Terrestrial laser scanning, geomorphology and archaeology of a Roman gypsum quarry (Vena del Gesso Romagnola area, Northern Apennines, Italy)

Roman-period extractive sites in gypsum outcrops are very rare, and most have become very degraded by later weathering or quarrying activities. This paper describes, using laser scanning, photogrammetry and survey using a UAV-based survey, the uniquely well-preserved Roman-period gypsum quarry of Ca’ Castellina (Northern Apennines, Italy). This site was excavated only in the last few years and the excavations have brought to light some gypsum blocks and the ancient quarry benches showing excavation marks, the remains of a rectangular building and a great number of artefacts that range between the Protohistoric Period and the modern times. The size of the extracted blocks, the extraction methodologies and the age of a charcoal fragment (361 – 178B CE) found immediately at the contact between the gypsum quarry floor and the infilling sediments date the quarry back to the Roman age. Archaeological evidences demonstrate the building to have been used for a short period of time during the XVI-XVII century. Immediately after its abandonment most of the quarry floor has been covered with a thick detrital layer, protecting it from dissolution (fossilizing this floor and leaving it as if it was abandoned very recently), whereas the naked or poorly covered floor of this quarry has been subjected to dissolution phenomena of the exposed gypsum rocks, with a lowering of the surface, the smoothening of the corners and the formation of a set of deeply carved karren features. A 3D survey using both a laser scanning instrument and a drone-mounted photo camera have allowed to get precise measures on the size of the blocks that were extracted in this quarry, the traces of pick axe marks, and on the dissolution morphologies that have developed on the bare gypsum rock. These typical gypsum landforms show how fast these solution forms can develop where concentrated runoff flows on bare gypsum. To prevent this exceptional archaeological extractive site of being further dissolved, it will be important to plan some measures to be put in place in order to protect this delicate historical landmark

Regret affects the choice between neoadjuvant therapy and upfront surgery for potentially resectable pancreatic cancer

Background: When treating potentially resectable pancreatic adenocarcinoma, therapeutic decisions are left to the sensibility of treating clinicians who, faced with a decision that post hoc can be proven wrong, may feel a sense of regret that they want to avoid. A regret-based decision model was applied to evaluate attitudes to-ward neoadjuvant therapy versus upfront surgery for potentially resectable pancreatic adenocarcinoma.Methods: Three clinical scenarios describing high-, intermediate-, and low-risk disease-specific mortality after upfront surgery were presented to 60 respondents (20 oncologists, 20 gastroenterologists, and 20 surgeons). Respondents were asked to report their regret of omission and commission regarding neo-adjuvant chemotherapy on a scale between 0 (no regret) and 100 (maximum regret). The threshold model and a multilevel mixed regression were applied to analyze respondents' attitudes toward neo-adjuvant therapy.Results: The lowest regret of omission was elicited in the low-risk scenario, and the highest regret in the high-risk scenario (P < .001). The regret of the commission was diametrically opposite to the regret of omission (P < .001). The disease-specific threshold mortality at which upfront surgery is favored over the neoadjuvant therapy progressively decreased from the low-risk to the high-risk scenarios (P <=.001). The nonsurgeons working in or with lower surgical volume centers (P = .010) and surgeons (P = .018) accepted higher disease-specific mortality after upfront surgery, which resulted in the lower likelihood of adopting neoadjuvant therapy.Conclusion: Regret drives decision making in the management of pancreatic adenocarcinoma. Being a surgeon or a specialist working in surgical centers with lower patient volumes reduces the likelihood of recommending neoadjuvant therapy.(c) 2023 Elsevier Inc. All rights reserved

Cytoreduction plus hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis in colorectal cancer patients: a single-center cohort study

BACKGROUND: In this study, we report our experience of cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) in patients with peritoneal carcinomatosis (PC) from colorectal cancer (CRC), focusing on the factors affecting survival. METHODS: All patients with surgically treated PC from colorectal cancer and with no involvement of other organs referred to our institute from March 2005 to December 2017 were included in the analysis. RESULTS: Thirty-eight patients underwent CRS-HIPEC, and all had a completeness of cytoreduction score of 0 (CC0). The median operating time was 645 min (interquartile range [IQR] 565-710). Five patients (13.1%) had Clavien-Dindo grade >\u20092 postoperative complications. Median overall survival (OS) was 60 months. In the Cox regression for OS, calculated on the CRS-HIPEC group, the peritoneal cancer index (PCI) >\u20096 (hazard ratio [HR] 4.48, IQR 1.68-11.9, P = 0.003) and significant nodal involvement (N2) (HR 3.89, IQR 1.50-10.1, P = 0.005) were independent prognostic factors. Median disease-free survival (DFS) was 16 months. Only N2 (HR 2.44, IQR 1.11-5.36, P = 0.027) was a significantly negative prognostic factor for DFS in multivariate analysis. CONCLUSIONS: CRS-HIPEC can substantially improve survival. However, patients with high PCI (PCI >\u20096) and significant nodal involvement (N2) may not benefit from the procedure

The 2015 version of the Italian Parametric Earthquake Catalogue (CPTI15)

The Italian Parametric Earthquake Catalogue (CPTI) represents the most extensive and reliable source of parameters for earthquakes in Italy and surrounding areas. Since its first introduction in 1999, CPTI benefits from the results of the 30-years-long Italian tradition in historical earthquake research that, still today, keeps on providing a wealth of studies and macroseismic data. Such data have been collected, homogenized and made available through several releases of the related macroseismic database (DBMI). In 2016, the fourth release of CPTI and DBMI, has been finalized. They provide the most advanced and updated sets of macroseismic and instrumental data and parameters, and cover the time-span 1000-2014 with earthquakes with maximum intensity I ≥ 5 or magnitude Mw ≥ 4.0. The catalogue lists 4574 events, 70% of which accompa- nied by intensity data points (about 125’000 as a whole). Macroseismic data derive from 185 studies, 54 of them are new with respect to the previous version CPTI11. Parameters related to historical earthquakes are completely re-assessed, and magnitudes from macroseismic data are derived with new intensity-to-Mw relationships. Such relationships are based on the same dataset that contributes updated instrumental magnitudes to the catalogue. Either Mw from moment tensor solutions or proxies calculated with new published conversion relationship are considered. If available, both macroseismic and instrumental parameters are provided, together with a set of “preferred ones”, which consist of a selection between the macroseismic and the instrumental epicentres, and the weighted average of the macroseismic and instrumental magnitudes.PublishedTrieste, Italy3T. Storia Sismica4T. Sismologia, geofisica e geologia per l'ingegneria sismica4IT. Banche dat

European' health care indicators and pancreatic cancer incidence and mortality: A mediation analysis of Eurostat data and Global Burden of Disease Study 2019.

AimTo highlight correlations existing between incidence and mortality of pancreatic cancer, and health care indicators in 36 European countries.MethodsThe Global Burden of Disease (GBD) and Eurostat databases were queried between 2004 and 2019. Incidence and mortality were age-standardized. From Eurostat, indicators regarding expenditure, hospital beds, medical technology, health personnel, physicians by medical specialty and unmet needs for medical examination were extracted. Correlations between GBD and Eurostat data were analysed through mediation analysis applying clustering for countries.ResultsIncidence increased by +0.6% per year (p = 0.001) and mortality by +0.3% (p = 0.001), being increasing for most of the European countries considered. Incidence and mortality were strongly positively correlated (p = 0.001). Higher current health expenditure, expenditure in inpatient curative care, the number of available beds, the number of computed tomography scan, magnetic resonance units, practising medical doctors were all related to higher incidence (p ConclusionsHealth care environment correlates with reported incidence and mortality of pancreatic cancer. This highlights both that ameliorated socio-economic societies suffer from higher incidence but lower mortality, as well as the epidemiological bias originating from countries' diagnostic ability

Prognostic Factors for Tumor Recurrence after a 12-Year, Single-Center Experience of Liver Transplantations in Patients with Hepatocellular Carcinoma

Background. Factors affecting outcomes after orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC) have been extensively studied, but some of them have only recently been discovered or reassessed. Methods. We analyzed classical and more recently emerging variables with a hypothetical impact on recurrence-free survival (RFS) in a single-center series of 283 patients transplanted for HCC between 1997 and 2009. Results. Five-year patient survival and RFS were 75% and 86%, respectively. Thirty-four (12%) patients had HCC recurrence. Elevated preoperative alpha-fetoprotein (AFP) levels, preoperative treatments of HCC, unfulfilled Milan and up-to-seven criteria at final histology, poor tumor differentiation, and tumor microvascular invasion negatively affected RFS by univariate analysis. Milan and up-to-seven criteria applied preoperatively, and the use of m-TOR inhibitors did not reach statistical significance. Cox's proportional hazard model showed that only elevated AFP levels (Odds Ratio = 2.88; 95% C.I. = 1.43–5.80; P = .003), preoperative tumor treatments (Odds Ratio = 4.84; 95% C.I. = 1.42–16.42; P = .01), and microvascular invasion (Odds Ratio = 4.82; 95% C.I. = 1.87–12.41; P = .001) were predictors of lower RFS. Conclusions. Biological aggressiveness and preoperative tumor treatment, rather than traditional and expanded dimensional criteria, conditioned the outcomes in patients transplanted for HCC

Nanoscale spin rectifiers controlled by the Stark effect

The control of orbital and spin state of single electrons is a key ingredient for quantum information processing, novel detection schemes, and, more generally, is of much relevance for spintronics. Coulomb and spin blockade (SB) in double quantum dots (DQDs) enable advanced single-spin operations that would be available even for room-temperature applications for sufficiently small devices. To date, however, spin operations in DQDs were observed at sub-Kelvin temperatures, a key reason being that scaling a DQD system while retaining an independent field-effect control on the individual dots is very challenging. Here we show that quantum-confined Stark effect allows an independent addressing of two dots only 5 nm apart with no need for aligned nanometer-size local gating. We thus demonstrate a scalable method to fully control a DQD device, regardless of its physical size. In the present implementation we show InAs/InP nanowire (NW) DQDs that display an experimentally detectable SB up to 10 K. We also report and discuss an unexpected re-entrant SB lifting as a function magnetic-field intensity

ANGPT2 and NOS3 Polymorphisms and Clinical Outcome in Advanced Hepatocellular Carcinoma Patients Receiving Sorafenib

Sorafenib represents the standard of care for advanced hepatocellular carcinoma (HCC), even though a large number of patients have reported limited ecacy. The aim of the present study was to evaluate the prognostic value of single-nucleotide polymorphisms on angiopoietin-2 (ANGPT2) and endothelial-derived nitric oxide synthase (NOS3) genes in 135 patients with advanced HCC receiving sorafenib. Eight ANGPT2 polymorphisms were analyzed by direct sequencing in relation to overall survival (OS) and progression-free survival (PFS). In univariate analysis, ANGPT2rs55633437 and NOS3 rs2070744 were associated with OS and PFS. In particular, patients with ANGPT2rs55633437 TT/GT genotypes had significantly lower median OS (4.66 vs. 15.5 months, hazard ratio (HR) 4.86, 95% CI 2.73\u20138.67, p < 0.001) and PFS (1.58 vs. 6.27 months, HR 4.79, 95% CI 2.73\u20138.35, p < 0.001) than those homozygous for the G allele. Moreover, patients with NOS3 rs2070744 TC/CC genotypes had significantly higher median OS (15.6 vs. 9.1 months, HR 0.65, 95% CI 0.44\u20130.97; p = 0.036) and PFS (7.03 vs. 3.5 months, HR 0.43, 95% CI 0.30\u20130.63; p < 0.001) than patients homozygous for the T allele. Multivariate analysis confirmed these polymorphisms as independent prognostic factors. Our results suggest that ANGPT2rs55633437 and NOS3 rs2070744 polymorphisms could identify a subset of HCC patients more resistant to sorafenib

Development and Multicenter Validation of a Novel Immune-Inflammation-Based Nomogram to Predict Survival in Western Resectable Gastric and Gastroesophageal Junction Adenocarcinoma (GEA): The NOMOGAST

Background. More than 50% of operable GEA relapse after curative-intent resection. We aimed at externally validating a nomogram to enable a more accurate estimate of individualized risk in resected GEA. Methods. Medical records of a training cohort (TC) and a validation cohort (VC) of patients undergoing radical surgery for c/uT2-T4 and/or node-positive GEA were retrieved, and potentially interesting variables were collected. Cox proportional hazards in univariate and multivariate regressions were used to assess the effects of the prognostic factors on OS. A graphical nomogram was constructed using R software’s package Regression Modeling Strategies (ver. 5.0-1). The performance of the prognostic model was evaluated and validated. Results. The TC and VC consisted of 185 and 151 patients. ECOG:PS > 0 (p < 0.001), angioinvasion (p < 0.001), log (Neutrophil/Lymphocyte ratio) (p < 0.001), and nodal status (p = 0.016) were independent prognostic values in the TC. They were used for the construction of a nomogram estimating 3- and 5-year OS. The discriminatory ability of the model was evaluated with the c-Harrell index. A 3-tier scoring system was developed through a linear predictor grouped by 25 and 75 percentiles, strengthening the model’s good discrimination (p < 0.001). A calibration plot demonstrated a concordance between the predicted and actual survival in the TC and VC. A decision curve analysis was plotted that depicted the nomogram’s clinical utility. Conclusions. We externally validated a prognostic nomogram to predict OS in a joint independent cohort of resectable GEA; the NOMOGAST could represent a valuable tool in assisting decision-making. This tool incorporates readily available and inexpensive patient and disease characteristics as well as immune-inflammatory determinants. It is accurate, generalizable, and clinically effectivex