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Optimal management strategies for patients presenting with complicated peritoneal carcinomatosis in the emergency setting: a clinical perspective
No full textPeritoneal carcinomatosis (PC) often represents an advanced intra-abdominal malignancy. In some cases, bowel obstruction represents the first manifestation of cancer; in others, it indicates disease progression in previously treated patients. Individuals presenting to the emergency department with symptoms such as vomiting and abdominal pain require prompt assessment to determine the appropriateness of conservative versus surgical management, decisions frequently made under prognostic uncertainty and limited survival expectations. Recent evidence suggests that surgery can offer symptomatic relief in selected patients, though it is associated with significant perioperative risks and has a limited impact on long-term survival. Non-operative management – including bowel rest, somatostatin analogues, corticosteroids, and antiemetics – remains the first-line approach in hemodynamically stable patients. Given the absence of formal guidelines, this commentary underscores the need for evidence-based recommendations, expert consensus, and the integration of palliative principles into emergency care. Communication strategies, individualized triage, and ethical alignment with patient values are essential to avoid inadvertently harmful interventions. Data from the ongoing World Society of Emergency Surgery (WSES)-endorsed international “End-of-Life Care” survey are expected to inform future best practices
A Method for Detecting Key Fiducial Points in Electrocardiographic Signals for Wave Characterization and HRV Analysis
No full textThe analysis of physiological signals is fundamental in fields such as healthcare and sports science, while cardiovascular disease remains a significant global health challenge. This study presents a method for detecting key fiducial points in electrocardiographic (ECG) signals. ECG signals were acquired using the Zephyr BioHarness 3.0 (reference device) and a new wireless ECG device (test device) to conduct the study. Measurements, including wave amplitude and duration, were obtained by identifying these points in the averaged waveform of each ECG signal. Hence, features such as P-wave, QRS complex, T-wave and their relative intervals were extracted from ECG signals provided by both devices. In addition, a heart rate variability (HRV) analysis was conducted, which provides additional information about cardiac health. HRV was analyzed in both time and frequency domains. The results demonstrate the reliability of both devices in identifying significant ECG features, with only minor variations in specific parameters. Notably, the QRS complex shows biases between 0 to 20 ms with percentage differences up to 30%, while the PR interval exhibits biases from 2 to 22 ms and percentage differences up to 33%. The HRV analysis shows strong agreement between the two devices. The study also highlights that both devices consistently measure heart rate (HR) (Pearson’s correlation coefficient: 0.88), further validating their accuracy and reliability for clinical and remote monitoring applications. These findings suggest that both devices are suitable for clinical and remote monitoring. Integrating these advanced ECG analysis methods could significantly improve patient monitoring and outcomes in both clinical and non-clinical environments
Evoluzione del regime giuridico delle collaborazioni di carattere amministrativo-gestionale
No full textIl workshop come strumento di condivisione e verifica nella formazione dei docenti universitari: i seminari conclusivi di IRIDI FULL
No full textNovel characterisation of biofuel-integrated phytoremediation of liquid wastes with Scenedesmus obliquus
No full textThis study investigates the feasibility of in situ phytoremediation of leachate and wastewater in municipal solid waste facilities using microalgae and their valorisation for biofuel production. Laboratory-scale experiments were conducted by cultivating the Scenedesmus obliquus microalga in a diluted growth medium inside a 4 L indoor photobioreactor, operating in batch mode. Volumetric productivity data were employed to evaluate the economic viability of the system. Then, a numerical model developed in Aspen Plus was used to estimate the utility requirements for upgrading crude microalgae oil into biodiesel meeting commercial specifications. The results indicate that, although the resulting biodiesel satisfies UNI EN 14214 quality standards, the limited biomass productivity remains a critical constraint for economic feasibility. Remuneration, in terms of net present value is achievable only under scenarios that combine high biomass yield and microalgae oil sale prices exceeding 2–2.5 € kg−1. The system generates 57–722 k€ after 20 years
Thermal energy characterization methodology based on GIS for energy communities and demand response strategies
No full textSearch and Matching in the “Four Quadrant” Model (Chapter 4)
No full textThe so-called four quadrant model (DiPasquale & Wheaton, 1992) is probably the most studied model of long-run equilibrium in aggregate housing markets. The modified version of the model proposed by Colwell (2002) also studies the short-run adjustments process that led from one long-run equilibrium to another. However, the introduction of the demand for vacant units by landlords makes the model much more complicated, without offering significant improvements. Since the analysis of vacant houses is closely related to the time involved in filling vacant units, this chapter introduces the vacancy dynamics in the DiPasquale–Wheaton–Colwell model. Furthermore, by using the concept of time-on-the-market, an endogenous capitalization rate can be obtained in a straightforward way
Massive intestinal mesenteric portal vein ischemia: Percutaneous endovascular thrombolysis as minimally invasive step-up approach
No full text: Acute mesenteric ischemia represents a group of diseases, which lead to an abrupt interruption of blood flow to the small intestine resulting in intestinal necrosis. Its first symptoms are vague and in the majority of cases nonspecific, so the diagnostic suspicion is of the utmost importance to establish the correct diagnostic and prompt treatment. It is a complex and difficult event, that needs a multidisciplinary approach involving different specialties such as gastrointestinal and vascular surgeons, interventional radiologists, and expertise from the acute care unit team. The fundamental aspect is the precocity of diagnostic based on abdominal computed angio-tomography and the immediate re-establishment of blood supply to the affected areas. In this report, we introduce a case of a patient with mesenteric venous thrombosis, who has beenundergone a percutaneous endovascular treatment (portal-mesenteric mechanical thrombectomy, besides an intravenous thrombolytic infusion), due to poor clinical response after anticoagulation approach that needed mechanical ventilation
Pedagogical reflection and transition: human, environmental and social
No full textPedagogical Reflection and Transition: Human, Environmental and Social
explores the transitions of our time – environmental, social and existential
– placing education at the centre of sustainable and inclusive change. The
book under scrutiny here highlights the role of pedagogy in building an
equitable and responsible future, capable of responding to global challenges
without sacrificing human dignity and collective well-being. The
contemporary context, characterised by the acceleration of technological
innovation and the need for educational and social transformation to mature,
necessitates a rethinking of the paradigms of education. The volume
proposes a critical and propositional framework to address the complexity
of contemporary challenges, drawing on the dialectic between transition
and Medical Humanities, education for sustainability and social pedagogy.
This volume is a valuable resource for education professionals seeking
to comprehend and navigate the complexities of contemporary
transitions, with the objective of enhancing the nexus between education,
change, and human development
Portare la scuola “fuori”. Outdoor Education, scuola, laboratori di educazione allo sguardo
No full textIl contributo in oggetto intende riflettere sull’outdoor education a scuola come occasione di riflessione pedagogica e di educazione alla sostenibilità. La pedagogia dell’ambiente da tempo si interroga sulla legittimità euristica della cosiddetta “educazione all’aperto” ma anche della sua spendibilità educativo-didattica, in ottica inclusiva e sostenibile. Una prospettiva che pare particolarmente evocativa è rappresentata da quei progetti ed attività che privilegiano esperienze estetiche, attive e creative, in ambienti esterni, dove poter cogliere la bellezza della natura, non in modo romantico e idealizzato, ma reale e antropizzata, connessa con i contesti esistenziali di ciascuno. Progettare laboratori di educazione allo sguardo per la sostenibilità, coniugando in maniera transdisciplinare diverse tematiche, proposte metodologiche ed attività pratiche, può essere utile per favorire l’acquisizione di uno sguardo diverso, alternativo, critico, sui fenomeni della realtà circostante, per insegnare un atteggiamento contemplativo e rispettoso, ma al contempo proattivo e imprenditivo, saggio e coraggioso, capacità chiave per il benessere relazionale delle giovani generazioni di studenti e studentesse a scuola. Saper osservare, saper creare, saper connettere fenomeni naturali e idee personali, saper collaborare con le parole e soprattutto con le azioni, per giungere al cuore dell’outdoor education, nell’ottica dell’ecologia integrale, per interagire e “curare” un giardino, un parco, un cortile scolastico come se fosse l’intera casa comune, per star bene a scuola, per star bene nel mondo