Impact of office-based surgery for hemorrhoids on clinical outcomes and institutional costs: a prospective controlled study

Aim: Transanal hemorrhoidal artery ligation with mucopexy (THAL-m) is a treatment option for symptomatic hemorrhoidal disease (HD). Open hemorrhoidectomy (OH) has stood the test of time in terms of radical cure for HD. Both techniques can be performed under local anesthesia. The aim of this study was to determine the impact on postoperative outcome and cost-effectiveness of performing these techniques in ambulatory setting in an Italian academic centre. Method: A prospective series of grade II /III HD. 100 consecutive patients undergoing ambulatory surgical treatment of hemorrhoids in 2015–2017 (group A) were compared to 100 patients operated at the same institution in the same period (Group H) by hospitalization. The primary outcome was sick leave used as a proxy of clinical outcome. Secondary outcomes included postoperative complications, cost-effectiveness, and patient satisfaction. Results: Sick leave was significantly reduced in Group A patients (8 days versus 15) with no increase in postoperative complications, and patient satisfaction was high. Total mean direct costs per patient were significantly lower in office-based setting versus the hospital stay group (431 euros versus 1320). Conclusion: Implementing ambulatory surgery for hemorrhoids is feasible, efficient, safe, and cost-effective but correct selection of patients is necessary

A method for selective stimulation of leg chemoreceptors in whole crustaceans

The integration of sensory information with adequate motor outputs is critical for animal survival. Here, we present an innovative technique based on a non-invasive closed-circuit device consisting of a perfusion/stimulation chamber chronically applied on a single leg of the crayfish Procambarus clarkii. Using this technique, we focally stimulated the leg inside the chamber and studied the leg-dependent sensory-motor integration involving other sensory appendages, such as antennules and maxillipeds, which remain unstimulated outside the chamber. Results show that the stimulation of a single leg with chemicals, such as disaccharides, is sufficient to trigger a complex search behaviour involving locomotion coupled with the reflex activation of antennules and maxillipeds. This technique can be easily adapted to other decapods and/or other sensory appendages. Thus, it has opened possibilities for studying sensory-motor integration evoked by leg stimulation in whole aquatic animals under natural conditions to supplement, with a direct approach, current ablation/silencing techniques

Phase-Based Binocular Perception of Motion in Depth: Cortical-Like Operators and Analog VLSI Architectures

We present a cortical-like strategy to obtain reliable estimates of the motions of objects in a scene toward/away from the observer (motion in depth), from local measurements of binocular parameters derived from direct comparison of the results of monocular spatiotemporal filtering operations performed on stereo image pairs. This approach is suitable for a hardware implementation, in which such parameters can be gained via a feedforward computation (i.e., collection, comparison, and punctual operations) on the outputs of the nodes of recurrent VLSI lattice networks, performing local computations. These networks act as efficient computational structures for embedded analog filtering operations in smart vision sensors. Extensive simulations on both synthetic and real-world image sequences prove the validity of the approach that allows to gain high-level information about the 3D structure of the scene, directly from sensorial data, without resorting to explicit scene reconstruction

\u201cIdentity and Pluralism: Who Am I? What Are We? How Are We?\u201d \u2013 A Reflection on Seeking, Giving and Making Sense of Organising in a Fluid, Uncertain and Digitised World

Organisation theory and practice are progressively challenged and enriched by conflicting expectations expressed by a plethora of stakeholders hose answers have often to be found by the embracement of academic multi-disciplinarity \u2013 i.e. the borrowing of constructs and models from other fields. In this fluid reality, organisations tend to be more problematic to design, but also to be implemented in organisational practices, according to a constant dialectic between two polarities: Organisational design and Organisation behaviour, in that constant dialectical tension that gives back the measure of the complexity and sense-making of organisational action. These are extremely significant polarities and privileged points of observation and interpretation of organisational phenomena, as well as a starting point for understanding how to put organisational action into practice

Chemosensitivity in the Sea Urchin Paracentrotus lividus (Echinodermata: Echinoidea) to Food-Related Compounds: An Innovative Behavioral Bioassay

Like other animals, echinoderms rely on chemical senses to detect and localize food resources. Here, we evaluate the chemical sensitivity of the sea urchin Paracentrotus lividus to a number of stimuli possibly related to food, such as a few sugars, compared to the blue-green algae Spirulina (Arthrospira platensis). To do this we developed a simple, innovative method based on the recording of “urchinograms” estimating the movements of spines, pedicellariae, tube feet, and eventually of the whole sea urchin, in response to chemicals, while keeping both the whole animal and the stimulus in their natural environment, underwater. Our results show that Spirulina is a highly stimulating compound for the sea urchin, by acting in a dose-dependent manner. The animals resulted also sensitive, even if to a lesser extent, to some sugars, such as the monosaccharide glucose, but not to its isomer fructose, while among disaccharides, they sensed cellobiose, but not sucrose or trehalose. From an applied point of view, any insight into the chemical sensitivity of sea urchins toward potential food-related compounds may lead to the discovery of key chemicals that would help improve the efficiency and reduce the costs of dietary substrates for optimization of intensive rearing strategies. Although this method has been developed for P. lividus, it will be suitable to evaluate the chemical sensitivity of other echinoderms and other marine invertebrates characterized by low mobility

Blue-Green Algae as Stimulating and Attractive Feeding Substrates for a Mediterranean Commercial Sea Urchin Species, Paracentrotus lividus

Sea urchins rely on chemical senses to localize suitable food resources, therefore representing model species for chemosensory studies. In the present study, we investigated the chemical sensitivity of the Mediterranean sea urchin Paracentrotus lividus to the blue-green alga Aphanizomenon flos-aquae, namely "Klamath", and to a few amino acids chosen from the biochemical composition of the same algae. To this end, we used the "urchinogram" method, which estimates the movement rate of the sea urchins in response to chemicals. Our results showed that Klamath represents a strong chemical stimulus for P. lividus as it elicits an overall movement of spines, pedicellariae, and tube feet coupled, in some cases, to a coordinated locomotion of the animals. Sea urchins also displayed a sensitivity, even if to a lesser extent, to leucine, threonine, arginine, and proline, thus implying that the amino acids contained in Klamath may account, at least in part, for the stimulating effects exerted by the whole algae. Additionally, our results show that Klamath, as well as spirulina, another blue-green alga with high nutritional value, is very attractive for this sea urchin species. These findings gain further importance considering the potential profit of echinoderms for commercial consumers and their growing role in aquaculture. Klamath and spirulina combine high nutritional profiles with attractive and stimulating abilities and may be considered potential valuable feed supplements in sea urchin aquaculture

EAG responses to pheromone as a tool in the control of population dynamics of the gypsy moth <i>Lymantria dispar</i>

The reproductive programme of the gypsy moth Lymantria dispar L. (Lepidoptera: Lymantriidae), the most important defoliator of Sardinian Quercus suber L. forests, is based on production and release of its sex pheromone (+)disparlure by calling female moths and its perception by conspecific males. The acquisition of information about any factors influencing male sensitivity to this sex attractant may help improve field techniques against this defoliator or possibly provide a basis for predicting where favourable conditions for control of population dynamics will occur. In this respect, the pheromone might be used as a specific tool for olfaction research and to monitor changes in male sensitivity, thus leading to a better control of population