaggia emersa/spiaggia sommersa) sono stati utilizzati per generare i modelli d’onda e idrodinamici delle spiagge campione (software Delf3D della WL Delft Hydraulics). Sono stati utilizzati, il modulo SWAN e il modulo FLOW, rispettivamente di modellistica del moto ondoso e dell’idrodinamica. Attraverso la costruzione di diverse griglie di calcolo, sono stati importati i dati batimetrici, sedimentologici, di ondazione e di vento e prodotta la simulazione degli angoli di approccio delle onde alla spiaggia per le diverse condizioni meteomarine (Modulo SWAN). L’idrodinamica e il trasporto sedimentario sono stati modellizzati utilizzando il Modulo FLOW. È seguita una validazione con osservazioni dirette e da webcam oltre che da misure di campo
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